Lambeau Kellen V, McRorie Johnson W
Employee and Community Health, Mayo Clinic, Rochester, Minnesota.
Global Clinical Sciences, Procter & Gamble, Mason, Ohio.
J Am Assoc Nurse Pract. 2017 Apr;29(4):216-223. doi: 10.1002/2327-6924.12447. Epub 2017 Mar 2.
Only 5% of adults consume the recommended level of dietary fiber. Fiber supplements appear to be a convenient and concentrated source of fiber, but most do not provide the health benefits associated with dietary fiber.
This review will summarize the physical effects of isolated fibers in small and large intestines, which drive clinically meaningful health benefits.
A comprehensive literature review was conducted (Scopus and PubMed) without limits to year of publication (latest date included: October 31, 2016).
The physical effects of fiber in the small intestine drive metabolic health effects (e.g., cholesterol lowering, improved glycemic control), and efficacy is a function of the viscosity of gel-forming fibers (e.g., psyllium, β-glucan). In the large intestine, fiber can provide a laxative effect if (a) it resists fermentation to remain intact throughout the large intestine, and (b) it increases percentage of water content to soften/bulk stool (e.g., wheat bran and psyllium).
It is important for nurse practitioners to understand the underlying mechanisms that drive specific fiber-related health benefits, and which fiber supplements have rigorous clinical data to support a recommendation.
For most fiber-related beneficial effects, "Fiber needs to gel to keep your patients well."
只有5%的成年人摄入了推荐水平的膳食纤维。纤维补充剂似乎是一种方便且浓缩的纤维来源，但大多数并不能提供与膳食纤维相关的健康益处。
本综述将总结分离纤维在小肠和大肠中的物理作用，这些作用带来了具有临床意义的健康益处。
进行了全面的文献综述（Scopus和PubMed），对发表年份没有限制（最新日期包括：2016年10月31日）。
纤维在小肠中的物理作用促进了代谢健康效应（如降低胆固醇、改善血糖控制），其功效取决于形成凝胶的纤维（如车前草、β-葡聚糖）的粘度。在大肠中，如果（a）纤维抵抗发酵并在整个大肠中保持完整，以及（b）纤维增加水分含量百分比以软化/增加粪便体积（如麦麸和车前草），则纤维可提供通便作用。
执业护士了解驱动特定纤维相关健康益处的潜在机制以及哪些纤维补充剂有严格的临床数据支持推荐非常重要。
对于大多数与纤维相关的有益作用，“纤维需要形成凝胶才能让患者保持健康。”
