Hälsoeffekter av fibrer och fullkorn olika studier olika svar? 1. Råg faktorn

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1 Hälsoeffekter av fibrer och fullkorn olika studier olika svar? 1. Råg faktorn 1

2 Rye products in the diabe8c diet. Postprandial glucose and hormonal responses in non- insulin- dependent diabe8c pa8ents as compared to starch availability in vitro and experiments in rats. Diabetes Res Clin Pract Mar- Apr;3(2): Hagander B, Björck I, Asp NG, Efendić S, Holm J, Nilsson- Ehle P, Lundquist I, Scherstén B. Rye flakes, rye bread and white wheat bread were given as suspensions to rats and in standardized breakfast meals to non- insulin- dependent diabe^cs. In both cases the postprandial glucose response was lower a_er rye bread than a_er wheat bread. Rye bran Reduced blood and urinary glucose compared with wheat bran in alloxan diabe8c rats Favorable effects on diabetes pa8ents and mice with gene8cally severe diabetes CharloCe Nygren, Thesis - Akademisk avhandling 1984, Umeå and Göteborg Metabolic effects: The Rye factor 20 healthy subjects Different rye breads vs refined wheat bread 50 g available CHO Leinonen et al. (1999) EJCN 2

3 Rye, insulin, intes^ne and appe^te Effects of cereal breakfasts on postprandial glucose, insulin, appe8te regula8on and voluntary energy intake at a subsequent standardized lunch Liza AH Rosén *, Elin M Östman and Inger ME Björck 2011 Konklusion: Rågfaktorn är kopplad 8ll ec minskat insulinbehov. Skydd mot diabetes? 3

4 NNR 2012 dra_ conclusion on dietary fiber and Risk for Type 2 Diabetes Mellitus..several larger cohort studies show convincing, protec^ve associa^ons between intake of wholegrain products and type- 2 diabetes.. 2. Fibrer och hjärt- kärl sjukdom Dietary fiber decreases fas8ng blood glucose levels and plasma LDL concentra8on in noninsulin dependent diabetes mellitus pa8ents. Hagander B, Asp NG, Efendić S, Nilsson- Ehle P, Scherstén B. Conclusion: The high- fiber diet induced lower fas8ng blood glucose levels and decreased the ra8o of low- density lipoproteins to high- density lipoproteins. 4

5 Fibrer skyddar mot hjärt- kärl sjukdom tydligt stöd från epidemiologi; motstridiga resultat från interven8onsstudier 3. Effekt av isolerade fiberkällor och olika former av berikning eller supplement Effect of two kinds of pec8n and guar gum on 1,2- dimethylhydrazine ini8a8on of colon tumors and on fecal beta- glucuronidase ac8vity in the rat. Bauer HG, Asp NG, Dahlqvist A, Fredlund PE, Nyman M, Oste R. Cancer Res Jun;41(6): Conclusion: Pec^n increased the mul^plicity of color tumors, whereas guar gum did not. 5

6 Konklusion: NyCjande av renade frak8oner från bl.a. koseiberkomplexet kan ge upphov 8ll problem. Flera exempel! 4 Höga insulinnivåer är kopplade 8ll en ökad cancerrisk?! Effect of dietary fibre on blood glucose, plasma immunoreac8ve insulin, C- pep8de and GIP responses in non insulin dependent (type 2) diabe8cs and controls. Hagander B, Scherstén B, Asp NG, Sartor G, Agardh CD, Schrezenmeir J, Kasper H, Ahrén B, Lundquist I. Acta Med Scand. 1984;215(3): The two- hour C- pep^d values.were lower for the diabe^cs a_er the high fibre breakfast. 6

7 Metabolic effects: Energy u^liza^on and C- pep^de excre^on Energy and total bile acid excre8on in 24- h urinary C- pep8de excre8on ileostomy effluents from 10 subjects 2,5 2 1,5 1 0,5 LFD-Nib LFD-Ord HFD-Nib HFD-Ord 0 Energy (MJ/d) Total bile acids (g/d) Lundin et al. (2004) EJCN The impact of insulin Insulin is a growth factor and experimental insulin depriva8on results in inhibi8on of tumor growth Kritchevsky, D. (1999) Caloric restric8on and experimental carcinogenesis. Toxicol. Sci. 52(suppl.):13-16 A twenty- first century cancer epidemic caused by obesity: the involvement of insulin, diabetes, and insulin- like growth factors. Westley RL, May FE: Int J Endocrinol. Epub 2013 Jul 31 7

8 Review Ar)cle A Twenty- First Century Cancer Epidemic Caused by Obesity: The Involvement of Insulin, Diabetes, and Insulin- Like Growth Factors Rosalyne L. Westley and Felicity E. B.May; 2013.Novel drugs that target the insulin and insulin- like growth factor.. are in clinical trial. Effects of a biguanide (Meeormin) on vitamin B 12 and folic acid absorp8on and intes8nal enzyme ac8vi8es Berchtold P, Dahlqvist A, Gustafson A, Asp NG. Scand J Gastroenterol. 1971;6(8): New perspec8ve for an old an8diabe8c drug: meeormin as an8cancer agent. Leone A, Di Gennaro E, Bruzzese F, Avallone A, Budillon A 2013.jus^fy ini^a^on of clinical trials of memormin as an an^cancer agent.including a large- scale adjuvant study in breast cancer 8

9 YCerligare stöd från experimentella studier på prostatacancer Conclusion experimental studies on rye bran and prostate cancer Tumour volume Cell proliferation ± 0 (rats and mice) (rats and mice) Apoptosis PSA (rats, mice, humans) (mice, humans) Insulin, C-reactive protein and C-peptide (mice, humans) First human pilot study Rye bran bread increased tumor cell apoptosis compared to base- line (P<0.05) No difference for control diet. 9

10 The Second Human interven8on study Rye whole grain and bran intake compared with refined wheat decreases urinary C- pep8de, plasma insulin and prostate specific an8gen in men with prostate cancer Landberg R, Andersson S- O, Zhang J- X, Johansson J- E, Stenman U- H, Adlercreutz H, Kamal- Eldin A, Åman P, Hallmans G 2010 J Nutr Dec;140(12): Prostate cancer rye- bran interven^on Study Design (n=17+7) Experimental period First dietary Intervention 6 weeks Washout Period two weeks Second dietary Intervention 6 weeks Group 1 M M Group 2 M M Urine sampling Blood Sampling Rye bran diet Wheat bread diet Rye products compared with refined wheat fiber products reduce PSA concentra^ons (P=0.04) Landberg et al., Nutr, 2010 * * 10

11 Conclusions from the interven8on study Total PSA was 15% lower a_er RB compared to WF treatment C- pep^de in urine was 30% lower a_er RB compared to WF treatment P- insulin and P- CRP were significantly lower a_er RB treatment A katabolic metabolomic parern in plasma The results need to be confirmed in a larger study! Effekt av insulin Konklusion: Lägre insulinnivåer leder 8ll en minskad risk för 8llväxt av cancer 5. Effekt av rågkli på 8llväxt av - Helicobacter pylori 11

12 SinoSwed R & D Centre Konklusion: Fermenterat råg kli minskar 8llväxt av Helicobacter Pylori 12

13 6. Svar 8ll kri8ker via popula8onbaserade studier av kosteffekter över 8den Resultat VIP + MONICA FatE% and Carbohydrate E% Ingegerd Johansson et.al Serum cholesterol Ingegerd Johansson et.al

14 FortsaC likartad utveckling i Sverige och Finland En jäcelik interven8on på en hel befolkning. Effekt på sjukdomspanoramat? Avslutar LCHF debacen? Konklusion: Hälsoeffekterna av en fiberrik kost är dokumenterade experimentellt, epidemiologiskt och på populationsnivå 14