1.
[The efficacy and safety of testa triticum tricum purif in treatment of functional constipation in the late middle-aged and elderly patients: a multicenter randomized controlled clinical trial].
Fang, XC, Zhang, J, Liu, S, Xin, HW, Wang, J, Ba, Y, Fan, WJ, Han, SM, Wang, ZF, Xie, XP, et al
Zhonghua nei ke za zhi. 2017;(8):577-582
Abstract
Objective: To evaluate the efficacy and safety of testa triticum tricum purif for the treatment of functional constipation(FC) in the late middle-aged and elderly patients. Methods: This study was designed as a multicenter randomized controlled trial. Patients who met Rome Ⅲ diagnostic criteria of FC were enrolled, with age between 55-85 years old. Those with organic diseases were excluded. The patients were randomly allocated to receive testa triticum tricum purif (3.5 g bid) or polyethylene glycol 4000 powder (PEG4000, 10g bid) for 8 weeks, followed by single dose of maintenance therapy for 4 weeks. Follow-up visits were at 4 and 12 weeks after treatment discontinuation. The independent investigators in each center evaluated the constipation symptoms scores. The primary endpoints included rates of significant improvement, improvement and overall improvement at the end of 2, 4 and 8 weeks of therapy, which were calculated by the reduction of symptom scores ≥75%, 50%-74%, ≥25% respectively. Results: A total of 127 FC subjects were enrolled from 3 centers, and 122 cases valid for final analysis. The mean age was (69.4±6.9) years old, including 62 cases in testa triticum tricum purif group and 60 cases in PEG4000 group. The demographic data, constipated symptoms scores and proportion of FC subtypes at baseline were comparable. The rates of significant improvement, improvement and overall improvement in testa triticum tricum purif and PEG4000 groups at the end of 2, 4 and 8 weeks were 37.70% (23/61) vs 59.32% (35/59) (P=0.018), 57.38% (35/61) vs 74.14% (43/58) (P=0.054), and 64.41% (38/59) vs 79.31% (46/58) (P=0.073) respectively. Testa triticum tricum purif therapy significantly improved the proportion of spontaneous bowel movement(SBM) ≥3 times/week from 43.55% (27/62) to 80.33% (49/61), 83.61% (51/61) and 93.22% (55/59) at 2, 4, and 8 weeks respectively (all P<0.01), which were comparable with PEG4000 group (all P>0.05). The proportion of normalized stool forms in study group was significant higher than that of control group at the end of 8 weeks [86.44% (51/59) vs 67.24% (39/58), P=0.014]. Only one patient complained mild abdominal distension during testa triticum tricum purif therapy. Conclusions: The efficacy of testa triticum tricum purif for the treatment of FC in late middle-aged and older patients is comparable with osmotic laxatives PEG4000, which has significant effect on normalization of fecal forms and reliable safety.
2.
Nutritional characterization and measurement of dietary carbohydrates.
Englyst, KN, Liu, S, Englyst, HN
European journal of clinical nutrition. 2007;:S19-39
Abstract
Dietary carbohydrate characterization should reflect relevant nutritional and functional attributes, and be measured as chemically identified components. A nutritional classification based on these principles is presented, with a main grouping into 'available carbohydrates', which are digested and absorbed in the small intestine providing carbohydrates for metabolism, and 'resistant carbohydrates', which resist digestion in the small intestine or are poorly absorbed/metabolized. For the available carbohydrates, the chemical division into the starch and total sugars categories does not adequately reflect the physiological or nutritional attributes of foods. Characterizing carbohydrate release from starchy foods provides insight into some of the inherent mechanisms responsible for the varied metabolic effects. Also, a pragmatic approach to product signposting consistent with guidelines to limit free (or added) sugars is proposed. The most prominent of the resistant carbohydrates are the non-starch polysaccharides (NSP) from plant cell walls, which are characteristic of the largely unrefined plant foods that provide the evidence base for the definition and measurement of dietary fibre as 'intrinsic plant cell-wall polysaccharides' as proposed in conjunction with this paper and endorsed by the scientific update. Indigestibility in the small intestine was not considered to be an adequate basis for the definition of dietary fibre, as there is insufficient evidence to establish public health policy by this approach and concerns have been raised about potential detrimental effects of high intakes of rapidly fermentable resistant carbohydrates. Functional ingredients such as resistant starch and resistant oligosaccharides should therefore be researched and managed separately from dietary fibre, using specific health or function claims where appropriate. This structured approach to the characterization of nutritionally relevant features of dietary carbohydrates provides the basis for establishing population reference intakes, nutrition claims and food labelling that will assist the consumer with properly informed dietary choices.
3.
Intake of refined carbohydrates and whole grain foods in relation to risk of type 2 diabetes mellitus and coronary heart disease.
Liu, S
Journal of the American College of Nutrition. 2002;(4):298-306
Abstract
Recent survey data indicate that more than 50% of all adult Americans are overweight or obese. In parallel with this epidemic of weight gain in the general population, the incidence rate of type 2 diabetes mellitus (DM) is rapidly rising. Although their precise contributions are unclear, dietary factors are thought to affect body weight and the development of insulin resistance. Recent epidemiological data indicate that diets rich in high-fiber whole grains are associated with lower risk of coronary heart disease (CHD) and type 2 DM. These data are consistent with results from recent metabolic experiments, suggesting favorable lipid profiles and glycemic control associated with higher intake of whole grains, but not with refined grains. It seems prudent, therefore, to distinguish whole-grain rather than refined-grain cereal products for the prevention of chronic diseases.
4.
A prospective study of dietary fiber intake and risk of cardiovascular disease among women.
Liu, S, Buring, JE, Sesso, HD, Rimm, EB, Willett, WC, Manson, JE
Journal of the American College of Cardiology. 2002;(1):49-56
Abstract
OBJECTIVES This study was designed to examine the hypothesis that higher intake of dietary fiber is inversely related to the risk of cardiovascular disease (CVD) and myocardial infarction (MI) in a large prospective cohort of women. BACKGROUND Although dietary fiber has been suggested to reduce the risk of coronary disease, few prospective studies have examined the association between the types and amounts of dietary fiber and CVD risk, particularly among women. METHODS In 1993, we used a semi-quantitative food frequency questionnaire to assess dietary fiber intake among 39,876 female health professionals with no previous history of CVD or cancer. Women were subsequently followed for an average of six years for incidence of nonfatal MI, stroke, percutaneous transluminal coronary angioplasty, coronary artery bypass graft or death due to CVD confirmed by medical records or death certificates. RESULTS During 230,006 person-years of follow-up, 570 incident cases of CVD were documented, including 177 MIs. After adjustment for age and randomized treatment status, a significant inverse association was observed between dietary fiber intake and CVD risk. Comparing the highest quintile of fiber intake (median: 26.3 g/day) with the lowest quintile (median: 12.5 g/day), the relative risks (RR) were 0.65 (95% confidence interval [CI]: 0.51, 0.84) for total CVD and 0.46 (95% CI: 0.30, 0.72) for MI. Additional adjustment for CVD risk factors reduced the RRs to 0.79 (95% CI: 0.58, 1.09) for total CVD and 0.68 (95% CI: 0.36, 1.22) for MI. The inverse trends across categories generally remained, although they were no longer statistically significant. Inverse relations were observed between both soluble and insoluble fiber and risk of CVD and MI, and among those who had never smoked and those with body mass index <25. CONCLUSIONS A higher intake of dietary fiber was associated with a lower risk of CVD and MI, although the association was not statistically significant after further adjusting for multiple confounding factors. Nevertheless, these prospective data generally support current dietary recommendations to increase the consumption of fiber-rich whole grains and fruits and vegetables as a primary preventive measure against CVD.