Thompson Sharon V, Hannon Bridget A, An Ruopeng, Holscher Hannah D
Division of Nutritional Sciences, and.
Departments of Kinesiology and Community Health and.
Am J Clin Nutr. 2017 Dec;106(6):1514-1528. doi: 10.3945/ajcn.117.163246. Epub 2017 Nov 1.
There is strong epidemiologic evidence that dietary fiber intake is protective against overweight and obesity; however, results of intervention studies have been mixed. Soluble fiber beneficially affects metabolism, and fiber supplementation may be a feasible approach to improve body composition and glycemia in adults with overweight and obesity. We evaluated randomized controlled trials (RCTs) of isolated soluble fiber supplementation in overweight and obese adults on outcomes related to weight management [body mass index (BMI; in kg/m), body weight, percentage of body fat, and waist circumference] and glucose and insulin metabolism (homeostasis model assessment of insulin resistance and fasting insulin) through a systematic review and meta-analysis. We searched PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature and Cochrane Library databases. Eligible studies were RCTs that compared isolated soluble fiber with placebo treatments without energy-restriction protocols. Random-effects models were used to estimate pooled effect sizes and 95% CIs. Meta-regressions were performed to assess outcomes in relation to the intervention duration, fiber dose, and fiber type. Publication bias was assessed via Begg's and Egger's tests and funnel plot inspection. Findings from 12 RCTs ( = 609 participants) from 2 to 17 wk of duration are summarized in this review. Soluble fiber supplementation reduced BMI by 0.84 (95% CI: -1.35, -0.32; = 0.001), body weight by 2.52 kg (95% CI: -4.25, -0.79 kg; = 0.004), body fat by 0.41% (95% CI: -0.58%, -0.24%; < 0.001), fasting glucose by 0.17 mmol/L (95% CI: -0.28, -0.06 mmol/L; = 0.002), and fasting insulin by 15.88 pmol/L (95% CI: -29.05, -2.71 pmol/L; = 0.02) compared with the effects of placebo treatments. No publication bias was identified. Considerable between-study heterogeneity was observed for most outcomes. Isolated soluble fiber supplementation improves anthropometric and metabolic outcomes in overweight and obese adults, thereby indicating that supplementation may improve fiber intake and health in these individuals. However, the interpretation of these findings warrants caution because of the considerable between-study heterogeneity. This trial was registered at clinicaltrials.gov as NCT03003897.
有充分的流行病学证据表明,膳食纤维摄入对超重和肥胖具有预防作用;然而,干预研究的结果却参差不齐。可溶性纤维对新陈代谢有有益影响,补充纤维可能是改善超重和肥胖成年人身体成分及血糖水平的一种可行方法。我们通过系统评价和荟萃分析,评估了超重和肥胖成年人补充分离出的可溶性纤维的随机对照试验(RCT),这些试验涉及与体重管理相关的结果[体重指数(BMI;单位为kg/m²)、体重、体脂百分比和腰围]以及葡萄糖和胰岛素代谢(胰岛素抵抗稳态模型评估和空腹胰岛素)。我们检索了PubMed、科学网、护理学与健康相关文献累积索引以及Cochrane图书馆数据库。符合条件的研究是将分离出的可溶性纤维与无能量限制方案的安慰剂治疗进行比较的RCT。采用随机效应模型估计合并效应量和95%置信区间。进行了荟萃回归分析,以评估与干预持续时间、纤维剂量和纤维类型相关的结果。通过Begg检验和Egger检验以及漏斗图检查评估发表偏倚。本综述总结了12项持续时间为2至17周的RCT(n = 609名参与者)的结果。与安慰剂治疗相比,补充可溶性纤维使BMI降低了0.84(95%置信区间:-1.35,-0.32;P = 0.001),体重降低了2.52 kg(95%置信区间:-4.25,-0.79 kg;P = 0.004),体脂降低了0.41%(95%置信区间:-0.58%,-0.24%;P < 0.001),空腹血糖降低了0.17 mmol/L(95%置信区间:-0.28,-0.06 mmol/L;P = 0.002),空腹胰岛素降低了15.88 pmol/L(95%置信区间:-29.05,-2.71 pmol/L;P = 0.02)。未发现发表偏倚。大多数结果在研究间存在相当大的异质性。补充分离出的可溶性纤维可改善超重和肥胖成年人的人体测量学和代谢结果,从而表明补充纤维可能改善这些个体的纤维摄入量和健康状况。然而,由于研究间存在相当大的异质性,对这些结果的解释需谨慎。该试验已在clinicaltrials.gov上注册,注册号为NCT03003897。