Dietary Fiber Intake Recommendations in North America

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Final food labeling regulations by the U.S. Food and Drug Administration (FDA) and U.S. Department of Agriculture (USDA) were disseminated through the January 6, 1993 issue of the Federal Register (34, 35). Both the FDA and USDA recognize the AOAC methods 985.29 (TDF) (15) and 991.43 (TDF, SDF/IDF)

Table 3 Dietary Recommendations Around the World-"Grain-Based" Foods*

-References to

Country

Name/Source of recommendation

Reference to ''grain-based' foods

Worldwide Food and Agriculture Organization (FAO) of the United Nations. "Get the best from your food'' (1995)

Recommend eating a variety of foods; 7 groups of foods listed. One is "foods rich in carbohydrate'' which are ''. . . rice, maize, wheat and other cereals

*Source: L. O'Rourke and S. Cho, Kellogg Company, USA

Dietary Fiber Intake

(16) as suitable methodologies for the analysis of DF for nutrition labeling purposes. Professionals in the DF research field, however, strongly support the enzymatic-gravimetric technique as the most appropriate approach for nutrition labeling and quality control purposes (9). Thus, recommendations for DF intake in both the United States and Canada are generally based on the AOAC methods. Recommendations for DF intake in North America range from 25 to 35 g/d. The U.S. FDA recommends that DF goals be based on a caloric basis (Table 2). General dietary recommendations by organizations in the U.S. and Canada are to increase intakes of grain products, fruits and vegetables which will increase overall DF intake if followed (Table 4). Recent U.S. recommendations for intakes of grain-based foods are at least 6 servings per day. In Canada, recommended intake levels of breads, cereals and other grain products have increased from 35 servings/d to 5-12 servings/d (Table 4).

Even though pediatric guidelines for intakes in the U.S. have been set for the consumption of other macronutrients such as protein, fat and carbohydrates, no specific recommendations on DF levels have been made until recently. In 1993, the American Academy of Pediatrics (AAP) Committee on Nutrition made the recommendation that DF intake in children over age 2 should be 0.5 g/kg body weight (36) (Table 2). To avoid the potential hazards of excessive consumption, especially for overweight children, the AAP suggest a cap at 35 g/d. However, intakes up to 25 g/d should not be deleterious even with suboptimal mineral intake (36). The American Health Foundation (AHF) recommends that a range of DF intake, between ''Age + 5'' and ''Age + 10'' g/d may represent a safe and tolerable level for most children over the age of 2 years (37) (Table 2). Consistent with guidelines for adult DF intake, the AHF recommendation gradually increases the fiber intakes to the minimal adult DF level by age 20. Consumption of recommended levels of DF by children may help reduce the risk of developing chronic diseases such as cancer and cardiovascular disease later on in life (37).

Dietary Fiber Intake Recommendations in Europe |

In the U.K., the recommendation for DF intake is based on NSP because it is t?

the major fraction of DF regardless of the DF definition used and is chemically ^

identifiable and measurable with reasonable precision. In the early 1970s, fiber tables in the U.K. had been constructed with Southgate's unavailable CHO |

method (17) which overestimates DF values of high-starch foods due to incomplete starch removal during the procedure (3). The NSP methods of analysis developed by Englyst and colleagues (21-23), classifying NSP into soluble and insoluble fractions, are now used for labeling purposes in the U.K. The U.K. Department of Health recommends an average NSP intake of 18 g/d to be consumed from a variety of foods and not supplements (Table 2). Confusion in data

Cho et al.

Table 4 Dietary recommendations in the U.S. and Canada

Country

Name/Source of recommendation

References to "grain-based" and complex CHO/DF

American Cancer Society (ACS), ''Guidelines on Diet, Nutrition, and Cancer Prevention'' (1996)

U.S. Department of Health and Human Services (USDHHS), Action Guide for Healthy Eating (1996) U.S. Department of Agriculture, Report of the Dietary Guidelines, Advisory Committee on the Dietary Guidelines for Americans (1995)

U.S. Department of Agriculture and USDHHS, ''Nutrition and Your Health: Dietary Guidelines for Americans,'' 4th edition (1995) American Cancer Society, Nutrition and Cancer: Cause and Prevention (1993) American Cancer Society, Eating Smart (1993)

American Dietetic Association (ADA), Position of the American Dietetic Association: Health Implications of Dietary Fiber (1993)

USDA Food Guide Pyramid (1992)

USDHHS, Eating to Lower Your High Blood Cholesterol (1992)

Eat 5 or more servings of fruits and vegetables each day. Eat other foods from plant sources, such as breads, cereals, grain products, rice, pasta, or beans several times each day. Choose whole grains over processed grains.

Eat lots of fruits and vegetables, grains, and beans.

Choose a diet with plenty of grain products, vegetables, and fruits. Adults should eat at least 3 servings of vegetables, 2 servings of fruits, and 6 servings of grain products each day.

Choose a diet with plenty of grain products, vegetables, and fruits.

Eat more high fiber foods. Fiber is found in fruits and vegetables, whole grains, and dried beans. (indirect) Eat more high-fiber foods; eat a varied diet including fruits and vegetables. The consensus drawn from numerous health authorities is that Americans should consume at least 5 servings of fruits/vegetables and 6 servings of breads/ cereals/legumes per day. ''At the base of the Food Guide Pyramid are the breads, cereals, rice and pasta-all foods from grains. You need the most servings of these each day (6-11).'' Breakfast cereals mentioned in text as an option. (indirect) Choose foods high in complex carbohydrates (starch and fiber).

Dietary Fiber Intake

Table 4 Continued

Country

Name/Source of recommendation

References to "grain-based" and complex CHO/DF

ACS, Nutrition and Cancer: American Cancer Society Guidelines, Programs, and Initiative (1990)

American Heart Association (AHA) Report: The Healthy American Diet (1990) California Department of Health and Human Services, The California Daily Food Guide: Dietary Guidance for Californians (1990)

USDHHS, Report of the Expert Panel on Population Strategies for Blood Cholesterol Reduction (1990)

National Research Council, National Academy of Sciences Diet and Health-Implications for Reducing Chronic Disease Risk (1989)

AHA, Position Statement-Dietary Guidelines for Healthy American Adults, A Statement for Physicians and Health Professionals by the Nutrition Committee (1988)

USDHHS, The Surgeon General's Report on Nutrition and Health (1988)

Include a variety of fruits and vegetables in the daily diet. Eat more high-fiber foods, such as whole grain cereals, vegetables, and fruits. ''Whole grain cereals'' recommended; i.e. breakfast cereals.

(indirect) Increase consumption of complex carbohydrates and fiber.

Adults in California should eat 4 servings of whole grain breads every day (plus addit'l servings of other grains to a total 6 servings per day). Eat 5 servings or more of fruits and vegetables every day.

Eat a greater quantity and variety of fruits, vegetables, breads, cereals, and legumes. Carbohydrates should be increased to 50-60% of total calories.

''Every day eat 5 or more servings of fruits and vegetables and increase intake of starches and other complex carbohydrates by eating 6 or more daily servings of a combination of breads, cereals, and legumes.'' ''Whole grain cereals'' referred to in text as a good cereal choice; ''cereals'' is understood to include breakfast cereals.

(indirect) Carbohydrate intake should constitute 50% or more of calories, with emphasis on complex carbohydrates.

Increase consumption of whole grain foods and cereal products, vegetables, and fruits.

Cho et al.

Table 4 Continued

Country

Canada

Canada

Canada

Canada

Canada

Name/Source of recommendation

References to "grain-based" and complex CHO/DF

AHA, Position Statement-Dietary Guidelines for Healthy American Adults, A Statement for Physicians and Health Professionals by the Nutrition Committee (1988)

ACS, Taking Control—10 Steps to a Healthier Life and Reduced Cancer Risk (1987)

United States Senate, Dietary Goals lor the United States (1977) Health and Welfare Canada, Canada 's Food Guide to Healthy Eating (1992)

Health and Welfare Canada, Summary of Report of the Scientific Review Committee and the Communications/Implementation Committee Canada's Guidelines for Healthy

Eating (1989) Canada Cancer Society, Healthy Food Choices May Reduce Your Cancer Risk (1988) Canadian Consensus Conference on Cholesterol: Final Report (1988)

(indirect) Carbohydrate intake should constitute 50% or more of calories, with emphasis on complex carbohydrates.

Add more high-fiber foods to the diet. Fiber occurs in whole grains (such as wheat and bran cereals), fruits, and vegetables. ''Bran cereals'' noted as a good fiber source. (indirect) Increase the consumption of complex carbohydrates. ''Enjoy a variety of foods from each group every day.'' Groups include ''Grain Products''-''choose whole grain and enriched products more often (5-12 servings per day)''; ''Vegetables and Fruit''-''choose dark green and orange vegetables and orange fruit more often (5-10 servings per day).'' ''. . . Choose whole grain and enriched products more often.''

Emphasize cereals, breads, other grain products, vegetables, and fruits. ''Preferably whole grain'' products recommended.

''Preferably whole grain'' products recommended. (indirect) Eat more fiber-containing foods. Eat several servings of fruits and vegetables daily. (indirect) Thirty-five to 40 percent of energy should come from carbohydrates, with emphasis on polysaccharides from a variety of foods containing dietary fiber.

Dietary Fiber Intake 85

Table 4 Continued

References to "grain-based" and Country Name/Source of recommendation complex CHO/DF

Canada Canadian Cancer Society, Fact on Cancer and Diet-Your Food Choices May Help You Reduce Your Cancer Risk (1986) Canada Health and Welfare Canada, Canada 's Food Guide Handbook (1985)

(indirect) Eat more fiber-containing foods. Have several servings of vegetables and fruits daily.

Eat 3-5 servings of breads and cereals, ''Preferably whole grain'' products recommended. Eat 4-5 servings of fruits and vegetables.

interpretation had resulted in the previous recommendation of 30 g/d, based on the unavailable CHO method, by the British National Advisory Committee on Nutrition Education in 1983 (38).

The present NSP recommendation is based on its importance for overall colonic health and regularity. At NSP intakes of less than 12 g/d, stool weights are less than 100 g/d which is associated with an increased risk of bowel disease (39). However, a recent study showed that NSP plus resistant starch, and not NSP alone, correlated with colon cancer incidence (28). Carbohydrate metabolism, insulin metabolism, or blood lipid profiles were not considered in the recommendation due to the lack of evidence that NSP plays any significant role (39). There does not appear to be any significant reduction in mineral bioavailability with populations which habitually consume high levels of NSP. Because this may be a factor in those with marginal mineral intakes like the elderly, the recommendation is only applicable to healthy adults (39).

In Continental Europe, DF tables are generally based on the AOAC TDF method 985.29 (15). Since NSP represent most, but not all DF fractions, the NSP values used in the U.K. tend to be lower than TDF values, especially for grain-based foods (3). Using the TDF method as a basis, most countries in Europe recommend a daily DF intake of 20-35 g (Table 2). General recommendations are to increase consumption of fruits, vegetables, and cereals and cereal products, replacing energy intakes from fatty or sugary foods (Table 5).

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