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Dietary fibre and human health

Article  in  International Journal of Food Safety Nutrition and Public Health · January 2012
DOI: 10.1504/IJFSNPH.2011.044528

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Int. J. Food Safety, Nutrition and Public Health, Vol. 4, Nos. 2/3/4, 2011 101

Dietary fibre and human health

Vikas Rana*
Bio-prospecting and Indigenous Knowledge Division,
Rain Forest Research Institute,
P.O. Box No. 136, Jorhat, Assam, India
Fax: +91-376-2350274
E-mail: ranav@icfre.org
E-mail: vikasranaji@gmail.com
*Corresponding author

Rakesh Kumar Bachheti

Department of Chemistry,
Graphic Era University,
Clement Town, Dehradun, Uttarakhand, India
Fax: 91-135-2644025
E-mail: rkbachheti@gmail.com

Tara Chand
Biotechnology and Genetics Division,
Rain Forest Research Institute,
P.O. Box No. 136, Jorhat, Assam, India
Fax: +91-376-2350274
E-mail: tarachand@icfre.org

Anjan Barman
Department of Biotechnology,
Pandu College,
Guwahati, 781012, Assam, India
E-mail: anjbth@gmail.com

Abstract: Food habits of new lifestyle have contributed to the appearance of

chronic diseases such as obesity or cardiovascular diseases, which are mainly
due to bad eating habits. Solutions can be found in providing the consumers
with functional foods and health capability. Such food is rich in dietary fibre,
with specific physicochemical behaviour and healthy properties. Dietary fibre
rich food products are associated with physiological actions in the small and
large intestine, having important implications in human health. These
properties include water dispersibility and solubility, viscosity effects, bulk,
absorption and fermentability, and binding of other compounds. These
properties may lead to various physiological actions such as reducing
cholesterol and attenuating blood glucose, maintaining gastrointestinal health,
and positively affecting calcium bioavailability and immune function.
Moreover, based on their physiochemical properties, many of the new sources

Copyright © 2011 Inderscience Enterprises Ltd.

102 V. Rana et al.

of dietary fibre can help to improve the health benefits of new generations. This
review paper gives an overview of occurrence, structures and various
physiological effects of dietary fibres.

Keywords: dietary fibre; DF; dietary recommendation; carbohydrates;

polysaccharides; blood glucose; heart disease; health.

Reference to this paper should be made as follows: Rana, V., Bachheti, R.K.,
Chand, T. and Barman, A. (2011) ‘Dietary fibre and human health’, Int. J.
Food Safety, Nutrition and Public Health, Vol. 4, Nos. 2/3/4, pp.101–118.

Biographical notes: Vikas Rana is a Polysaccharide Chemist. He graduated

from the M.J.P. Rohilkhand University, India. He obtained his Masters in
Organic Chemistry from the same university in the year 1999. He obtained his
Doctorate degree in Forest Products Chemistry from the Forest Research
Institute, Dehradun in 2007. He was also involved at Forest Research Institute
in the development of low viscosity dietary fibre from guar/cassia tora gums.
He started his career as a Lecturer in Uttaranchal Institute of Technology,
Dehradun, India. He joined Indian Council of Forestry Research & Education
(ICFRE) as a Plant Chemist in the year 2008. Currently, he is working as a
Scientist at Rain Forest Research Institute (ICFRE), Jorhat, Assam. His present
areas of interest include polysaccharides, dietary fibre and protein chemistry.

Rakesh Kumar Bachheti graduated from the Hemwati Nandan Bahuguna

University, Garhwal, in 1996. He obtained his MSc in Organic Chemistry from
Hemwati Nandan Bahuguna University, Garhwal, in 1998. He had undergone
one-year Post Graduate Diploma in Pulp and Paper Technology from Forest
Research Institute (F.R.I.), Dehradun, in 2001. He obtained his PhD in Organic
Chemistry from Kumaun University, Nainital, India in 2007. He has been an
academic member of Graphic Era University, Dehradun since 2008. His recent
researches involve chemistry of natural products. He is also a member of board
of studies and editorial board of Journal of Graphic Era University. He is also
a member in the list of external examiner of Hemwati Nandan Bahuguna
University.

Tara Chand obtained his BSc in Forestry from the Dr. Y.S Parmar University
of Horticulture and Forestry in 2000. He obtained his MSc in Forestry from the
University of Agricultural Sciences Dharwad, Karnatka, India in 2003. Also,
he obtained his PhD in Forestry from the Dr. Y.S Parmar University of
Horticulture and Forestry in 2008. His recent research involves genetic
improvement of trees and bamboos.

Anjan Barman obtained his Masters in Biotechnology from the Tezpur

University, India. Currently, he is working as a Lecturer of Biotechnology in
the Pandu College of Guwahati, India.

1 Introduction

Historically the term dietary fibre (DF) has been used to define a collection of
plant-based cell wall materials. According to the American Association of Cereal
Chemists (AACC, 2000), DF is the edible part of plant or analogous carbohydrates that
are resistant to digestion and adsorption in the human intestine with complete or partial
fermentation in the large intestine. DF includes polysaccharides, oligosaccharides, lignin
 Dietary fibre and human health 103

and associated plant substances. DF promotes beneficial physiological effects, such as

laxation, and or blood cholesterol attenuation (Anon., 2001). Clinical studies consistently
show that the intake of viscous DF decreases the low density lipoprotein cholesterol and
postprandial glucose levels, and induces short term satiety. Further, few clinical trials
have demonstrated that the intake of DF has a positive effect on the control of diabetes
and body weight (Anderson et al., 2009).
This definition links the chemical composition of fibre to its physiological effects. At
the same time it includes all non-starch polysaccharides (NSP) resistant to digestion in
the small intestine and is fermentable in the large intestine (cellulose, hemicelluloses,
pectins, modified celluloses, oligosaccharides, and polyfructans such as inulin, gums, and
mucilages). It also includes oligosaccharides and polysaccharide components bound to
the plant cell wall (lignin, waxes, cutin and suberin). Materials with analogous
characteristics to DF are included in the new definition under the term of analogous
carbohydrates.
Important constituents of DF is summarised in Table 1, which relates actual plant
components to demonstrable physiological effect (Brennan and Tudorica, 2007).

Table 1 Constituents of dietary fibre

Dietary fibre
Non-starch polysaccharide
Analogous carbohydrates Lignin
and resistant oligosaccharides
Cellulose Indigestible dextrins Waxes
Hemicellulose Resistant maltodextrins Phytates
Arabinoxylans Resistant potato dextrins Cutins
Arabinogalactans Synthetic gums Saponins
Polyfructose Polydextrose Suberin
Inulin Methyl cellulose Tanins
Oligofructans Hydroxymethyl propyl cellulose
Galactooligosaccharides Indigestable starches
Gums
Mucilages
Pectins

DF can be separated into two basic types based on its properties and effects on the body.
These two types are insoluble and soluble fibre. Insoluble fibres, such as cellulose,
hemicellulose, and lignin, do not dissolve in water. Insoluble fibres are found in foods
such as wheat bran, whole grains, and vegetables. Insoluble fibres absorb water and
increase the intestinal bulk, which helps the intestine function properly.
Soluble fibres, such as gum and pectin, dissolve in water and are found in beans, oats,
barley, some fruits and vegetables. Soluble fibres may play a role in lowering blood
cholesterol and in regulating the body’s use of sugar.
Plant foods are the only source of dietary fibre. The best sources of fibre are whole
grain breads and cereals, fruits and vegetables, and dried beans and peas. These foods
provide both soluble and insoluble fibres (Table 2).
104 V. Rana et al.

Table 2 Food source of dietary fibre

Insoluble fibre Soluble fibre

Cellulose Hemicellulose Lignin Gum Pectins
Whole wheat flour Bran cereals Bran cereals Oatmeal Squash
Unprocessed bran Whole grains Unprocessed bran Rolled oat products Apples
Cabbage Brussels sprouts Strawberries Dried beans Citrus fruit
Peas Mustard greens Eggplant Cauliflower
Green beans Beet root Pears Carrots
Wax beans Green beans Strawberries
Broccoli Radishes
Cucumber with skin
Green peppers
Apples
Carrots

DF has been considered to be an inert carbohydrate fraction with little nutritional value;
however current research has shown it as an essential component of the human diet. The
consumption of food rich in DF has been associated with decreased risk of developing
diet related chronic diseases (WHO, 2003) and the physiological effects are usually
compared with intakes or contents of total dietary fibre (TDF).
However, the reliance on TDF fraction is simplistic as DF refers to a large number of
substances encompassing very diverse macromolecules, which also exhibit a large variety
of physiochemical properties. As a result of compositional variations, different sources of
DF have different metabolic and physiological effect depending upon the chemical and
physical properties of the DF.
The physiological response to specific fibres can be understood with the help of these
properties and is listed in Tables 3 and 4 (Schneeman, 1999).

Table 3 Properties of dietary fibre and their response to small intestinal functions

Characteristic Response to small intestine Physiological implication

Water dispersibility Increases volume in the intestinal
contents; dilution of compounds.
Bulk Expands bulk material phase of
contents; alters mixing of contents.
Viscosity Slow gastric emptying; alters
mixing and diffusion.
Adsorb/bind compounds Increased excretion of bile acids
and other bound compounds.
Slower digestion of carbohydrate
and lipids, which promotes
nutrient absorption more distal in
the intestine and is associated
with reduction of plasma
cholesterol and blunting the
glucose and insulin response to a
carbohydrate load and satiety.
Reduction in plasma cholesterol
 Dietary fibre and human health 105

Table 4 Properties of dietary fibre and their response to large intestinal functions

Characteristic Response to small intestine Physiological implication

Water dispersibility Provides an aqueous phase
for penetration of microbes.
Bulk Increases material entering
the large intestine; affects
mixing of contents.
Viscosity Increase the amount of bile
acids in the large bowel.
Adsorb/bind compounds Growth of microflora;
microbial adaptation to
polysaccharide substrates.
Increases microbial breakdown
of polysaccharide structure.
Provides substrate for
microflora; aids laxation.
Excretion is increased;
opportunity for microbial
modification of bile acids.
Increased microbial mass
and products of metabolism.

2 Structural aspects of dietary fibre

DF includes primarily polysaccharides, but also oligosaccharides and substances from

plant cell walls associated with the NSP. The common characteristics are that these
escape digestion in the small intestine and reaches the large intestine, where a proportion
undergo fermentation; hence the intrinsic effect on metabolism and disease risk are likely
to be mediated through their properties as they pass through the gastrointestinal tract. The
majority of DF constituents are represented by carbohydrates: poly and oligosaccharides
(Robertson et al., 2000). Similar to oligosaccharides, polysaccharide molecules are
composed of glycosil units in linear or branched arrangements. The degree of
polymerisation (DP) varies from less than 100 (only a few of them) to 10,000–15,000
(cellulose) with the majority of DF having a DP ranging between 200 and 3,000. Each
type of polysaccharide is characterised by its monosaccharide unit and the nature of
linkages between them.
The physical properties of polysaccharides are dominated by their conformation
(sometimes described as ordered or disordered ‘random coil’ chain geometry) and the
way they interact with one another. The chemical structures and chain conformations of
DFs dictate their physical characteristics, which may have profound effects on their
physiological role as constituents of digest, and may induce both local and systemic
responses. Some of the most important physical characteristics of DF include: hydration
properties, solubility/dispersability in water, rheological properties, bulk due to
non-digestibility, the ability to adsorb bile acids, fermentability by gut microflora and
surface area characteristics.

3 Physiological effects of dietary fibre

DF has important benefits in nutrition and health. DF has preventive health benefits for
many conditions, including diverticular disease, colon cancer, heart disease, and diabetes.
Interestingly, a multi-centric case-control study conducted in Italy manifested a beneficial
role of dietary fibres on renal cell cancer risk (Galeone, 2007). Health benefits of isolated
and intrinsic DF have been discussed in numerous reviews and books published during
106 V. Rana et al.

the two decades (Carnovale et al., 1995; Champ et al., 2003; Cherbut et al., 1995; Guillon
et al., 1998; Mälkki and Cummings, 1996; McCleary and Prosky, 2001) but these will not
be detailed in the present review.

3.1 Effect of fibre on digestive system

DF has health benefits through its effect on the digestive system. A high-fibre diet helps
relieve constipation. Both types of fibre play important roles in the digestive tract.
Insoluble fibre draws water from the system and increases the bulk and softness of the
food mass in the intestine. This decreases the time it takes to travel through the digestive
system, making elimination easier. Soluble fibre seems to delay the digestion and
absorption of nutrients and alters the action of digestive enzymes and hormones.

3.1.1 Fibre, colonic motility and faecal energy excretion

The most convincing evidence, that dietary fibre has an important role in the maintenance
of normal health, relates to its effects on colonic motility. The various components of
dietary fibre, especially those associated with resistant starch, reach the large intestine
virtually unchanged (Baghurt et al., 2001). Fibre has been shown to speed up intestinal
transit time when it is slow, slow it down when it is fast, and enlarge small stools and
moderate high pressures. Increasing the fibre content of the diet increases the faecal
energy excretion, principally in the form of fat and nitrogen. By virtue of its water
holding capacity, fibre also helps in the formation of soft stools with bulk, which can be
easily evacuated. Research suggests that fibre from different sources differ in its ability to
increase stool weight. Cereal fibre in the form of bran increases stool weight more than
most other fibre sources. The larger the particle size of the bran, the more effective it is.
In old age constipation problems increased dietary fibre intake is recommended for
smooth colon functioning (Hsieh, 2005).
Fibre affects each phase of gastrointestinal motility differently; however, the most
dramatic effect on decreased transit time and frequency of bowel movements results from
the variations it causes in colonic transit time (Hillemeier, 1995).
High-fat intake has been correlated to the incidence of colon cancer. A high-fibre,
low-fat diet may reduce the risk of colon cancer in several ways. First, fibre absorbs
water, lowering the concentration of potential carcinogenic (cancer causing) substances
in the intestine. Second, since insoluble fibre speeds up the movement of waste material
in the intestine, the colon is exposed to any cancer causing substance in the intestine for a
shorter length of time. Finally, fibre is adjuvant to better gastro-intestinal movement and
results to better defecation with constipation relief and less opportunity of large intestinal
cancer (Jitpukdeebodintra and Jangwang, 2009).

3.1.2 Fibre and weight reduction

An increased intake of DF appears to be useful for the treatment of both obesity and
diabetes mellitus (Mehta, 2005, 2009). Fibre-rich food is usually satisfying without being
calorically dense. Supplementing a normal diet with gel-forming fibres, such as guar
gum, leads to an increased satiation probably due to a slower gastric emptying (Smith,
1987).
 Dietary fibre and human health 107

Recent long-term studies have confirmed the usefulness of viscous fibres as an

adjunct to the regular dietary management of obesity (Mors et al., 2000). Apart from the
beneficial effect of caloric restriction, DF may improve some of the metabolic aberrations
seen in obesity (Mälkki, 2004). Gel forming fibres are particularly effective in reducing
elevated LDL-cholesterol without changing the HDL-fraction. The impaired glucose
tolerance of diabetes manifest is also improved. These effects are probably in part
associated with the gelling property of the fibre, which leads to an increased viscosity of
the unstirred layer thereby delaying the absorption process (Smith, 1987). However, it
has been shown that dietary guar gum supplementation is unable to reduce
insulin resistance in gross obesity if the overweight status is constantly maintained
(Cavallo-Perin et al., 1985). DF or foods containing a high amount of DF are very low in
caloric content. DF yields only 2–3 calories/g (Pomare, 1977). Thus, a high-fibre diet is
recommended for weight reducing regimes.

3.1.3 Fibre and rectal disorders

A large number of patients suffer from a variety of anal and lower rectal disorders and
most find treatment with a high-fibre diet very beneficial. A soft formed stool, which can
be easily passed without straining, usually produces an improvement in the symptoms
resulting from these disorders. Most patients with haemorrhoids present with bright red
anal bleeding after defaecation. Bleeding and prolapse are often precipitated by a period
of constipation and it is possible that straining at stools is the cause of this condition.
High-fibre diet prevents constipation and helps to relieve this condition (Bassotti et al.,
2003).

3.1.4 Fibre and bowel function

DF consists of water-soluble and insoluble plant compounds that are resistant to digestion
by small bowel enzymes but is fermented to varying degrees by colonic bacteria. DFs are
fermented by the microbial flora in colon. Short chain fatty acids (SCFA) are one of the
major components in the products produced after fermentation and are also responsible
for the lowering of pH in colon. This is beneficial to health because the reduced pH
creates an environment that prevents the growth of harmful bacteria (MacFarlans and
MacFarlans, 2003; Nugent, 2005; Topping and Clifton, 2001). Many physiological
effects of fibre may be related to the degree of fermentation. An increase in DF increases
stool weight and the number of defaecations and decrease bowel transit time.
DF increases the bulk of the faecal mass by virtue of their water holding capacity and
the stools therefore become bulkier and most moist. High-fibre diets therefore go a long
way in the prevention and cure of constipation. As the contents move rapidly, it reduces
the transit time in the colon thereby resulting in reduced re-absorption of water from the
colon, again contributing to bulkier and moistened stools (Southgate and Penson, 1983).
Studies on human subjects have concluded that TDF given at doses ranging from 20–26 g
helps to normalise and improve bowel function by decreasing the incidence of
constipation in elderly population (Dahl et al., 2003; Khaja et al., 2005).
The products of fermentation like the SCFA also help to accelerate the movement of
the faeces through the colon. This action coupled with the additional unfermentable
residue increase the faecal bulk. Fermentation of soy fibre leads to higher proportions of
propionate and butyrate than do fermentation of other substrates. Similarly, ferment at ion
108 V. Rana et al.

of gums leads to more propionate and butyrate production than do apple pectin. It may be
possible to select fibre sources capable of supporting stipulated amounts of both total and
individual SCFA production in the human colon (Titgemeyer et al., 1991).

3.1.5 Diverticular disease

Diverticular disease is characterised by protrusions or out-pouches in the wall of the
colon. These pouches, or diverticula, are believed to develop from excessive pressure,
which weakens the wall of the colon. In many cases, there are no obvious symptoms but
in some people the diverticula become inflamed and painful. High-fibre foods may help
in the prevention of diverticular disease by making a larger soften stool that requires less
pressure to pass through the digestive system (Bassotti et al., 2003).
There is a profound geographic variation between Asian and western countries with
regard to the prevalence and pathophysiology of diverticular diseases (Painter and
Burkitt, 1971). Diverticulosis is much less common in Asian patients and is more likely
to be found in the proximal colon when compared to their western counterparts, in whom
the sigmoid colon is the most commonly affected segment. Several factors have been
proposed to account for this difference, but observation that Asians who adopt a
western-style diet have increased rates of diverticulosis lend support to the role of DF in
diverticular formation. The most widely accepted theory of DF’s role in diverticular
formation states that smaller-volume stool results in alterations in colonic motility that
produce increased intraluminal pressures (Painter and Burkitt, 1975). High intraluminal
pressures are generated when the sigmoid colon undergoes ‘segmentation’, a process
during which smooth muscle contraction separates the colon into functionally distinct
compartments. This normal physiological process becomes exaggerated in those with
low-volume stools, thereby generating markedly elevated intra-segmental colonic
pressures that are then transmitted to the colonic wall (Sheth et al., 2008).
The proportion of DF undergoing fermentation will depend on chemical and physical
structure of the DF, the microflora present and the residence time in the large intestine.
Present evidences suggest, that the DF from wheat bran is less well fermented and
contributes to faecal mass by its presence, where as the thin walled less lignified cell
walls of vegetables and fruits are virtually completely digested and their bulking effect
are due to an increased bacterial mass.

3.2 Effect of fibre on heart disease

Soluble fibre may have a role in reducing heart disease risk by lowering blood cholesterol
concentration in some people (Pereira et al., 2004). As it passes through the intestine,
soluble fibre binds to dietary cholesterol, helping the body to eliminate it. There is also
some evidence that soluble fibre can slow the liver’s production of cholesterol, as well as
alter low-density lipoprotein (LDL) particles to make them less of a health risk. A
high-fibre diet, combined with a low-fat diet, can be an effective approach to reducing the
risk of heart disease.
High-fibre protects against hyperlipidamia and ischemic heart diseases (Flight and
Clifton, 2006). Low intake of this dietary component is related to other risk factors of
heart disease in susceptible genotypes such as obesity and diabetes. Gums and pectic
substances have hypocholesterolemic and hypotriglyceridemic effects. This action of
DF is very important in the treatment of atherosclerosis, coronary heart disease,
 Dietary fibre and human health 109

hypercholesterolemia and hyperlipidemia (Akiba and Matsumoto, 1980). Diets rich in

fibre alter biliary lipid and bile salt metabolism making bile less saturated with
cholesterol. Such bile would be less likely to precepitate its cholesterol and form
gallstones. The degree of absorption of common bile acids, lithocholic, deoxycholic and
cholic acids depends on the kind of raw material, conditions of processing and type of
bile acids (Gorecka et al., 2002).
The ability of guar gum and oat bran to alter post prandial lipid and lipoprotein
composition when added to a test meal (42% total calories as carbohydrate, 16% as
protein and 42% as fat) and examination in six males and six females who consumed
both low (0.49) and high (15.49) fibre test meals on separate days showed that gender
and fibre supplementation influences postprandial glycemia, lipemia and lipoprotein
composition (Redard et al., 1990). The effect of reduced serum levels of HbA1C and
several amino acids, after giving diet rich in natural fibre (NF) or extractive fibre (guar
gum) on 12 male showed that metabolic control significantly improved under each
dietary regimen (Bruttomesso et al., 1989). DFs with a high content of viscous
gums, such as oats, have been shown to reduce LDL – cholesterol (Smith, 1987).
Doses of soluble fibre ranging from 3 g to 8 g have been found to induce significant
reductions ranging from 2.0% to up to 24% in total and LDL cholesterol in both
hypercholesterolemic and non-hypercholesterolemic individuals (Aller et al., 2004;
Behall et al., 2004a, 2004b; Jenkins et al., 2002). Higher intakes of soluble fibre may
reduce the incidence of metabolic syndrome characterised by elevated LDL cholesterol
levels, decreasing the risk of cardiovascular disease (McKeown et al., 2002, 2004).
Cholesterol lowering action of soluble DF was explained by Yoshida et al. (2005) as a
result of an increased fecal sterol excretion and/or production of short-chain fatty acids
previously shown to play a role in the suppression of cholesterol biosynthesis.
There is a strong relationship between the amount, and type, of DF (soluble type) in
the diet and the risk of developing coronary heart diseases. It thus seems prudent to set a
dietary recommendation at an intake level that has been demonstrated to have a
significant impact on risk of developing the disease in large cohort studies. On this basis,
population recommendations should be in the range of 13–15 g/1,000 kcal (Lunn and
Buttriss, 2007). In conclusion, evidence shows that soluble fibre reduces the risk of
cardiovascular diseases (Kassis et al., 2009).

3.3 Fibre and blood glucose

Diabetes is a condition characterised by high blood sugar levels. DF has a favourable
effect on blood glucose (blood sugar). Soluble fibre delays digestion and absorption of
glucose into the blood, which may help prevent wide swings in blood glucose throughout
the day. A diet rich in carbohydrate and fibre, essentially based on legumes, vegetables,
fruits, and whole cereals, may be particularly useful for treating diabetic patients because
of its multiple effects on different cardiovascular risk factors, including postprandial
lipids abnormalities (de Mello and Laaksonen, 2009).
It has been reported that a greater incidence of diabetes is found in populations that
are exposed to affluence and urbanisation, than in isolated populations used to hard work
and limited food. This may be due to a change in diet, particularly to an increased
consumption of refined carbohydrates (Davidson et al., 1975). However, factors other
than diet may play an important role in the development of diabetes. Dietary factors may
act indirectly for example through an increased incidence of obesity. Beyond cancer
110 V. Rana et al.

prevention and general digestive health, foods high in fibre tend to be low on the
glycemic index (GI) (Tenscher, 1986). The GI is a measurement of the speed at which
food is converted to glucose in the bloodstream. High GI foods, such as white bread and
pasta, sugary snacks and other highly refined products, tend to cause a rapid, dramatic,
brief spike in blood sugar levels, followed by a rapid plummeting down below the
original levels of blood glucose. This results in the infamous sugar-high/sugar-crash and
after-dinner sleepiness. It can contribute to complications in insulin function, even
leading to the onset of type 2 diabetes. Foods which score lower on the GI, such as
high-fibre foods, release their sugars more slowly and evenly, and the body gently returns
to its original levels (Cliona, 2006).
Fibre has proved to be useful in the treatment of diabetes mellitus. Jenkins et al.
(1977) showed that post prandial glycemia and rise in serum insulin after consumption of
carbohydrate containing meals were reduced by the addition of guar flour or pectin or
both. A high intake of dietary fibre, particularly of the soluble type improves glycemic
control, decreases hyperinsulinemia, and lowers plasma lipid concentrations in patients
with type 2 diabetes (Chandalia et al., 2000; de Natale et al., 2009).
Fibre is beneficial for diabetic patients because absorbed glucose is released slowly
into the blood circulation hence resulting in decreased insulin secretion. Diabetic patients
on high carbohydrate high-fibre diets have lower insulin secretions. DF has a blood
glucose reducing effect as is manifested by a diminished GI (Tenscher, 1986). This helps
in overweight diabetics because it has been proved that as the weight decreases the
number of insulin receptor increases.
Jenkins et al. (1977) have also shown that post-prandial rise in serum glucose and
reduction in insulin with the intake of a high-fibre diet.
Guar gum possesses distinct hypoglycemic properties. The other fraction of the guar
bean, guar by-product (GBP), has been studied to determine if it possesses any
hypoglycemic properties. The analysed data indicated that GBP, like guar gum, possessed
hypoglycemic properties: because of the different chemical characteristics of these two
guar bean fractions, it seems that their hypoglycemic properties are due probably to
different mechanisms (Track et al., 1985). Low dose of guar may help improve glycaemic
control in diabetic patients. This may be achieved with a low incidence of gastrointestinal
side effects (Jones et al., 1985). In epidemiological studies the intake of insoluble fibre,
but not the intake of soluble fibre, has been inversely associated with the incidence of
type 2 diabetes mellitus (T2DM). In contrast, in postprandial studies, meals containing
sufficient quantities of betaglucan, psyllium, or guar gum have decreased insulin and
glucose responses in both healthy individuals and patients with T2DM. Diets enriched
sufficiently in soluble fibre may also improve overall glycemic control in T2DM.
Insoluble fibre has little effect on postprandial insulin and glucose responses. Fibre
increases satiety. In some studies, insoluble fibre has been associated with less weight
gain over time. Limited cross-sectional evidence suggests an inverse relationship between
intake of cereal fibre and whole-grains and the prevalence of the metabolic syndrome.
Although long-term data from trials focusing specifically on DF are lacking, meeting
current recommendations for a minimum fibre intake of 25 g/d based on a diet rich in
whole grains, fruits and legumes will probably decrease the risk of obesity, the metabolic
syndrome and T2DM (Babio et al., 2010).
The beneficial effect of dietary fibre in the metabolic control of non-insulin
dependent diabetes mellitus (NIDDM) patients was evaluated (Hegander et al., 1988).
 Dietary fibre and human health 111

Realistic high-fibre and regular low-fibre diets were given for eight week each to
NIDDM patients whose diabetes was being controlled satisfactorily by diet alone. The
high-fibre diet induced lower fasting blood glucose levels (p < 0.01) and decreased the
ratio of LDLs to high-density lipoproteins (p < 0.025): no difference was found in
HbA1C between the two diet periods. Continuous glucose monitoring also showed a
difference in fasting glucose levels that remained after identical low-fibre test meals.
The incremental glucose responses did not differ. The fasting and incremental
post-prandial levels of insulin, C-peptide glucagon and somatostatin did not change,
whereas the mean triglyceride concentrations were lower after the high-fibre diet
(Hegander et al., 1988).
The use of diets rich in unabsorbable carbohydrate (fibre) has been advocated for the
treatment of NIDDM. Soluble viscous fibres such as guar gum are most effective in
normalising carbohydrate intolerance in such patients while particulate fibres such as
cellulose have little or no effect. While the latter are known to affect many aspects of
nutrition when consumed in great quantity, little is known of the toxicity of guar gum.
Consumption of 30 grams of guar gum per day for prolonged periods is without serious
consequences (Mclvor et al., 1985). Increased intake of viscous fibre leads to a gradual
reduction in fasting glucose levels in diabetics. The reason for this is unclear but it cannot
readily be explained by a delayed absorption process. Since insulin levels are also
simultaneously reduced, these findings suggest that insulin resistance be alleviated.
Glucose uptake by isolated fat cells as well as insulin sensitivity and responsiveness are
also increased (Smith, 1987). Guar gum can reduce post-prandial blood glucose, insulin
requirements, and serum total cholesterol levels in type 1 diabetic patients, (Ebeling
et al., 1988).
Long-term high-fibre, low fat diet in gestational diabetes is recommended (Paisey
et al., 1985).

4 Fibre on food labels

The amount of dietary fibre in a serving of food is listed in grams and as a percent of the
daily value on the nutrition label. The percent daily value for dietary fibre shows how
much fibre a serving contributes to a 2,000 calorie reference diet.
In 1993, a health claim regarding fibre was approved by FDA which allowed the
statement that diets low in fat and rich in fibre-containing grain products, fruits, and
vegetables may reduce the risk of some types of cancer. The most recent claim approved
by FDA in 1997, allows the statement that foods with soluble fibre from whole oats may
reduce heart disease risk when eaten as a part of a diet low in saturated fat and
cholesterol.
One can get enough dietary fibre without using fibre supplements by following the
food guide pyramid recommendations. The food guide pyramid recommends at least six
grain bread and cereal servings and at least five fruit and vegetable servings each day,
which provide fibre in the diet. Foods are our best source of DF. Foods provide both
soluble and insoluble fibre. In addition, food sources of fibre can be spaced out over the
whole day.
112 V. Rana et al.

5 Guidelines for increasing dietary fibre

When an individual increase fibre in his/her diet, it is important to do so gradually.

Increasing DF too rapidly can initially cause excess gas formation or diarrhoea. Since
water-insoluble fibres absorb water, it is also important to drink plenty of liquids along
with increased DF intake. Also, is necessary to spread high-fibre foods out throughout the
day, at meals and snacks. Some guidelines for increasing DF are to go gradually, drink
plenty of water and spread fibre out throughout the day.
Table 5 Recommended daily requirement of fibre intake

Age group Years Needed fibres (g.)

Men 19–50 38
(over 50) 30
Women 19–50 25
(over 50) 21
Girls 9–18 26–36
Boys 9–18 31–38

Table 6 Dietary fibre content of various ingredient sources

Source Typical total

Source type Ingredient
category DF range (%)
Cereal grains Oats Whole oats/flour ~14
Oat fibre 80–99
Oat bran 16–32
Wheat Other oat ingredients ~10–15
Whole wheat/flour ~12
Wheat bran 34–45
Barley Wheat germ 10–20
Barley flour ~10
Barley bran 18–50
Barley bran flour 35–70
Rye Whole rye flour 15–17
Rye bran ~25
Rice Rice bran 20–35
Corn Corn bran 50–65
Soy Soy hull fibre 65–95
Soy cotyledon fibre ~75
Soy protein concentrate ~20
Other grains Amaranth, flax seed, spelt etc. 10–15
 Dietary fibre and human health 113

Table 6 Dietary fibre content of various ingredient sources (continued)

Source Typical total

Source type Ingredient
category DF range (%)
Plant derived Bamboo, wood, cottonseed, etc. Cellulose 80–99
Modified cellulose Microcrystalline cellulose 80–99
Methylcellulose 80–99
Gums seaweed extracts Carrageenan, alginates 80–90
Plant extracts Gum acacia, gum karaya, 80–90
tragacanth gum
Seed extracts Guar gum, locust bean gum 80–90
Microbially fermented Xanthan, gellan, pullan 80–90
Chicory roots, Jerusalem Inulin and ~90
artichoke etc. fructooligosaccharides
Konjac tuber Konjac flour ~95
Peas, outer shell Pea fibre 75–85
Potatoes, corn etc. Resistant starch 1–40
Sugar beets Sugar beet fibre ~75
Western larch tree Arabinogalactan ~80–95
Psyllium seed coat Psyllium ~80
Fruits Prunes, dates figs, raisins Whole or fruit pieces 5–8
Powder 10–65
Apple, pear Powder 20–70
Apple, citrus Pectin 50–80
Other Shellfish Chitin ~80
Bacterial fermentation Curdlan ~95
Synthetically produced Polydextrose ~95

The recommendations about the intake of DF are not the same in all countries (Sharma
et al., 2006): while UK proposes 18 g/day of DF expressed as NSP, this amount is
increased to 30 g/day in Germany and USA has specified that intake should be 38 g/day
for man and 26 g/day for women (Miller, 2004). A Mediterranean diet, typical in Spain,
Italy and Greece, provides a significant content of DF as it is rich in vegetables, cereals,
fruits and legumes. The recommended intakes in these countries being 20 g/day for
men and 15.7 g/day for women (Capita and Alonso-Calleja, 2003). Reviewing
recommendations of healthy populations from various agencies and countries suggest that
fibre intake should be increased but the recommendations are somewhat unclear as to the
amounts and types of fibre recommended. Table 5 is a sum up of needed fibre against
different age group (Olson, 2003). Nelson (2001) summarised these and a few other
ingredient sources of DF are in Table 6.
Further it is recommended that, in order to reap the most benefit to health, an
individual’s daily fibre intake should ideally include a variety of fibre types. As yet, there
is insufficient evidence to make specific recommendations for the exact amounts of these
different fibre types, but the food combinations shown in Table 7 demonstrate how
114 V. Rana et al.

intakes of the different fibre components can contribute to a TDF intake in the range of
30–36 g of total fibre (AOAC) per day (Lunn and Buttriss, 2007).
Table 7 Example of food combination with a fibre range of 30–36 g/day

Total AOAC Total Insoluble Soluble Resistant

Combinations
fibre (g) NSP fibre NCP fibre NCP fibre starch
Muesli with milk (70 g) 3.9 3.9 1.8 0.9 2.2
Orange juice, tea/coffee (50 ml) 0.1 0.1 0.1 0.1 n/a
Baked beans (150 g) 7.0 5.3 0.9 3.3 2.9
On wholemeal toast (70 g) 5.4 4.1 2.2 1.1 1.0
with grated cheese
Apple (112 g) 2.7 2.0 0.4 0.8 n/a
Mixed nuts (40 g) 3.2 2.4 1.1 0.7 n/a
Baked potato (180 g) 6.5 4.9 0.7 2.7 n/a
with tuna mayonnaise
Broccoli (85 g) 2.6 2.0 0.3 0.9 n/a
Tomato (85 g) 1.1 0.9 0.2 0.3 n/a
33.6 25.3 7.7 10.6 6.1
Porridge with milk (160 g) 1.7 1.3 0.5 0.8 0.3
Stewed rhubarb (140 g) 5.0 3.8 2.2 0.7 n/a
Orange juice, tea/coffee (50 ml) 0.1 0.1 0.1 0.1 n/a
Pea soup (220 g) 4.7 3.6 0.5 1.1 2.8
RS enriched bread (70 g) 9.2 6.9 0.4 0.6 3.9
Banana (120g) 1.8 1.3 0.1 2.0 7.4
Mixed dried fruit (50 g) 1.5 1.1 0.2 0.6 n/a
Grilled chicken with cold 6.5 4.9 0.7 2.7 9.0
potato salad (180 g)
Mushrooms (40 g) 0.8 0.6 0.2 0.1 n/a
Tomato (50 g) 1.1 0.9 0.2 0.3 n/a
RS enriched bread (35 g) 4.6 3.4 0.2 0.3 1.8
Low fat fruit yoghurt (20 g) 0.1 0.1 0.1 0.1 n/a
37.0 27.9 5.5 9.5 25.2
Note: Association of Official Analytical Chemists (AOAC), non-starch polysaccharides
(NSP), and non-cellulosic polysaccharides (NCP).

6 Conclusions

Consuming adequate quantities of DF can lead to improvements in gastrointestinal

health, and reduction in susceptibility to diseases such as diverticular disease, heart
disease, cancer, and diabetes. Increased consumption has also been associated with
increased satiety and weight loss. Currently, we do not have sufficient data from
well-designed human intervention trials to attempt to make specific recommendations on
the amounts of these fibre components in the diet, but it might be useful for health
 Dietary fibre and human health 115

professionals to talk in terms of the different food sources of these types of fibre, as well
as total fibre amounts.
In addition, focusing on the physiological health aspects of DF and the types of DF
meeting a physiological definition will help to communicate further to the consumer that
fibre is important for their diets. This, in turn, will educate the public, which currently is
not consuming adequate levels of fibre, with no idea to obtain additional sources.

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