Application of dietary fibre - PowerPoint Presentation

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Application of dietary fibre in patients with metabolic disorders

3-month Progress Reportuntil December 2, 2021

Anna Evelin Juhász

About the lecturer

Anna Evelin JuhászPhD Student

Department:

Doctoral

School

of Health Sciences, Semmelweis UniversitySupervisor:Réka Hermánné Juhász (University associate professor, The Department of Dietetics and Nutrition Sciences, Semmelweis University)Scientific methodology supervisor:Brigitta TeutschStatistician: Alex VáradiVision: Normalise the metabolic disorders of the patients by using dietary fibre instead of a drug Mission: To draw the attention of physicians to the results of studies regarding the dietary management of polycystic ovary syndromeContact: juhaszannaevelin@gmail.com

OVERVIEWPROJECT LIST

Effects of dietary

fibr

e

supplementation on glycemic

control and lipid profile in patients with type 2 diabetes

:a systematic review and network meta-analysis Project started: September 20212. Effectiveness of dietary fibre and inositol on the ovarian function and metabolic balance in women with Polycystic ovary syndrome (PCOS): protocol of a randomised controlled trial Project started: October 2021

Effects of dietary fiber supplementation on glycemic control and lipid profile in patients with type 2 diabetes

Project started:September 2021Planned

submission

date

:

May 2022Systematic review and network meta-analysisCo-investigator

:

Dorina

Greff

1

Background

Type 2 diabetes 6.28% of the world’s population 

(M. Abdul

Basith

Khan et al. 2019,

Epidemiology of Type 2  Diabetes, Journal of Epidemiology and Global Health)Lifestyle management -> medical nutrition therapy (MNT) (Powers MA, et al. 2015, Diabetes self management education and support in type 2 diabetes, Diabetes Care)Dietary fibre

c

ould

d

e

crease

(

30%

)

the

fasting

glucose level in 1 month (Chen C. et al, 2016, Therapeutic effects of soluble dietary fiber consumption on type 2 diabetes mellitus. Experimental and therapeutic medicine )Using dietary fibre is a gap in the Guidelines on Diabetes

AIM:

to investigate the effects of dietary fiber

supplementation on glycemic control and lipid profiles in patients with type 2 diabetes

QuestionClinical

question: Does dietary fibre intake decrease the HbA1C compared to another type dietary fibre/no dietary fibre intake?P

p

atients

with type 2 diabetes

I v. C

soluble (B-glucan, Galactomannan, Glucomannan, Inulin, Tora fibre, Fucoidan), non-soluble dietary fibre (Cellulose) and no fibreO glycaemic factors (HbA1C, fasting glucose level, postprandial blood glucose, insulin level, HOMA-IR) lipid factors (Total cholesterol, LDL cholesterol, HDL cholesterol, Triacylglycerols

)

Clinical

i

mplication

:

To

prevent

long

term complications in T2DMHypothesis: Soluble dietary fibre intake can significantly normalise glucose and lipid levels in patients with T2DM.

Systematic searchDatabases

: Medline (601), Embase (428), Central

(

576

)

Date

of search: October 20, 2021Searchkey: type 2 diabetes AND dietary fibre AND random*(type 2 diabetes OR type 2 diabetes mellitus OR type II diabetes OR non insulin dependent diabetes OR non insulin dependent diabetes mellitus OR NIDDM) AND (“soluble dietary fibre” OR “soluble

dietary

fiber

” OR

inulin

OR

polycarbofil

OR

psyllium OR “resistant starch” OR “

resistant

maltodextrin” OR “wheat dextrin” OR xylooligosaccharide OR XOS OR roughage OR “beta glucan” OR “b-glucan” OR “β-glucan” OR “guar gum” OR guaran OR “gellan gum” OR alginate OR alginic OR algin OR “maize-based soluble fibre” OR “maize-based soluble fiber” OR galactomannan OR galactomannans OR konjac OR plantain OR “soluble corn fiber” OR “soluble maize fiber” OR arabinoxylan OR arabinoxylans OR “acacia gum” OR fructooligosaccharide OR FOS OR oligofructose OR galactooligosaccharide OR GOS OR glucomannan OR mannan OR “gum Arabic” OR pectin OR pectins OR laminarin OR laminarins OR polydextrose OR polyglycoplex OR “mixed-linkage glucans” OR pullulan

OR “plant gum” OR “plant gums” OR gum OR

gums

OR “

plant

mucilage

” OR

mucilage

OR “

fermentable fiber” OR prebiotic OR “prebiotic fiber”) AND random*

Flowchart of selection

Cohen’s Kappa: 0.8

2

Cohen’s Kappa:

0.81

Data

extraction

Effectiveness of dietary fibre and inositol on the ovarian function and metabolic balance in women with Polycystic ovary syndrome (PCOS)

Project started:October 2021Planned submission date:July 2022

P

rotocol

of a

randomised

controlled trial2

BackgroundPolycystic ovary syndrome (PCOS) is one of the most

common (12-24%) diseases in women of reproductive age (Eiras, M.C.,et

al. 2021, Polycystic Ovary

Syndrome: the Epigenetics Behind the Disease)

Clinical

manifestations: elevated serum androgen levels, menstrual irregularities, anovulation, insulin resistance, hyperinsulinemia (70%) and obesity (80%) (John C.M. et al 2012, All Women With PCOS Should Be Treated For Insulin Resistance, Fertil Steril)First choice of treatment: insulin sensitizers -> serious short (vomiting,diarrhea) and long-term (vitamin B12 deficiency) complications (Goldenberg N,

et

al

,

2008

,

Medical therapy in

women with polycystic ovary syndrome before and

during pregnancy and lactation)

Alternative

treatment: dietary fibre and inositol (Torres, N. et al, 2020. Dietary fiber and diabetes)( Franca F. et al, 2017,Comparison of two insulin sensitizers, metformin and myo-inositol, in women with polycystic ovary syndrome (PCOS))Aim:

to examine the effects of dietary fibre

and

inositol

in

the

treatment

of PCOS

QuestionClinical

question: Can dietary fibre and inositol improve metabolic disorders in PCOS?P women

with

PCOS

I

soluble dietary fibreC inositolO main: ovulation, menstrual cycle regularization additional: glycaemic factors (fasting glucose, fasting insulin, glucose/insulin ratio, HOMA- IR)Clinical and/or research

i

mplication:

Improve

ovarian

function

Hypothesis

:

soluble

dietary fibre is not inferior than inositol in the treatment of women with PCOS

Protocol drafting - eligibility criteria

Inclusion criteria:women aged between 18 and 45 years with PCOS according to the Rotterdam criteria

take only metformin

Exclusion

criteria

:pregnancy or lactationusing contraceptive medicationspatients on hormonal therapyprevious surgery to remove one or both ovariessymptoms of thyroid gland disorders and Cushing’s syndrome

Intervention

Arm A: soluble

dietary

fibre

Arm B: inositolProtocol drafting - intervention

Protocol drafting - outcomes

Primary

outcome

:

o

vulationmenstrual cycle regularization

Secondary

outcomes

:

Metabolic

parameters

(

fasting

glucose

, fasting insulin , glucose/insulin ratio, HOMA- IR)Hormonal parameters (FHS/LH ratio, dehydroepiandrosterone sulfate (DHEAS))

SPECIFIC GOALSAIMS

Effects of dietary fiber supplementation on glycemic

control and lipid profile in patients with type 2 diabetes

:

a

systematic

review and network meta-analysis Planned submission date: May 20222. Effectiveness of dietary fibre and inositol on the ovarian function and metabolic balance in women with Polycystic ovary syndrome (PCOS): protocol of a randomised controlled trial Planned submission date: July 2022

Thank

you for your attention!

“Let food be thy medicine and medicine be thy food.”

― 

Hippocrates