Dietary Fibre as a Unifying Remedy for the Whole Spectrum of Obesity-Associated Cardiovascular Risk

Abstract

Obesity is a pandemic carrying the heavy burden of multiple and serious co-morbidities including metabolic syndrome, type 2 diabetes and cardiovascular diseases. The pathophysiological processes leading to the accumulation of body fat slowly evolve to fat accumulation in other body compartments than subcutaneous tissue. This abnormal fat deposition determines insulin resistance which in turn causes blood glucose and lipid metabolism derangement, non-alcoholic fatty liver disease, hypertension, and metabolic syndrome. All these conditions contribute to increase the cardiovascular risk of obese people. Several randomized clinical trials demonstrated that moderate weight loss (5–10%) in obese patients improves obesity-related metabolic risk factors and coexisting disorders. Therefore, nutritional strategies able to facilitate weight management, and in the meantime positively influence obesity-associated cardiovascular risk factors, should be implemented. To this aim, a suitable option could be dietary fibres that may also act independently of weight loss. The present narrative review summarizes the current evidence about the effects of dietary fibres on weight management in obese people. Moreover, all of the different cardiovascular risk factors are individually considered and evidence on cardiovascular outcomes is summarized. We also describe the plausible mechanisms by which different dietary fibres could modulate cardio-metabolic risk factors. Overall, despite both epidemiological and intervention studies on weight loss that show statistically significant but negligible clinical effects, dietary fibres seem to have a beneficial impact on main pathophysiological pathways involved in cardiovascular risk (i.e., insulin resistance, renin-angiotensin, and sympathetic nervous systems). Although the evidence is not conclusive, this suggests that fibre would be a suitable option to counteract obesity-related cardio-metabolic diseases also independently of weight loss. However, evidence is not consistent for the different risk factors, with clear beneficial effects shown on blood glucose metabolism and Low Density Lipoprotein (LDL) cholesterol while there is fewer, and less consistent data shown on plasma triglyceride and blood pressure. Ascribing the beneficial effect of some foods (i.e., fruits and vegetables) solely to their fibre content requires more investigation on the pathophysiological role of other dietary components, such as polyphenols.

Analog Rice Reduces Weight and Total Cholesterol Levels in Overweight and Hypercholesterolemic Rats

“…Fiber-rich foods can support the peptide release in the form of cholecystokinin that is involved in the regulation of gastric emptying and stimulate the nucleus of fullness in the hypothalamus. Satiety induced by dietary fiber shows the potential for sustainable weight loss without hyperphagia and weight re-bound in obesity cases (2,25,26).…”

Successful salvage of allograft dysfunction triggered by transplant renal vein thrombosis immediately after kidney transplantation: a case report

“…Therefore, we retrospectively suggest that the cause of TRVT in our case is that the relatively short renal vein (due to the right kidney) was compressed by surrounding tissues, including the swelling allograft, and the compression was worsened by abdominal closure. Although obesity itself is a risk of the development of cardiovascular events and affects mortality, 18 when performing kidney transplantation in obese patients, surgeons must pay attention to the various obesity-related complications. These include not only wound complications but also vascular complications, such as artery stenosis and TRVT.…”

Diet, Lifestyle, Smoking

“…fibre from whole grain, legumes, fruit and vegetables and fibre supplementson body weight changes, blood glucose metabolism, plasma lipids and blood pressure control. The overall evidence shows that soluble fibre, mainly β-glucans from oat and barley but also inulin, guar gum, glucomannan, pectin and psyllium principally found in fruit, vegetables and legumes, are able to significantly reduce plasma LDL-cholesterol levels, improve blood pressure (mainly β-glucan and psyllium) and induce a small reduction in body weight (Bozzetto et al 2018). Moreover, there is evidence of a triglyceride-lowering effect of dietary fibre and whole grain during the postprandial period (Bozzetto et al 2014;De Natale et al 2009;Giacco et al 2014).…”