The Energy Values of Dietary Fibre and Sugar Alcohols for Man

Livesey, Geoffrey

doi:10.1079/nrr19920007

Cited by 126 publications

(111 citation statements)

References 85 publications

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“…It has been estimated that the energy obtained from carbohydrates which are completely fermented in the colon, about 2 Kcal/g, is only about 50% of that obtained from carbohydrates absorbed from the small intestine. 22 Thus, the daily energy de®cit on acarbose treatment necessary to account for the observed weight loss, 26 Kcal/d over six months, or 17 Kcal/d over 12 months, can be provided by the malabsorption of 13 or 8.5 g carbohydrate per day, respectively, or about 4±6.5% of total carbohydrate intake. It seems very reasonable to ascribe this amount of carbohydrate malabsorption to acarbose, since even on a normal diet, it has been estimated that 5±10% of dietary carbohydrate is normally malabsorbed, and enters the colon.…”

Section: Discussionmentioning

confidence: 99%

Small weight loss on long-term acarbose therapy with no change in dietary pattern or nutrient intake of individuals with non-insulin-dependent diabetes

et al. 1997

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OBJECTIVES: To see if the long-term treatment of non-insulin dependent diabetes (NIDDM) with the a a-glucosidase inhibitor acarbose affects food intake and body weight. DESIGN: Randomized, double-blind, placebo-controlled, parallel design clinical trial of 12 months duration. SUBJECTS: Subjects with NIDDM in four treatment strata: 77 on diet alone, 83 also treated with metformin, 103 also treated with sulfonylurea and 91 also treated with insulin. MEASUREMENTS: Two 3 day diet records were obtained before randomization to acarbose or placebo therapy, and additional 3 day diet records were obtained at 3, 6, 9 and 12 months after randomization. Body weight was also measured at these times. RESULTS: Of the 354 subjects randomized, 279 (79%) completed at least 9 months of therapy and, of these, 263 (94%) provided at least one diet record during the baseline period and two diet records during the treatment period. After one year, subjects on acarbose had lost 0.46 AE 0.28 kg, which differed signi®cantly from the 0.33 AE 0.25 kg weight gain on placebo (P 0.027). The difference in weight change between acarbose and placebo did not differ signi®cantly in the different treatment strata. Being in the study had signi®cant effects on diet, including a reduction in energy intake from 1760±1700 Kcal/d (P`0.05), a reduction in simple sugars intake from 18.5±17.4% of energy (P`0.001), and reductions in the number of different foods consumed (33±30, P`0.001) and the number of meals eaten per day (4.7± 4.3, P`0.001). However, compared to placebo treatment, acarbose had no effect on energy intake, nutrient intakes, or dietary patterns. CONCLUSIONS: In subjects with NIDDM on weight-maintaining diets, long-term acarbose therapy results in a small weight loss, but has no effect on energy or nutrient intakes. The weight loss induced by acarbose may be due partly to reduced doses of concomitant oral agents and insulin and partly to energy loss due to increased colonic fermentation.

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Section: Discussionmentioning

confidence: 99%

Small weight loss on long-term acarbose therapy with no change in dietary pattern or nutrient intake of individuals with non-insulin-dependent diabetes

et al. 1997

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“…Based on a number of studies, e.g. Livesey et al (1990), reviewed by Livesey (1995), the efficiency of microbial biomass production (A in the model) was estimated to be approximately 0.3 kJ/kJ RS fermented. Regarding B, no quantitative experiments have been reported measuring how much energy might be lost as combustible gases.…”

Section: Calculating the E N E R G Y Value O F Resistant Starch I N Mmentioning

confidence: 99%

“…Regarding B, no quantitative experiments have been reported measuring how much energy might be lost as combustible gases. Livesey (1992) andLivesey et al (1993) reviewed all types of carbohydrates and sugar alcohols investigated so far, concluding that this loss is < 5 % of all the carbohydrate energy fermented. A similar figure for RS is supported by a number of in vitro experiments reviewed by Livesey (1995).…”

Section: Calculating the E N E R G Y Value O F Resistant Starch I N Mmentioning

confidence: 99%

“…These studies, however, consider only the non-fermentative phase of intestinal degradation. A number of preliminary studies, reviewed by Livesey (1995), indicate that the thermogenic effect of the fermentative degradation of carbohydrates is of the order of 3 kJ/g. While the range of RS investigated and the number of observations in adults are limited, it did not appear that RS would be more thermogenic than expected, and that the terms C and G would together account for about 20% of the energy in starch fermented, i.e.…”

Section: Calculating the E N E R G Y Value O F Resistant Starch I N Mmentioning

confidence: 99%

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Nutritional Implications Of Resistant Starch

Asp

Amelsvoort

Hautvast³

1996

Nutr. Res. Rev.

181

129

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“…19 However, one plausible explanation may be the small energy loss due to increased carbohydrate fermentation in the colon, as the energy obtained from carbohydrates which are fermented in the colon is estimated to be only 50% of that obtained from carbohydrates absorbed from the intestine. 20 The current view is that this modest weight reduction is not clinically signi®cant, but may represent a small advantage compared to other antidiabetic drugs which increase body weight.…”

Section: Metforminmentioning

confidence: 99%

The impact of pharmacotherapy on weight management in type 2 diabetes

Hauner

1999

Int J Obes

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Today, obesity is the most important modi®able risk factor for type 2 diabetes. An excess of body fat is associated with a deterioration of glucose utilisation and promotes the development of type 2 diabetes, particularly in those with a genetic predisposition for the disease. It is also well established that a reduction of excess body fat improves insulin sensitivity and can prevent the conversion to diabetes. In those with overt diabetes, weight loss usually ameliorates glycaemic control and associated metabolic disturbances. Among the pharmacological agents that are used for the treatment of type 2 diabetes only metformin has a weak weight-lowering activity and is considered as the drug of choice for adjunct pharmacotherapy in obese diabetic subjects. A few studies also suggest that acarbose can induce a modest weight reduction in such patients. In contrast, sulphonylurea and insulin treatment is frequently accompanied by substantial weight gain which should be taken into consideration when these drugs are used. Another approach to improve metabolic control in obese type 2 diabetic patients is the use of weight-lowering agents. The new serotonin and noradrenaline reuptake inhibitor sibutramine promotes weight loss which subsequently leads to improved glycaemic control. Orlistat, a lipase inhibitor, is also able to ameliorate metabolic control in such patients due to its weight-lowering potential. As obesity remains a therapeutic challenge in most type 2 diabetic subjects, weight management drugs may represent an alternative or supplement to antidiabetic agents. Moreover, weight management agents have the advantage that they have additional favourable effects on associated cardiovascular risk factors.

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The Energy Values of Dietary Fibre and Sugar Alcohols for Man

Cited by 126 publications

References 85 publications

Small weight loss on long-term acarbose therapy with no change in dietary pattern or nutrient intake of individuals with non-insulin-dependent diabetes

Small weight loss on long-term acarbose therapy with no change in dietary pattern or nutrient intake of individuals with non-insulin-dependent diabetes

Nutritional Implications Of Resistant Starch

The impact of pharmacotherapy on weight management in type 2 diabetes

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