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FALL 2014 Focus on Fibre: ne w polic y and the l atest science Health Canada’s new Policy for Labelling and Advertising of Dietary FibreContaining Food Products1 provides an updated and broadened definition of dietary fibre. The new policy has allowed for an expanded breadth of fibrecontaining foods in the Canadian market, potentially increasing fibre consumption among Canadians. Currently there is a widespread fibre gap between the recommended fibre intake and fibre consumption in Canada. The consequences of the fibre gap are evident when the physiological outcomes and health benefits of fibre are understood. Some of the benefits of fibre are well-established while others are only beginning to emerge. DID YOU KNOW? Over 90% of Canadians do not get the recommended daily amount of dietary fibre. 2 Die tary fibre polic y in C anada Claudine Gourgue, PhD, Food Directorate, Health Canada Background on Health Canada’s Revised Dietary Fibre Policy Dietary fibre is one of 13 nutrients declared in the Nutrition Facts table on food labels. The first Canadian dietary fibre definition was adopted in 1985 and included only non-starch polysaccharides of plant origin as fibre sources. In subsequent years, with scientific advances in fibre, many new products with fibre properties were developed, but they did not meet the Canadian fibre definition. In the 2000s, many countries and scientific bodies, including Australia, New Zealand, the U.S. Institute of Medicine, Codex Alimentarius and the European Union, revised their fibre definition which expanded the list of eligible fibres sources to include non-digestible oligosaccharides, resistant starch and other modified substances. The 1985 Canadian fibre definition was very restrictive and limited consumer choices regarding dietary fibre ingredients, so the need arose to harmonize the Canadian fibre definition to those used in other countries. Recently, Health Canada’s Food Directorate released a revised dietary fibre policy after a consultation period. The purpose of updating the old policy was also to develop guidance for the food industry, to assure consumers that ingredients declared to be dietary fibre sources are safe and perform one or more of the physiological functions expected of dietary fibre. This approach meets Health Canada’s mandate to maintain and improve the health of the Canadian population. Features of the New Dietary Fibre Policy Definition of Dietary Fibre Compared to the 1985 definition, the new fibre definition encompasses a wider range of products. Dietary fibre consists of: 1) Carbohydrates with a degree of polymerization (number of saccharide units) of 3 or more that naturally occur in foods of plant origin and that are not digested and absorbed by the small intestine; and 2) Accepted novel fibres. Novel fibres are ingredients manufactured to be sources of dietary fibre and consist of carbohydrates with a degree of polymerization of 3 or more that are not digested and absorbed by the small intestine. They are synthetically produced or are obtained from natural sources which have no history of safe use as dietary fibre or which have been processed so as to modify the properties of the fibre contained therein. Accepted novel fibres have at least one physiological effect demonstrated by generally accepted scientific evidence. Health Canada’s Recognized Physiological Fibre Effects 1)Improves laxation or regularity by increasing stool bulk 2)Reduces total blood and/or low density lipoprotein cholesterol levels 3)Reduces post-prandial blood glucose and/or insulin levels 4)Provides energy-yielding metabolites through colonic fermentation Dietary fibre includes all edible plant materials that meet the definition for fibre stated above, have a history of use as food and have been processed or cooked using conventional processes. Typical fibre sources include fruits, vegetables, pulses, seeds, nuts, cereals, legumes, etc. Novel fibres may either be extracted from agricultural crops or their by-products (e.g. pea hull fibre) or modified from such materials (e.g. resistant starch type 4); substances of animal or bacterial origin (e.g. chitin derived from lobster shells or xanthan gum obtained from bacterial fermentation of sugars); or synthesized materials (e.g. polydextrose). All novel fibres must be shown to meet standards of safety for food ingredients. Once a physiological function has been demonstrated for a novel fibre, the product can be labelled as a dietary fibre and is known as such. Examples of dietary fibres accepted by Health Canada: Fructooligosaccharides inulin oat bran oat hull fibre pea hull fibre polydextrose Energy Value It is now well established that dietary fibre provides the body with less energy than digestible carbohydrates such as sugars and starch. Therefore, the energy value of 2 kcal (8 kJ) / g has been adopted to replace the default value of 4 kcal (17 kJ) / g of fibre previously used in Canada for nutrition labelling. The new value is a more accurate reflection of the energy available to the body from the fibre fraction of a food. In addition, products with energy values lower than 2 kcal (8 kJ) / g based on scientific evidence may carry a label declaration of these specific caloric values. Outcomes of the New Fibre Policy The new fibre definition provides consumers with greater choice of fibre sources, since most of the ingredients which were not eligible as fibres based on the 1985 definition are currently in the Canadian market as accepted fibres. While Health Canada recognizes that the best sources of dietary fibres are fruits, vegetables, pulses, seeds, nuts, cereals, legumes, etc., the consumption of food products enriched with accepted dietary fibres may also contribute to increasing the Canadian daily fibre intake which is currently below the recommended values. Fibre, Whole Gr ains and Health Julie Miller Jones, PhD, LN, CNS, CFS, FICC. St. Catherine University, St. Paul, MN, USA Dietary fibre intake in Canada is far below recommended levels creating an extreme fibre gap. This is unfortunate because dietary fibres, especially the right mix of viscous, soluble and insoluble fibres found in a diet containing a variety of fibre sources - both intrinsic and added fibres - has many health benefits. The new Health Canada guidance on dietary fibre can help consumers address the fibre gap because it recognizes the importance of giving fibre status to all carbohydrate oligomers. Dietary Fibre Gap in Canada According to the Dietary Reference Intakes3, North American females, 19 - 50 years old, need 25 g of dietary fibre per day and males of the same age need 38 g per day. Data from the Canadian Community Health Survey, shows that the average intake for adults was 17 g per day. 2 DID YOU KNOW? High fibre food choices are more likely eaten at breakfast. A recent study showed that only 0.3% of breakfast skippers met the dietary recommendation for fibre. By contrast, 13% who ate cereal for breakfast met the fibre recommendations compared to just 3.5% of breakfast eaters not choosing cereal. 4 Evidence for Health Benefits of Dietary Fibre Dietary fibre’s role in promoting health and reducing disease risk are many and recognized. Health Canada has approved dietary fibres which show laxation benefits; blood lipid attenuation; blood glucose and insulin modulation; and provide energy-yielding metabolites through colonic fermentation. Other benefits, such as those associated with aiding satiety and maintaining body weight, are actively being researched. Laxation Fibres found naturally in food and added to food result in bulkier, more easily passed stools5,6. Health Canada has approved function claims for both coarse wheat bran and psyllium fibre for their role in promoting laxation or regularity. Blood Lipids Viscous fibres such as soluble β-glucan in oats help lower total and LDL cholesterol and alter a number of aspects of lipid metabolism. Thus, many jurisdictions, including Canada, allow health claims for whole grain oats or oat bran, oat derivatives, barley and psyllium. 22 of 24 studies showed that oat products reduced cholesterol in those with elevated levels. Just a 3 week intervention with 3 g per day oat β-glucan improved lipid parameters in men with type 2 diabetes, but the polymer is effective only if the β-glucan has a high molecular weight.7-10 Blood Glucose and Insulin Viscous soluble fibres have been shown to reduce postprandial glycemia and insulin resistance in various populations.11-13 However, in prospective studies, insoluble fibre, not soluble fibre, in food was inversely related to the risk type 2 diabetes.14 Groups eating a diet low in cereal fibre with a high glycemic load had high rates of abnormal glucose tolerance.15 Soluble fibre from oats (0.3 -12 g β-glucan) has been shown in 75% of 34 human studies to decrease blood glucose by an average of 48 mmol min/L. The greatest decrease was observed with intact grains. In foods with higher levels of processing, the effect depended on β-glucan dose and molecular weight.7,11 Fermentation Products and Energy-Yielding Metabolites Dietary fibre’s fermentation to short chain fatty acids provides fuel for healthy colonic cells and acts as a prebiotic that may favourably affect gut health and microflora. The effects of colonic fermentation and the ability of dietary fibre to alter the microbiome needs much more study, despite an exponential increase in information in the last few years. At this point, we cannot even name and culture all the organisms. We do not know if there is an optimal balance of organisms for good health, or if there are many healthy ways to provide the balance. While we know many of the organisms that are present in the guts of healthy breast-fed babies, we do not know if organisms should change as we age or what organisms are critical for good health. We do know that fibre increases fermentation in the gut and the products of fermentation not only lower gut pH that may have a health benefit, including lowering cancer risk, but also may improve mineral absorption. Further, pH determines which microbial species will thrive and affects enzyme systems beyond the gut such as those affecting cholesterol and perhaps glucose metabolism. However, we do not know if all fermentation is good and what level of fermentation is optimal.16,17 Emerging Benefits: Satiety, Maintaining Body Weight and the Benefits of Whole Grains Beyond Fibre Satiety’s measurement and definition are not uniform, making interpretation of the literature difficult. But it is known that certain food components influence appetite and satiety. Satiety, for these studies, is defined as absence of the motivation to eat and is a key element in adjusting energy balance so it is a legitimate field to explore. Dietary fibre’s role in satiety is related to its water-holding in a food and/or its impact on viscosity of a meal. Both aspects are thought to increase feelings of fullness and therefore reduce appetite. Soluble fibres especially have been shown to impact satiety ratings, but other physical properties may determine the degree of satiety reported. Processing impacts on fibres need to be measured as they can affect viscosity, which has been shown to influence short-term satiety.7 In some prospective cohorts, cereal fibre is associated with lower body mass index (BMI) and tendency to lose weight over time, so perhaps the satiety afforded by fibres and whole grain cereals have a moderate impact.18,19 In data from the Framingham cohort of older individuals, only cereal fibre, not total or fruit or vegetable fibre, was related to lower BMI and fat mass. 20,21 The benefits of cereal fibre may reflect that whole grain cereals have many benefits beyond fiber. Often the risk reduction between a particular health outcome and whole grains in prospective cohort studies is even more impressive than the reductions seen with fibre on its own. That is because whole grain cereals offer an impressive array of other nutrients such as B vitamins; magnesium; phytochemicals such as stanols and sterols; lignins and lignans; alkylresorcinols; avenanthramides; and essential and unusual fatty acids. The synergy of these with the fibres and other components of the grain may enhance their effects and determine where in the body they exert their effect. 22-24 FALL 2014 the bot tom line Health Canada’s revised fibre policy now recognizes the many impactful roles dietary fibres can play in the health of Canadians. The consumption of food products enriched with dietary fibres may contribute to increased fibre intake, which is important given that the vast majority of Canadians are not getting enough fibre. Dietitians are in a good position to recommend a variety of high-fibre foods, including foods with added fibre, to help Canadians increase their dietary fibre intake and reap the health benefits associated with all types of dietary fibre. Health Canada recognizes the physiological effects of fibre on laxation, cholesterol reduction, blood glucose and/or insulin control and production of energy-yielding metabolites through colonic fermentation. Other areas of emerging research include satiety and maintaining body weight. Whole grains play an important role in providing the right mix of soluble and insoluble fibres to deliver health benefits which may go beyond fibre due to their synergistic effects with the other nutrients and components of the grain. In the Marketplace PepsiCo Canada offers a number of products that are a source of fibre. The fibre in these products comes from ingredients such as inulin, oat hull fibre, corn bran and whole grains - including oats, wheat, rye, barley, brown rice and triticale. Quaker® High Fibre Raisins & Spice Instant Oatmeal 4 g fibre, 23 g whole grains per 43 g serving Quaker® Fibre & Omega-3 Honey & Pecan Granola Bars 5 g fibre, 11 g whole grains per 35 g serving Quaker® Corn Bran Squares™ Cereal 5 g fibre, 4 g whole grains per 30 g serving Quaker® Banana & Chocolate Chunk Cookies 3 g fibre, 9 g whole grains per 35 g serving SunChips® Original Multigrain Snacks 4 g fibre, 33 g whole grains per 50 g serving Tostitos® Artisan Recipes™ Roasted Garlic & Black Bean Flavoured Tortilla Chips 4 g fibre, 14 g whole grains per 50 g serving Quaker® Wheat Bran Cereal 10 g fibre, 0 g whole grains per 30 g serving Large Flake Quaker® Oats 3 g fibre, 30 g whole grains per 30 g serving Brought to you by the Nutrition Professionals at PepsiCo Canada To download this resource, and others, please scan: or visit www.pepsiconutrition.ca If you would like to receive our e-newsletter, please scan: or email [email protected] REFERENCES 1. Health Canada, Bureau of Nutritional Sciences, Food Directorate, Policy for Labelling and Advertising of Dietary Fibre-Containing Food Products, 2012 2. Statistics Canada, Canadian Community Health Survey, Cycle 2.2, Nutrition (2004) 3. Dietary Reference Intakes, Institute of Medicine of the National Academies, Copyright 2006 by the National Academy of Sciences 4. Deshmukh-Taskar PR1, Nicklas TA, O’Neil CE, Keast DR, Radcliffe JD, Cho S. The relationship of breakfast skipping and type of breakfast consumption with nutrient intake and weight status in children and adolescents: the National Health and Nutrition Examination Survey 1999-2006. J Am Diet Assoc. 2010 Jun;110(6):869-78. 5. Burkitt DP, Walker AR, Painter NS. Effect of dietary fibre on stools and the transit- times, and its role in the causation of disease. Lancet. 1972 Dec 30;2(7792):1408-12. 6. Timm DA, Thomas W, Boileau TW, Williamson-Hughes PS, Slavin JL. Polydextrose and soluble corn fiber increase five-day fecal wet weight in healthy men and women. J Nutr. 2013 Apr;143(4):473-8. 7. Wolever TM, Tosh SM, Gibbs AL, Brand-Miller J, Duncan AM, Hart V, Lamarche B, Thomson BA, Duss R, Wood PJ. Physicochemical properties of oat β-glucan influence its ability to reduce serum LDL cholesterol in humans: a randomized clinical trial. Am J Clin Nutr. 2010 Oct;92(4):723-32. 8. Food and Drug Administration. A Food Labeling Guide (11. Appendix C: Health Claims) http://www.fda.gov/food/guidanceregulation/guidancedocuments regulatoryinformation/labelingnutrition/ucm064919.htm 9. Health Canada, Oat Products and cholesterol lowering. http://www.hc-sc.gc.ca/ fn-an/label-etiquet/claims-reclam/assess-evalu/oat-avoine-eng.php. 10.Health Canada. Summary of Health Canada’s Assessment of a Health Claim about Barley Products and Blood Cholesterol Lowering. http://www.hc-sc.gc.ca/ fn-an/label-etiquet/claims-reclam/assess-aevalu/barley-orge-eng.php 11.Tosh SM. Review of human studies investigating the post-prandial blood- glucose lowering ability of oat and barley food products. Eur J Clin Nutr. 2013 Apr;67(4):310-7. 12.Hall M, Flinkman T. Do fiber and psyllium fiber improve diabetic metabolism? Consult Pharm. 2012 Jul;27(7):513-6. 13.Hallfrisch J, Behall KM. Mechanisms of the effects of grains on insulin and glucose responses. J Am Coll Nutr. 2000 Jun;19(3 Suppl):320S-325S. 14.Fung TT, Hu FB, Pereira MA, Liu S, Stampfer MJ, Colditz GA, Willett WC. Whole-grain intake and the risk of type 2 diabetes: a prospective study in men. Am J Clin Nutr. 2002 Sep;76(3):535-40. 15.Livesey G1, Taylor R, Hulshof T, Howlett J. Glycemic response and health--a systematic review and meta-analysis: the database, study characteristics, and macronutrient intakes. Am J Clin Nutr. 2008 Jan;87(1):223S-236S. 16.Walsh CJ, Guinane CM, O’Toole PW, Cotter PD. Beneficial modulation of the gut microbiota. FEBS Lett. 2014 Mar 26. pii: S0014-5793(14)00254-3. doi: 10.1016/j. febslet.2014.03.035. [Epub ahead of print] 17.Roberfroid M1, Gibson GR, Hoyles L, McCartney AL, Rastall R, Rowland I, Wolvers D, Watzl B, Szajewska H, Stahl B, Guarner F, Respondek F, Whelan K, Coxam V, Davicco MJ, Léotoing L, Wittrant Y, Delzenne NM, Cani PD, Neyrinck AM, Meheust A. Prebiotic effects: metabolic and health benefits. Br J Nutr. 2010 Aug;104 Suppl 2:S1-63. 18.Ye EQ, Chacko SA, Chou EL, Kugizaki M, Liu S Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain. J Nutr. 2012 Jul;142(7):1304-13 19.Babio N, Balanza R, Basulto J, Bulló M, Salas-Salvadó J.Dietary fibre: influence on body weight, glycemic control and plasma cholesterol profile. Nutr Hosp. 2010 May-Jun;25(3):327-40. 20.Wang H, Troy LM, Rogers GT, Fox CS, McKeown NM, Meigs JB, Jacques PF. Longitudinal association between dairy consumption and changes of body weight and waist circumference: the Framingham Heart Study. Int J Obes (Lond). 2014 Feb;38(2):299-305. 21.Block JP, Subramanian SV, Christakis NA, O’Malley AJ. Population trends and variation in body mass index from 1971 to 2008 in the Framingham Heart Study Offspring Cohort. PLoS One. 2013 May 10;8(5):e63217. 22.Jones, JM 2007. Mining whole grains for functional components. Food, Science and Technology Bulletin. foodsciencecentral.com. 23.Belobrajdic DP, Bird AR. The potential role of phytochemicals in wholegrain cereals for the prevention of type-2 diabetes. Nutr J. 2013 May 16;12:62. 24.Bartłomiej S, Justyna RK, Ewa N. Bioactive compounds in cereal grains occurrence, structure, technological significance and nutritional benefits a review. Food Sci Technol Int. 2012 Dec;18(6):559-68.