Intake of Soluble Fiber Is Important Part of a Prudent, Low-Fat Diet

The precise role of oat bran as a variable in lowering blood cholesterol is now a matter of public debate, but scientists have known for some time that soluble fiber isn’t the cornerstone of cholesterol-lowering therapy.

Research data has proven that soluble fiber intake, in general, and oat bran intake, in particular, when combined with a low-fat diet can influence cholesterol levels in the bloodstream. But consumers overlooked that connection and instead sprinkled oat bran over everything from pretzels to beer as a quick-fix solution to a more complicated problem.

The controversy stimulated by the recently released Harvard study, however, may cause consumers to re-evaluate the placement of oat bran in the daily diet. At least that’s what health experts hope.

The Harvard study supports what dietitians and others have said all along: “Oat bran is not a panacea . . . sprinkling it on cereals and other foods will not provide an adequate supply of the body’s total fiber needs.”

What it does do, said one cholesterol expert, is prove that “You can’t eat whatever you want and eat oat bran and expect to lower your cholesterol that much. It’s best used as part of a prudent diet.”

According to the evidence, there has always been a wide assortment of foods, besides the much ballyhooed oat bran, and its recently touted cousin, rice bran, that lower blood cholesterol.

Adding 1 1/2 cups of cooked dried beans to the diets of men with elevated blood cholesterol has been shown to produce as much as a 19% decrease in serum cholesterol; barley also has been shown to have an effect.

And, as recently as last week, a new study from the University of Florida suggested that eating a grapefruit every day, along with other pectin-rich foods, could have a potential cholesterol-reducing effect and thus reduce one’s risk for heart disease. In this trial, 15 grams of grapefruit pectin, which is found just below the skin in the white interior peel, caused the blood cholesterol level of the volunteers to decline about 8%--without dietary change.

According to Environmental Nutrition, a diet and health newsletter, a study of five adults in Scotland demonstrated a 10% to 20% reduction in serum cholesterol when seven ounces of carrots were added to the diet. One cup of chopped cabbage or onions has a similar effect, the newsletter reported last July. Psyllium, currently marketed as the laxative Metamucil, also has the added benefit of lowering blood cholesterol, when given in regular daily doses.

But, none of these results is especially surprising to scientists, said Jo Ann Hattner, clinical nutritionist, Department of Dietetics, Stanford University Medical Center. She reports that when studying individuals with an elevated blood cholesterol level, usually above 215 milligrams per deciliter, a 20% decrease is to be expected when dietary regimens are followed.

It’s more difficult to expect dramatic results when the individuals are healthy to begin with, she said, as in the case of a Harvard study where the volunteers were dietitians with healthy diets and an average blood cholesterol level of 186 milligrams per deciliter. The inclusion of oat bran, she explained, proves most effective when the participants are hypercholesterolemics, people who already have a high blood cholesterol level.

“One of the problems (with oat bran) has been that it was probably overused, and overused in a way that was no longer medically beneficial,” said Hattner. “As a source of fiber in the diet it is just like any other source. . . . People who were eating oat bran were not also lowering fat in their diet. They were just adding oat bran.

“Clinically, the people who respond the best (to oat bran supplementation therapy) are those with a higher blood cholesterol level--at least 75% above the acceptable cholesterol,” she said, explaining that the body has a built-in regulation system so that if a person already has a low cholesterol level it probably won’t be influenced much with diet.

She explained that dietitians have always focused on the total fiber content of the diet and have encouraged consumers to select from a wide assortment of fibrous foods, including grains, cereals, fruits and vegetables to meet the recommended daily goal.

Ideally, she said, consumers should seek to include as much as 35 to 50 grams of fiber each day, although 25 grams is a good beginning goal for those with very low intakes. (The American Dietetic Assn. recommends intakes below 50 grams to avoid any adverse effects such as decreased mineral absorption.) And, the Harvard study pointed out, anyone who makes a drastic change in the amount of fiber they eat each day is likely to experience some gastrointestinal discomfort.

“Obviously,” Hattner said, “you have to find those sources that you do tolerate and you have to start slowly. You can use bran as part of it but you need to learn to ask for beans, lentils, whole grains and fruits.” When increasing the fiber content of the diet is it important to also include at least a quart of fluids to prevent constipation.

But there are numerous other reasons to increase fiber in the diet. Lowering cholesterol, Hattner said, “just happens to be one of them. It aids in digestion, promotes feelings of fullness and, therefore, serves as a diet aid, and it has a role in preventing colon cancer.

“As you increase your fiber (intake), you change the type of foods you eat and you ultimately decrease the fats,” she said, adding that “. . . fiber is one of the most important components of the diet, but it’s not ever a good idea to single out just one source. Choose from a variety of sources.”

Some other suggestions from Hattner: eat raw or slightly steamed vegetables; select 100% whole grain cereals, then top with another high-fiber cereal; choose whole grains breads; eat popcorn for snacks.

Here are some other ways of increasing total fiber in the diet from the American Dietetic Assn. Have bean dip and salsa instead of a sour cream-based dip. This will contribute two grams of fiber, compared with none for the creamy dip. Eat green peas instead of green beans. This provides 7.7 grams fiber vs. 1.7, and whole-wheat toast with one-half pat butter and one teaspoon jam offers about 3.2 grams fiber compared to white with one pat butter, at 0.8 grams.

Some sources of soluble fiber, the type that dissolves to form gel-like substances during digestions, are oat products, legumes such as dried beans and peas, barley and fruits such as apples, citrus, prunes and figs.

Water-insoluble fibers, those that cannot be broken down by the digestive process and thus add bulk to the intestines, reducing risk of colon cancer, include: whole grain breads and cereals, wheat bran and the skins of fruits and vegetables.

Here is a list from the National Cancer Institute of some foods and the amount of fiber they provide:

--Whole grain cereals: All Bran with extra fiber, 13 grams; Fiber One, 12 grams.

--Beans, peas and lentils, (one-half cup cooked): black-eyed peas, 12.4 grams; kidney beans, 5.8 grams; pinto beans, 5.3; split peas, 5.1; white beans, five grams; lima beans, four; lentils two grams.

--Fruits: one medium pear, five grams; apple, 2.6 grams; medium banana, two grams; one-half cup applesauce, two grams; one-half medium grapefruit, 1.7 grams; medium peach, 1.6 grams; small orange, 1.2 grams.

--Vegetables (one-half cup cooked): peas, 4.1 grams; corn 3.9 grams; medium baked potato, 3.8 grams; zucchini 2.7 grams; carrots, 2.3 grams; collard greens, 2.2 grams; green beans, 2.1 grams; broccoli, two grams; raw celery 1.3 grams; tomato and lettuce, less than one gram each.

--Whole grain breads and rice: one slice pumpernickel, 4.3 grams; one slice whole wheat, 1.4 grams; one slice rye or enriched white, less than one gram.

--Flours (one-quarter cup): dark rye, four grams; whole wheat, 2.9 grams; all-purpose white 1.1 grams; light rye, less than one gram.

BREAKFAST RICE PUDDING

1 1/2 cups instant rice

3/4 cup frozen egg substitute, thawed

2 tablespoons brown sugar, packed

1/8 teaspoon salt

1 3/4 cups scalded low-fat milk

1 cup small pitted prunes, halved

1/2 teaspoon vanilla

1/2 teaspoon ground cinnamon

1/2 teaspoon ground nutmeg

1/4 cup granola cereal

Prepare rice according to package directions for 4 servings, omitting butter. Set aside.

Combine egg substitute, sugar and salt in 1 1/2- to 2-quart saucepan. Gradually whisk in milk. Stir over medium-low heat, stirring constantly, until mixture coats spoon, about 5 to 6 minutes. Do not boil.

Stir in prunes, rice, vanilla, cinnamon and nutmeg. Stir over low heat 2 minutes. Serve warm.

Top each serving with granola. Garnish with orange slices and additional prunes, if desired. Makes 4 to 6 servings.

MEXICAN TURKEY SALAD

2 tablespoons lime juice

2 tablespoons oil

1 teaspoon finely chopped cilantro

1/2 teaspoon finely chopped seeded jalapeno chile

1 (5-ounce) can chunk white turkey, drained

1/2 cup cooked or canned black beans, rinsed and drained

1 orange, peeled and sliced, each slice cut in half

Lettuce leaves

Combine lime juice, oil, cilantro and chile in bowl. Add turkey, beans and orange and toss gently to coat. Serve over lettuce leaves. Makes 2 servings.

COCOA-BANANA CRUNCH CAKE

1/2 cup margarine, softened

1/2 cup sugar

1 cup mashed banana

2 egg whites, lightly beaten

1 teaspoon vanilla

1 cup flour

2/3 cup oats

1/2 cup unsweetened cocoa powder

1/2 teaspoon baking soda

1/4 teaspoon salt

Topping

Beat margarine and sugar until fluffy. Blend in banana, egg whites and vanilla. Combine flour, oats, cocoa, soda and salt. Mix well and add to banana mixture. Spread evenly in 8- or 9-inch baking pan, sprayed with non-stick vegetable spray.

Sprinkle with Topping and bake at 350 degrees 35 to 40 minutes or until wood pick inserted in center comes out clean. Cool completely. Makes 9 servings.

Topping

2/3 cup oats

1/3 cup brown sugar, packed

2 tablespoons melted margarine

1/2 teaspoon ground cinnamon

Combine oats, brown sugar, margarine and cinnamon.

HEARTY LENTIL STEW

1 potato, peeled and cubed

2 medium onions, peeled and chopped

1/4 pound mushrooms, sliced

1 clove garlic, chopped

1 medium carrot, peeled and sliced

2 stalks celery, chopped

1 1/2 cups lentils, rinsed and drained

1 (16-ounce) can tomatoes, undrained and crushed

2 cups beef broth

1 cup water

1/2 cup dry red wine

1 small bay leaf

1 tablespoon Worcestershire sauce

1/2 teaspoon thyme

1/2 teaspoon marjoram

1/4 teaspoon black pepper

1/4 teaspoon chervil

1/4 teaspoon caraway seeds

Lightly brown potato, onions, mushrooms, garlic, carrot and celery in non-stick skillet sprayed with vegetable coating spray. Add lentils, tomatoes, broth, water, wine, bay leaf, Worcestershire, thyme, marjoram, pepper, chervil and caraway seeds.

Simmer, partly covered, adding water as needed, 1 to 1 1/2 hours, until vegetables and lentils are tender. Makes 6 servings.

GINGER-TURKEY STIR-FRY

2 cups boiling water

1 cup cracked wheat bulgur

1/3 cup water

2 tablespoons lemon juice

2 tablespoons honey

1 teaspoon grated ginger root

1 tablespoon soy sauce

1 clove garlic, minced

2 tablespoons cornstarch

1 tablespoon oil

2 cups diagonally sliced carrots

2 cups broccoli florets

2 cups sliced mushrooms

1 (8-ounce) can water chestnuts, drained and sliced

1 pound turkey breast slices or cutlets, cut in strips

Pour boiling water over wheat and let stand 1 hour. Drain and set aside.

Combine water, lemon juice, honey, ginger, soy sauce and garlic. Dissolve cornstarch in mixture and set aside.

Heat oil over high heat in wok or large skillet. Add carrots and stir-fry 3 minutes or until tender-crisp. Add broccoli, mushrooms and water chestnuts and stir-fry 2 minutes longer. Remove from pan and keep warm.

Add turkey to pan and stir-fry until lightly browned. Add sauce and cook, stirring constantly, until thickened and translucent. Add vegetables and heat through. Serve over cooked wheat. Makes 6 servings.

GOLDEN HARVEST SOUP

2 tablespoons olive oil

1 large onion, chopped

2 ounces turkey ham, diced

1/2 pound yellow split peas

2 cups water

1 (14 1/2-ounce) can chicken broth

1 (10-ounce) package frozen, mashed acorn squash

Salt

Ground nutmeg

Heat oil in large saucepan over medium-high heat and cook onion until tender, about 7 minutes. Add ham, peas, water, broth and squash. Heat to boiling, then reduce heat to medium-low and simmer, covered, until peas are very tender, about 30 to 35 minutes. Soup will be very thick.

Blend additional cup of water or broth to make thinner soup, if desired. Season to taste with salt and nutmeg. Makes 6 servings.

APPLE-CABBAGE SALAD

4 cups shredded cabbage

2 Winesap apples, cored and cubed

1/3 cup raisins

1/4 cup chopped green pepper

1/3 cup reduced calorie mayonnaise

1 tablespoon cider vinegar

1 teaspoon prepared mustard

1/4 teaspoon sugar

1/4 teaspoon salt

Dash black pepper

Combine cabbage, apples, raisins and green pepper in bowl. Combine mayonnaise, vinegar, mustard, sugar, salt and pepper. Pour over cabbage and toss to coat well. Makes 6 servings.

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Comments from health experts provide a perspective on the oat bran issue.