Dietary fibre intakes and reduction in functional constipation rates among Canadian adults: a cost-of-illness analysis

Inadequate dietary fiber intake contributes to the prevalent irregularity and constipation in Western countries. Although eating adequate amounts of fibers from fiber-rich foods, foods with added fibers and dietary fiber supplements is considered the first option for improving laxation, the efficacy can vary among types of fibers. The present study is a randomized control trial that included healthy adult participants with ≤3 bowel movements/week and a habitual low dietary fiber intake in a parallel design to evaluate the benefits for laxation by supplementing the daily diet with oligofructose (Orafti® P95; OF), a fermentable source of fiber and established prebiotic (n = 49); maltodextrin was the placebo (n = 48). After a run-in phase, OF was initially provided at 5 g/day, then increased to 10 and 15 g/day with four weeks for each phase. Stool frequency (bowel movements per week) for the OF and maltodextrin (MD) groups were initially similar (3.98 ± 1.49 vs. 4.06 ± 1.48), did not change for the placebo group, but increased for the OF group with the difference significant at 15 g/day (p = 0.023). Stool consistency was similar and remained unchanged at all doses for both groups. Gastrointestinal sensations were low for both groups. Laxation benefits were especially pronounced for participants with >13 g/day habitual dietary fiber intake, with significant laxation at 10 g and 15 g OF/day (p = 0.04 and p = 0.004, respectively) A daily supplement with a short-chain inulin-type fructan derived from chicory roots, i.e., oligofructose (Orafti® P95) provided a laxation effect without causing gastrointestinal (GI) distress for healthy participants with irregularity associated with low dietary fiber intake.

Section: Introductionsupporting

confidence: 76%

Oligofructose Provides Laxation for Irregularity Associated with Low Fiber Intake

Buddington

Kapadia

Neumer³

et al. 2017

“…Evidence from prospective studies shows cereal fibre specifically reduces the risk of colorectal cancer [ 52 ], diverticular disease [ 53 ], weight gain [ 54 , 55 ] and all-cause mortality [ 34 ]. In addition, modelling studies in the US [ 56 ] and Canada [ 57 ] have demonstrated substantial savings in medical costs from a reduction in constipation with increased dietary fibre consumption, for which some types of cereal fibre are considered particularly efficacious [ 58 ]. Furthermore, our findings are modelled based on a population who are free of CVD and T2D, and not to those who already have these diseases.…”

Section: Discussionmentioning

confidence: 99%

Healthcare Expenditure and Productivity Cost Savings from Reductions in Cardiovascular Disease and Type 2 Diabetes Associated with Increased Intake of Cereal Fibre among Australian Adults: A Cost of Illness Analysis

Fayet‐Moore

George²,

Cassettari

et al. 2018

An ageing population and growing prevalence of chronic diseases including cardiovascular disease (CVD) and type 2 diabetes (T2D) are putting increased pressure on healthcare expenditure in Australia. A cost of illness analysis was conducted to assess the potential savings in healthcare expenditure and productivity costs associated with lower prevalence of CVD and T2D resulting from increased intake of cereal fibre. Modelling was undertaken for three levels of increased dietary fibre intake using cereal fibre: a 10% increase in total dietary fibre; an increase to the Adequate Intake; and an increase to the Suggested Dietary Target. Total healthcare expenditure and productivity cost savings associated with reduced CVD and T2D were calculated by gender, socioeconomic status, baseline dietary fibre intake, and population uptake. Total combined annual healthcare expenditure and productivity cost savings of AUD$17.8 million–$1.6 billion for CVD and AUD$18.2 million–$1.7 billion for T2D were calculated. Total savings were generally larger among adults of lower socioeconomic status and those with lower dietary fibre intakes. Given the substantial healthcare expenditure and productivity cost savings that could be realised through increases in cereal fibre, there is cause for the development of interventions and policies that encourage an increase in cereal fibre intake in Australia.

“…However, limitations are worth noting. First, while recent literature and national databases were reviewed for identification of consumer trends and healthcare-related costs, as with previous cost-of-illness analyses [ 54 , 81 , 82 ], isolating the effects of pulses from other elements of lifestyle is challenging.…”

Section: Discussionmentioning

confidence: 99%

Canadian Potential Healthcare and Societal Cost Savings from Consumption of Pulses: A Cost-Of-Illness Analysis

Abdullah

Marinangeli²,

Jones

et al. 2017

Consumption of dietary pulses, including beans, peas and lentils, is recommended by health authorities across jurisdictions for their nutritional value and effectiveness in helping to prevent and manage major diet-related illnesses of significant socioeconomic burden. The aim of this study was to estimate the potential annual healthcare and societal cost savings relevant to rates of reduction in complications from type 2 diabetes (T2D) and incidence of cardiovascular disease (CVD) following a low glycemic index (GI) or high fiber diet that includes pulses, or 100 g/day pulse intake in Canada, respectively. A four-step cost-of-illness analysis was conducted to: (1) estimate the proportions of individuals who are likely to consume pulses; (2) evaluate the reductions in established risk factors for T2D and CVD; (3) assess the percent reduction in incidences or complications of the diseases of interest; and (4) calculate the potential annual savings in relevant healthcare and related costs. A low GI or high fiber diet that includes pulses and 100 g/day pulse intake were shown to potentially yield Can$6.2 (95% CI $2.6–$9.9) to Can$62.4 (95% CI $26–$98.8) and Can$31.6 (95% CI $11.1–$52) to Can$315.5 (95% CI $110.6–$520.4) million in savings on annual healthcare and related costs of T2D and CVD, respectively. Specific provincial/territorial analyses suggested annual T2D and CVD related cost savings that ranged from up to Can$0.2 million in some provinces to up to Can$135 million in others. In conclusion, with regular consumption of pulse crops, there is a potential opportunity to facilitate T2D and CVD related socioeconomic cost savings that could be applied to Canadian healthcare or re-assigned to other priority domains. Whether these potential cost savings will be offset by other healthcare costs associated with longevity and diseases of the elderly is to be investigated over the long term.