Background: Health claims regarding the cholesterol-lowering effect of soluble fiber from oat products, approved by food standards agencies worldwide, are based on a diet containing ≥3 g/d of oat β-glucan (OBG). Given the number of recently published randomized controlled trials (RCTs), it is important to update the findings of previous meta-analyses.Objective: The objective was to quantify the effect of ≥3 g OBG/d on serum cholesterol concentrations in humans and investigate potential effect modifiers.Design: A meta-analysis was performed on 28 RCTs comparing ≥3 g OBG/d with an appropriate control. Systematic searches were undertaken in PubMed, AGRICOLA, and Scopus between 1 January 1966 and 6 June 2013, plus in-house study reports at CreaNutrition AG. Studies were assessed with regard to inclusion/exclusion criteria, and data were extracted from included studies by reviewers working independently in pairs, reconciling differences by consensus. Estimates of the mean reduction in serum cholesterol from baseline between the OBG and control diets were analyzed by using random-effects meta-analysis models and meta-regression.Results: OBG in doses of ≥3 g/d reduced low-density lipoprotein (LDL) and total cholesterol relative to control by 0.25 mmol/L (95% CI: 0.20, 0.30; P < 0.0001) and 0.30 mmol/L (95% CI: 0.24, 0.35; P < 0.0001), respectively, with some indication of heterogeneity (P = 0.13 and P = 0.067). There was no significant effect of OBG on high-density lipoprotein (HDL) cholesterol or triglycerides and no evidence that dose (range across trials: 3.0–12.4 g/d) or duration of treatment (range: 2–12 wk) influenced the results. LDL cholesterol lowering was significantly greater with higher baseline LDL cholesterol. There was a significantly greater effect for both LDL and total cholesterol in subjects with diabetes compared with those without (although based on few studies).Conclusions: Adding ≥3 g OBG/d to the diet reduces LDL and total cholesterol by 0.25 mmol/L and 0.30 mmol/L, respectively, without changing HDL cholesterol or triglycerides.

Dietary fibre has been consumed for centuries with known health benefits, but defining dietary fibre is a real challenge. From a functional perspective, dietary fibre is described as supporting laxation, attenuating blood glucose responses and assisting with cholesterol lowering. The problem is different types of dietary fibre have different effects, and new effects are increasingly observed, such as the influence on gut microbiota. Thus, a single definition may need to be described in more generic terms. Rather than being bound by a few functional definitions, we may need to embrace the possibilities of new horizons, and derive a working definition of dietary fibre based on a set of conceptual principles, rather than the limited definitions we have to date. To begin this process, a review of individual fibre types and their physiological effects would be helpful. Dietary fibre is a complex group of substances, and there is a growing interest in specific effects linked to fibre type. Different fractions of dietary fibre have different physiological properties, yet there is a paucity of literature covering the effects of all fibres. This paper describes a range of individual fibre types and identifies gaps in the literature which may expose new directions for a working definition of dietary fibre.

Objective Promoting adherence to healthy dietary patterns is a critical public health issue. Models of behaviour, such as the Theory of Planned Behaviour (TPB) allow programme designers to identify antecedents of dietary patterns and design effective interventions. The primary aim of this study was to examine the association between TPB variables and dietary patterns. Methods A systematic literature search was conducted to identify relevant studies. Random-effects meta-analysis was used to calculate average correlations. Meta-regression was used to test the impact of moderator variables. Results In total, 22 reports met the inclusion criteria. Attitudes had the strongest association with intention (r+ = 0.61) followed by perceived behavioural control (PBC, r+ = 0.46) and subjective norm (r+ = 0.35). The association between intention and behaviour was r+ = 0.47, and between PBC and behaviour r+ = 0.32. Moderator analyses revealed that younger participants had stronger PBC-behaviour associations than older participants had, and studies recording participants' perceptions of behaviour reported significantly higher intention-behaviour associations than did those using less subjective measures. Conclusions TPB variables were found to have medium to large associations with both intention and behaviour that were robust to the influence of key moderators. Recommendations for future research include further examination of the moderation of TPB variables by age and gender and the use of more valid measures of eating behaviour. AbstractPromoting adherence to healthy dietary patterns is a critical public health issue. Models of behavior, such as the Theory of Planned Behavior (TPB) allow program designers to identify antecedents of dietary patterns and design effective interventions. The primary aim of this study was to examine the association between TPB variables and dietary patterns. A systematic literature search was conducted to identify relevant studies. Random-effects metaanalysis was used to calculate average correlations. Meta-regression was used to test the impact of moderator variables. In total, 22 reports met the inclusion criteria. Attitudes had the strongest association with intention (r + = 0.61) followed by perceived behavioral control (PBC, r + = 0.46) and subjective norm (r + = 0.35). The association between intention and behavior was r + = 0.47, and between PBC and behavior r + = 0.32. These associations were robust to the influence of key moderators. However, analyses revealed that younger participants had stronger PBC-behavior associations than older participants, and studies recording participants' perceptions of behavior reported significantly higher intentionbehavior associations than those using less subjective measures. Recommendations for future research include further examination of the moderation of TPB variables by age and gender and the use of more valid measures of eating behavior.3

This study recorded acute biochemical and subjective measures of satiety, followed by energy intake from a subsequent meal, after varying doses of beta-glucan in extruded breakfast cereals. Molecular weight, solubility and viscosity of beta-glucan products were determined. Seven male and seven female subjects (BMI 25-36 kg/m) consumed five breakfasts (different doses of beta-glucan sourced from two different technological processes) and dietary intake was measured after four hours. Blood was collected to measure glucose, insulin, ghrelin and cholecystokinin, and visual analogue scales measured subjective satiety. Molecular weight, solubility and viscosity indicated products were likely to increase luminal viscosity. beta-Glucan was found to decrease insulin secretion over 2 h (RMANOVA, p = 0.011) in a dose responsive manner from 2.16 to 5.68 g per serving (p = 0.007). Cholecystokinin levels increased linearly over the same range of beta-glucan concentrations (p = 0.002) in women. Subjective satiety was increased at a beta-glucan dose of 2.2 g (p = 0.039). Subsequent meal intake decreased by greater than 400 kJ with higher beta-glucan dose (>5 g). beta-Glucan improves satiety and release of cholecystokinin is likely to be part of the mechanism. Products with different sources of beta-glucan provide similar benefits but each product requires individual testing.

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The combination of economic and social costs associated with non-communicable diseases provide a compelling argument for developing strategies that can influence modifiable risk factors, such as discrete food choices. Models of behaviour, such as the Theory of Planned Behaviour (TPB) provide conceptual order that allows program designers and policy makers to identify the substantive elements that drive behaviour and design effective interventions. The primary aim of the current review was to examine the association between TPB variables and discrete food choice behaviours. A systematic literature search was conducted to identify relevant studies. Calculation of the pooled mean effect size (r+) was conducted using inverse-variance weighted, random effects meta-analysis. Heterogeneity across studies was assessed using the Q- and I2-statistics. Meta-regression was used to test the impact of moderator variables: type of food choice behaviour; participants’ age and gender. A total of 42 journal articles and four unpublished dissertations met the inclusion criteria. TPB variables were found to have medium to large associations with both intention and behaviour. Attitudes had the strongest association with intention (r+ = 0.54) followed by perceived behavioural control (PBC, r+ = 0.42) and subjective norm (SN, r+ = 0.37). The association between intention and behaviour was r+ = 0.45 and between PBC and behaviour was r+ = 0.27. Moderator analyses revealed the complex nature of dietary behaviour and the factors that underpin individual food choices. Significantly higher PBC-behaviour associations were found for choosing health compromising compared to health promoting foods. Significantly higher intention-behaviour and PBC-behaviour associations were found for choosing health promoting foods compared to avoiding health compromising foods. Participant characteristics were also found to moderate associations within the model. Higher intention-behaviour associations were found for older, compared to younger age groups. The variability in the association of the TPB with different food choice behaviours uncovered by the moderator analyses strongly suggest that researchers should carefully consider the nature of the behaviour being exhibited prior to selecting a theory.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-015-0324-z) contains supplementary material, which is available to authorized users.

Epidemiological evidence shows an inverse relationship between dietary fibre intake and body weight gain. Oat b-glucan, a soluble fibre alters appetite hormones and subjective satiety in acute meal test studies, but its effects have not been demonstrated with chronic consumption. The present study aimed to test the effects in women of two different doses of oat b-glucan on weight loss and hormones associated with appetite regulation. In a 3-month parallel trial, sixty-six overweight females were randomised into one of three 2 MJ energy-deficit diets: a control and two interventions including 5 -6 g or 8 -9 g b-glucan. Anthropometric and metabolic variables (blood glucose level, insulin, total cholesterol (TC), LDL, HDL, TAG and leptin), together with markers of appetite regulation (cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1), ghrelin, peptide YY (PYY) and PYY 3-36 ) were measured at baseline and at 3 months. After 3 months, all groups lost weight (P,0·001) and showed a reduced waist circumference (P,0·001). The study sample also showed reductions in TC, LDL, HDL, leptin, PYY, GLP-1 values (all P, 0·001) and an increase in CCK levels (P,0·001). No significant differences were noted between the groups for all outcome values except PYY levels (P¼ 0·018). In broad terms, the addition of oat b-glucan did not enhance the effect of energy restriction on weight loss in mildly overweight women, although wide variations in observed results suggests that individual responsiveness may be an issue. b-D-Glucan: Weight loss: Weight control: Appetite hormonesLarge bodies of epidemiological data show an inverse relationship between dietary fibre intake and body weight (1 -5) so that the logic and simplicity of including fibre in an energy-controlled diet remains tantalising. As a component of food, fibres are found in a fermentable (soluble) or non-fermentable (insoluble) form, but early research has been unable to show benefits from including either form in short term (3 -4 weeks) ad libitum diets (6) . This was also the case when the form of fibre was mixed linkage b-glucan, a soluble fibre delivered by oats (7) , well recognised for its cholesterol (8) and glucose lowering (9) actions. In order to better expose the advantages apparent from epidemiological studies, more work is required in understanding the physical features of fibre, the food delivery system, and how these may work together to affect mechanisms associated with weight management, such as satiety, particularly over longer periods of time.It is accepted that soluble fibre, by its viscous nature will not only increase upper gastrointestinal transit time, but also stimulate cholecystokinin (CCK) that will increase peristalsis (10) . The effects of other hormones are less clear, but the ileal brake formed by undigested foods in the distal gut (occurring with high fibre foods), in addition to the fermentation of soluble fibres in the large bowel are all seen as positive benefits of fibre. Meal studies are able to expose these mechanisms of action. This i...

(2015). Energy and protein intake increases with an electronic bedside spoken meal ordering system compared to a paper menu in hospital patients. Clinical Nutrition ESPEN, 10 (4), e134-e139.Energy and protein intake increases with an electronic bedside spoken meal ordering system compared to a paper menu in hospital patients AbstractBackground and aims Electronic bedside spoken meal ordering systems (BMOS) have the potential to improve patient dietary intakes, but there are few published evaluation studies. The aim of this study was to determine changes in the dietary intake and satisfaction of hospital patients, as well as the role of the Nutrition Assistant (NA), associated with the implementation of an electronic BMOS compared to a paper menu. Methods This study evaluated the effect of a BMOS compared to a paper menu at a 210-bed tertiary private hospital in Sydney during 2011-2012. Patient dietary intake, patient satisfaction and changes in NA role were the key outcomes measured. Dietary intake was estimated from observational recordings and photographs of meal trays (before and after patient intake) over two 48 h periods. Patient satisfaction was measured through written surveys, and the NA role was compared through a review of work schedules, observation, time recordings of patient contact, written surveys and structured interviews. Results Baseline data were collected across five wards from 54 patients (75% response rate) whilst using the paper menu service, and after BMOS was introduced across the same five wards, from 65 patients (95% response rate). Paper menu and BMOS cohorts' demographics, self-reported health, appetite, weight, body mass index, dietary requirements, and overall foodservice satisfaction remained consistent. However, 80% of patients preferred the BMOS, and importantly mean daily energy and protein intakes increased significantly (paper menu versus BMOS): 6273 kJ versus 8273 kJ and 66 g versus 83 g protein; both p < 0.05. No additional time was required for the NA role, however direct patient interaction increased significantly (p < 0.05), and patient awareness of the NA and their role increased with the BMOS. Conclusions The utilisation of a BMOS improved patient energy and protein intake. These results are most likely due to an enhancement of existing NA work processes, enabling more NA time with patients, facilitating an increase in patient participation and satisfaction with the service.