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
Similar content being viewed by others
References
Goldstein DJ (1992) Beneficial health effects of modest weight loss. Int J Obes Relat Metab Disord 16(6):397–415
Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M (2001) Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 344(18):1343–1350. https://doi.org/10.1056/nejm200105033441801
Saltzman E, Moriguti JC, Das SK, Corrales A, Fuss P, Greenberg AS, Roberts SB (2001) Effects of a cereal rich in soluble fiber on body composition and dietary compliance during consumption of a hypocaloric diet. J Am Coll Nutr 20(1):50–57
Clark MJ, Slavin JL (2013) The effect of fiber on satiety and food intake: a systematic review. J Am Coll Nutr 32(3):200–211. https://doi.org/10.1080/07315724.2013.791194
Jovanovski E, Khayyat R, Zurbau A, Komishon A, Mazhar N, Sievenpiper JL, Blanco Mejia S, Ho HVT, Li D, Jenkins AL, Duvnjak L, Vuksan V (2019) Should viscous fiber supplements be considered in diabetes control? Results from a systematic review and meta-analysis of randomized controlled trials. Diabetes Care 42(5):755–766. https://doi.org/10.2337/dc18-1126
Zhang L, Pagoto S, Olendzki B, Persuitte G, Churchill L, Oleski J, Ma Y (2018) A nonrestrictive, weight loss diet focused on fiber and lean protein increase. Nutrition (Burbank, Los Angeles County, Calif) 54:12–18. https://doi.org/10.1016/j.nut.2018.02.006
Smethers AD, Rolls BJ (2018) Dietary management of obesity: cornerstones of healthy eating patterns. Med Clin N Am 102(1):107–124. https://doi.org/10.1016/j.mcna.2017.08.009
Chutkan R, Fahey G, Wright WL, McRorie J (2012) Viscous versus nonviscous soluble fiber supplements: mechanisms and evidence for fiber-specific health benefits. J Am Acad Nurse Pract 24(8):476–487. https://doi.org/10.1111/j.1745-7599.2012.00758.x
Lambeau KV, McRorie JW Jr (2017) Fiber supplements and clinically proven health benefits: how to recognize and recommend an effective fiber therapy. J Am Acad Nurse Pract 29(4):216–223. https://doi.org/10.1002/2327-6924.12447
Vuksan V, Rogovik AL, Jovanovski E, Jenkins AL (2009) Fiber facts: benefits and recommendations for individuals with type 2 diabetes. Curr Diab Rep 9(5):405–411
Institute of Medicine (US) Panel on the Definition of Dietary F tSCotSEoDRI (2001) Dietary reference intakes proposed definition of dietary fiber. National Academics Press, Washington
Slavin JL (1987) Dietary fiber: classification, chemical analyses, and food sources. J Am Diet Assoc 87(9):1164–1171
Jovanovski EMN, Komishon A, Khayyat R, Li D, Blanco Mejia S, Khan T, Jenkins AL, Smircic-Duvnjak L, Sievenpiper JL, Vuksan V (2019) Can dietary viscous fiber affect body weight independently of an energy-restrictive diet? A systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 111:471–485
Cochrane Handbook for Systematic Reviews of Interventions (2011) Cochrane Book Series. The Cochrane Collaboration and John Wiley & Sons Ltd., New York
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700
Anderson JW, Bridges SR (1988) Dietary fiber content of selected foods. Am J Clin Nutr 47:440–447
Limberger-Bayer VM, de Francisco A, Chan A, Oro T, Ogliari PJ, Barreto PL (2014) Barley beta-glucans extraction and partial characterization. Food Chem 154:84–89. https://doi.org/10.1016/j.foodchem.2013.12.104
McMaster University, Evidence Prime Inc. (2015) GRADEpro GDT: GRADEpro guideline development tool [software]. McMaster University, Hamilton, ON
Akbarzadeh Z, Nourian M, Askari G, Maracy MR (2015) The effect of Psyllium on anthropometric measurements and liver enzymes in overweight or obese adult with nonalcoholic fatty liver. J Isfahan Med School 33(355):1771–1783
Beck EJ, Tapsell LC, Batterham MJ, Tosh SM, Huang XF (2010) Oat beta-glucan supplementation does not enhance the effectiveness of an energy-restricted diet in overweight women. Br J Nutr 103(8):1212–1222. https://doi.org/10.1017/s0007114509992856
Birketvedt GS, Shimshi M, Erling T, Florholmen J (2005) Experiences with three different fiber supplements in weight reduction. Med Sci Monitor 11(1):Pi5–Pi8
Cairella M (1995) Valutazione dell'attivita del glucomannano su alcuni parametri metabollici e sulla sensazione di sazieta in pazienti con sovappeso ed obesita. Clin Ter 146:269–297
Ghajandari H, Kamalpour M, Alimadadi A, Nasrollahzadeh J (2018) Comparison of two calorie-reduced diets of different carbohydrate and fiber contents and a simple dietary advice aimed to modify carbohydrate intake on glycemic control and inflammatory markers in type 2 diabetes: a randomized trial. Int J Endocrinol Metab 16(1):e12089. https://doi.org/10.5812/ijem.12089
Georg Jensen M, Kristensen M, Astrup A (2012) Effect of alginate supplementation on weight loss in obese subjects completing a 12-week energy-restricted diet: a randomized controlled trial. Am J Clin Nutr 96(1):5–13. https://doi.org/10.3945/ajcn.111.025312
Li X, Cai X, Ma X, Jing L, Gu J, Bao L, Li J, Xu M, Zhang Z, Li Y (2016) Short- and long-term effects of wholegrain oat intake on weight management and glucolipid metabolism in overweight type-2 diabetics: a randomized control trial. Nutrients. https://doi.org/10.3390/nu8090549
Maeda H, Yamamoto R, Hirao K, Tochikubo O (2005) Effects of agar (kanten) diet on obese patients with impaired glucose tolerance and type 2 diabetes. Diabetes Obes Metab 7(1):40–46. https://doi.org/10.1111/j.1463-1326.2004.00370.x
Maki KC, Beiseigel JM, Jonnalagadda SS, Gugger CK, Reeves MS, Farmer MV, Kaden VN, Rains TM (2010) Whole-grain ready-to-eat oat cereal, as part of a dietary program for weight loss, reduces low-density lipoprotein cholesterol in adults with overweight and obesity more than a dietary program including low-fiber control foods. J Am Diet Assoc 110(2):205–214. https://doi.org/10.1016/j.jada.2009.10.037
Moran S (1997) Effecto de la administracion de fibra en la prevencion de litiasis vesicukar en obesos sometidos a dieta de reduction. Rev Gastroenterol Max 62(4):266–272
Reyna-Villasmil N, Bermudez-Pirela V, Mengual-Moreno E, Arias N, Cano-Ponce C, Leal-Gonzalez E, Souki A, Inglett GE, Israili ZH, Hernandez-Hernandez R, Valasco M, Arraiz N (2007) Oat-derived beta-glucan significantly improves HDLC and diminishes LDLC and non-HDL cholesterol in overweight individuals with mild hypercholesterolemia. Am J Ther 14(2):203–212. https://doi.org/10.1097/01.pap.0000249917.96509.e7
Straczkowski M, Nikolajuk A, Majewski R, Filarski R, Stefanowicz M, Matulewicz N, Karczewska-Kupczewska M (2018) The effect of moderate weight loss, with or without (1, 3)(1, 6)-beta-glucan addition, on subcutaneous adipose tissue inflammatory gene expression in young subjects with uncomplicated obesity. Endocrine 61(2):275–284. https://doi.org/10.1007/s12020-018-1619-z
Tabesh F, Sanei H, Jahangiri M, Momenizadeh A, Tabesh E, Pourmohammadi K, Sadeghi M (2014) The effects of beta-glucan rich oat bread on serum nitric oxide and vascular endothelial function in patients with hypercholesterolemia. Biomed Res Int 2014:481904. https://doi.org/10.1155/2014/481904
Beattie VA, Edwards CA, Hosker JP, Cullen DR, Ward JD, Read NW (1988) Does adding fibre to a low energy, high carbohydrate, low fat diet confer any benefit to the management of newly diagnosed overweight type II diabetics? Br Med J (Clin Res ed) 296(6630):1147–1149. https://doi.org/10.1136/bmj.296.6630.1147
Berg A, Konig D, Deibert P, Grathwohl D, Berg A, Baumstark MW, Franz IW (2003) Effect of an oat bran enriched diet on the atherogenic lipid profile in patients with an increased coronary heart disease risk. A controlled randomized lifestyle intervention study. Ann Nutr Metab 47(6):306–311. https://doi.org/10.1159/000072404
Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, Hu FB, Hubbard VS, Jakicic JM, Kushner RF, Loria CM, Millen BE, Nonas CA, Pi-Sunyer FX, Stevens J, Stevens VJ, Wadden TA, Wolfe BM, Yanovski SZ (2014) 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol 63(25 Pt B):2985–3023. https://doi.org/10.1016/j.jacc.2013.11.004
Johnston BC, Kanters S, Bandayrel K, Wu P, Naji F, Siemieniuk RA, Ball GD, Busse JW, Thorlund K, Guyatt G, Jansen JP, Mills EJ (2014) Comparison of weight loss among named diet programs in overweight and obese adults: a meta-analysis. JAMA 312(9):923–933. https://doi.org/10.1001/jama.2014.10397
Howarth NC, Saltzman E, Roberts SB (2001) Dietary fiber and weight regulation. Nutr Rev 59(5):129–139. https://doi.org/10.1111/j.1753-4887.2001.tb07001.x
Rebello CJ, O'Neil CE, Greenway FL (2016) Dietary fiber and satiety: the effects of oats on satiety. Nutr Rev 74(2):131–147. https://doi.org/10.1093/nutrit/nuv063
Pereira MA, Ludwig DS (2001) Dietary fiber and body-weight regulation. Observations and mechanisms. Pediatric Clin N Am 48(4):969–980. https://doi.org/10.1016/s0031-3955(05)70351-5
Vitaglione P, Lumaga RB, Stanzione A, Scalfi L, Fogliano V (2009) beta-Glucan-enriched bread reduces energy intake and modifies plasma ghrelin and peptide YY concentrations in the short term. Appetite 53(3):338–344. https://doi.org/10.1016/j.appet.2009.07.013
Baer DJ, Rumpler WV, Miles CW, Fahey GC Jr (1997) Dietary fiber decreases the metabolizable energy content and nutrient digestibility of mixed diets fed to humans. J Nutr 127(4):579–586. https://doi.org/10.1093/jn/127.4.579
Gowd V, Xie L, Zheng X, Chen W (2019) Dietary fibers as emerging nutritional factors against diabetes: focus on the involvement of gut microbiota. Crit Rev Biotechnol 39(4):524–540. https://doi.org/10.1080/07388551.2019.1576025
Blundell J, de Graaf C, Hulshof T, Jebb S, Livingstone B, Lluch A, Mela D, Salah S, Schuring E, van der Knaap H, Westerterp M (2010) Appetite control: methodological aspects of the evaluation of foods. Obes Rev 11(3):251–270. https://doi.org/10.1111/j.1467-789X.2010.00714.x
Thompson SV, Hannon BA, An R, Holscher HD (2017) Effects of isolated soluble fiber supplementation on body weight, glycemia, and insulinemia in adults with overweight and obesity: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 106(6):1514–1528. https://doi.org/10.3945/ajcn.117.163246
Genta S, Cabrera W, Habib N, Pons J, Carillo IM, Grau A, Sanchez S (2009) Yacon syrup: beneficial effects on obesity and insulin resistance in humans. Clin Nutr (Edinb, Scotl) 28(2):182–187. https://doi.org/10.1016/j.clnu.2009.01.013
Kim SJ, de Souza RJ, Choo VL, Ha V, Cozma AI, Chiavaroli L, Mirrahimi A, Blanco Mejia S, Di Buono M, Bernstein AM, Leiter LA, Kris-Etherton PM, Vuksan V, Beyene J, Kendall CW, Jenkins DJ, Sievenpiper JL (2016) Effects of dietary pulse consumption on body weight: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 103(5):1213–1223. https://doi.org/10.3945/ajcn.115.124677
Naude CE, Schoonees A, Senekal M, Young T, Garner P, Volmink J (2014) Low carbohydrate versus isoenergetic balanced diets for reducing weight and cardiovascular risk: a systematic review and meta-analysis. PLoS ONE 9(7):e100652. https://doi.org/10.1371/journal.pone.0100652
Huang RY, Huang CC, Hu FB, Chavarro JE (2016) Vegetarian diets and weight reduction: a meta-analysis of randomized controlled trials. J Gen Intern Med 31(1):109–116. https://doi.org/10.1007/s11606-015-3390-7
Esposito K, Kastorini CM, Panagiotakos DB, Giugliano D (2011) Mediterranean diet and weight loss: meta-analysis of randomized controlled trials. Metab Syndr Relat Disord 9(1):1–12. https://doi.org/10.1089/met.2010.0031
Li H, Li X, Yuan S, Jin Y, Lu J (2018) Nut consumption and risk of metabolic syndrome and overweight/obesity: a meta-analysis of prospective cohort studies and randomized trials. Nutr Metab 15:46. https://doi.org/10.1186/s12986-018-0282-y
Sievenpiper JL, Chan CB, Dworatzek PD, Freeze C, Williams SL (2018) Nutrition therapy. Can J Diabetes 42(Suppl 1):S64–s79. https://doi.org/10.1016/j.jcjd.2017.10.009
National Health and Medical Research C (2013) Clinical Practice Guidelines for the management of overweight and obesity in adults, adolescents, and children in Austrailia. https://www.nhmrc.gov.au/about-us/publications/clinical-practice-guidelines-management-overweight-and-obesity#block-views-block-file-attachments-content-block-1). 2019. Accessed 1 Apr 2018
National Clinical Guideline C (2014) National Institute for Health and Clinical Excellence: Guidance. In: Obesity: Identification, Assessment and Management of Overweight and Obesity in Children, Young People and Adults: Partial Update of CG43. National Institute for Health and Care Excellence (UK). Copyright (c) National Clinical Guideline Centre, 2014. London
Durrer Schutz D, Busetto L, Dicker D, Farpour-Lambert N, Pryke R, Toplak H, Widmer D, Yumuk V, Schutz Y (2019) European practical and patient-centred guidelines for adult obesity management in primary care. Obes Facts 12(1):40–66. https://doi.org/10.1159/000496183
Wharton S, Pedersen SD, Lau DCW, Sharma AM (2018) Weight Management in diabetes. Can J Diabetes 42(Suppl 1):S124–s129. https://doi.org/10.1016/j.jcjd.2017.10.015
Williams LT, Barnes K, Ball L, Ross LJ, Sladdin I, Mitchell LJ (2019) How effective are dietitians in weight management? A systematic review and meta-analysis of randomized controlled trials. Healthcare. https://doi.org/10.3390/healthcare7010020
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.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
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.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
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
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00394-020-02224-1