The dietary fibre story and diabetes.

There are basically two different types of fibre obtained from plants.

Non-soluble fibre is found in foods like wheat bran, and consists of basically roughage – non-digestible parts of the seed and plant.   It will also be found in skins of fruits and the fibrous part of vegetables.

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Soluble fibre is more gelatinous and is typically found in oats, legumes and some fruits.  When you cook up oats porridge and let it stand, the porridge goes firm/gelatinous from the soluble fibre.  This form of fibre is particularly useful for controlling absorption of carbohydrates – acting as a slow-release capsule for the latter.  It also is known to reduce serum cholesterol.

Dietary fibre is important for many health reasons.

• It feeds our microbiome – a 20-50 trillion strong army of helpers and enablers for all sorts of activities including digestion and absorption of nutrients, modulating and even manufacturing neuro-transmitters, controlling the immune system and maintaining homeostasis (equilibrium) in the body.
• It keeps the bowels functioning normally by providing bulk to the stools and thus reducing pressures needed within the bowel to propel the stools along.
• It counteracts the production of cancer-producing chemicals that develop in the intestines, and speeds up elimination time, reducing exposure of the intestinal lining to these harmful toxins.
• As mentioned above it allows the slow release of nutrients, particularly sugars, to prevent sudden spikes.
• It allows for better satiety – feeling of satisfaction and fullness – after a meal with plenty of nutritional fibre, as well as staving off hunger pangs for a bit longer before the next meal is required.

What impact does dietary fibre have on the development and the control of diabetes? 

By now over the last 13 weeks we have established that the incidence of diabetes has mushroomed in the last 20-40 years, most importantly since the onset of food processing and production of convenience foods in the 70’s and 80’s.

These are foods that have been modified to increase shelf-life as well as to increase palatability and attractiveness.

Many of the nutrients have been removed, particularly fibre, making them calorically dense, but nutritionally deficient.  Manufacturers try to fool us that the foods have been enhanced or fortified by the addition of vitamins, but a large portion of the nutrients were first removed, only to replace some of them in the so-called fortification process!

Here is a review article on the subject of fibre obtained from whole grains and legumes and its effect on the prevention and control of diabetes.

The main messages from this review article are firstly that fibre obtained from whole grains is the most efficient at both preventing diabetes type 2 and controlling blood sugars.  Of interest is that just adding back fibre to processed grains is not nearly as effective as eating the whole grains in the first place.  For instance, the most effective way of eating oats is through steel cut grits, then rolled oats, and then on down to the least effective being instant oats.  The most effective way of eating wheat is boiled up wheat kernels, then less effective is whole-wheat flour and All-Bran flakes, and least effective is white flour with added fibre.  It seems as if the benefit is best obtained from the intact grain, where the starch is encapsulated naturally in its own fibre capsule.  Once that is crushed and milled it loses its maximum efficacy.

Secondly the most effective frequency of taking whole grains is around 3 times per day, and least effective less than 3 times per week.  In many far eastern countries, people eat rice three times per day, and the incidence of diabetes is traditionally very low.

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Thirdly a good variety of grains and legumes, fruits and vegetables is ideal.  Good sources of whole grains are oats, barley, brown rice, millet, sorghum, quinoa (actually a legume but used like a grain) and maize on the cob.  More processed but still nutritious grains include braai pap, polenta, bulgar wheat, oats porridge, quinoa (actually a legume), polished rice, samp and least beneficial are your refined flours, fine maize meal etc.  Legumes include brown beans, sugar beans, haricot beans, butter beans, black beans, dried peas, chick-peas, lentils – brown, green and yellow.

This article confirms what is now also World Health Organization recommendations – to eat mostly  a wide variety of fruits and vegetables, whole grains and legumes, with very little animal products.  This diet not only helps to prevent and control diabetes type 2, but also most other chronic lifestyle diseases.

Incidentally that was basically the original diet presented to our first ancestors, Adam and Eve, for those of you who acknowledge the authority of the Bible, in Genesis 1:29 – what I like to call the Designer Diet.

May you week be complete with fibre from grains and legumes!

Dave Glass

Dr David Glass graduated from UCT in 1975. He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital.

He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world. He no longer delivers babies but is still very clinically active in gynaecology.

An old passion, preventive health care, has now replaced the obstetrics side of his work. He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc.

He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing. He is active in community health outreach and deeply involved in church activities. He enjoys teaching and sharing information.

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