Dietary Fiber in Health and Disease

GWUMC Department 01 Biochemistry Annual Spring Symposia

Series Editors: Allan L. Goldstein, Ajit Kumar, and George V. Vahouny The George Washington University Medical Center

DIET ARY FIBER IN HEAL TH AND DISEASE Edited by George V. Vahouny and David Kritchevsky

Dietary Fiber in Health and Disease

Edited by

George V. Vahouny The George Washington University Medical Center Washington, D.C.

and

David Kritchevsky The Wistar Institute Philadelphia, Pennsylvania

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Plenum Press New York and London

Library of Congress Cataloging in Publication Data

Main entry under title:

Oietary fiber in health and disease.

(GWUMC department of biochemistry annual spring symposia) Includes bibli9graphical references and index. 1. Fiber deficiency diseases. 2. High-fiber diet. I. Vahouny, George V., 1932-

11. Kritchevsky, Oavid, 1920- . 111. Series. [ONLM: 1. Oietary fiber-Congress-es. WB 427 0565] RC627.F5054 ISBN 978-1-4615-6852-0 DOI 10.1007/978-1-4615-6850-6

©1982 Plenum Press, New York

616.3'96 ISBN 978-1-4615-6850-6 (eBook)

Softcover reprint of the hardcover 1 st edition 1982

A Division of Plenum Publishing Corporation 233 Spring Street, New York, N. Y. 10013

All rights reserved

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Contributors

MARGARET J. ALBRINK Department of Medicine West Virginia University Medical Center Morgantown, West Virginia 26505

R. All Nutritional Research and Development Bristol-Myers International Division New York, New York 10154

JAMES W. ANDERSON Endocrine-Metabolic Section Veterans Administration Medical Center and Departments of Medicine and Clinical

Nutrition University of Kentucky College of Medicine Lexington, Kentucky 40511

LUIS ARIAS-AMADO Centro de Investigaci6n en Ciencas de la

Alimentaci6n Facultad de Medicina Veterinaria y Zootecnia Universidad de Guadalajara Guadalajara, Mexico

J. D. BAIRD Wolfson Gastrointestinal Laboratory Metabolie Unit, University Department of

Medicine Department of Clinical Chemistry Western General Hospital Edinburgh EH4 2XU, Seotland

P. C. BOYLE Department of Nutrition and Health Scienees General Foods Teehnieal Center Tarrytown, New York 10591

v

W. J. BRANCH Dunn Clinieal Nutrition Centre Old Addenbrookes Hospital Cambridge CB2 lQE, England

W.G.BRYDON Wolfson Gastrointestinal Laboratory Metabolie Unit, University Department of

Medicine Department of Clinical Chemistry Western General Hospital Edinburgh EH4 2XU, Scotland

MARIE M. CASSIDY Department of Physiology The George Washington University School of Medicine and Health Sciences Washington, D.C. 20037

JOHN H. CUMMINGS Dunn Clinieal Nutrition Centre Old Addenbrookes Hospital Cambridge CB2 lQE, England

N. T. DAVIES Rowett Research Institute Bucksburn, Aberdeen AB2 9SB, Scotland

M. A. EASTWOOD Wolfson Gastrointestinal Laboratory Metabolie Unit, University Department of

Medicine Department of Clinieal Chemistry Western General Hospital Edinburgh EH4 2XU, Seotland

vi

HUGH JAMES FREEMAN University of British Columbia Faculty of

Medicine (Gastroenterology) and Cancer Research Center

Vancouver, B.C., Canada V5Z lL3

PEDRO M. GARCiA L. Centrö de lnvestigaci6n en Ciencias de la

Alimentaci6n Facultad de Medicina Veterinaria y Zootecnia Universidad de Guadalajara Guadalajara, Mexico

PEDRO GARZON Laboratorio dei Bioqufmica Divisi6n de Biologfa dei Desarrollo Unidad de Investigaciones Biomedicas de

Occidente Instituto Mexicano dei Seguro Social Guadalajara, Mexico

M.HARTOG University Department of Medicine Bristol Royal Infirmary Bristol BS2 8HW, England

K. W. HEATON University Departrnent of Medicine Bristol Royal Infirmary Bristol BS2 8HW, England

S. HELLlWELL Wolfson Gastrointestinal Laboratory Metabolie Unit, University Department of

Medicine Departrnent of Clinical Chemistry Western General Hospital Edinburgh EH4 2XU, Scotland

C. L. HENRY University Departrnent of Medicine Bristol Royal Infirmary Bristol BS2 8HW, England

M. J. HILL Bacterial Metabolism Research Laboratory PHLS Centre for Applied Microbiology and

Research Salisbury SP4 010, England

MICHAEL J. KELLEY Department of Foods and Nutrition Purdue University West Lafayette, Indiana 47907

CONTRIBUTORS

JUNE L. KELSA Y Carbohydrate Nutrition Laboratory Beltsville Human Nutrition Research Center Human Nutrition, Science and Education

Administration U.S. Departrnent of Agriculture Beltsville, Maryland 20705

DAVID KRITCHEVSKY The Wistar Institute of Anatomy and Biology Philadelphia, Pennsylvania 19104

ANTHONY RICHARD LEEDS Department of Nutrition Queen Elizabeth College University of London London W8 7AH, England and Departrnent of General Medicine and

Endocrinology Central Middlesex Hospital London NWIO 7NS, England

G. A. LEVEILLE Department of Nutrition and Health Sciences General Foods Technical Center Tarrytown, New York 10591

FRED G. LIGHTFOOT Department of Anatomy The George Washington University School of Medicine and Health Sciences Washington, D.C. 20037

A. MANHIRE University Department of Medicine Bristol Royal Infirmary Bristol BS2 8HW, England

JUAN M. MUNOZ Fargo Clinic Fargo, North Dakota 58123

J. L. PRITCHARD Wolfson Gastrointestinal Laboratory Metabolie Unit, University Department of

Medicine Department of Clinical Chemistry Western General Hospital Edinburgh EH4 2XU, Scotland

BANDARU S. REDDY Naylor Dana Institute for Disease Prevention American Health Foundation Valhalla, New York 10595

CONTRIBUTORS

JOHN G. REINHOLD Centro de Investigaci6n en Ciencas de la

Alimentaci6n Facultad de Medicina Veterinaria y Zootecnia Universidad de Guadalajara Guadalajara, Mexico

BARBARA OLDS SCHNEEMAN Departmentsof Nutrition and Food Science

and Technology University of California Davis, California 95616

J. H. SMITH West Granton Medical Group Edinburgh EH4 4PL, Scotland

D. A. T. SOUTHGATE Nutrition and Food Quality Division Agricultural Research Council Food Research Institute Norwich NR4 7UA, England

GENE A. SPILLER Department of Biology Mills College Oakland, California 94613

H.STAUB Department of Nutrition and Health

Sciences General Foods Technical Center Tarrytown, New York 10591

JON A. STORY Department of Foods and Nutrition Purdue University West Lafayette, Indiana 47907

JAMES N. THOMAS Department of Foods and Nutrition Purdue University West Lafayette, Indiana 47907

IRMA H. ULLRICH Department of Medicine West Virginia University Medical Center Morgantown, West Virginia 26505

GEORGE V. VAHOUNY Department of Biochemistry The George Washington University School of Medicine and Health Sciences Washington, D.C. 20037

vII

Preface

Dietary fiber is a topic that has burgeoned from an esoteric interest of a few research laboratories to a subject of international interest. This growth has been helped by the intense public interest in the potential benefits of adding fiber to the diet. The general popularity of fiber may have been helped by the perception that, for once, medicine was saying "do" instead of "don't." There has been a proliferation of excellent scientific books on dietary fiber. Why another?

The Spring Symposium on Dietary Fiber in Health and Disease was an outgrowth of our belief that informal discussion among peers-a discussion in which fact is freely interlaced with speculation-was the most effective way to organize our knowledge and direct our thinking. The normal growth progression of a discipline inc1udes its branching into many areas. Soon the expertise, which was once general, is broken into many specialties. Intercommunication becoIlles increasingly difficult. It was our intent to provide a forum that would expose its participants to developments in areas related to their research interest. Free exchange under these conditions could not help but broaden everyone's knowl­edge and expand his horizons.

We feel that this symposium was singularly successful in achieving its goals. It resulted in a free and friendly exchange of knowledge and ideas. It helped to establish seeds for future collaborations based on mutual interest and friendship. The proceedings of this conference will serve as yet another basic resource in the fiber field.

The volume opens with a discussion of definitions and terminology-ours is a field in which we all recognize the subject of our research but cannot name it adequately.

Chapters on the effect of fiber on colonic function are followed by discus­sions of fiber and its effects on nutrients, with special reference to trace minerals. Metabolie aspects of fiber ingestion are covered in chapters on obesity and diabetes. These are followed by discussions of lipids and lipid metabolism. The

Ix

x PREFACE

c10sing chapters are devoted to dietary fiber and cancer. In all , this volume represents a state-of-the-art report as of the date of the conference. State-of-the­art quickly becomes obsolete in rapidly developing areas of research, but this meeting inc1uded enough basic background and future direction to provide a valuable, lasting reference.

We also feel that homage should be paid to the scientists who have done so much to popularize the metabolic aspects of dietary fiber and to establish its place in the field of nutrition. Surgeon Captain T. L. Cleave propounded much of the basic theory in his paper entitled "The Neglect of Natural Principles in Current Medical Practice," which appeared in the Journal 0/ the Royal Naval Medical Service in 1956 (Vol. 42, p. 55). Cleave's hypothesis was refined, confirmed, and expanded, principally by Denis Burkitt, but also by Hugh Trowell and A. R. P. Walker. Clearly, dietary fiber is not a panacea, but its place in nutrition has been established through the efforts of many, inc1uding the scientists cited.

We are particularly grateful for the important suggestions and valuable contributions of several colleagues during the organization of the conference. These inc1uded Drs. M. M. Cassidy, M. J. HilI, R. Kay, D. Southgate and G. Spiller. The organizers of the conference are indebted to the George Washington University and to I. T. T. Continental Baking Company for their continued interest and support not only of this conference, but of other research and com­munication activities in the area of human nutrition and pathophysiology. We are also indebted to Mrs. Fran Nigro for assistance in the preparation of the index.

George V. Vahouny David Kritchevsky

Contents

Chapter 1

Definitions and Terminology of Dietary Fiber . ..................... . D. A. T. Southgate

Chapter 2

Consequences of the Metabolism of Fiber in the Human Large Intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 9

lohn H. Cummings

Chapter 3

Dietary Fiber and Colon Function in a Population Aged 18-80 Years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 23

M. A. Eastwood, l. D. Baird, W. G. Brydon, l. H. Smith,

S. Helliwell, and l. L. Pritchard

Chapter 4

Colonic Bacterial Activity: Effect of Fiber on Substrate Concentration and on Enzyme Action . . . . . . . . . . . . . . . . . . . . . . . . . . .. 35

M. l. Hili

Chapter 5

Digestion and Absorption of Nutrients . . . . . . . . . . . . . . . . . . . . . . . . . . .. 45 D. A. T. Southgate

xl

xII CONTENTS

Chapter 6

Modification of Intestinal Absorption by Dietary Fiber and Fiber Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 53

Anthony Richard Leeds

Chapter 7

Pancreatic and Digestive Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 73

Barbara Olds Schneeman

Chapter 8

Interactions of Dietary Fiber and Nutrients . . . . . . . . . . . . . . . . . . . . . . .. 85

luan M. Munoz

Chapter 9

Effects of Fiber on Mineral and Vitamin Bioavailability ............. 91

lune L. Kelsay

Chapter 10

Effects of Phytic Acid on Mineral Availability ..................... 105

N. T. Davies

Chapter 11

Dietary Fiber-Iron Interactions: Fiber-Modified Uptakes of lron by

Segments of Rat Intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 117 lohn G. Reinhold, Pedro M. Garda L., Luis Arias-Amado, and

Pedro Garzon

Chapter 12

Fiber, Obesity, and Diabetes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 133

David Kritchevsky

Chapter 13

Dietary Fiber and Obesity: A Review. . . . . . . . . . . . . . . . . . . . . . . . . . .. 139

R. AU, H. Staub, G. A. Leveille, and P. C. Boyle

CONTENTS xIII

Chapter 14

Dietary Fiber and Diabetes .................................... 151

farnes W. Anderson

Chapter 15

Effect of Dietary Fiber on Lipids and Glucose Tolerance of Healthy

Young Men .................................................. 169

Margaret f. Albrink and 1rrna H. Ullrich

Chapter 16

Does Simple Substitution of Fiber-Rich Foods for Refined Foods

Aid in the Treatment of Diabetes Mellitus? . . . . . . . . . . . . . . . . . . . . . .. 183

K. W. Heaton, A. Manhire, C. L. Henry, and M. Hartog

Chapter 17

Fiber and Lipids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 187

David Kritchevsky

Chapter 18

Modification of Bile Acid Spectrum by Dietary Fiber. . . . . . . . . . . . . .. 193

fon A. Story and farnes N. Thornas

Chapter 19

Dietary Fibers and Intestinal Absorption of Lipids ................. 203

George V. Vahouny

Chapter 20

Dietary Fiber and Lipoproteins ................................. 229

fon A. Story and Michael f. Kelley

Chapter 21

Colon Cancer and Dietary Fiber: An Overview . . . . . . . . . . . . . . . . . .. 237

Gene A. Spiller

xlv CONTENTS

Chapter 22

Dietary Fiber, Bile Acids, and Intestinal Morphology .............. 239

Marie M. Cassidy, Fred G. Lightfaat, and Gearge V. Vahauny

Chapter 23

Dietary Fiber and Colon Carcinogenesis: A Critical Review . ....... 265

Bandaru S. Reddy

Chapter 24

Studies on the Effects of Single Fiber Sources in the Dimethylhydrazine Rodent Model of Human Bowel Neoplasia . ..... 287

Hugh lames Freeman

Chapter 25

Bile Acids and Human Colorectal Cancer . ....................... 299 M. l. Hili

Chapter 26

Postulated Mechanisms whereby Fiber May Protect against Large

Bowel Cancer . ............................................... 313

lahn H. Cummings and W. l. Branch

Index ....................................................... 327