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Overview
• Research continues to show that dietary fiber is essential for good health,
yet nine out of 10 Americans consume less than half the recommended
daily amounts of fiber.
• Recent research suggests consumers are confused about where to find
fiber and consume very few foods that provide at least a good source of
fiber. This may be contributing to Americans‘ fiber deficit.
• Innovations in the development of functional fibers, also called ‗novel‘ or
‗isolated‘ fibers, which are added to foods can help consumers meet fiber
recommendations through a wider variety of food options.
• Although different types of fiber offer different health benefits, all fibers
that can demonstrate a physiological benefit are beneficial to health.
• Health professionals can provide practical guidance on the importance of
increasing fiber intake and where to look for fiber in foods.
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Learning Objectives
• Become familiar with the most updated IOM definition of fiber, including
the fundamental properties of ―dietary‖ fibers and ―functional‖ fibers.
• Understand the science supporting the health benefits of fiber and
know the mechanisms that explain their beneficial effects.
• Review consumer research that helps explain why consumers are
falling short of fiber recommendations.
• Discuss the role of whole foods and fiber-enhanced foods in helping to
meet fiber recommendations.
• Discover resources to guide discussions with clients and patients to
increase their fiber knowledge and skills for seeking out fiber-containing
foods.
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ContentsA. Fiber Basics
A. What it is
B. How it works
C. Categorizing fiber
D. Where it comes from
E. Summary
B. Health Benefits of Fiber
A. Overview: fiber and health
B. Heart health
C. Diabetes
D. Healthy weight
E. Digestive health
F. Certain cancers
G. For children
H. Summary
C. Fiber Recommendations and Current Intakes
A. Daily fiber recommendations
B. Dietary fiber intake
C. Dietary fiber sources
D. Closing the fiber gap
E. Summary
D. Consumer Interest and Understanding of Fiber
A. Interest in fiber
B. Understanding of fiber
C. A look at whole grain/fiber confusion
D. Is consumer confusion fueling the fiber deficit?
E. Summary
E. Conclusions and Next Steps
A. Role of nutrition professionals
B. Fiber messages for consumers
C. Fiber resources
D. Conclusions®, ™, © 2010 Kellogg NA Co.
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Fiber Basics
• What it is
• How it works
• Categorizing fiber
• Where it comes from
• Summary
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Fiber: What it is
• Dietary fiber is the edible parts of plants or analogous carbohydrates
that are resistant to digestion and absorption in the human small
intestine with complete or partial fermentation in the large intestine.
• Dietary fiber includes polysaccharides, oligosaccharides, lignin, and
associated plant substances.
• Dietary fibers promote beneficial physiological effects including
laxation, and/or blood cholesterol attenuation, and/or blood glucose
attenuation.
The fact that fiber is not digested by the body is part of what makes it so
beneficial to health.
The Definition of Dietary Fiber: report of the dietary fiber definition committee to the board of directors of the American Association of
Cereal Chemists. Cereal Foods World. 2001;46(3):112-126.
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Fiber: How it works
• As a non-digestible carbohydrate, fiber offers health benefits from one
or more of the following mechanisms:
– Bulking: Absorbs water to provide bulk, which improves laxation.
– Viscosity: Forms a gel-like substance that helps lower serum
cholesterol and modulate blood glucose (e.g. beta-glucan found in
oat fiber).
– Fermentation: Produces short-chain fatty acids (SCFA) from the
fermentation of fiber by beneficial bacteria in the gut, providing
energy to the cells lining the digestive tract which helps to promote
gastrointestinal health.
• Emerging research also suggests a role for SCFA in promoting
a healthy immune system, possibly by promoting a healthy
barrier function in the intestinal tract.
• Some fibers that undergo fermentation also have prebiotic
function – selectively feeding and stimulating the growth of the
beneficial bacteria over other bacteria found in the gut. ®, ™, © 2010 Kellogg NA Co.
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Categorizing fiber
• Humans lack the digestive enzymes to break down fiber, which is why it
passes through the digestive system without being broken down.
• Generally, plant sources provide three types of fiber:
– Polysaccharides: most fiber types fall into this category, such as
cellulose, pectin and gums. Found in most vegetable/plant foods.
– Non-Digestible Oligosaccharides and Resistant Starches:
these substances resist digestion in the upper digestive tract and
feed and stimulate growth of friendly bacteria in the lower digestive
tract (i.e. serve as prebiotics). Found in some fruits and vegetables,
seeds and grains.
– Lignin: technically is not a carbohydrate, this is the tough, fibrous
part of plant cell walls, including stalks and skins. As plants mature,
their concentration of lignin increases, which is why celery and
carrots get tougher as they age.
Anderson JW, Baird P, Davis RH et al. Health benefits of dietary fiber. Nutr Rev. 2009;67:188-205.
Brown, A. Understanding Food: Principles and Preparation, 2nd Ed. 2004.
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Categorizing fiber: traditional
• Traditionally, fiber has been classified based on its ability to dissolve in
water; i.e. soluble or insoluble. Both types are intrinsic in plant foods,
and they can be isolated and added to other foods.
– Soluble fiber: Dissolves in water, often absorbs the water and may
form a viscous gel that is fermented in the colon. Food sources
include legumes, oats, barley, nuts, some fruits and vegetables,
and psyllium.
– Insoluble fiber: Does not dissolve in water but rather swells like a
sponge and passes through the intestines mostly unchanged. Food
sources include wheat bran and bran cereals, nuts and seeds,
some vegetables, and skins of some fruits.
• Classifying fiber as soluble vs. insoluble has many limitations due to the
many variations and overlap in functions.
• More recently, there has been a movement to classify fiber in a
different way, based on its origin.
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Categorizing fiber: modern
• In 2005, the Institute of Medicine (IOM) created a new classification for
fibers based on the food source:1
– Dietary Fiber: non-digestible carbohydrates and lignin that are
intrinsic and intact in plant cell walls.
– Functional Fiber: isolated, non-digestible carbohydrates that have
beneficial physiological effects in humans.
• May be extracted from fruits, vegetables, legumes, and seeds;
modified forms of traditional fibers (e.g. fructooligosaccharides,
or FOS, from inulin) or manufactured from other ingredients
such as corn or wheat. These are often referred to as novel,
added and/or isolated fiber.
– Total Fiber: the sum of dietary fiber and functional fiber
1. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes: Energy, Carbohydrates, Fiber, Fat, Fatty Acids,
Cholesterol, Protein and Amino Acids. Washington, DC: National Academies Press; 2002/2005.
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• It is important to note that in order to be classified as a functional
fiber, the ingredient must demonstrate a physiological benefit 1.
• Non-digestible carbohydrates (NDC), whether ―dietary‖ or ―functional,‖
are not differentiated within the intestinal tract2 and provide at least one
physiological benefit - such as laxation, reducing blood cholesterol, or a
lower glycemic index.3
– Studies on non-digestible oligosaccharides (shorter-chain NDCs)
have found that the body recognizes them as dietary fiber,
contributing to laxation and healthy gastrointestinal bacterial
growth.2
– Examples of NDCs include fructooligosaccharides (FOS), inulin,
resistant starch, galactooligosaccharides (GOS) and polydextrose.
1. Report by the AACC Dietary Fiber Technical Committee: All dietary fiber is fundamentally functional. Cereal Foods World, 2003, vol 48, no. 3
2. Gordon, DT. Contribution of nondigestible oligosaccharides (NDO) in meeting dietary fiber needs: laxation and bacterial growth. Poster, DF2009
3. Anderson JW et al. Health benefits of dietary fiber. Nutr Rev. 2009;67:188-205.
Categorizing fiber: modern
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Fiber: Where it comes from
• “Dietary” or intrinsic fibers (as defined by the IOM) come from a
variety of plant foods:
– Fruits, vegetables
– Legumes (e.g., beans, lentils)
– Nuts and seeds
– Whole grains (such as brown rice, whole wheat, popcorn)
• Within each of these categories of foods, the fiber content varies.
• Other essential nutrients are also provided by these foods and may
work with fiber to provide health benefits.
– According to the IOM, much of what we have learned about the
positive physiological aspects of fiber has been obtained through
the study of isolated or synthetic fiber sources. The study of
traditional fibers is often done from whole foods and, therefore, the
data are confounded by other nutrients provided from those foods.Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes: Energy, Carbohydrates, Fiber, Fat, Fatty Acids,
Cholesterol, Protein and Amino Acids. Washington, DC: National Academies Press; 2002/2005.
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Fiber: Where it comes from
• “Functional” or isolated fibers (as defined by the IOM) are isolated,
non-digestible carbohydrates extracted from fruits, vegetables,
legumes, and seeds, or made from other ingredients, like corn or
wheat.
– These fiber ingredients can be added to foods, much like fortifying
foods with vitamins and minerals.
– As previously mentioned, in order to be classified as fiber, it must
provide at least one physiological benefit of fiber - such as laxation,
reducing blood cholesterol, or a lower glycemic index.
– Examples include pectins, gums, polydextrose, maltodextrin, and
inulin and other oligosaccharides.
– Other common fiber ingredients added to foods such as beta-
glucan (from oats and barley), psyllium (used in fiber supplements)
and wheat fiber would be classified as functional fibers if they were
isolated from their original source.
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Fiber: Where it comes from
• Functional or “isolated” fibers, cont.
– There is growing recognition of the positive health benefits of
functional or isolated fibers.
– These newer fibers can often be added to foods with minimal
perceptible differences in taste.
– Adding functional fibers to processed foods may help people reach
their fiber intake goals.
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Fiber: Where it comes from• Below is a sample list of the most common functional fibers
and reported physiological benefits, according to the most
recent IOM report on Dietary Reference Intakes for Fiber.(1)
1. Institute of Medicine (IOM). Dietary, Functional, and Total Fiber. In: Food and Nutrition Board (FNB), editor. Institute of Medicine Expert Panel on Dietary Reference
Intakes for Macronutrients .Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC:
National Academies Press; 2002/2005. p. 339-42
2. Human studies are inconclusive
3. As seen in animal studies
Isolated Fiber (Functional
Fiber)
Demonstrated Benefit (2) Primary Source
Cellulose Laxation Plant foods
Chitin/Chitosan Blood lipid lowering (3) Fungi or shellfish
Guar Gum Blood lipid lowering
Attenuates blood glucose response
May promote gut health
Guar bean (legume)
Inulin/Oligofructose/
Fructooligosaccharide (FOS)
Laxation
Blood lipid lowering
Chicory root
Jerusalem artichoke
Synthesized from
simple
carbohydrates
β-glucan (beta-glucan) and
oat bran
Blood lipid lowering
Attenuates blood glucose response
Oats and Barley
Pectin Blood lipid lowering
Attenuates blood glucose response
Plant foods
Polydextrose Laxation
Blood lipid lowering
Synthesized from
dextrose (glucose)
Psyllium Laxation
Blood lipid lowering
Psyllium husk
(plant)
Resistant Dextrins Blood lipid lowering
Attenuates blood glucose response
Corn and wheat
Resistant Starch Laxation
Attenuates blood glucose response
Plant foods
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Fiber: A summary
• The definition and classification of dietary fiber has evolved as our
understanding of fiber has increased.
• Due to advances in food technology, there are a variety of newer fiber
sources available as components of fiber are being extracted (isolated)
from plant foods or synthesized from corn or other ingredients.
• According to the IOM, much of what we have learned about the benefits
of dietary fiber has been obtained through the study of isolated or
synthetic fibers.
• These newer fibers are not differentiated from intrinsic fibers in the
digestive tract, and they offer the same health benefits as dietary fibers.
In fact, when added to commonly eaten foods they may help Americans
reach their fiber intake goals.
• To gain the multiple benefits of a diet high in fiber, a mixture of dietary
fibers from a variety of food sources is desirable.
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Health Benefits of Fiber
• Overview: Fiber and Health
• Heart Health
• Diabetes
• Healthy Weight
• Digestive Health
• Certain Cancers
• For Children
• Summary
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Overview: Fiber and Health
Higher-fiber diets have been associated with:
– Improving serum lipid concentrations, e.g. certain soluble fibers
help lower LDL cholesterol
– Lowering blood pressure
– Helping with weight management
– Improving glucose tolerance and insulin response
– Maintaining a healthy digestive system
– Reducing cancer risk
Source: Fiber evidence analysis project. ADA Evidence Analysis Library: http://www.adaevidencelibrary.com/topic.cfm?cat=1586
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Fiber and Heart Health: Health Claims
• Evidence of the inverse relationship between fiber and heart disease is
strong enough to support two FDA-approved health claims:
– ―Diets low in saturated fat and cholesterol and rich in fruits,
vegetables and grain products that contain some types of dietary
fiber, particularly soluble fiber, may reduce the risk of heart disease,
a disease associated with many factors.‖1
– ―Soluble fiber from foods such as oat bran, rolled oats, whole oat
flour, oatrim, whole grain barley, and soluble fiber from psyllium
husk, as part of a diet low in saturated fat and cholesterol, may
reduce the risk of heart disease.‖2
• Foods bearing a psyllium seed husk health claim must also
indicate the need to consume the product with sufficient liquid.
1. Fruits, Vegetables and Grain Products that contain Fiber, particularly Soluble Fiber, and Risk of Coronary Heart Disease
(21 CFR 101.77)
2. Soluble Fiber from Certain Foods and Risk of Coronary Heart Disease (21 CFR 101.81)
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Example Evidence Supporting Fiber and
Heart Health
• Pereira et al. 2004 (meta-analysis)
– Compared intakes of total dietary fiber with coronary heart disease
(CHD) risk.
– Analysis of 10 large prospective studies reported that for each 10g
per day increment in dietary fiber intake, there was a 14% decrease
in CHD risk.
– Fiber from cereals and fruits had a strong, inverse association with
CHD risk (10% and 16% reduction in risk, respectively).
– In terms of coronary deaths, association was stronger: 27%
reduction in risk associated with total fiber, 24% reduction with
cereal fiber, and 30% reduction with fruit fiber.
Pereira et al . Dietary Fiber and Risk of Coronary Heart Disease. Arch Int Med . 2004;64: 370-376
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Example Evidence Supporting Fiber and
Heart Health (cont.)
• Life Sciences Research Office (2008)
– Conducted a review of intervention and observational studies on
whole grains to evaluate the effect of applying the FDA definition of
whole grains on the scientific evidence for the whole-grain health
claim on reduced risk for CVD and type 2 diabetes.
– Health claims about whole grain and reduced risk of CVD is
supported only when a broader concept of whole grain (including
fiber-rich bran and germ as well as whole grain) is applied.
– The results support the positive effects of fiber (particularly bran) in
heart health.
Life Science Research Office, Whole-Grain Intake and Cardiovascular Disease and Whole-Grain Intake and Diabetes:
A Review, Nov. 2008. http://www.lsro.org/articles/wholeGrainIntake.html
De Moura FF et al. Applying the FDA definition of whole grains to the evidence for cardiovascular disease health claims J. Nutr
2009 139: 2220S-2226S.
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Fiber and Diabetes
Higher fiber diets are associated with reduced risk of type 2 diabetes
and metabolic syndrome.
– The exact mechanism is unclear, but likely due to a combination of
improving glucose tolerance and insulin response, and weight
management.
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Example Evidence Supporting Fiber and
Diabetes
• 2008 Cochrane Collaboration (an international not-for-profit
organization)1
– A systematic review of the literature found that eating a fiber-rich
diet (28-37% of total intake) may help reduce the risk for diabetes
by about one-third.
• 2008 United Kingdom Scientific Advisory Committee on Nutrition2
– A comprehensive review of the health effects of fiber found nine out
of 11 prospective studies concluded that increasing cereal-fiber
intake significantly reduced the risk of developing type 2 diabetes.
1. Cochrane Database of Systematic Reviews. Priebe MG et al. Whole grain foods for the prevention of type 2 diabetes mellitus.
2008. http://www.cochrane.org/reviews/en/ab006061.html.
2. Scientific Advisory committee on Nutrition (2008). Statement on Dietary Fibre.
http://www.sacn.gov.uk/pdfs/final_draft_sacnstatement_on_dietary_fibre_for_website.pdf
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Fiber and Healthy Weight
• Fiber can play a key role in managing weight by:
– Slowing down the rate of eating because foods higher in fiber take
longer to chew.
– Absorbing fluid (as much as 15 times its own weight) to create a
feeling of fullness.
– Helping reduce calories, i.e., a higher-fiber diet is a lower energy
density diet because fiber doesn‘t contribute substantially to caloric
intake and can replace higher-calorie ingredients.
• Emerging science suggests that fiber‘s role in feeding friendly bacteria
in the gut and possibly other mechanisms may be associated with a
reduced risk for overweight and obesity.1
1. Fava F et al. The potential role of the intestinal gut microbiota in obesity and the metabolic syndrome. Food SciTech Bull Func
Foods. 2008; 5(7):71-92
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Example Evidence Supporting Fiber and
Healthy Weight
• Nurses Health Study (2003)1 and the U.S. Health Professionals Follow-up
Study(2004)2
– Prospective studies, tracking 74,000 female nurses and 51,500 male
health professionals, respectively.
– Increasing fiber is associated with less weight gain over the study
period (12 years and 8 years, respectively).
• National Health and Nutrition Examination Survey (NHANES) 1999-2004 3
– Increased consumption of dietary fiber was associated with lower BMI
and waist circumference in women, and lower waist circumference in
men.1. Liu S et al. Relation between changes in intakes of dietary fiber and grain products and changes in weight and development o
obesity among middle-aged women. Am J Clin Nutr. 2003;78:920-7.
2. Koh-Banerjee P et al. Changes in whole grain, bran, and cereal fiber consumption in relation to 8-year weight gain among men. Am
J Clin Nutr. 2004;80:1237-45.
3. Cho S et al. Consumption of fiber is associated with lower body weight measure in U.S. adults: The National Health and Nutrition
Examination Survey (NHANES) 1999-2004. FASEB J. 2009 [Abstract LB485]
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Example Evidence Supporting Fiber and
Healthy Weight (cont.)
• Tucker et al. 20091
– Increasing dietary fiber significantly reduces the risk of gaining
weight and fat in women. For each 1 g increase in total fiber
consumed, weight was lower by 0.25 kg.
• Yao et al. 20012
– People eating diets low in fat and high in fiber lose weight three
times faster than those eating low-fat, low-fiber diets.
1. Tucker LA and Thomas KS. Increasing total fiber intake reduces risk of weight and fat gains in women. J Nutr. 2009;139:576-
81.
2. Yao et al. Dietary energy density and weight regulation. Nutr Rev. 2001;59:247-58.
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Fiber and Digestive Health
• Increasing fiber intake (particularly insoluble fibers such as wheat bran)
may contribute to digestive health by:
– Providing more bulk, making it easier for the muscles of the
digestive tract to move its contents along.
– This in turn promotes regularity and prevents constipation, as waste
moves more quickly through the digestive tract (i.e. decreases
transit time).
• An emerging area of research is on prebiotics and dietary fiber and
associated positive effects on digestive health and the immune
response.1
1. Douglas LC, Sanders ME. Probiotics and prebiotics in dietetics practice. J Am Diet Assoc. 2008;108:510-21.
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Example Evidence Supporting Fiber and
Digestive Health
• Considerable evidence suggests that dietary fiber may play a role in
prevention and treatment in several gastrointestinal disorders:1,2
– GERD (Gastroesophageal reflux disease/‖acid reflux‖), duodenal
ulcers, diverticulitis, constipation, hemorrhoids, and in some cases
of irritable bowel syndrome and inflammatory bowel disease.
1. Guamer et al. Gut flora in health and disease. Lancet. 2003;360:512-519 .
2. Gibson et al. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics.
J Nutr. 1995;125:1401-1412.
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Fiber and Cancer
• A diet rich in fiber may reduce the risk of developing certain types of
cancer by:
– Promoting the health of the digestive tract.
– Speeding the passage of food waste, thereby reducing the time
certain toxic substances stay in the body and improving the balance
of beneficial bacteria in the gut.
– Increasing the intake of antioxidants, i.e., foods rich in fiber tend to
be rich in vitamins, minerals, and phytochemicals linked to cancer
prevention.
– Altering hormone levels in the body, particularly lowering estrogens
linked to breast cancer risk.
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Example Evidence Supporting Fiber and
Cancer
• 2003 European Prospective Investigation into Cancer and Nutrition
(EPIC) 1
– A 10-country study involving more than 500,000 subjects found that
doubling fiber intake (from approximately 15 g/day) may reduce the
risk of bowel cancer by 40%.
• Women‘s Cohort Study (2007)2 and the Malmo Diet and Cancer Cohort
(2004)3
– Changing the diet to one rich in high-fiber foods may help protect
against developing breast cancer.
1. Bingham et al. Dietary fiber in food and protection against colorectal cancer in the European Prospective Investigation into Cancer
and Nutrition (EPIC): an observational study. Lancet. 2003;361:1496-1501
2. Cade et al. Dietary Fiber and risk of breast cancer in the UK Women's Cohort Study. Int J Epid. 2007;36:231-238
3. Mattisson et al. Intakes of plant foods, fiber and fat and risk of breast cancer - a prospective study in the Malmo Diet and Cancer
Cohort. Br J Cancer. 2004;90: 22-127
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Fiber and Children
• Adequate intake of fiber for children (2 years and older) promotes
overall health by:
– Helping to keep the digestive system healthy so it can function.
properly and ―do its job,‖ such as absorbing nutrients from the diet.
– Developing and maintaining a healthy population of gastrointestinal
bacteria. 1
– Promote regularity and bowel function. 1
– Establishing healthful eating habits that are more likely to be
sustained throughout life. 1
1. Pereira et al. Dietary Fiber and body weight regulation. Observations and mechanisms. Pediatr Clin North Am. 2001;48: 969-980
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Example Evidence Supporting Fiber and
Children
• Pereira at al. 20011
– A review of observational studies show that children with higher-fiber
intakes are less likely to be overweight compared to children with
low-fiber intakes.
• Williams et al. 20082
– Higher-fiber diets during childhood have been shown to be inversely
related to blood cholesterol levels.
1. Pereira et al. Dietary Fiber and body weight regulation. Observations and mechanisms. Pediatr Clin North Am. 2001;48: 969-980
2. Williams CL et al. Childhood diet, overweight and CVD risk factors: the Healthy Start Project. Prev Cardiol. 2008;11:11-20
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Summary
• There is consistent and strong data for the role of dietary fiber in a
number of health outcomes and throughout the life cycle, as supported
by epidemiological, prospective and intervention studies.
– Heart disease, diabetes, weight management, digestive health and
cancer are among them.
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Fiber Recommendations and
Current Intakes
• Daily Fiber Recommendations
• Dietary Fiber Intake
• Dietary Fiber Sources
• Closing the Fiber Gap
• Summary
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Daily Fiber Recommendations
• The IOM established an Adequate Intake (AI) level for fiber as part of
the Dietary Reference Intake (DRIs) for macronutrients (14 grams of
fiber for each 1,000 calories for individuals ages 1 year and older). The
AIs were based on amounts that had been observed in adults to
decrease the risk of heart disease. There is no Tolerable Upper Intake
Level (UL) for fiber.
Fiber Recommendations by Age and Gender Recommended
Daily Fiber Intake
• Children ages 1-3 years old 19 grams
• Children ages 4-8 years old 25 grams
• Young boys ages 9-13 years old 31 grams
• Young girls ages 9-13 years old 26 grams
• Teenage boys ages 14-18 years old 38 grams
• Teenage girls ages 14-18 years old 26 grams
• Adult men ages 19-50 years old 38 grams
• Adult women ages 19-50 years old 25 grams
• Older adult men ages 50 years and older 30 grams
• Older adult women ages 50 years and older 21 grams
• Pregnant women 28 grams
• Lactating women 29 grams
Adapted from: Institute of Medicine, Dietary Reference Intakes; Energy, Carbohydrate, Fiber, Fat Fatty Acids, Cholesterol, Protein
and Amino Acids. Washington, DC. National Academies Press 2002/2005.®, ™, © 2010 Kellogg NA Co.
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Dietary Recommendations –
U.S. Dietary Guidelines for Americans• In the 2005 Dietary Guidelines for Americans, fiber is identified as a
―nutrient of concern‖ for adults and children and is highlighted in other
sections, including:
– Food Groups to Encourage:
• ―Diets rich in foods containing fiber, such as fruits, vegetables,
and whole grains, may reduce the risk of coronary heart
disease.‖
– Carbohydrate Key Recommendation:
• ―Choose fiber-rich fruits, vegetables, and whole grains.‖
– Carbohydrate Recommendation:
• ―Diets rich in dietary fiber have been shown to have a number
of beneficial effects, including decreased risk of coronary heart
disease and improvement in laxation. There is also interest in
the potential relationship between diets containing fiber-rich
foods and lower risk of type 2 diabetes.‖®, ™, © 2010 Kellogg NA Co.
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Dietary Fiber Intake
• Nine out of 10 adults and children do not meet current fiber
recommendations.1
• According to intake data2, Americans‘ average consumption of fiber is
about half of the recommended amount with:
– women eating about 14 grams per day.
– men eating about 18 grams per day.
– children (ages 2-19) eating about 13 grams per day.
1. Moshfegh, Alanna; Goldman, Joseph; and Cleveland, Linda; 2005 What We Eat in America, NHANES 2001-2002: Usual Nutrition
Intake From Foods as Compared to Dietary Reference Intakes
2. What We Eat in America, National Health and Nutrition Examination Survey (NHANES) 2005-2006. See www.ars.usda.gov.
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Dietary Fiber Sources
• According to national data, white flour and white potatoes provide the
most fiber in the U.S. diet, not because they are rich sources of fiber,
but because they are most widely consumed across the population.1
• Current research revealed it takes more than 25 different foods to
deliver the 13.8 grams of fiber people are eating each day, suggesting
Americans are eating very few foods that are good sources of fiber.2
1. Slavin JL. Position of the American Dietetic Association: Health implications of dietary fiber. J Am Diet Assoc. 2008:108:1716-1731.
2. The NPD Group's Nutrient Intake Database – Research for Kellogg Company, 2009: www.kelloggsnutrition.com
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Closing the Fiber Gap
• Programs and policies implementing the Dietary Guidelines that
promote increased consumption of fruits, vegetables, and whole grains
have not been successful in helping Americans meet fiber
recommendations.
– Overall intakes of fruits, vegetables and whole grains remain low,
and not all foods in these categories are considered a ―good‖
source of fiber.
– A recent modeling exercise using NHANES 2003-2006 intake data
found that in order to achieve intake goals of 28 grams of fiber/day,
adults would need to double their intake of dietary fiber-containing
foods they currently eat. Doing so would also add about 1,042
calories to one‘s daily intake. Conversely, adding fiber to low-fiber
foods that are commonly eaten would result in reaching fiber goals
without a significant calorie increase.1
• Consuming fiber-rich food sources, including foods enhanced with fiber,
helps people reach their recommended daily intake goals.
1. National Health and Nutrition Examination Survey (NHANES) 2003-2006.®, ™, © 2010 Kellogg NA Co.
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Summary
• Research reveals it takes more than 25 different foods to deliver the
13.8 grams of fiber people are currently eating each day, suggesting
Americans are eating very few foods that are good sources of fiber.
• Despite the 2005 Dietary Guidelines recommendation to increase
consumption of fruits, vegetables, and whole grains, nine out of 10
Americans continue to fall short of fiber recommendations.
– Overall consumption of foods in these categories remains low, plus
many do not provide a good source of fiber.
• In order to achieve intake goals of 28 grams of fiber/day, adults would
need to double their intake of the dietary fiber-containing foods they
currently eat, resulting in an additional 1,042 calories.
• Adding fiber to commonly eaten, low-fiber foods allows people to
achieve fiber intake goals without a commensurate increase in calories.
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Consumer Interest and
Understanding of Fiber
• Interest in Fiber
• Understanding of Fiber
• A Look at Whole Grain/Fiber Confusion
• Is Consumer Confusion Fueling the Fiber Deficit?
• Summary
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Interest in Fiber
• According to the 2008 IFIC Food & Health Survey1, consumers
understand that fiber is important.
– 92% of Americans said they‘re trying to get more fiber into their
diets.
• Yet, only one in three consumers recognized they are falling short of
recommended fiber intakes.2
1. International Food Information Council. Food & Health Survey: Consumer Attitudes toward Food, Nutrition & Health, 2008.
2. Kellogg Whole Grains & Fiber Omnibus Survey, 2009: www.kelloggsnutrition.com.
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Understanding of Fiber
• Consumer research provides a greater understanding of what
consumers know and understand about fiber.1
• In a recent survey, nearly 70% of consumers surveyed said they are
eating more foods made with whole grains as a way to increase their
fiber intake.
– In fact, they expect those products to contain fiber at significant
levels. About 85% of consumers who are choosing foods made with
whole grain assume that product is a good or excellent source of
fiber.
– About half of those surveyed see fiber and whole grains as one and
the same.
• While many people believe that all products with whole grain-
ingredients are a good source of fiber, this is not the case.
1 . The American Consumer: ―Whole‖ Lot of Fiber Confusion?: www.kelloggsnutrition.com
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Whole Grain/Fiber Confusion
• The reality is the fiber content of foods made with whole grain can vary
greatly…
– The fiber content in individual whole grains such as brown rice, oats
and rye ranges from 0.6 grams to 1.7 grams to 2.9 grams per serving,
respectively.1
1. Whole Grains Council: http://www.wholegrainscouncil.org/newsroom/whole-grain-statistics.
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Whole Grain/Fiber Confusion
• The reality is the fiber content of foods made with whole grain can vary
greatly…(cont.)
– The type of grain, amount of bran, density of the product, and moisture
content are factors that determine the amount of fiber in packaged
foods that are made with whole grain.
– Food packages can be labeled as made with whole grain or similar
claims so long as it contains at least some whole grain – even a small
percentage. Accordingly, fiber content in such foods often is low.
– Additionally, the whole-grain content of foods that meet FDA‘s definition
of a whole-grain food can also vary widely – anywhere from 51-100% of
total grain ingredients1…which, again, can directly impact the total fiber
content.
1. FDA Whole Grain Health Claim 1999/2003/2008.
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Whole Grain/Fiber Confusion
• An audit* of products available today illustrates that many foods that
carry messages about whole-grain content on the package do not
provide at least a good source of fiber (as consumers believe).
• In the cereal aisle:
– At the time of the audit, 72 nationally distributed ready‐to‐eat cereal
products included clearly visible whole‐grain messages on the
package (e.g. ―whole grain guaranteed,‖ made with whole grains,‖
―with whole grains,‖ and ―rich in whole grains‖).
– Of those 72 breakfast cereals, only about half provided a good or
excellent source of fiber. The fiber varied greatly, ranging from 0 to
11 grams per serving.
– Of the cereals that did not provide at least a good source of fiber,
60% provided 1 gram of fiber or less.
The ―claim audit‖ was completed using a syndicated database, capturing items entered into the database from 01/01/05 to 07/24/08.
The database is maintained by an independent research company who pulls packaging from the shelf and puts in a database for the
use of their subscribers. Current product formulations or on-pack messaging may be different from the information reflected in this
report. See Whole Grains Half Truths on www.kelloggsnutrition.com.®, ™, © 2010 Kellogg NA Co.
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Whole Grain/Fiber Confusion
• In the cereal/granola bar aisle:1
– 46 nationally distributed cereal and granola bars included clearly
visible whole‐grain messaging on the package.
– The fiber content of these granola bars also varied greatly, ranging
from 0 to 9 grams per serving.
– Of the 46 granola bars with whole‐grain messages, nearly all (40)
were found to provide less than a good source of fiber.
– Two‐thirds of the cereal and granola bars – or 26 of 40 ‐ that did
not provide a good source of fiber, provided just 1 gram or less per
serving.
1. Whole Grain Half Truths: www.kelloggsnutrition.com.
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Is Consumer Confusion
Fueling the Fiber Deficit?• Consumers are eating more whole grains to get more fiber. Yet, many
products that make whole-grain claims are not a good source of fiber.
• To determine if this confusion contributes to the fiber deficit, an analysis
was conducted:1
– Ready-to-eat cereals are one of the most significant sources of
fiber in the diet, delivering levels of fiber only slightly less than fruits
and vegetables.
– Consumers who eat cereals made with whole-grain ingredients do
have higher daily fiber intakes, get more fiber at breakfast, and get
at least 78% more fiber (1.6 g vs. 0.9 g) from their breakfast.
– However, if those consumers choosing cereals made with whole
grains were to flip to the Nutrition Facts panel to ensure it was at
least a good source of fiber, this could result in a 144% increase in
fiber intake (2.2 g vs. 0.9 g).1. The NPD Group's Nutrient Intake Database – Research for Kellogg Company, 2009: www.kelloggsnutrition.com
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• Over a two-week period, if those cereal eaters that were choosing
cereals made with whole grains ensured that the cereal also had a
good source of fiber (3 grams per serving), they would consume more
than 8 extra grams of fiber… equivalent to nearly three extra servings
of cereal, fruit, vegetables or other ―good source of fiber‖ foods every
two weeks.
• If they were to ‗flip for fiber‘ and choose a cereal that was an excellent
source of fiber (5 grams or more per serving) the advantage over time
is further enhanced … adding up to 14 extra grams of fiber over a
two-week period … nearly 5 servings of ―good source‖ cereal.
• This research demonstrates the importance checking the Nutrition
Facts Panel for fiber content rather than assuming it is there based on
front-of-pack messaging about whole-grain content. The NPD Group's Nutrient Intake Database – Research for Kellogg Company, 2009: www.kelloggsnutrition.com .The NPD
Group‘s Nutrient Intake Database is based on 14-day eating frequency diary information gathered at the individual level,
supplemented with average portion size and nutrient composition information from the U.S. government. Cereal made with whole
grain ingredients and fiber was not necessarily chosen each day - data represents the cumulative fiber intake over two weeks.
Is Consumer Confusion
Fueling the Fiber Deficit? (cont.)
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Summary• Most Americans say they‘re trying to get more fiber into their diets yet,
only one in three consumers recognized they are falling short.
• The majority of consumers indicate they are eating more foods made
with whole grains as a way to increase their fiber intake.
• Most consumers assume products with whole-grain messaging are a
good source of fiber but this is not the case. A recent audit revealed:
– Of 72 breakfast cereals examined, only about half provided a good
or excellent source of fiber. The fiber varied greatly, ranging from 0
to 11 grams per serving.
– Of 46 granola bars examined, nearly all (40) were found to provide
less than a good source of fiber.
• If consumers choosing cereals made with whole grains were to flip to
the Nutrition Facts panel to ensure it was at least a good source of fiber
(rather than assume it was), this could result in a 144% increase in
fiber intake.
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Conclusions and
Next Steps
• Conclusions
• Role of Nutrition Professionals
• Fiber Messages for Consumers
• Fiber Resources
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Conclusions
• The definition and classification of dietary fiber has evolved and there
are a variety of new fiber ingredients available.
• Much of what we know about the benefits of fiber comes from studying
isolated, ―functional‖ fibers.
• Adding these newer fibers to foods consumers eat will provide a
greater variety of fiber-rich foods for consumers to chose from.
• There is growing recognition of the positive health benefits of functional
fibers. In fact, the development and use of these newer-fiber sources
may allow Americans to increase their fiber intake without sacrificing
taste.
• There are consistent and strong data for the role of dietary fiber in a
number of health outcomes, including heart disease, diabetes, weight
management, digestive health and cancer.
• Because different fibers have different physiological benefits, a mixture
of dietary fibers from a variety of food sources is desirable.
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Conclusions (cont.)
• Nine out of 10 Americans – both children and adults – fall short of their
fiber recommendations. Among the many variables that may be driving
the fiber deficiency:
– Consumers mistakenly believe foods ‗made with whole grain‘ provide
significant levels of fiber.
– Intake of fruits, vegetables and legumes remain low.
– Americans eat very few foods that are at least a good source of fiber.
• To increase fiber intake, dietary advice should continue to emphasize
fruits, vegetables, legumes, whole grains, and nuts and seeds, in
addition to encouraging intake of fiber-enhanced foods.
– Given the lack of fiber-rich foods in today‘s diets, enhancing foods
with fiber, much like adding vitamins and minerals to foods, can play
a positive role in closing the fiber gap.
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Role of Nutrition Professionals
• Provide practical guidance on how to incorporate more fiber in daily
diets, including both traditional fiber-containing foods as well as foods
with added fiber.
• Re-train consumers to look specifically at fiber content on the labels of
packaged foods, specifically when choosing foods made with whole-
grain ingredients.
• Help educate consumers and the media about the importance of all
types of fiber in helping to meet fiber-intake recommendations.
• Stay current on fiber research and innovations to provide continued
guidance to consumers.
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Fiber Messages for Consumers
• ―Flip for Fiber‖ – Flip to the Nutrition Facts to get the full information on
fiber. Just looking at the front of the package is not enough.
• On the Nutrition Facts label—a good source of fiber provides at least 3
grams or 10% Daily Value (DV) and an excellent source of fiber
provides at least 5 grams or 20% DV.
• To get the most benefits of fiber, choose a variety of fiber-containing
foods, including whole foods such as fruits, vegetables and whole
grains, as well as fiber-enhanced foods.
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Fiber Resources: for Nutrition Education
• Kellogg‘s Nutrition: www.kelloggsnutrition.com:
– KNOW Fiber—a downloadable, ready-to-use, consumer-friendly
presentation to use with patients and clients.
– FIBER-pe-dia—a comprehensive resource on fiber basics, benefits,
recommendations, and food sources.
– Fiber Tracker—an online interactive tool to track daily intake of fiber
– ―From the Store to Your Table: Bringing Fiber To Your Family,‖ a
fiber fact sheet and recipe ideas.
– ―Charting Your Fiber Choices,‖ offering month-by-month tips for
increasing fiber and a chart to jot down daily fiber goals.
• WebMD: www.webmd.com:
– ―Why You Need More Fiber,‖ other fiber fact sheets.
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Fiber Resources: for Professionals
• American Dietetic Association (ADA):
– Slavin JL. Position of the American Dietetic Association: Health
implications of dietary fiber. J Am Diet Assoc. 2008:108:1716-1731.
– Fiber evidence analysis project. ADA Evidence Analysis Library
Web site. http://www.adaevidencelibrary.com/topic.cfm?cat=1586
• International Food Information Council (IFIC): www.foodinsight.org
– ―Fiber Fact Sheet‖
– ―Functional Foods Backgrounder‖
• Kellogg‘s Nutrition: www.kelloggsnutrition.com
– Fact Sheets:
• ―The American Consumer: ‗Whole‘ Lot of Fiber Confusion‖
• ―Whole Grain Half Truths‖
• ―Every Gram Counts: Eating Away at the Fiber Deficit‖
– KNOW Nutrition Network
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Glossary of terms
Dietary Fiber: non-digestible carbohydrates and lignin that are intrinsic and intact in plant cell
walls.
Fermentation: A process in which a microorganism (or other agent) transforms organic matter
into other products, such as breaking down fiber into short-chain fatty acids.
Fructooligosaccharides (FOS) – glucose or fructose-terminated polymers of fructose
naturally occurring in a variety of plants
Functional Fiber: isolated, non-digestible carbohydrates that have beneficial physiological
effects in humans. Also: novel, added and/or isolated
Polysaccharide: a carbohydrate, as starch, inulin, or cellulose, containing more than three
monosaccharide units per molecule
Prebiotic: A type of fiber that provide benefits by selectively stimulating the growth and/or
activity of bacteria in the colon.
Total Fiber: the sum of dietary fiber and functional fiber
Viscosity: resistance to flow
Source: Douglas LC and Sanders ME. Probiotics and Prebiotics in Dietetics Practice. J Am Diet Assoc. 2008;108:510-521.
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