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Effect of viscous fiber supplementation on obesity indicators in individuals consuming calorie-restricted diets: a systematic review and meta-analysis of randomized controlled trials

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Abstract

Background

Dietary fiber has played a consistent role in weight management, with efficacy potentially attributed to increased viscous fiber consumption.

Purpose

To summarize the effects of viscous fiber on body weight and other anthropometric parameters, along with a calorie-deficient diet, through a systematic review and meta-analysis.

Methods

MEDLINE, EMBASE, and the Cochrane library were searched through July 24, 2019 for randomized controlled trials that assessed the effect of viscous fiber supplementation as part of a restricted calorie diet for ≥ 4 weeks relative to comparator diets. Data were pooled using the generic inverse-variance method with random-effects models and expressed as mean differences with 95% confidence intervals. Inter-study heterogeneity was assessed using Cochran’s Q and quantified with I2. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the overall certainty of evidence.

Results

Findings from 15 studies (n = 1347) showed viscous fiber supplementation significantly decreased body weight (− 0.81 kg [− 1.20, − 0.41]; p < 0.0001), BMI (− 0.25 kg/m2 [− 0.46, − 0.05]; p = 0.01), and body fat (− 1.39% [− 2.61, − 0.17]; p = 0.03), compared to control. No effect on waist circumference was found. The certainty of evidence was graded as “moderate” for body weight, BMI, and body fat based on downgrades for imprecision. Waist circumference was graded “low” for downgrades of inconsistency and imprecision.

Conclusion

Viscous fiber within a calorie-restricted diet significantly improved body weight and other markers of adiposity in overweight adults and those with additional risk factors for cardiovascular disease. This trial is registered at www.clinicaltrials.gov as NCT03257449.

Registration

ClinicalTrials.gov identifier: NCT03257449

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Acknowledgments

NM and RK received funding from the King Abdullah Scholarship Program, Saudi Arabia. JLS was funded by a PSI Graham Farquharson Knowledge Translation Fellowship, Diabetes Canada Clinician Scientist Award, and Banting & Best Diabetes Centre Sun Life Financial New Investigator Award.

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Author notes

  1. Elena Jovanovski and Nourah Mazhar contributed equally to the work

Authors and Affiliations

  1. Clinical Nutrition and Risk Factor Modification Centre, St. Michael’s Hospital, 30 Bond Street, Toronto, ON, M5B1X1, Canada

    Elena Jovanovski, Nourah Mazhar, Allison Komishon, Rana Khayyat, Dandan Li, Sonia Blanco Mejia, Tauseef Khan, Alexandra L. Jenkins, John L. Sievenpiper & Vladimir Vuksan

  2. Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Elena Jovanovski, Nourah Mazhar, Rana Khayyat, Dandan Li, Sonia Blanco Mejia, Tauseef Khan, John L. Sievenpiper & Vladimir Vuksan

  3. Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael’s Hospital, Toronto, Canada

    Sonia Blanco Mejia, Tauseef Khan & John L. Sievenpiper

  4. Clinic for Diabetes, Endocrinology and Metabolic Diseases Vuk Vrhovac, University Hospital Merkur, University of Zagreb, School of Medicine, Zagreb, Croatia

    Lea Smircic-Duvnjak

  5. Division of Endocrinology and Metabolism, Department of Medicine, St. Michael’s Hospital, Toronto, Canada

    John L. Sievenpiper & Vladimir Vuksan

  6. Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada

    John L. Sievenpiper & Vladimir Vuksan

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  1. Elena Jovanovski
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Correspondence to Vladimir Vuksan.

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Conflict of interest

VV holds a research grant from the Canadian Diabetes Association for study of dietary intervention including viscous soluble fiber and holds the Canadian (2,410,556) and American (7,326,404) patents on the medical use of viscous fiber blend for reducing blood glucose for treatment of diabetes, increasing insulin sensitivity, and reducing systolic blood pressure and blood lipids. ALJ is part owner of INQUIS Clinical Research (formally Glycemic Index Laboratories, Inc.), a contract research organization. LS-D has previously received honoraria for speaking and consultancy and grants for attending scientific conferences from Abbott, Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Merck, Merck Sharp & Dohme, Novo Nordisk, Novartis, Sanofi, Servier, and Takeda. JLS has received research support from the Canadian Foundation for Innovation, Ontario Research Fund, Province of Ontario Ministry of Research and Innovation and Science, Canadian Institutes of health Research (CIHR), Diabetes Canada, PSI Foundation, Banting and Best Diabetes Centre (BBDC), American Society for Nutrition (ASN), INC International Nut and Dried Fruit Council Foundation, National Dried Fruit Trade Association, The Tate and Lyle Nutritional Research Fund at the University of Toronto, The Glycemic Control and Cardiovascular Disease in Type 2 Diabetes Fund at the University of Toronto (a fund established by the Alberta Pulse Growers), and the Nutrition Trialists Fund at the University of Toronto (a fund established by an inaugural donation from the Calorie Control Council). He has received in-kind food donations to support a randomized controlled trial from the Almond Board of California, California Walnut Commission, American Peanut Council, Barilla, Unilever, Unico/Primo, Loblaw Companies, Quaker, Kellogg Canada, and WhiteWave Foods. He has received travel support, speaker fees and/or honoraria from Diabetes Canada, Mott’s LLP, Dairy Farmers of Canada, FoodMinds LLC, International Sweeteners Association, Nestlé, Pulse Canada, Canadian Society for Endocrinology and Metabolism (CSEM), GI Foundation, Abbott, Biofortis, ASN, Northern Ontario School of Medicine, INC Nutrition Research & Education Foundation, European Food Safety Authority (EFSA), Comité Européen des Fabricants de Sucre (CEFS), and Physicians Committee for Responsible Medicine. He has or has had ad hoc consulting arrangements with Perkins Coie LLP, Tate & Lyle, and Wirtschaftliche Vereinigung Zucker e.V. He is a member of the European Fruit Juice Association Scientific Expert Panel and Soy Nutrition Institute Scientific Advisory Committee. He is on the Clinical Practice Guidelines Expert Committees of Diabetes Canada, European Association for the study of Diabetes (EASD), Canadian Cardiovascular Society (CCS), and Obesity Canada. He serves or has served as an unpaid scientific advisor for the Food, Nutrition, and Safety Program (FNSP) and the Technical Committee on Carbohydrates of the International Life Science Institute (ILSI) North America. He is a member of the International Carbohydrate Quality Consortium (ICQC), Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the EASD, and Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. His wife is an employee of Sobeys Inc. All other authors declare no conflict of interest. None of the sponsors had a role in any aspect of the current study, including design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review and approval of the manuscript or decision to publish.

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Jovanovski, E., Mazhar, N., Komishon, A. et al. Effect of viscous fiber supplementation on obesity indicators in individuals consuming calorie-restricted diets: a systematic review and meta-analysis of randomized controlled trials. Eur J Nutr 60, 101–112 (2021). https://doi.org/10.1007/s00394-020-02224-1

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