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Fotini Lappa MSc

Nutritionist – Dietitian with specialization in Sports Nutrition

Lecturer in Nutrition and Food Science

(Intercollege / University of Nicosia)

Dietary fiber was almost an unknown phraseand fibers were considered only annoyingintestinal wastes until the 1970s when a widerange of potential therapeutic applications

dwere suggested.Dietary fiber is deemed to be a key componentin healthy eating. It contains a unique blend ofbioactive components including resistantstarches, vitamins, minerals, phytochemicalsand antioxidants.

Major sources: fruits, vegetables, wholegrains, cereals and legumes.

Fibers are most commonly characterizedbased on their solubility.Insoluble fibers primarily consist of celluloseand some hemicelluloses, lignins, resistantt h d hitistarch and chitin.

Soluble fibers include pectins, β-glucans,gums, mucilages and some hemicelluloses.

Solubility can be used as a means to broadlycharacterize the physiological effects of fibers.

In general, insoluble fibers increase fecalbulk and the excretion of bile acids anddecrease intestinal transit time (i e laxativedecrease intestinal transit time (i.e., laxativeeffect).Soluble fibers increase total transit time by

delaying gastric emptying and also slowingglucose absorption.

Wheat bran, cereal grains and vegetables arehigher in insoluble fiber. Some examplesinclude figs, blackberries, shredded wheatcereal, millet, cucumbers, eggplant and leafygreensgreens .

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Vegetables, legumes and grains are goodsources of soluble fiber. Some examplesinclude split peas, artichokes, oat bran, barley,different kinds of beans, lentils, prunes, pears,flax seedsflax seeds.

The general recommendation for adequateintake is 14 g/1000 kcal.

Using the energy guideline of 2000 kcal/dayfor women and 2600 kcal/day for men thefor women and 2600 kcal/day for men, therecommended daily dietary fiber intake is 28g/day for adult women and 36 g/day for adultmen.

The mean daily dietary intake of dietary fiber in western countries is ~ 12-15 gwhile in developing countries it is ~ 40 - 150g!

In Cyprus it is ~ 15 4 gIn Cyprus it is ~ 15.4 g

Food Fiber content

Apple with the skin 3.3 g

A small orange 3.1 g

1 cup of cooked green beans 4.0 g

Sweet potato cooked without skin 3 9 gSweet potato cooked without skin 3.9 g

½ cup of beet greens, collards, kale, turnip greens

4.0 g

One cup of cooked brown rice 3.5 g

A cup of cooked oatmeal 4.0 g

A whole-wheat English muffin 3.7 g

Almonds (about 24) 3.3 g

Food Fiber content

1 cup portion of whole-wheat spaghetti 6.3 g

A whole-wheat bagel 6.0 g

½ cup serving of 100% all-bran cereal 8.8 g

Two slices of seven-grain bread 6.5 g

T l f h l d k b d 5 8 Two slices of whole-grain dark rye bread 5.8 g

One cup of blackberries 7.6 g

A medium pear with skin intact 5.1 g

A cup of raisins 5.4 g

A cup of cooked winter squash 5.7 g

¾ cup of fresh cooked broccoli 7.0 g

A medium-baked potato with skin 5.0 g

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Food Fiber content

A single cup of cooked lentils 15.6 g

1 cup of cooked split peas 16.3 g

1 cup portion of cooked white beans 11.0 g

1 cup portion of cooked pinto beans 15.0 g

1 cup portion of cooked chickpeas 12.0 g

A ½ cup serving of bran buds 10.4 g

3 dried figs 10.5 g

Coronary Heart Disease (CHD)

Hypertension

Type II diabetes

Obesity

Cancer

Certain gastrointestinal disorders such asconstipation and hemorrhoids

Table 1 Dietary fiber intake related to relative risk for disease based on estimates from prospective cohort studies. Anderson et al. 2010 Nutr Rev 67(4):188-205

Disease No. of subjects Relative risk† 95% CI(no. of studies)

CHD 158,327 (7) 0.71 0.47–0.95

Diabetes 239,485 (5) 0.81 0.70–0.93

Obesity 115,789 (4) 0.70 0.62–0.78

† Relative risks adjusted for demographic, dietary, and non-dietary factors.

Soluble fiber clearly lowers serum cholesteroland LDL-cholesterol by binding bile acids inthe small intestine and increasing theirexcretion in the feces.F t ti f fib i th l ithFermentation of fibers in the colon withproduction of the short-chain fatty acidpropionate may contribute tohypocholesterolemia by attenuatingcholesterol synthesis.

Increasing dietary fiber intake has been shownto decrease circulating levels of C-Reactiveprotein (CRP), a marker of inflammation anda predictor of CHD.

Dietary Fiber has been shown to decrease pro-inflammatory cytokines such as interleukin-18which may have an effect on plaque stability.

The American Heart Association (AHA)recommends a total dietary fiber intake of25 g/day to 30 g/day from foods (notsupplements) to ensure nutrient adequacy andpp ) q ymaximize the cholesterol-lowering impact of afat-modified diet.

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Table 1 Dietary fiber intake related to relative risk for disease based on estimates from prospective cohort studies. Anderson et al. 2010 Nutr Rev 67(4):188-205

Disease No. of subjects Relative risk† 95% CI(no. of studies)

CHD 158,327 (7) 0.71 0.47–0.95

Diabetes 239,485 (5) 0.81 0.70–0.93

Obesity 115,789 (4) 0.70 0.62–0.78

† Relative risks adjusted for demographic, dietary, and non-dietary factors.

Five RCTs have assessed the effects of high-fiber foods or fiber-enhanced food products inweight-loss studies.

Reported mean weight losses over an 8-weekReported mean weight losses over an 8 weekperiod were approximately 1 kg greater withhigh-fiber diets than with control diets.(Anderson 2008, in Nutraceuticals,Glycemic Health and Type2 Diabetes).

First, soluble fiber, when fermented in thelarge intestine, produces glucagon-likepeptide (GLP-1) and peptide YY (PYY).These two gut hormones play a role inducingsatietysatiety.Second, dietary fiber may significantlydecrease energy intake. Women whoconsumed increased levels of fiber tended toalso have a decreased consumption ofdietary fat.

Table 1 Dietary fiber intake related to relative risk for disease based on estimates from prospective cohort studies. Anderson et al. 2010 Nutr Rev 67(4):188-205

Disease No. of subjects Relative risk† 95% CI(no. of studies)

CHD 158,327 (7) 0.71 0.47–0.95

Diabetes 239,485 (5) 0.81 0.70–0.93

Obesity 115,789 (4) 0.70 0.62–0.78

† Relative risks adjusted for demographic, dietary, and non-dietary factors.

A meta-analysis of eight randomizedcontrolled trials (RCTs) including 136 subjectswith type 1 or type 2 diabetes indicated thatthe moderate-carbohydrate, high-fiber diets,compared to the moderate-carbohydrate, low-fiber diets, produced the following significantchanges:

postprandial plasma glucose -21%;LDL-cholesterol -7.9%triglycerides -8.3%

(Anderson et al. 2004, J Am Coll Nutr. 23:5-17)

These studies clearly indicate that increasingdietary fiber consumption without altering theenergy intake from carbohydrates, proteins, orfats significantly improves glycemic controland reduces the need for medication andand reduces the need for medication andinsulin in individuals with type 1 or type 2diabetes.

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Early research regarding soluble fiberdemonstrated delayed gastric emptying anddecreased absorption of macronutrients,resulting in lower postprandial blood glucoseand insulin levels This is most likely due toand insulin levels. This is most likely due tothe viscosity of soluble fibers inside the GItract.

Interestingly, different types of soluble fiberhad varying effects on viscosity and nutrientabsorption. Guar had the highest viscosity aswell as the greatest effect at decreasingpostprandial blood glucose.

Therefore, it could be assumed that anincreased level of soluble fiber would beassociated with a decreased risk of diabetes.

Fig 1 Dose-response analyses between cereal fiber and risk ofcolorectal cancer. NHS=Nurses’ Health Study; HPFS=HealthProfessionals Follow-up Study Aune et al 2011; BMJ;343:d6617

Fig 2 Dose-response analyses between whole grains and risk ofcolorectal cancer. NHS=Nurses’ Health Study; HPFS=HealthProfessionals Follow-up Study Aune et al 2011; BMJ;343:d6617

Total whole grains included whole grain ryebreads, whole grain breads, oatmeal, wholegrain cereals, high fiber cereals, brown rice,and porridge. The range of whole grain intakevaried from and 61 128 g/dayvaried from and 61-128 g/day.

Increasing stool bulkDiluting fecal carcinogens and decreasingtransit time, thus reducing the contactbetween carcinogens and the lining of theg gcolorectum.In addition, bacterial fermentation of fiber

results in the production of short chain fattyacids, which may have protective effectsagainst colorectal cancer.

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Other components of whole grains may alsoprotect against colorectal cancer, includingantioxidants, vitamins, trace minerals,phytate, phenolic acids, lignans, andphytoestrogensphytoestrogens.Whole grains have a high content of folate andmagnesium, which have been associated witha reduced risk of colorectal cancer.

INGREDIENTS

150gr margarine softened

15gr wheat bran

50gr fructose 1/2 teaspoon baking soda

30gr soft brown sugar 1/2 teaspoon cream of g g / ptartar

1 egg white 1/4 teaspoon cinnamon

60gr applesauce, unsweetened

1 orange, zested and juiced

130gr whole wheat pastry flour

1 tablespoon orange juice

100gr old fashioned oats 150gr almonds chopped

Preheat oven to 180°C.

Place the margarine in a medium mixing bowl.Cream the margarine using an electric mixer. Slowlyadd the sugars and continue to mix for 2-3 minutes.

Add the egg white and applesauce, and mix just tocombinecombine.

Sift the dry ingredients together in a separate mixingbowl. Add to the wet ingredients, along with the juiceand zest. At the end add the chopped almonds. Dropthe dough one tablespoon at a time onto two cookiesheets lined with a silicone mat or parchment paper.Bake 10 minutes or until the bottom of the cookiesare just browned. Cool on a wire rack.

Nutrition FactsServing Size: 1 piece (24gr)Serving per  Recipe: 20Amount per serving Calories: 101 Kcal    Calories from fat: 66kcal

% Daily Value*Total fat: 7.3g 11.2%Saturated fat: 1.1g 5.5%Cholesterol: 0.1mg 0.03%Sodium: 75mg 3.1%Total carbohydrates: 7.2g 2.4%Dietary Dietary Fiber: Fiber: 0.6g0.6g 2.4%Sugars: 1.7gProtein: 1.9g 3.8%Vitamin A: 0.68% Vitamin C: 1.67%Calcium: 3.1 mg Iron: 2.33%*Percent daily values are based on a 2000 calorie diet. Your daily values 

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INGREDIENTS

400gr cooked lentils 1 teaspoon salt

1 zucchini grated 3 egg whites

1 carrot grated 3 teaspoons olive oil (plus extra for cooking)

2 spring onions chopped

20gr wheat germ

120gr whole wheat bread crumbs

1 tablespoon oregano

¼ bunch fresh coriander chopped

1/4 teaspoon freshly ground pepper

Chop or grate the ingredients. Mix them together ina bowl and process until the mixture just comestogether in a mass. Form into burgers (about 1/3 cupeach).

Heat 2 teaspoons oil in a large non stick skillet overdi h t C k th b til b dmedium heat. Cook the burgers until browned on

the bottom, 2 to 4 minutes. Carefully turn over andreduce heat to medium-low. Drizzle the remaining 1teaspoon oil around the burgers and cook untilbrowned on the other side and heated through, 4 to6 minutes more.Serve on buns with lettuce, tomato and onion.

Nutrition FactsServing Size 1 Burger (55g)Service per recipe 10Amount per servingCalories    92                                                      Calories from Fat  17

% Daily Value*Total Fat 1.9g 3%Saturated Fat0.3g 2%Trans Fat  0gCholesterol 0mg 0%Sodium 273mg 12%Total Carb 12.6g 5%

Dietary Fiber  3.3g Dietary Fiber  3.3g  14%

Sugars 0.9gProtein 6g                                                                         12%Vitamin A   0.5%                Vitamin C  1.6%Calcium 2.7%                   Iron  10.5%Thiamin  6.6%                  Riboflavin 4.1 %Niacin 4%

INGREDIENTS

2 cups water 2 carrots, grated

180 gr quinoa 1 cup fresh parsley, chopped

1 pinch salt 1 cup fresh mint, chopped p p , pp

2 teaspoons olive oil

1/2 teaspoon sea salt

1/4 cup lemon juice

1 tomato, diced

1cucumber, diced

2 spring onions, chopped

In a saucepan bring water to a boil. Add quinoaand a pinch of salt. Reduce heat to low, coverand simmer for 15 minutes. Allow cooling toroom temperature or under cold running water.M hil i l g b l bi li ilMeanwhile, in a large bowl, combine olive oil,sea salt, lemon juice, tomatoes, cucumber,green onions, carrots, parsley and mint. Stir incooled quinoa.

Nutrition Facts

Serving Size: 1 (159gr)Servings per Recipe:8Amount per serving Calories: 109kcal          Calories from fat: 23

% Daily Value*Total fat: 3g 4%Saturated fat: 0g 0%Cholesterol: 0mg 0%Cholesterol: 0mg 0%Sodium: 40mg 2%Total carbohydrates: 19g 6%Dietary Dietary Fiber: Fiber: 2g2g 8%8%Sugars: 0gProtein: 4g 8%Vitamin A   25%                 Vitamin C  35%Calcium 4%                    Iron  15%*Percent daily values are based on a 2000 calorie diet. Your daily values may be higher or lower depending on your calorie needs

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INGREDIENTS

110 gr rolled oats (60gr rolled oats + 75gr provital, Golden Choice)

125 gr margarine

45 gr desiccatedcoconut 280 gr honey60 gr wheatgerm 100 gr pistachios

110 gr sesameseeds

80 g rsunflowerkernels

80 gr pumpkinseeds

Line a 3cm deep, 16cm x 28cm (base) baking panwith baking paper. Cook oats, coconut, wheat germ,sesame seeds, sunflower kernels and pumpkin seedsin a frying pan over medium heat, stirring, for 8 to 10minutes or until golden. Transfer to a bowl. Set asideto cool. You can cook in the oven as well at 170° C for14 i t14 minutes.

Cook butter and honey in a small saucepan overmedium heat, stirring, for 3 to 4 minutes or until sugardissolves. Bring to the boil. Reduce heat to low.Simmer, without stirring, for 7 minutes. Add to dryingredients. Stir until combined.

Spoon mixture into pan. Use a large metal spoon topress down firmly. Allow to cool. Cut into squares.Store in a foil-lined airtight container for up to 7 days.

Serving  Size :1(55g)Servings Per Recipe: 18Total calories                                253kcal Calories from fat 174kcal

% Daily valueTotal fat                                          19.3g 30%Saturated fat                                   6.1 g 31%Trans fat                                         0.3gCholesterol                                        1mg 0.33%S di 75 3%Sodium                                            75mg 3%Total carb 15. 5 g 5%Dietary Dietary fiber                                     fiber                                     2.9g2.9g 12%Sugars                                              13    gProtein                                              5.2g 10%VitA 1% VitC0  Calcium5.7% Iron 11%Thiamin16% Riboflavin 4%Niacin4.3%*Percent daily values are based on a 2000 calorie diet. Your daily values may 

INGREDIENTS

3 egg whites 20gr flaxseed

230gr whole wheat flour 20gr wheat germ

200gr skim milk

55g t d 55gr unsweetened applesauce

3 tsp baking powder

In medium mixing bowl beat together egg whites andmilk. Mix in applesauce. Add flour, baking powder,flaxseed, and wheat germ. Mix well.Heat a non-stick skillet. (You may wish to add a TBSof vegetable oil or spray with non-stick cookingspray). Cook pancakes on one side until the edgesappear dry and bubbles form in the batter. Flip andfinish cooking on the other side. Serve with carobhoney.

Nutrition Facts

Serving Size: 1 pancake (50gr)Serving per  Recipe:40Amount per serving Calories: 78 Kcal                                                        Calories from fat: 12.6KCal

% Daily Value*Total fat: 1.4g 2%Saturated fat: 0.2g 1%Trans fat: 0g 0%Cholesterol: 0.4mg 0.1%Sodium: 170mg 7%Total carbohydrates: 13 3g 4%Total carbohydrates: 13.3g 4%

Dietary Dietary Fiber: Fiber: 2.4g2.4g 10%

Sugars: 1.5gProtein: 3.9g 8%Vitamin A: 0ug 0%Calcium: 50.5 mg 5%Thiamine: 0.11mg 7%Niacin: 1.14mg 6%Vitamin C: 2mg 3%Iron: 1.79mg 10%Riboflavin: 0.17mg 10%*Percent daily values are based on a 2000 calorie diet. Your daily values may be higher or