Loading up on fibre

There is more evidence now that a diet high on roughage cuts health risks

January 20, 2019 12:02 am | Updated 12:04 pm IST

A study commissioned by the World Health Organisation (WHO) has provided “convincing evidence” that consuming fibre and whole grains can reduce health risks from non-communicable diseases (NCDs) such as heart disease.

In a series of systematic reviews and meta-analyses, which was published in The Lancet on January 10, a 15%-30% decrease in all-cause and cardiovascular-related mortality was noted when comparing people who ate the highest amount of fibre to those who ate the least. According to the summary of the paper, eating fibre-rich foods also reduces the incidence of coronary heart disease, stroke, type 2 diabetes and colorectal cancer by 16%-24%.

A higher fibre intake is also associated with lower bodyweight, systolic blood pressure and total cholesterol when compared with lower intake. The paper adds that risk reduction associated with a range of critical outcomes is greatest when the daily intake of dietary fibre was between 25g and 29g.

Corroborating the findings, Avula Laxmaiah, a senior scientist at the National Institute of Nutrition, Indian Council of Medical Research (ICMR), Hyderabad, says that the recommended daily allowance, or RDA, of the ICMR for fibre is 25g/day. He says, “The consumption levels should be more than 25g/day for the protective effect.”

What to have

Attributing the increase in the incidence of NCDs to changing dietary habits (inclusion of more salt, fat and sugar diets) and more sedentary work, the scientist says promoting a “healthy diet” is very important.

According to him, a healthy diet is one in which about half is made up fruits and vegetables (45%-50% quantity) and a fourth from cereal and millets (rice/wheat/millets, etc). A person should get 55%-60% of energy from carbohydrates, 25%-30% energy from fats and oils (less than 10% energy from saturated fats and almost nil from trans fats), and 10%-15% energy from protein diet.

Dr. Laxmaiah says, “We have been conducting National Nutrition Monitoring Bureau (NNMB) studies on diet and nutrition among rural, tribal and urban populations since 1975. These studies revealed that the intake of fruits and vegetables among urban population is about 246g/Consumption Units/day, while it is very low among the rural population (153g/CU/day) as against the recommended levels of fruits and vegetables of 400g/CU/day. In case of visible fats and oils, the intake among rural population is 32g/CU/day as against the RDA of 20g/CU/day.”

C.N. Manjunath, director of the Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, says that for cardiac patients, cardiologists insist on a diet that is rich in fibre and proteins and low in carbohydrates. He points out that NCDs were negligible in the past as diets were generally rich in fibre. He explains, “A high fibre diet has a low glycemic index (a measure of carbohydrates in food) as a result of which the release of sugar into blood is slow. This means there will not be an abrupt rise of blood sugar.”

Says Sheela Krishnaswamy, nutrition and wellness consultant, and former head of the Indian Dietetic Association, “The Position Paper on Dietary Fibre and Health brought out in December 2018 by the Indian Dietetic Association says people should consume at least 30g of dietary fibre from a variety of plant sources in order to attain various physiological benefits.” She adds, “It is easy to bring back the fibre in our meals by incorporating unrefined grains, vegetables, fruits, pulses, nuts and seeds, regularly.”

According to her, “More than 10g of fibre is found in wheat, jowar, bajra, ragi, maize and pulses (in 100g of edible portion each). Not just NCDs, higher intake of dietary fibre also helps in weight management and bowel function, better glycemic control, lower postprandial (after food) glucose levels and increased insulin sensitivity.”

yasmeen.afshan@thehindu.co.in

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