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Benefits of Talking
Wheat Bran
Digestive health is top of mind for Canadians!
Market research indicates that consumers continue
to look for strategies to help manage functional
digestive concerns such as constipation, bloating
and cramping.
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A recent report on health concerns and habits of consumers has placed
digestive health as a top health and nutrition trend in 2012 (Mellentin, 2011). In
managing their digestive health, consumers are increasingly looking for food
remedies rather than pills or supplements. Furthermore, a related trend is “feelthe-benefit”, which refers to a demand for foods that produce health benefits
that can be felt or measured. For digestive health, foods that contain dietary
fibre such as wheat bran can facilitate “feeling good” by promoting regularity.
Foods that…
• deliver on fibre content
• contain wheat bran or other dietary fibres that promote
digestive regularity
• are consumed on a regular basis
…can deliver on “feel-the-benefit” for digestive health
By educating clients on this “feel-the- benefit” aspect of fibre, dietitians can
help improve fibre intakes. Together with insights from market research, this
approach may resonate with patients and encourage them to consume more
fibre as a healthy dietary habit.
Effects of Wheat Bran Fibre on
Gastrointestinal Regularity
Studies have demonstrated that wheat bran fibre consistently improves
regularity, which is measured by stool weight, stool consistency and
gastrointestinal (GI) transit time. As pioneers in the field, Cummings and his
group first described the relationship between wheat bran fibre and regularity
in the 1970s. In one study, they showed that the addition of 28 g of wheat fibre
to the diet (doses ranging from 17 g to 45 g per day) increased stool weight
from 79 g to 228 g per day and decreased transit time from 58 hrs to 40
hrs (Cummings et al., 1976). In a follow up study, wheat bran fibre induced a
greater increase in fecal weight and reduction in transit time, compared with
carrot, cabbage or apple fibre (Cummings et al., 1978).
Fecal Weight
Treatment
GI Transit Time
Control
Diet
Fibre
Diet Effect
of Fibre
Control
Diet
Fibre
Diet
Effect
of Fibre
Bran 95 g
197 g
102 g
73 hrs
43 hrs
30 hrs
Carrot
117 g
189 g
72 g
60 hrs
50 hrs
10 hrs
Cabbage
88 g
143 g
55 g
80 hrs
64 hrs
16 hrs
Apple
141 g
203 g
62 g
50 hrs
43 hrs
7 hrs
Cummings et al., 1978
The Constipation
Problem
Although Canadian statistics
regarding digestive health are
sparse, a nationwide survey found
that constipation is a common
health concern, which often leads
Canadians to seek medical attention
(Pare et al., 2001). Of 1149 subjects
randomly surveyed across Canada,
27% and 39% reported constipation
within the past 3 months and
12 months, respectively. Moreover,
34% of the subjects who reported
constipation in the past 3 months had
visited a physician due to constipation,
and 34% had used laxatives as a
therapeutic strategy. Women were
twice as likely to seek medical
attention for constipation compared
with men (37% vs. 20%). Women 65
years or older also had the greatest
likelihood (51%) of visiting a medical
practitioner for constipation.
This Canadian study was included
in a more recent literature
review on the prevalence of
constipation in North America
(McCrea et al., 2009). Depending
on the definition of constipation
and the population sampled, the
prevalence of constipation in North
America varied between 2% and 28%
among the studies; however, gender
and age trends in the prevalence
of constipation were generally
consistent across the studies. The
authors concluded that constipation
prevalence is consistently higher
in women compared with men;
and across genders, prevalence
increases gradually to the age of 50,
with the largest increase after the
age of 70.
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Since the early work of Cummings and his group, researchers have replicated
this work and continue to study the benefits of dietary fibre on regularity.
Investigating the benefits of wheat bran and psyllium fibres, researchers have
demonstrated that wheat bran fibre (29 g per day) from a breakfast cereal
increased stool weight by 71 g per day (Vuksan et al., 2008). This effect was
further enhanced when 7 g of psyllium fibre was combined with 22 g wheat
bran fibre, which increased stool weight by 119 g per day. Compared with
controls, wheat bran and wheat bran plus psyllium combinations reduced transit
time by 10 hrs and 12 hrs, respectively.
How Wheat Bran Fibre Modulates
Gastrointestinal Regularity
For the most part, wheat bran fibre is not
fermented by colonic microflora in the large
intestine. It modulates regularity by binding
and trapping water within the lumen, which
increases the bulk of luminal content, and
in turn, promotes its peristaltic movement
through the large intestine. With a reduced
transit time of fecal matter through the large
intestine (the content moves through faster),
less water is able to be re-absorbed by
the epithelium and stool bulk is increased.
Laxation is facilitated by both of these effects.
The Use of Wheat Bran Fibre to Treat Constipation
in Various Population and Patient Groups
Children
Constipation is a common childhood problem and an increase in dietary fibre is widely recommended as a first
treatment step. A recent study evaluated whether a fibre-rich diet containing wheat bran could be effectively applied
to children (Maffei and Vicenti, 2011). After two years of collecting information on the dietary intake and bowel habits
of 28 constipated children, researchers concluded that a diet containing wheat bran was a feasible and economical
tool to treat childhood constipation. However, frequent reinforcement with the children on the importance of bran was
required in order to ensure dietary adherence.
Post-surgical Patients
Orthopedic surgery patients can become constipated during post-operative recovery for various reasons, including
increased pain, pain medications and decreased mobility. Wheat bran plus Colace was compared with Metamucil®
plus Colace as strategies for preventing constipation in patients who underwent orthopaedic surgery (Groth, 1988).
Results showed that compared with Metamucil® plus Colace, wheat bran plus Colace facilitated softer, more
well-formed stools and resulted in a decreased need for suppositories, enemas and laxatives. The recommendations
from this study were that orthopedic patients should initiate the use of wheat bran as soon as they are able to tolerate
a regular diet following surgery, rather than waiting until constipation prevails.
Pregnancy
It is not unusual for a woman to complain of constipation when pregnant. In a review paper on interventions
for treating constipation in pregnancy, it has been suggested that a contributing factor is increased circulating
progesterone levels during the second and third trimester of pregnancy (Jewell and Young, 2009). This review
concluded that bulk forming supplements such as bran are effective as an initial treatment strategy for reducing
constipation in pregnant women; and if constipation persists, stimulant laxative therapy can be implemented.
The Geriatric Population
Constipation is a considerable problem in the elderly due to various issues, including decreased physiological
function, lower physical activity and medications. Using a cross-over design, researchers have compared bulk
laxatives and wheat bran (20 g per day) in 10 constipated geriatric patients over two, 8-week treatment periods
(Andressen et al., 1979). Results demonstrated that when receiving laxatives, transit time was 126 hrs compared
with 89 hrs for wheat bran.
The Bottom Line
Digestive health is a top trend and Canadians seek foods as opposed to pills
or supplements to facilitate digestive benefits that they can “feel.” No where
is this trend more relevant than in constipation, a major digestive ailment.
Wheat bran is effective in treating constipation generally, as well as in
specific population and patient groups. During education sessions with
patients, emphasizing the “feel-the-benefit” aspect of dietary fibre,
particularly of wheat bran in regularity, dietitians can improve the willingness
of patients to increase daily dietary fibre intake.
The Registered Dietitians
at Kellogg Canada invite you
to take the Wheat Bran Challenge!
Anderssen H et al. Transit time in constipated
geriatric patients during treatment with a bulk laxative
and bran: A comparison. Scand J Gastroenterol
14(7):821-6 (1979)
Cummings JH et al. Changes in fecal composition
and colonic function due to cereal fiber. Am J Clin
Nutr 29(12):1468-73 (1976)
Cummings JH et al. Colonic response to dietary fibre
from carrot, cabbage, apple, bran. Lancet 1(8054):5-9
(1978)
Groth F. Effects of wheat bran in the diets of
post-surgical orthopaedic patients to prevent
constipation. Orthop Nurs Jul-Aug;7(4):41-6 (1988)
Jewel D and Young G. Interventions for treating
constipation in pregnancy. Cochrane Database
Syst Rev. 1:1-11 (2009)
Maffei HVL et al. Prospective evaluation of dietary
treatment in childhood constipation: High dietary
fiber and wheat bran intake are associated with
constipation amelioration. J Pediatr Gastroenterol
Nutr 52: 55–9 (2011)
McCrea GL et al. A review of the literature on gender
and age differences in the prevalence and
characteristics of constipation in North America.
J Pain Symptom Manage 37(4):737-45 (2009)
Mellentin J. 10 Key Trends for 2012. New Nutrition
Business. 17(3):7-14 (2011)
Pare P et al. An epidemiological survey of
constipation in Canada: Definitions, rates,
demographics, and predictors of health care seeking.
Am J Gastroenterol 96(11):3130-7 (2001)
Vuksan V et al. Using cereal to increase dietary fiber
intake to the recommended level and the effect of
fiber on bowel function in healthy persons
consuming North American diets. Am J Clin Nutr 88:
1256–62 (2008)
Eat at least 4 grams of wheat bran every day for two weeks
Sources of wheat bran fibre in cereals that can help you along…
≥ 7 grams Wheat Bran fibre
per serving
4-6 grams Wheat Bran fibre
per serving
All-Bran Flakes* All-Bran* Strawberry Bites
Mini-Wheats*
All-Bran Buds*
All-Bran Original*
After you “feel-the-benefit”, share your creative ideas that may help
Canadians eat more wheat bran each day. Email your “wheat bran words
of wisdom” to [email protected] for your
chance to win a year’s supply of any Kellogg products!
Kellogg Canada publishes quarterly newsletters on topics that are relevant to healthcare professionals.
The newsletters are available at www.kelloggnutrition.ca/professional.
The editor of the Kellogg’s* Nutrition newsletters is Loretta DiFrancesco, PhD, RD, MBA of Source! Nutrition®.
* © 2012, Trademark of Kellogg Company used under licence by Kellogg Canada Inc. | Summer 2012
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