Building Competency in Diabetes Education THE ESSENTIALS

5-16 | CHAPTER 5

Dietary Fibre Dietary fibre may have the following effects: • Prevention or treatment of constipation. • Prevention or treatment of several gastrointestinal disorders. • Beneficial effect on serum lipids. • Beneficial effect on postprandial BG control. • Increased satiety. • May help protect against certain types of cancer.

Although fibre is considered to be a carbohydrate, only negligible amounts of fibre are converted to glucose during normal digestion. Because fibre is not digested, it does not provide the body with energy or glucose. For this reason, when carbohydrate counting, the fibre must be subtracted from the total carbohydrate to attain total available carbohydrate. There are two different types of fibre: soluble and insoluble. • Insoluble fibre helps maintain bowel regularity and prevent constipation. It may help protect against some cancers, such as colon cancer, and help with the treatment of diverticular disease. Sources of insoluble fibre include seeds, wheat bran and whole grains, and the skin of many fruits and vegetables. • Soluble fibre breaks down as it passes through the digestive tract and forms a gel that traps substances related to high cholesterol, thereby reducing the absorption of cholesterol into the bloodstream. Soluble fibre may also help control BG by slowing gastric emptying and delaying the absorption of glucose in the small intestine, thereby decreasing postprandial BG (59). Sources include oat products, brown rice, psyllium, barley, some seeds, legumes, potatoes, some fruits (apples, strawberries, pears and citrus) and some vegetables (eggplant, okra and broccoli). A fibre-rich diet provides vitamins, minerals and other substances that are important for good health. Planning food intake to emphasize high intakes of dietary fibre from a combination of types and sources have shown benefit for post-prandial BG control and blood lipids. The slower gastric transit time may also help with weight management by promoting satiety. Given the recognized benefits of dietary fibre intake in people with diabetes, the DC recommends an intake of 30 to 50 g per day or >20 g per 1,000 kcal), including a third or more provided by viscous soluble fibre (10-20 g per day) (35). Diabetes Canada’s fibre recommendation is higher than the amount recommended for the general population (25 to 38 g for women and men, and 21 g and 30 g for women and men over 51 years, respectively)