The great grain

Whole wheat and rye breads are a good source of fibre, a nutrient that few adults are getting enough of.

Fibre can help lower the risk of everything from heart disease to cancer, yet most of us are still not getting enough, writes Michelle Gelok

New study findings released this month in The American Journal of Clinical Nutrition are once again bringing fibre to the forefront of consumers' minds.

The study, conducted by researchers in China, found that women who eat more fibre are less likely to get breast cancer. Researchers reviewed data on more than 700,000 women and found that individuals who consumed the most fibre in their diets were 11 per cent less likely to get breast cancer, compared with women who got the least amount of fibre in their diets.

Fibre often takes a back seat to other, more glamorous nutrients and food trends, such as antioxidants and gluten-free products. Yet studies show that a diet high in fibre may help lower the risk of everything from heart disease to cancer and diabetes. It is also known to help reduce blood cholesterol levels and blood pressure and assist with the management of blood glucose levels. But despite its many health benefits, research shows most adults don't get enough fibre in their diets.

Fibre is a nutrient that has special importance here in the UAE, where rates of diabetes are some of the highest in the world. According to the International Diabetes Federation, the UAE is one of six countries in the region that are among the world's 10 highest for diabetes prevalence. It's estimated that 19 per cent of people living in the UAE have the disease - a figure that far surpasses the global average of six per cent.

Research shows that a diet high in fibre may be able to help prevent the development of type 2 diabetes. One such study, published in the journal Diabetes Care in 2009, found that older men who consumed less than 20g of fibre per day had an increased risk of developing the disease. Another study, published in the Archives of Internal Medicine in 2007, found similar results; researchers reported that men and women who consumed the most fibre from grains and cereals had a 33 per cent lower risk of developing diabetes than those who consumed the least amount of fibre.

According to Dr Richard Stangier, a diabetologist and consultant in internal medicine at Al Rawdah German Medical Center in Abu Dhabi, fibre also plays an important role in the management of diabetes by preventing rapid spikes in blood glucose levels. He says by getting adequate fibre in the diet "the metabolism of carbohydrates will be slowed down, with the sequence of avoiding blood glucose peaks after food intake", which he explains "is a typical problem of type 2 diabetes". He adds that high-fibre foods also prolong feelings of fullness, which he says is especially helpful to diabetics and overweight individuals looking to consume fewer calories.

Fibre is found in foods that come from plant sources, including fruits, vegetables, whole grains, nuts, seeds and legumes such as beans and lentils. According to the National Health Service in the UK, there are two types of fibre - soluble and insoluble - both of which are beneficial to health and well-being.

Soluble fibre partially dissolves in water and forms a thick gel as it passes through the digestive tract, which helps lower blood cholesterol and control blood sugar levels. Soluble fibre is most commonly found in oat bran, oatmeal, bean, lentils, apples and barley.

Insoluble fibre forms a bulky substance in the gut where it helps prevent constipation and improve bowel regularity. Dietary sources of insoluble fibre include whole grains, as well as the skins, leaves and seeds of fruits and vegetables.

According to the Institute of Medicine in the US, men under the age of 50 need 38g of fibre per day, while women need 25g. For adults over the age of 50, the requirement is 30g per day for men and 21g for women.

It seems the effects of getting enough fibre can add up over time, and may even lead to a longer life. A landmark study published earlier this year in the Archives of Internal Medicine found that of the 400,000 people they studied, men who ate 29g of fibre and women who ate 26g of fibre per day were 22 per cent less likely to die after nine years, compared with men and women who consumed just 13g and 11g of fibre per day, respectively.

Few other nutrients have the documented health benefits of fibre; yet research shows most adults continue to fall short on their intake. While studies aren't available for the UAE, according to Statistics Canada adults in that country get on average just 14 grams per day. Similar estimates suggest Britons and Americans aren't much better with just 14g and 15g of fibre day, respectively.

According to Stangier, most people do not get adequate amounts of fibre in their diet. He says diets that are high in processed food, such as fast food, white bread and sweets often lack the necessary fibre for good health.

Ellen Gerero, a clinical dietician at Sheikh Khalifa Medical City in Abu Dhabi, agrees that it's a nutrient most people fall short on. "Definitely most people could benefit from more fibre in their diets," she says.

Fortunately increasing your fibre intake need not be difficult or expensive. In fact, Gerero recommends some simple food swaps. "Eat whole grain sources of bread and cereals," she says, and recommends looking for products that list "100 per cent whole wheat, rye, oats or bran as the first or second ingredient".

"Have brown or wild rice instead of white rice or potatoes, compare the nutrition facts label to similar foods to find higher fibre products and add beans and lentils to dishes."

Gerero also suggests accompanying your diet with at least eight glasses of fluids per day. According to the American Dietetic Association in the US, a sudden increase in fibre intake can cause abdominal bloating and stomach cramps. They recommend increasing your fibre intake slowly and making sure you get plenty of fluids, which can help alleviate any discomfort.

Michelle Gelok is a member of Dieticians of Canada and holds a BSc in Food and Nutrition. She lives in Abu Dhabi.