Dietary Fiber - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

DIETARY FIBER A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2003 by ICON Group International, Inc. Copyright 2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Dietary Fiber: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83889-5 1. Dietary Fiber-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on dietary fiber. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes & Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON DIETARY FIBER .......................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Dietary Fiber ................................................................................. 8 E-Journals: PubMed Central ....................................................................................................... 40 The National Library of Medicine: PubMed ................................................................................ 41 CHAPTER 2. NUTRITION AND DIETARY FIBER ................................................................................ 85 Overview...................................................................................................................................... 85 Finding Nutrition Studies on Dietary Fiber................................................................................ 85 Federal Resources on Nutrition ................................................................................................... 89 Additional Web Resources ........................................................................................................... 90 CHAPTER 3. ALTERNATIVE MEDICINE AND DIETARY FIBER.......................................................... 93 Overview...................................................................................................................................... 93 National Center for Complementary and Alternative Medicine.................................................. 93 Additional Web Resources ........................................................................................................... 98 General References ..................................................................................................................... 102 CHAPTER 4. DISSERTATIONS ON DIETARY FIBER.......................................................................... 103 Overview.................................................................................................................................... 103 Dissertations on Dietary Fiber................................................................................................... 103 Keeping Current ........................................................................................................................ 103 CHAPTER 5. PATENTS ON DIETARY FIBER .................................................................................... 105 Overview.................................................................................................................................... 105 Patents on Dietary Fiber............................................................................................................ 105 Patent Applications on Dietary Fiber ........................................................................................ 132 Keeping Current ........................................................................................................................ 157 CHAPTER 6. BOOKS ON DIETARY FIBER ........................................................................................ 159 Overview.................................................................................................................................... 159 Book Summaries: Federal Agencies............................................................................................ 159 Book Summaries: Online Booksellers......................................................................................... 164 The National Library of Medicine Book Index ........................................................................... 167 Chapters on Dietary Fiber.......................................................................................................... 168 CHAPTER 7. MULTIMEDIA ON DIETARY FIBER ............................................................................. 179 Overview.................................................................................................................................... 179 Video Recordings ....................................................................................................................... 179 Bibliography: Multimedia on Dietary Fiber .............................................................................. 180 CHAPTER 8. PERIODICALS AND NEWS ON DIETARY FIBER .......................................................... 181 Overview.................................................................................................................................... 181 News Services and Press Releases.............................................................................................. 181 Newsletter Articles .................................................................................................................... 183 Academic Periodicals covering Dietary Fiber ............................................................................ 187 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 191 Overview.................................................................................................................................... 191 NIH Guidelines.......................................................................................................................... 191 NIH Databases........................................................................................................................... 193 Other Commercial Databases..................................................................................................... 196 APPENDIX B. PATIENT RESOURCES ............................................................................................... 197 Overview.................................................................................................................................... 197 Patient Guideline Sources.......................................................................................................... 197 Finding Associations.................................................................................................................. 219 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 221

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Overview.................................................................................................................................... 221 Preparation................................................................................................................................. 221 Finding a Local Medical Library................................................................................................ 221 Medical Libraries in the U.S. and Canada ................................................................................. 221 ONLINE GLOSSARIES................................................................................................................ 227 Online Dictionary Directories ................................................................................................... 227 DIETARY FIBER DICTIONARY ................................................................................................ 229 INDEX .............................................................................................................................................. 293

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with dietary fiber is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about dietary fiber, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to dietary fiber, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on dietary fiber. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to dietary fiber, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on dietary fiber. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON DIETARY FIBER Overview In this chapter, we will show you how to locate peer-reviewed references and studies on dietary fiber.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and dietary fiber, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “dietary fiber” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Dietary Fiber: Nostrum or Critical Nutrient? (editorial) Source: New England Journal of Medicine. 322(3): 193-195. January 18, 1990. Summary: A high-fiber diet is now widely accepted as treatment for patients with constipation, diverticulitis, or hemorrhoids. The link to the prevention of coronary heart disease rests largely on the possible effects of dietary fiber on plasma lipid levels. Such effects may be mediated by the promotion of bile-acid excretion in the stool or by the blockage of cholesterol absorption. However, many experiments, both in outpatients and in metabolic wards, have failed to demonstrate that wheat bran lowers plasma cholesterol levels. Perhaps even more important are the beneficial gastrointestinal effects of a diet high in fiber. Besides preventing constipation, hemorrhoids, and possibly diverticulitis, dietary fiber may have a role in preventing cancer of the large bowel, which is rapidly becoming the most common cancer in the United States. Colon cancers

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have been prevented in laboratory animals by dietary fiber, and there is good reason for supposing that potential carcinogens in the intestinal contents would be diluted, bound, and more rapidly passed out of the system by a diet high in fiber. 11 references. •

Dietary Fiber: An Overview Source: Diabetes Care. 14(12): 1126-1131. December 1991. Summary: Diabetes diets should aim at ensuring an ideal body weight with normoglycemia and normolipidemia. This article presents the authors' experience with high-fiber, high-carbohydrate diets and reviews knowledge on the likely mechanisms of action of fiber, its long-term effectiveness, and the concerns about its long-term safety. The authors suggest that reports on the risk of hypertriglyceridemia from highcarbohydrate diets are inconsistent and invalidated if those diets are also high in fiber content. They conclude that there is no compelling reason to change the current diabetes diets, which should continue to be high in carbohydrate and fiber. 71 references. (AAM).

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Health Benefits of Dietary Fiber for People with Diabetes Source: Diabetes Educator. 27(4): 511-514. July-August 2001. Contact: Available from American Association of Diabetes Educators. 100 West Monroe Street, 4th Floor, Chicago, IL 60603-1901. (312) 424-2426. Summary: Dietary fiber has long been known to provide many health benefits. However, most people fall exceedingly short of approaching the daily recommended amount of 20 to 35 grams. This article describes the importance of educating people with diabetes about the importance of a high fiber diet. The author first describes the different types of fiber (insoluble and soluble) and the impact of each on the gastrointestinal tract and on nutrition. The author considers the role of fiber and colon cancer, fiber and heart disease, and fiber and diabetes. The author notes that the role of dietary fiber in managing diabetes has been somewhat controversial. Eating a fiber risk diet may actually help to prevent diabetes. Soluble fiber, in addition to delaying gastric (stomach) emptying and binding to bile acids, can delay the absorption of glucose from the intestine into the blood. Recent research demonstrated a lowering of blood glucose in participants who were on a 50 gram fiber diet, compared to those on a 24 gram fiber diet. The average daily fiber intake for most Americans is 17 grams, while the recommended daily intake is between 20 and 35 grams. The author offers suggestions for ways to help patients increase their fiber intake. Patients should also be advised to gradually increase their fiber intake over time to help avoid gastrointestinal discomfort and to increase their fluid intake at the same time (to prevent constipation). In addition, it is preferable for people to obtain fiber from food sources rather than from supplements. 3 tables. 5 references.

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Long-term Intake of Dietary Fiber and Decreased Risk of Coronary Heart Disease Among Women Source: JAMA. 281(21):1998-2004; June 2, 1999. Contact: American Medical Association, (800) 621-8335. Summary: Epidemiological studies of men suggest that dietary fiber intake protects against coronary heart disease, but data on this association in women are sparse. Using a group of 68,782 women aged 37 to 64 without previously diagnosed angina, myocardial infarction, stroke, cancer, hypercholesterolemia, or diabetes, the study

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examined the association between long-term intake of total dietary fiber as well as fiber from different sources and risk of coronary heart disease in women. The findings support the hypothesis that higher fiber intake, particularly from cereal sources, reduces the risk of coronary heart disease. •

Dietary Fiber in the Management of Diabetes Source: Diabetes. 42(4): 503-508. April 1993. Summary: In this article, the author reviews the literature regarding dietary fiber in the management of diabetes, focusing on people with noninsulin-dependent diabetes (NIDDM). The author notes that several national diabetes associations have recommended that individuals with diabetes ingest a diet high in fiber-containing foods. The author discusses research studies that investigated various diets that included added fiber and questions the methodology with which most of these studies were undertaken. He stresses that it has not been possible to determine if dietary fiber was playing a significant role, as confounding variables such as weight loss, decreased food energy intake, different food sources with potential for differences in starch digestibility, and decreased dietary fat content were present. The author concludes that the results of studies in which specific, defined fibers have been added to the diet would suggest that the naturally occurring fiber in foods is likely to play only a minor role in the management of diabetes. 4 tables. 59 references. (AA-M).

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Dietary Fiber, Food Intolerance, and Irritable Bowel Syndrome Source: Nutrition Reviews. 48(9): 343-346. September 1990. Summary: Irritable bowel syndrome (IBS) is a multifactorial disorder whose therapy has been difficult and frustrating. This article provides a brief critical review of the published controlled trials of all treatment modalities for IBS and concludes that none was proved to be efficacious. Topics include the role of intolerance to specific foods, the importance of psychologic and emotional factors in this disorder, and the ineffectiveness of supplementation with dietary fiber. 1 table. 15 references.

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Dietary Fiber Guidelines in the Exchange Lists for Menu Planning: Should They Be Revised? Source: Diabetes Care. 17(12): 1534-1541. December 1994. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: The authors briefly review major methods of dietary fiber analyses, highlighting differences that may be responsible for differences in fiber values noted in food lists. They compare fiber values obtained by two classic methods, which were used for the recommendations in the Exchange Lists for Meal Planning, with their two sets of analyses and with data obtained using the method that is used in the British Food Composition Tables. The authors' research consisted of fiber analysis of over 300 foods using a detailed chemical method (Uppsala method); about two-thirds of the same samples were also analyzed using a gravimetric procedure that was developed to determine fiber values for food labeling. Their comparisons are used to illustrate how difference analytical steps produce different fiber values. 1 figure. 4 tables. 44 references. (AA-M).

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Benefits of Dietary Fiber: Myth or Medicine? Source: Postgraduate Medicine. 99(2): 153-154, 156, 166-168, 171-172, 175. February 1996. Summary: This article describes the classification of dietary and supplemental fiber and reviews studies evaluating the role of fiber in disease prevention and treatment. An overview of current fiber supplements and recommendations for their use is included. The authors conclude that fiber has some preventive or therapeutic benefits in irritable bowel syndrome (IBS), diverticulosis, colorectal cancer, diabetes, and hypercholesterolemia. However, it appears to have no direct benefit in patients with inflammatory bowel disease (IBD), gallstones, or obesity. One sidebar explores the physiologic effects of dietary fiber. 1 figure. 4 tables. 34 references. (AA-M).

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Dietary Fiber: Variables That Affect its Nutritional Impact Source: Diabetes Spectrum. 3(3): 191-196. May-June 1990. Summary: This article discusses the gastrointestinal (GI) response to dietary fibe r in people with diabetes. Carbohydrate and fiber terminology are reviewed along with carbohydrate digestion and absorption. The author presents information concerning the structure and function of fiber, and notes that self-monitoring of blood glucose is recommended, especially when fiber is increased in the diet of people with insulindependent diabetes, because of a possible lowering of glycemic response to the meal and decreased insulin need. 2 figures. 1 tables. 52 references.

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Dietary Fiber and Distressing Gastrointestinal Symptoms in Midlife Women Source: Nursing Research. 43(6): 357-361. November-December 1994. Summary: This article reports on a descriptive study in which 20 midlife women experiencing chronic distressing gastrointestinal (GI) symptoms recorded symptom severity in a symptom diary for a 30-day period and dietary intake in a 9-day food record. Wide variability in symptom severity was noted. Significant negative relationships were present between dietary fiber intake and abdominal pain, awaking with abdominal pain, nausea, awakening with nausea, and awakening with rectal pain. No significant relationships were noted between amount of caffeine or alcohol intake and distressing GI symptoms. 2 tables. 30 references. (AA-M).

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Dietary Fiber, Glycemic Load, and Risk of Non-Insulin-Dependent Diabetes Mellitus in Women Source: JAMA. Journal of the American Medical Association. 277(6): 472-477. February 12, 1997. Summary: This article reports on a study to examine prospectively the relationship between glycemic diets, low fiber intake, and risk of noninsulin-dependent diabetes mellitus (NIDDM, or Type II). In 1986, a total of 65,173 U.S. women, 40 to 65 years of age and free from diagnosed cardiovascular disease, cancer, and diabetes, completed a detailed dietary questionnaire. From their responses, the authors calculated usual intake of total and specific sources of dietary fiber, dietary glycemic index, and glycemic load. During 6 years of followup, 915 incident cases of diabetes were documented. The dietary glycemic index was positively associated with risk of diabetes after adjustment for age, body mass index, smoking, physical activity, family history of diabetes, alcohol and cereal fiber intake, and total energy intake. The relative risk (RR) of diabetes was 1.37. The glycemic load was also positively associated with diabetes. Cereal fiber intake was inversely associated with risk of diabetes. The combination of a high glycemic load

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and a low cereal fiber intake further increased the risk of diabetes, when compared with a low glycemic load and high cereal fiber intake. Further, the authors conclude that these results suggest that grains should be consumed in a minimally refined form to reduce the incidence of diabetes. 1 figure. 4 tables. 82 references. (AA-M). •

Dietary Fiber Controversy: Three Gastroenterologists Speak Out at Symposium on the Subject Source: Practical Gastroenterology. 14(5). May-June 1990. Summary: This article reports on a symposium, The Dietary Fiber Controversy, that was held in New Orleans in October 1989. Three gastroenterologists discuss the role of dietary fiber in the prevention of disease, as well as the place of dietary fiber in medical practice. One of the participants discusses the beneficial effects of dietary fiber, including the reduction of serum cholesterol and the reduction in the frequency and incidence of colorectal cancer. Other topics include how dietary fiber exerts a beneficial effect; how common gastrointestinal disorders such as irritable bowel syndrome, diverticulosis, and hemorrhoids benefit from a high-fiber diet; and how to achieve a high-fiber diet. 4 references.

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Effects of Dietary Fiber and Carbohydrate on Glucose and Lipoprotein Metabolism in Diabetic Patients Source: Diabetes Care. 14(12): 1115-1125. December 1991. Summary: This article reviews the effects of dietary fiber and carbohydrate on glucose and lipoprotein metabolism in patients with diabetes. The authors stress that some highfiber foods may be more appropriate than others and that the identification of these foods with a low-glycemic response would help to enlarge the list of foods particularly suitable for patients with diabetes. They conclude that a balanced increase in consumption of fiber-rich foods and unsaturated fat is the most rational way to replace foods rich in saturated fat and cholesterol in the diabetic diet. 7 figures. 2 tables. 61 references. (AA-M).

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Clinical Uses of Dietary Fiber Source: American Family Physician. 51(2): 419-426. February 1, 1995. Summary: This article reviews the medical uses of dietary fiber and fiber products. The author notes that fiber is a complex mixture of substances, and research on its effects is difficult to interpret. Topics include pitfalls in fiber research; food sources of dietary fiber; the use of fiber in the treatment of gastrointestinal tract diseases, including constipation, hemorrhoids, diverticulosis, diverticulitis, and hiatal hernia; the role of dietary fiber in the treatment of diabetes mellitus; hyperlipidemia; obesity; disease prevention; and side effects and adverse reactions. The author stresses that any increase in dietary fiber intake should be accompanied by an increase in water intake. The article concludes with a patient information handout on how to increase the amount of fiber in the diet that readers can photocopy and distribute to their patients. 7 tables. 18 references. (AA-M).

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Impact of Dietary Fiber on Absorption from the Small Intestine (editorial) Source: Current Opinion in Gastroenterology. 15(2): 100-102. March 1999. Contact: Available from Lippincott Williams and Wilkins Publishers. 12107 Insurance Way, Hagerstown, MD 21740. (800) 637-3030. Fax (301) 824-7390.

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Summary: This editorial review addresses the impact of dietary fiber on absorption from the small intestine. The epidemiological evidence associating fiber depleted diets with the diseases of industrialization such as diabetes, obesity, and hypercholesterolemia has long suggested that dietary fiber can exert important influences on nutrient absorption. 'Dietary fiber' is a popular but inexact term, encompassing a wide range of chemically diverse, complex, nonstarch polysaccharides and lignin largely derived from plant cell walls. Topics include the effect of fiber on small intestinal function, glucose absorption, antidiarrheal effect of fiber, performance of oral rehydration solutions, and cholesterol lowering effects of high fiber diets. The author concludes that advances at the molecular level in understanding their physicochemical properties promise an increasing ability to unlock the storehouse of natural products to be found in our diet. 43 references.

Federally Funded Research on Dietary Fiber The U.S. Government supports a variety of research studies relating to dietary fiber. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to dietary fiber. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore dietary fiber. The following is typical of the type of information found when searching the CRISP database for dietary fiber: •

Project Title: ALTERING DIETARY PATTERNS IN PRESCHOOL CHILDREN Principal Investigator & Institution: Haire-Joshu, Debra; Professor of Behavioral Science; Community Health; St. Louis University St. Louis, Mo 63110 Timing: Fiscal Year 2001; Project Start 14-JAN-1997; Project End 30-JUN-2005 Summary: Background. Community-based studies are needed that examine the effect of parent behaviors on the developing food preferences and dietary patterns of young children. This proposal is a competing continuation of the successful Altering Dietary Patterns in African American Parents Study (R01 CA68398), which resulted in the development of the High 5, Low Fat Program (H5LF). H5LF taught parents how to be positive models of dietary behavior to their young children and was integrated within Parent As Teachers (PAT), a parent education program. Significant improvements were noted in fruit and vegetable intake (FV) of intervention parents who engaged in frequent modeling of dietary behaviors, compared to control group parents who were less frequent modelers (5.4 vrs. 4.2 servings per day; p less than.05); but we were unable to assess the extent to which parental changes influenced child intake due to their age (0 to 36 months). Aims. The primary aim of this proposal is to test High 5 for Preschool

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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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Kids (H5-Kids), a community based intervention to which we will intervene with parents to promote their preschool children's (ages 3 to 5 years) preference for and intake of FV. Secondary aims will examine whether all or part of improvements in child intake are explained by changes in parent behavior. Methods and Evaluation. H5-Kids is based on a conceptual model of family reciprocal determinism and ecological perspectives. The child's FV preferences and intake will be impacted by an intervention using social cognitive strategies to target mediating factors within the intrapersonal environment of the parent (intake, knowledge of developing child nutrition patterns), interpersonal environment of parent-child (modeling, interaction-communication), and physical environment (FV access, availability). This approach combines personal visits with child-focused computer-tailored storybooks, and interactive newsletters. A group randomized, nested cohort design will evaluate impact on FV intake of children and their parents randomized to a control (n=840) or intervention (n=840) group. Innovation. This study will evaluate the parent to child path of influence on the developing dietary patterns of children. We will build upon our longstanding and successful partnership with Parents As Teachers, a national parent education agency that will disseminate H5Kids through over 2000 PAT-affiliated sites across all 50 states. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BETA 2 ADRENERGIC RECEPTORS AND PROSTATE CANCER RISK Principal Investigator & Institution: Strom, Sara S.; Assistant Professor; Epidemiology; University of Texas Md Anderson Can Ctr Cancer Center Houston, Tx 77030 Timing: Fiscal Year 2001; Project Start 17-JUL-2000; Project End 30-JUN-2003 Summary: (Applicant's Description) This proposal is designed to build upon ongoing studies evaluating epidemiologic and molecular determinants of clinical prostate cancer (PC) susceptibility being conducted at the UT MD Anderson Cancer Center (CA 68578 M. Spitz, M.D., Principal Investigator, DAMD 17-98-1-8471 S.Strom, Ph.D., Principal Investigator. A role for individual variability in androgen biosynthesis as a modifier of PC risk is under intensive investigation. Based on the fact that catecholamines act synergistically with androgens through beta-adrenergic receptors as important regulators of prostate growth and differentiation, we present a novel hypothesis that individual genetic differences in the beta-adrenergic receptor may be associated with PC risk. Specifically, we will determine whether common allelic variants in beta-adrenergic gene modify the risk of developing prostate cancer. By integrating these genotypic data with information on diet, body composition, co-morbid conditions, and other lifestyle characteristics known to alter testosterone levels, we will gain insight into the role that individual variability in the neuroendocrine control of prostate growth plays in PC risk. The proposed pilot epidemiologic study will be the first of which we are aware to examine the contribution of gene-based variability in the beta-adrenergic response and risk of developing prostate cancer. Correlation of markers with PC risk in this pilot or hypothesis generating study would provide the impetus to pursue further the role of neuroendocrine factors in the etiology and progression of PC. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: BREAST & OTHER CANCER IN THE CALIFORNIA TEACHERS COHORT Principal Investigator & Institution: Wright, William E.; Chief; Public Health Institute 555 12Th St, 10Th Fl Oakland, Ca 94607 Timing: Fiscal Year 2001; Project Start 25-SEP-1998; Project End 30-SEP-2003

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Summary: (adapted from applicant's Description): A cohort of 133,000 California school teachers has been established by a collaborative group of epidemiological investigators with the goals of evaluating unresolved issues related to breast cancer risk factors and studying other important issues related to women's health. The teachers were recruited with a detailed multiple choice, optically-scanned mail survey. Scanning of the questionnaires has been completed and data editing is ongoing. Planned follow-up includes routine linkage with the California Cancer Registry and California mortality files, annual re-contact of cohort members for follow-up, and biennial contact for collecting additional risk factor exposure data and information on other health outcomes. The Specific Aims for this project are to: 1) test a series of unresolved and emerging hypotheses related to breast cancer aetiology (specifically associations with the lactation, hormone replacement therapy, abortion/miscarriage, dietary phytoestrogens, fibre, micronutrient consumption, alcohol intake, physical exercise and activities, family history of breast and other cancers, and active and passive cigarette smoke exposure); 2) conduct calibration/validation studies of the food-frequency questionnaire and self-reported information on family history of breast and other cancers reported in the baseline questionnaire; and 3) follow this cohort for five additional years, during which time, two or more questionnaires will be mailed to update initial exposure assessments, collect new exposure information, and assess additional disease outcomes for testing novel hypotheses of major importance to women's health, in a timely manner. During the next five years, 2,025 invasive incident and 390 in situ incident breast cancers are anticipated which will provide ample statistical power to address each of the proposed hypotheses in detail. The California Teachers Study presents a rare opportunity to study women's health, because of the size of the cohort, the uniformly high level of education among teachers, their experience with survey instruments, their diversity of exposures and geographic residences, and the relative ease with which they can be followed in California. This research is intended to substantially increase knowledge of preventable risk factors for cancer and other health outcomes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: WORKERS

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BLUE

COLLAR

Principal Investigator & Institution: Sorensen, Glorian C.; Director, Center for Community Based Res; Dana-Farber Cancer Institute 44 Binney St Boston, Ma 02115 Timing: Fiscal Year 2001; Project Start 15-AUG-2000; Project End 31-JUL-2004 Summary: (Adapted from the Applicant's Abstract): This study responds to an urgent need for research to understand risk perceptions influencing health behavior change among blue-collar workers and to develop efficacious interventions for this group. Concern about occupational exposures is likely to influence the risk perceptions of many blue collar workers, given their potentially high levels of exposures on the job. Previous work has shown that workers exposed to job risks are most receptive to health promotion programs that incorporate occupational health concerns, rather than exclusively focusing on individual lifestyles. The intervention tested in the proposed study targets tobacco use, consumption of fruits and vegetables, and awareness of job risks. This study specifically targets mobile blue collar workers--represented here by construction laborers--for whom cancer prevention strategies are especially lacking. The specific aims of this study are to: (1) Assess the perceptions of job and behavioral risks of construction laborers through a survey of a national random sample of members of the Laborers' International Union of North America (LIUNA). (2) Identify mediating

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mechanisms and modifying conditions associated with risk perceptions and likely to influence tobacco use and consumption of fruits and vegetables among mobile bluecollar workers. (3) Develop and estimate the efficacy of an integrated cancer prevention intervention targeting work practices and behavioral risks of unionized mobile blue collar workers in increasing smoking cessation and consumption of fruits and vegetables. This study is a partnership between the DFCI and the Laborers' Health and Safety Fund of North America. This partnership provides unique access to a large population of mobile blue-collar workers, comprised of the 750,000 members of LIUNA. LIUNA members have generally low literacy skills, low levels of education, and high levels of behavioral risks for cancer. Forty-four percent of LIUNA members are smokers. This is also an ethnically diverse population, and includes at least 50% minority populations. This study is a Phase II methods development study designed to provide the basis for further research on cancer prevention interventions in collaboration with unions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CANCER PREVENTION IN RURAL YOUTH--TEACHING HEALTH GOALS Principal Investigator & Institution: Danish, Steven J.; Director, Life Skills Center; Psychology; Virginia Commonwealth University Richmond, Va 232980568 Timing: Fiscal Year 2001; Project Start 18-AUG-1996; Project End 30-JUN-2002 Summary: The investigators propose a five year school based project that meets the criteria for a cutting edge prevention with high risk, rural youth. In contrast to the comparison group, these youth will consume more foods that reflect low fat and high fiber choices as well as choose not to initiate tobacco use. The innovative and interactive cancer prevention program that the investigators propose to use is based in theory and research and builds upon an existing life skills program -- Going for the Goal (GOAL). GOAL is an interactive, school-based life skills program taught by high school students to middle school student; it is designed to increase the ability of sixth graders to make choices that promote their long term health. The skills taught include how to identify positive life goals; how to identify and engage in health promoting behaviors that can facilitate goal attainment; how to identify and avoid health compromising behaviors that can impede goal attainment; how to construct step- by-step plans to reach goals; how to create and utilize social support; and how to transfer these skills from one life context to another. By focusing specifically on diet and tobacco use in the enhanced GOAL Program, the sixth graders will learn how to make life choices and goals for health. Twenty-two schools in rural Virginia and New York will be randomly assigned to either intervention or control groups. The key behaviors (as well as relevant attitudes and knowledge) of diet and tobacco use will be assessed both prior to and following the intervention (immediately post, and one- and two-year follow- ups). The intervention program will consist of (1) twelve peer- led classroom sessions based on the GOAL Program and implemented during the sixth grade; (2) six teacher-led classroom sessions based on a social influence smoking prevention program in the seventh grade; and (3) six teacher-led classroom sessions based on GOAL in the seventh grade, as well. Several different evaluations strategies will be used to investigate the impact of the intervention on eating and tobacco behaviors, as well as the behavioral, attitudinal, cognitive and environmental factors influenced by the intervention. The impact of the intervention will be assessed by observed food choices in the cafeteria, several carefully crafted self reported measures of dietary intake and self- and parent-reported tobacco use. This project will contribute to the ability to prevent cancer in rural populations by creating a

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non-intrusive cancer prevention program based on life skills that not only impacts cancer-related behaviors, but extends to other health behaviors as well. This program can be delivered in the future with minimal support from sources outside the school. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CANCER PREVENTION PROGRAM IN RURAL CHURCHES Principal Investigator & Institution: Winett, Richard A.; Professor; Psychology; Virginia Polytechnic Inst and St Univ 460 Turner Street, Suite 306 Blacksburg, Va 24060 Timing: Fiscal Year 2001; Project Start 01-JUL-2000; Project End 30-JUN-2004 Summary: (adapted from investigator's abstract): The aim of this revised application is to develop and evaluate a theory-based intervention delivered in rural churches serving people of diverse socioeconomic levels. The purpose of the intervention is to initiate and maintain changes in nutrition, activity and exercise patterns to meet cancer risk reduction guidelines. The intervention will uniquely combine individual, self-regulatory behavior change procedures with supportive social and environmental components identified as essential for maintaining behavior change by social cognitive theory (SCT; Bandura, 1997). Individual behavior and family-focused change procedures involve tailored information, formulating and evaluating individual behavior change goals, and structuring guided master experiences provided through an electronically mediated health behavior intervention. Supportive components include advocacy and modeling by religious leaders, lay health advisors, and respected members of congregations. In addition, collective goal-setting, feedback, and structured, collective church-based mastery experiences for initiating and sustaining health behavior change will follow an approach based on SCT and used in other community risk reduction interventions. The four- year period of the project will allow ample time to carefully tailor program content and develop software allowing programs to be highly salient with easy access at home or at church. A pilot test, and a large field experiment involving approximately 3000 people (20 percent African American) from moderately large (400 - 800 members) rural churches are planned. A mixed model of covariance will be used with churches as the unit of randomization. A treatment involving the complete SCT-based intervention will be compared to a treatment only involving the instructional programs, and a control condition. Major outcome measures include percent calories from fat, dietary fiber, servings of fruits and vegetables, caloric expenditure in activity, V02Max, and body composition. Measures of SCT determinants will address the theoretical underpinnings of the intervention, and process measures will assess fidelity, dose, and contamination issues. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CHRONIC DENTAL DISEASE AND CARDIOVASCULAR DISEASE Principal Investigator & Institution: Joshipura, Kaumudi J.; Assistant Professor; Oral Health Policy & Epidem; Harvard University (Medical School) Medical School Campus Boston, Ma 02115 Timing: Fiscal Year 2001; Project Start 30-SEP-1998; Project End 31-JUL-2003 Summary: Several recent reports have found significant associations between periodontal disease, tooth loss and increased coronary heart disease (CHD). Possible associations between dental caries and CHD and between dental disease and stroke have also been reported. Recent literature also supports the possible role of other chronic bacterial and viral infection, fibrinogen and other inflammatory mediators in increasing CHD risk. We propose to study the relation between periodontal disease,

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caries and tooth loss, and risk of incidence of coronary heart disease and stroke and to assess if these associations are independent of common risk factors including behavioral factors. Additionally, we propose to evaluate two possible explanations for these associations: (1) tooth loss leads to reduced masticatory efficiency, which could lead to reduced intake of dietary antioxidant and fiber, which in turn has been associated with increased risk for cardiovascular disease; and (2) chronic dental disease could lead to hyperfibrinogenemia which is strongly and probably causally associated with increased risk of CHD. We will also evaluate C-reactive protein, von Willebrand factor, tissue plasminogen activator, and Factor VII as additional mediators. Participants include 51,529 men enrolled in the Health Professionals Follow-Up Study since 1986 and 90,000 females enrolled in the Nurses Health Study since 1976 who reported their dental status in 1992. The follow-up in these cohorts is excellent and has been consistently over 90 percent. The outcome measures will include incident cases of CHD and stroke in 15 years of follow-up among men and 9 years of follow-up among women free of cardiovascular disease and cancer at baseline. Over 4500 incident cases of CHD and stroke are anticipated. Biomarker assays will be performed for a sub-population consisting of new CHD cases incident after the time of initial blood collection, and one matched control per case. Blood samples were provided by 32,000 nurses in 1989-90 and by 18,100 male health professionals in 1993-94, allowing for sufficient follow-up to include an estimated 600 incident cases among males and 600 cases among females for the biomarker analyses. The high prevalence of dental infection makes its potential association with inflammatory and dietary mediators, and ultimately increased risk of CHD and stroke very important with implications for millions of Americans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COLON CANCER--MOLECULAR BIOLOGY OF CELL RESPONSE TO DIET Principal Investigator & Institution: Augenlicht, Leonard H.; Professor & Director, Molecular Oncology; Montefiore Medical Center (Bronx, Ny) Bronx, Ny 104672490 Timing: Fiscal Year 2001; Project Start 15-JUL-1997; Project End 30-JUN-2002 Summary: Short-chain fatty acid (SCFA) levels in the colon are greater than 200 mM, derived from fermentation of dietary fiber and other dietary components. These SCFAs play critical roles in colonic cell physiology. First, they are the principal energy source for colonic epithelial cells via their metabolism by beta-oxidation in the colonic cell mitochondria. Second, they are natural inducers of colonic cell differentiation both in vivo, and of colonic carcinoma cell lines in vitro, and a differentiation program that they initiate has a component pathway that results in colonic cell apoptosis. Our previous work, and that of others, has demonstrated a clear link among the metabolism of SCFAs, mitochondrial gene expression and function, growth arrest and the entry of cells into a pathway which results in differentiation and/or apoptosis. Moreover, recent reports have provided compelling data for a direct role of mitochondria in apoptosis in other systems. This application is to use novel genetic mouse models, and genetic and biochemical manipulation in culture, to define the pathways and mechanisms that link SCFAs, their metabolism, mitochondrial function, and normal cellular development in the colonic mucosa, and how perturbations of this pathway modulate genetic and carcinogen initiated colon tumorigenesis. There are 3 specific aims: 1) To utilize a genetic mouse model in which there is a homozygous deletion of the nuclear gene for short-chain acyl dehydrogenase (SCAD), which encodes the mitochondrial enzyme that catalyzes the first step in mitochondrial beta oxidation of SCFAs, to determine the role of SCFA metabolism in the effects of tributyrin, the triglyceride of butyrate, on both

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chemically (AOM) and genetically (Apc) initiated colon cancer, and on the intermediate end-points of aberrant crypt focus formation, cell proliferation, and apoptosis; 2) based on our data, to determine the role of mitochondrial function and interaction with the waf1/cip1 gene in mechanisms of SCFA induced cell cycle arrest and entry into a pathway of apoptosis in SW620 colonic epithelial cells in culture; 3) to use waf1/cip1 null mice, and a mouse strain with a conditional targeted inactivation of the nuclear gene for mitochondrial cytochrome C, to test the following model: that SCFA inhibition of Apc initiated gastrointestinal tumors is waf1/cip1 dependent; and that this inhibition requires mitochondrial function, and not only metabolism of SCFAs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COMMUNITY RANDOMIZED TRIAL OF HISPANIC CANCER PREVENTION Principal Investigator & Institution: Thompson, Beti; Member; Fred Hutchinson Cancer Research Center Box 19024, 1100 Fairview Ave N Seattle, Wa 98109 Timing: Fiscal Year 2001; Project Start 02-JUL-1998; Project End 30-APR-2003 Summary: Hispanics are the fastest growing minority group in the U.S. and also have the highest poverty rates in the U.S. They have higher rates of certain types of cancer, are less likely to have cancer screening, and tend to have less knowledge about cancer and cancer prevention than Non-Hispanics. Cancer rates are increasing in this group. This application builds on two years of developmental work in a community that is 65 percent to 75 percent Mexican-American. The overall goals of this proposed project are to increase cancer prevention lifestyle behaviors, specifically to decrease fat consumption, increase fruit and vegetable consumption, and increase smoking cessation rates; and to increase colorectal cancer screening. Twenty communities in the lower Yakima Valley, which has a 40 percent to 50 percent Hispanic population, will be recruited for participation. After an in-person randomized household survey of approximately 100 households per community, communities will be matched and randomized within blocks to an intervention or control condition. In intervention communities, a community board will be established, will hire a field coordinator, mobilize the community, and plan intervention activities, with FHCRC staff serving as facilitators, and local project staff hired to assist the Boards. Community-wide events will be conducted to raise consciousness and increase knowledge about cancer prevention and access to screening. These will be pilot-tested in our developmental study community. Individual activities will focus on one-to-one outreach where volunteers and community people will discuss behavior changes that may decrease the risks of contracting cancer. A nested study will be included to assess the efficacy of an intensive, individual intervention to change dietary behavior among groups of women in the intervention communities. After intervention, another cross-sectional survey will be conducted. Primary outcomes are changes in the behaviors defined in the primary aims. A score of combined changes will also be generated. The sample sizes take into account intraclass correlation and are sufficient to examine differences among Hispanics as well as the entire Valley population. The analysis is based on intent to treat. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: COMPARING APPROPRIATENESS

THREE

APPROACHES

TO

CULTURAL

Principal Investigator & Institution: Thompson, Vetta S.; St. Louis University St. Louis, Mo 63110

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Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2008 Summary: There is widespread agreement that cancer communication programs and materials will be more effective when they are "culturally appropriate" for the populations they serve. Yet surprisingly little is known about how best to achieve cultural appropriateness, what (if any) communication effects can be attributed to cultural appropriateness, and whether different approaches to cultural appropriateness will have different effects. We have identified three basic approaches currently used to achieve cultural appropriateness. Peripheral approaches seek to enhance effectiveness of cancer communication by packaging generic content in colors, fonts, images, pictures or declarative titles (e.g., "A guide for African Americans") likely to appeal to a given group. Evidential approaches provide and discuss data specific to that group (e.g., "Between 1973-1992, colorectal cancer in African American men increased 40 percent"). Sociocultural approaches discuss cancer in the context of specific social and/or cultural characteristics of the group (e.g., "Being there for family, friends, and community is an African American tradition."). No study has yet compared the effects of these approaches, and in particular the effects of combined approaches, as they are more commonly used. This study will do so using a 3-arm randomized controlled trial among 1,200 African American men and women. We will track for one year the progression of affective, cognitive, and behavioral effects described in McGuire's Communication/Persuasion Model that result from 3 exposures to colorectal cancer risk reduction magazines. Participants will be randomly assigned to receive either peripheral, peripheral+evidential, or peripheral+sociocultural materials. All groups will be followed-up at 4-, 28-, and 52-weeks post-enrollment. This study will provide the first evidence for which communication effects can be expected, from which cultural approaches, at which intervals in a 12-month time period. It will thus contribute to establishing a theory of cultural cancer communication, guidelines for cancer educators and practitioners, and meeting the Healthy People 2010 goal of eliminating health disparities. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CORE--NUTRITIONAL BIOMARKER Principal Investigator & Institution: Henning, Susanne M.; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 20-SEP-2002; Project End 30-APR-2003 Summary: CORE SUBPROJECT ABSTRACT NOT PROVIDED Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: COUNSELING FOR OVERWEIGHT WOMEN FOR DIET AND ACTIVITY Principal Investigator & Institution: Patrick, Kevin M.; Adjunct Professor; Student Health Services; San Diego State University 5250 Campanile Dr San Diego, Ca 92182 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-AUG-2005 Summary: Improved physical activity (PA) and dietary behaviors show great promise to reduce risk of cancers, CVD, NIDDM and other diseases. Improvements in PA and nutrition are particularly important for the overweight, a condition now affecting more than 50 percent of Americans. There are few effective programs for treating overweight in primary care. In this project we will evaluate an integrated clinical and home- based intervention to improve PA and dietary behaviors in overweight (BMI 25-29.9) women. PACE+ has three integrated components, a computer assessment and action planner,

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provider counseling; and 12 months of extended phone and mail contact. Pilot study results (n=173) demonstrate that PACE+ shows substantial promise in improving dietary and PA behaviors We will recruit 360 overweight women age 18 to 45 seen in 4 healthcare settings. Subjects will be randomly assigned to PACE+ or a usual care, delayed treatment control comparison condition. PACE+ targets three primary and three secondary behaviors: Primary: a) dietary quality (fruits and vegetables, vitamin C, carotenoids, and fiber); b) total dietary fat as a percent of energy consumed; and c) energy expenditure from moderate and vigorous physical activity during leisure-time. Secondary: a) recreational media use; b) overeating; c) saturated fat as percent of energy consumed. PACE+ also assesses stage of change and psychosocial mediators of behavior change. The PACE+ computer program guides patients to select one dietary and one PA target behavior for which they develop action or maintenance plans to discuss with the provider. The provider endorses or modifies the action plan and encourages participation in the extended phone and mail intervention. Phone counseling, mail and print materials guide the patient to use cognitive and behavioral skills to make changes in target behaviors. At six months subjects are reassessed over the phone and then continue to receive stage-appropriate intervention to address their new diet and PA goals. Primary outcomes ((a) a combined measure of energy expended in moderate and vigorous physical activity during leisure; ) an index of dietary quality encompassing increased fruits and vegetables and nutrient indicators of these foods; and (c) total dietary fat as a percent of energy consumed) will be assessed at baseline and 12 months with 7-day PA recall and food frequency questionnaires. Secondary outcomes and mediators of behavior change will be measured at baseline, 6, 12 and 24 months. Secondary outcomes include objective and self-report measures of PA and recreational media use and self-reported dietary behaviors (overeating; saturated fat intake as a percent of total energy consumed), BMI, skinfolds, waist circumference, psychosocial mediators of change. Exploratory assessment of plasma carotenoids and 24-hour dietary recall will be performed on a sub-sample of subjects to validate self report measures. The PACE+ intervention is particularly innovative in that three components - computer, primary care provider counseling, and an extended home-based intervention - are unified through a common theoretical framework. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CREATION OF A MULTIETHNIC DIETARY SURVEY FOR ELDERS Principal Investigator & Institution: Gustafson, Deborah R.; Nutrition and Food Sciences; Utah State University Logan, Ut 84322 Timing: Fiscal Year 2002; Project Start 15-AUG-1999; Project End 31-DEC-2003 Summary: Cancer rates differ dramatically among various ethnic subgroups in the United States (U.S.). Although cancer rates have typically been lower among Native American populations, recent data indicate that these numbers are increasing. Changing patterns of dietary intake may account for some of these differences. Since cancer is a disease of aging, accurate and reliable measurements of dietary intake among the elderly are very important in estimating diet and cancer relationships. This knowledge will facilitate the development and evaluation of culturally-specific cancer control programs. There is a dearth of dietary assessment tools available for assessing intakes of elderly in the U.S., particularly elderly of various ethnic backgrounds. The goal of this project is to formulate a dietary survey that will accurately and reliably assess dietary intakes of elderly Native American (Navajo and Ute) and Caucasian populations in Utah. Completion of this project will form an excellent basis for future dietary data collection efforts among the elderly. Four sequential objectives are described in this

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proposal: 1) Determine the food sources of cancer-related nutrients, e.g., vitamin C, betacarotene, vitamin E, folate, and fiber, in the diets of Native American and Caucasian elderly adults who over 50 years of age using 24 hour recall methods. 2) Compose a relevant food list for the creation of a multi-ethnic food frequency questionnaire-based dietary assessment strategy for Native American and Caucasian elderly. 3) Modify the PicSort dietary assessment method to assess the frequency of intake of cancerpreventive nutrients and foods in the elderly. Focus groups will be used to assess its utility. 4) Determine traditional plant and animal food sources among Navajo and Ute to provide a basis for cancer risk reduction food-based interventions based on traditional foodways. Focus groups will be conducted to accomplish this goal. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DIET AND GENETIC INTERACTIONS IN PROSTATE CANCER Principal Investigator & Institution: Giovannucci, Edward L.; Nutrition; Harvard University (Sch of Public Hlth) Public Health Campus Boston, Ma 02460 Timing: Fiscal Year 2001; Project Start 01-FEB-1998; Project End 31-JAN-2003 Summary: Polymorphisms in the CAG repeat length in the AR gene have been demonstrated to correlate with risk of prostate cancer. Using blood samples collected in 1993-94 from 18,000 men in the ongoing HPFS, in combination with buccal brushings to be acquired from an additional 20,000 cohort members, there are plans to characterize risk of prostate cancer, based on CAG polymorphisms in the AR gene. Then, using a nested case-control design of approximately 1,000 projected cases from 1993-2000, the impact of specific nutritional factors on prostate cancer risk will be examined, stratifying across genetic risk. Specifically, associations of diet and nutritional status (pre-adult adiposity and attained height) will be examined with incidence of prostate cancer among men stratified by risk according to number of CAG repeats in the AR gene. Then, an assessment will be made of whether men at higher risk can potentially reduce their excess risk by decreasing their consumption of animal fat and by increasing lycopene and fiber intake, aspects of diet that have already been associated with reduced risk in the overall cohort. Non-nutritional factors that are hypothesized to influence testosterone levels will also be examined, in particular physical activity and smoking, in relation to incidence of prostate cancer among men, stratified by genetic risk according to AR characteristics. A final Aim is to acquire buccal smears for DNA analyses from HPFS participants who did not previously provide blood specimens. This will complete the establishment of a large database consisting of a) updated dietary and other exposure information over a 15 year period for 50,000 men, b) stored DNA samples (blood or buccal brushing) from approximately 38,000 of these men, c) stored plasma from 18,000 participants, and d) archived tissue from incident prostate cancers. The buccal brushings, along with providing the basis for the specific aims in this application, will allow for the rapid testing of future specific hypotheses. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DIET, COLON CANCER, AND CANCER COMMUNICATIONS Principal Investigator & Institution: Abouta, Jessie S.; Nutrition; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2002; Project Start 10-SEP-2002; Project End 31-JUL-2005 Summary: (provided by applicant): This application describes a career development/transition plan for Jessie A. Satia, PhD, MPH, a newly appointed Assistant Professor in the Department of Nutrition at the University of North Carolina,

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Chapel Hill. The candidate's overall career goal is to establish an interdisciplinary research career combining her background in epidemiology, nutrition, and laboratory sciences to conduct methodologic, observational, and intervention studies of diet and human cancers. In particular, she would like to conduct studies to identify risk factors for cancer and design appropriate interventions for prevention and control in minority and underserved populations. The candidate proposes a career development plan that includes: teaching and mentoring students; submitting research manuscripts and pilot project proposals; and a research plan (75% of her effort) with two proposed projects. Project 1 titled "Cancer Communications among African American Adolescents" aims to collect information necessary to design diet-related cancer prevention messages for African American adolescents; and evaluate the effectiveness of messages framed in different ways on knowledge, attitudes, beliefs, and intentions to improve diet in this population. Qualitative methods will be used to collect information on various factors that affect dietary behavior among African American adolescents (14 to 16 years) in Durham, NC. This information will then be used to design messages focused on lowering dietary fat intake in this population that will be delivered via the Internet. Participants will be randomized into four groups based on Prospect theory and message framing, and will complete pre- and post-tests and cognitive interviews to assess the short-term impact of the framed messages. Project 2, "Diet and Colon Cancer in African Americans and Whites in North Carolina" describes proposed analyses using previously collected data from a study of 654 colon cancer cases (40-80 years) and 1067 populationbased controls, with equal numbers of African Americans and whites, in a 33-county area of North Carolina. The specific aims of the analyses proposed here are to examine effects of dietary factors (e.g., fat, fruits, vegetables, antioxidants, fiber, alcohol, and total calories) and food intake patterns (meal frequency and snacking timing) on colon cancer risk. Potential future research opportunities using biological specimens from this study are described. The long-term success of cancer research efforts rests, in part, on building the career of talented young faculty. Obtaining this award will greatly broaden and strengthen the candidate's focus on cancer prevention and control. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DIET, EXOGENOUS HORMONES AND BREAST CANCER RISK Principal Investigator & Institution: Colditz, Graham A.; Professor of Medicine and Epidemiology; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2001 Summary: Using repeated measures of exposure and the long follow-up in the Nurses' Health Study (1976 to 2004), we propose a series of analyses relating specific aspects of diet, nutritional status, and postmenopausal use to breast cancer incidence and survival among women with breast cancer. DNA samples from cohort numbers will be used to evaluate associations between functional important polymorphisms and risk of breast cancer and potential gene-diet interactions. Specific exposures will also be related to tumor characteristics using pathology blocks that have been collected from incident breast cancer cases. Dietary hypotheses include that low folate intake and blood levels increase breast cancer risk, in particular tumors characterized by negative estrogen receptor status and aberrant methylation of the genes for this receptor and p16; that dietary fiber and specific types and sources of fiber, flavonoids, overall antioxidant intake, conjugated linoleic acid (CLA), and decreases in adiposity each reduce risk. We further hypothesize that high dietary glycemic load and intakes of heterocyclic amines from cooked meat, N-3 fatty acids from fish, and (after a long latent period) total fat each in increase risk. Polymorphisms in genes related to specificity dietary exposures

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(MTHFR, manganese SOD, and NAT1/2) will be examined in relation to breast cancer directly and as interactions with the corresponding dietary factors. We also propose to evaluate the type and dose of post-menopausal hormone preparations in relation to overall risk of breast cancer and estrogen receptor status of tumors. Finally, we hypothesize that high intake of dietary fat reduces survival among women with breast cancer, but that high intake of protein, regular physical activity, and avoidance of weight gain each increase survival. Because of the prospective design with repeated measures of exposure, long follow-up, and large numbers of breast cancer cases (over 5,000 cases for most dietary analyses), these analyses will provide important data for women and their health providers attempting to reduce risk of breast cancer. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DIET, HORMONE REPLACEMENT THERAPY AND BREAST CANCER Principal Investigator & Institution: Zhang, Shumin; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2003; Project Start 12-AUG-2003; Project End 31-JUL-2007 Summary: (provided by applicant): This is a resubmission of I K07 CA096619-01 "Diet, Hormone Replacement Therapy and Breast Cancer". Candidate: Shumin Zhang received her MD at the Harbin Medical University in 1986 and her ScD in epidemiology and nutrition at the Harvard School of Public Health in 1998. She then completed her postdoctoral training in 2000, and now is an Assistant Professor of Medicine at the Harvard Medical School (HMS). She applies for this Career Development Award to acquire the methodological and theoretical research skills needed to become an independent scientist in cancer and nutritional epidemiology. Sponsor and Environment: JoAnn Manson, MD, DrPH, is the Chief of the Division of Preventive Medicine at the Brigham and Women's Hospital, Professor of Medicine at the HMS and Co Principal investigator (Co-Principal Investigator) of the Women's Health Study ONHS). Julie Buring, ScD, is the Deputy Director of the Division, Professor of Ambulatory Care and Prevention at the HMS and Principal Investigator of the WHS. They have trained numerous investigators in the fields of diet, lifestyle and chronic diseases, areas in which they have published extensively. Research: We plan to conduct a prospective analysis within the WHS, an ongoing clinical trial of vitamin E and low-dose aspirin in the primary prevention of cancer and cardiovascular disease among 39,876 women. We will test 4 dietary hypotheses that moderate alcohol intake increases risk of breast cancer, whereas high intake of folate and fiber reduces risk; and caffeine intake is not associated with risk. We will link fiber intake to plasma endogenous sex steroid hormones in a subsample of the WHS. We will also test 4 hormone replacement therapy (HRT) hypotheses that tong-term use of estrogen plus progestin increases risk of breast cancer more than estrogen alone; estrogen plus cyclic progestin increases risk more than estrogen plus continuous progestin; low-dose estrogens confer lower risk than highdose; and use of estrogen is more strongly associated with risk among women drinking alcohol. The ongoing WHS will provide updated and repeated measures of HRT, comprehensive dietary assessment at baseline, and important covariates for breast cancer in addition to follow-up of the cohort and documentation of breast cancer cases (expected N = 1550). The findings from this project could have direct clinical application for efforts to reduce risk of breast cancer. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DIETARY ENERGY RESTRICTION AND METABOLIC AGING IN HUMANS Principal Investigator & Institution: Roberts, Susan B.; Associate Professor; None; Tufts University Boston Boston, Ma 02111 Timing: Fiscal Year 2002; Project Start 15-MAY-2002; Project End 30-APR-2009 Summary: Reducing morbidity and delaying mortality are recognized as major goals of aging research, and are addressed by this proposal to conduct a 2-year human caloric restriction (CR) intervention. A 1-year pilot study will be conducted in 32 overweight men and women to develop an effective CR regimen when fed at 70% of energy requirements determined at baseline. As part of this pilot we will refine all aspects of a CR intervention, including exercise and behavioral counseling, and will obtain necessary information on outcome variability with which to perform power calculations for the main study. Subjects will be randomized to two dietary regimens with different levels of dietary fat and glycemic index (GI) (20% fat and moderate GI vs. 35% fat and low GI) and dietary compliance and key outcome measurements will be determined at 5 periods throughout the year. Dietary factors such as dietary variety, liquid sources of energy, and dietary fiber will then be taken into account in the design of the interventions. Following identification of an effective CR regimen, a randomized 2- year intervention will be conducted in 117 overweight men and women fed 70%, 80% or 100% of energy requirements determined at baseline. The hypothesis will be tested that, compared to control subjects fed 100% of baseline energy requirements. The parameters to be evaluated will include immune function, oxidative stress, fasting insulin, hemoglobin Alc, and cardiopulmonary function. W further hypothesize that, compared control subjects, individuals randomized to 70% or 80% of baseline energy requirements will not experience adverse change sin thyroid and reproductive hormones, bone mineral density, disease incidence, mood or cognitive function. Dose-response relationships between the extent of CR and changes in outcome variables are anticipated. As part of the study, changes in total energy expenditure and resting metabolic rate, body composition and body temperature will be quantified to document the effects of CR on energy metabolism. We anticipate that the results of this study will have a major impact on our understanding of the relevance of CR to human health. In addition, this study will contribute to the development of new avenues for long- term treatment of overweight and obesity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DIETARY FIBER AND DIETARY FAT INTERACTIONS IN COLON CARCINOGENESIS Principal Investigator & Institution: Hyghes, Joe J.; Northern Arizona University Department of Biological Sciences Flagstaff, Az 86011 Timing: Fiscal Year 2001 Summary: There is no text on file for this abstract. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EFFECT OF DIETARY FIBER IN PATIENTS WITH NIDDM Principal Investigator & Institution: Garg, Abhimanyu; University of Texas Sw Med Ctr/Dallas Dallas, Tx 753909105 Timing: Fiscal Year 2001

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Summary: The primary aim of this investigation is to study the effect of total dietary fiber on glucose and lipid metabolism in patients with NIDDM. In addition, effect of dietary fiber on intestinal lipid absorption as well as calcium and other minerals will be studied. Soluble fibers may have a cholesterol lowering effect, decreasing the risk of atherosclerosis and cardiovascular disease as well as improving glycemic control. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EXERCISE AND A HIGH CARBOHYDRATE DIET Principal Investigator & Institution: Evans, William J.; Professor; Geriatrics; University of Arkansas Med Scis Ltl Rock 4301 W Markham St Little Rock, Ar 72205 Timing: Fiscal Year 2001; Project Start 02-DEC-1998; Project End 30-NOV-2003 Summary: A high carbohydrate (CHO) high fiber diet and exercise have been promoted by health professionals as an important way to prevent NIDDM or to help prevent the vast array of symptoms that result from the disease. We have demonstrated that regularly performed aerobic exercise improved glucose tolerance (OGTT), insulin stimulated glucose uptake and skeletal muscle GLUT-4 levels in older, glucose intolerant men and women. However, when combined with a eucaloric, high CHO, high fiber diet (60 percent CHO, 20 percent fat, 20 percent protein, 25 g fiber/1000 kcal) there were no exercise induced improvements in OGTT, meal tolerance, or insulin stimulated glucose uptake. The high CHO diet was also associated with a significant drop in HDL cholesterol and an increase in circulating triglyceride levels. This was a carefully controlled metabolic study in which subjects were not permitted to lose body weight. A subsequent investigation demonstrated that when older men and women consume a similar high CHO diet ad libitum (with no attempt at energy restriction), they experience significant weight loss. Using a group of older men and women (120 through 150 percent of ideal BMI, age 65 to 80 years), we propose to examine the influence of an ad libitum high CHO diet alone or in conjunction with an aerobic exercise program on body composition, insulin action, and muscle metabolism. We propose to test the hypothesis that when subjects consume a high CHO, high fiber diet ad libitum, they will lose weight and demonstrate increases in glucose tolerance and insulin stimulated glucose uptake. We will also examine the effects of a hypocaloric (-500 kcal/d) high CHO diet alone and in conjunction with an aerobic exercise to produce an energy deficit. Specifically, we will examine body composition, insulin stimulated glucose disposal (during a euglycemic, hyperinsulinemic clamp), components of energy metabolism, muscle strength and power, maximal aerobic capacity and muscle metabolism (fiber type and size, glycogen synthase, glycogen content, GLUT 4 mRNA) before and after 3 months of weight loss. This study will be the first to examine metabolic effects of an ad libitum and a hypocaloric high CHO diet (with or without exercise) in the elderly. The proposed studies will have important implications for the treatment of obesity and its vast array of complications that are often seen in older men and women. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EXERCISE INTERVENTIONS IN HIV INFECTED ADULTS Principal Investigator & Institution: Roubenoff, Ronenn; Associate Professor of Medicine and Nutr; Tufts University Boston Boston, Ma 02111 Timing: Fiscal Year 2001 Summary: This project will examine the effect of exercise training on functional status in patients with HIV wasting; and the effect of exercise on abdominal visceral fat and

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insulin resistance in patients with HIV-associated fat redistribution. In the past several years, we have shown that 1) one bout of hard exercise does not raise HIV RNA levels; 2) progressive resistance exercise (RE) leads to increase in lean mass, comparable to that seen with growth hormone or androgen therapy; 3) RE leads to fat loss in normalweight subjects, but to fat (and total mass) gain in wasted subjects; 4) in patients with fat redistribution, aerobic plus resistance exercise (ARE) leads to significant decline in trunk fat mass without loss of lean body mass or peripheral fat mass. In addition, we have preliminary evidence that 5) RE improves functional status via increases in strength and lean mass; 6) the protein metabolic response to one bout of hard exercise differs substantially between wasted and non-wasted patients; and 7) that this response can be used to predict who will benefit from RE with a gain in lean mass. Thus exercise potentially offers singular advantages in treatment and prevention of both wasting and abdominal obesity in HIV infection. The long-range goal of this research is to develop practical ways of using exercise to prevent and treat body composition abnormalities caused by HIV infection. We propose to recruit 100 patients with HIV infection with either wasting or fat redistribution, and enroll them in a long-term, randomized, outpatient study of exercise and diet. The major outcomes for the wasting group will be increased in lean mass and functional status, and whether the protein metabolic response to one bout of acute exercise predicts the response to RE. For the fat redistribution group, the expected outcomes are a decrease in abdominal visceral ft, improved insulin resistance, increased muscle glucose transporter-4 (GLUT-4) levels, and improved lipoprotein status. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EXPOSURE REDUCTION AND PREVENTION Principal Investigator & Institution: Knize, Mark G.; University of Calif-Lawrnc Lvrmr Nat Lab Lawrence Livermore National Lab Livermore, Ca 94550 Timing: Fiscal Year 2002; Project Start 19-APR-2002; Project End 31-JAN-2007 Summary: (provided by applicant): Recent studies estimate that most human cancers result from modifiable lifestyle factors, including diet. Lowering exposure to heterocyclic amines (HAs), which are formed in cooked meats, is an obtainable goal that may have a real impact on cancer incidence. This proposal addresses: 1) safe cooking methods that reduce HA formation, 2) identifying unknown mutagens and establishing their potency, 3) understanding the influence of other foods on reducing human HA absorption, 4) mechanistic studies of inhibition of flavonoids and 5) establishing the relationship between dietary questionnaires and HAs in urine. Meat cooking will be investigated to understand the conditions that reduce the formation of heterocyclic amines while using microbiology to monitor food safety. New, unknown mutagens will be isolated from beef and their amounts determined in a survey of well-cooked foods. Additionally, the parameters responsible for high mutagenic potency in new and existing HAs will be investigated as structure/activity relationships. Since there is human exposure to HAs, we can now investigate HA-diet interactions in individuals via the analysis of urinary metabolites. Exploratory studies will determine if parsley, green tea, and fiber, each shown to be preventative in epidemiology studies, can affect the total human uptake and metabolism of one HA, PhIP. Enticing results in reducing mutations with the flavonoid apigenin compel us to investigate structure/inhibition relationships experimentally and with a computational model. To quantify the dietary dose of heterocyclic amines in the population and in individuals, HA biomarkers will be developed and related to dietary questionnaires that account for diverse cooking practices. In all, this interdisciplinary research to reduce exposure combines toxicology

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with analytical chemistry, computational chemistry and physics to investigate heterocyclic amines and human cancer etiology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FOOD FOR LIFE: HEALTHIER MEALS ELDERS CAN LIVE WITH Principal Investigator & Institution: Dugan, Elizabeth; New England Research Institutes, Inc. 9 Galen St Watertown, Ma 02472 Timing: Fiscal Year 2001; Project Start 15-MAY-2000; Project End 31-JUL-2003 Summary: (provided by applicant): Americans are coming to realize that our typical diet is unhealthy - that we tend to consume an excess of food that are dense in calories, e.g., fats and sugar, and are high in sodium, and too little of foods that are dense with nutrients and fiber, e.g., fruits and vegetables and whole grains. The importance of these dietary choices increases as we age - for example, with changes in metabolism, body composition, nutrient absorption, and energy expenditures. Yet, older people are especially likely to have learned to select and prepare food in an era that preceded this knowledge, and are increasingly likely to rely on processes or prepared foods. The specific aims of this Phase II SBIR are: 1. to produce an innovative educational package about healthy eating for older adults who prepare most of their meals. Such a package is not currently available. This will involve (a) finalizing and producing a video kit (25minute video and printed materials) for participants, and (b) developing and producing a training manual for facilitators to use the kit in a 2-hour workshop. 2. To rigorously evaluate the effectiveness of using the package in a workshop in improving participants' diet. PROPOSED COMMERCIAL APPLICATION: NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GENE-DIET INTERACTIONS AND HEART DISEASE Principal Investigator & Institution: Campos, Hannia; Nutrition; Harvard University (Sch of Public Hlth) Public Health Campus Boston, Ma 02460 Timing: Fiscal Year 2001; Project Start 01-AUG-1999; Project End 31-JUL-2004 Summary: Evidence is building from epidemiological and laboratory investigations to support the hypothesis that genetic variation can modulate the effect of dietary intake on metabolic parameters to promote atherosclerosis and increase the incidence of coronary heart disease (CHD). Technological advances in molecular and nutritional epidemiology now make it possible to study gene-diet interactions and CHD in human populations at a new level of sophistication. The overall goal of this project is to carry out a population-based case-control study in 2,150 cases of myocardial infarction and 2,150 matched controls from Costa Rica, to test specific hypotheses relating gene-diet induced atherosclerosis susceptibility (GDAS) markers to CHD. Twelve GDAS markers were selected for this study. GDAS markers are defined as common genetic variants that modulate the effect of intake of specific fatty acids, tocopherols, and carotenoids on atherosclerosis. We will determine whether carriers of the GDAS marker variants are at increased risk of CHD compared to wild type homozygotes when exposed to high intakes of lauric 12:0, myristic 14:0, and palmitic 16:0, and trans fatty acids particularly 18:2 trans from partially hydrogenated soybean oil. We will study whether high intakes of alpha-linolenic acid, vitamin E, carotene, particularly alpha- carotene, lutein, and lycopene reduce the risk of CHD, and whether the GDAS marker variants alleles lessen this protective effect. In secondary analyses, we will test the hypotheses that the GDAS variant alleles influence the effect of dietary fiber, cholesterol, physical activity, and smoking on CHD. Haplotypes of metabolically related GDAS markers that are better

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predictors of CHD than individual markers alone will be established, and for each haplotype, we will determine specific adverse dietary patterns. Dietary exposure variables will be evaluated by simultaneous analyses of a semi-quantitative food frequency questionnaire, and biochemical measures of intake including adipose tissue tocopherols and carotenoids by HPLC, and fatty acids, including trans isomers of partially hydrogenated soybean oil by GC. This study will provide the most complete data set to study numerous hypotheses relating genes, diet, and CHD, and could lead to specific targeted interventions for reducing the development of CHD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IMPACT OF FIBER FERMENTATION ON FECAL INCONTINENCE Principal Investigator & Institution: Bliss, Donna Z.; None; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 29-FEB-2008 Summary: (provided by applicant): Fecal incontinence (FI), the involuntary leakage of feces, is a chronic problem with debilitating effects on health and well-being. Symptom management of FI is essential to maintain the dignity, self-esteem, and health of the individual, ease the burden of caregivers, and prevent admission to a nursing home. FI is worsened by loose/liquid stool consistency and the first step in its management is to firm stool consistency. The proposed study addresses a major gap in clinical management of FI since there is a lack of research on interventions to firm stool consistency in FI. The beneficial effects of fiber on stool consistency and FI appear to be related to the extent to which the fiber is fermented. A pivotal step in optimizing fiber therapy and improving the clinical response is to determine the importance of fermentation of fiber. The long-range objectives of this research are 1) to develop evidenced-based recommendations for using soluble dietary fiber to effectively manage FI and 2) to determine the mechanisms by which soluble dietary fiber improves stool consistency and FI. The objectives of this proposal are to determine the impact of fermentation on a fiber's ability to firm stool consistency, reduce FI, promote supplement tolerance, and improve quality of life in community-living adults with FI of loose or liquid stools. A randomized, controlled, single blind between groups design will be used. After a 2 wk. Baseline period, 184 community-living adults with FI of loose/liquid stool will be randomized to receive placebo or 16 g of total fiber/d in gum Arabic, psyllium, or carboxy-methylcellulose, representing three levels of ferment ability (completely, moderately, and non-fermentable, respectively). During the baseline and at the end of the supplementation period, subjects will complete a stool diary (14d), diet record (7d), FI Quality of Life survey, and collect all stools (7d). Differences among the measures of the groups after supplementation will be compared after controlling for baseline values of these measures using ANCOVA. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: INNOVATIVE NUTRITION COMMUNICATION FOR LATINOS Principal Investigator & Institution: Elder, John P.; Professor of Public Health; Graduate School of Public Hlth; San Diego State University 5250 Campanile Dr San Diego, Ca 92182 Timing: Fiscal Year 2001; Project Start 12-MAY-1999; Project End 28-FEB-2003 Summary: The proposed study combines innovative and traditional methods for promoting healthy diets among Latinos. The first phase of the study will employ focus groups, depth interviews and participant observations to develop and test concepts,

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message framing, and personalization strategies. Results from the first phase will be incorporated into the interventions designed for the second phase of the study. This phase will recruit 351 Spanish-dominant Latino women in San Diego area to participate in a 12-week nutritional health promotion intervention. Women will be randomly assigned to one of three groups: promotora/personalized material condition personalized/distance learning condition; and the usual care condition. In the first condition, participants will receive 12 weekly home visits by trained promotoras who will implement the intervention face-to-face via contingency contracting and personalized print pieces. In the second condition, participants will receive the same 12 weekly personalized print piece, but no home visits from a promotora. Participants in the third condition will receive 12 weekly :off the shelf" print pieces considered highquality and language-appropriate. This longitudinal research study will include 4 repeated assessments over a 15-month period. The primary outcome variables for this study are percent calories from dietary fat and number of grams of dietary fiber. Measures will be collected by trained bilingual/bicultural measurement technicians at baseline, immediately following the 12-weeks of intervention. Aggresive cohort maintenance strategies (used extensively in the past by our research team) and incentives are expected to help retain 85% of the study group over time. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INTL POPULATION STUDY ON MACRONUTRIENTS AND BP INTERMAP Principal Investigator & Institution: Stamler, Jeremiah; Professor and Chairman; Preventive Medicine; Northwestern University Office of Sponsored Programs Chicago, Il 60611 Timing: Fiscal Year 2001; Project Start 01-JUL-1995; Project End 30-JUN-2004 Summary: (Adapted from Investigator's Abstract) This application requests support for further testing of study hypotheses and exploratory analyses in the international cooperative INTERMAP Study, a basic epidemiologic investigation designed to help clarify unanswered questions on the role of dietary factors, particularly macronutrients, in the etiology of unfavorable blood pressure (BP) levels prevailing for a majority of middle-aged and older individuals in the U.S. population. A particular focus within the context of this overall objective is to help elucidate the role of these dietary factors in accounting for the even more adverse BP patterns of less educated population strata, e.g., in the U.S. for less educated African-Americans, Hispanics, and Whites. INTERMAP aims to achieve a major advance on these important issues, based on its design: a large sample size of 4,700 men and women ages 40 to 59 years of age from 17 diverse population samples of varied ethnicity, socioeconomic status (SES), and dietary habits in four countries (China, Japan, UK, and the U.S.). Efficiency has been assured by major cost-sharing by non-U.S. centers, so that resources requested have been much less than for research of this scope done solely in the U.S. Specific aims involve elucidating influences on BP of amount and type of protein, lipids, carbohydrates, also amino acids, Ca, Mg, antioxidants, fiber, and caffeine. Primary hypotheses to be tested, with control for BMI, intake of alcohol, Na, K, age, sex, and other confounders are as follow: dietary protein is inversely related to BP; inverse relations between education and BP are significantly accounted for by education-correlated differences in dietary protein intake; there is a direct relation to BP of dietary SFA, cholesterol, Keys score, starch; there is an inverse relation of PFA and of P/S. Participants, randomly selected, provided two timed 24-hr urine collections for assessment of Na, K, creatinine, urea, and completed four 24hr dietary recalls. BP was measured twice at each of four clinic visits. The study has

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been coordinated by two Coordinating Centers -- Northwestern University, Chicago and Imperial College of Medicine, London. Urinary determinations were made at a Central Laboratory in Leuven, Belgium. The 24-hr dietary recalls have been converted into nutrients with use in each country of an up-to-date, extensive, high quality, well maintained national data base, with international study-wide standardization and quality control. Findings on relations of multiple dietary factors to BP are to be used to estimate favorable impact on BP of multiple improvements in nutrition by populations. The investigators point out that this, in turn, should aid in enhancing dietary recommendations toward achieving the goal of primary prevention of hypertension, and shifting BP distributions downward to avoid excess risk associated with present levels, generally above optimal. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: LARGE INTERVENTION STUDY

BOWEL

ADENOMATOUS

POLYP

DIETARY

Principal Investigator & Institution: Burt, Randall W.; Senior Director for Prevention and Outre; University of Utah 200 S University St Salt Lake City, Ut 84112 Timing: Fiscal Year 2001 Summary: Patient ascertainment for this study has been completed and data analysis's nearly completed. No additional patients will be seen on the GCRC related to this protocol. This was a randomized intervention trial testing the hypothesis that a diet low in fat and high in fiber, fruits, and vegetables would be protective against the recurrence of colonic adenomatous polyps. The study coordinated by the National Cancer Institute and the University is one of multiple centers involved. Approximately 300 subjects were randomized at the University of Utah during the enrollment phase of the study. Patients have undergone serial colonoscopy with resection of polyps if polyps reoccur. The results of this study will be prepared for publication in the coming year. Preliminary analysis suggests that there is a decreased rate of polyp occurrence in the high fiber diet limb. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: LATITUDE WITHIN AN NCEP STEP I DIET--AN OPTIMAL DIET Principal Investigator & Institution: Farquhar, John W.; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2001 Summary: This nutrition study was intended to contrast two different approaches to selecting a low-fat diet. One diet was a relatively typical American low-fat diet (n=61). The other incorporated considerably more vegetables, legumes, and whole grains (n=59), with modest amounts of butter, cheese and egg added so that both diets had the same amount of saturated fat and cholesterol. Participants were adults with moderately elevated cholesterol levels, but with no history of heart disease. After assigning the participants to either one group or the other and then providing them with all of their meals for four weeks, cholesterol levels and other heart disease risk factors were examined. The diet with more plant foods was found to be more effective than the "typical" diet at lowering levels of LDL-cholesterol, even though both had the same levels of fat and cholesterol. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: LOW FAT, HIGH FIBER SOY PROTEIN DIET AND PROSTATE CANCER Principal Investigator & Institution: Heber, David; Professor/Chief; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2001 Summary: There is no text on file for this abstract. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: LUMINAL LIPID EXPOSURE, GENETICS AND COLON CANCER RISK Principal Investigator & Institution: Kato, Ikuko; Pathology; Wayne State University 656 W. Kirby Detroit, Mi 48202 Timing: Fiscal Year 2002; Project Start 05-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): The long-term goal of the proposed study is to provide the scientific basis for public health strategies to reduce incidence of and mortality from colorectal cancer. Several lines of evidence suggest that a high fat diet increases the risk of colorectal cancer. While ecologic studies and earlier case-control studies demonstrated a strong association with high fat intake, the results from cohort studies and recent case-control studies have rather been inconsistent. These discrepancies may indicate some genetic susceptibility that modify the effects of a high fat diet. One of the major mechanistic bases for the roles of fat in colorectal carcinogenesis is intracolonic exposure to potentially carcinogenic substances which are generated from lipid and its metabolites with fecal bacterial activities. In this context fat absorption may play a key role in determining the effects of a high fat diet on colorectal cancer risk via modifying the levels of luminal exposure to potentially carcinogenic metabolites. Recently, two common genetic polymorphisms (FABP2 and Apo E) that affect intestinal fat absorption and bile acid secretion have been reported and associated with risks of cardiovascular diseases, diabetes and dementia. We hypothesize that individuals with genotypes for lower intestinal absorption, which results in more intracolonic exposure to potentially carcinogenic substances, have a higher risk of developing colorectal cancer in relation to a high fat diet. To test this hypothesis, we propose to conduct a population-based case-control study in Metropolitan Detroit taking an advantage of the SEER Cancer Registry. We plan to interview 2000 cases and 2000 controls for their usual diet to estimate fat and other nutrient intake and collect blood or buccal cell specimens for genotyping assays. Specific aims of the study are (1) To determine whether the genotype, FABP2 A54, Apo E2/E3 or a combination of these, is associated with risk of colorectal cancer; (2) To determine whether the effect of a high fat diet on colorectal cancer risk is more pronounced in the subjects with these genotypes; and (3) To determine if the above interactions are modified by intake of other dietary components, such as fiber, calcium and iron, which affect luminal lipid metabolism. The results from the proposed study would provide useful information for effective dietary modification in primary prevention for colorectal cancer. In addition, accumulated dietary data and biological specimens will serve as an important resource for future research on other nutrient-gene interactions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MODERATE GLYCEMIC MEAL BEFORE ENDURANCE EXERCISE CAN ENHANCE PERFORMANCE Principal Investigator & Institution: Kirwan, Jp; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2001 Summary: The purpose of this study was to determine whether presweetened breakfast cereals with various fiber contents and a moderate glycemic index optimize glucose availability and improve endurance exercise performance. Six recreationally active women ate 75 g of available carbohydrate in the form of breakfast cereals sweetened whole-grain rolled oats (SRO, 7 g of dietary fiber) or sweetened whole-oat flour (SOF, 3 g of dietary fiber) and 300 ml of water or water alone (Con). The meals were provided 45 min before semirecumbent cycle ergometer exercise to exhaustion at 60% of peak O2 consumption. Diet and physical activity were controlled by having the subjects reside in the General Clinical Research Center for 2 days before each trial. Glucose disposal is studied with stable isotope labeled tracers and mass spectrometry. Blood samples were drawn from an antecubital vein for glucose, free fatty acid (FFA), glycerol, insulin, epinephrine, and norepinephrine determinati on. Ther e was no difference in exercise time for the SOF and Con trials. We conclude that eating a meal with a high dietary fiber content and moderate glycemic index 45 min before prolonged moderately intense exercise significantly enhances exercise capacity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MOTIVATING DIETARY CHANGES IN CHURCHES Principal Investigator & Institution: Bowen, Deborah J.; Member; Fred Hutchinson Cancer Research Center Box 19024, 1100 Fairview Ave N Seattle, Wa 98109 Timing: Fiscal Year 2001; Project Start 30-SEP-1998; Project End 31-JUL-2002 Summary: We know how to change the dietary habits of motivated individuals. The results of our past randomized intervention trials indicate that if people are ready and motivated to change dietary behaviors, the likelihood of success is very high. We know far less about how to change the dietary habits of individuals who are not yet motivated to attempt changes. We hypothesize that two finding from our own and others' research will increase motivation for dietary change: the relationship of social support to health behaviors, and the effects of messages specifically designed to motivate individuals to change. This proposal will rigorously test an intervention package, based on our previous experience, designed to change dietary practices (lowering fat, increasing fruit and vegetable consumption) among lower socioeconomic (SES) families in religious organizations. We selected religious organizations because of the important role they play in the lives of their members and because of the social and supportive messages that can be delivered by them. The intervention package will deliver social support and motivating messages, as well as materials and skill-building opportunities for dietary change. Forty religious organizations will be randomized to intervention or comparison status. The 18-month intervention package, based on a merger of Social Learning Theory and Trans-theoretical Model of Behavior Change, will consist of material adapted from interventions of proven efficacy that present strategies for changing current behavior, messages that influence motivations and beliefs, and organization-wide interventions that affect environmental variables. We will base evaluation upon a randomly selected cohort from each religious organization's mailing list. Dietary habits will be assessed at baseline and 6 and 18 months follow-up, using a modified version of the Fat and Fiber Behavior Questionnaire, with a subset selected to receive 24-hour recalls. The

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intervention process will be measured and used as a mediator of dietary change in all intervention organizations. The primary outcome will be the difference in change in fat scores between intervention and comparison religious organizations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MULTIETHNIC/MINORITY COHORT STUDY OF DIET AND CANCER Principal Investigator & Institution: Kolonel, Laurence N.; Deputy Director; None; University of Hawaii at Manoa Honolulu, Hi 96822 Timing: Fiscal Year 2001; Project Start 01-JAN-1983; Project End 28-FEB-2003 Summary: This revised competing renewal application is for continued follow-up and data analyses on a large epidemiologic cohort, which was established in Hawaii and Los Angeles during the period 1993-1996. The population- based cohort, comprised of more than 215,000 members is unique in its multiethnic composition, including substantial numbers of Latinos, African Americans, Japanese Americans, and whites. At entry, each participant complete a 26-page mail questionnaire that contained a quantitative diet history, medical, medication, physical activity, and female reproductive histories; and demographic information. In addition to maintaining a high rate of follow-up on the cohort, we will study the relationship of several dietary factors to four common cancer sites: prostate, breast, colorectum and lung. Associations of these cancers with nutrients (e.g., prostate cancer with saturated fat, lycopene; breast cancer with the ratio of monounsaturated to saturated/ polyunsaturated fat, components of dietary fiber; colorectal cancer with fat, energy, folate; lung cancer with specific fats, carotenoids) and with foods (e.g., prostate cancer with red meat, legumes; breast cancer with high-fiber vegetables; colorectal cancer with meats cooked at high temperature legumes; lung cancer with animal products, food sources of carotenoids) will be examined, taking advantage of both the diversity and range of intakes among cohort members. These relationships will first be examined within each ethnic group. Then, the consistency of relationships among the different ethnic group will be evaluated, using calibrated dietary exposure values based on 24-hour dietary recall data collected on a large subsample of the cohort. Finally, the extent to which dietary and non-dietary data can account for interethnic differences in cancer risk will be assessed. Passive follow-up on the cohort will use computer linkage to the population-based cancer registries in Hawaii and California, and should yield at least 2542 breast, 3426 prostate, 2737 colorectal, and 2034 lung cancer incident cases by the year 2002. Active follow-up will include the administration of a brief follow-up questionnaire in the first two years of the renewal period, as well as regular mailings of a study newsletter. Findings from this study should help to elucidate relationships of diet to cancer, and to better understand the basis for ethnic variations in cancer incidence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NUTRITION COUNSELING TO REDUCE CARDIOVASCULAR RISKS IN HYPERCHOLESTEROLEMIA Principal Investigator & Institution: Kris-Etherton, Penny M.; Pennsylvania State Univ Hershey Med Ctr 500 University Dr Hershey, Pa 17033 Timing: Fiscal Year 2001 Summary: The purpose of this study is to determine if psyllium supplemented foods with cholesterol lowering behavior counseling given to moderately hypercholesteremic study participants will more favorable affect plasma lipid and liproproteins compared

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with study participants in a usual care (control ) group. We will also determine if the study participants who have access to psyllium supplement foods and the cholesterol lowering behavior counseling will have more favorable food patterns (e.g. eat more whole grain bread products and less saturated fat from animal products ) compared with usual care study participants. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NUTRITION INTERVENTION: METABOLIC COMPLICATIONS OF HIV+ Principal Investigator & Institution: Woods, Margo N.; Associate Professor; Family Medicine & Cmty Health; Tufts University Boston Boston, Ma 02111 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-JUL-2007 Summary: (provided by applicant): As the HIV population survives and ages, a new syndrome is being observed that appears to be affected by PI medications but is also seen independent of PI use. This syndrome is characterized by hyperlipidemia, lipodystrophy and insulin resistance. Elevated triglycerides are a common observation with or without hypercholesterolemia. Since statin do not reduce serum triglycerides and may be counter-indicated to lower serum cholesterol because of potential liver damage in the HIV+ population that are on PI, dietary interventions have been getting more attention. Literature suggests that a diet lower in fat with reduced levels of saturated fat relative to polyunsaturated fat, increased omega 3-fatty acids intake, high fiber, and use of carbohydrates lower in glycemic index may be beneficial when they were studied individually. We propose to use a nutrition intervention in a HIV+ population that has elevated triglycerides (>220 mg/dl) to test whether a diet that combines all of these factors can have a significant effect on reducing serum triglycerides. The nutrition intervention will be a low fat diet (25% of calories from fat) with a 1:1:1 ratio of Saturated:Monounsat: Polyunsaturated fat, high in fiber (40 g/day) with carbohydrates of lower glycemic index (< 70 whenever possible). This diet will contain 3 g/day of omega 3-fatty acids which will be supplemented with 3.0 g of omega 3-fatty acids from capsules to give a total of 6 g/day of omega 3-fatty acids and a ratio of n-6/n-3 of 4:1. In addition to measuring triglycerides, serum cholesterol and its subfractions will be determined as well as insulin area under the curve (AUC) and body composition using CT scan. HIV+ participants eligible for the study (N=100) would be randomized into a control or nutrition intervention group and be tested for changes after 3 weeks, 13 weeks and 6 months of intervention. During the first 3 weeks the intervention group will be given all their meals at the hospital General Clinical Research Center, followed by an additional 10 weeks in which some food products are supplied to them along with the continued use of omega 3-fatty acids supplements at 3 gms/day (in 10 capsules). After 13 weeks the participants will be asked to continue to take the omega 3-fatty acid capsules but food products high in n-3 fatty acids will not be supplied. A 6-month follow-up will then remeasure all the study parameters to determine if the nutrition intervention group had experienced an improvement of the listed risk factors compared to the control group. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NUTRITION PROGRAM-CARIBBEAN HISPANIC ELDERS & DIABETES Principal Investigator & Institution: Bermudez, Odilia I.; Assistant Professor; None; Tufts University Boston Boston, Ma 02111

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Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2004 Summary: (provided by applicant): Nutritional management is an important component in the control of diabetes, and appropriate dietary adherence is associated with better glycemic control. However, adherence to a nutrition program is one of the most challenging aspects of diabetes care. From data from our baseline study, the Massachusetts Hispanic Elders Study, we have identified diabetes as highly prevalent among elderly Hispanics of Caribbean origin. Their disease status is characterized by high rates of uncontrolled diabetes and lack of appropriate strategies to self-manage the nutritional component of their disease. We hypothesize that, compared to the standard recommendations for nutrition care of Hispanics with diabetes, an ethnically and culturally specific nutrition program will result in improved fruit and vegetable and fiber intakes. To address this hypothesis, our proposed project has two phases: 1) development of a Caribbean Nutrition Program, including an ethnographic study to obtain the culturally relevant elements that will make this program unique for the target population, and 2) a pilot study to test the feasibility of implementing the Caribbean Nutrition Program with elderly Hispanics of Caribbean origin living in Massachusetts. The goal is to have a culturally specific nutrition self-management program designed to improve dietary intake of fruit and vegetables and dietary fiber, which, once incorporated into the diabetes self-management plan of Hispanic elders with diabetes will result in appropriate food choices, in better quality of life, and in improved glycemic control. Specific aims are: 1) To design a culturally appropriate nutrition program to increase access and use of fruit and vegetables and other high fiber foods for Caribbean Hispanics with diabetes. 2) To pilot test the Caribbean Nutrition Program in a sample of Hispanic elders with diabetes, and 3) To evaluate adherence to the Program by assessing intakes of specific foods and dietary components as well as levels of total plasma carotenoids. The study population will be recruited among Puerto Rican and Dominican men and women, (50-70 years of age) with diabetes. Volunteers for both phases of the study will be recruited in the Greater Springfield area (Hampden County), Massachusetts. For the intervention pilot study (4 months), volunteers will be randomly divided into two groups and will be given the standard recommendations for individuals with diabetes (control group) or the Caribbean Nutrition Program (intervention group). A semi-quantitative food frequency questionnaire will be administered to obtain detailed data on food intake and patterns. Volunteers will also provide a fasting blood sample and serum carotenoids, HbA1c and blood glucose will be tested. Differences between baseline and 4 months, within and between groups, will be assessed to test our hypotheses as follow: 1) A nutrition program that is consonant with current dietary guidelines and tailored to the ethnic and cultural characteristics of elderly Caribbean Hispanics with diabetes is feasible. It will be accepted and followed by participants, as measured by indicators of adherence and compliance. 2) Among Caribbean Hispanics with diabetes, dietary self-management to increase fruit and vegetables consumption and fiber intake, as evaluated by changes in certain dietary components from food frequency questionnaire and by plasma carotenoids, will be more effective with the Caribbean Nutrition Program than with standard dietary recommendations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PILOT -- EFFECTS OF DIET ON CARDIOVASCULAR RISK Principal Investigator & Institution: Samuel-Hodge, Carmen; Shaw University 118 E South St Raleigh, Nc 27611 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2007

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Summary: African American women suffer disproportionately from diabetes and its cardiovascular complications. For African American women with diabetes (with high prevalence of overweight and CHD risk), research is needed to determine how best to improve lipid profiles (particularly, LDL- and HDL-cholesterol), through dietary patterns that are palatable and promote a higher level of compliance than the current high carbohydrate low fat (HCLF) diet prescription, While recent studies among patients with diabetes have shown positive metabolic effects of diets high in monounsaturated fatty acids (HMUFA), none have included African Americans. The overall aim of this pilot study is to assess the acceptability and monitor the metabolic effects of a HMUFA vs. HCLF diet in a sample of free-living African American women with type 2 diabetes. A randomized crossover design is proposed for evaluating the acceptability and metabolic effects of the study diets. Twenty African American women with type 2 diabetes will be recruited from 1 primary health care facility. At baseline, measures of diet, weight, height, blood pressure, blood lipids, red blood cell (RBC) membrane fatty acids, and hemoglobin Alo (HbAlc) will be collected. Randomization to 1 of the 2 study diets will follow a 1-week run-in period, where participants will be evaluated for compliance with the diet protocols. Study diets will be isocaloric to the diet consumed during the run-in period. The study diets will have the following composition (as a percentage of total calories): HMUFA- 40% carbohydrates, 20% protein, 40% fat, 9% saturated, 21% monounsaturated, and 10% polyunsaturated; HCLF - 55% carbohydrates, 20% protein, 25% fat, 9% saturated, 10% monounsaturated, and 6% polyunsaturated. Both diets will have < 300 mg/d cholesterol and similar levels of dietary fiber. Daily menus specifying foods and portidns to be consumed for 3 meals + 1-2 snacks will be provided to each participant. Foods in both diets will be the same except for key foods high in monounsaturated fats added to the menus for the HMUFA study diet; all key foods will be supplied to study participants. After 6 weeks on the 1st study diet, participants will return to an isocaloric usual diet for 2 weeks, then crossover to the 2ndstudy diet. Following each 6-week diet period, measures taken at baseline will be repeated. A questionnaire will be used to evaluate the acceptability of the HMUFA diet relative to the HCLF diet in terms of palatability, preference, ease of preparation, satiety, etc. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: POR LA VIDA INTERVENTION MODEL IN CANCER EDUCATION Principal Investigator & Institution: Navarro, Ana M.; Associate Professor; Family and Preventive Medicine; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 92093 Timing: Fiscal Year 2001; Project Start 01-SEP-1994; Project End 31-AUG-2003 Summary: The potential for reducing cancer incidence and mortality through prevention and early detection appears to be large.Research is showing the important role of nutrition in preventing cancer. Because many members of the Hispanic community have limited access to health care services and are in need of health promotion services, the Hispanic community is an appropriate target for specialized cancer prevention efforts. In particular, Hispanics of low level of acculturation and low level of formal education are a most important target for education about nutrition cancer control. The Por La Vida intervention model establishes community-based health promotion interventions, utilizing existing social networks and building on contemporary theories of social learning and social support Interventions based on the Por La Vida model have been successful in modifying behaviors relevant to cardiovascular risk and, most recently, breast and cervical cancer prevention. This study

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is a competing renewal of a project that examines the effectiveness of the Por La Vida intervention in the area of breast cancer education. This proposal will expand the scope of the intervention to nutrition cancer education. An additional goal of this proposal is to familiarize UCSD medical students and residents in the Family Medicine program with the Por La Vida intervention model in cancer education, and to encourage students to develop and complete related research projects. Approximately 36 consejeras will be recruited from the Hispanic community in San Diego and trained to conduct-the educational sessions. Each consejera will then recruit between 10 to 15 peers from the community to participate in the educational program. In addition, each of the program participants will identify two adults in their existing social networks with whom they will share information about cancer prevention. A randomized experimental control study with pretest, posttest, and follow-up has been designed to assess the impact of the educational interventions. Half of the consejeras will be trained and will conduct educational sessions in the Por La Vida nutrition cancer control curriculum. The other half of the consejeras will be trained in the Por La Vi ia breast and cervical cancer early detection curriculum. We will examine the extent to which the interventions are implemented as planned. Furthermore we will investigate (l) the impact of the intervention on knowledge of nutrition cancer prevention and breast cancer screening on program participants, and (2) the impact of the diffusion of cancer prevention information mediated through program participants to friends and family. Outcome measures will be collected through telephone interviews and review of medical records. In addition, face-to-face interviews will be conducted to collect three-day food records from 15% of the program participants. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PREVENTION OF OVERWEIGHT IN PRESCHOOL MINORITY CHILDREN Principal Investigator & Institution: Fitzgibbon, Marian L.; Professor; Psychiatry and Behavioral Scis; Northwestern University Office of Sponsored Programs Chicago, Il 60611 Timing: Fiscal Year 2001; Project Start 01-AUG-1998; Project End 31-JUL-2003 Summary: The prevalence of overweight among preschool children in the U.S. is over 10 percent. Overweight in childhood is linked to overweight in adulthood, as well as earlier morbidity and mortality. This strongly suggests the need for primary prevention and intervention in children. Furthermore, in contrast to the disappointing weight loss outcome data for adults, weight loss studies with children report far more effective results. The inclusion of a parent in the intervention appears to contribute to the success. Thus, it seems vital that a successful overweight prevention and intervention program must include both children and parents. Finally, studies indicate that early prevention and intervention efforts may be particularly important for minority populations. For example, the prevalence of overweight among minority women approaches a staggering 50 percent compared to 33 percent for White women. Children often acquire a genetic predisposition toward overweight and model their eating patterns after their parents. Therefore, it follows that minority children from families where one or both parents are overweight are at greatest risk for becoming overweight themselves. The proposed research was designed to address the needs of the Black and Hispanic communities, focusing on intervention with preschool aged children. Twenty-four Head Start sites will be randomly assigned to intervention or no-intervention conditions. Of these 24 sites, 12 will serve a predominantly Black population, and 12 will serve a predominantly Hispanic population. The investigators anticipate enrolling an average of 35 Black or

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Hispanic children and parents per site. Parents and children will participate in health screenings at baseline, following the intervention, and 12 and 24 months later. The intervention consists of a 16-week nutrition and activity based weight control program that includes parental participation. The no-intervention control group will receive the standard curriculum provided by the Head Start preschool program. It is expected that children in the intervention group will show a greater mean reduction in the primary outcome measure, percent ideal body weight for height (%IBWH), as well as dietary fat intake; and an increase in dietary fiber and fruit and vegetable intake. It is expected that the parent intervention group will show a greater mean reduction in body mass index; decreased dietary fat; and increased dietary fiber, fruit and vegetable intake, physical activity, nutrition knowledge, nutrition attitudes, and support for healthy eating. These changes will be seen following the intervention and at 12 and 24 months later. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PROSTATE CANCER DEVELOPMENT & GROWTH Principal Investigator & Institution: Wang, Christina C.; Professor and Program Director; Harbor-Ucla Research & Educ Inst 1124 W Carson St Torrance, Ca 90502 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2005 Summary: (Provided by the applicant) Increasing evidence from studies in experimental animals and men show that dietary intake of fat especially animal fat is associated with increased risk of development and growth of carcinoma of the prostate (CaP). We have shown in our recently completed study that in white men changing their customary diet (37.9 plus or minus 1.0% energy from fat, 19 plus or minus 1 g fiber per day) to a low-fat, high-fiber diet (13.9 plus or minus 0.3% energy from fat, 32 plus or minus 1 g fiber per day) significantly decreased their serum testicular and adrenal androgens; urinary excretion rates of both testicular and adrenal androgens, and the production rate of testosterone. The specific aim for this study is to verify in multiethnic groups that the decreases in serum androgens after diet modulation to a low fat diet are also reflected by decreases in intraprostatic androgens and changes in their metabolism resulting in increased 5 alpha reduced androgens. To address the specific aim we will recruit patients presenting to the Urology clinics with elevated serum PSA and or/abnormal digital rectal examination where a routine transrectal ultrasound guided prostate biopsy is indicated. Prostate samples not used for pathological diagnosis will be stored. Subjects whose biopsies show no evidence of CaP and have a persistently elevated PSA will require a repeat biopsy 8 to 12 months later. These subjects will be eligible for the study if they customarily consume a high-fat diet and will have serum/urine androgen levels measured. They will be randomized to continue on their customary high-fat diet or to diet modulation on an isocaloric low fat-high fiber diet (<15% of total calories as fat/ 25 to 35 g fiber a day) for eight weeks. After diet study, serum and androgen levels will be measured on the day before their scheduled second biopsy. All subjects will return for weekly clinic visits to ensure compliance with customary or low fat diet. The biopsies before and after diet modulation will be used for measurement of intraprostatic androgen levels and androgen metabolic enzyme activities including 5 alpha reductase, 3alpha/beta hydroxysteroid oxi/reductase and 17 beta hydroxysteroid dehydrogenase. The proposed study will provide unequivocal evidence to answer whether reduction in dietary fat will result in significant changes in intraprostatic androgens and enzyme activities. Small but significant decreases in intraprostatic androgen may create an unfavorable macroenvironment which over protracted time may slow or prevent the development and growth of CaP. The results will provide the important missing link between diet fat and CaP growth and development.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: REACHING RURAL RESIDENTS WITH NURTITION STRATEGIES Principal Investigator & Institution: Fries, Elizabeth A.; Psychology; Virginia Commonwealth University Richmond, Va 232980568 Timing: Fiscal Year 2001; Project Start 01-AUG-1997; Project End 31-JUL-2002 Summary: Addressing cancer among rural, African American, and low-income Americans is a high priority for cancer prevention in the U.S. Cancer mortality rates among these groups are often disproportionately high compared to urban, Caucasian, and high-income populations. Some of the high cancer mortality rates in these groups can be slowed by changing the foods Americans eat. Specifically, government agencies, including the National Cancer Institute, recommend that Americans consume at least 20 grams of fiber per day and no more than 30 percent of their daily calories from fat. We are far from reaching these goals, and rural, low-income individuals are especially disadvantaged when it comes to dietary programs and knowledge. These groups are often less ready to change their diets, and in need of both reading level appropriate material and extra motivation to make changes. Yet, our educational materials and techniques for changing diet in the underserved are clearly inadequate. The investigators propose testing a theoretically guided intervention package designed to decrease fat and increase fiber consumption in rural, low-income, low-literacy level individuals in southern Virginia. This intervention will adapt an effective dietary change booklet entitled "Help yourself: A Guide to Healthful Eating" to this population. Personalized dietary feedback and recommendations, and personal physician letters will be provided for additional motivation for dietary modification. One thousand and fifty individuals recruited through rural primary care practices in southern Virginia will participate in this five year study. Subjects will be randomly assigned to intervention and control conditions. The revised self-help booklets and motivational materials will be delivered in the mail to the home of patients. All intervention information will be provided with the personal rural primary care physician's endorsement. Study participants will be followed up by telephone at one, six, and twelve month intervals. Primary outcomes of dietary fat and fiber behavior will be measured using the Fat and Fiber Behavior Questionnaire (FFB). A sub-study in the intervention participants will test three different strategies for presenting personalized dietary feedback based on prior research. This project will provide new information on motivating this underserved population toward dietary change. The combined strategies will form a self-help intervention package that is maximally effective while retaining the long term, desirable qualities of low intensity and cost. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: REGULATION OF P21 INDUCTION BY BUTYRATE IN COLONIC CELLS Principal Investigator & Institution: Fleming, Sharon E.; Professor; Nutritional Scis & Toxicology; University of California Berkeley Berkeley, Ca 94720 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2004 Summary: (provided by applicant): Butyrate is normally produced in the colonic lumen via microbial fermentation of dietary fiber and undigested starch. Butyrate reduces the size and incidence of colonic tumors in animal models, and influences cultured colonic adenocarcinoma cells by inhibiting growth and stimulating apoptosis and differentiation. A better understanding of the mechanism by which butyrate achieves its

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effects may lead to more effective exploitation of dietary prevention practices, therapeutic interventions and treatment strategies. In this proposal, we pursue our recent observation that butyrate causes a rapid and sustained increase in p21 mRNA. p21 is known to affect the cell cycle and growth by inhibiting kinases. We hypothesize that the cell growth inhibition effects of butyrate are due to p21 induction and we hypothesize that this induction is mediated via histone acetylation induced changes in the chromatin structure, and via phosphorylation. To confirm preliminary findings, six colonic cell lines (p53 wild-type and mutated) will be exposed to butyrate. Cell growth and p21 mRNA levels will be measured. Using transient transfection, we will determine whether butyrate increases p21 mRNA by rapidly stimulating the p21 promoter. We will also determine whether the increase in p21 mRNA results also in rapid increases in p21 protein. To determine whether butyrate changes the configuration of the chromatin surrounding the p21 promoter to an "open" configuration, DNaseI hypersensitivity sites will be mapped along an 11 kb segment of genomic DNA that includes and flanks p21. We expect to find that butyrate increases sensitivity of these sites to DNaseI cleavage. In our final aim, we will determine if phosphorylation is involved in butyrate-induced gene transcription in colonic adenocarcinoma cells. Initial studies with phosphatase and kinase inhibitors will be conducted in cultured and p21 transiently transfected cells. These studies will provide new knowledge. They will also provide data that will be used to support a follow-up R01 application. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: REINVENTING 5 A DAY TESTED INTERVENTION WITH TECHNOLOGY Principal Investigator & Institution: Buller, Mary K.; President; Klein Buendel, Inc. Suite 190 Golden, Co 80401 Timing: Fiscal Year 2002; Project Start 01-JUN-2000; Project End 31-OCT-2004 Summary: (provided by applicant): Emerging Internet-based technology has vast potential to extend cancer prevention communications and interventions widely through corporate wellness markets. While access to web-based technology is not yet universal, computer-based tools for worksite health promotion offer the potential for significantly increasing the accessibility of programs and breadth of option that employers can provide. Currently, 51 percent of worksites with 750+ employees use Internet, Intranet or kiosk-based delivery channels for lifestyle behaviors change programs. A 1999 national survey of worksites found that, in as few as 3 years, computer-based programs could become the most feasible and comprehensive channel for employee health promotion. Of all the dietary factors related to cancer prevention, research evidence is most consistent for an inverse association between cancer risk and fruit and vegetable consumption. We will produce a web-based multimedia worksite 5 A Day health promotion program with computer resources for worksite wellness professionals and educational interfaces and communication features for employees. The multimedia program is based on successful worksite 5 A Day interventions developed by researchers at the AMC Cancer Research Center (AMC) and Fred Hutchinson Cancer Research Center (FHCRC) in NCI-funded ROl projects. Partners for Health Systems, Inc. will collaborate with AMC, FHCRC, and the Produce for Better Health Foundation on multimedia development and evaluation. A pair-matched randomized controlled trial with 800 employees and 64 worksite wellness professionals in 32 companies will test the effectiveness of the web-based 5 A Day Program at increasing consumption of fruits and vegetables and its efficacy for Phase III commercialization. PROPOSED COMMERCIAL APPLICATIONS: Worksite health

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promotion programs are considering by employers to be one of the most effective strategies for managing health care costs, increasing employee moral, and improving employee health status. The interactive multimedia nutrition education program created in this project will represent the next generation in worksite health promotion technologies. It will have application in any and all worksite wellness settings as personal computers and Internet/Intranet systems expand in the workplace. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: RISK FACTORS FOR BREAST CANCER AMONG YOUNGER NURSES Principal Investigator & Institution: Willett, Walter C.; Professor and Chairman; Nutrition; Harvard University (Sch of Public Hlth) Public Health Campus Boston, Ma 02460 Timing: Fiscal Year 2001; Project Start 17-JUL-1989; Project End 31-DEC-2003 Summary: We propose to continue the follow-up of over 116,000 women who in 1989 were enrolled in a prospective study to evaluate potentially modifiable risk factors for major health problems among younger women. In this unique cohort, the Nurses' Health Study II (NHS II), exposure information has been collected at two-year intervals in early adult life, and we have maintained over 90% response to follow-up questionnaires. The proposed specific aims build upon and extend the original objectives. Specifically, we will tet the following hypothesis for breast cancer and melanoma, the two most important malignancies in this age group, and will quantify and characterize associations that are observed: 1) higher intakes of specific carotenoids, dietary fiber, and unsaturated fat during adolescent and early adult life reduce risk of premenopausal breast cancer, whereas higher dietary glycemic load and intake of saturated fat increase risk; 2) higher levels of physical activity reduce risk of breast cancer (for this aim we will evaluate contributions of different activity levels during different stages of life, and assess the degree to which error in measuring activity or recall bias can account for major inconsistencies in the literature); 3) current use of lower- dose oral contraceptives does not increase breast cancer risk, but long-term use before first pregnancy increases risk; 4) breast-feeding reduces risk of breast cancer among premenopausal women; 5) long duration of oral contraceptive use and low intake of specific antioxidants increase the risk of melanoma; and 6) higher plasma levels of IGF-1 increase breast cancer risk. In the proposed follow-up, we will continue to mail questionnaires to participants at two year intervals to update information on the primary exposures and relevant covariates, and to ascertain incident cases of cancer and other major illness. For all reported cancers, we seek medical records for confirmation and more detailed characteristics. Through 2003, we expect to ascertain 1,685 cases of invasive breast cancers and 301 invasive melanomas, thus providing substantial statistical power to address the above hypotheses. A nested case-control study of IGF-1 in relation to breast cancer will utilize the blood specimens currently being collected from approximately 30,000 participants. In addition to the above aims, the NHS II provides the exposure data and initial case identification to examine many other important outcomes among young women. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SOLUBLIZED CELLULOSE TRIAL Principal Investigator & Institution: Keenan, Joseph; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070

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Timing: Fiscal Year 2001 Summary: Coronary heart disease (CHD) is still the most prevalent cause of death in the US. Despite its multifactorial etiology, plasma cholesterol levels are considered to be a useful predictor of risk and numerous interventions are continuously tested in a effort to control hypercholesterolimia. Research has suggested that insulin resistance may play a central role in the pathophysiology of CHD. Thus, there has been an increasing interest in insulin and glucose metabolism as relevent parameters in disease intervention or prevention efforts. A large body of evidence supports a role of soluble fiber in both reducing serum cholesterol concentration and improving fasting and postpandrial blood glucose and insulin levels. The mechanism by which fibers exert these effects is largely unknown, but it is thought to be at least partially related to its viscous nature. The purpose of this six-week, double-blind, placebo-controlled study is to investigate the cholesterol-lowering effect of modified cellulose as well as its ability to beneficially modulate glucose and insulin metabolism. The unique physical characteristics of this fiber contribute to contribute to its high water-holding capacity, yet it is virtually nonfermentable. Thirty men and women, randomized to an active or control treatment group, will be asekd to consume 8 fl oz of beverages differing in fiber content twice daily for six weeks. Bllod samples will be drawn pre- and post-intervention to measure serum levels of fasting lipids, insulin, and glucose. Additionally, the participants will undergo an meal challenge and an intravenous glucose tolerance test to determine cholecystokinin, glucose and insulin responses. The data will be analyzed for differentces between pre- and post-intervention values for all parameters studied. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TRIAL OF DIETARY FIBER AND BLOOD PRESSURE Principal Investigator & Institution: He, Jiang; Tulane University of Louisiana New Orleans, La New Orleans, La 70112 Timing: Fiscal Year 2001 Summary: Hypertension is a highly prevalent condition which substantially increases the risk of cardiovascular and renal diseases. Lifestyle modifications, including nutrition supplementation, have been suggested as an important means to prevent and treat hypertension. In observational studies, consumption of diets with high fiber content has been associated with a lower blood pressure (BP). However, the few randomized controlled trials that have studied the BP-lowering effect of dietary fiber have produced contradictory results. The overall objective of the proposed study is to test whether dietary fiber supplementation will lower BP in human subjects. The proposed randomized, double-blind, placebo-controlled trial will utilize a prospective parallel design with 200 participants randomly allocated to one of the two treatment arms. The trial is designed to have greater than 80% power to detect a 2 mm Hg reduction in diastolic BP (DBP) and a 3 mm Hg reduction in systolic BP (SBP) over a 6 month intervention. The main eligibility criterion for participation will be a DBP 80 to 89 mm Hg and/or SBP 130 to 139 mm Hg, mean of 9 readings over 3 screening visits. The study participants will be recruited by mass mailing and community-based screening. Following a 2-week run-in period, eligible participants will be randomly allocated to receive either 10 grams of soluble fiber (-glucan extracted from oat bran) per day or placebo. The primary outcome will be change in DBP (defined as the disappearance of the fifth Korotkoff sound) from baseline to termination, with the mean at each of these two points being determined from 9 BP readings (taken over 3 visits). The secondary endpoint will be change in SBP (defined as the appearance of the first Korotkoff sound). In addition, changes in fasting serum glucose, insulin, and total, HDL- and LDL-

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cholesterol, triglyceride and body weight will be measured, and the impact of these variables on the mechanism of any BP lowering effect will be examined. Results from the proposed study may provide the scientific evidence for new dietary fiber supplementation recommendations for primary prevention of hypertension in the general population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: WEIGHT MGT & NUTRITION FOR PRE-/PERIMENOPAUSAL BREAST CANCER SURVIVORS Principal Investigator & Institution: Wylie-Rosett, Judith; Professor; Yeshiva University 500 W 185Th St New York, Ny 10033 Timing: Fiscal Year 2001; Project Start 01-DEC-2000; Project End 30-NOV-2001 Summary: More than half of premenopausal breast cancer survivors gain weight during the first postsurgical year. A greater than average weight gain has been associated with an increased risk for breast cancer recurrence weight gain during menopause is greatest during its first decade.and death. Adult weight gain also increases the risk of postmenopausal breast cancer. It is estimated that weight gain during menopause is greatest during its first decade. There is increasing evidence that elevated plasma free estradiol, the portion of estradiol not bound to plasma proteins, is associated with both weight gain and an increased risk for breast cancer. There has been very limited research on whether free estradiol can be modulated through dietary or body fat changes. Therefore, we will also evaluate in this protocol the impact that a reduction in dietary fat, an increase in dietary fiber, weight loss and a change in body fat percentage or body fat distribution has on plasma free estradiol. The aims of this pilot study are to conduct a randomized controlled clinical trial with 72 breast cancer survivors (36 to the intervention group and 36 to the control group). The sample will be stratified evenly between pre/peri menopausal and post-menopausal subjects. Participants in the intervention group will be offered 13 nutrition education sessions. The goals of the nutrition intervention are to help paritipants: a) Reduce fat intake to 15% of calories (with the calorie level set to maintain or achieve a healthy weight); b) Increase fiber intake to 40 grams per day by consuming a diet rich in fruits, vegetables and unprocessed complex carbohydrates and c) Establishing or maintaining an exercise pattern of at at least 1000 kilocalories/week. The primary hypothesis is that the intervention group will have a significantly greater reduction in the percentage of plasma free estradiol than the control group. A secondary hypothesis is that the intervention group will have significantly fewer women than the control group who have a net weight gain since breast cancer surgery of five or more pounds. Other variables of interest are whether the intervention results in changes in the body fat percentage, the ratio of upper to lower body fat, and in the lipid profile. We will also assess whether the intervention hormonal patterns differently between pre, peri and postmenopausal women. Additionally, we will compare the effect of the dietary intervention on the percentage of plasma free estradiol to another potential biomarker for breast cancer risk, the ratio of 2-hydroxyestrone to 16-alpha-hydroxyestrone. Secondary questions include how changes in dietary intake, physical activity, and weight-related parameters are related to the quality of life, perception of risk from breast cancer, and participants' satisfaction with the protocol. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: WOMEN'S HEALTHY EATING AND LIVING TRIAL IN THE BAY AREA Principal Investigator & Institution: Carlson, Robert W.; Professor of Medicine; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2001 Summary: Evidence suggests that regression and progression of localized breast cancer, after the disease has been diagnosed and treated by conventional means, might be reduced by 30-50% if current dietary guidelines for Americans were enriched markedly for edible plants and fiber and had a reduced fat content. The Women's Healthy Eating and Living (WHEL) study, a multi-center randomized trial, will test the effect of a diet composed of 15-20% of calories from total fat, = 30 gm of fiber/day, and twice the vegetable and fruit goals of the National Cancer Institute (NCI) dietary recommendations of 5 servings/day, with an emphasis on consuming "nutrient-dense" vegetables, i.e. those with a high content of antioxidants and specific phytochemicals. Medical follow-up is by usual oncology practice to determine clinical study endpoints of disease-free and total survival. The goal is to enroll 3000 breast cancer survivors over a 4-year period, who are within 4 years of their diagnosis of stage I (>1 cm), II and IIIA disease and who have completed conventional therapy. The Northern California Cancer Center, as one of six clinical centers, will enroll 500 women who will be tested and followed at the Stanford and University of California, San Francisco, General Clinical Research Centers. In addition, to telephone counseling by staff at the USCD Coordinating Center, women will attend regular cooking classes directed by registered dietitians who may also provide interim counseling. WHEL will determine if the risk of recurrence can be reduced by 20% at 6 years. To gain insight into mechanisms of how diet might influence the disease, WHEL will compare plasma carotenoids and endogenous estrogen levels in women who have a secondary cancer event with levels in women who have not yet recurred, but who are matched for other characteristics from both the study and control groups. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “dietary fiber” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for dietary fiber in the PubMed Central database: •

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Dietary fiber showed no preventive effect against colon and rectal cancers in Japanese with low fat intake: an analysis from the results of nutrition surveys from 23 Japanese

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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prefectures. by Nakaji S, Shimoyama T, Umeda T, Sakamoto J, Katsura S, Sugawara K, Baxter D.; 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=59673

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with dietary fiber, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “dietary fiber” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for dietary fiber (hyperlinks lead to article summaries): •

A deficiency of dietary fiber may be one cause of certain colonic and venous disorders. Author(s): Burkitt DP. Source: Am J Dig Dis. 1976 February; 21(2): 104-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1274909&dopt=Abstract

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A diet rich in fat and poor in dietary fiber increases the in vitro formation of reactive oxygen species in human feces. Author(s): Erhardt JG, Lim SS, Bode JC, Bode C. Source: The Journal of Nutrition. 1997 May; 127(5): 706-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9164990&dopt=Abstract

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A new recommendation for dietary fiber in childhood. Author(s): Williams CL, Bollella M, Wynder EL. Source: Pediatrics. 1995 November; 96(5 Pt 2): 985-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7494677&dopt=Abstract

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A prospective study of dietary fiber intake and risk of cardiovascular disease among women. Author(s): Liu S, Buring JE, Sesso HD, Rimm EB, Willett WC, Manson JE. Source: Journal of the American College of Cardiology. 2002 January 2; 39(1): 49-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11755286&dopt=Abstract

6

PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A prospective study of dietary fiber types and symptomatic diverticular disease in men. Author(s): Aldoori WH, Giovannucci EL, Rockett HR, Sampson L, Rimm EB, Willett WC. Source: The Journal of Nutrition. 1998 April; 128(4): 714-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9521633&dopt=Abstract

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Acute appendicitis and dietary fiber. Author(s): Arnbjornsson E. Source: Archives of Surgery (Chicago, Ill. : 1960). 1983 July; 118(7): 868-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6305309&dopt=Abstract

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Addition of dietary fiber to liquid formula diets: the pros and cons. Author(s): Scheppach W, Burghardt W, Bartram P, Kasper H. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 1990 March-April; 14(2): 204-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2161959&dopt=Abstract

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AGA technical review: impact of dietary fiber on colon cancer occurrence. Author(s): Kim YI. Source: Gastroenterology. 2000 June; 118(6): 1235-57. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10833499&dopt=Abstract

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Alleviation of constipation in the elderly by dietary fiber supplementation. Author(s): Hull C, Greco RS, Brooks DL. Source: Journal of the American Geriatrics Society. 1980 September; 28(9): 410-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6251128&dopt=Abstract

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Alterations of fecal steroid composition induced by changes in dietary fiber consumption. Author(s): Ullrich IH, Lai HY, Vona L, Reid RL, Albrink MJ. Source: The American Journal of Clinical Nutrition. 1981 October; 34(10): 2054-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6270998&dopt=Abstract

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An hypothesis for the action of dietary fiber along the gastrointestinal tract. Author(s): Eastwood MA, Kay RM. Source: The American Journal of Clinical Nutrition. 1979 February; 32(2): 364-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=420131&dopt=Abstract

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An in vitro method, based on chewing, to predict resistant starch content in foods allows parallel determination of potentially available starch and dietary fiber. Author(s): Akerberg AK, Liljeberg HG, Granfeldt YE, Drews AW, Bj-orck IM. Source: The Journal of Nutrition. 1998 March; 128(3): 651-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9482777&dopt=Abstract

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An overview of the effects of dietary fiber on gastrointestinal transit. Author(s): Hillemeier C. Source: Pediatrics. 1995 November; 96(5 Pt 2): 997-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7494680&dopt=Abstract

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Apparent fiber digestibility and fecal short-chain fatty acid concentrations with ingestion of two types of dietary fiber. Author(s): Fredstrom SB, Lampe JW, Jung HJ, Slavin JL. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 1994 January-February; 18(1): 14-9. Erratum In: Jpen J Parenter Enteral Nutr 1994 March-April; 18(2): 197. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8164297&dopt=Abstract

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Are dietary fiber-induced alterations in colonic epithelial cell proliferation predictive of fiber's effect on colon cancer? Author(s): Whiteley LO, Klurfeld DM. Source: Nutrition and Cancer. 2000; 36(2): 131-49. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10890023&dopt=Abstract

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Association between dietary fiber intake and the folate status of a group of female adolescents. Author(s): Houghton LA, Green TJ, Donovan UM, Gibson RS, Stephen AM, O'Connor DL. Source: The American Journal of Clinical Nutrition. 1997 December; 66(6): 1414-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9394694&dopt=Abstract

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Association of diet and colorectal adenomatous polyps: dietary fiber, calcium, and total fat. Author(s): Martinez ME, McPherson RS, Annegers JF, Levin B. Source: Epidemiology (Cambridge, Mass.). 1996 May; 7(3): 264-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8728439&dopt=Abstract

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Baseline dietary fiber intake and colorectal adenoma recurrence in the wheat bran fiber randomized trial. Author(s): Jacobs ET, Giuliano AR, Roe DJ, Guillen-Rodriguez JM, Alberts DS, Martinez ME. Source: Journal of the National Cancer Institute. 2002 November 6; 94(21): 1620-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12419788&dopt=Abstract

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Beans, as a source of dietary fiber, increase cholecystokinin and apolipoprotein b48 response to test meals in men. Author(s): Bourdon I, Olson B, Backus R, Richter BD, Davis PA, Schneeman BO. Source: The Journal of Nutrition. 2001 May; 131(5): 1485-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11340104&dopt=Abstract

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Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. Author(s): Chandalia M, Garg A, Lutjohann D, von Bergmann K, Grundy SM, Brinkley LJ. Source: The New England Journal of Medicine. 2000 May 11; 342(19): 1392-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10805824&dopt=Abstract

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Beneficial effects of viscous dietary fiber from Konjac-mannan in subjects with the insulin resistance syndrome: results of a controlled metabolic trial. Author(s): Vuksan V, Sievenpiper JL, Owen R, Swilley JA, Spadafora P, Jenkins DJ, Vidgen E, Brighenti F, Josse RG, Leiter LA, Xu Z, Novokmet R. Source: Diabetes Care. 2000 January; 23(1): 9-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10857960&dopt=Abstract

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Benefits of dietary fiber. Myth or medicine? Author(s): Bennett WG, Cerda JJ. Source: Postgraduate Medicine. 1996 February; 99(2): 153-6, 166-8, 171-2 Passim. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8632964&dopt=Abstract

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Beyond dietary fiber. Author(s): Spiller GA. Source: The American Journal of Clinical Nutrition. 1991 October; 54(4): 615-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1654738&dopt=Abstract

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Binding of bile acids by dietary fiber. Author(s): Kern F Jr, Birkner HJ, Ostrower VS. Source: The American Journal of Clinical Nutrition. 1978 October; 31(10 Suppl): S175S179. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=30273&dopt=Abstract

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Biochemical epidemiology of colon cancer: effect of types of dietary fiber on colonic diacylglycerols in women. Author(s): Reddy BS, Simi B, Engle A. Source: Gastroenterology. 1994 April; 106(4): 883-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8143994&dopt=Abstract

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Biochemical epidemiology of colon cancer: effect of types of dietary fiber on fecal mutagens, acid, and neutral sterols in healthy subjects. Author(s): Reddy B, Engle A, Katsifis S, Simi B, Bartram HP, Perrino P, Mahan C. Source: Cancer Research. 1989 August 15; 49(16): 4629-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2545348&dopt=Abstract

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Blood pressure and diet in normotensive volunteers: absence of an effect of dietary fiber, protein, or fat. Author(s): Brussaard JH, van Raaij JM, Stasse-Wolthuis M, Katan MB, Hautvast JG. Source: The American Journal of Clinical Nutrition. 1981 October; 34(10): 2023-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6270996&dopt=Abstract

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Bowel function of healthy men consuming liquid diets with and without dietary fiber. Author(s): Slavin JL, Nelson NL, McNamara EA, Cashmere K. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 1985 May-June; 9(3): 317-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2989571&dopt=Abstract

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Bowel function of long-term tube-fed patients consuming formulae with and without dietary fiber. Author(s): Shankardass K, Chuchmach S, Chelswick K, Stefanovich C, Spurr S, Brooks J, Tsai M, Saibil FG, Cohen LB, Edington JD. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 1990 September-October; 14(5): 508-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2172578&dopt=Abstract

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Bran as a source of dietary fiber in oatmeal cookies. Author(s): Vratanina D, Zabik ME. Source: Journal of the American Dietetic Association. 1980 July; 77(1): 26-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6248587&dopt=Abstract

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Breath hydrogen and methane excretion produced by commercial beverages containing dietary fiber. Author(s): Kondo T, Nakae Y. Source: Journal of Gastroenterology. 1996 October; 31(5): 654-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8887030&dopt=Abstract

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Building scientific consensus: the importance of dietary fiber. Author(s): Schneeman BO. Source: The American Journal of Clinical Nutrition. 1999 January; 69(1): 1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9925113&dopt=Abstract

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Can fecal weight be used to establish a recommended intake of dietary fiber (plantix) Author(s): Spiller GA, Chernoff MC, Shipley EA, Beigler MA, Briggs GM. Source: The American Journal of Clinical Nutrition. 1977 May; 30(5): 659-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=855809&dopt=Abstract

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Carbohydrates, dietary fiber, and incident type 2 diabetes in older women. Author(s): Meyer KA, Kushi LH, Jacobs DR Jr, Slavin J, Sellers TA, Folsom AR. Source: The American Journal of Clinical Nutrition. 2000 April; 71(4): 921-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10731498&dopt=Abstract

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Carcinogen binding to various types of dietary fiber. Author(s): Smith-Barbaro P, Hanson D, Reddy BS. Source: Journal of the National Cancer Institute. 1981 August; 67(2): 495-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6267346&dopt=Abstract

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Changes in content and composition of dietary fiber in yellow onions and red delicious apples during commercial storage. Author(s): Marlett JA, Marlett JA. Source: J Aoac Int. 2000 July-August; 83(4): 992-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10995128&dopt=Abstract

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Changes in dietary fiber intake among Japanese in the 20th century: a relationship to the prevalence of diverticular disease. Author(s): Ohi G, Minowa K, Oyama T, Nagahashi M, Yamazaki N, Yamamoto S, Nagasako K, Hayakawa K, Kimura K, Mori B. Source: The American Journal of Clinical Nutrition. 1983 July; 38(1): 115-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6305184&dopt=Abstract

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Changing concepts of dietary fiber: implications for carcinogenesis. Author(s): Ferguson LR, Chavan RR, Harris PJ. Source: Nutrition and Cancer. 2001; 39(2): 155-69. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11759275&dopt=Abstract

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Changing food knowledge, food choice, and dietary fiber consumption by using tailored messages. Author(s): Brinberg D, Axelson ML, Price S. Source: Appetite. 2000 August; 35(1): 35-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10896759&dopt=Abstract

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Chelating properties of dietary fiber and phytate. The role for mineral availability. Author(s): Frolich W. Source: Advances in Experimental Medicine and Biology. 1990; 270: 83-93. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1964021&dopt=Abstract

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Cholesterol absorption and sterol balance in normal subjects receiving dietary fiber or ursodeoxycholic acid. Author(s): Salvioli G, Lugli R, Pradelli JM. Source: Digestive Diseases and Sciences. 1985 April; 30(4): 301-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2983956&dopt=Abstract

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Cholesterol-lowering effects of dietary fiber: a meta-analysis. Author(s): Brown L, Rosner B, Willett WW, Sacks FM. Source: The American Journal of Clinical Nutrition. 1999 January; 69(1): 30-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9925120&dopt=Abstract

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Chronological changes and inter-regional differences in dietary fiber intakes among middle-aged Japanese women. Author(s): Shimbo S, Higashikawa K, Hatai I, Murakami M, Hayase A, Watanabe T, Moon CS, Zhang ZW, Ikeda M. Source: The Tohoku Journal of Experimental Medicine. 1996 September; 180(1): 1-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8933667&dopt=Abstract

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Clinical response to dietary fiber treatment of chronic constipation. Author(s): Voderholzer WA, Schatke W, Muhldorfer BE, Klauser AG, Birkner B, MullerLissner SA. Source: The American Journal of Gastroenterology. 1997 January; 92(1): 95-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8995945&dopt=Abstract

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Collaborative study of a method for soluble and insoluble dietary fiber. Author(s): Prosky L. Source: Advances in Experimental Medicine and Biology. 1990; 270: 193-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1964008&dopt=Abstract

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Comparative contents of dietary fiber, total phenolics, and minerals in persimmons and apples. Author(s): Gorinstein S, Zachwieja Z, Folta M, Barton H, Piotrowicz J, Zemser M, Weisz M, Trakhtenberg S, Martin-Belloso O. Source: Journal of Agricultural and Food Chemistry. 2001 February; 49(2): 952-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11262055&dopt=Abstract

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Comparison of dietary fiber contents of selected baby foods from two major brands in Canada using three methods. Author(s): Mongeau R, Brassard R, Deeks JR, Laffey PJ, Nguyen L, Brooks SP. Source: Journal of Agricultural and Food Chemistry. 2001 August; 49(8): 3782-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11513666&dopt=Abstract

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Complexity in the interpretation of data derived from studies of dietary fiber. Author(s): Spiller GA. Source: Advances in Experimental Medicine and Biology. 1990; 270: 179-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1964006&dopt=Abstract

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Constipation and dietary fiber intake in children. Author(s): McClung HJ, Boyne L, Heitlinger L. Source: Pediatrics. 1995 November; 96(5 Pt 2): 999-1000. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7494681&dopt=Abstract

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Consumption of prunes as a source of dietary fiber in men with mild hypercholesterolemia. Author(s): Tinker LF, Schneeman BO, Davis PA, Gallaher DD, Waggoner CR. Source: The American Journal of Clinical Nutrition. 1991 May; 53(5): 1259-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1850578&dopt=Abstract

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Content and composition of dietary fiber in 117 frequently consumed foods. Author(s): Marlett JA. Source: Journal of the American Dietetic Association. 1992 February; 92(2): 175-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1310700&dopt=Abstract

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Current status of dietary fiber. Author(s): Pitchumoni CS, Hertan HI, Yerra N. Source: Trop Gastroenterol. 1988 July-August; 9(3): 113-22. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2848341&dopt=Abstract

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Determination of polydextrose as dietary fiber in foods. Author(s): Craig SA, Holden JF, Khaled MY, Craig SA, Holden JF, Khaled MY. Source: J Aoac Int. 2000 July-August; 83(4): 1006-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10995130&dopt=Abstract

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Dietary fiber analysis of cassava using gravimetric methods. Author(s): Rivera CJ, Gerardi AG, Infante RB, Carrasco HJ, Rodriguez O. Source: Arch Latinoam Nutr. 1993 March; 43(1): 78-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8002709&dopt=Abstract

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Dietary fiber and body-weight regulation. Observations and mechanisms. Author(s): Pereira MA, Ludwig DS. Source: Pediatric Clinics of North America. 2001 August; 48(4): 969-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11494646&dopt=Abstract

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Dietary fiber and bowel function in tube-fed patients. Author(s): Frankenfield DC, Beyer PL. Source: Journal of the American Dietetic Association. 1991 May; 91(5): 590-6, 599. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1850436&dopt=Abstract

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Dietary fiber and cancer prevention. Author(s): Shankar S, Lanza E. Source: Hematology/Oncology Clinics of North America. 1991 February; 5(1): 25-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1851150&dopt=Abstract

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Dietary fiber and cardiovascular disease: experimental and epidemiologic advances. Author(s): Pereira MA, Pins JJ. Source: Current Atherosclerosis Reports. 2000 November; 2(6): 494-502. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11122784&dopt=Abstract

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Dietary fiber and colorectal cancer risk. Author(s): Dwyer J. Source: Nutrition Reviews. 1993 May; 51(5): 147-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8392670&dopt=Abstract

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Dietary fiber and colorectal cancer: what is appropriate advice? Author(s): Story JA, Savaiano DA. Source: Nutrition Reviews. 2001 March; 59(3 Pt 1): 84-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11330626&dopt=Abstract

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Dietary fiber and colorectal neoplasia. Author(s): Sengupta S, Tjandra JJ, Gibson PR. Source: Diseases of the Colon and Rectum. 2001 July; 44(7): 1016-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11496083&dopt=Abstract

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Dietary fiber and coronary artery disease. Author(s): Chu WW, Hanson PG. Source: Wmj. 2000 October; 99(7): 32-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11089448&dopt=Abstract

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Dietary fiber and coronary heart disease in middle-aged hypercholesterolemic men. Author(s): Humble CG, Malarcher AM, Tyroler HA. Source: American Journal of Preventive Medicine. 1993 July-August; 9(4): 197-202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8398218&dopt=Abstract

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Dietary fiber and diabetes: what else do we need to know? Author(s): Anderson JW. Source: Diabetes Research and Clinical Practice. 1992 August; 17(2): 71-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1330465&dopt=Abstract

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Dietary fiber and gender: effect on postprandial lipemia. Author(s): Redard CL, Davis PA, Schneeman BO. Source: The American Journal of Clinical Nutrition. 1990 November; 52(5): 837-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2173389&dopt=Abstract

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Dietary fiber and lifestyle influence serum lipids in free living adult men. Author(s): Ballesteros MN, Cabrera RM, Saucedo MS, Yepiz-Plascencia GM, Ortega MI, Valencia ME. Source: Journal of the American College of Nutrition. 2001 December; 20(6): 649-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11771682&dopt=Abstract

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Dietary fiber and prevention of cardiovascular disease. Author(s): Rosamond WD. Source: Journal of the American College of Cardiology. 2002 January 2; 39(1): 57-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11755287&dopt=Abstract

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Dietary fiber and total enteral nutrition: fermentative assessment of five fiber supplements. Author(s): McBurney MI, Thompson LU. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 1991 May-June; 15(3): 267-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1650853&dopt=Abstract

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Dietary fiber and type 2 diabetes. Author(s): Tabatabai A, Li S. Source: Clin Excell Nurse Pract. 2000 September; 4(5): 272-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11858448&dopt=Abstract

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Dietary fiber and weight gain. Author(s): Waugh RJ. Source: Jama : the Journal of the American Medical Association. 2000 April 12; 283(14): 1821; Author Reply 1821-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10770137&dopt=Abstract

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Dietary fiber and weight gain. Author(s): McCarty MF. Source: Jama : the Journal of the American Medical Association. 2000 April 12; 283(14): 1821; Author Reply 1821-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10770136&dopt=Abstract

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Dietary fiber and weight regulation. Author(s): Howarth NC, Saltzman E, Roberts SB. Source: Nutrition Reviews. 2001 May; 59(5): 129-39. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11396693&dopt=Abstract

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Dietary fiber content of commonly fresh and cooked vegetables consumed in India. Author(s): Khanum F, Siddalinga Swamy M, Sudarshana Krishna KR, Santhanam K, Viswanathan KR. Source: Plant Foods for Human Nutrition (Dordrecht, Netherlands). 2000; 55(3): 207-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11030475&dopt=Abstract

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Dietary fiber down-regulates colonic tumor necrosis factor alpha and nitric oxide production in trinitrobenzenesulfonic acid-induced colitic rats. Author(s): Rodriguez-Cabezas ME, Galvez J, Lorente MD, Concha A, Camuesco D, Azzouz S, Osuna A, Redondo L, Zarzuelo A. Source: The Journal of Nutrition. 2002 November; 132(11): 3263-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12421838&dopt=Abstract

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Dietary fiber for reducing blood cholesterol. Author(s): Lipsky H, Gloger M, Frishman WH. Source: Journal of Clinical Pharmacology. 1990 August; 30(8): 699-703. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2169487&dopt=Abstract

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Dietary fiber in hospitalized geriatric patients: too soft a solution for too hard a problem? Author(s): Snustad D, Lee V, Abraham I, Alexander C, Bella D, Cumming C. Source: J Nutr Elder. 1991; 10(2): 49-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1849571&dopt=Abstract

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Dietary fiber in the management of diabetes. Author(s): Nuttall FQ. Source: Diabetes. 1993 April; 42(4): 503-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8384131&dopt=Abstract

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Dietary fiber in the prevention of cardiovascular disease. Author(s): Riccardi G, Ciardullo AV. Source: Advances in Experimental Medicine and Biology. 1993; 348: 99-104. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8172027&dopt=Abstract

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Dietary fiber intake and glycemic index and incidence of diabetes in AfricanAmerican and white adults: the ARIC study. Author(s): Stevens J, Ahn K, Juhaeri, Houston D, Steffan L, Couper D. Source: Diabetes Care. 2002 October; 25(10): 1715-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12351467&dopt=Abstract

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Dietary fiber intake for the elderly. Author(s): Dror Y. Source: Nutrition (Burbank, Los Angeles County, Calif.). 2003 April; 19(4): 388-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12679178&dopt=Abstract

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Dietary fiber intake in patients with myofascial face pain. Author(s): Raphael KG, Marbach JJ, Touger-Decker R. Source: J Orofac Pain. 2002 Winter; 16(1): 39-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11889658&dopt=Abstract

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Dietary fiber intake of Japanese younger generations and the recommended daily allowance. Author(s): Nishimune T, Sumimoto T, Konishi Y, Yakushiji T, Komachi Y, Mitsuhashi Y, Nakayama I, Okazaki K, Tsuda T, Ichihashi A, et al. Source: J Nutr Sci Vitaminol (Tokyo). 1993 June; 39(3): 263-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8229318&dopt=Abstract

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Dietary fiber intake, stool frequency and colonic transit time in chronic functional constipation in children. Author(s): Guimaraes EV, Goulart EM, Penna FJ. Source: Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas / Sociedade Brasileira De Biofisica. [et Al.]. 2001 September; 34(9): 1147-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11514838&dopt=Abstract

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Dietary fiber intakes and insulin requirements in pregnant women with type 1 diabetes. Author(s): Kalkwarf HJ, Bell RC, Khoury JC, Gouge AL, Miodovnik M. Source: Journal of the American Dietetic Association. 2001 March; 101(3): 305-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11269608&dopt=Abstract

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Dietary fiber prevents carbohydrate-induced hypertriglyceridemia. Author(s): Anderson JW. Source: Current Atherosclerosis Reports. 2000 November; 2(6): 536-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11122790&dopt=Abstract

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Dietary fiber reduces the antioxidative effect of a carotenoid and alpha-tocopherol mixture on LDL oxidation ex vivo in humans. Author(s): Hoffmann J, Linseisen J, Riedl J, Wolfram G. Source: European Journal of Nutrition. 1999 December; 38(6): 278-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10784384&dopt=Abstract

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Dietary fiber showed no preventive effect against colon and rectal cancers in Japanese with low fat intake: an analysis from the results of nutrition surveys from 23 Japanese prefectures. Author(s): Nakaji S, Shimoyama T, Umeda T, Sakamoto J, Katsura S, Sugawara K, Baxter D. Source: Bmc Cancer [electronic Resource]. 2001; 1(1): 14. Epub 2001 October 29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11701093&dopt=Abstract

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Dietary fiber, inulin, and oligofructose: a review comparing their physiological effects. Author(s): Roberfroid M. Source: Critical Reviews in Food Science and Nutrition. 1993; 33(2): 103-48. Review. Erratum In: Crit Rev Food Sci Nutr 1993; 33(6): 553. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8257475&dopt=Abstract

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Dietary fiber, phytoestrogens, and breast cancer. Author(s): Rose DP. Source: Nutrition (Burbank, Los Angeles County, Calif.). 1992 January-February; 8(1): 47-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1314118&dopt=Abstract

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Dietary fiber, vitamins A, C, and E, and risk of breast cancer: a cohort study. Author(s): Rohan TE, Howe GR, Friedenreich CM, Jain M, Miller AB. Source: Cancer Causes & Control : Ccc. 1993 January; 4(1): 29-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8381678&dopt=Abstract

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Dietary fiber--an overview. Author(s): Anderson JW, Akanji AO. Source: Diabetes Care. 1991 December; 14(12): 1126-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1663444&dopt=Abstract

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Dietary fiber-mediated mechanisms in carcinogenesis. Author(s): Klurfeld DM. Source: Cancer Research. 1992 April 1; 52(7 Suppl): 2055S-2059S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1311988&dopt=Abstract

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Effect of dietary fiber (soy polysaccharide) on the severity, duration, and nutritional outcome of acute, watery diarrhea in children. Author(s): Brown KH, Perez F, Peerson JM, Fadel J, Brunsgaard G, Ostrom KM, MacLean WC Jr. Source: Pediatrics. 1993 August; 92(2): 241-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8393174&dopt=Abstract

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Effect of dietary fiber and protein intake on blood pressure: a review of epidemiologic evidence. Author(s): He J, Whelton PK. Source: Clinical and Experimental Hypertension (New York, N.Y. : 1993). 1999 JulyAugust; 21(5-6): 785-96. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10423101&dopt=Abstract

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Effect of dietary fiber and starch on fecal composition in preschool children consuming maize, amaranth, or cassava flours. Author(s): Hamaker BR, Rivera K, Morales E, Graham GG. Source: Journal of Pediatric Gastroenterology and Nutrition. 1991 July; 13(1): 59-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1656007&dopt=Abstract

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Effect of dietary fiber in insulin-dependent diabetics: insulin requirements and serum lipids. Author(s): Harold MR, Reeves RD, Bolze MS, Guthrie RA, Guthrie DW. Source: Journal of the American Dietetic Association. 1985 November; 85(11): 1455-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2997314&dopt=Abstract

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Effect of dietary fiber on colonic bacterial enzymes and bile acids in relation to colon cancer. Author(s): Reddy BS, Engle A, Simi B, Goldman M. Source: Gastroenterology. 1992 May; 102(5): 1475-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1314747&dopt=Abstract

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Effect of dietary fiber on iron absorption in man. Author(s): Rossander L. Source: Scandinavian Journal of Gastroenterology. Supplement. 1987; 129: 68-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2820047&dopt=Abstract

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Effect of dietary fiber on oral glucose tolerance test in pregnancy. Author(s): Fraser RB, Milner RD. Source: American Journal of Obstetrics and Gynecology. 1983 July 15; 146(6): 745-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6307051&dopt=Abstract

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Effect of dietary fiber on pancreatic enzyme activity in vitro. Author(s): Isaksson G, Lundquist I, Ihse I. Source: Gastroenterology. 1982 May; 82(5 Pt 1): 918-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6174390&dopt=Abstract

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Effect of dietary fiber on pancreatic lipase activity in vitro. Author(s): Hansen WE. Source: Pancreas. 1987; 2(2): 195-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2819858&dopt=Abstract

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Effect of dietary fiber on proteolytic pancreatic enzymes in vitro. Author(s): Hansen WE. Source: International Journal of Pancreatology : Official Journal of the International Association of Pancreatology. 1986 December; 1(5-6): 341-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2824629&dopt=Abstract

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Effect of dietary fiber on serum bile acids in patients with chronic cholestatic liver disease under ursodeoxycholic acid therapy. Author(s): Sauter G, Beuers U, Paumgartner G. Source: Digestion. 1995; 56(6): 523-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8536824&dopt=Abstract

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Effect of dietary fiber on symptoms and rectosigmoid motility in patients with irritable bowel syndrome. Author(s): van Steensel CJ. Source: Gastroenterology. 1990 November; 99(5): 1538. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2170225&dopt=Abstract

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Effect of dietary fiber on symptoms and rectosigmoid motility in patients with irritable bowel syndrome. A controlled, crossover study. Author(s): Cook IJ, Irvine EJ, Campbell D, Shannon S, Reddy SN, Collins SM. Source: Gastroenterology. 1990 January; 98(1): 66-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2152777&dopt=Abstract

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Effect of dietary fiber on the metabolizable energy of human diets. Author(s): Miles CW, Kelsay JL, Wong NP. Source: The Journal of Nutrition. 1988 September; 118(9): 1075-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2843615&dopt=Abstract

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Effect of dietary fiber on the oral glucose tolerance test in pregnancy. Author(s): Gabbe SG, Cohen AW, Herman GO, Schwartz S. Source: American Journal of Obstetrics and Gynecology. 1982 July 1; 143(5): 514-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6283891&dopt=Abstract

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Effect of dietary fiber on the vitamin B6 status among vegetarian and nonvegetarian elderly (Dutch nutrition surveillance system). Author(s): Lowik MR, Schrijver J, van den Berg H, Hulshof KF, Wedel M, Ockhuizen T. Source: Journal of the American College of Nutrition. 1990 June; 9(3): 241-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2162868&dopt=Abstract

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Effect of dietary fiber on total carbohydrate losses in ileostomy effluent. Author(s): Steinhart AH, Jenkins DJ, Mitchell S, Cuff D, Prokipchuk EJ. Source: The American Journal of Gastroenterology. 1992 January; 87(1): 48-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1309407&dopt=Abstract

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Effect of dietary fiber, glucomannan, on absorption of sulfonylurea in man. Author(s): Shima K, Tanaka A, Ikegami H, Tabata M, Sawazaki N, Kumahara Y. Source: Hormone and Metabolic Research. Hormon- Und Stoffwechselforschung. Hormones Et Metabolisme. 1983 January; 15(1): 1-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6299917&dopt=Abstract

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Effect of structured dietary fiber on bioavailability of amoxicillin. Author(s): Lutz M, Espinoza J, Arancibia A, Araya M, Pacheco I, Brunser O. Source: Clinical Pharmacology and Therapeutics. 1987 August; 42(2): 220-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3038451&dopt=Abstract

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Effect of the dietary fiber glucomannan on chronic constipation in neurologically impaired children. Author(s): Staiano A, Simeone D, Del Giudice E, Miele E, Tozzi A, Toraldo C. Source: The Journal of Pediatrics. 2000 January; 136(1): 41-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10636972&dopt=Abstract

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Effect of thickening agents, based on soluble dietary fiber, on the availability of calcium, iron, and zinc from infant formulas. Author(s): Bosscher D, Van Caillie-Bertrand M, Deelstra H. Source: Nutrition (Burbank, Los Angeles County, Calif.). 2001 July-August; 17(7-8): 6148. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11448582&dopt=Abstract

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Effect of types of dietary fiber on fecal mutagens and bacterial enzymes in relation to colon cancer. Author(s): Reddy BS. Source: Advances in Experimental Medicine and Biology. 1990; 270: 159-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1964003&dopt=Abstract

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Effects of a gel forming dietary fiber, guar gum, on the absorption of glibenclamide and metabolic control and serum lipids in patients with non-insulin-dependent (type 2) diabetes. Author(s): Uusitupa M, Sodervik H, Silvasti M, Karttunen P. Source: Int J Clin Pharmacol Ther Toxicol. 1990 April; 28(4): 153-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2110937&dopt=Abstract

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Effects of cottonseed dietary fiber on metabolic parameters in diabetic rats and noninsulin-dependent diabetic humans. Author(s): Madar Z, Nir M, Trostler N, Norenberg C. Source: The Journal of Nutrition. 1988 September; 118(9): 1143-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2843617&dopt=Abstract

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Effects of dietary fiber and carbohydrate on glucose and lipoprotein metabolism in diabetic patients. Author(s): Riccardi G, Rivellese AA. Source: Diabetes Care. 1991 December; 14(12): 1115-25. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1663443&dopt=Abstract

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Effects of dietary fiber and phytic acid on mineral availability. Author(s): Torre M, Rodriguez AR, Saura-Calixto F. Source: Critical Reviews in Food Science and Nutrition. 1991; 30(1): 1-22. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1657026&dopt=Abstract

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Effects of dietary fiber from wheat, corn, and soy hull bran on excretion of fecal bile acids in humans. Author(s): Bell EW, Emken EA, Klevay LM, Sandstead HH. Source: The American Journal of Clinical Nutrition. 1981 June; 34(6): 1071-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6263074&dopt=Abstract

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Effects of dietary fiber intake before meals on weight loss and hunger in a weightreducing club. Author(s): Hylander B, Rossner S. Source: Acta Med Scand. 1983; 213(3): 217-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6303061&dopt=Abstract

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Effects of dietary fiber on digestive enzyme activity and bile acids in the small intestine. Author(s): Schneeman BO, Gallaher D. Source: Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine (New York, N. Y.). 1985 December; 180(3): 409-14. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2417249&dopt=Abstract

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Effects of dietary fiber on postprandial glycemic profiles in diabetic patients submitted to continuous programmed insulin infusion. Author(s): Chenon D, Phaka M, Monnier LH, Colette C, Orsetti A, Mirouze J. Source: The American Journal of Clinical Nutrition. 1984 July; 40(1): 58-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6331149&dopt=Abstract

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Effects of lowering fat and increasing dietary fiber on fasting and postprandial plasma lipids in hypercholesterolemic subjects consuming a mixed MediterraneanWestern diet. Author(s): Mekki N, Dubois C, Charbonnier M, Cara L, Senft M, Pauli AM, Portugal H, Gassin AL, Lafont H, Lairon D. Source: The American Journal of Clinical Nutrition. 1997 December; 66(6): 1443-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9394698&dopt=Abstract

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Efficacy of dietary fiber in lowering serum cholesterol. Author(s): Garg A. Source: The American Journal of Medicine. 1994 December; 97(6): 501-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7985707&dopt=Abstract

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Epidemiological evaluation of colonic diverticulosis and dietary fiber in Japan. Author(s): Munakata A, Nakaji S, Takami H, Nakajima H, Iwane S, Tuchida S. Source: The Tohoku Journal of Experimental Medicine. 1993 October; 171(2): 145-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8128483&dopt=Abstract

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Esophageal obstruction with a dietary fiber product designed for weight reduction. Author(s): Opper FH, Isaacs KL, Warshauer DM. Source: Journal of Clinical Gastroenterology. 1990 December; 12(6): 667-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2176230&dopt=Abstract

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Estimation of dietary fiber supply. Author(s): Rutishauser IH. Source: The American Journal of Clinical Nutrition. 1985 April; 41(4): 824-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2984916&dopt=Abstract

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Estimation of per capita crude and dietary fiber supply in 38 countries. Author(s): Bright-See E, McKeown-Eyssen GE. Source: The American Journal of Clinical Nutrition. 1984 May; 39(5): 821-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6324569&dopt=Abstract

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Evaluation of dietary fiber intake in Belgian children with cystic fibrosis: is there a link with gastrointestinal complaints? Author(s): Proesmans M, De Boeck K. Source: Journal of Pediatric Gastroenterology and Nutrition. 2002 November; 35(5): 6104. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12454573&dopt=Abstract

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Evaluation of mushroom dietary fiber (nonstarch polysaccharides) from sclerotia of Pleurotus tuber-regium (Fries) singer as a potential antitumor agent. Author(s): Zhang M, Cheung PC, Zhang L. Source: Journal of Agricultural and Food Chemistry. 2001 October; 49(10): 5059-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11600066&dopt=Abstract

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Evaluation of safety of inulin and oligofructose as dietary fiber. Author(s): Carabin IG, Flamm WG. Source: Regulatory Toxicology and Pharmacology : Rtp. 1999 December; 30(3): 268-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10620476&dopt=Abstract

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Excretion and degradation of dietary fiber constituents in ileostomy subjects consuming a low fiber diet with and without brewer's spent grain. Author(s): Aman P, Zhang JX, Hallmans G, Lundin E. Source: The Journal of Nutrition. 1994 March; 124(3): 359-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8120654&dopt=Abstract

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Fat and dietary fiber intake and colon cancer mortality: a chronological comparison between Japan and the United States. Author(s): Honda T, Kai I, Ohi G. Source: Nutrition and Cancer. 1999; 33(1): 95-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10227050&dopt=Abstract

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Fecal output, gastrointestinal transit time, frequency of evacuation and apparent excretion rate of dietary fiber in young men given diets containing different levels of dietary fiber. Author(s): Saito T, Hayakawa T, Nakamura K, Takita T, Suzuki K, Innami S. Source: J Nutr Sci Vitaminol (Tokyo). 1991 October; 37(5): 493-508. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1666410&dopt=Abstract

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Fecal weight, colon cancer risk, and dietary intake of nonstarch polysaccharides (dietary fiber) Author(s): Cummings JH, Bingham SA, Heaton KW, Eastwood MA. Source: Gastroenterology. 1992 December; 103(6): 1783-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1333426&dopt=Abstract

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Fecal weight, transit time, and recommendations for dietary fiber intake. Author(s): Stasse-Wolthuis M, Katan MB, Hautvast JG. Source: The American Journal of Clinical Nutrition. 1978 June; 31(6): 909-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=665552&dopt=Abstract

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Folate, iron, and dietary fiber contents of the gluten-free diet. Author(s): Thompson T. Source: Journal of the American Dietetic Association. 2000 November; 100(11): 1389-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11103663&dopt=Abstract

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Food labeling: health claims; soluble dietary fiber from certain foods and coronary heart disease. Final rule. Author(s): Food and Drug Administration, HHS. Source: Federal Register. 2003 July 28; 68(144): 44207-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12884876&dopt=Abstract

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Food labeling: health claims; soluble dietary fiber from certain foods and coronary heart disease. Interim final rule. Author(s): Food and Drug Administration, HHS. Source: Federal Register. 2002 October 2; 67(191): 61773-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12361061&dopt=Abstract

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Foods contributing to absolute intake and variance in intake of selected vitamins, minerals and dietary fiber in middle-aged Japanese. Author(s): Imaeda N, Tokudome Y, Ikeda M, Kitagawa I, Fujiwara N, Tokudome S. Source: J Nutr Sci Vitaminol (Tokyo). 1999 October; 45(5): 519-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10683805&dopt=Abstract

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Fruit, vegetables, dietary fiber, and risk of colorectal cancer. Author(s): Terry P, Giovannucci E, Michels KB, Bergkvist L, Hansen H, Holmberg L, Wolk A. Source: Journal of the National Cancer Institute. 2001 April 4; 93(7): 525-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11287446&dopt=Abstract

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Gastric cardia cancer and dietary fiber. Author(s): Kurtz RC, Zhang ZF. Source: Gastroenterology. 2001 February; 120(2): 568-70. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11159898&dopt=Abstract

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Gastrointestinal responses to dietary fiber. Author(s): Schneeman BO. Source: Advances in Experimental Medicine and Biology. 1990; 270: 37-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1964016&dopt=Abstract

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Geriatric diabetes: latest research on the role of dietary fiber. Author(s): Kritchevsky D. Source: Geriatrics. 1986 May; 41(5): 117-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3007303&dopt=Abstract

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Going against the grain? Current status of the dietary fiber-colorectal cancer hypothesis. Author(s): Schatzkin A. Source: Biofactors (Oxford, England). 2000; 12(1-4): 305-11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11216501&dopt=Abstract

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Growth, sexual maturation, and dietary fiber in pubertal girls. Author(s): Sandstead HH. Source: The American Journal of Clinical Nutrition. 1992 June; 55(6): 1186-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1317666&dopt=Abstract

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Health benefits of dietary fiber for people with diabetes. Author(s): Campbell AP. Source: Diabetes Educ. 2001 July-August; 27(4): 511-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12212339&dopt=Abstract

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Hepatic and intestinal cytochrome P-450, glutathione-S-transferase and UDPglucuronosyl transferase are affected by six types of dietary fiber in rats inoculated with human whole fecal flora. Author(s): Roland N, Nugon-Baudon L, Flinois JP, Beaune P. Source: The Journal of Nutrition. 1994 September; 124(9): 1581-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8089725&dopt=Abstract

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High dietary fiber and low saturated fat intake among oligomenorrheic undergraduates. Author(s): Snow RC, Schneider JL, Barbieri RL. Source: Fertility and Sterility. 1990 October; 54(4): 632-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2170167&dopt=Abstract

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High dietary fiber consumption is not associated with gastrointestinal discomfort in a diet intervention trial. Author(s): McEligot AJ, Gilpin EA, Rock CL, Newman V, Hollenbach KA, Thomson CA, Pierce JP. Source: Journal of the American Dietetic Association. 2002 April; 102(4): 549-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11985415&dopt=Abstract

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Hypocholesterolemic action of dietary fiber unrelated to fecal bulking effect. Author(s): Jenkins DJ, Reynolds D, Leeds AR, Waller AL, Cummings JH. Source: The American Journal of Clinical Nutrition. 1979 December; 32(12): 2430-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=506965&dopt=Abstract

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Hypocholesterolemic effects of a dietary fiber supplement. Author(s): Hunninghake DB, Miller VT, LaRosa JC, Kinosian B, Brown V, Howard WJ, DiSerio FJ, O'Connor RR. Source: The American Journal of Clinical Nutrition. 1994 May; 59(5): 1050-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8172090&dopt=Abstract

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Importance of dietary fiber in childhood. Author(s): Williams CL. Source: Journal of the American Dietetic Association. 1995 October; 95(10): 1140-6, 1149; Quiz 1147-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7560686&dopt=Abstract

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Improved lithogenicity of fasting hepatic bile by dietary fiber and cholestyramine: studies in mice and humans. Author(s): Hall RC, Klauda HC, Waite VM, Friedman A, Feher J, Tepperman J. Source: Surg Forum. 1975; 26: 435-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1216185&dopt=Abstract

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In defense of dietary fiber. Author(s): Williams CL. Source: Journal of the American Dietetic Association. 1997 March; 97(3): 248. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9060937&dopt=Abstract

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In vitro inhibition of pancreatic enzyme activities by dietary fiber. Author(s): Isaksson G, Lundquist I, Ihse I. Source: Digestion. 1982; 24(1): 54-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6290301&dopt=Abstract

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In vitro study of possible role of dietary fiber in lowering postprandial serum glucose. Author(s): Ou S, Kwok K, Li Y, Fu L. Source: Journal of Agricultural and Food Chemistry. 2001 February; 49(2): 1026-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11262066&dopt=Abstract

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Increasing amounts of dietary fiber provided by foods normalizes physiologic response of the large bowel without altering calcium balance or fecal steroid excretion. Author(s): Haack VS, Chesters JG, Vollendorf NW, Story JA, Marlett JA. Source: The American Journal of Clinical Nutrition. 1998 September; 68(3): 615-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9734738&dopt=Abstract

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Indigestible residue or dietary fiber? Author(s): Trowell H. Source: The American Journal of Clinical Nutrition. 1982 July; 36(1): 194-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6283874&dopt=Abstract

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Influence of dietary fiber (konjac mannan) on absorption of vitamin B12 and vitamin E. Author(s): Doi K, Matsuura M, Kawara A, Tanaka T, Baba S. Source: The Tohoku Journal of Experimental Medicine. 1983 December; 141 Suppl: 67781. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6096987&dopt=Abstract

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Influence of dietary fiber from vegetables and fruits, bran or citrus pectin on serum lipids, fecal lipids, and colonic function. Author(s): Stasse-Wolthuis M, Albers HF, van Jeveren JG, Wil de Jong J, Hautvast JG, Hermus RJ, Katan MB, Brydon WG, Eastwood MA. Source: The American Journal of Clinical Nutrition. 1980 August; 33(8): 1745-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6250396&dopt=Abstract

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Influence of dietary fiber on bile acid metabolism. Author(s): Kritchevsky D. Source: Lipids. 1978 December; 13(12): 982-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=108494&dopt=Abstract

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Influence of dietary fiber on fecal excretion of volatile fatty acids by human adults. Author(s): Fleming SE, Rodriguez MA. Source: The Journal of Nutrition. 1983 August; 113(8): 1613-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6308193&dopt=Abstract

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Influence of dietary fiber on the intestinal environment. Author(s): Salyers AA, Kuritza AP, McCarthy RE. Source: Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine (New York, N. Y.). 1985 December; 180(3): 415-21. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3001739&dopt=Abstract

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Influence of dietary fiber on trace element balance. Author(s): Sandstead HH, Munoz JM, Jacob RA, Klevay LM, Reck SJ, Logan GM Jr, Dintzis FR, Inglett GE, Shuey WC. Source: The American Journal of Clinical Nutrition. 1978 October; 31(10 Suppl): S180S184. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=707370&dopt=Abstract

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Influence of methodologic factors in a pooled analysis of 13 case-control studies of colorectal cancer and dietary fiber. Author(s): Friedenreich CM, Brant RF, Riboli E. Source: Epidemiology (Cambridge, Mass.). 1994 January; 5(1): 66-79. Review. Erratum In: Epidemiology 1994 May; 5(3): 385. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8117785&dopt=Abstract

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Intake of dietary fiber and risk of coronary heart disease in a cohort of Finnish men. The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Author(s): Pietinen P, Rimm EB, Korhonen P, Hartman AM, Willett WC, Albanes D, Virtamo J. Source: Circulation. 1996 December 1; 94(11): 2720-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8941095&dopt=Abstract

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Intake ratio of water-insoluble dietary fiber to the water-soluble one in Japanese: an estimation on dietary records and the secular consideration on the national nutrition survey. Author(s): Nishimune T, Sumimoto T, Sueki K, Morita S, Okazaki K, Nakayama I, Ichihashi A, Imanaka M, Saeki K, Yamamoto Y, Adachi T, Kurashina S, Yoshida Y, Mori T, Miyamura Y, Kawabata N, Sato S, Komachi Y. Source: J Nutr Sci Vitaminol (Tokyo). 1996 August; 42(4): 277-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8906629&dopt=Abstract

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Intakes and sources of dietary fiber in the British population. Author(s): Bingham S, Cummings JH, McNeil NI. Source: The American Journal of Clinical Nutrition. 1979 June; 32(6): 1313-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=443192&dopt=Abstract

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Interaction of dietary fiber with lipids--mechanistic theories and their limitations. Author(s): Furda I. Source: Advances in Experimental Medicine and Biology. 1990; 270: 67-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1964019&dopt=Abstract

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Interaction of dietary fiber with other dietary components: a possible factor in certain cancer etiologies. Author(s): Spiller GA. Source: The American Journal of Clinical Nutrition. 1978 October; 31(10 Suppl): S231S232. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=707379&dopt=Abstract

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International survey on dietary fiber: definition, analysis, and reference materials. Author(s): Lee SC, Prosky L. Source: J Aoac Int. 1995 January-February; 78(1): 22-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7703724&dopt=Abstract

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Interrelationship between insulin, dietary fiber, and exercise in the management of pregnant diabetics. Author(s): Winn HN, Reece EA. Source: Obstetrical & Gynecological Survey. 1989 October; 44(10): 703-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2552365&dopt=Abstract

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Intestinal fuels: glutamine, short-chain fatty acids, and dietary fiber. Author(s): Evans MA, Shronts EP. Source: Journal of the American Dietetic Association. 1992 October; 92(10): 1239-46, 1249. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1328345&dopt=Abstract

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Inulin and oligofructose are part of the dietary fiber complex. Author(s): Prosky L. Source: J Aoac Int. 1999 March-April; 82(2): 223-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10191527&dopt=Abstract

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Inulin and oligofructose as dietary fiber: a review of the evidence. Author(s): Flamm G, Glinsmann W, Kritchevsky D, Prosky L, Roberfroid M. Source: Critical Reviews in Food Science and Nutrition. 2001 July; 41(5): 353-62. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11497328&dopt=Abstract

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Irritable bowel syndrome and dietary fiber. Author(s): Achord JL. Source: Journal of the American Dietetic Association. 1979 October; 75(4): 452-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=113444&dopt=Abstract

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Is dietary fiber beneficial in chronic ischemic heart disease? Author(s): Vajifdar BU, Goyal VS, Lokhandwala YY, Mhamunkar SR, Mahadik SP, Gawad AK, Halankar SA, Kulkarni HL. Source: J Assoc Physicians India. 2000 September; 48(9): 871-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11198784&dopt=Abstract

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Ischemic heart disease and dietary fiber. Author(s): Trowell H. Source: The American Journal of Clinical Nutrition. 1972 September; 25(9): 926-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4559894&dopt=Abstract

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Issues in dietary fiber analysis. Author(s): Marlett JA. Source: Advances in Experimental Medicine and Biology. 1990; 270: 183-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1964007&dopt=Abstract

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Lack of effect of dietary fiber on serum lipids, glucose, and insulin in healthy young men fed high starch diets. Author(s): Ullrich IH, Albrink MJ. Source: The American Journal of Clinical Nutrition. 1982 July; 36(1): 1-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6283873&dopt=Abstract

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Letter: Coronary heart disease and dietary fiber. Author(s): Klevay LM. Source: The American Journal of Clinical Nutrition. 1974 November; 27(11): 1202-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4447087&dopt=Abstract

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Letter: Refined carbohydrates, dietary fiber, and gastrointestinal abnormality. Author(s): Kimura KK. Source: Jama : the Journal of the American Medical Association. 1976 January 26; 235(4): 375. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=946080&dopt=Abstract

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Letters to the editor: Coronary heart disease and dietary fiber. Author(s): Trowell H. Source: The American Journal of Clinical Nutrition. 1975 August; 28(8): 798-800. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1146734&dopt=Abstract

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Long-term blood cholesterol-lowering effects of a dietary fiber supplement. Author(s): Knopp RH, Superko HR, Davidson M, Insull W, Dujovne CA, Kwiterovich PO, Zavoral JH, Graham K, O'Connor RR, Edelman DA. Source: American Journal of Preventive Medicine. 1999 July; 17(1): 18-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10429748&dopt=Abstract

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Long-term effects of dietary fiber on glucose tolerance and gastric emptying in noninsulin-dependent diabetic patients. Author(s): Ray TK, Mansell KM, Knight LC, Malmud LS, Owen OE, Boden G. Source: The American Journal of Clinical Nutrition. 1983 March; 37(3): 376-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6299089&dopt=Abstract

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Long-term effects of water-soluble dietary fiber in the management of hypercholesterolemia in healthy men and women. Author(s): Jensen CD, Haskell W, Whittam JH. Source: The American Journal of Cardiology. 1997 January 1; 79(1): 34-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9024732&dopt=Abstract

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Long-term intake of dietary fiber and decreased risk of coronary heart disease among women. Author(s): Wolk A, Manson JE, Stampfer MJ, Colditz GA, Hu FB, Speizer FE, Hennekens CH, Willett WC. Source: Jama : the Journal of the American Medical Association. 1999 June 2; 281(21): 1998-2004. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10359388&dopt=Abstract

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Long-term treatment of hypercholesterolemia with dietary fiber. Author(s): Hunninghake DB, Miller VT, LaRosa JC, Kinosian B, Jacobson T, Brown V, Howard WJ, Edelman DA, O'Connor RR. Source: The American Journal of Medicine. 1994 December; 97(6): 504-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7985708&dopt=Abstract

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Low dietary fiber and high protein intakes associated with newly diagnosed diabetes in a remote aboriginal community. Author(s): Wolever TM, Hamad S, Gittelsohn J, Gao J, Hanley AJ, Harris SB, Zinman B. Source: The American Journal of Clinical Nutrition. 1997 December; 66(6): 1470-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9394701&dopt=Abstract

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Low vs high dietary fiber and serum, biliary, and fecal lipids in middle-aged men. Author(s): Kesaniemi YA, Tarpila S, Miettinen TA. Source: The American Journal of Clinical Nutrition. 1990 June; 51(6): 1007-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2161613&dopt=Abstract

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Measurement of low dietary fiber intake as a risk factor for chronic constipation in children. Author(s): Morais MB, Vitolo MR, Aguirre AN, Fagundes-Neto U. Source: Journal of Pediatric Gastroenterology and Nutrition. 1999 August; 29(2): 132-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10435648&dopt=Abstract

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Meta-analysis of the cholesterol-lowering effects of dietary fiber. Author(s): Truswell AS. Source: The American Journal of Clinical Nutrition. 1999 November; 70(5): 942-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10539761&dopt=Abstract

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Metabolic effects of dietary fiber from dehulled soybeans in humans. Author(s): Schweizer TF, Bekhechi AR, Koellreutter B, Reimann S, Pometta D, Bron BA. Source: The American Journal of Clinical Nutrition. 1983 July; 38(1): 1-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6305183&dopt=Abstract

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Metabolic effects of dietary fiber. Author(s): Kritchevsky D. Source: The Western Journal of Medicine. 1979 February; 130(2): 123-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=106555&dopt=Abstract

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Metabolic epidemiology of colon cancer: effect of dietary fiber on fecal mutagens and bile acids in healthy subjects. Author(s): Reddy BS, Sharma C, Simi B, Engle A, Laakso K, Puska P, Korpela R. Source: Cancer Research. 1987 January 15; 47(2): 644-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3024823&dopt=Abstract

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Metabolizable energy and dietary fiber. Author(s): Wisker E, Feldheim W. Source: The Journal of Nutrition. 1988 May; 118(5): 654-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2835465&dopt=Abstract

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Metabolizable energy in humans in two diets containing different sources of dietary fiber. Calculations and analysis. Author(s): Goranzon H, Forsum E. Source: The Journal of Nutrition. 1987 February; 117(2): 267-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3031253&dopt=Abstract

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Metabolizable energy of diets low or high in dietary fiber from cereals when eaten by humans. Author(s): Wisker E, Maltz A, Feldheim W. Source: The Journal of Nutrition. 1988 August; 118(8): 945-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2841437&dopt=Abstract

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Metabolizable energy of diets low or high in dietary fiber from fruits and vegetables when consumed by humans. Author(s): Wisker E, Feldheim W. Source: The Journal of Nutrition. 1990 November; 120(11): 1331-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2172491&dopt=Abstract

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Methodological development of dietary fiber intervention to lower colon cancer risk. Author(s): Ho EE, Atwood JR, Meyskens FL Jr. Source: Prog Clin Biol Res. 1987; 248: 263-81. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2823286&dopt=Abstract

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No association among total dietary fiber, fiber fractions, and risk of breast cancer. Author(s): Terry P, Jain M, Miller AB, Howe GR, Rohan TE. Source: Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. 2002 November; 11(11): 1507-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12433738&dopt=Abstract

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Non-soluble dietary fiber effects on lipid absorption and blood serum lipid patterns. Author(s): Kies C. Source: Lipids. 1985 November; 20(11): 802-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2999551&dopt=Abstract

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Non-starch polysaccharides (dietary fiber) and resistant starch. Author(s): Englyst HN, Cummings JH. Source: Advances in Experimental Medicine and Biology. 1990; 270: 205-25. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1964009&dopt=Abstract

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Nutritional implications of dietary fiber. Author(s): Cummings JH. Source: The American Journal of Clinical Nutrition. 1978 October; 31(10 Suppl): 521-529. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=707402&dopt=Abstract

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Oral guar gum, a gel-forming dietary fiber relieves pruritus in intrahepatic cholestasis of pregnancy. Author(s): Riikonen S, Savonius H, Gylling H, Nikkila K, Tuomi AM, Miettinen TA. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2000 April; 79(4): 260-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10746839&dopt=Abstract

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Perspectives in dietary fiber in human nutrition. Author(s): Spiller GA, Shipley EA. Source: World Review of Nutrition and Dietetics. 1977; 27: 105-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=333787&dopt=Abstract

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Physical activity and dietary fiber determine population body fat levels: the Seven Countries Study. Author(s): Kromhout D, Bloemberg B, Seidell JC, Nissinen A, Menotti A. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2001 March; 25(3): 301-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11319625&dopt=Abstract

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Physical properties of dietary fiber that influence physiological function: a model for polymers along the gastrointestinal tract. Author(s): Eastwood MA, Morris ER. Source: The American Journal of Clinical Nutrition. 1992 February; 55(2): 436-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1310375&dopt=Abstract

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Physiological and anti-inflammatory roles of dietary fiber and butyrate in intestinal functions. Author(s): Andoh A, Bamba T, Sasaki M. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 1999 September-October; 23(5 Suppl): S70-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10483900&dopt=Abstract

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Physiological and metabolic effects of dietary fiber. Author(s): Anderson JW. Source: Fed Proc. 1985 November; 44(14): 2902-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2996944&dopt=Abstract

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Physiological implications of wheat and oat dietary fiber. Author(s): Knudsen KE, Hansen I, Jensen BB, Ostergard K. Source: Advances in Experimental Medicine and Biology. 1990; 270: 135-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1964002&dopt=Abstract

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Physiological role of dietary fiber: a ten-year review. Author(s): Trowell H, Burkitt D. Source: Bol Asoc Med P R. 1986 December; 78(12): 541-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3028444&dopt=Abstract

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Physiological role of dietary fiber: a ten-year review. Author(s): Trowell H, Burkitt D. Source: Asdc J Dent Child. 1986 November-December; 53(6): 444-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3025279&dopt=Abstract

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Pilot study of the efficacy of spent grain dietary fiber in the treatment of constipation. Author(s): Odes HS, Madar Z, Trop M, Namir S, Gross J, Cohen T. Source: Isr J Med Sci. 1986 January; 22(1): 12-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3007392&dopt=Abstract

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Plant residue and bacteria as bases for increased stool weight accompanying consumption of higher dietary fiber diets. Author(s): Kurasawa S, Haack VS, Marlett JA. Source: Journal of the American College of Nutrition. 2000 August; 19(4): 426-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10963460&dopt=Abstract

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Position of the American Dietetic Association: health implications of dietary fiber. Author(s): Marlett JA, McBurney MI, Slavin JL; American Dietetic Association. Source: Journal of the American Dietetic Association. 2002 July; 102(7): 993-1000. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12146567&dopt=Abstract

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Position of The American Dietetic Association: health implications of dietary fiber. Author(s): Gorman MA, Bowman C. Source: Journal of the American Dietetic Association. 1993 December; 93(12): 1446-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8245382&dopt=Abstract

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Postprandial glucose, insulin, and lipid responses to four meals containing unpurified dietary fiber in non-insulin-dependent diabetes mellitus (NIDDM), hypertriglyceridemic subjects. Author(s): Guevin N, Jacques H, Nadeau A, Galibois I. Source: Journal of the American College of Nutrition. 1996 August; 15(4): 389-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8829095&dopt=Abstract

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Practical aspects of implementing increased dietary fiber intake. Author(s): Floch MH, Maryniuk MD, Bryant C, Franz MJ, Tietyen-Clark J, Marotta RB, Wolever T, Maillet JO, Jenkins AL. Source: The American Journal of Gastroenterology. 1986 October; 81(10): 936-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3020972&dopt=Abstract

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Prevention of colon carcinogenesis by components of dietary fiber. Author(s): Reddy BS. Source: Anticancer Res. 1999 September-October; 19(5A): 3681-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10625939&dopt=Abstract

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Preventive role of dietary fiber in gastric cardia cancers. Author(s): Roth J, Mobarhan S. Source: Nutrition Reviews. 2001 November; 59(11): 372-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11720343&dopt=Abstract

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Probiotics and dietary fiber: the clinical coming of age of intestinal microecology. Author(s): Floch MH, Moussa K. Source: Journal of Clinical Gastroenterology. 1998 September; 27(2): 99-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9754769&dopt=Abstract

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Protective effect of dietary fibers against colorectal carcinoma. Author(s): Mia MA, Siddiqui MN, Rukunuzzaman M, Rahman MM, Deb K. Source: Mymensingh Med J. 2002 January; 11(1): 54-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12148400&dopt=Abstract

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Quantification of the fate of dietary fiber in humans by a newly developed radiolabeled fiber marker. Author(s): Carryer PW, Brown MI, Malagelada JR, Carlson GL, McCall JT. Source: Gastroenterology. 1982 June; 82(6): 1389-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6279467&dopt=Abstract

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Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with mesalamine in maintaining remission in ulcerative colitis. Spanish Group for the Study of Crohn's Disease and Ulcerative Colitis (GETECCU). Author(s): Fernandez-Banares F, Hinojosa J, Sanchez-Lombrana JL, Navarro E, Martinez-Salmeron JF, Garcia-Puges A, Gonzalez-Huix F, Riera J, Gonzalez-Lara V, Dominguez-Abascal F, Gine JJ, Moles J, Gomollon F, Gassull MA. Source: The American Journal of Gastroenterology. 1999 February; 94(2): 427-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10022641&dopt=Abstract

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Recent advances in dietary fiber and colorectal diseases. Author(s): Spiller GA, Freeman HJ. Source: The American Journal of Clinical Nutrition. 1981 June; 34(6): 1145-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6263077&dopt=Abstract

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Recent progress in dietary fiber (plantix) in human nutrition. Author(s): Spiller GA, Shipley EA, Blake JA. Source: Crc Crit Rev Food Sci Nutr. 1978; 10(1): 31-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=363363&dopt=Abstract

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Recommendations and conclusions of the dietary fiber workshop of the XI International Congress of Nutrition, Rio de Janeiro, 1978. Author(s): Spiller GA, Kay RM. Source: The American Journal of Clinical Nutrition. 1979 October; 32(10): 2102-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=39450&dopt=Abstract

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Recurrent abdominal pain and dietary fiber. Author(s): Christensen MF. Source: Am J Dis Child. 1986 August; 140(8): 738-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3014862&dopt=Abstract

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Relation between dietary fiber consumption and fibrinogen and plasminogen activator inhibitor type 1: The National Heart, Lung, and Blood Institute Family Heart Study. Author(s): Djousse L, Ellison RC, Zhang Y, Arnett DK, Sholinsky P, Borecki I. Source: The American Journal of Clinical Nutrition. 1998 September; 68(3): 568-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9734732&dopt=Abstract

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Relation of dietary fiber to blood lipids in the special intervention and usual care groups in the Multiple Risk Factor Intervention Trial. Author(s): Tillotson JL, Grandits GA, Bartsch GE, Stamler J. Source: The American Journal of Clinical Nutrition. 1997 January; 65(1 Suppl): 327S337S. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8988946&dopt=Abstract

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Relationship between dietary fiber and cancer: metabolic, physiologic, and cellular mechanisms. Author(s): Jacobs LR. Source: Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine (New York, N. Y.). 1986 December; 183(3): 299-310. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3025886&dopt=Abstract

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Relationship between dietary fiber content and composition in foods and the glycemic index. Author(s): Wolever TM. Source: The American Journal of Clinical Nutrition. 1990 January; 51(1): 72-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2153335&dopt=Abstract

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Relationships between transit time in man and in vitro fermentation of dietary fiber by fecal bacteria. Author(s): Oufir LE, Barry JL, Flourie B, Cherbut C, Cloarec D, Bornet F, Galmiche JP. Source: European Journal of Clinical Nutrition. 2000 August; 54(8): 603-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10951507&dopt=Abstract

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Role of dietary fiber and short-chain fatty acids in the colon. Author(s): Andoh A, Tsujikawa T, Fujiyama Y. Source: Current Pharmaceutical Design. 2003; 9(4): 347-58. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12570825&dopt=Abstract

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Role of dietary fiber in colon cancer: an overview. Author(s): Reddy BS. Source: The American Journal of Medicine. 1999 January 25; 106(1A): 16S-19S; Discussion 50S-51S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10089109&dopt=Abstract

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Role of dietary fiber in diverticular disease and colon cancer. Author(s): Talbot JM. Source: Fed Proc. 1981 July; 40(9): 2337-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6265284&dopt=Abstract

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Role of dietary fiber in the prevention of cancer. Author(s): Greenwald P, Lanza E. Source: Important Adv Oncol. 1986; : 37-54. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2837435&dopt=Abstract

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Role of fat, animal protein, and dietary fiber in breast cancer etiology: a case-control study. Author(s): Lubin F, Wax Y, Modan B. Source: Journal of the National Cancer Institute. 1986 September; 77(3): 605-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3018342&dopt=Abstract

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Role of water-soluble dietary fiber in the management of elevated plasma cholesterol in healthy subjects. Author(s): Haskell WL, Spiller GA, Jensen CD, Ellis BK, Gates JE. Source: The American Journal of Cardiology. 1992 February 15; 69(5): 433-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1310566&dopt=Abstract

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Roughage revisited: the effect on intestinal function of inert plastic particles of different sizes and shape. Author(s): Lewis SJ, Heaton KW. Source: Digestive Diseases and Sciences. 1999 April; 44(4): 744-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10219832&dopt=Abstract

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Self-regulation training enhances dietary self-efficacy and dietary fiber consumption. Author(s): Schnoll R, Zimmerman BJ. Source: Journal of the American Dietetic Association. 2001 September; 101(9): 1006-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11573751&dopt=Abstract

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Short-chain fatty acid production from mono- and disaccharides in a fecal incubation system: implications for colonic fermentation of dietary fiber in humans. Author(s): Mortensen PB, Holtug K, Rasmussen HS. Source: The Journal of Nutrition. 1988 March; 118(3): 321-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2832567&dopt=Abstract

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Sites and mechanisms for the hypocholesterolemic actions of soluble dietary fiber sources. Author(s): Marlett JA. Source: Advances in Experimental Medicine and Biology. 1997; 427: 109-21. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9361837&dopt=Abstract

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Soluble dietary fiber and short-chain fatty acids: an advance in understanding the human bacterial flora. Author(s): Floch MH. Source: The American Journal of Gastroenterology. 1990 October; 85(10): 1313-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2171326&dopt=Abstract

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Soluble dietary fiber workshop. Author(s): Marlett JA. Source: Advances in Experimental Medicine and Biology. 1997; 427: 311-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9361855&dopt=Abstract

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Some dietary fibers reduce the absorption of carotenoids in women. Author(s): Riedl J, Linseisen J, Hoffmann J, Wolfram G. Source: The Journal of Nutrition. 1999 December; 129(12): 2170-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10573545&dopt=Abstract

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Starch and dietary fiber components are excreted and degraded to variable extents in ileostomy subjects consuming mixed diets with wheat- or oat-bran bread. Author(s): Aman P, Pettersson D, Zhang JX, Tidehag P, Hallmans G. Source: The Journal of Nutrition. 1995 September; 125(9): 2341-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7666251&dopt=Abstract

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Studies on the extent of dietary fiber intake in West Germany. Author(s): Kasper H, Rabast U, Ehl M. Source: Nutr Metab. 1980; 24(2): 102-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6255381&dopt=Abstract

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Supplementation with dietary fiber improves fecal incontinence. Author(s): Bliss DZ, Jung HJ, Savik K, Lowry A, LeMoine M, Jensen L, Werner C, Schaffer K. Source: Nursing Research. 2001 July-August; 50(4): 203-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11480529&dopt=Abstract

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The 'age+5' rule: comparisons of dietary fiber intake among 4- to 10-year-old children. Author(s): Hampl JS, Betts NM, Benes BA. Source: Journal of the American Dietetic Association. 1998 December; 98(12): 1418-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9850110&dopt=Abstract

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The apolipoprotein E gene and the serum low-density lipoprotein cholesterol response to dietary fiber. Author(s): Jenkins DJ, Hegele RA, Jenkins AL, Connelly PW, Hallak K, Bracci P, Kashtan H, Corey P, Pintilia M, Stern H, et al. Source: Metabolism: Clinical and Experimental. 1993 May; 42(5): 585-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8388072&dopt=Abstract

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The benefits of dietary fiber on glycemic control in type 2 diabetes: relevance to gastroenterologists. Author(s): Hasler WL. Source: Gastroenterology. 2000 October; 119(4): 1168-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11040206&dopt=Abstract

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The clinical implications of dietary fiber. Author(s): Jenkins DJ, Jenkins AL. Source: Adv Nutr Res. 1984; 6: 169-202. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6095622&dopt=Abstract

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The clinical uses of dietary fiber. Author(s): Gray DS. Source: American Family Physician. 1995 February 1; 51(2): 419-26. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7840038&dopt=Abstract

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The dietary fiber hypothesis. Author(s): Almy TP. Source: The American Journal of Clinical Nutrition. 1981 March; 34(3): 432-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6259927&dopt=Abstract

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The effect of acacia gum and a water-soluble dietary fiber mixture on blood lipids in humans. Author(s): Jensen CD, Spiller GA, Gates JE, Miller AF, Whittam JH. Source: Journal of the American College of Nutrition. 1993 April; 12(2): 147-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8385164&dopt=Abstract

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The effect of dietary fiber and other factors on insulin response: role in obesity. Author(s): Ullrich IH, Albrink MJ. Source: Journal of Environmental Pathology, Toxicology and Oncology : Official Organ of the International Society for Environmental Toxicology and Cancer. 1985 July; 5(6): 137-55. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2995635&dopt=Abstract

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The effect of dietary fiber in tube-fed elderly patients. Author(s): Bass DJ, Forman LP, Abrams SE, Hsueh AM. Source: Journal of Gerontological Nursing. 1996 October; 22(10): 37-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8954383&dopt=Abstract

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The effect of dietary fiber on bowel function following radical hysterectomy: a randomized trial. Author(s): Griffenberg L, Morris M, Atkinson N, Levenback C. Source: Gynecologic Oncology. 1997 September; 66(3): 417-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9299255&dopt=Abstract

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The effect of dietary fiber on human pancreatic enzyme activity in vitro. Author(s): Dunaif G, Schneeman BO. Source: The American Journal of Clinical Nutrition. 1981 June; 34(6): 1034-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6165234&dopt=Abstract

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The effect of dietary fiber on the bioavailability of digoxin in capsules. Author(s): Johnson BF, Rodin SM, Hoch K, Shekar V. Source: Journal of Clinical Pharmacology. 1987 July; 27(7): 487-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2821081&dopt=Abstract

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The influence of dietary fiber on gastric transit time. Author(s): Kasper H, Eilles C, Reiners C, Schrezenmeir J. Source: Hepatogastroenterology. 1985 April; 32(2): 69-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2989138&dopt=Abstract

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The influence of dietary fiber source on human intestinal transit and stool output. Author(s): Wrick KL, Robertson JB, Van Soest PJ, Lewis BA, Rivers JM, Roe DA, Hackler LR. Source: The Journal of Nutrition. 1983 August; 113(8): 1464-79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6308191&dopt=Abstract

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The irritable bowel syndrome: the possible link between dietary fiber deficiency and disturbed intestinal motility. Author(s): Floch MH. Source: The American Journal of Gastroenterology. 1988 September; 83(9): 963-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2843036&dopt=Abstract

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The pharmacology of dietary fiber for laxation. Author(s): Floch MH. Source: The American Journal of Gastroenterology. 1987 December; 82(12): 1295-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2825517&dopt=Abstract

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The physiological effect of dietary fiber: an update. Author(s): Eastwood MA. Source: Annual Review of Nutrition. 1992; 12: 19-35. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1323981&dopt=Abstract

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The plant cell wall as a source of dietary fiber: chemistry and structure. Author(s): Selvendran RR. Source: The American Journal of Clinical Nutrition. 1984 February; 39(2): 320-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6320629&dopt=Abstract

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The protective properties of dietary fiber. Author(s): Burkitt DP. Source: N C Med J. 1981 July; 42(7): 467-71. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6265811&dopt=Abstract

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The protective role of dietary fiber in diverticular disease. Author(s): Aldoori WH. Source: Advances in Experimental Medicine and Biology. 1997; 427: 291-308. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9361853&dopt=Abstract

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The role of cholesterol in atherosclerosis and its potential management by dietary fiber. Author(s): Kohn IJ, Ribeiro LG. Source: Arquivos Brasileiros De Cardiologia. 1991 March; 56(3): 173-84. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1653562&dopt=Abstract

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The role of dietary fiber in gastrointestinal disease. Author(s): Klurfeld DM. Source: Journal of the American Dietetic Association. 1987 September; 87(9): 1172-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3040840&dopt=Abstract

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The role of dietary fiber in health and disease. Author(s): Kritchevsky D. Source: Journal of Environmental Pathology, Toxicology and Oncology : Official Organ of the International Society for Environmental Toxicology and Cancer. 1986 MarchApril; 6(3-4): 273-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3012064&dopt=Abstract

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The role of dietary fiber in satiety, glucose, and insulin: studies with fruit and fruit juice. Author(s): Bolton RP, Heaton KW, Burroughs LF. Source: The American Journal of Clinical Nutrition. 1981 February; 34(2): 211-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6259919&dopt=Abstract

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The role of dietary fiber in the development and treatment of childhood obesity. Author(s): Kimm SY. Source: Pediatrics. 1995 November; 96(5 Pt 2): 1010-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7494672&dopt=Abstract

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The role of dietary fiber in the etiology of non-insulin-dependent diabetes mellitus. The San Luis Valley Diabetes Study. Author(s): Marshall JA, Weiss NS, Hamman RF. Source: Annals of Epidemiology. 1993 January; 3(1): 18-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8287151&dopt=Abstract

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The use of dietary fiber in the management of simple, childhood, idiopathic, recurrent, abdominal pain. Results in a prospective, double-blind, randomized, controlled trial. Author(s): Feldman W, McGrath P, Hodgson C, Ritter H, Shipman RT. Source: Am J Dis Child. 1985 December; 139(12): 1216-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2998181&dopt=Abstract

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Time to discontinue antigenotoxicity studies of dietary fiber? Author(s): Santana-Rios G, Dashwood RH. Source: Mutation Research. 1999 October 19; 429(2): 269-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10526211&dopt=Abstract

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Time-lag effect of dietary fiber and fat intake ratio on Japanese colon cancer mortality. Author(s): Tsuji K, Harashima E, Nakagawa Y, Urata G, Shirataka M. Source: Biomed Environ Sci. 1996 September; 9(2-3): 223-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8886335&dopt=Abstract

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To what extent does increased dietary fiber improve glucose and lipid metabolism in patients with noninsulin-dependent diabetes mellitus (NIDDM)? Author(s): Hollenbeck CB, Coulston AM, Reaven GM. Source: The American Journal of Clinical Nutrition. 1986 January; 43(1): 16-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3002163&dopt=Abstract

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Total dietary fiber in children's diets. Author(s): Fulgoni VL 3rd, Mackey MA. Source: Annals of the New York Academy of Sciences. 1991; 623: 369-79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1645942&dopt=Abstract

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Total dietary fiber in urban and rural Costa Rican adolescents' diets. Author(s): Monge-Rojas R, Nunez Rivas H. Source: Arch Latinoam Nutr. 2001 December; 51(4): 340-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12012558&dopt=Abstract

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Treatment of chronic renal failure with dietary fiber. Author(s): Yatzidis H, Koutsicos D. Source: Clinical Nephrology. 1985 February; 23(2): 106-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2985308&dopt=Abstract

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Treatment of chronic renal failure with dietary fiber. Author(s): Rampton DS, Cohen SL, Crammond VD, Gibbons J, Lilburn MF, Rabet JY, Vince AJ, Wager JD, Wrong OM. Source: Clinical Nephrology. 1984 March; 21(3): 159-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6323075&dopt=Abstract

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Trends in dietary fiber intake in Japan over the last century. Author(s): Nakaji S, Sugawara K, Saito D, Yoshioka Y, MacAuley D, Bradley T, Kernohan G, Baxter D. Source: European Journal of Nutrition. 2002 October; 41(5): 222-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12395216&dopt=Abstract

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Two problems: diagnosing the EEC/EECUT syndrome and recommending dietary fiber. Author(s): Donlan MA. Source: Am J Dis Child. 1986 July; 140(7): 617-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3012994&dopt=Abstract

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Underutilized sources of dietary fiber: a review. Author(s): McKee LH, Latner TA. Source: Plant Foods for Human Nutrition (Dordrecht, Netherlands). 2000; 55(4): 285-304. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11086873&dopt=Abstract

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Urinary ascorbic acid excretion in the human as affected by dietary fiber and zinc. Author(s): Keltz FR, Kies C, Fox HM. Source: The American Journal of Clinical Nutrition. 1978 July; 31(7): 1167-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=665568&dopt=Abstract

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Use of dietary fiber and stimulus control to treat retentive encopresis: a multiple baseline investigation. Author(s): Houts AC, Mellon MW, Whelan JP. Source: Journal of Pediatric Psychology. 1988 September; 13(3): 435-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2848942&dopt=Abstract

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Use of dietary fiber to lower cholesterol. Author(s): Nuovo J. Source: American Family Physician. 1989 April; 39(4): 137-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2539711&dopt=Abstract

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Usefulness of soluble dietary fiber for the treatment of diarrhea during enteral nutrition in elderly patients. Author(s): Nakao M, Ogura Y, Satake S, Ito I, Iguchi A, Takagi K, Nabeshima T. Source: Nutrition (Burbank, Los Angeles County, Calif.). 2002 January; 18(1): 35-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11827762&dopt=Abstract

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Validity of a self-administered food frequency questionnaire used in the 5-year follow-up survey of the JPHC Study Cohort I to assess dietary fiber intake: comparison with dietary records. Author(s): Sasaki S, Matsumura Y, Ishihara J, Tsugane S; JPHC. Source: J Epidemiol. 2003 January; 13(1 Suppl): S106-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12701638&dopt=Abstract

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Vegetarianism, dietary fiber, and mortality. Author(s): Burr ML, Sweetnam PM. Source: The American Journal of Clinical Nutrition. 1982 November; 36(5): 873-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6291372&dopt=Abstract

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Vitamins, carotenoids, dietary fiber, and the risk of gastric carcinoma: results from a prospective study after 6.3 years of follow-up. Author(s): Botterweck AA, van den Brandt PA, Goldbohm RA. Source: Cancer. 2000 February 15; 88(4): 737-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10679641&dopt=Abstract

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Water-soluble dietary fiber and low-density lipoprotein cholesterol. Author(s): Masse J. Source: The American Journal of Cardiology. 1992 September 15; 70(7): 840. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1325735&dopt=Abstract

•

What is dietary fiber? Author(s): Prosky L. Source: J Aoac Int. 2000 July-August; 83(4): 985-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10995126&dopt=Abstract

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What to tell your patients about dietary fiber. Author(s): Cerrato PL. Source: Rn. 1987 January; : 63-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3026023&dopt=Abstract

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When is dietary fiber considered a functional food? Author(s): Prosky L. Source: Biofactors (Oxford, England). 2000; 12(1-4): 289-97. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11216498&dopt=Abstract

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Whole grains--impact of consuming whole grains on physiological effects of dietary fiber and starch. Author(s): Stephen AM. Source: Critical Reviews in Food Science and Nutrition. 1994; 34(5-6): 499-511. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7811380&dopt=Abstract

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CHAPTER 2. NUTRITION AND DIETARY FIBER Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and dietary fiber.

Finding Nutrition Studies on Dietary Fiber The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “dietary fiber” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7

Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following is a typical result when searching for recently indexed consumer information on dietary fiber: •

A forgotten natural dietary fiber: psyllium mucilloid. Source: Chan, J.K.C. Wypyszyk, V. Cereal-Foods-World. St. Paul, Minn. : American Association of Cereal Chemists. November 1988. volume 33 (11) page 919, 920, 922. 0146-6283

•

A study on dietary fiber intakes of Korean. Author(s): Dankook University, Seoul (Korea Republic). Department of Food Science and NutritionKorea Advanced Food Research Institute, Seoul (Korea Republic) Source: Lee, K.H. Park, M.A. Kim, E.S. Moon, H.K. Journal-of-The-Korean-Society-ofFood-and-Nutrition (Korea Republic). (October 1994). volume 23(5) page 767-773. 02533154

•

A study on the contents of dietary fibers and crude fiber in Kimchi ingredients and Kimchi. Author(s): Pusan National University, Pusan (Korea Republic). Department of Food Science and Nutrition Source: Park, K.Y. Ha, J.O. Rhee, S.H. Journal-of-the-Korean-Society-of-Food-andNutrition (Korea Republic). (February 1996). volume 25(1) page 69-75. 0253-3154

•

Barley bran flour evaluated as dietary fiber ingredient in wheat bread. Source: Chaudhary, V.K. Weber, F.E. Cereal-foods-world. St. Paul, Minn., American Association of Cereal Chemists. June 1990. volume 35 (6) page 560-562. 0146-6283

•

Decreasing the roughage:concentrate ratio of a diet to determine the critical roughage part for beef cattle. Author(s): Agricultural Research Centre-Ghent, Belgium. [email protected] Source: De Campeneere, S Fiems, L O De Boever, J L Vanacker, J M De Brabander, D L Arch-Tierernahr. 2002 February; 56(1): 1-12 0003-942X

•

Development of a dietary fiber gel for calorie-reduced foods. Source: Inglett, G.E. Cereal-foods-world. St. Paul, Minn., American Association of Cereal Chemists. May 1997. volume 42 (5) page 382-385. 0146-6283

•

Dietary fiber and large bowel cancer. Author(s): Tokyo University, Tokyo (Japan). Department of Nutrition Source: Oku, T. Journal-of-the-Korean-Society-of-Food-and-Nutrition (Korea Republic). (June 1996). volume 25(3) page 539-549. 0253-3154

•

Dietary fiber showed no preventive effect against colon and rectal cancers in Japanese with low fat intake: an analysis from the results of nutrition surveys from 23 Japanese prefectures. Author(s): Department of Hygiene, Hirosaki University School of Medicine Zaifu-cho 5, Hirosaki, 036-8562 Japan. [email protected] Source: Nakaji, S Shimoyama, T Umeda, T Sakamoto, J Katsura, S Sugawara, K Baxter, D BMC-Cancer. 2001; 1(1): 14 1471-2407

•

Modulation of CD8+ intraepithelial lymphocyte distribution by dietary fiber in the rat large intestine. Author(s): Division of Applied Bioscience, Graduate School of Agriculture Hokkaido University, Sapporo 060-8589, Japan. [email protected] Source: Ishizuka, S Tanaka, S Exp-Biol-Med-(Maywood). 2002 December; 227(11): 101721 1535-3702

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Protective effect of dietary fibers against colorectal carcinoma. Source: Mia, M A Siddiqui, M N Rukunuzzaman, M Rahman, M M Deb, K Mymensingh-Med-J. 2002 January; 11(1): 54-6 1022-4742

•

Recovery and nutritional evaluation of dietary fiber ingredients from a barley byproduct. Source: Weber, F.E. Chaudhary, V.K. Cereal-foods-world (USA). (August 1987). volume 32(8) page 548-550. 0146-6283

•

Structure and components of dietary fiber. Source: Theander, O. Westerlund, E. Aman, P. Cereal-Foods-World. St. Paul, Minn. : American Association of Cereal Chemists. March 1993. volume 38 (3) page 135-138, 140141. 0146-6283

•

Studies on the composition of lipid, amino acid and dietary fiber from functional food source - Platycodi radix, perilla seed, evening primrose seed and aloe vera. Author(s): Kyungsan University, Kyungsan (Korea Republic). Department of Food Science Source: Hwang, S.W. Park, M.H. Shim, H.K. Bae, M.J. Journal-of-The-Korean-Society-ofFood-and-Nutrition (Korea Republic). (August 1994). volume 23(4) page 647-653. 02533154

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The effect of dietary fiber on the liver xanthine oxidase activity in rats. Author(s): Keimyung Junior College, Taegu (Korea Republic). Department of Food and NutritionKeimyung University, Taegu (Korea Republic). Department of Public Health Source: Lee, Y.S. Lee, H.J. Yoon, C.G. Journal-of-The-Korean-Society-of-Food-andNutrition (Korea Republic). (December 1995). volume 24(6) page 843-847. 0253-3154

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The effect of high fat diet and dietary fiber on lipid metabolism in rats. Author(s): Korea University, Seoul (Korea Republic). Department of Home Economics Source: Han, J.S. Han, Y.B. Journal-of-The-Korean-Society-of-Food-and-Nutrition (Korea Republic). (August 1994). volume 23(4) page 541-547. 0253-3154

•

Total dietary fiber in urban and rural Costa Rican adolescents' diets. Author(s): Costa Rican Institute for Research and Education on Nutrition and Health (Inciensa), Tres Rios, Costa Rica. Source: Monge Rojas, R Nunez Rivas, H Arch-Latinoam-Nutr. 2001 December; 51(4): 340-5 0004-0622

The following information is typical of that found when using the “Full IBIDS Database” to search for “dietary fiber” (or a synonym): •

A forgotten natural dietary fiber: psyllium mucilloid. Source: Chan, J.K.C. Wypyszyk, V. Cereal-Foods-World. St. Paul, Minn. : American Association of Cereal Chemists. November 1988. volume 33 (11) page 919, 920, 922. 0146-6283

•

A study on dietary fiber intakes of Korean. Author(s): Dankook University, Seoul (Korea Republic). Department of Food Science and NutritionKorea Advanced Food Research Institute, Seoul (Korea Republic) Source: Lee, K.H. Park, M.A. Kim, E.S. Moon, H.K. Journal-of-The-Korean-Society-ofFood-and-Nutrition (Korea Republic). (October 1994). volume 23(5) page 767-773. 02533154

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•

A study on the contents of dietary fibers and crude fiber in Kimchi ingredients and Kimchi. Author(s): Pusan National University, Pusan (Korea Republic). Department of Food Science and Nutrition Source: Park, K.Y. Ha, J.O. Rhee, S.H. Journal-of-the-Korean-Society-of-Food-andNutrition (Korea Republic). (February 1996). volume 25(1) page 69-75. 0253-3154

•

Barley bran flour evaluated as dietary fiber ingredient in wheat bread. Source: Chaudhary, V.K. Weber, F.E. Cereal-foods-world. St. Paul, Minn., American Association of Cereal Chemists. June 1990. volume 35 (6) page 560-562. 0146-6283

•

Decreasing the roughage:concentrate ratio of a diet to determine the critical roughage part for beef cattle. Author(s): Agricultural Research Centre-Ghent, Belgium. [email protected] Source: De Campeneere, S Fiems, L O De Boever, J L Vanacker, J M De Brabander, D L Arch-Tierernahr. 2002 February; 56(1): 1-12 0003-942X

•

Development of a dietary fiber gel for calorie-reduced foods. Source: Inglett, G.E. Cereal-foods-world. St. Paul, Minn., American Association of Cereal Chemists. May 1997. volume 42 (5) page 382-385. 0146-6283

•

Dietary fiber and large bowel cancer. Author(s): Tokyo University, Tokyo (Japan). Department of Nutrition Source: Oku, T. Journal-of-the-Korean-Society-of-Food-and-Nutrition (Korea Republic). (June 1996). volume 25(3) page 539-549. 0253-3154

•

Dietary fiber showed no preventive effect against colon and rectal cancers in Japanese with low fat intake: an analysis from the results of nutrition surveys from 23 Japanese prefectures. Author(s): Department of Hygiene, Hirosaki University School of Medicine Zaifu-cho 5, Hirosaki, 036-8562 Japan. [email protected] Source: Nakaji, S Shimoyama, T Umeda, T Sakamoto, J Katsura, S Sugawara, K Baxter, D BMC-Cancer. 2001; 1(1): 14 1471-2407

•

Modulation of CD8+ intraepithelial lymphocyte distribution by dietary fiber in the rat large intestine. Author(s): Division of Applied Bioscience, Graduate School of Agriculture Hokkaido University, Sapporo 060-8589, Japan. [email protected] Source: Ishizuka, S Tanaka, S Exp-Biol-Med-(Maywood). 2002 December; 227(11): 101721 1535-3702

•

Protective effect of dietary fibers against colorectal carcinoma. Source: Mia, M A Siddiqui, M N Rukunuzzaman, M Rahman, M M Deb, K Mymensingh-Med-J. 2002 January; 11(1): 54-6 1022-4742

•

Recovery and nutritional evaluation of dietary fiber ingredients from a barley byproduct. Source: Weber, F.E. Chaudhary, V.K. Cereal-foods-world (USA). (August 1987). volume 32(8) page 548-550. 0146-6283

•

Structure and components of dietary fiber. Source: Theander, O. Westerlund, E. Aman, P. Cereal-Foods-World. St. Paul, Minn. : American Association of Cereal Chemists. March 1993. volume 38 (3) page 135-138, 140141. 0146-6283

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Studies on the composition of lipid, amino acid and dietary fiber from functional food source - Platycodi radix, perilla seed, evening primrose seed and aloe vera. Author(s): Kyungsan University, Kyungsan (Korea Republic). Department of Food Science Source: Hwang, S.W. Park, M.H. Shim, H.K. Bae, M.J. Journal-of-The-Korean-Society-ofFood-and-Nutrition (Korea Republic). (August 1994). volume 23(4) page 647-653. 02533154

•

The effect of dietary fiber on the liver xanthine oxidase activity in rats. Author(s): Keimyung Junior College, Taegu (Korea Republic). Department of Food and NutritionKeimyung University, Taegu (Korea Republic). Department of Public Health Source: Lee, Y.S. Lee, H.J. Yoon, C.G. Journal-of-The-Korean-Society-of-Food-andNutrition (Korea Republic). (December 1995). volume 24(6) page 843-847. 0253-3154

•

The effect of high fat diet and dietary fiber on lipid metabolism in rats. Author(s): Korea University, Seoul (Korea Republic). Department of Home Economics Source: Han, J.S. Han, Y.B. Journal-of-The-Korean-Society-of-Food-and-Nutrition (Korea Republic). (August 1994). volume 23(4) page 541-547. 0253-3154

•

Total dietary fiber in urban and rural Costa Rican adolescents' diets. Author(s): Costa Rican Institute for Research and Education on Nutrition and Health (Inciensa), Tres Rios, Costa Rica. Source: Monge Rojas, R Nunez Rivas, H Arch-Latinoam-Nutr. 2001 December; 51(4): 340-5 0004-0622

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

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Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMDHealth: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

The following is a specific Web list relating to dietary fiber; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Food and Diet Acorn Squash Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,190,00.html Almonds Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,113,00.html Amaranth Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,69,00.html Artichokes Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,28,00.html Barley Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,70,00.html Buckwheat Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com

Nutrition

Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,71,00.html Burdock Alternative names: Arctium lappa Source: Healthnotes, Inc.; www.healthnotes.com Butternut Squash Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,189,00.html Complex Carbohydrates Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,993,00.html Dates Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,50,00.html Fructo-oligosaccharides (fos) and Other Oligosaccharides Source: Healthnotes, Inc.; www.healthnotes.com Hazelnuts Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,307,00.html High-fiber Diet Source: Healthnotes, Inc.; www.healthnotes.com Lettuce & Other Salad Greens Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,196,00.html Okra Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,26,00.html Oranges Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,59,00.html Peanuts Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,110,00.html

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Pears Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,62,00.html Raisins & Currants Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,67,00.html Seeds Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,288,00.html Shiitake Mushrooms Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,308,00.html Strawberries Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,108,00.html Sweet Potatoes Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,40,00.html Swiss Chard Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,140,00.html Weight Loss and Obesity Source: Healthnotes, Inc.; www.healthnotes.com Wheat Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,78,00.html

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CHAPTER 3. ALTERNATIVE MEDICINE AND DIETARY FIBER Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to dietary fiber. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to dietary fiber and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “dietary fiber” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to dietary fiber: •

Baseline dietary fiber intake and colorectal adenoma recurrence in the wheat bran fiber randomized trial. Author(s): Jacobs ET, Giuliano AR, Roe DJ, Guillen-Rodriguez JM, Alberts DS, Martinez ME. Source: Journal of the National Cancer Institute. 2002 November 6; 94(21): 1620-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12419788&dopt=Abstract

•

Beans, as a source of dietary fiber, increase cholecystokinin and apolipoprotein b48 response to test meals in men. Author(s): Bourdon I, Olson B, Backus R, Richter BD, Davis PA, Schneeman BO. Source: The Journal of Nutrition. 2001 May; 131(5): 1485-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11340104&dopt=Abstract

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•

Behavior, reproduction, and immunity of crated pregnant gilts: effects of high dietary fiber and rearing environment. Author(s): McGlone JJ, Fullwood SD. Source: Journal of Animal Science. 2001 June; 79(6): 1466-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11424683&dopt=Abstract

•

Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. Author(s): Chandalia M, Garg A, Lutjohann D, von Bergmann K, Grundy SM, Brinkley LJ. Source: The New England Journal of Medicine. 2000 May 11; 342(19): 1392-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10805824&dopt=Abstract

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Composition of fractional and functional properties of dietary fiber of lupines (L. luteus and L. albus). Author(s): Gorecka D, Lampart-Szczapa E, Janitz W, Sokolowska B. Source: Die Nahrung. 2000 August; 44(4): 229-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10996894&dopt=Abstract

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Dietary fiber and body-weight regulation. Observations and mechanisms. Author(s): Pereira MA, Ludwig DS. Source: Pediatric Clinics of North America. 2001 August; 48(4): 969-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11494646&dopt=Abstract

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Dietary fiber and breast cancer. Author(s): Cohen LA. Source: Anticancer Res. 1999 September-October; 19(5A): 3685-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10625940&dopt=Abstract

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Dietary fiber and colorectal cancer: what is appropriate advice? Author(s): Story JA, Savaiano DA. Source: Nutrition Reviews. 2001 March; 59(3 Pt 1): 84-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11330626&dopt=Abstract

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Dietary fiber and plant foods in relation to colorectal cancer mortality: the Seven Countries Study. Author(s): Jansen MC, Bueno-de-Mesquita HB, Buzina R, Fidanza F, Menotti A, Blackburn H, Nissinen AM, Kok FJ, Kromhout D. Source: International Journal of Cancer. Journal International Du Cancer. 1999 April 12; 81(2): 174-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10188715&dopt=Abstract

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Dietary fiber and weight regulation. Author(s): Howarth NC, Saltzman E, Roberts SB. Source: Nutrition Reviews. 2001 May; 59(5): 129-39. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11396693&dopt=Abstract

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Dietary fiber fraction of germinated barley foodstuff attenuated mucosal damage and diarrhea, and accelerated the repair of the colonic mucosa in an experimental colitis. Author(s): Kanauchi O, Iwanaga T, Andoh A, Araki Y, Nakamura T, Mitsuyama K, Suzuki A, Hibi T, Bamba T. Source: Journal of Gastroenterology and Hepatology. 2001 February; 16(2): 160-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11207896&dopt=Abstract

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Dietary fiber prevents carbohydrate-induced hypertriglyceridemia. Author(s): Anderson JW. Source: Current Atherosclerosis Reports. 2000 November; 2(6): 536-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11122790&dopt=Abstract

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Dietary fiber reduces the antioxidative effect of a carotenoid and alpha-tocopherol mixture on LDL oxidation ex vivo in humans. Author(s): Hoffmann J, Linseisen J, Riedl J, Wolfram G. Source: European Journal of Nutrition. 1999 December; 38(6): 278-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10784384&dopt=Abstract

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Dietary fiber supplementation with psyllium or gum arabic reduced fecal incontinence in community-living adults. Author(s): Korula J. Source: Acp Journal Club. 2002 January-February; 136(1): 23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11829564&dopt=Abstract

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Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults. Author(s): Ludwig DS, Pereira MA, Kroenke CH, Hilner JE, Van Horn L, Slattery ML, Jacobs DR Jr. Source: Jama : the Journal of the American Medical Association. 1999 October 27; 282(16): 1539-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10546693&dopt=Abstract

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Dietary fibre: a roughage guide. Author(s): James SL, Muir JG, Curtis SL, Gibson PR. Source: Internal Medicine Journal. 2003 July; 33(7): 291-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12823674&dopt=Abstract

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Effect of diets containing n-3 fatty acids on muscle long-chain n-3 fatty acid content in lambs fed low- and medium-quality roughage diets. Author(s): Ponnampalam EN, Sinclairt AJ, Egan AR, Blakeley SJ, Leury BJ. Source: Journal of Animal Science. 2001 March; 79(3): 698-706. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11263830&dopt=Abstract

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Effects of dietary fiber on performance of multiparous lactating sows in a tropical climate. Author(s): Renaudeau D, Anais C, Noblet J. Source: Journal of Animal Science. 2003 March; 81(3): 717-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12661652&dopt=Abstract

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Effects of insoluble and soluble dietary fiber on glycemic control in dogs with naturally occurring insulin-dependent diabetes mellitus. Author(s): Kimmel SE, Michel KE, Hess RS, Ward CR. Source: J Am Vet Med Assoc. 2000 April 1; 216(7): 1076-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10754666&dopt=Abstract

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Effects of wheat maturation stage and cooking method on dietary fiber and phytic acid contents of firik, a wheat-based local food. Author(s): Ozboy O, Ozkaya B, Ozkaya H, Koksel H. Source: Die Nahrung. 2001 October; 45(5): 347-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11715347&dopt=Abstract

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Foods contributing to absolute intake and variance in intake of selected vitamins, minerals and dietary fiber in middle-aged Japanese. Author(s): Imaeda N, Tokudome Y, Ikeda M, Kitagawa I, Fujiwara N, Tokudome S. Source: J Nutr Sci Vitaminol (Tokyo). 1999 October; 45(5): 519-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10683805&dopt=Abstract

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Influence of two dietary fibers in the oral bioavailability and other pharmacokinetic parameters of ethinyloestradiol. Author(s): Garcia JJ, Fernandez N, Diez MJ, Sahagun A, Gonzalez A, Alonso ML, Prieto C, Calle AP, Sierra M. Source: Contraception. 2000 November; 62(5): 253-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11172796&dopt=Abstract

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Is dietary fiber beneficial in chronic ischemic heart disease? Author(s): Vajifdar BU, Goyal VS, Lokhandwala YY, Mhamunkar SR, Mahadik SP, Gawad AK, Halankar SA, Kulkarni HL. Source: J Assoc Physicians India. 2000 September; 48(9): 871-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11198784&dopt=Abstract

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Long-term blood cholesterol-lowering effects of a dietary fiber supplement. Author(s): Knopp RH, Superko HR, Davidson M, Insull W, Dujovne CA, Kwiterovich PO, Zavoral JH, Graham K, O'Connor RR, Edelman DA. Source: American Journal of Preventive Medicine. 1999 July; 17(1): 18-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10429748&dopt=Abstract

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New method for determining total dietary fiber by liquid chromatography. Author(s): Ohkuma K, Matsuda I, Katta Y, Tsuji K, Ohkuma K, Matsuda I, Katta Y, Tsuji K. Source: J Aoac Int. 2000 July-August; 83(4): 1013-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10995131&dopt=Abstract

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Physical activity and dietary fiber determine population body fat levels: the Seven Countries Study. Author(s): Kromhout D, Bloemberg B, Seidell JC, Nissinen A, Menotti A. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2001 March; 25(3): 301-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11319625&dopt=Abstract

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Physiological and anti-inflammatory roles of dietary fiber and butyrate in intestinal functions. Author(s): Andoh A, Bamba T, Sasaki M. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 1999 September-October; 23(5 Suppl): S70-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10483900&dopt=Abstract

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Plant residue and bacteria as bases for increased stool weight accompanying consumption of higher dietary fiber diets. Author(s): Kurasawa S, Haack VS, Marlett JA. Source: Journal of the American College of Nutrition. 2000 August; 19(4): 426-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10963460&dopt=Abstract

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Position of the American Dietetic Association: health implications of dietary fiber. Author(s): Marlett JA, McBurney MI, Slavin JL; American Dietetic Association. Source: Journal of the American Dietetic Association. 2002 July; 102(7): 993-1000. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12146567&dopt=Abstract

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Preventive role of dietary fiber in gastric cardia cancers. Author(s): Roth J, Mobarhan S. Source: Nutrition Reviews. 2001 November; 59(11): 372-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11720343&dopt=Abstract

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Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle-aged women. Author(s): Liu S, Willett WC, Manson JE, Hu FB, Rosner B, Colditz G. Source: The American Journal of Clinical Nutrition. 2003 November; 78(5): 920-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14594777&dopt=Abstract

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Soluble dietary fiber protects against cholesterol gallstone formation. Author(s): Schwesinger WH, Kurtin WE, Page CP, Stewart RM, Johnson R. Source: American Journal of Surgery. 1999 April; 177(4): 307-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10326849&dopt=Abstract

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Supplementation with dietary fiber improves fecal incontinence. Author(s): Bliss DZ, Jung HJ, Savik K, Lowry A, LeMoine M, Jensen L, Werner C, Schaffer K. Source: Nursing Research. 2001 July-August; 50(4): 203-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11480529&dopt=Abstract

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Underutilized sources of dietary fiber: a review. Author(s): McKee LH, Latner TA. Source: Plant Foods for Human Nutrition (Dordrecht, Netherlands). 2000; 55(4): 285-304. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11086873&dopt=Abstract

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Whole-grain foods, dietary fiber, and type 2 diabetes: searching for a kernel of truth. Author(s): Liu S. Source: The American Journal of Clinical Nutrition. 2003 March; 77(3): 527-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12600838&dopt=Abstract

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMDHealth: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to dietary fiber; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Amenorrhea Source: Healthnotes, Inc.; www.healthnotes.com Atherosclerosis Source: Healthnotes, Inc.; www.healthnotes.com Breast Cancer Source: Healthnotes, Inc.; www.healthnotes.com Cardiovascular Disease Overview Source: Healthnotes, Inc.; www.healthnotes.com Colon Cancer Source: Healthnotes, Inc.; www.healthnotes.com Colorectal Cancer Source: Integrative Medicine Communications; www.drkoop.com Constipation Source: Healthnotes, Inc.; www.healthnotes.com Constipation Source: Prima Communications, Inc.www.personalhealthzone.com Diabetes Source: Healthnotes, Inc.; www.healthnotes.com Diabetes Mellitus Source: Integrative Medicine Communications; www.drkoop.com Diarrhea Source: Healthnotes, Inc.; www.healthnotes.com

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Diverticular Disease Source: Healthnotes, Inc.; www.healthnotes.com Heart Attack Source: Healthnotes, Inc.; www.healthnotes.com Heart Attack Source: Integrative Medicine Communications; www.drkoop.com High Cholesterol Source: Healthnotes, Inc.; www.healthnotes.com High Cholesterol Source: Integrative Medicine Communications; www.drkoop.com Hypercholesterolemia Source: Integrative Medicine Communications; www.drkoop.com Hypoglycemia Source: Healthnotes, Inc.; www.healthnotes.com Inflammatory Bowel Disease Source: Integrative Medicine Communications; www.drkoop.com Insulin Resistance Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Intestinal Parasites Source: Integrative Medicine Communications; www.drkoop.com Irritable Bowel Syndrome Alternative names: Spastic Colon Source: Prima Communications, Inc.www.personalhealthzone.com Myocardial Infarction Source: Integrative Medicine Communications; www.drkoop.com Obesity Source: Integrative Medicine Communications; www.drkoop.com Pancreatic Insufficiency Source: Healthnotes, Inc.; www.healthnotes.com Peptic Ulcer Source: Healthnotes, Inc.; www.healthnotes.com Ulcerative Colitis Source: Healthnotes, Inc.; www.healthnotes.com Ulcerative Colitis Source: Integrative Medicine Communications; www.drkoop.com

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Varicose Veins Source: Integrative Medicine Communications; www.drkoop.com •

Alternative Therapy Nutrition Source: Integrative Medicine Communications; www.drkoop.com

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Herbs and Supplements Acidophilus Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,748,00.html Ampicillin Source: Healthnotes, Inc.; www.healthnotes.com Arctium Alternative names: Burdock, Gobo; Arctium lappa L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Beta-carotene Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10103,00.html Cascara Sagrada Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10013,00.html Dandelion Alternative names: Taraxacum officinale Source: Healthnotes, Inc.; www.healthnotes.com Echinacea Alternative names: Echinacea purpurea, Echinacea angustifolia, Echinacea pallida Source: Healthnotes, Inc.; www.healthnotes.com Elecampane Alternative names: Inula helenium Source: Healthnotes, Inc.; www.healthnotes.com Fiber Source: Healthnotes, Inc.; www.healthnotes.com Fiber Source: Integrative Medicine Communications; www.drkoop.com

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Fos Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10026,00.html Glucomannan Source: Healthnotes, Inc.; www.healthnotes.com Hibiscus Alternative names: Hibiscus, Roselle; Hibiscus sp. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Ip-6 Source: Healthnotes, Inc.; www.healthnotes.com Ispaghula Source: Integrative Medicine Communications; www.drkoop.com Mesalamine Source: Healthnotes, Inc.; www.healthnotes.com Musa Banana Alternative names: Plantain, Banana; Musa sp. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Plantago Isphagula Source: Integrative Medicine Communications; www.drkoop.com Plantago Psyllium Alternative names: Psyllium, Ispaghula; Plantago psyllium/ovata Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Psyllium Alternative names: Plantago ovata, Plantago ispaghula Source: Healthnotes, Inc.; www.healthnotes.com Psyllium Alternative names: Ispaghula,Plantago isphagula Source: Integrative Medicine Communications; www.drkoop.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. DISSERTATIONS ON DIETARY FIBER Overview In this chapter, we will give you a bibliography on recent dissertations relating to dietary fiber. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “dietary fiber” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on dietary fiber, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Dietary Fiber ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to dietary fiber. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

Cholesterol Cholelithiasis: Role of Dietary Fiber by McDougall, Roderick; PhD from University of Alberta (Canada), 1978 http://wwwlib.umi.com/dissertations/fullcit/NK40228

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Evaluation of Several Sources of Dietary Fiber for Use in Food Products by Cadden, Ann-Marie John; PhD from The University of Saskatchewan (Canada), 1981 http://wwwlib.umi.com/dissertations/fullcit/NK55995

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 5. PATENTS ON DIETARY FIBER Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “dietary fiber” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on dietary fiber, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Dietary Fiber By performing a patent search focusing on dietary fiber, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 8Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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example of the type of information that you can expect to obtain from a patent search on dietary fiber: •

ATP synthesis activator containing a mixture of herbs Inventor(s): Yoon; JungMan (1-2-30, Oyamadai, Setagaya-ku, Tokyo 158-0086, JP) Assignee(s): none reported Patent Number: 6,645,533 Date filed: December 7, 2001 Abstract: An ATP synthesis activator is provided, which allows the promotion of ATP synthesis in the body and results in an increased ATP level in the body for a long period of time. The ATP synthesis activator comprises, as an active ingredient, a mixture of a plurality of herbs having an ion-exchange capacity. It may stimulate electron generation in the body and hence results in an improved ATP synthesis activity due to the generated electrons, because dietary fiber contained in the herbs has an ion-exchange capacity. Preferably, the herb mixture includes thyme, rosemary, turmeric, fennel, grape seeds, dandelion, and Acanthopanax senticosus. Also the composition is useful for treating immune deficiency diseases. Excerpt(s): The present invention relates to an ATP synthesis activator for promoting the synthesis of ATP (adenosine triphosphate) used as an energy source for living cells. An enzyme used in such an enzyme-catalyzed technique includes acetate kinase, carbamate kinase and creatine kinase, and in these cases, acetyl phosphate, carbamyl phosphate and creatine phosphate are used as a phosphate donor, respectively. In an embodiment of this technique in a bioreactor, there has been developed a procedure using acetate kinase and adenylate kinase isolated in a pure form from a thermophilic bacterial strain, Bacillus stearothermophilus. On the other hand, a fermentation-based technique using glycolysis in yeast cells involves ATP production through phosphorylation at a substrate level. This technique is based on the fact that two ATP molecules can be generated when one molecule of glucose is metabolized into two molecules of ethanol and two molecules of CO.sub.2. In the pharmaceutical and food fields, however, there has been no activator known to be particularly effective in promoting ATP synthesis in the body. The promotion of ATP synthesis in the body can eliminate the need for oral ATP administration to increase ATP level in the body. Further, prolonged promotion of ATP synthesis may contribute to health maintenance and the like. Web site: http://www.delphion.com/details?pn=US06645533__

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Bacteria-and fiber-containing composition for human gastrointestinal health Inventor(s): Katke; Jeffrey J. (San Clemente, CA), Krumhar; Kim Carleton (Carlsbad, CA), Paul; Stephen M. (Rancho Santa Margarita, CA) Assignee(s): Metagenics, Inc. (San Clemente, CA) Patent Number: 6,241,983 Date filed: May 26, 1999 Abstract: A composition for promoting gastrointestinal health contains an effective amount of a beneficial human intestinal microorganism and an effective amount of dietary fiber. Preferably, the dietary fiber is a member selected from the group consisting of pentosans,.beta.-glucans, pectins and pectic polysaccharides, mannans,

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arabinans and galactans, fructo-oligosaccharides, and mixtures thereof. The bacteriaand fiber-containing composition can optionally contain one or more of an immunoglobulin composition containing concentrated immunologically active immunoglobulins, components of a non-immune defense system, an iron-sequestering molecule, and gluconic acid. Preferred beneficial human intestinal microorganisms include lactobacilli and bifidobacteria. Methods of use are also described. Excerpt(s): This invention relates to a bacteria- and fiber-containing composition and methods of use thereof for promoting gastrointestinal health. More particularly, the invention relates to a composition comprising living bacteria that are beneficial for gastrointestinal health; soluble and insoluble dietary fiber that provides the advantages typically offered by dietary fibers with the additional advantages of not affecting blood glucose or insulin levels, being readily fermented by the intestinal microflora, and promoting growth of certain beneficial intestinal microorganisms; and optionally one or more of the following: concentrated immunoglobulins capable of binding and inactivating foreign antigens such as pathogenic bacteria, viruses, fungi, and protozoa that are detrimental to gastrointestinal health, lactoperoxidase and/or thiocyanate for strengthening a natural non-immune defense system, lactoferrin for inhibiting detrimental iron-catalyzed processes and harmful microorganisms, and gluconic acid for inhibiting growth of harmful bacteria and stimulating immune function. Fiber in the diet is well known for its salutary effects on gastrointestinal health. Such effects include providing bulk to the stool, decreasing the pH of the gastrointestinal tract, producing volatile fatty acids, decreasing intestinal transit time, and beneficially influencing various blood parameters. Dietary fiber has also been shown to have a beneficial effect on cholesterol and lipid metabolism that results in decreased serum cholesterol, triglycerides, and phospholipids and an improved (increased) HDL to LDL ratio. A study on laboratory animals showed that adding fiber to the diet decreases the incidence of bacterial translocation, i.e. crossing the intestinal barrier and entering systemic circulation. C. Palacio et al., Dietary Fiber: Physiologic Effects and Potential Applications to Enteral Nutrition, in Clinical Nutrition: Enteral and Tube Feeding (2d. ed., 1990). Nutritional and epidemiological studies have indicated that a general increase in the consumption of dietary fiber may play a role in preventing deleterious effects of oxygen free radicals that have been accused of being involved in such processes as aging, inflammation, and some disease processes. R. Kohen et al., Prevention of Oxidative Damage in the Rat Jejunal Mucosa by Pectin, 69 Br. J. Nutrition 789 (1993). Certain bacteria have also been shown to be beneficial to human gastrointestinal health. Bacteria of the genus Lactobacillus have been used for several hundred years for treating various illnesses. Lactobacilli found in the human intestinal tract include L. acidophilus, L. casei, L. fermentum, L. salivaroes, L. brevis, L. leichmannii, L. plantarum, and L. cellobiosus. In recent years, L. acidophilus has been shown to be exceptionally useful in treating conditions such as antibiotic-induced imbalances in the gastrointestinal microflora, hypercholesterolemia, vaginal infections, E. coli infection, oral contraceptive failure, depressed immunity, cancerous tumors, chronic granulomatous disease, and lactose indigestion. A. G. Shauss, Method of Action, Clinical Application, and Toxicity Data, 3 J. Advancement Med. 163 (1990). In vitro studies have shown L. acidophilus to have an inhibitory effect on the growth of pathogenic bacteria such as Campylobacter pylori, Staphylococcus aureus, Pseudomonas aeruginosa, and Sarcina lutea K. M. Shahani et al., Natural Antibiotic Activity of Lactobacillus Acidophilus and Bulgaricus, 11 Cultured Dairy Products J. 14 (1976). Web site: http://www.delphion.com/details?pn=US06241983__

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Cellulose-containing composite Inventor(s): Enatsu; Kouichirou (Nobeoka, JP), Kamada; Etsuo (Nobeoka, JP), Mochihara; Nobuyoshi (Nobeoka, JP), Yaginuma; Yoshihito (Nobeoka, JP) Assignee(s): Asahi Kasei Kabushiki Kaisha (JP) Patent Number: 6,495,190 Date filed: July 5, 2000 Abstract: A cellulose-containing composite contains 20-99% by weight of a fine cellulose and 1-80% by weight of at least one low-viscosity water-soluble dietary fiber selected from the group consisting of 1) a hydrolyzed gallactomannan, 2) an indigestible dextrin and 3) a mixture of a polydextrose and xanthan gum and/or gellan gum, wherein the total amount of gellan gum and xanthan gum is 0.1% by weight or more but less than 3% by weight of the composite, in which composite the average particle size of the fine cellulose is 30.mu.m or less when the composite is dispersed in water. Excerpt(s): The present invention relates to a cellulose-containing composite. More particularly, the present invention relates to a cellulose-containing composite which comprises a particular fine cellulose and a low-viscosity water-soluble dietary fiber and which is superior in feeling when taken into the mouth, and which is also superior in shape retainability, and fluidity when made into a liquid food, etc. and further in effects as dietary fiber or as oil and fat substitute. Cellulose has been used in foods for various purposes of, for example, imparting suspension stability, emulsion stability, shape retainability or cloudiness, or for adding dietary fiber. However, when cellulose is used alone as a stabilizer or the like, there have been cases that the addition effect is insufficient or the cellulose-added food gives slightly rough feeling to the tongue. Natural dietary fibers are ordinarily a composite of a water-insoluble dietary fiber and a water-soluble dietary fiber and these two kinds of dietary fibers differ in action in the intestinal tract. Therefore, the dietary fiber material used in food is preferred to be a combination of the above two kinds of dietary fibers. However, neither dietary fiber material nor combined dietary fiber material is currently available which has a low viscosity suitable for use in food, which has good feeling when taken into the mouth, and which has high stability. In JP-B-57-14771 is described a composite comprising a microcrystalline cellulose, a dispersing agent (a gum) and a disintegrating agent in particular proportions. The composite has a high viscosity depending upon the kind of gum used and, therefore, it has given paste-like viscous feeling when taken into the mouth, in some cases. For example, Avicel RC-591 (trade name) (a product of Asahi Chemical Industry Co., Ltd.), which is a commercially marketed crystalline cellulose preparation, comprises a microcrystalline cellulose and, as a dispersing agent, sodium carboxymethylcellulose and, when dispersed in water in a 3% concentration, gives a high viscosity of 1,200 mPa.multidot. Web site: http://www.delphion.com/details?pn=US06495190__

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Composition and method for improving clinical signs in animals with renal disease Inventor(s): Reinhart; Gregory A. (Dayton, OH), Sunvold; Gregory D. (Eaton, OH), Tetrick; Mark A. (Dayton, OH) Assignee(s): The Iams Company (Dayton, OH) Patent Number: 6,039,952 Date filed: October 21, 1998

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Abstract: A pet food composition is provided which improves several important clinical indicators in an animal suffering from renal disease and includes adequate protein, has low phosphorus levels, improves metabolic buffering, and lowers blood triglyceride levels in the animal. The animal is fed a composition which includes from about 10 to about 32% crude protein, from about 8 to about 20% fat, from about 3 to about 25% total dietary fiber, and fermentable fibers which have an organic matter disappearance of 15 to 60 percent when fermented by fecal bacteria for a 24 hour period, the fibers being present in amounts from about 1 to 11 weight percent of supplemental total dietary fiber. Excerpt(s): This invention relates to a pet food product and process for its use in improving clinical signs in animals suffering from renal disease. Renal failure is one of the most common causes of death in dogs. In animals which suffer from renal disease, several blood indices are used to determine the severity of the disease. These indices include blood urea nitrogen (BUN) and creatinine. BUN and creatinine levels in the bloodstream increase during the course of renal failure because damage to the kidney of the animal makes the kidney inadequate to filter waste products. Because inadequate filtration of waste products is the fundamental basis of renal disease, BUN and creatinine are considered the primary indicators of renal disease. Other clinical parameters which are important to the animal suffering from renal disease are phosphorus, carbon dioxide, and triglyceride levels. Hyperphosphatemia (abnormally high blood levels of phosphorus) often manifests itself during renal disease. Previous scientific research has indicated that lowering dietary intake of phosphorus is beneficial to lessening the progression of renal disease. However, prior commercial pet food formulations have been unable to provide low levels of dietary phosphorus and still meet all of the amino acid requirements of the canine because the phosphorus component of such diets is primarily derived from ingredients high in protein. Thus, lowering the phosphorus content of the diet required a lowering of the protein components in the diet to levels which are insufficient to supply the amino acid requirements of the animal. Web site: http://www.delphion.com/details?pn=US06039952__ •

Composition and method for repartitioning nitrogen and increasing colonic blood flow in dogs to promote intestinal health Inventor(s): Reinhart; Gregory Allen (Dayton, OH), Sunvold; Gregory Dean (Eaton, OH) Assignee(s): The Iams Company (Dayton, OH) Patent Number: 5,965,175 Date filed: March 27, 1997 Abstract: A pet food product and process for repartitioning nitrogen and increasing colonic blood flow in dogs is provided which involves feeding a dog a diet of a pet food composition containing fermentable fibers which have an organic matter disappearance of 15 to 60 percent when fermented by fecal bacteria for a 24 hour period, the fibers being present in amounts from about 1 to 11 weight percent of supplemental total dietary fiber. The dog is maintained on the diet for a sufficient period of time to allow the fermentable fibers to ferment in the colon of the dog. The fermentation results in an increased quantity of bacteria in the colon of the dog, resulting in increased nitrogen excretion through the feces of the dog.

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Excerpt(s): This invention relates to a pet food product for use in repartitioning nitrogen and increasing colonic blood flow in dogs to promote intestinal health, and more particularly to a process involving a pet food composition containing fermentable fibers. Many dogs suffer from poor health due to renal insufficiency. It is desirable to reduce the stress placed on the kidneys of dogs with this condition. One factor that contributes to such stress is nitrogen-containing metabolites in the blood. Nitrogen in the blood is primarily removed by the kidneys. Weakened kidneys can be overworked attempting to remove nitrogen from the blood, resulting in renal failure. Therefore, a need exists for a method of reducing the amount of nitrogen in the blood of dogs without using the kidneys. Web site: http://www.delphion.com/details?pn=US05965175__ •

Composition for limiting the assimilation of dietary fat and methods of making and using same Inventor(s): Segelman; Alvin Burton (Orem, UT) Assignee(s): Nature's Sunshine Products, Inc. (Provo, UT) Patent Number: 6,214,349 Date filed: January 28, 1999 Abstract: The present invention is an dietary supplement which inhibits the assimilation of dietary fat during digestion, and method of making and using the same. The composition includes surfactant and non-digestible dietary fiber. In a preferred embodiment of the invention, the composition further comprises an emulsifying agent. The composition may be taken before, during or after eating. Excerpt(s): A. Field of the Invention. This invention relates to the field of compositions for limiting the assimilation of dietary fat, and methods of making and using such compositions. More specifically, this invention relates to the field of compositions that inhibit dietary fat assimilation by physically entrapping the fat, and methods for making and using such compositions. B. Description of Related Art. Web site: http://www.delphion.com/details?pn=US06214349__

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Composition of nixtamilized maize dough for the production of maize pancakes Inventor(s): Celorio Garrido; Sergio Alejandro (Newton #7-401, Col. Polanco, MX) Assignee(s): none reported Patent Number: 6,268,008 Date filed: April 21, 2000 Abstract: A corn paste for making tortillas is disclosed, which comprises between ten to one-hundred grams of dietary fiber in one kilogram of corn paste that provides a suitable proportion of raw fiber that can fulfill the minimum dietary fiber requirements of the human body and with the appropriate organoleptic attributes, as well as commercially adequate minimum shelf life. Excerpt(s): This application claims benefit under 35 U.S. 371 of PCT/MX98/00033, filed Jul. 13, 1998. It is well known that the consumption of fiber in the diet is beneficial to human health. Since this discovery, the number of products containing large amounts of

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fiber has increased, and products with 100% fiber have been commonly made. From the point of view of digestion, dietary fiber stimulates the peristaltic movements of the digestive tract and improving the displacement through the tract. Also, fiber has the attribute of absorbing fat and reducing its assimilation. Web site: http://www.delphion.com/details?pn=US06268008__ •

Compositions of dietary fiber rich and low viscosity beverages Inventor(s): Troup; John P. (Wexford, PA), Wang; Linji (Pittsburgh, PA) Assignee(s): General Nutrition Corporation (Pittsburgh, PA) Patent Number: 6,004,610 Date filed: June 16, 1998 Abstract: The present invention is directed to compositions of a fiber blend and a fiber rich, low viscosity beverages. The fiber blend and fiber beverage are enriched with low viscosity fibers including both arabinogalactan and hydrolyzed guar gums. Excerpt(s): The present invention relates to dietary and nutritional supplements for human consumption and more particularly, beverages enriched with dietary fibers. Medical and nutrition studies in the past thirty years have established that dietary fiber is a necessary dietary element for good human health. Low intake of dietary fiber is associated with high incidents of several diseases including coronary heart disease, diabetes, obesity, and colon cancer. Dietary fiber is broadly divided into water soluble and water insoluble subgroups. Plant and fungi foods are major sources of dietary fiber. Dietary fiber functions as a gastrointestinal regulator in food digestion process. The modes of action of dietary fiber in the human gastrointestinal tract include providing mechanical distention through its water holding activity, stimulating bowel movement, slowing down the gastrointestinal transition and digestion process, modifying fat absorption, increasing bile acids excretion, and detoxicating toxic substances. Soluble dietary fibers are found to have cholesterol-lowering and leveling postprandial glycemic response effects in clinical studies. Average intake of dietary fiber in the United States is reported to be 13 grams per day per person. The USDA currently recommends that dietary fiber intake be 25 grams for people with a diet of 2,000 calories intake per day and 30 grams for people with a diet of 3,000 calories per day. In order to increase dietary fiber intake from 13 grams per day to 25 grams per day or even 30 grams per day, one would need to ingest an extra 12 grams to 17 grams of dietary fiber per day. Relying on vegetables, fruits and grains as the source of dietary fiber would requires at least double the consumption of these products per day. This approach would require a dramatic change of lifestyle, which appears to be difficult to accomplish in today's fast-paced society where most food items are highly processed for convenience and ease of preparation and consumption. In view of the desire for fast, convenient yet healthy foods, a practical approach for sufficient dietary fiber intake is to enrich processed food products with dietary fiber. It would therefore be advantageous to enrich the most frequently consumed convenient food items such as beverages, pastries and baked products with dietary fiber. Web site: http://www.delphion.com/details?pn=US06004610__

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Dietary fiber composition Inventor(s): Kaczmarczyk; Sabina W. (E. Main St., Somerville, NJ 08876) Assignee(s): none reported Patent Number: 5,919,513 Date filed: November 5, 1997 Abstract: A sucrose-free, artificial sweetener-free dietary fiber composition contains about 5 to about 95 percent methylcellulose by weight based on total weight of the composition, about 5 to about 75 percent natural coconut, and about 5 to about 75 percent banana. In some embodiments, about 20 to about 80 percent non-sucrose, nonartificial sweetener containing, inactive materials. The inactive materials include particulate filler materials, such as powered natural grains. In one preferred embodiment, the invention is a sucrose-free, non-allergenic dietary fiber composition, containing about 5 to about 95 percent methylcellulose, balance being about 5 to 75 percent natural coconut and about 5 to 75 percent banana, based on the total weight of the methylcellulose, the coconut and the banana. More preferably, there is about 5 to about 40 percent methylcellulose balance being natural coconut and banana in the preceding ranges. Excerpt(s): The present invention relates to dietary supplements for regularity, and more particularly, to substantially sucrose-free, artificial sweetener-free dietary compositions containing methylcellulose, coconut and banana. In one preferred composition, only non-allergenic constituents are used. U.S. Pat. No. 4,619,831 issued to Shri C. Sharma, on Oct. 28, 1986, describes a dietary fiber composition which is prepared by coating an insoluble fiber with a soluble fiber. The insoluble fiber is preferably derived from cereal bran by enzymatically and chemically purifying the bran. The soluble fiber is preferably pectin or an alginate. The dietary fiber composition can be used to prepare low calorie, high fiber content dietary food products. U.S. Pat. No. 5,073,370 issued to E. Harvey Meer et al, on Dec. 17, 1991, describes a natural fiber laxative that is provided which consists of psyllium husk, apple fiber, fructose, gum arabic and flavorants. The psyllium husk and the apple fiber constitute together at least 75% by weight of the composition. The granular components are controlled to have a particle size less than that determined by a No. 50 mesh, thereby improving mouthfeel. The composition is, in addition to being all natural, low in calorie and high in fiber and when mixed with water has a palatable mouthfeel. Web site: http://www.delphion.com/details?pn=US05919513__

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Fiber enriched foods Inventor(s): Onwulata; Charles I. (Cheltenham, PA) Assignee(s): The United States of America as represented by the Secretary of Agriculture (Washington, DC) Patent Number: 6,610,347 Date filed: December 20, 2000 Abstract: Disclosed is a dietary fiber composition produced by a process involving cooking a calcium caseinate or calcium caseinate and whey protein isolate slurry (containing no more than 50% whey protein isolate) in an evaporator to produce a slurry of cross-linked matrices of protein, adding dietary fiber to the slurry of cross-linked

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matrices of protein to form a mixture, and spray atomizing the mixture in a spray dryer to produce the dietary fiber composition. Also disclosed is a fiber enriched food product containing at least one food ingredient and the dietary fiber composition. Additionally, there is disclosed a method of making a fiber enriched food product involving mixing one or more food ingredients with the dietary fiber composition. Furthermore, there is disclosed a method of increasing fiber in the diet of a mammal involving feeding to the mammal the fiber enriched food product. Excerpt(s): The present invention relates to a dietary fiber composition produced by a process involving cooking a calcium caseinate or calcium caseinate and whey protein isolate slurry (containing no more than 50% whey protein isolate) in an evaporator to produce a slurry of cross-linked matrices of protein, adding dietary fiber to the slurry of cross-linked matrices of protein to form a mixture, and spray atomizing the mixture in a spray dryer to produce the dietary fiber composition. The present invention also concerns a fiber enriched food product containing at least one food ingredient and the dietary fiber composition. Additionally, the present invention also relates to a method of making a fiber enriched food product involving mixing the dietary fiber composition with one or more food ingredients. Furthermore, the present invention concerns a method of increasing fiber in the diet of a mammal involving feeding to the mammal the fiber enriched food product. As the reports of the health and nutraceutical benefits of consuming dietary fibers continue to grow, research is focused on increasing the amount, content and quality of fibers in human diet. Consumers as well as nutritionfocused professional organizations are demanding increased amounts of fiber in processed foods. The results of recent surveys of the amount of fiber consumed by Americans reveal that most consume less than 50% of the estimated desirable daily fiber intake. Current average fiber intake is estimated at about 12 g/day, but the American Dietetic Association recommends 20-35 g/day (J. Am. Dietetic Assoc., 93: 1446-1447 (1993)). It is desirable and beneficial to increase the amount of fiber in most prepared foods; however, there are considerable difficulties associated with increased levels of fiber in foods. Increasing the amount of fiber in prepared foods alters the textural properties (Vratanina, D. L., et al., J. Food Sci., 43(5): 1590-1594 (1978); Zhang, D., et al, J. Sci. Food Agric., 74:490-496 (1977); Cadden, A., J. Food Sci., 52(6):1595-1599, 1631 (1987)). Dietary fibers tend to absorb and withhold water from their surrounding environment, hence the water holding capacity is increased. When dietary fiber is incorporated into foods, it absorbs water from the other components, making the surrounding food components dry and brittle. Incorporating large amounts of unmodified fiber into food products destroys the natural cohesion and moistness of the products. When unmodified fiber is incorporated into baked foods there is a tendency to reduced volume. Unmodified fiber also can not be used in various foods such as drinks, yogurt or in pizzas. Overall, increasing the level of unmodified fiber in food products destroys textural integrity (Zhang, D., et al, J. Sci. Food Agric., 74: 490-496 (1977)). Web site: http://www.delphion.com/details?pn=US06610347__ •

Food grade starch resistant to.alpha.-amylase and method of preparing the same Inventor(s): Seib; Paul A. (Manhattan, KS), Woo; Kyungsoo (Manhattan, KS) Assignee(s): Kansas State University Research Foundation (Manhattan, KS) Patent Number: 5,855,946 Date filed: June 6, 1997

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Abstract: Chemically modified RS.sub.4 starches are provided which have a high degree of resistance to.alpha.-amylase digestion and can serve as low calorie food additives in products such as breads or crackers as a source of dietary fiber. The starches of the invention can be prepared from any type of starting starch (e.g., wheat, corn, oat, rice, tapioca, mung bean, potato or high amylose starches) and are preferably formed as phosphorylated distarch phosphodiesters. The preferred phosphorylating agent is a mixture of sodium trimetaphosphate (STMP) and sodium tripolyphosphate (STPP) in the presence of sodium chloride or sulfate. The starches are advantageously prepared in an aqueous slurry reaction at basic pH and moderate heating. Excerpt(s): The present invention is broadly concerned with chemically modified starches highly resistant to.alpha.-amylase digestion, food products containing such modified starches, and methods of forming the starches. More particularly, the invention pertains to such starches wherein the starches are of the RS.sub.4 variety and exhibit at least about 20% resistance to.alpha.-amylase digestion; these starches may be incorporated into yeast- or chemically-leavened food products, such as breads and crackers to provide a low calorie source of dietary fiber. The starches hereof are preferably prepared by cross-linking thereof using a multifunctional phosphorylating agent (e.g., sodium trimetaphosphate (STMP) or a mixture of STMP and sodium tripolyphosphate (STPP)). Starch serves as a food reserve in plants, and it is an important component in the human diet. The digestion of starch is mediated by salivary and pancreatic.alpha.-amylase, which catalyze the formation of maltose, maltotriose and dextrins. The latter products are further hydrolyzed to D-glucose in the brush border of the small intestines.alpha.-Amylases (MW 50,000-60,000 Daltons) are endo-acting enzymes that catalyze the hydrolysis of the.alpha.-1,4 bonds in the amylose and amylopectin molecules that comprise starch; they do not hydrolyze the.alpha.-1,6-bonds but can by-pass them. Glucoamylase and.alpha.-glucosidase are exo-acting enzymes that cleave both.alpha.-1,4 and.alpha.-1,6 linkages between D-glucose. In the early 1980's it became apparent that some starch resists digestion. Instead, it enters the colon where it is fermented by bacteria. The resistance of starch to digestion in the upper GI tract is recognized to depend on intrinsic factors, which include the physical state of a food and its preparation and storage, and on extrinsic factors, which are the physiological conditions influencing starch digestion. Starch entering the colon exerts a number of different physiological effects (see below) compared to just one in the upper gastrointestinal tract, namely production of D-glucose to provide energy. Web site: http://www.delphion.com/details?pn=US05855946__ •

High amylose starch and resistant starch fractions Inventor(s): Brown; Ian L (Tamworth, AU), Knight; Adrian Timothy (Lane Cove, AU), McNaught; Kenneth J (North Epping, AU), Moloney; Eric (Tamworth, AU) Assignee(s): Goodman Fielder Limited (New South Wales, AU) Patent Number: 6,409,840 Date filed: November 12, 1997 Abstract: Starch, particularly maize starch, having an amylose content of more than 80% w/w, including physically or chemically modified derivatives thereof, and destructurized and non-destructurized forms thereof. Also, disclosed are hybrid maize seeds capable of producing a starch having an amylose content of more than 80%. Also disclosed are starch fractions of enhanced dietary fiber and/or resistant starch content.

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Excerpt(s): This invention relates to high amylose content starch, in particular to a maize starch having an amylose content of more than 80% w/w. The invention further relates to single, double and multiple cross maize hybrids, particularly to a maize single cross F1 hybrid, capable of producing grain having such a high amylose content and to this grain. The invention still further relates to fractions of high amylose starch that are enriched in dietary fibre and resistant starch content whilst claiming a high amylose content. Most common starches contain approximately 25% amylose and 75% amylopectin. Amylose is a linear glucose polymer fraction, whilst amylopectin is a branched glucose polymer fraction. Web site: http://www.delphion.com/details?pn=US06409840__ •

Method for enriching soluble dietary fibre Inventor(s): Malkki; Yrjo (Espoo, FI), Myllymaki; Olavi (Espoo, FI) Assignee(s): Exavena OY (Espoo, FI) Patent Number: 5,846,590 Date filed: December 4, 1995 Abstract: The subject of this invention is a method for producing a product with an enriched content of soluble dietary fiber, such as.beta.-glucan and/or pentosans from a raw material deriving from cereal grains, by using thermal, enzymatic or osmotic treatments or combinations of these. As a first step, suspending of milled cereal or a fraction of cereal in water and when needed, a limited proteolysis is performed in order to improve the solubility of the fiber. Temperature of the mixture is elevated, and the soluble fiber is precipitated with a polar organic solvent on solid carrier particles, which can derive from the raw material or are added in the suspension. A fine fraction, consisting primarily of starch, is separated from the more coarse fraction containing the precipitated fiber, by using methods based on the particle size or density. When processing materials rich in fat, the soluble fiber fraction is extracted with a concentrated polar organic solvent for removing the residual lipids, and the particles obtained are finally dried. Excerpt(s): The subject of this invention is a method for preparing concentrates of soluble dietary fibre, such as.beta.-glucan, and/or pentosans, from a raw material deriving from cereal grains. In particular, according to the invention, preparations rich in.beta.-glucan, which expression is used for.beta.- (1.fwdarw.3) (1.fwdarw.4) D-glucan, or pentosans, are made from grains of oat, barley or rye, which preparations dissolve rapidly in water and elevate the viscosity of the solutions and act as water binding agents in the digestive tract or in food preparations.beta.-Glucan acts in the human digestive tract as a soluble fibre component and functions in particular as a reducer of the cholesterol content of blood, and by attenuating fluctuations in postprandial blood glucose concentration. Both of these effects are based on the increase of viscosity in the contents of the stomach and intestines. In addition, the viscosity elevating and binding properties of.beta.-glucan can potentially be exploited in several technological applications.beta.-Glucan has been found plentifully in grains of barley, oats and rye. Preparation of pure or nearly pure.beta.-glucan from cereal grains in laboratory scale is known from several patent and scientific publications, and has been reviewed e.g. in the Finnish patent No. 84775 and conforming European patent application No 379499 of the inventors of the present invention. Methods for preparing products with an enriched content of.beta.-glucan have been reviewed by Paton and Lenz in 1993 in the book Oat Bran, published by the American Association of Cereal Chemists. There exist also

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several barley cultivar varieties where the content of.beta.-glucan is already in the grains as high as in the oat bran concentrates, that is from 14 to 17%. Web site: http://www.delphion.com/details?pn=US05846590__ •

Method for preparing an extract of active principles in the form of microgranules based on dietary fibers Inventor(s): Cingotti; Dominique (Villeurbanne, FR) Assignee(s): Vegetalys Corporation (Tortola, VG) Patent Number: 6,190,687 Date filed: January 18, 2000 Abstract: A method of preparing an extract of at least one active principle in the form of completely dry soluble granules wherein an extract of an active principle is prepared in a solvent medium and depositing the extract upon the internal and external walls of microporous carriers that are insoluble in the solvent, drying the impregnated granules, and coating the walls of the granules with a film forming polymer. The granules are a soluble dietary fiber based upon a polymer selected from the group comprising inulin and oligofructoses and, fructo-oligosaccharides separately or mixed. Excerpt(s): The invention relates to a new method for preparing completely soluble microgranules prepared from extracts or solutions of active principles; these microgranules are intended to be used as they are for the reconstitution of solutions or to be incorporated into various galenic forms. The production, in dry form, of these different extracts of active principles involves, for the majority, methods using a substantial supply of heat; nebulization-spray-drying, evaporation under vacuum or otherwise, recovery from grinding or micronization, these various operations being capable of causing substantial adverse modifications. The dry forms of these various extracts which are thus obtained are subjected to adverse modifications of active principles which are linked to high hygroscopicity due to the increases in specific surface area induced by the physical treatments cited. There has for example been proposed in the document EP-A-0,524,484 a powder for preparing instant drinks which is obtained by aqueous dissolution of tea extracts and of an inulin carrier, the mixture then being dried, and then spray-dried. Web site: http://www.delphion.com/details?pn=US06190687__

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Method for removing nitrogenous waste products from animals with hepatic disease Inventor(s): Reinhart; Gregory A. (Dayton, OH), Sunvold; Gregory Dean (Eaton, OH), Tetrick; Mark A. (Dayton, OH) Assignee(s): The Iams Company (Dayton, OH) Patent Number: 6,093,418 Date filed: September 16, 1998 Abstract: A process for removing nitrogenous wastes from animals with hepatic disease is provided and includes the steps of feeding an animal a diet consisting essentially of a pet food composition containing fermentable fibers which have an organic matter disappearance of from about 15 to about 60 percent when fermented by fecal bacteria for a 24 hour period, said fibers being present in amounts from about 1 to about 11 percent

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by weight of supplemental total dietary fiber, and maintaining the animal on that diet for a sufficient period of time to allow the fermentable fibers to ferment in the colon of the animal to enhance bacterial activity and provide an acidic environment in said colon for trapping the nitrogenous wastes for excretion through the feces of the animal. Excerpt(s): This invention relates to a pet food composition and process for removing nitrogenous wastes from the blood of companion animals, such as dogs and cats, with hepatic disease, and more particularly to such a process involving the use of a pet food composition containing fermentable fibers. In animals suffering from liver (hepatic) disease, the ability of the liver to convert ammonia to urea is compromised, and blood levels of ammonia build up causing hyperammonemia. Ammonia is a principal breakdown product of amino acids in the liver. Amino acids can be derived from the breakdown of body protein (muscle, organs, etc.) as well as dietary protein. Liver disease is clinically evident by the detection of abnormally high levels of ammonia in the blood. High blood ammonia levels are thought to contribute to the encephalopathy or loss of mental function, lethargy, and disorientation associated with hepatic disease. High blood ammonia levels also result in increased respiration, nausea, and vomiting in the affected animal. Dietary means to control blood ammonia levels would be of benefit in helping the animal deal with this life threatening disease. Current therapies for liver disease include severe side effects to the animal. One therapy involves the use of antibiotics to virtually sterilize the intestinal environment. This is done to eliminate bacterial generation of ammonia and other toxins. The major side effect of this therapy is that beneficial intestinal bacteria in the animal are also killed. The beneficial bacteria are important to a healthy intestine because they produce an energy source for the intestine, produce vitamins, enhance immunity, and prevent pathogen overgrowth. Another therapy involves the use of lactulose, a laxative agent. A severe side effect of lactulose is excessive diarrhea. A third therapy involves feeding the animal a diet which severely restricts the animal's intake of protein. However, such low protein diets result in muscle catabolism and decreased immune function in the animal. Thus, these current therapies are less than ideal for treating liver disease. Web site: http://www.delphion.com/details?pn=US06093418__ •

Method for the production of a reduced calorie honey composition Inventor(s): Hammond; Neal A. (Baton Rouge, LA) Assignee(s): T. W. Burleson & Son (Waxahachie, TX) Patent Number: 6,162,484 Date filed: October 30, 1991 Abstract: Low-sugar dietetic or diabetic honey compositions and method of production are described. Honey compositions containing approximately less than 25% sugar are produced by extending natural honey with extender molecules selected from oligosaccharides, polyols, and dietary fiber which are not metabolized or are slowly metabolized in the human digestive system. Excerpt(s): This invention relates to a low glucose honey and its method of production. Honey is a natural product derived from the digestive conversion of flower nectar to simple sugars by the common honey bee. Honey is composed of glucose, fructose, water, minerals, organic acids, and a small amount of proteinaceous material. Natural honey is comprised of multiple nutrients including carbohydrates, proteins, vitamins and minerals. Honey is comprised of approximately 38.5% fructose and 31.0% glucose.

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Web site: http://www.delphion.com/details?pn=US06162484__ •

Method of bleaching cereal grain Inventor(s): Metzger; Lloyd E. (Champlin, MN) Assignee(s): General Mills, Inc. (Minneapolis, MN) Patent Number: 6,497,909 Date filed: September 9, 1999 Abstract: The present invention describes bleached grain products, such as bleached whole wheat flour, that are obtained having the color and taste of white flour by bleaching whole wheat kernels prior to conventional flour milling. The wheat kernels are treated with a peroxide solution to lighten the color of the bran layers. The bleached grain kernels can be tempered and milled into whole grain flours having 10% to 12% dietary fiber. Excerpt(s): The present invention relates to food products and to methods for their preparation. More particularly, the present invention is directed towards bleached grain products such as whole wheat flour, to bleached grain intermediate products such as bleached wheat kernels and to their methods of preparation. The present invention provides improvements in the processing or treatment of grains such as wheat. More particularly, the present invention is directed towards the provision of whole grain flour such as whole wheat with the color and taste comparable to white flour or a "white" whole wheat flour. Also, the present invention provides methods for preparing such improved white whole wheat flour and further to intermediate products useful in the production of such improved finished products as white whole wheat flour. Such intermediate products include, for example, bleached grain kernels such as bleached wheat kernels. Most consumers have experienced and readily recognize the difference between whole wheat bread and ordinary white bread. Most consumers also know that whole wheat bread is more nutritious, but consume white bread anyway, because they like the taste better. This is especially true of children who can be particularly selective in food choices. Web site: http://www.delphion.com/details?pn=US06497909__

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Method of extraction of commercially valuable fractions of fenugreek Inventor(s): Chang; Peter (Saskatoon, CA) Assignee(s): Emerald Seed Products Ltd. (Saskatchewan, CA) Patent Number: 5,997,877 Date filed: November 25, 1998 Abstract: A process for the fractionation of fenugreek seeds (Trigonelle foenumgraecum) and extraction of the various fractions thereof. The process has a high yield rate, and provides a number of high-quality fractions of the fenugreek seed including a soluble dietary fiber fraction, de-flavored fenugreek seed, high-protein fenugreek meal, and dioscin and other saponins, along with the fenugreek oleoresins which have conventional commercial use. Excerpt(s): This invention is in the field of methods of extraction and purification of various commercially useful fractions of seeds, and in particular deals with the

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fractionation of fenugreek. Fenugreek (Trigonella foenum-graecum) has attracted considerable interest as a natural source of soluble dietary fiber and diosgenin (sapogenins). The fenugreek seed contains a central hard, yellow embryo surrounded by a corneous and comparatively large layer of white, semi-transparent endosperm. This endosperm contains galactomannan gum. The endosperm is surrounded by a tenacious, dark brown husk. The color of the gum fraction depends upon the amount of outer husk (brown color) and cotyledon (yellow color) present. There are commercial uses for the various fractions of the fenugreek seed. The commercial fenugreek oleoresins are used as an ingredient for imitation maple flavors and is effective in butter, butterscotch, black walnut, nut and spice flavors. Another fraction of the fenaugreek seed has been found to be a quantity of saponins. Fenugreek seed saponins are steriodal in nature with diosgenin as the main sapogenin. Disogenin is used by the drug industry as a precursor to progesterone (steriod hormones) which is used in the manufacturing of oral contraceptives. Web site: http://www.delphion.com/details?pn=US05997877__ •

Method of using immunoglobulin and fiber-containing compositions for human health Inventor(s): Paul; Stephen M. (San Clemente, CA) Assignee(s): Metagenics, Inc. (San Clemente, CA) Patent Number: 6,180,099 Date filed: April 17, 1998 Abstract: A composition for restoring and maintaining gastrointestinal health comprises 40-60% by weight of an immunoglobulin composition comprising concentrated immunologically active immunoglobulins and 40-60% by weight of soluble dietary fiber selected from inulin, fructo-oligosaccharides, pectin, guar gum, and mixtures thereof. The immunoglobulin and fiber-containing composition can optionally contain one or more of a beneficial human intestinal microorganism, components of a non-immune natural defense system, an iron-sequestering molecule, and gluconic acid. Preferred beneficial human intestinal microorganisms include lactobacilli and bifidobacteria. The immunologically active immunoglobulins are preferably purified from bovine milk, milk products, or whey. Methods of use are also described. Excerpt(s): This invention relates to an immunoglobulin and fiber-containing composition and methods of use thereof for promoting gastrointestinal health. More particularly, the invention relates to a composition comprising an immunoglobulin preparation containing immunoglobulins that are capable of binding and inactivating foreign antigens such as pathogenic bacteria, viruses, fungi, and protozoa that are detrimental to gastrointestinal health; soluble dietary fiber that provides the advantages typically offered by dietary fibers with the additional advantages of not affecting blood glucose or insulin levels, being readily fermented by the intestinal microflora and promoting growth of certain beneficial intestinal microorganisms; and optionally one or more of the following: living intestinal bacteria that are beneficial for gastrointestinal health, lactoperoxidase and/or thiocyanate for strengthening a natural non-immune defense system, lactoferrin for inhibiting detrimental iron-catalyzed processes and harmful microorganisms, and gluconic acid for inhibiting growth of harmful bacteria and stimulating immune function. Since the time of Hypocrites and throughout the Middle Ages, large doses of whey were prescribed by alchemists for treating many ailments, primarily acute septic conditions. Although it was not then known the reason

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that whey was useful for treating such conditions, recent studies have shown that whey contains antibodies or immunoglobulins capable of providing passive immunity against various pathogens and their toxic by-products. Antibodies or immunoglobulins are high mblecular weight proteins produced in the bodies of mature animals that enhance immunity to infection by bacteria, viruses, fungi, protozoa, and the like. Antibodies in human and bovine milk promote development of a healthy gastrointestinal tract and provide protection against infections by pathogenic microorganisms. These antibodies interfere with the process that allows such pathogenic microorganisms to adhere to and colonize the intestinal lining. Studies have shown that immunoglobulins from whey are particularly effective against viruses (e.g., rotavirus), bacteria (e.g., E. coli, Vibrio cholerae, Salmonella), fungi (e.g., Candida), and protozoa (e.g., Cryptosporidium). Detectable levels of anti-rotavirus antibodies (IgG.sub.1) have been found in raw and pasteurized milk. R. H. Yolken, Antibody to Human Rotavirus in Cow's Milk, 312 New Eng. J. Med. 605 (1985). The high temperatures used in processing infant formula, however, destroy all traces of naturally occurring IgG.sub.1. Many infants develop gastroenteritis around 6 months of age, about the time they are weaned from breast milk and started on formula. Web site: http://www.delphion.com/details?pn=US06180099__ •

Milled cereal by-product which is an additive for increasing total dietary fiber Inventor(s): Burianek; Mark D. (Greenwood, IN), Delrue; Rita M. (Minnetonka, MN), Sheehan; Steve T. (Fishers, IN), Valle; Sergio (Indianapolis, IN), Xenides; Carol J. (Indianapolis, IN) Assignee(s): Cargill, Incorporated (Minneapolis, MN) Patent Number: 6,610,349 Date filed: June 2, 2000 Abstract: The present invention provides a high fiber additive composition which is a by-product of milling processes wherein the high fiber additive enhances the fiber content of a variety of products including flour, yoghurts, beverages, baking items, snack foods such as pretzels, cereal products such as breakfast cereals, and salsa. The additive is provided from a high fiber, low starch source of plant material. Excerpt(s): The present invention generally relates to an additive composition effective for increasing total dietary fiber in a wide variety of food products. For the preparation of refined foods, cereal grain is usually subjected to a milling process. In these processes, the hulls (bran) and germ, which are the structures rich in minerals and vitamins, are more or less completely removed. Refined mill products, such as masa flour, consist chiefly of the endosperm. Portions of the corn kernel removed from the endosperm, such as the hulls or bran, are considered to be waste by-products which are often put into animal feed. Pericarp: The maize kernel is covered by a water-impermeable cuticle. The pericarp (hull or bran) is the mature ovary wall which is beneath the cuticle, and comprises all the outer cell layers down to the seed coat. It is high in non-starchpolysaccharides, such as cellulose and pentosans. {A pentosan is a complex carbohydrate present in many plant tissues, particularly brans, characterized by hydrolysis to give five-carbon-atom monosaccharides [pentoses]. It is any member of a group of pentose polysaccharides having the formula (C.sub.5 H.sub.8 O.sub.4).sub.n found in various foods and plant juices.} Because of its high fiber content, the pericarp is tough.

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Web site: http://www.delphion.com/details?pn=US06610349__ •

Morinda citrifolia dietary fiber and method Inventor(s): Jensen; C. Jarakae (Cedar Hills, UT), Story; Stephen P. (Alpine, UT), Wadsworth; John J. (Orem, UT) Assignee(s): Morinda, Inc. (Provo, UT) Patent Number: 6,254,913 Date filed: August 27, 1999 Abstract: A dietary fiber product obtained from the Indian mulberry (Morinda citrifolia) plant and the process of extracting and purifying the fiber is disclosed. According to one embodiment, the Indian mulberry pulp is washed and separated from the juice by filtration. The wet pulp is pasteurized. The wet pulp can be further processed by drying. A high fiber products can be prepared by mixing the pulp with ingredients, such as supplemental dietary fiber, water, sweeteners, flavoring agents, coloring agents, and nutritional ingredients. Excerpt(s): The present invention relates to dietary fiber obtained from the Morinda citrifolia plant and to the process of extracting and purifying the fiber. The Indian Mulberry plant, known scientifically as Morinda citrifolia L., is a shrub, or small or medium sized tree 3 to 10 meters high. It grows in tropical coastal regions around the world. The plant grows randomly in the wild, and it has been cultivated in plantations and small individual growing plots. The Indian mulberry plant has somewhat rounded branches and evergreen, opposite (or spuriously alternate), dark, glossy, wavy, prominently-veined leaves. The leaves are broadly elliptic to oblong, pointed at both ends, 10-30 cm in length and 5-15 cm wide. The Indian mulberry flowers are small, white, 3 to 5 lobed, tubular, fragrant, and about 1.25 cm long. The flowers develop into compound fruits composed of many small drupes fused into an ovoid, ellipsoid or roundish, lumpy body, 5-10 cm long, 5-7 cm thick, with waxy, white or greenish-white or yellowish, semi-translucent skin. The fruit contains "eyes" on its surface, similar to a potato. The fruit is juicy, bitter, dull-yellow or yellowish-white, and contains numerous red-brown, hard, oblong-triangular, winged, 2-celled stones, each containing about 4 seeds. Web site: http://www.delphion.com/details?pn=US06254913__

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Nuritional formula containing hydrolyzed protein and a fiber blend Inventor(s): Berk; David F. (Columbus, OH), Breen; Merlin D. (Westerville, OH), Chmura; James N. (Canal Winchester, OH), Huston; Todd A. (Columbus, OH), Malone; William T. (Columbus, OH), Ostrom; Karin M. (Reynoldsburg, OH) Assignee(s): Abbott Laboratories (Abbott Park, IL) Patent Number: 6,017,550 Date filed: April 14, 1998 Abstract: The use of fiber to control infantile colic and diarrhea and adult constipation and diarrhea is well accepted. This invention is specifically directed to liquid nutritional formulas which contain hydrolyzed protein and/or amino acids and dietary fiber. This invention overcomes the problems of product physical stability and high viscosities

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through the use of soluble/non-fermentable fibers in combination with a blend of insoluble/non-fermentable and soluble/fermentable fibers. The invention is also directed to the use of physiologically effective levels of fibers in nutritional products that use hydrolyzed protein and/or free amino acids for the source of amino nitrogen to treat colic, diarrhea, short gut syndrome and other gastrointestinal maladies. Excerpt(s): The present invention generally relates to liquid nutritional products that contain fiber, and more particularly, to infant formulas with hydrolyzed protein which contain a fiber blend that is useful in the management of infantile colic. The invention also relates to medical nutritional products that contain hydrolyzed protein and/or amino acids, and high levels of total dietary fiber that are useful in the management of diarrhea and other maladies. Fiber is an important component in the treatment of humans with colic, diarrhea, short gut syndrome, impaired bowel function, Chron's disease, gastrointestinal intolerance and malabsorption. Colic is one of the most confusing subjects facing pediatrics today. In the absence of a standard definition of "colic," it is difficult to compare one study on "colicky infants" with another. Furthermore, given the absence of a standard definition, studies assessing the causes and/or management of colic undoubtedly involve a heterogeneous group of infants with both a variety of problems as well as no problems at all. Web site: http://www.delphion.com/details?pn=US06017550__ •

Pectinase from Saccharomyces bayanus Inventor(s): Uchida; Setsuko (Yokohama, JP), Watabe; Satoshi (Yokohama, JP) Assignee(s): Japan Tobacco Inc. (Tokyo, JP) Patent Number: 5,807,727 Date filed: June 2, 1995 Abstract: A pectinase for degradation a pectin or pectic acid is disclosed wherein(1) the novel pectinase is an endopolygalacturonase produced from a, Saccharomyces bayanus,(2) the optimal pH is 4.0,(3) the stable pH range is 4.0 to 8.0,(4) the optimal temperature is 45.degree. C.,(5) the enzymatic activity is stable up to 45.degree. C., and(6) the molecular weight is 38,000. A low-molecular pectin having a low viscosity and a high solubility and maintaining the physiological activity as the dietary fiber, and food and drink each of which contains 0.01 to 50 wt % of the low molecular pectin are also disclosed. Excerpt(s): The present invention relates to a novel pectinase capable of degrading a pectin into a low-molecular pectin having a molecular weight of 20,000 to 80,000. The present invention also relates to a low-molecular pectin converted from a pectin while the physiological activity of the pectin as a dietary fiber is maintained, and food and drink which contain the low-molecular pectin. Dietary fibers are defined as hard digestive components in foodstuffs which cannot be digested by human digestive enzymes. The dietary fibers include non-digestive organic materials such as chitin and chitosan in addition to plant cell wall components such as cellulose, lignin, and pectin. In recent years, these dietary fibers are found to have various activities such as a defecation improving effect and an activity of reducing the cholesterol content of blood and to play an important role in preventing diseases of adult people. Of these dietary fibers, pectic substances such as a pectin and pectic acid have a strong activity as the dietary fibers. Various effects such as a defecation improving effect, an effect of repressing the level of the cholesterol content of blood, an effect of repressing formation

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of gallstones, and a hypertensive repression effect have been reported. Conventionally, pectic substances have been used as stabilizers in jams, fruit jellies, yoghurt drinks, and lactic acid beverages in food industries. Since the pectic substances have the above effects, they are expected as dietary fibers to be added in food and drink. Web site: http://www.delphion.com/details?pn=US05807727__ •

Prediction of total dietary fiber in cereal products using near-infrared reflectance spectroscopy Inventor(s): Barton; Franklin E. (Bogart, GA), Kays; Sandra E (Athens, GA), Windham; William R (Watkinsville, GA) Assignee(s): The United States of America as represented by the Secretary of (Washington, DC) Patent Number: 6,114,699 Date filed: November 26, 1997 Abstract: Near-infrared spectroscopic calibration models are developed for the rapid, accurate and non-polluting prediction of the total dietary fiber content in a wide range of cereal products, including mixed grain products, products with high sugar content, products with high crystal sugar content, products with high fat content, and cereal products with high sugar and high fat content. Excerpt(s): Near-infrared spectroscopic calibration models are developed for the rapid, clean and reliable prediction of the total dietary fiber content in a wide range of cereal products, including mixed grain products and cereal products with high sugar content, high crystal sugar content, high fat content, and high sugar and fat content. The medical and nutritional communities have long recognized the health benefits of a high fiber diet. For many years Americans have been encouraged to increase their consumption of high fiber foods such as vegetables, fruits and whole grain cereal products. To help consumers to make informed and healthful food choices, the Nutrition Labeling and Education Act (NLEA) was created in 1990. This legislation requires that the amount of total dietary fiber present in a product be included on the nutrition label (Code of Federal Regulations, FDA, HHS; 21 CFR.sctn.101.9, 1995). The method currently in use in the United States, Canada, and many European countries for dietary fiber content analysis for nutrition labeling is the AOAC enzymatic-gravimetric total dietary fiber method (AOAC Official Methods of Analysis, 15.sup.th Ed., "Total Dietary Fiber in Foods: Method"; AOAC: Arlington, Va. 1990 and 1992). The AOAC method has been used with consistent results, over time, and on a wide variety of food products, grains, and fresh fruits and vegetables. However, it is a very time consuming "wet technique" (taking 2-3 days), expensive, and labor intensive. A more rapid method is needed to help industries comply with the NLEA and to help regulatory agencies efficiently monitor industry compliance. Web site: http://www.delphion.com/details?pn=US06114699__

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Prepackaged therapeutic meal for treatment of diet-responsive conditions Inventor(s): Bangs; William E. (Philadelphia, PA), Dibenedetto; Joseph D. (Roebling, NJ), Friedberg; Joyce L. (Robbinsville, NJ), Giordano; Denise A. (Jackson, NJ), Glover; Judy M. (Marlton, NJ), Khoo; Chor San Heng (Mt. Laurel, NJ), Ko; Sandy (Abington, PA), MacNair; R. David C. (King of Prussia, PA), Noar; Scott R. (Cherry Hill, NJ), Randazzi, Jr.; John J. (Sicklerville, NJ), Stoever; Harro (Greenwich, CT), Ziegler; Paula J. (Cherry Hill, NJ) Assignee(s): Campbell Soup Company (Camden, NJ) Patent Number: 6,039,989 Date filed: June 6, 1995 Abstract: The invention is a prepackaged therapeutic meal for administration to a patient having at least one diet-responsive condition. The meal includes a plurality of separate meal components. At least one of the meal components contains a predetermined level of nutritional enhancement. The nutritionally enhanced meal component may be selected from the group consisting of meats, baked goods, sauces, starch sources, cereals, soups, desserts, and fruit juice beverages. In particular, the component supplies dietary fiber in the range of up to about 10 grams; vitamins and minerals at a range of at least about 5 to 35% USRDA; sodium in an amount less than about 2400 mg; potassium in an amount less than about 3500 mg; protein, such that up to about 30% of caloric intake is derived from protein; and fat, such that up to about 20% of caloric intake derived from fat. Consumption of a daily diet including at least three of the meals supplies the patient with a desired total daily caloric content, improved quality of life, and sufficient nutritional enhancement to facilitate management of the diet-responsive condition. Excerpt(s): This invention relates generally to therapeutic systems and methods for dietary health management, i.e., the prevention, treatment, or reduction of risk factors associated with diet-responsive conditions, or a combination thereof. In particular, it relates to systems providing a choice of prepackaged, easy to prepare, and good tasting, therapeutic meals which are intended to improve the health and quality of life of patients utilizing the system. Further, it relates to the fortification of meals and food products for use with such a system. As confirmed by clinical trials, the systems and methods disclosed herein achieve improvements in quantifiable indicators of dietresponsive conditions, improved quality of life, and a high degree of compliance. People have become increasingly aware of the importance of a proper diet for health maintenance and disease prevention and treatment. Unfortunately, because numerous different and often conflicting dietary guidelines are presented in such complex manners, it is often very difficult for a person attempting to follow a diet for health and disease management (hereinafter a "patient") to understand and fully and effectively implement a healthy diet. For example, a diet which maximizes health and disease management concerns might control the intake of simple sugars, cholesterol, and different quantities and types of fat, as well as calories, while also attempting to optimize levels of macro- and micronutrients, e.g., protein, carbohydrates, and fat, and vitamins and minerals, and to provide adequate dietary fiber. As suggested above, however, the problem of planning and maintaining a healthful diet goes beyond the usual health concerns and exists with respect to special diet situations, including those associated with diet-responsive conditions, such as cardiovascular disease (hypertension and hyperlipidemia), diabetes and cancer. Diet planning assistance available to patients has been of limited value and often fails to satisfy long term compliance. Much additional planning has been left in the hands of patients who usually lack sufficient

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knowledge in the field of nutrition to fully and properly implement an adequate diet plan as part of a system or method for health management. More specifically, prior approaches to the planning and maintenance of a patient's diet have supplied the patient with general food and beverage categories to be consumed or avoided: for example, meat, eggs, and fish; fruits and vegetables; breads and cereals; and dairy products. Such approaches generally fail to achieve their desired goal, however, because patients do not consume general food and beverage categories; instead, they consume complex meals composed of specific foods and beverages. Even within these broad categories, specific foods and beverages are so diverse that it is often difficult for patients to convert the broad categories into meals, i.e., to plan, actual diets, while still maintaining adequate consumption of protein, carbohydrates, fat, sugars, cholesterol, fiber and other macro- and micronutrients meeting the dietary guidelines. Web site: http://www.delphion.com/details?pn=US06039989__ •

Preparation of fiber, L-glutamine and a soy derivative for the purpose of enhancement of isoflavone bioavailability Inventor(s): Hsu; Charles C. (Long Beach, CA), Hu; Qing-Fu (Laguna Niguel, CA), Paul; Stephen M. (Rancho Santa Margarita, CA), See; Melissa (Long Beach, CA), Shu; Daniel (Laguna Niguel, CA) Assignee(s): Sun Ten Laboratories, Inc. (Irvine, CA) Patent Number: 6,375,994 Date filed: August 18, 2000 Abstract: A composition for improving isoflavone metabolism and the bioavailability of phytoestrogens in warm blooded animals comprising a phytoestrogen, a dietary fiber, L-glutamine, and optionally N-acetyl-D-glucosamine, in admixture with a biologically acceptable inert carrier. Excerpt(s): This invention relates to nutritional supplements. More particularly, the invention relates to a nutritional supplement composition, and methods of use thereof, to enhance the bioavailability of isoflavone. Nearly 70 years ago, it was reported that certain plants could induce estrus in animals. Subsequently, over 300 plants have been found to possess estrogenic activity (see e.g., Bradbury and White, Vitamin Horm. 12:207 (1954), and Farnsworth et al., J. Pharm. Sci. 64:717(1954)). These compounds have been given the general name of "phytoestrogens" and represent several chemical classes of diphenolic plant compounds that are somewhat related structurally to the mammalian sex hormone 17-beta-estradiol. See Setchell, K. D. R., et al Am. J. Clin. Nutr., 40:569 to 578 (1984). Similarities in the molecular structure of phytoestrogens facilitate binding to the estrogen receptor. An important class of the phytoestrogens is the isoflavone class. Two chemical classes of phytoestrogens are abundant in soybeans, total soy products, and soy protein isolates. Those two classes are coumestrol and isoflavones. The latter class includes daidzein, genistein, glycitein, as well as their glycoside and acetylated forms. Phytoestrogens and their metabolites interact with specific cell receptors and compete with endogenous hormone molecules [see Folman, Y. et al, J. Endocr., 44:213 to 218 (1969)], but the biological estrogen-like effect of these compounds is relatively weak. See Kaziro, R. et al, J. Endocr., 103:395 to 399 (1984) and Tang, B. Y. et al, J. Endocr. 85:291 to 297 (1980). Phytoestrogens can induce two different effects in an organism. When the level of endogenous sex hormones is relatively high, the antiestrogenic effect prevails. There are several mechanisms of antiestrogenic activity of the phytoestrogens, including feedback inhibition at the hypothalamus and

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pituitary gland, and competition and blockade of cell receptors. It has been observed that a phytoestrogen and lignan-rich diet is associated with a reduction in free plasma estradiol, and in reduction of the risk of breast cancer. See Adlercreutz, H. et al, J. Steroid. Biochem., 27:1135 to 1144 (1987) and Mousavi, Y. et al, Steroids, 58:301 to 304 (1993). On the other hand, in postmenopausal women, phytoestrogens can provoke an estrogenic response. See Adlercruetz, H. et al, Lancet, 339:1233 (1992). This dual effect of weak estrogens is demonstrated, and well known "partial" antigens such as Tamoxifen have these properties. Web site: http://www.delphion.com/details?pn=US06375994__ •

Preservative for digestible food and beverage products Inventor(s): Bendiner; Bernard (Michigan City, IN) Assignee(s): Preservation Products, Inc. (Michigan City, IN) Patent Number: 6,103,294 Date filed: June 19, 1998 Abstract: A process for producing cellulose pulp and a filtrate of cellulose pulp that functions as a preservative for digestible food products that are intended for human and animal consumption. In the emulsification process wax paper, water, preservative potassium sorbate and the surfactant hydroxylated lecithin are heated and blended. The cellulose pulp is filtered through a filter having openings of about 2 micrometers. The cellulose pulp acts as a preservative when used with food products such as dietary fiber, a caking agent used in the dairy industry to prevent caking and clumping of graded cheese, dry seasoning and spiced soups. The cellulose pulp can also be used to improves the flowability of products which enhances their performance in packaging. The filtrate can be used as a water base for food products and acts to preserve the food product. Also fresh fruits and vegetables can be washed with the filtrate which increases the time that they can be stored without refrigeration. Excerpt(s): This invention relates to a preservative for digestible food products that is made from substances that are currently used in food products and generally recognized as safe. The base ingredient of this preservative is cellulose which is an indigestible carbohydrate composed of carbon, hydrogen and oxygen. The chemical terminology for this natural polymer is beta-1,4-glucan. Due to the atomic arrangements at its glycosidic bonds, the bonds linking the basic units, cellulose is insoluble in water. For all practical purposes, cellulose is considered non-caloric and is considered a GRAS (generally recognized as safe) substance by the FDA. Cellulose is the principal structural component of plants and is the most abundant source of complex carbohydrates in the world. To obtain pure cellulose, this component is progressively extracted and purified from plants. During the entire extraction process, the cellulose is not dissolved. Therefore, it exists in a naturally fibrous form and exhibits characteristics common to all fibers. The length of cellulose fibers is dependent upon the extraction process, while the typical width (diameter) of cellulose fiber is approximately 15-25 microns. Powdered cellulose is currently used in the food industry as a high fiber source and/or a noncaloric bulking agent. Most paper is made from plant fiber, most often wood, in a process that separates the cellulose from the other plant fiber material. Cellulose is the major constituent of plant fibers. Carbohydrates, including cellulose are convertible into glucose by hydrolysis, a chemical process of decomposition. Under appropriate conditions the bacteria present in the paper making process contribute to and hasten decomposition. As a result, when cellulose pulp material is maintained in a hydrous

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state it has a very short shelf life. In the paper making industry biocides are added to the slurry in the pulper. A pulper is basically a vat for receiving a material that can be agitated by mechanical means and includes means for controlling the temperature. The biocides slow the deterioration of the hydrous cellulose pulp material but do not stop it. The biocides that are added to the slurry in the pulper are poisonous and thus the hydrous cellulose pulp material can not be used in many consumer products especially products intended for human consumption. Thus, not only are the biocides not effective, they are poisonous and therefore present a hazard. In the paper making process, the water is driven from the cellulose pulp and the remaining fiber is dried in a continuous operation. After the water has been removed, decomposition of the cellulose pulp ceases. However, if the process is suspended with the cellulose pulp in the hydrous state, for example over 90% water, the pulp has a very short shelf life. This short shelf life has been a major obstacle to the development of non-paper industry uses for hydrous cellulose pulp. Generally speaking, hydrous cellulose pulp is vulnerable to decomposition regardless of whether the pulp is derived from virgin vegetable constituents or from paper in a recycling operation. Web site: http://www.delphion.com/details?pn=US06103294__ •

Prevention of fiber-induced intestinal gas production by chitosan Inventor(s): Day; Charles E. (1224 Bear Creek Rd., Leitchfield, KY 42754) Assignee(s): none reported Patent Number: 5,773,427 Date filed: May 31, 1996 Abstract: The tendency of an orally-ingestible dietary fiber composition to cause excessive flatulence upon oral administration is reduced considerably by the incorporation therein, in addition to other dietary fiber components, a flatulencereducing amount of chitosan, or by administering such a flatulence-reducing amount of chitosan concurrently with the other dietary fiber components, illustratively the usual antihyperlipidemic pharmaceutical dietary fiber composition or dietary supplement composition. A preferred dietary fiber composition according to the invention incorporates a plurality of dietary fiber components other than chitosan, preferably acacia gum, pectin, and guar gum, together with a flatulence-reducing amount of chitosan. Excerpt(s): Dietary fiber consumption and therapy with dietary fiber compositions, amelioration of flatulation effects arising therefrom by the employment of a flatulationreducing amount of chitosan in admixture or concurrently with other dietary fibers, and certain dietary fiber compositions incorporating a flatulation-reducing amount of chitosan. Dietary fiber consumption offers protection from a variety of diseases including coronary artery disease, constipation, diverticulosis, appendicitis, obesity, diabetes, and colon cancer (1). Because of the widespread recognition of its many healthful benefits, a plethora of food products and dietary supplements is readily available to the consumer and is widely utilized. Also, increased consumption of fresh fruits, whole grains, beans, and vegetables, high in dietary fiber content, is widely recommended by most health authorities. The recommended daily value (DV) for dietary fiber consumption in this country is currently thirty (30) grams per day for an adult. Dietary fiber formulations useful for the control of serum cholesterol concentrations and for reducing the risk of coronary artery disease (2,3) have been developed previously. In addition to their many healthful benefits, dietary fibers also

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cause some undesirable side effects, primarily increased intestinal gas formation which can induce socially embarrassing and/or malodorous flatulence as well as bloating, abdominal pains and discomfort (4,5). Unfortunately, nothing is presently available to effectively prevent intestinal gas formation induced by a wide variety of dietary fibers.alpha.-Galactosidase enzyme preparations are widely used to prevent intestinal gas formation caused by ingesting beans and various other legumes. These preparations are effective since they digest the galactose-containing oligosaccharides found in beans, which are the primary cause for the gas production (6). However, such enzyme preparations are not useful for preventing intestinal gas production brought about by increased dietary fiber consumption. Because of the increased consumption of foods and dietary supplements enriched with various dietary fibers, a growing need exists to find effective methods and means for controlling intestinal gas production induced by dietary fibers when ingested by a person for whom such gas production would cause a problem and hence inhibit or curtail their use and consequent healthful benefits thereof. Web site: http://www.delphion.com/details?pn=US05773427__ •

Process for altering the function and composition of gut associated lymphoid tissue in an animal Inventor(s): Hayek; Michael G. (Dayton, OH), Sunvold; Gregory D. (Eaton, OH) Assignee(s): The Iams Company (Dayton, OH) Patent Number: 5,958,898 Date filed: March 30, 1998 Abstract: A process for feeding an animal a diet which alters the function and composition of gut associated lymphoid tissue (GALT) by increasing the proportion of T cells in the GALT is provided. The diet includes fermentable fibers which have an organic matter disappearance of 15 to 60 percent when fermented by fecal bacteria for a 24 hour period, the fibers being present in amounts from about 1 to 11 weight percent of supplemental total dietary fiber. The animal is maintained on the diet for a sufficient period of time to allow the fermentable fibers to ferment in the colon of the animal to increase the proportion of T cells in the GALT of the animal. Excerpt(s): This invention relates to a process involving the use of a pet food composition containing fermentable fibers to alter the function and composition of lymphoid tissue in an animal. Recent research has suggested that dietary fiber is important for its fermentation properties in the large intestine of dogs and cats. For example, Reinhart, U.S. Pat. No. 5,616,569, describes the addition of fermentable dietary fiber to a pet food composition for the purpose of maintaining normal gastrointestinal function and ameliorating chronic diarrhea in animals. Howard et al, FASEB J. (1996) 10:A257, teach that fermentable fiber consumption by dogs can result in the partition of waste nitrogen from the urine to the feces, increasing nitrogen excretion through the feces of the animal. Sunvold et al, J. Anim. Sci. (1995) 73:1099-1109, found that feeding moderately fermentable fibers to dogs could promote gastrointestinal tract health by optimizing short chain fatty acid (SCFA) production in the intestines of the animals. Disease prevention is important both in humans as well as animals. A healthy immune system plays an important role both in preventing and fighting diseases. The effects of certain dietary additives such as anti-oxidants and vitamins on the immune systems of animals has also been reported. However, there remains a need in the art for promoting a healthy immune system in animals such as dogs.

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Web site: http://www.delphion.com/details?pn=US05958898__ •

Process for producing amylase resistant granular starch Inventor(s): Chiu; Chung-Wai (Westfield, NJ), Sedam; Marc (Chapel Hill, NC), Shi; Yong-Cheng (Neshanic Station, NJ) Assignee(s): National Starch and Chemical Investment Holding Corporation (Wilmington, DE) Patent Number: 5,902,410 Date filed: December 6, 1996 Abstract: A resistant granular starch with high dietary fiber content and the method of preparing this product wherein a high amylose starch having at least 40% by weight amylose content and total moisture content of from about 10 to 90% by weight, based on the weight of starch and water is heated in the presence of a starch swelling inhibiting agent, particularly an inorganic salt, to a temperature of from about 60 to 160.degree. C. to provide a granular starch which retains its granular structure and has a total dietary fiber content of at least 12%. Excerpt(s): This invention relates to an improved process for preparing a resistant granular starch with high dietary fiber content. More particularly, this invention involves the preparation of a resistant granular 10 starch by the selected heat treatment of high amylose starch in the presence of a starch swelling inhibiting agent and more particularly an inorganic salt and further to the use of this resistant granular starch in food products. Starch, a complex carbohydrate, is composed of two types of polysaccharide molecules, amylose, a mostly linear and flexible polymer of Danhydroglucose units that are linked by alpha-1,4-D-glucosidic bonds, and amylopectin, a branched polymer of short linear chains that are linked by alpha-1,6-D-glucosidic bonds. Starch is digested predominantly in the small intestine by the enzyme alphaamylase. Alpha-amylase hydrolyzes alpha-1,4-D-glucosidic bonds and therefore hydrolyzes the amylose fraction of starch almost completely to simple sugars. Alphaamylase does not hydrolyze the alpha-1,6-D-glucosidic linkages, resulting in less complete hydrolysis of the amylopectin fraction. It is known that certain starch processing operations result in the transformation of starch into starch that is resistant to amylase, known simply as resistant starch. Resistant starch is not digested by amylase in the small intestine, but passes into the large intestine where research literature indicates it behaves with properties similar to dietary fiber. Resistant starch, thus may have reduced caloric value because it resists digestion and is likely to be a factor in prevention of diverticulosis and colon cancer. Web site: http://www.delphion.com/details?pn=US05902410__

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Process for producing L-arabinose, L-arabinose-containing enzymatically processed products, diet foods, diabetic diet foods and fruit or vegetable juices and process for producing the same Inventor(s): Morimoto; Akemi (Kyoto, JP), Mukai; Katsuyuki (Kyoto, JP), Nisikawa; Yosihiro (Kyoto, JP), Tanaka; Hiromi (Kyoto, JP), Yoshikawa; Genichi (Kyoto, JP) Assignee(s): Unitika Ltd. (Hyogo, JP) Patent Number: 6,632,448 Date filed: October 1, 2001 Abstract: Processes for conveniently and economically producing L-arabinose, enzymetreated products containing L-arabinose, diet foods and diabetic foods containing Larabinose with dietary fiber, and fruit or vegetable juices containing L-arabinose are provided.(1) A process for producing L-arabinose by treating a natural material containing arabinan, arabinoxylan or arabinogalactan with an enzyme having an activity of acting on natural substances containing arabinan, arabinoxylan or arabinogalactan and thus releasing L-arabinose to give L-arabinose, characterized in that the above-described natural substance is directly treated with the above-described enzyme without separating or extracting arabinan, arabinoxylan or arabinogalactan.(2) A process for producing a diet food and a diabetic food characterized by comprising treating a dietary fiber material originating in a natural substance containing arabinan, arabinoxylan or arabinogalactan with an enzyme which degrades arabinan, arabinoxylan or arabinogalactan to give an enzyme-treated product containing Larabinose and dietary fiber, and adding the thus obtained enzyme-treated product to a food.(3) An L-arabinose-containing fruit or vegetable juice characterized by containing an L-arabinose-containing fraction obtained by treating a fruit or vegetable press cake containing arabinan, arabinoxylan or arabinogalactan with an enzyme, and a process for producing the same. Excerpt(s): This invention relates to a process for producing L-arabinose, enzymetreated products containing L-arabinose and a process for producing the same, and diet foods, diabetic foods and fruit or vegetable juices with the use of the same, and processes for the production thereof. L-Arabinose is a non-caloric sweetener which has taste characteristics similar to sucrose and shows little absorbability. It is also known that L-arabinose inhibits enzymes which hydrolyze dissacharides such as sucrose and thus exerts an effect of suppressing an increase in blood glucose level due to the intake of sucrose. Using these characteristics of L-arabinose, there have been known body fat accumulation inhibitors (JP-A-7-309765, JP-A-7-242551), preventives and remedies for diseases related tohyperglycemia (JP-A-6-65080), diet sweeteners and preventives for obesity (JP-X-6-812057) and pet foods (JP-A-2-299555) each containing L-arabinose (the term "JP-A" as used herein means an "unexamined published Japanese patent application" and "JP-X" as used herein means a publication of Japanese translation of a PCT patent application). Also, L-arabinose is a saccharide which is useful as a starting material for synthesizing drugs. L-Arabinose occurs as arabinan, arabinoxylan, arabinogalactan and the like in hemicellulose of higher plants. Also, a trace amount of Larabinose in a free state is contained in fermented foods such as miso and sake, instant coffee, etc. Thus, L-arabinose is a saccharide which has been commonly taken over a long time. Web site: http://www.delphion.com/details?pn=US06632448__

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Psyllium containing snack bars, processes for making these, and uses thereof Inventor(s): Bailey; John (Battle Creek, MI) Assignee(s): Board of Trustees of Michigan State University (East Lansing, MI) Patent Number: 6,419,911 Date filed: September 17, 1993 Abstract: The invention is a psyllium containing snack bar. Also included as part of the invention are processes for making snack bars. The product may be used in a therapeutic or dietary regime, for purposes such as increasing dietary fiber or for reducing cholesterol. Dry mixes for making psyllium containing snack bars are also a feature of the invention. Excerpt(s): This invention relates to snack bar food products. More particularly, it relates to snack bars containing psyllium, as well as mixes useful in making the snack bars. The psyllium may be incorporated into the snack bars in any of a number of ways, so as to yield an organoleptically acceptable product. The snack bars may be used to assimilate psyllium into the diet for any of the therapeutic goals associated therewith. Psyllium is a known mucilaginous material which has found extensive use in bulk laxatives. The source of psyllium is seeds from the plants of the Plantago genus, which grow in certain sub-tropical regions. The seeds are dark brown, smooth, boat-shaped and shiny. Since it is believed by those skilled in the art that the active ingredient of psyllium is the psyllium seed gum, which is located primarily in the seed husk, present technology uses the ground seed husk as the source for psyllium. However, the whole seed is also known as a psyllium source, as well as the dehusked psyllium seed. Due to the mucilaginous nature of psyllium, however, psyllium acquires a slimy or adhesive texture and mouthfeel upon hydration. This slimy mouthfeel is unpalatable and, accordingly, various additives have been incorporated in psyllium-containing ingestible compositions in order to mask the undesirable texture and mouthfeel of the psyllium. In addition, psyllium develops a distinctive, undesirable flavor in the presence of heat and moisture which further limits its use in food products. Web site: http://www.delphion.com/details?pn=US06419911__

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Two-phase preparation Inventor(s): Hamm; Michael (Heimweg 6, D-20148 Hamburg, DE), Schlachter; Herbert (Kolumbusstrasse 7, D-81543 Munich, DE) Assignee(s): none reported Patent Number: 6,471,969 Date filed: March 30, 1998 Abstract: The invention relates to a two-phase preparation for use at differential times and comprising a product A for the first phase and a product B for the second phase which comprise, independently of each other, at least one representative of the unsaturated fatty acids and/or, at least one representative of the group of trace elements and minerals and/or at least one representative of the group of vitamins and/or at least one representative of the group of bioactive plant substances, e.g. polyphenoles, bioflavonoids or dietary fiber and/or at least one amino acid and/or amino acid derivative, product A and/or) product B optionally additionally containing soy lecithin, with the proviso that product A and product B differ from each other in their

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quantitative and/or their material composition. The preparation can be used as a food supplement (dietary supplement) or as a drug. Excerpt(s): The invention relates to a two-phase preparation for use at differential times containing a product A for the first phase and a product B for the second phase which comprise, independently of each other, at least one representative of the unsaturated fatty acids and/or at least one representative of the group of trace elements and minerals and/or at least one representative of the group of vitamins and/or at least one representative of the group of bioactive plant substances, e.g. polyphenoles, bioflavonoids or dietary fiber, and/or at least one amino acid and/or amino acid derivative, product A and/or product B optionally additionally containing soy lecithin, with the proviso that product A and product B differ from each other in their quantitative and/or their material composition. The preparation can be used as a food supplement (dietary supplement) or as a drug. In particular, the invention relates to a two-phase preparation for use at differential times comprising a product A and a product B which include, independently of each other, at least one representative of the unsaturated fatty acids, one representative of the group of trace elements and minerals and one representative of the group of vitamins, product A and/or product B optionally additionally containing soy lecithin, and/or at least one representative of the group of bioactive plant substances and/or at least one amino acid and/or amino acid derivative which is used as a food supplement (dietary supplement). It is generally known that the nutrients carbohydrates as well as the dietary fats are mainly used to cover the body's energy requirement. Proteins are important building components for cells and endogenous active substances such as enzymes and certain hormones. Polyunsaturated fatty acids, vitamins, minerals and trace elements as well as bioactive plant substances such as flavonoids are becoming more and more important for health and fitness. Web site: http://www.delphion.com/details?pn=US06471969__

Patent Applications on Dietary Fiber As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to dietary fiber: •

Additive, food, beverage, seasoning, and cosmetic product Inventor(s): Ariga, Toyohiko; (Tokyo, JP), Kawakami, Tadao; (San Francisco, CA) Correspondence: Armstrong,westerman & Hattori, Llp; 1725 K Street, NW.; Suite 1000; Washington; DC; 20006; US Patent Application Number: 20030008058 Date filed: June 5, 2002 Abstract: The additive according to the present invention contains the fruit juice of a prickly pear cactus. The prickly pear cactus fruit juice contains rich vitamins, minerals, soluble dietary fiber, pectin, etc. Thus, the additive prevents increase of body weight even when the amount of food being taken is increased. The rich soluble fiber included in the prickly pear cactus fruit juice shortens the intestinal retention time of food,

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This has been a common practice outside the United States prior to December 2000.

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thereby regulating the functions of the intestines, preventing obese. The additive reduces the adipose tissue weight without increasing organ weight. The additive also reduces serum lipids by the pectin included in the cactus fruit juice. Excerpt(s): The present invention relates to an additive, food product such as heath food, dairy product, sweets, bread, ice cream, sherbet and jam, beverage such as soft drink, fruit juice, vegetable juice, lactic acid bacteria beverage and alcoholic beverage, seasoning, and cosmetic product that contain the fruit juice of a prickly pear cactus. The prickly pear cactus, which is a plant of the family Cactaceae, can be found in a wide area ranging from the southwest of America to a portion of Canada, and grows on its stem a bright purple red fruit. The fruit of the prickly pear cactus has been one of the favorite foods among cowboys from the time of settlement of the American West. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

ATP synthesis activator Inventor(s): Yoon, JungMan; (Tokyo, JP) Correspondence: Birch Stewart Kolasch & Birch; PO Box 747; Falls Church; VA; 220400747; US Patent Application Number: 20030039707 Date filed: December 7, 2001 Abstract: The present invention provides an ATP synthesis activator which allows the promotion of ATP synthesis in the body and results in an increased ATP level in the body for a long period of time. The ATP synthesis activator comprises, as an active ingredient, a mixture of a plurality of herbs having an ion-exchange capacity. It may stimulate electron generation in the body and hence results in an improved ATP synthesis activity due to the generated electrons, because dietary fiber contained in the herbs has an ion-exchange capacity. Excerpt(s): The present invention relates to an ATP synthesis activator for promoting the synthesis of ATP (adenosine triphosphate) used as an energy source for living cells. ATP is a nucleotide molecule having three phosphate molecules attached to a 5-hydroxyl group on a ribose of adenosine, which has a formal name of adenosine 5'-triphosphate. ATP, which was found by Fiske et al. in 1929, is a compound widely present in any living tissue or organism including animal's muscles or yeast cells. ATP has two highenergy phosphate bonds per molecule, thereby yielding a free energy of about 7.3 kcal/mol when hydrolyzed around a neutral pH and itself being converted into adenosine diphosphate. Thus, the energy yielded from ATP hydrolysis allows nucleic acid synthesis as well as various metabolisms including protein metabolism, carbohydrate metabolism and/or lipid metabolism. A compound having a phosphate ester bond provided from ATP will enter an "activated state" to contribute to various synthesis reactions. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Beta-glucan compositions and process therefore Inventor(s): Gruess, Olaf; (Maple Grove, MN), Meuser, Friedrich P.; (Berlin, DE), Van Lengerich, Bernhard H.; (Plymouth, MN) Correspondence: General Mills, INC.; P.O. Box 1113; Minneapolis; MN; 55440; US Patent Application Number: 20030153746 Date filed: February 4, 2002 Abstract: An efficient method for producing high quality beta glucan enriched soluble dietary fiber products is described. An aqueous extraction slurry of beta glucancontaining grain material is homogenized, acidified and enzymatically digested to reduce viscosity and optimize separation of insolubles from the aqueous extract solution. The resulting extract is heat processed to precipitate denatured protein components and subsequently dried or otherwise processed to provide the products for use as food additives or dietary supplements. Excerpt(s): The present invention relates to a method of isolating soluble fiber from cereal grains. In particular, the invention is directed to an efficient method for producing high quality beta glucan isolates for use as food additives, dietary supplements, seasonings, ingredients, food intermediates and food products which are ready to eat or may undergo a further processing step. High fiber products are generally considered to be healthful foods and food ingredients. Foods high in water insoluble fiber are known to improve regularity and bulk formation. Water-soluble fiber content in natural and processed foods has been linked to such beneficial effects as cholesterol reduction, blood sugar regulation in diabetics and prevention of colon cancer. Yet it is widely recognized that soluble fiber is lacking in the diet of most populations, which may be due in part to the taste, availability and difficulty in obtaining high fiber sources. Accordingly there have been significant research and development efforts in the food industry to create high fiber, multifunctional food additives, supplements, ingredients for use in the manufacture of processed foods and food intermediates for health conscious consumers. Cholesterol in humans comes from primarily two sources, the bodies own production of cholesterol (endogenic) and dietary cholesterol. Typically, the average person consumes between 350-400 milligrams of cholesterol daily, while the recommended intake is around 300 milligrams. Increased dietary cholesterol consumption, especially in conjunction with a diet high in saturated fat intake, can result in elevated serum cholesterol. Elevated serum cholesterol is a well-established risk factor for heart disease and therefore there is a need to mitigate the undesired effects of cholesterol accumulation. High cholesterol levels are generally considered to be those total cholesterol levels at 200 milligrams and above or LDL cholesterol levels at 130 milligrams and above. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Beverage compositions comprising arabinogalactan and defined vitamins Inventor(s): Manchuso, Scott Edward; (Cincinnati, OH), Mehansho, Haile; (Fairfield, OH), Mellican, Renee Irvine; (Bradenton, FL), Nunes, Raul Victorino; (Loveland, OH), Spence, Kris Eugene; (Madeira, OH) Correspondence: The Procter & Gamble Company; Intellectual Property Division; Winton Hill Technical Center - Box 161; 6110 Center Hill Avenue; Cincinnati; OH; 45224; US Patent Application Number: 20020110632 Date filed: August 24, 2001 Abstract: The present invention is directed to compositions comprising:a) a first component which is arabinogalactan; andb) a second component comprising two or more vitamins selected from the group consisting of vitamin A, vitamin C, vitamin D, vitamin E, and B-complex vitamins.In an alternative embodiment of the present invention, the compositions comprise:a) a first component which is arabinogalactan; andb) a second component comprising one or more vitamins selected from the group consisting of vitamin A, vitamin D, and vitamin E.The present compositions are useful to provide beverages which increase the solubility of fat-soluble vitamins, and deliver the benefits of fiber, one or more of the defined vitamins, and/or provide other health benefits, including fighting infection, promoting healthy bacteria, and providing a desired dietary fiber benefit. Additionally, the present invention provides beverage compositions having excellent taste, and other organoleptic properties, despite the inclusion of the fiber and vitamin components. These and other benefits of the present invention are described herein. Excerpt(s): This patent document claims priority to U.S. Provisional Application Serial No. 60/236,507, filed Sep. 29, 2000, under 35 U.S.C.sctn. 119(e). The present invention is directed to beverage compositions which comprise arabinogalactan and defined nutrients, including one or more fat-soluble vitamins, optionally in combination with one or more other vitamins, without affecting taste, solubility, and bioavailability. Beverage compositions are important for a variety of consumer benefits, for example, hydration, refreshment, energy, relaxation and, of course, nutritive benefits. Vitamin supplementation is common in the field of beverage compositions. For example, it is quite common to deliver fruit juices supplemented with vitamin A or other essential vitamins for various nutritive purposes. However, vitamin solubility can be a serious problem when formulating beverage compositions with fat-soluble vitamins, causing such formulation to be either unfeasible or unacceptable due to insolubility and, ultimately, instability of the desired vitamin supplement. In such beverage compositions, the vitamin may ultimately settle to the bottom of a container which holds the composition. Since appropriate and consistent vitamin delivery is important in order to provide the nutritive benefit, such benefit will be significantly diminished as the desired vitamin dosage will indeed not be delivered. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Bleached grain and grain products and methods of preparation Inventor(s): Metzger, Lloyd E.; (Champlin, MN) Correspondence: General Mills, INC.; Number One General Mills BLVD.; Minneapolis; MN; 55426; US Patent Application Number: 20030082280 Date filed: December 10, 2002 Abstract: The present invention describes bleached grain products such as bleached whole wheat flour that are obtained having the color and taste of white flour by bleaching whole wheat kernels prior to conventional flour milling. The wheat kernels are treated with a peroxide solution to lighten the color of the bran layers. The bleached grain kernels can be tempered and milled into whole grain flours having 10% to 12% dietary fiber from the bran but which are white in color and bland in flavor. The whitened, high fiber whole wheat flours can be used to prepare good tasting, and nutritious products such as baked goods such as breads and pastries as well as pasta product, and ready-to-eat cereals or grain based snacks. Excerpt(s): The present invention relates to food products and to methods for their preparation. More particularly, the present invention is directed towards bleached grain products such as whole wheat flour, to bleached grain intermediate products such as bleached wheat kernels and to their methods of preparation. The present invention provides improvements in the processing or treatment of grains such as wheat. More particularly, the present invention is directed towards the provision of whole grain flour such as whole wheat with the color and taste comparable to white flour or a "white" whole wheat flour. Also, the present invention provides methods for preparing such improved white whole wheat flour and further to intermediate products useful in the production of such improved finished products as white whole wheat flour. Such intermediate products include, for example, bleached grain kernels such as bleached wheat kernels. Most consumers have experienced and readily recognize the difference between whole wheat bread and ordinary white bread. Most consumers also know that whole wheat bread is more nutritious, but consume white bread anyway, because they like the taste better. This is especially true of children who can be particularly selective in food choices. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Cereal grains with high total dietary fiber and/or resistant starch content and their preparation thereof Inventor(s): Liu, Yayun; (Hillsborough, NJ), Shi, Yong-Cheng; (Hillsborough, NJ) Correspondence: Laurelee A. Duncan; National Starch & Chemical Company; Box 6500; Bridgewater; NJ; 08807; US Patent Application Number: 20020197373 Date filed: March 26, 2001 Abstract: This invention relates to a process for preparing cereal grain having increased dietary fiber and/or resistant starch content and the process tolerant grain prepared thereby. Further, this invention provides high amylose grain with unusually high dietary fiber and resistant starch content. In particular, this invention involves the preparation of the improved grain by a combination of moisture and temperature

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conditions and further to use of the grain in the preparation of products containing starch. Excerpt(s): Cereal grains, including wheat, corn (or maize), rice, barley, rye, oats, and sorghum are basic food components of the human diet and contain important nutrients such as dietary fiber and starch. The consumption of dietary fiber is particularly important to digestive health, and has been implicated as being useful for the prevention or treatment of certain diseases such as colon cancer. Generally, dietary fiber is defined to be the polysaccharides and remnants of plant materials that are resistant to hydrolysis (digestion) by human alimentary enzymes, including nonstarch polysaccharides, resistant starch, lignanin and minor components such as waxes, cutin and suberin. Because of the potential health benefits of foods rich in dietary fiber, many countries have recommended the increased consumption of such foods as a part of their dietary guidelines. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Confectionery compositions containing fiber Inventor(s): Pfeiffer, Eric John; (Newburgh, IN) Correspondence: Nelson Mullins Riley & Scarborough Llp; Keenan Building, Third Floor; 1330 Lady Street; Columbia; SC; 29201; US Patent Application Number: 20020197357 Date filed: March 12, 2002 Abstract: Chewy confectionery compositions made from fats, optional proteins, carbohydrates comprising reducing sugars and non-reducing sugars having a ratio of from about 1:0.2 to about 1:1, and one or more dietary fibers. The ingredients are present in the compositions in specific amounts and ratios so that the fiber can be easily incorporated into the confectionery compositions without adversely affecting the stability, feel, and taste of the compositions. Preferably, the composition is a "fiber chew" in the form of a palatable, good tasting, bite-sized confectionery containing the dietary fiber. Excerpt(s): The present application claims the benefit of U.S. Provisional Application Serial No. 60/275,097 filed Mar. 12, 2001, which is incorporated herein by reference thereto. This invention relates generally to confectionery compositions and particularly to confectionery compositions containing fiber and to methods for preparing such confectionery compositions. The prior art is replete with information about confectionery compositions. For example, Harris et al. (A Formulary of Candy Products, 1991, pg. 69) discloses an economy caramel composition and method for making such composition. This caramel contains typical components for a caramel, e.g., fats, carbohydrates, water, non-fat milk solids, and starch. U.S. Pat. No. 4,582,709, issued to Peters et al. on Apr. 15, 1986, discloses pleasant tasting, soft, chewable mineral supplements based upon caramel or nougat confectionery compositions. Troller (Water Activity and Food) discloses confectioneries protected from microbial spoilage by controlling the water activity. The water activity is controlled to prevent microbial spoilage, particularly due to yeast fermentation. U.S. Pat. No. 4,753,805, issued to Cherukuri et al. on Jun. 28, 1988, discloses the use of encapsulated flavorings for chewing gum. U.S. Pat. No. 5,571,441, issued to Andon et al. on Nov. 5, 1996, discloses vitamin supplements containing bracers and flavanols or green tea solids and possibly carbohydrates. U.S. Pat. No. 5,223,264, issued to Wehling et al. on Jun. 29, 1993, discloses

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the addition of the mineral magnesium phosphate to products as a dietary supplement. None of these confectionery compositions, however, contain fiber as a dietary supplement. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Dietary fiber delivery system Inventor(s): Licari, Jerome J.; (Plymouth, MN) Correspondence: Fulbright & Jaworski L.L.P.; Suite 4850; 225 South Sixth Street; Minneapolis; MN; 55402-4320; US Patent Application Number: 20030049313 Date filed: July 16, 2002 Abstract: A delivery system and method for delivering soluble dietary fibers in a chewable tablet form which is palatable and demonstrates a high degree of consumer acceptability. Excerpt(s): This application claims the benefit of Provisional Application No. 60/009,231 filed Dec. 26, 1996. The present invention relates generally to a delivery system for dietary fibers and more particularly to a delivery system for soluble dietary fiber supplements preferably in the form of a safe, chewable tablet, lozenge, wafer, cookie or the like which is comprised in part of a relatively low viscosity, non-gelling and organoleptically pleasing dietary fiber component. Unlike other nutrients, dietary fiber is not a single substance, but is a term used to identify plant polysaccharides and lignins that are not hydrolyzed by the endogenous secretions of the human digestive system. Thus, they reach the colon intact. Plant components which make up dietary fiber include, among others: structural polysaccharides (cellulose and hemicellulose), nonstructural polysaccharides (pectines, B-glucans; gums and mucilages) and structural non-polysaccharides (lignin). Dietary fibers are commonly characterized by their water solubility and their relative susceptibility to microbial degradation into fermentable and nonfermentable fiber fractions. In general, pectines, gums and mucilages are water soluble, while lignin, cellulose and hemicellulose are water insoluble. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Encapsulated carob fibers having improved product properties, process for production thereof and use thereof Inventor(s): Haber, Bernd; (Mainz, DE), Meer, Hans-Ulrich Ter; (Frankfurt, DE) Correspondence: Propat, L.L.C.; 2912 Crosby Road; Charlotte; NC; 28211-2815; US Patent Application Number: 20030059458 Date filed: September 12, 2002 Abstract: The invention relates to encapsulated dietary fiber consisting of a core of essentially water-insoluble carob fiber and an encapsulating material of at least one water-soluble dietary fiber. The invention also relates to a process for producing such encapsulations and their use, in particular in foods, animal feed, cosmetics and pharmaceuticals.

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Excerpt(s): The invention relates to encapsulated carob fibers consisting of insoluble carob fibers and one or more encapsulating materials. In addition, the invention relates not only to the production process but also to the use of these stable encapsulated carob fibers. Dietary fiber is plant food components which cannot be digested by humans. They comprise indigestible polysaccharides, oligosaccharides, lignin and associated substances. Dietary fiber is highly important from the nutritional aspect and, in addition to an effect promoting digestion can also have a regulating action on blood cholesterol and the blood glucose level. Furthermore, in the large intestine, fermentable oligosaccharides and polysaccharides display a prebiotic activity. A high-fiber diet is also reported as a cause for the relatively rare occurrence of bowel cancer in Africa or in certain population groups. In most industrial countries, however, the consumption of dietary fiber is considerably below the daily dose of at least 30 g which is recommended by nutritionists. An increased supply of dietary fiber is therefore desirable from the nutritional aspect. This includes achieving a balanced ratio between soluble and insoluble dietary fiber in the diet. Since this knowledge is becoming increasingly established, the desire on the part of the consumer for foods having a specific health benefit is becoming increasingly strong. In practice, when foods are enriched with dietary fiber, there is the problem that texture and mouth feel and also color can suffer. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Encapsulated multifunctional biologically active food component, process for its production and its use Inventor(s): Bache, Georg; (Buehlertann, DE), Bollinger, Hartmut; (Neuler, DE), Brendle, Hans-Georg; (Ellwangen, DE), Haber, Bernd; (Mainz, DE), Jager, Martin; (Gauersheim, DE), Kunz, Benno; (Meckenheim, DE), Strater, Stephanie; (Roesrath-Hasbach, DE), Weissbrodt, Jenny; (Wiehl, DE) Correspondence: Propat Llc; Suite 400; 6230 Fairview RD.; Charlotte; NC; 28210; US Patent Application Number: 20010016220 Date filed: December 21, 2000 Abstract: The invention relates to a multifunctional encapsulated biologically active food component consisting of a core which comprises at least one dietary fiber, which core is surrounded by at least one biologically active substance, in which the core and the biologically active substance(s) is (are) surrounded by one or more shell-forming substance(s). Excerpt(s): The invention relates to a multifunctional encapsulated biologically active food component which consists of a core that comprises at least one dietary fiber, which core is surrounded by at least one biologically active substance and in which the core and the biologically active substance are surrounded by at least one shell-forming substance. The stability of the multifunctional food component is based on interactions of the components with one another. Biologically active substances in nutrition are physiologically important components. They can have the most varied functions in the organism and as a result make a positive contribution to health. Biologically active substances can act, for example, as classical nutrients, can stimulate immune activity or have protective activity or intervene in physiological processes in the body. Biologically active substances can include, inter alia, probiotic microorganisms, prebiotic substances, nutrients or secondary plant constituents. Enrichment of the diet with components of this type in a stable and in particular bioavailable form is therefore desirable from the nutritional aspect. Dietary fibers are a heterogeneous product group. Many dietary fiber

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preparations are based on plant fibers and consist predominantly of water-insoluble polysaccharides in addition to pectin, lignin and plant gums (for example wheat fibers, oat dietary fibers, rice dietary fibers, apple fibers, citrus dietary fibers etc.). In addition there are also soluble dietary fibers which are mostly made up of complex carbohydrates (for example fructo- or galactooligosaccharides,.beta.-glucans etc.). Dietary fibers taken in via the diet are distinguished by the fact that they are indigestible constituents for humans. Because of their inert character, dietary fibers reside in the intestine and can there optimally exert their physiological effects, for example increasing intestinal peristalsis, effects on cholesterol absorption, prebiotic activities etc. An increased intake of dietary fibers is desirable for nutritional reasons. A daily intake of 25-30 g of dietary fiber is recommended by nutritionists. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Food compositions including resistant starch Inventor(s): Brown, Ian Lewis; (Gymea, AU), Ganly, Robert; (Kew, AU), McNaught, Kenneth John; (North Epping, AU) Correspondence: Marshall, O'toole, Gerstein, Murray & Borun; 6300 Sears Tower; 233 South Wacker Drive; Chicago; IL; 60606-6402; US Patent Application Number: 20020054948 Date filed: October 12, 2001 Abstract: The invention described in this application relates to food compositions such as breakfast cereals, bread and the like which have an enhanced dietary fiber content. In each case the source of dietary fiber is a starch, preferably a maize starch, having an amylose content of 50% or more, the starch being incorporated into a food composition as appropriate. Alternatively, grains or legumes or parts thereof which include starch of this amylose content may be used. Excerpt(s): This invention relates to food composition which include resistant starch as a source of dietary fibre and in particular to food compositions which include grain or parts thereof and starch derived from the grain which is high in amylose. It has been recognised that a balanced diet must include an adequate level of dietary fibre. There are many natural food sources of dietary fibre of which cereals, particularly bran, are recognized as a good source. However, it would seem that a high proportion of diets of people of the developed countries contain an inadequate level of dietary fibre. An inadequate level of dietary fibre has been linked with a number of diseases which may be broadly classified as metabolic and gastrointestinal. Examples of these diseases are diabetes mellitus, diverticular disease and colonic cancer. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Low sugar honey Inventor(s): Hammond, Neal A.; (Baton Rouge, LA) Correspondence: Merchant & Gould PC; P.O. Box 2903; Minneapolis; MN; 55402-0903; US Patent Application Number: 20020187246 Date filed: February 1, 2002

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Abstract: Low-sugar dietetic or diabetic honey compositions and method of production are described. Honey compositions comprising approximately less than 25% sugar are produced by extending natural honey with extender molecules selected from oligosaccharides, polyols, and dietary fiber which are not metabolized or are slowly metabolized in the human digestive system. Excerpt(s): This invention relates to a low glucose honey and its method of production. Honey is a natural product derived from the digestive conversion of flower nectar to simple sugars by the common honey bee. Honey is composed of glucose, fructose, water, minerals, organic acids, and a small amount of proteinaceous material. Natural honey is comprised of multiple nutrients including carbohydrates, proteins, vitamins and minerals. Honey is comprised of approximately 38.5% fructose and 31.0% glucose. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method and formulation for treating candidiasis using morinda citrifolia Inventor(s): Gerson, Scott; (Brewster, NY), Jensen, Claude Jarakae; (Cedar Hills, UT), Ogden, Robert V.; (Cedar Hills, UT), Palu, Afa Kehaati; (Orem, UT), West, Brett Justin; (Orem, UT) Correspondence: Kirton And Mcconkie; 1800 Eagle Gate Tower; 60 East South Temple; P O Box 45120; Salt Lake City; UT; 84145-0120; US Patent Application Number: 20030161901 Date filed: November 14, 2002 Abstract: The present invention features a novel use of processed ingredients from the Indian mulberry plant, and particularly a novel use of one or more processed Morinda citrifolia-based naturaceutical formulations comprising one or more of a processed Morinda citrifolia fruit juice, puree juice, oil or oil extract, dietary fiber, alcohol extract, etc., for inhibiting and preventing the overgrowth of Candida fungus and for treating Candidiasis and its associated symptoms. Excerpt(s): The present invention is directed toward methods and formulations for treating Candidiasis, and particularly towards various methods and naturaceutical formulations, compositions, and substances comprising Morinda citrifolia for inhibiting, blocking, and preventing the overgrowth of Candida albicans in mammals. There exists in the body literally billions of microorganisms that function to assist in everyday maintenance and development. This normal resident microbial population includes potential pathogens as well as organisms that help to keep the potential pathogens in check. Microorganisms Candida albicans, and other strains of Candida, are yeast or yeast-like fungi that are capable of growing on and within the human body and that normally or naturally inhabit our digestive system: the mouth, throat, intestines and genitourinary tract. Candida is a normal part of the bowel flora (the organisms that naturally live inside our intestines, and are not parasitic). It has many functions inside our digestive tract, one of them which is to recognize and destroy harmful bacteria. Without Candida albicans in our intestines we would be defenseless against many pathogenic bacteria. Under normal circumstances, a healthy individual can have millions of Candida albicans in their system. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method lfor preparing soluble dietary fiber from corn hull Inventor(s): Kim, Jin-Keun; (Seo-ku, KR), Woo, Dong-Ho; (Bupyeong-ku, KR) Correspondence: Richard P Berg; Ladas & Parry; Suite 2100; 5670 Wilshire Boulevard; Los Angeles; CA; 90036-5679; US Patent Application Number: 20030003216 Date filed: June 19, 2002 Abstract: The present invention relates to a high yield process for producing soluble dietary fiber from corn hull. More specifically, the present invention comprises removing starch and protein with enzymes from corn hull which is by-product of wetmilling process for production of corn starch, extracting the resultant with alkaline solution to form a alkaline extract, treating the alkaline extract with enzymes, and drying the enzyme-treated solution, to produce dietary fiber with low viscosity and containing hemicellulose as a major component at high yield. Excerpt(s): The present invention relates to a method for preparing soluble dietary fiber from corn hulls. Dietary fiber can be classified into a water-insoluble group and a watersoluble group. It has been known that soluble dietary fiber has a good effect on suppression of increase of serum cholesterol level. The mechanism of soluble dietary fiber to improve lipid metabolism is supported by the functions that soluble dietary fiber inhibits lipid absorption in the digestive tract and accelerates excretion of bile acid, and that the short chain fatty acids, in particular propionic acid produced from fermentation of the fiber in the colon, suppresses the synthesis of cholesterol. Wellknown insoluble dietary fibers include cellulose, lignin, and the like, and soluble dietary fibers include Guar gum, Arabic gum, pectin, hemicellulose, and the like. In addition, indigestible components that are contained in cell walls and cell contents of plants such as grains have been called crude fiber, and they include hulls of grains such as rice, corn, and beans. Corn hulls, produced from wet milling in the preparation process of starch, can be used as a good source of dietary fiber, because the corn hulls contain a lot of dietary fiber, and in particular more hemicellulose than hulls of other grains. Hemicellulose is a polysaccharide that consists of complicatedly connected monomers, and that is a component of cell walls of plants except for cellulose and pectin. Hemicelluloses are divided into two groups: water-insoluble hemicellulose A, and water-soluble hemicellulose B. Soluble hemicellulose B includes a main component of arabinoxylan which consists of xylose and arabinose. Arabinoxylan has a beta-1,4linkage that cannot be hydrolyzed by human digestive enzymes, and thus can be a good dietary fiber. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Methods of using and compositions comprising cacao extract including dietary fiber Inventor(s): Kwon, Ik Boo; (Seoul, KR), Lee, Jung-Suk; (Leecheon-si, KR), Lee, ShinYoung; (Chuncheon-si, KR) Correspondence: Pennie And Edmonds; 1155 Avenue OF The Americas; New York; NY; 100362711 Patent Application Number: 20030206981 Date filed: May 5, 2003

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Abstract: The present invention relates to cacao extract including dietary fiber, more specifically cacao extract including dietary fiber useful for the treatment of diabetes obtained as a residue of solvent extraction of the cacao bean husk (CBH) conventionally wasted after using only cacao bean (CB), which has the following characteristics:(a) A high content of dietary fiber is included, and especially, insoluble dietary fiber (IDF) is in excess of soluble dietary fiber (SDF);(b) The physical and chemical properties of these fibers, such as water holding capacity (WHC), oil binding capacity (OBC), viscosity characteristics and dialysis retardation index of glucose and bile acid; and(c) It improves the physiological activity of intestinal disease and metabolic disease, for example, blood sugar depression and cholesterol metabolism enhancement. Excerpt(s): This application is a division of U.S. patent application Ser. No. 09/958,873 filed on Dec. 28, 2001, the entirety of which is incorporated herein by reference. c) It improves the physiological activity of intestinal disease and metabolic disease, for example, blood sugar depression and cholesterol metabolism enhancement. Cacao (Theobroma cacao L.) is a Latin America originated perennial belonging to Byttneriaceae family, which grows as high as 6-8 m. It produces an oval-type pod, in which about 3040 seeds are embedded by pulp. Cacao comprises a shell (or testa), a nib (or cotyledon) and a germ, and the main ingredient of chocolate is a ground mass made by grinding the nib with high butter content. This mass is called cacao liquor or cacao mass (CM) because it is in a paste phase below the melting point of butter. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Morinda citrifolia dietary fiber Inventor(s): Jensen, C. Jarakae; (Cedar Hills, UT), Story, Stephen P.; (Alpine, UT), Wadsworth, John J.; (Orem, UT) Correspondence: Michael F. Krieger; Kirton & Mcconkie; 60 East South Temple, Suite 1800; Salt Lake City; UT; 84111; US Patent Application Number: 20010046550 Date filed: April 9, 2001 Abstract: A dietary fiber product obtained from the Indian mulberry (Morinda citrifolia) plant and the process of extracting and purifying the fiber is disclosed. According to one embodiment, the Indian mulberry pulp is washed and separated from the juice by filtration. The wet pulp is pasteurized. The wet pulp can be further processed by drying. A high fiber products can be prepared by mixing the pulp with ingredients, such as supplemental dietary fiber, water, sweeteners, flavoring agents, coloring agents, and nutritional ingredients. Excerpt(s): The present application is related to and claims priority to U.S. application Ser. No. 09/384,784, filed Aug. 27, 1999, which is incorporated by reference of all purposes. The present invention relates to dietary fiber obtained from the Morinda citrifolia plant and to the process of extracting and purifying the fiber. The Indian Mulberry plant, known scientifically as Morinda citrifolia L., is a shrub, or small or medium sized tree 3 to 10 meters high. It grows in tropical coastal regions around the world. The plant grows randomly in the wild, and it has been cultivated in plantations and small individual growing plots. The Indian mulberry plant has somewhat rounded branches and evergreen, opposite (or spuriously alternate), dark, glossy, wavy, prominently-veined leaves. The leaves are broadly elliptic to oblong, pointed at both ends, 10-30 cm in length and 5-15 cm wide.

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Novel preparation of fiber, L-glutamine and a soy derivative for the purpose of enhancement of isoflavone bioavailability Inventor(s): Hsu, Charles C.; (Long Beach, CA), Hu, Qing-Fu; (Laguna Niguel, CA), Paul, Stephen M.; (Rancho Santa Margarita, CA), See, Melissa; (Long Beach, CA), Shu, Daniel; (Laguna Niguel, CA) Correspondence: M. Wayne Western; Thorpe North & Western, L.L.P.; P.O. Box 1219; Sandy; UT; 84091-1219; US Patent Application Number: 20020076455 Date filed: February 22, 2002 Abstract: A composition for improving isoflavone metabolism and the bioavailability of phytoestrogens in warm blooded animals comprising a phytoestrogen, a dietary fiber, L-glutamine, and optionally N-acetyl-D-glucosamine, in admixture with a biologically acceptable inert carrier. Excerpt(s): This application claims the benefit of U.S. Provisional Application No. 60/150,018 filed on Aug. 20, 1999. This invention relates to nutritional supplements. More particularly, the invention relates to a nutritional supplement composition, and methods of use thereof, to enhance the bioavailability of isoflavone. Nearly 70 years ago, it was reported that certain plants could induce estrus in animals. Subsequently, over 300 plants have been found to possess estrogenic activity (see e.g., Bradbury and White, Vitamin Horm. 12:207 (1954), and Farnsworth et al., J. Pharm. Sci. 64:717(1954)). These compounds have been given the general name of "phytoestrogens" and represent several chemical classes of diphenolic plant compounds that are somewhat related structurally to the mammalian sex hormone 17-beta-estradiol. See Setchell, K. D. R., et al Am. J. Clin. Nutr., 40:569 to 578 (1984). Similarities in the molecular structure of phytoestrogens facilitate binding to the estrogen receptor. An important class of the phytoestrogens is the isoflavone class. Two chemical classes of phytoestrogens are abundant in soybeans, total soy products, and soy protein isolates. Those two classes are coumestrol and isoflavones. The latter class includes daidzein, genistein, glycitein, as well as their glycoside and acetylated forms. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Nutritional dietary system, formulation, kit and method for use in preparing an individual for a predetermined activity Inventor(s): Stern, Howard S.; (Old Westbury, NY) Correspondence: Coudert Brothers; Attn: Lewis Reff; 1114 Avenue OF The Americas; New York; NY; 10036; US Patent Application Number: 20030180393 Date filed: June 21, 2002 Abstract: This invention relates to a nutritional dietary system, formulation, kit and method for use in preparing an individual for a predetermined activity which requires a clean digestive tract, particularly the colon. Such predetermined activities include, but are not limited to, gastrointestinal surgery and colon screenings. Specifically, the present

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invention provides an individual low amounts of fat, dietary fiber and solid food content to minimize stool formation and/or facilitate removal of stool from the digestive tract prior to the predetermined activity. The present invention also provides the individual with sufficient calories and nutrition to enable the individual to conduct daily, routine activities while utilizing the present invention. In one alternative embodiment, the dietary regimen of the present invention provides a variety of prepackaged, ready to eat or easy to prepare nutritional liquid or solid foods which, when coordinated with a laxative regimen, result in removal of residue such that a medically and/or diagnostically useful procedure can be performed on the digestive tract. Excerpt(s): This is a continuation-in-part of International Application No. PCT/US01/32039, with an international filing date of Oct. 12, 2002, published in English under PCT Article 21(2) under publication No. W0 02/30439. The International Application claims priority under 35 U.S.C.sctn.119(e) from U.S. Provisional Application Serial No. 60/240,569, filed Oct. 13, 2000. Each of these prior applications and the international publication are incorporated herein by reference in their entirety. This invention relates to a nutritional dietary system, formulation, kit and method for use in preparing an individual for a predetermined activity. Specifically, the present invention provides an individual low amounts of fat, dietary fiber and solid food content to aid in the minimization in and/or removal of food residue from the digestive tract. The present invention also provides the individual with sufficient calories and nutrition to enable the individual to conduct daily, routine activities while utilizing the present invention. In one alternative embodiment, the nutritional dietary regimen of the present invention is used to minimize the production of and/or facilitate the removal of food residue from the digestive tract in an individual preparing for a predetermined medical activity, such as a medical or diagnostic procedure, including gastrointestinal surgery or colon screening and the like. In another alternative embodiment, the dietary regimen of the present invention provides a variety of pre-packaged, ready to eat or easy to prepare nutritional liquid or solid foods which, when coordinated with a laxative regimen, result in removal of food residue such that a medically and/or diagnostically useful procedure can be performed on the digestive tract. The digestive tract is a major component of the gastrointestinal system. Essentially, it is a tube about five meters in length of variable cross-sectional areas running from mouth to anus that includes the mouth, pharynx, esophagus, stomach, small intestine, large intestine, which includes the colon, also known as the bowel. In the digestive tract, food is propelled by muscular contractions through its different regions. These contractions are referred to as peristalsis. Eventually, unabsorbed food residues are moved to the end of the tract and are eliminated from the body in the form of solids, semi-solids or liquids. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Nutritious supplemental composition for suppression against onset of large intestinal cancer and manufacturing method thereof Inventor(s): Iwasaki, Teruaki; (Sapporo-shi, JP) Correspondence: Mckee, Voorhees & Sease, P.L.C.; 801 Grand Avenue; Suite 3200; Des Moines; IA; 50309-2721; US Patent Application Number: 20020172667 Date filed: September 13, 2001 Abstract: In view of an acknowledgement that keeping a healthy body is a fundamental matter for overcoming cancer, it is an object of the present invention to provide

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composition containing well-balanced nutrition, having an effect to suppress the mutagenesis substances, having no sub-action even if the composition is continued to be taken as nutritious supplemental substance and capable of promoting healthy state. There are provided a nutritious supplemental composition for suppression against large intestinal cancer and its manufacturing method in which dietary fiber in a range of 15 wt % to 30 wt % in respect to a total amount of composition is contained in the dried koji fine powder including dead fungi of Aspergillus while keeping a capability of catalysis of groups of enzyme produced by Aspergillus. Excerpt(s): This invention relates to a nutritious supplemental composition for suppression against onset of large intestinal cancer in which it shows a superior suppression against onset of large intestinal cancer. In particular, in the present invention, rice bran is heated with steam, Aspergillus, Aspergillus oryzae strain, for example, is mixed with the rice bran, they are cultivated and ripened to make rice bran koji, Aspergillus is annihilated, and the enzyme groups produced by Aspergillus are changed into the dried koji fine powder of dried powder under a state in which a proper capability of catalysis of enzyme itself is not lost. Either dietary fiber aiming at removal of mutagen or plant protein acting as nutritious element is contained in it and the present invention relates to the nutritious supplemental composition for suppression against onset of large intestinal cancer and its manufacturing method. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Preventative and treatment effects of morinda citrifolia on diabetes and its related conditions Inventor(s): Jensen, Claude Jarakae; (Cedar Hills, UT), Ohishi, Hifumi; (Tokyo, JP), Palu, Afa Kehaati; (Orem, UT), Tani, Hisanori; (Tokyo, JP) Correspondence: Kirton & Mcconkie; 1800 Eagle Gate Tower; 60 East South Temple; Salt Lake City; UT; 84111; US Patent Application Number: 20030138506 Date filed: November 1, 2002 Abstract: The present invention features a unique, natural formulation and method of administering the same to treat and prevent diabetes, or rather advances treatment of diabetes, by providing a naturaceutical composition or treatment formulated with one or more processed Morinda citrifolia products as derived from the Indian Mulberry plant. The Morinda citrifolia is particularly adapted to treat Type II diabetes. The Morinda citrifolia product is preferably a leaf extract, but may also be in the form of a juice, a puree juice, a dietary fiber, or other similar forms and is incorporated into various carriers or naturaceutical compositions suitable for in vivo treatment of a patient. The naturaceutical may also combine other food products into the naturaceutical, such as fruit juices, dietary supplements, vitamins and minerals, and others. Excerpt(s): The present invention relates to methods and various compositions and formulations for treating and preventing diabetes and its associated symptoms and conditions. Specifically, the present invention relates to Morinda citrifolia-based methods and naturaceutical formulations for treating pre-existing diabetes conditions, as well as to Morinda citrifolia-based methods and naturaceutical formulations for inhibiting, reducing, or preventing the onset or reducing the onset potential of future or additional diabetic developments. The present invention is suited for treatment and

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prevention of diabetes as commonly experienced in mammals, and particularly humans. Diabetes mellitus (diabetes) is a complex chronic disease which affects a large number of people in the United States. More specifically, diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. It is characterized as a progressive breakdown in normal insulinrelated usage of glucose. In order to function properly, the body's use of glucose must comprise a balanced output of insulin from the pancreas to transport glucose effectively to other organs and tissues for storage. Any insulin imbalance or loss of sensitivity can cause a chronic overabundance of glucose leading to diabetes. It is estimated that a total of 15.7 million people in the United States, approximately 5.9% of the population, have diabetes in one form or another. Of those, 10.3 million people have actually been diagnosed with diabetes, while the other speculated additional 5.4 million people have gone undiagnosed. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

PROCESS AND APPARATUS FOR PRODUCING DIETARY FIBER PRODUCTS Inventor(s): HARDEN, JEROME; (PHILADELPHIA, PA), REDDING, BRUCE K. JR.; (BROOMALL, PA) Correspondence: Martin Savitzky Esq; Synnestvedt & Lechner; 1101 Market Street 26th Floor; Philadelphia; PA; 19107 Patent Application Number: 20030194473 Date filed: July 26, 1999 Abstract: Dietary fibers have their properties modified by applying a shock wave to a dispersion of the fibers in a fluid carrier. Pressure from a piston, in either a single or a series of compressive strokes or pulses exerted on the dispersion applies the shock wave. Increasing the effect of cavitation caused by the shock wave can enhance the modified properties of the fibers. The resulting pressure treated dietary fiber exhibits reduced calories, higher insoluble fiber content, reduced moisture absorption properties, and greater uniformity from batch to batch. Excerpt(s): This is a continuation-in-part of U.S. application Ser. No. 08/988,758 filed Dec. 11, 1997, which is a continuation of U.S. application Ser. No. 08/696,614 filed Aug. 14, 1996, both of which are titled "Dietary Fiber Products and Process and Apparatus for Producing Same" by Bruce K. Redding, Jr. and Jerome Harden, which applications are incorporated by reference as if fully set forth herein. The invention relates to dietary fibers and more particularly to novel dietary fiber products and a process for producing it. Dietary fibers are used in a variety of food applications as both a means to reduce overall fat and calorie content for the ultimate food product and as a bulking agent replacement for products with reduced sugar or sweeteners. Used as a fat replacement, dietary fibers are employed as a fat mimic, approximating the mouth feel and texture of fat while affording a lower calorie alternative. As a bulking agent, dietary fibers are employed in efforts to reduce sugar and other sweeteners especially from baked goods such as snack food, cakes, pies and bread products. In such products having a reduced sugar content, a bulking agent is used to return the desired mass, texture and mouth feel to the product. Dietary fibers are usually fibers that are derived from corn, wheat, cellulose, oats, or other natural grains. Generally, a dietary fiber is high in insoluble (i.e., indigestible) fiber content, ideally low in calories and low in fat content. Most dietary fibers offer great promise as an improved dietary additive to food products, but there are also several drawbacks.

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Process and apparatus for producing fiber product with high water-binding capacity and food product made therefrom Inventor(s): Lang, Cristina E.; (Bakersfield, CA), Roney, David L.; (Bakersfield, CA) Correspondence: Flehr Hohbach Test Albritton & Herbert Llp; Suite 3400; Four Embarcadero Center; San Francisco; CA; 94111-4187; US Patent Application Number: 20030044509 Date filed: June 22, 2001 Abstract: A dietary fiber product having a water absorption capacity of 8 to 15 times its weight and process for producing the same. The process includes the steps of selecting carrot material as the source for the fiber product (21), leaching a puree of the carrot material with an aqueous solution to remove the sugars from the carrot material (26), sizing the particles in the carrot material (34), bleaching the sized carrot material (41), reducing the moisture content of the bleached carrot material (46), flash drying the carrot material (43) and milling the dried carrot material to produce the dietary fiber product (49). A product produced by the process and apparatus for performing the process are disclosed, as are food products made from the carrot-based dietary fiber. Excerpt(s): The present invention relates, in general, to the production of fiber products, and particularly dietary fiber products, from various fiber-containing plant material such as fruits, grains, vegetables and cellulose products. More specifically, the present invention relates to a process, and resulting product, and the apparatus for the production thereof, which is capable of producing a dietary fiber of high water-binding capacity, that in turn may be used to produce high fiber food products. Diets high in fiber have been endorsed by many sources for the potential health benefits they offer. High fiber diets are reported to reduce the risk of colon and rectal cancers and to reduce blood serum cholesterol levels. In addition, since fibers are not easily digested by humans, dietary fiber ingredients are non-caloric and contribute to a reduction in total food calories consumed when used as a replacement for carbohydrates, proteins, and fats in a wide variety of food product formulations. The total dietary fiber (TDF) of a food or food ingredient is in two forms: soluble dietary fiber (SDF) and insoluble dietary fiber (IDF). Soluble dietary fiber can be defined as a fiber that is soluble in aqueous solutions designed to simulate human digestive systems. However, the term soluble fiber often is used loosely to refer to the solubility of the fiber in water. If a fiber is declared water-soluble this does not mean a completely dissolved state, as for example, glucose would be in water. Solubility of fiber is the dispersion state of the polymer in water, existing in a colloidal dispersion. Insoluble dietary fibers resist even a colloidal dispersion. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Process and composition for controlling fecal hair excretion and trichobezoar formation Inventor(s): Davenport, Gary Mitchell; (Dayton, OH), Hayek, Michael Griffin; (Dayton, OH), Reinhart, Gregory A.; (Dayton, OH), Sunvold, Gregory D.; (Eaton, OH) Correspondence: Killworth, Gottman, Hagan & Schaeff, L.L.P.; One Dayton Centre, Suite 500; Dayton; OH; 45402-2023; US Patent Application Number: 20020012709 Date filed: January 8, 2001 Abstract: A process and composition for controlling fecal hair excretion and trichobezoar formation in animals such as cats and rabbits is provided and includes feeding the animal a composition comprising from about 10 to about 42 wt % crude protein, from about 4 to about 30 wt % fat, from about 1 to about 25 wt % total dietary fiber, and a supplemental fiber source. The supplemental fiber source is present in amounts which provide from about 1 to about 13 weight percent of supplemental total dietary fiber. The animal is maintained on the diet for a sufficient period of time to control fecal hair excretion and trichobezoar formation. Excerpt(s): This application claims the benefit of U.S. provisional application Ser. No. 60/175,095, filed Jan. 7, 2000. The present invention relates to a process and composition for controlling fecal hair excretion and trichobezoar formation in animals such as cats and rabbits which are prone to hairball formation. Animals that constantly groom themselves, such as cats and rabbits, regularly ingest large quantities of hair. Normally, the ingested hair passes through the gastrointestinal tract of the animal and is excreted in the feces. However, the ingestion of large quantities of hair may cause the hair to accumulate in the stomach and form a hairball or trichobezoar. A hairball is typically composed of hair, mucous, water, food particles and mineral salts. A hairball can be harmful to the animal if it impedes the normal digestive process by blocking the pylorus and preventing the passage of digesta down the gastrointestinal tract. More frequently, hairballs are nothing more than a nuisance to the animal and its owner. For example, the cat will attempt to eliminate the hairball from the stomach through the vomiting reflex. A hairball may produce constipation and defecation difficulties if it passes from the stomach and becomes lodged in the lower bowel. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Process for controlling body weight Inventor(s): Forman, Adrienne; (Great Neck, NY), Frye, Wanema; (Overland Park, KS), Melnyk, Mary Grace; (Astoria, NY), Miller-Kovach, Karen; (Centerport, NY), Schmitz, Kathryn H.; (Minneapolis, MN), Watson, Sarah May; (Surrey, GB), Way, Marian Jane; (Hampshire, GB) Correspondence: Samuel C. Miller, Iii; Burns, Doane, Swecker & Mathis, L.L.P.; P.O. Box 1404; Alexandria; VA; 22313-1404; US Patent Application Number: 20030050540 Date filed: July 15, 2002 Abstract: The disclosure relates to a process for controlling body weight in which selection of food servings is based on a calculated point value and a range of allotted daily points which is adjusted for weight change. The calculated point value is a

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function of measured calories, total fat and dietary fiber for serving sizes specified in readily estimatable units. A range or maximum number of points allotted per day may be calculated based on current body weight, caloric reduction to be achieved, physical activity level, and physical activity duration. Excerpt(s): This is a Continuation-in-Part of U.S. patent application Ser. No. 08/896,855 filed Jul. 18, 1997, which is a Continuation-in-Part of PCT/US96/17511 filed Nov. 1, 1996 which designated the United States and claimed priority to GB 9522364.0 filed Nov. 1, 1995. The PCT application is entitled "SLIMMER'S CALCULATOR" and corresponds to International Publication No. WO 97/16791, dated May 9, 1997 which is incorporated herein by reference. The present invention relates to processes and devices for assisting persons in weight control or weight loss. It is widely recognized that diet is important to the health and psychological well being of human beings. Choice of types and amounts of food is an important factor in maintaining or modifying body weight. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Process for improving glucose metabolism, satiety, and nutrient absorption in companion animals Inventor(s): Hayek, Michael G.; (Dayton, OH), Sunvold, Gregory D.; (Eaton, OH) Correspondence: Schwegman, Lundberg, Woessner & Kluth, P.A.; P.O. Box 2938; Minneapolis; MN; 55402; US Patent Application Number: 20020197275 Date filed: August 7, 2002 Abstract: A process for feeding an animal a diet which alters the function and morphology of the gastrointestinal tract (GIT), a large lymphoid organ in the animal and which improves glucose metabolism, satiety, and nutrient absorption. The process involves feeding a companion animal such as, for example, a dog or cat a diet of a pet food composition containing fermentable fibers which have an organic matter disappearance (OMD) of 15 to 60 percent when fermented by fecal bacteria for a 24 hour period, the fibers being present in amounts from about 1 to 11 weight percent of supplemental total dietary fiber. The animal is maintained on the diet for a sufficient period of time to allow the fermentable fibers to ferment in the GIT of the animal. Excerpt(s): This patent application is a continuation of U.S. patent application Ser. No. 09/723,163, filed Nov. 27, 2000, which is a continuation of U.S. patent application Ser. No. 09/055,790, filed Apr. 6, 1998, which claims the benefit of U.S. Provisional Patent Application Serial No. 60/042,957, filed Apr. 7, 1997. This invention relates to a process involving the use of a pet food composition containing fermentable fibers to improve glucose metabolism, satiety, and nutrient absorption in companion animals such as, for example, dogs and cats. Recent research has suggested that dietary fiber is important for its fermentation properties in the large intestine of dogs and cats. For example, Reinhart, U.S. Pat. No. 5,616,569, describes the addition of fermentable dietary fiber to a pet food composition for the purpose of maintaining normal gastrointestinal function and ameliorating chronic diarrhea in animals. Howard et al FASEB J. (1996) 10:A257, teach that fermentable fiber consumption by dogs can result in the partition of waste nitrogen from the urine to the feces, increasing nitrogen excretion through the feces of the animal. Sunvold et al, J. Anim. Sci. (1995) 73:1099-1109, found that feeding moderately fermentable fibers to dogs could promote gastrointestinal tract health by optimizing short chain fatty acid (SCFA) production in the intestines of the animals.

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Process for making a reduced-calorie fruit and/or vegetable spread Inventor(s): Toves, Frances Ann; (Reno, NV) Correspondence: Troutman Sanders Llp; Bank OF America Plaza, Suite 5200; 600 Peachtree Street , NE; Atlanta; GA; 30308-2216; US Patent Application Number: 20020197385 Date filed: March 8, 2001 Abstract: A process for making, or preparing, a reduced-calorie fruit and/or vegetable spread product including whole, natural fruit(s) and/or vegetable(s), or combinations thereof, having improved flavor, texture (e.g., mouth feel), color, and nutritional value as compared to fruit and/or vegetable spread products made with conventional processes. More particularly, the process of the present invention includes a pasteurization step, using a swept-surface heat exchanger, for making fruit and/or vegetable spread products having reduced caloric and sugar content and having increased soluble dietary fiber content. The minimal processing of the present process enables the produced fruit and/or vegetable spread products to retain flavor, texture, color, vitamins and other nutrients which are, typically, lost in traditionally-processed fruit and/or vegetable spread products. The process' preferable use of squeeze tube packaging eliminates the need for cutlery in order to use or consume the fruit and/or vegetable spread products and serves to make the products more portable. Excerpt(s): The present invention relates, generally, to the field of reduced-calorie fruit and vegetable spread products and, in its preferred embodiments, to a process for making, or preparing, a reduced-calorie, natural, whole-fruit and/or vegetable spread product fortified with dietary fiber. Many individuals apply fruit or vegetable spreads, such as jams, jellies, purees and preserves, to other food products in order to enhance the flavor and nutritional value of the other food products with the taste and nutritional content of the fruit or vegetable spreads. Such fruit or vegetable spreads, generally, include a fruit or vegetable ingredient and a saccharide ingredient, but may also contain nutritive carbohydrate sweeteners, spice, acidifying agents, pectin (i.e., in an amount sufficient to compensate for natural deficiency in fruit or vegetable), buffering and antifoaming agents, preservatives, and other ingredients or agents for improving or preserving their taste, nutritional value, and quality. The saccharide ingredient in jams, jellies and preserves is typically sugar, which provides sweetening, bulk, texture, and mouth feel. The sugar also reduces the water activity level, thereby reducing pathogen growth. Typically, the preparation of jams, jellies, purees and preserves comprises a number of steps. Initially, fruit ingredients, sweeteners and water are blended together. A stabilizing solution, such as pectin, is then prepared and added to the fruit, sweetener, and water blend to produce a mixture. During subsequent cooking of the mixture, unwanted water is evaporated to create a cooked mixture having a desired soluble solids content. Finally, the cooked mixture is placed in suitable receptacles, such as jars, through a hot-filling process. Unfortunately, the steps of cooking and evaporation cause the fruit spread to lose flavor intensity (i.e., through boiling-off), texture (i.e., through breakdown of the fruit fibers into mush), natural color (i.e., through darkening or oxidation), and nutrients (i.e., through boiling-off). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Process for making enzyme-resistant starch for reduced-calorie flour replacer Inventor(s): Gimmler, Norbert; (Ringwood, NJ), Haynes, Lynn; (Morris Plains, NJ), Kweon, Mee-Ra; (Randolph, NJ), Levine, Harry; (Morris Plains, NJ), Locke, John P. III; (Woodcliff Lake, NJ), Slade, Louise; (Morris Plains, NJ) Correspondence: Barry I. Hollander, ESQ.; Hollander Law Firm, P.L.C.; Suite 305; 10300 Eaton Place; Fairfax; VA; 22030; US Patent Application Number: 20020146497 Date filed: January 4, 2002 Abstract: An enzyme resistant starch type III which has a melting point or endothermic peak of at least about 140.degree. C. as determined by differential scanning calorimetry (DSC) is produced in yields of at least about 25% by weight, based upon the weight of the original starch ingredient. A gelatinization stage, nucleation/propagation stage, and preferably a heat-treatment stage are used to produce reduced calorie starch-based compositions which contain the enzyme resistant starch type III. The enzyme resistant starch is produced calf using crystal nucleation and propagation temperatures which avoid substantial production of lower melting amylopectin crystals, lower melting amylose crystals, and lower melting amylose-lipid complexes. The nucleating temperature used is above the melting point of e amylopectin crystals. The propagating temperature used is above the melting point of any amylose-lipid complexes but below the melting point of the enzyme resistant starch. Starch-based compositions comprising the high-melting RS type III of the present invention exhibit unexpectedly superior baking characteristics, such as cookie spread, golden brown color, pleasant aroma, and surface cracking which are comparable to those achieved with conventional wheat flour. The high melting point of the enzyme resistant starch, as measured by DSC, permits its use in baked good formulations without substantial loss of enzyme resistance upon baking. It may therefore be used for the production of reduced calorie baked goods such as cookies. The heat-treatment may be applied to enzyme resistant starch type I, II, and IV, as well as type III, to increase the yield of enzyme resistant starch or dietary fiber content of the enzyme resistant starch composition and enhance its baking characteristics. Excerpt(s): This invention relates to the production of enzyme-resistant starch in high yield for a reduced-calorie flour replacer. Doughs and cookies containing the enzymeresistant starch are also contemplated by the present invention. This invention also relates to reduced-calorie baked goods which contain the enzyme-resistant starch for substantial calorie reduction. Enzyme-resistant starch (RS) is a fraction of starch not digested in the small intestine of healthy individuals. Microflora may partially ferment certain types of resistant starch in the large bowel. According to a doctoral thesis by Relinde Eeriingen entitled "Formation, Structure and Properties of Enzyme Resistant Starch," Katholieke Universiteit te Leuven (February 1994), enzyme-resistant starch may be defined as the sum of starch and products of starch degradation not absorbed in the small intestine, and it may be classified into four types. Physically inaccessible starch, which is locked in the plant cell, is classified as type I resistant starch. It is a fraction which can be found in foodstuffs with partially milled grains and seeds and legumes. Native granular starch found in uncooked ready-to-eat starch-containing foods, such as in bananas, is classified as type II resistant starch. Enzyme susceptibility of type II resistant starch is reduced by the high density and the partial crystallinity of the granular starch. The amount of type I and type II resistant starches is generally less than about 12% by weight, based upon the total amount of uncooked or raw starch contained in the starch source. However, the type I and type II resistant starches have low melting

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points, do not survive a baking process, and do not exhibit good baking functionality. For example, granular starches in the presence of excess water melt at a temperature of about 80.degree. C. to about 100.degree. C., which is generally below baking temperatures for cookies and crackers. Additionally, yields of resistant starch substantially greater than 12% by weight of the original starch component are desirable for the mass production of baked products having substantially reduced calorie content. Starch may be treated to obtain an indigestible starch fraction. Depending upon the type of treatment, a type III resistant starch or a type IV resistant starch may be produced. An indigestible starch fraction which forms after certain heat-moisture treatments of the starch, which may be present in, for example, cooled, cooked potatoes and canned peas or beans, is type III enzyme-resistant starch. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Process for obtaining useful materials from fenugreek seeds Inventor(s): Ponraj, Angappa M.; (Tamil Nadu, IN), Rajendran, Thavitturpalayan K.; (Tamil Nadu, IN), Rao, Garrimella B.; (Tamil Nadu, IN) Correspondence: Innovar, Llc; P O Box 250647; Plano; TX; 75025; US Patent Application Number: 20010024665 Date filed: February 9, 2001 Abstract: A method for obtaining substantially pure fixed oil(s), oleoresin and dietary fiber from Fenugreek seeds is provided. The method employs two different solvent extraction stages, wherein the first extraction isolates fixed oils and the second extraction isolates oleoresin. The dietary fiber remaining after extraction is clean, approximately light yellow to light brown, substantially tasteless and substantially odorless. An extraction system (23) for conducting the extractions is also provided. The extraction system (23) includes a condenser (24), a seed holding extraction vessel (25), a reboiler ((26), solvent and extract reservoir) and a feedback loop (28). The extraction solvent is obtained from the reboiler and it is contacted with the Fenugreek seeds while hot shortly after condensation in the condenser. The extraction system employs minimal amounts of solvent compared to conventional processes. In terms of color, taste, and/or odor, the food grade isolated fixed oils, oleoresin and dietary fiber are superior to those products obtained from conventional extraction processes. Excerpt(s): This invention relates generally to a process for extraction of seeds and specifically to a process for the preparation of useful materials such as dietary fiber, oleoresin and fixed oils from the seeds of Fenugreek (Trigonella Foenum Graecum L). This invention also relates to an extraction apparatus for extraction of the seeds. Fenugreek is an herbaceous plant of the leguminous family and is native to Western Asia, from where it has spread widely over Europe, the Mediterranean and rest of Asia. It is one of the oldest cultivated plants and through the ages has found wide application as a food, a food additive and in the traditional medicine of every region in which it has been cultivated. For example, one of its earliest uses was in Egypt where it was used as a flavoring agent in bread and other foods and as an anti-pyretic. Similarly, in India and elsewhere, the leaves, and both the ripe and unripe seeds of Fenugreek are used as vegetables and the ripe seed further, has numerous applications in the traditional medicine system of India. The seeds also function as a preservative and are added to pickles, chutneys and other similar products. In modem food practice, the seeds or the extract are used in bakery products, frozen dairy products, meat products, relish, condiments, candy, gravy sauces, gelatin puddings and in alcoholic and non-alcoholic

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beverages. The leaves of Fenugreek are also used in forage for cattle and the seeds as an additive in cattle feeds. Because of its significant nutrition potential, the seeds and products made therefrom are also used as food supplements. Fenugreek has been used in treating colic flatulence, dysentery, diarrhea, dyspepsia with loss of appetite, chronic cough, dropsy, enlargement of liver and spleen, rickets, gout and diabetes. The seed is stated to be a tonic. It is also used in post-natal cure and to increase lactation in nursing mothers. Its lactation inducing property is also used with milch cattle to increase the yield of milk. The seed was used as a cure for baldness in the middle ages and today it is used as part of hair tonics in some countries. The seed also has several applications in veterinary medicine. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Process for producing l-arabinose, l-arabinose-containing enzymatically processed products, diet foods, diabetic diet foods and fruit or vegetable juices and process for producting the same Inventor(s): Morimoto, Akemi; (Kyoto, JP), Mukai, Katsuyuki; (Kyoto, JP), Nisikawa, Yosihiro; (Kyoto, JP), Tanaka, Hiromi; (Kyoto, JP), Yoshikawa, Genichi; (Kyoto, JP) Correspondence: Sughrue Mion Zinn Macpeak & Seas; 2100 Pennsylvania Avenue NW; Washington; DC; 20037; US Patent Application Number: 20030040489 Date filed: October 1, 2001 Abstract: Processes for conveniently and economically producing L-arabinose, enzymetreated products containing L-arabinose, diet foods and diabetic foods containing Larabinose with dietary fiber, and fruit or vegetable juices containing L-arabinose are provided.(1) A process for producing L-arabinose by treating a natural material containing arabinan, arabinoxylan or arabinogalactan with an enzyme having an activity of acting on natural substances containing arabinan, arabinoxylan or arabinogalactan and thus releasing L-arabinose to give L-arabinose, characterized in that the above-described natural substance is directly treated with the above-described enzyme without separating or extracting arabinan, arabinoxylan or arabinogalactan.(2) A process for producing a diet food and a diabetic food characterized by comprising treating a dietary fiber material originating in a natural substance containing arabinan, arabinoxylan or arabinogalactan with an enzyme which degrades arabinan, arabinoxylan or arabinogalactan to give an enzyme-treated product containing Larabinose and dietary fiber, and adding the thus obtained enzyme-treated product to a food.(3) An L-arabinose-containing fruit or vegetable juice characterized by containing an L-arabinose-containing fraction obtained by treating a fruit or vegetable press cake containing arabinan, arabinoxylan or arabinogalactan with an enzyme, and a process for producing the same. Excerpt(s): This invention relates to a process for producing L-arabinose, enzymetreated products containing L-arabinose and a process for producing the same, and diet foods, diabetic foods and fruit or vegetable juices with the use of the same, and processes for the production thereof. L-Arabinose is a non-caloric sweetener which has taste characteristics similar to sucrose and shows little absorbability. It is also known that L-arabinose inhibits enzymes which hydrolyze dissacharides such as sucrose and thus exerts an effect of suppressing an increase in blood glucose level due to the intake of sucrose. Using these characteristics of L-arabinose, there have been known body fat accumulation inhibitors (JP-A-7-309765, JP-A-7-242551), preventives and remedies for

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diseases related tohyperglycemia (JP-A-6-65080), diet sweeteners and preventives for obesity (JP-X-6-812057) and pet foods (JP-A-2-299555) each containing L-arabinose (the term "JP-A" as used herein means an "unexamined published Japanese patent application" and "JP-X" as used herein means a publication of Japanese translation of a PCT patent application). Also, L-arabinose is a saccharide which is useful as a starting material for synthesizing drugs. L-Arabinose occurs as arabinan, arabinoxylan, arabinogalactan and the like in hemicellulose of higher plants. Also, a trace amount of Larabinose in a free state is contained in fermented foods such as miso and sake, instant coffee, etc. Thus, L-arabinose is a saccharide which has been commonly taken over a long time. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

SOFT CAPSULE Inventor(s): ISHIKAWA, TOSHIMITSU; (SHIZUOKA, JP), KAJIMA, KOJI; (SHIZUOKA, JP), KAWAGUCHI, FUTAO; (SHIZUOKA, JP), WADA, NOBUYUKI; (SHIZUOKA, JP) Correspondence: Wenderoth Lind & Ponack Llp; 2033 K Street NW; Suite 800; Washington; DC; 20006 Patent Application Number: 20030012797 Date filed: September 10, 1999 Abstract: A soft capsule capable being substantially free of or having a minimum content of a fat and oil material and an emulsifier in an encapsulated liquid or medicinal liquid. The soft capsule contains a dietary fiber in an amount of 5 to 90% by weight based on a whole composition of the medicinal liquid. Excerpt(s): This invention relates to a soft capsule, and more particularly to a soft capsule for foods, pharmaceuticals, cosmetics or the like. Conventionally, a capsule has been commercially available in the art which is constructed in such a manner that a fat and oil material, an oil-soluble material, an oil-soluble perfume, and/or the like are charged or encapsulated in an encapsulating material made of gelatin. Such a capsule permits any ingredient in any desired amount to be readily provided or each dose to be handy to carry. Also, the capsule effectively prevents contact of an encapsulated ingredient with an ambient atmosphere, to thereby ensure stability of the ingredient. A medicinal liquid which is an ingredient or material encapsulated in a soft capsule is constituted of a first medicinal liquid ingredient of a fat and oil material and a second medicinal liquid ingredient obtained by adding an effective component extract and/or an effective component powder to a fat and oil material to prepare a mixture and stabilizing the mixture with a suitable emulsifier. Then, the medicinal liquid thus obtained is charged or encapsulated in a soft encapsulating material, resulting in the soft capsule being provided. Methods of producing soft capsules include techniques using a rotary type capsule manufacturing equipment, a seamless type capsule manufacturing equipment and a flat plate type capsule manufacturing equipment. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Soybean processed food and method of producing the same Inventor(s): Hayashi, Noriaki; (Ikoma-shi, JP), Kagawa, Masaru; (Osaka-shi, JP), Mitani, Takahiko; (Kyoto-shi, JP), Shioaki, Koichiro; (Ashiya-shi, JP), Tsuchiya, Rumi; (Itami-shi, JP) Correspondence: J.C. Patents, INC.; Suite114; 1340 Reynolds AVE.; Irvine; CA; 92614; US Patent Application Number: 20010028907 Date filed: March 9, 2001 Abstract: A soybean processed food having crisp feelings of eating and good tasting is provided. The soybean processed food is produced by kneading a mixture of a soybeanderived material and a condiment in the presence of water to obtain dough, and drying the dough under a reduced pressure of 0.1 kPa to 10 kPa. It is preferred that the soybean-derived material contains isolated soybean protein as the major constituent, soybean saccharide, soybean dietary fiber, and/or soybean lecithin. According to this soybean processed food, users of all ages can easily and efficiently ingest nutrients of soybean Excerpt(s): The present invention relates to a soybean processed food rich in nutrients of soybean, which is easy for users of all ages to eat, and a method of producing the same food. In recent years, research on nutrients of soybean has rapidly advanced on a world scale. For example, it is known that soybean protein has a plasma-cholesterol lowering effect and a blood-pressure lowering effect. The Food and Drug Administration (FDA) is authorizing the use, on food labels and in food labeling, of health claims on the association between soy protein and reduced risk of coronary heart disease (CUD). In addition, it is reported that isoflavone included in soybean is effective to prevent a serious disease such as breast cancer, prostate cancer, osteoporosis or menopausal disorders. Thus, ingesting soybean protein is indispensable to maintain health, and soybean comes to international attention. In the past, processed foods containing soybean protein are provided in powder or granular form, and usually dispersed in water or milk to allow users to easily ingest it. Alternatively, the processed foods are often used as cooking materials. In any event, it is hard to say that the powder or granular foods of soybean protein is tasty. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Water containing soluble fiber Inventor(s): Stillman, Suzanne Jaffe; (Los Angeles, CA) Correspondence: Reed Smith Crosby Heafey Llp; 1901 Avenue OF The Stars, Suite 700; Los Angeles; CA; 90067; US Patent Application Number: 20030211201 Date filed: April 2, 2003 Abstract: A water-like fluid containing safe water and a significant quantity of soluble dietary fiber. The resulting solution is generally optically clear and has physical properties similar to potable water. The fluid is intended as a replacement for bottled, or other water, as a means to ensure proper hydration. Depending on the soluble fiber used the fluid is either non-caloric or extremely low in calories. The amount of soluble fiber is adjusted to a specific amount of water so that consumption of an adequate amount of fluid ensures hydration (e.g., eight 8 oz. glasses per day) will also providing

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an optimal amount of dietary fiber. This is particularly valuable in stressed situations where the diet may not provide adequate fiber without supplementation. The constant metered supply of fiber provided throughout the day is preferable to, and more convenient than, "bolus" administration of fiber through laxatives, etc. Additionally, the constant presence of soluble fiber in the digestive tract provides the known beneficial effects of moderating the postprandial increase in blood glucose, modulating serum lipid levels, and suppressing appetite. Excerpt(s): The present Application is a Continuation-in-Part of the U.S. patent application Ser. No. 09/510,400 filed Feb. 22, 2000, entitled "FIBER-WATER-WATER CONTAINING SOLUBLE FIBER," the contents of which are incorporated herein by reference in its entirety. The present application concerns generally components of the human diet and more specifically water and fiber. Many of the major problems in human health revolve around which dietary components are truly essential for animal and human health and which components are merely hyped by various companies to sell product. A related problem is that of the accuracy of information regarding the appropriateness of a given food, nutrient or nutraceutical for a given individual. Certainly the "one size fits all" scenario is untrue when it comes to pharmaceuticals and nutrition. Further, the Federal Drug Administration has very little control over dietary supplements so that companies compete in making claims and launching new products, which may or may not be helping humans or animals that consume the products. New information constantly comes forth warning of potential interactions between herbal supplements, ethical pharmaceuticals and various disease states. The present inventor is concerned with providing a composition that can be extremely beneficial to humans and animals with few, if any, dangers or drawbacks. In the following description consumption by humans should also be taken to include consumption by domestic animals--primarily dogs and cats. While many of the concepts discussed are applicable to other animals, the digestive systems of herbivores, particularly ruminates, varies tremendously from that of humans. Therefore, the thrust of the present invention is towards carnivores and omnivores whose digestive systems more closely resemble those of humans. One of the conundrums of human health is that dietary components, which may appear mundane are actually incredibly essential. One such vital component that is frequently overlooked, or given insufficient importance, is water. Although water is not metabolized, it is absolutely essential for metabolism. A majority of the weight of the body is water which serves as the solvent for the chemical reactions of life. Many living cells are more water than anything else. The various nutrients needed for cellular growth and survival enter the cells dissolved in water. After metabolism, the waste products are carried away by water, and death can occur in as little as three to five days without water. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with dietary fiber, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “dietary fiber” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on dietary fiber.

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You can also use this procedure to view pending patent applications concerning dietary fiber. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 6. BOOKS ON DIETARY FIBER Overview This chapter provides bibliographic book references relating to dietary fiber. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on dietary fiber include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “dietary fiber” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on dietary fiber: •

Pediatric Nutrition Handbook, Fourth Edition Source: Elk Grove Village, IL: American Academy of Pediatrics. 1998. 833 p. Contact: Available from American Academy of Pediatrics. P.O. Box 927, 141 Northwest Point Boulevard, Elk Grove Village, IL 60009-0927. (800) 433-9016. PRICE: $47.95 (members) plus $6.25 shipping and handling; $52.95 for nonmembers; plus $8.95 shipping and handling. ISBN: 1581100051. Summary: Assessment of nutritional status and providing dietary advice and nutritional support are important and increasingly prominent components of the practice of those who provide health care for infants, children, and adolescents. This handbook serves as a ready desk reference on the nutritional requirements and impact of nutritional status on the health of infants, children, and adolescents. Forty-three chapters cover breastfeeding; formula feeding of term infants; supplemental foods for infants; vitamin and mineral supplement needs of healthy children in the United States; feeding from

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age 1 year to adolescence; adolescent nutrition; the nutritional needs of preterm infants; the recognition and management of pediatric swallowing disorders; energy; proteins; carbohydrate and dietary fiber; fats and fatty acids; calcium, phosphorus, and magnesium; trace elements; vitamins; infant nutrition and the development of gastrointestinal function; parenteral nutrition; enteral nutrition; nutrition and oral health; sports nutrition; community nutrition services for children; current legislation and regulations regarding infant formulas; assessment of nutritional status; failure to thrive; gastrointestinal disease, persistent diarrheal disease, and malabsorption; oral rehydration therapy and posttreatment feeding after enteritis; iron deficiency; inborn errors of metabolism; dietary management of diabetes mellitus; hypoglycemia; hyperlipidemia; obesity in children; food hypersensitivity; nutrition and immunity; nutritional management of children with a chronic illness; nutrition in children with HIV infection; diet in the prevention of cancer or hypertension; food labeling; nutritional aspects of vegetarian diets; fast foods, organic foods and megavitamins; food safety; and new food ingredients. Extensive appendices and a subject index conclude the volume. •

Managing Your Diabetes Without Insulin Source: Boston, MA: Joslin Diabetes Center. 1997. 18 p. Contact: Available from Joslin Diabetes Center. One Joslin Place, Boston, MA 02215. (800) 344-4501. Fax (617) 732-2562. Website: www.joslin.org. PRICE: $3.50; plus shipping and handling. Item number: JDC 260. Summary: Individuals with type 2 diabetes can make some insulin but do not use it properly; this type of diabetes often can be managed without insulin injections. This booklet offers diabetes management strategies for readers with type 2 diabetes who do not use insulin. The booklet covers the symptoms of uncontrolled diabetes, the causes of diabetes, the diabetes care team, why it is important to maintain blood glucose (sugar) at healthful levels, food and nutrition guidelines (the role of carbohydrates, dietary fiber, portion control, sugar intake), the role of exercise, target heart rate, weight management, blood glucose testing (SMBG), recordkeeping, medication, the complications of poorly managed diabetes, how to cope with low blood glucose (hypoglycemia) and high blood glucose (hypertension) episodes, foot care, sick days, traveling with diabetes, support groups, and behavior modification strategies. The booklet offers practical, everyday tips for patients. 2 figures. 6 tables.

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Nutrition Care of People With Diabetes: A Nutrition Reference for Health Professionals Source: Binghamton, NY: Food Products Press. 1991. 263 p. Contact: Available from Haworth Press. 10 Alice Street, Binghamton, NY 13904-1580. (800) 342-9678. PRICE: $39.95 hardcover, $19.95 softcover. ISBN: 156022004x (hardcover); 1560220074 (softcover). Summary: This book for general practitioners offers nutrition guidelines for the management of diabetes. Topics addressed in the book's six sections include diet instruction competencies; nutrition in the early years and during pregnancy; nutrition in the adult and aging years; nutrition in special conditions; weight correction and control; and information about the glycemic index, dietary fiber, sweeteners, and nutrient content of foods. The use of computerized nutrient analysis is addressed where appropriate. A comprehensive glossary of nutrition terms relating to diabetes and a subject index are included.

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Tell Me What to Eat If I Have Diabetes Source: Franklin Lakes, NJ: Career Press, Inc. 1999. 157 p. Contact: Available from Career Press, Inc. 3 Tice Road, P.O. Box 687, Franklin Lakes, NJ 07417. (800) 227-3371. Website: www.careerpress.com or www.newpagebooks.com. PRICE: $10.99 plus shipping and handling. Summary: This book offers eating and nutrition guidelines for people who have been diagnosed with diabetes mellitus. The author focuses on type 2 diabetes, noting that diabetes can manifest differently in different patients and sometimes even changing throughout its course within one person. The author encourages readers to learn as much as they can about their disease and to utilize nutrition as an adjunct therapy and a vital component of their diabetes care. The author emphasizes the importance of following a personalized eating plan that helps keep blood glucose (sugar) levels normal, and helps protect against heart disease and weight gain without making the patient feel deprived. The book offers seven chapters that cover an overview of diabetes, the top 7 profiles of type 2 diabetes, working with a dietitian to manage diabetes, ten food steps to freedom, 20 recommended recipes, food shopping guidelines, and eating out at restaurants. Two of the ten recommended 'food' steps actually do not involve food: one involves monitoring the blood glucose (sugar) levels; the other the need for regular exercise. The eight remaining recommended food steps are: make dietary fiber a part of almost every meal; count carbohydrates; emphasize heart-protective fats; keep saturated fat and cholesterol low; count caloric intake; eat more fruits and vegetables; avoid eating large meals; and improve the diet with supplements as necessary. Recipes are provided for a light Denver omelet, egg muffin sandwich lite, sun dried tomato pesto spread, the Loxness monster spread, apple lover's oatmeal, honey wheat bread with flaxseed, flaxseed jam muffins, flaxseed focaccia, flaxseed maple scones, high legume fried rice, 3 minute burrito, pintos and cheese, quick fix chili and fries, lemon dijon salmon, simple salmon pasta salad, easy omega 3 fatty acid tuna sandwich, oat bran meat loaf, light club sandwich, monosaturated side salad, easy 3 bean salad, quick ranch dip with vegetables, spicy hummus with crudites and crackers, iced caf mocha, and oatmeal raisin bites. A brief subject index concludes the book.

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Food Finder Vitamin and Mineral Source Guide Source: Salem, OR: Esha Research. 1995. 475 p. Contact: Available from Esha Research. P.O. Box 13028, Salem, OR 97309. (800) 659-3742. Fax (503) 585-5543. PRICE: $29.95 plus $5 shipping (as of 1995). Summary: This book presents nutrient data compiled from over 1000 scientific sources, including the most recent USDA data. Estimates of nutrient amounts in foods include adjustments in the interest of accuracy. Nutrient information is provided for thirteen vitamins, including A, thiamin (B1), riboflavin (B2), niacin (B3), B6, biotin, folacin, B12, pantothenic acid, C (ascorbic acid), D, E, and K; and for twelve minerals, including calcium, chromium, copper, iodine, iron, magnesium, manganese, phosphorus, potassium, selenium, sodium, and zinc. Additional sections cover caffeine, cholesterol, and dietary fiber. Introductory material is provided that can help readers understand and interpret the nutrient data, as well as information about recommended dietary allowances, safe and adequate daily intakes, and dietary guidelines and goals.

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Power of Your Plate: A Plan for Better Living Source: Summertown, TN: Book Publishing Company. 1995. 255 p.

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Contact: Available from Book Publishing Company. Mail Order Catalog, P.O. Box 180, Summertown, TN 38483. (800) 695-2241. Wholesale orders available from Book Publishing Company. P.O. Box 99, Summertown, TN 38483. (615) 964-3571. PRICE: $12.95 plus $2.50 shipping. ISBN: 157067003X. Summary: This book provides detailed information on how food choices can improve health, emphasizing the benefits of a vegetarian diet. Eleven chapters cover topics including cholesterol, food, and the heart; tackling cancer; new strategies for weight control; foodborne illness; common health problems that are related to diet; food and the mind; the evolution of the human diet; lessons from Asia; recommendations; will power; and food ideas and recipes. The book also includes an interview with Dr. Michael DeBakey, a cardiovascular surgeon and pioneer in heart transplants. The chapter on common health problems covers constipation, hemorrhoids, hiatus hernia, diabetes, osteoporosis and kidney disease as problems related to food. A brief discussion of Dr. Denis Burkitt's work with dietary fiber is included. 83 references. •

Handbook of Diabetes Medical Nutrition Therapy Source: Gaithersburg, MD: Aspen Publishers, Inc. 1996. 711 p. Contact: Available from Aspen Publishers. P.O. Box 990, Frederick, MD 21705-9727. (800) 638-8437. Fax (301) 695-7931. PRICE: $89.00. ISBN: 0834206315. Summary: This book provides dietitians and other health care professionals with information they need to provide comprehensive diabetes care and self-management training in the area of diabetes medical nutrition therapy. Thirty-six chapters are presented in seven sections: understanding diabetes, setting and achieving management goals, selecting a nutrition education approach, the influence of macronutrients on blood glucose and health, making food choices, life stages, nutrition and specific clinical conditions, and making it all work. Topics include nutritional assessment, exercise benefits, blood glucose monitoring, counseling skills for improved behavioral change, meal-planning, the exchange system, carbohydrate counting, weight loss, cultural considerations, protein needs, lipid metabolism, caloric intake, dietary fiber, food selection, pregnancy, caring for older persons with diabetes, renal disease, hypertension, eating disorders, diabetes during surgery, gastrointestinal issues, dental care, HIV and diabetes, and reimbursement issues. Each chapter includes numerous references, and a subject index concludes the volume.

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New Soul Food Cookbook for People with Diabetes Source: Alexandria, VA: American Diabetes Association. 1999. 192 p. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-6733. PRICE: $14.95. ISBN: 1580400086. Summary: This cookbook features more than 140 recipes with an authentic African American flavor. The book begins with an introductory chapter that uses a question and answer format to provide advice on reducing fat, calories, and sodium; to present the basics of healthy food preparation and menu planning; and to offer suggestions on cooking with herbs and spices. Recipe chapters have numerous photographs and focus on meat and seafood dishes; vegetables and side dishes; breads, cereals, and grains; soups and salads; appetizers; and desserts. Each recipe lists preparation time, number served, and serving size and also includes exchanges and a per serving analysis of calories, total and saturated fat, cholesterol, sodium, carbohydrates, dietary fiber,

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sugars, and protein. The cookbook concludes with an alphabetical list of recipes, a subject index, and information about the American Diabetes Association. 2 figures. •

Tasty, Tender Temptations: Recipes for Soft, High-Fiber, Low-Salt Meals for Folks with Kidney Disease Source: Roanoke, TX: Niche Pharmaceuticals, Inc. 1997. 19 p. Contact: Available from Niche Pharmaceuticals, Inc. 200 North Oak Street, Roanoke, TX 76262. (800) 677-0355. Fax (817) 491-3533. PRICE: Single copy free to health professionals; bulk copies available. Summary: This cookbook features recipes that are acceptable for a person following a renal diet and that combine high fiber and low salt foods in an easy to ingest and easy to digest form. The recipes are designed to help kidney disease patients who have trouble chewing or swallowing and who may be at increased risk of malnutrition as they try to follow the recommended renal diet. The introductory material discusses the importance of dietary fiber (including the use of supplements), the role of caloric intake, and the individual recommendations for protein foods, starches, vegetables, and fruits. The recipes begin with three basic sauces: a white sauce, a brown sauce, and a tomato sauce; the nutritional values (calories, protein, sodium, potassium, and phosphorus) are provided for each. The cookbook then provides recipes for lasagna, chicken pot pie, beef burgundy, beef stroganoff, shrimp creole, mock stuffed crab, Garden-roni, curried egg, and Dialyzing potatoes. All of the recipes include the supplemental fiber product, Unifiber, manufactured by the company that created the cookbook. All of the recipes include a nutrient analysis that notes calories, protein, sodium, potassium, and phosphorus amounts. The cookbook is spiral bound for ease of use.

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American Dietetic Association's Complete Food and Nutrition Guide Source: Minneapolis, MN: Chronimed Publishing. 1996. 619 p. Contact: Available from Chronimed Publishing. P.O. Box 59032, Minneapolis, MN 55459. (800) 848-2793 or (612) 541-0239. Fax (800) 395-3344 or (612) 541-0210. PRICE: $29.95; bulk orders available. ISBN: 1565610989. Summary: This food and nutrition guide focuses on a healthful diet for all stages of life. The author describes nutrition and health concepts in clear, nontechnical language and includes charts, graphs, and illustrations. Each chapter offers readers the opportunity to assess their own food and nutrition knowledge and practices. The author also uses reallife examples and tips on how sound nutrition habits and physical activity can be incorporated into diverse lifestyles. Twenty-three chapters cover food choices for fitness, determining and maintaining a healthy weight, facts about dietary fats, vitamins and minerals, sugar and other sweeteners, dietary fiber, sodium, fluids, food sensitivities, food marketing and the food supply, nutritional guidelines (including the Food Pyramid), supermarket smarts (shopping hints), food safety, kitchen nutrition, choosing healthy food away from home, healthy nutrition for infants, food considerations for children and adolescents, nutritional considerations for women, the role of nutrition in preventing health problems, nutrition for older adults, the role of nutrition for athletes, and vegetarian diets. A final chapter describes how readers can get more information and how to judge health claims. One section in the prevention chapter covers diabetes and the role of nutrition in preventing or managing the disease. The book concludes with an extensive list of resources, appendices, and a subject index.

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Pediatric Nutrition Handbook. 3rd ed Source: Elk Grove Village, IL: American Academy of Pediatrics. 1993. 472 p. Contact: Available from American Academy of Pediatrics. P.O. Box 927, 141 Northwest Point Boulevard, Elk Grove Village, IL 60009-0927. (800) 433-9016. PRICE: $47.95 (members) plus $6.25 shipping and handling; $52.95 for nonmembers; plus $8.95 shipping and handling. ISBN: 0910761388. Summary: This handbook serves as a ready desk reference on the nutritional requirements and impact of nutritional status on the health of infants, children, and adolescents. Thirty-five chapters cover breastfeeding; formula feeding of term infants; supplemental foods for infants; vitamin and mineral supplement needs of healthy children in the United States; feeding from age 1 year to adolescence; adolescent nutrition; the nutritional needs of preterm infants; energy; proteins; carbohydrate and dietary fiber; fats and fatty acids; calcium, phosphorus, and magnesium; trace elements; vitamins; infant nutrition and the development of gastrointestinal function; parenteral nutrition; nutrition and oral health; community nutrition services for children; current legislation and regulations regarding infant formulas; assessment of nutritional status; failure to thrive; gastrointestinal disease, chronic diarrhea, and malabsorption; oral fluid therapy and posttreatment feeding after enteritis; iron deficiency; inborn errors of metabolism; diabetes mellitus; hypoglycemia; hyperlipidemia; obesity; food hypersensitivity; nutrition and infection; diet in the prevention of cancer or hypertension; nutritional aspects of vegetarian diets; fast foods, organic foods, and megavitamins; and food additives. Extensive appendices and a subject index conclude the volume.

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Diet and Health: Implications for Reducing Chronic Disease Risk Source: Washington, DC: National Academy Press. 1989. 749 p. Contact: Available from National Academy Press. Box 285, 2101 Constitution Avenue, NW, Washington, DC 20418. {202} 334-3313. PRICE: $54.95 plus shipping and handling. ISBN: 030903994. Summary: This report by the National Research Council is the result of a comprehensive analysis of the scientific literature on diet and the spectrum of major chronic diseases. Twenty-eight chapters are presented in four sections: introductions, definitions, and methodology; evidence on dietary components and chronic diseases, including calories, fats, protein, carbohydrates, dietary fiber, vitamins, minerals, trace elements, alcohol, and caffeine; the impact of dietary patterns on chronic diseases, including diabetes mellitus, atherosclerotic cardiovascular diseases, hypertension, obesity, cancer, osteoporosis, hepatobiliary disease, and dental caries; and overall assessment, conclusions, and recommendations. The chapter on diabetes focuses on the evidence associating dietary factors with diabetes mellitus, as shown in epidemiologic, clinical, and animal studies. Exhaustive references are included in each chapter. A subject index concludes the volume.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and

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commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “dietary fiber” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “dietary fiber” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “dietary fiber” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Controlling Dietary Fiber in Food Products by Leon Prosky, Jonathan W. Devries (1992); ISBN: 0442002394; http://www.amazon.com/exec/obidos/ASIN/0442002394/icongroupinterna

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CRC Handbook of Dietary Fiber in Human Nutrition, Third Edition by Gene A. Spiller (Editor); ISBN: 0849323878; http://www.amazon.com/exec/obidos/ASIN/0849323878/icongroupinterna

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Dietary Fiber by David Kritchevsky (Editor), Charles Bonfield (Editor) (2004); ISBN: 0306466953; http://www.amazon.com/exec/obidos/ASIN/0306466953/icongroupinterna

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Dietary Fiber by Shirley S. Lorenzani; ISBN: 087983479X; http://www.amazon.com/exec/obidos/ASIN/087983479X/icongroupinterna

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Dietary Fiber by Brian McNamee, Virginia Mansour-McNamee; ISBN: 354111102X; http://www.amazon.com/exec/obidos/ASIN/354111102X/icongroupinterna

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Dietary fiber; ISBN: 0842241264; http://www.amazon.com/exec/obidos/ASIN/0842241264/icongroupinterna

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Dietary Fiber Analysis & Applications by Sungsoo Cho, et al (1997); ISBN: 0935584625; http://www.amazon.com/exec/obidos/ASIN/0935584625/icongroupinterna

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Dietary Fiber and Cardiovascular Disease (Evaluation of Publicly Available Scientific Evidence Regarding Certain nutrIent Series) by David Kritchevsky (1991); ISBN: 9992239875; http://www.amazon.com/exec/obidos/ASIN/9992239875/icongroupinterna

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Dietary Fiber and Obesity (Current Topics in Nutrition and Disease, Vol 14) by Per Bjoerntorp, et al; ISBN: 0471847593; http://www.amazon.com/exec/obidos/ASIN/0471847593/icongroupinterna

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Dietary fiber and obesity : proceedings of a satellite symposium to the Second Washington Symposium on Dietary Fibers, held in Washington, DC, April 24-28, 1984; ISBN: 0845116134; http://www.amazon.com/exec/obidos/ASIN/0845116134/icongroupinterna

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Dietary Fiber Handbook by M. L. Dreher (2003); ISBN: 0824793455; http://www.amazon.com/exec/obidos/ASIN/0824793455/icongroupinterna

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Dietary Fiber in Health & Disease by David Kritchevsky (Editor), et al (1995); ISBN: 0962440760; http://www.amazon.com/exec/obidos/ASIN/0962440760/icongroupinterna

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Dietary Fiber in Health and Disease by G. Vahouny; ISBN: 0306409267; http://www.amazon.com/exec/obidos/ASIN/0306409267/icongroupinterna

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Dietary Fiber Research by Zecharia Madar, H. Selwyn Odes (1989); ISBN: 380555043X; http://www.amazon.com/exec/obidos/ASIN/380555043X/icongroupinterna

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Dietary Fiber Weight Control by Roger A. Brumback; ISBN: 0815107498; http://www.amazon.com/exec/obidos/ASIN/0815107498/icongroupinterna

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Dietary Fiber, Calories and Cancer: Index of Modern Authors and Subjects With Guide for Rapid Research by Joseph M. Bahr (1992); ISBN: 1559149582; http://www.amazon.com/exec/obidos/ASIN/1559149582/icongroupinterna

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Dietary Fiber, Prebiotics, Probiotics and Their Role in Intestinal Health: Ift Basic Symposium by Dennis T. Gordon, Susan Sungsoo Cho (Editor) (2004); ISBN: 0824709748; http://www.amazon.com/exec/obidos/ASIN/0824709748/icongroupinterna

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Dietary Fiber: Basic and Clinical Aspects by George V. Vahouny, David Kritchevsky (Editor) (1986); ISBN: 0306420287; http://www.amazon.com/exec/obidos/ASIN/0306420287/icongroupinterna

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Dietary Fiber: Chemistry, Physiology, and Health Effects by David Kritchevsky, et al (1990); ISBN: 0306433109; http://www.amazon.com/exec/obidos/ASIN/0306433109/icongroupinterna

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Dietary Fiber: Subject Survey and Research Index With Bibliography by Vincent A. Spedding (1987); ISBN: 0881646776; http://www.amazon.com/exec/obidos/ASIN/0881646776/icongroupinterna

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Dietary Fibers: Chemistry and Nutrition by George E. Inglett, S. Ingemar Falkehag (1979); ISBN: 0123709504; http://www.amazon.com/exec/obidos/ASIN/0123709504/icongroupinterna

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Dietary Reference Intakes: Proposed Definition of Dietary Fiber by Panel on the Definition of Dietary Fiber Food and Nutrition Board Staf, et al; ISBN: 0309075645; http://www.amazon.com/exec/obidos/ASIN/0309075645/icongroupinterna

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Fiber Facts: Get the Truth Concerning Dietary Fiber by Rita Elkins (1999); ISBN: 1580540686; http://www.amazon.com/exec/obidos/ASIN/1580540686/icongroupinterna

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Handbook of Dietary Fiber (Food Science and Technology, Vol 113) by Sungsoo Cho (Editor), et al (2001); ISBN: 0824789601; http://www.amazon.com/exec/obidos/ASIN/0824789601/icongroupinterna

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Medical Aspects of Dietary Fiber by Spiller; ISBN: 0306405075; http://www.amazon.com/exec/obidos/ASIN/0306405075/icongroupinterna

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New Developments in Dietary Fiber: Physiological, Physiochemical, and Analytical Aspects (Advances in Experimental Medicine and Biology, 270) by Agricultural and Food Chemistry Division Symposium on Dietary Fiber-Ne, et al; ISBN: 0306435837; http://www.amazon.com/exec/obidos/ASIN/0306435837/icongroupinterna

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Soy Fiber and Dietary Fiber: Bibliography and Sourcebook, A.D. 1445 to 1995: Detailed Information on 633 Published Documents (Extensively Annotated Bbliography), 203 Commercial (Bibliographies and Sourcebooks on Soya Series) by William Shurtleff, Akiko Aoyagi (1995); ISBN: 0933332963; http://www.amazon.com/exec/obidos/ASIN/0933332963/icongroupinterna

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The Analysis of Dietary Fiber in Food by James; ISBN: 0824711920; http://www.amazon.com/exec/obidos/ASIN/0824711920/icongroupinterna

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The Dietary Fiber Counter to Brand Name and Whole Foods by Lynn Sonberg (Editor); ISBN: 0425104990; http://www.amazon.com/exec/obidos/ASIN/0425104990/icongroupinterna

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The Miracle Nutrient: How Dietary Fiber Can Save Your Life by Carl I. Flath; ISBN: 0871311860; http://www.amazon.com/exec/obidos/ASIN/0871311860/icongroupinterna

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Topics in Dietary Fiber Research; ISBN: 0306311267; http://www.amazon.com/exec/obidos/ASIN/0306311267/icongroupinterna

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Unconventional Sources of Dietary Fibers: Physiological and in Vitro Functional Properties by Ivan Furda (Editor) (1983); ISBN: 0841207682; http://www.amazon.com/exec/obidos/ASIN/0841207682/icongroupinterna

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The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “dietary fiber” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:10 •

Clinical value of dietary fiber Author: Floch, Martin H.; Year: 1982; Norwalk, Conn.: Purdue Frederick Co., c1982

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Dietary fiber: January 1975 through June 1977 Author: National Library of Medicine (U.S.); Year: 1977; [Bethesda, Md.]: Dept. of Health, Education, and Welfare, Public Health Service, National Institutes of Health, [1977]

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Dietary fiber: subject survey & research index with bibliography Author: Spedding, Vincent A.; Year: 1987; Washington, D.C.: ABBE Publishers, c1987; ISBN: 0881646768 http://www.amazon.com/exec/obidos/ASIN/0881646768/icongroupinterna

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Dietary fiber and peptic ulcer: a review Author: Rydning, Andreas.; Year: 1986; Oslo, Norway: Oslo City Health Authorities, 1986

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Dietary fibers, chemistry and nutrition Author: Inglett, George E.,; Year: 1979; New York: Academic Press, 1979; ISBN: 0123709501

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Effects of dietary fiber on iron absorption Author: Fernandez, Roger.; Year: 1980; [Minneapolis?: s. n.]., 1980

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Handbook of dietary fiber: an applied approach Author: Dreher, Mark L.,; Year: 1987; New York: Dekker, c1987; ISBN: 0824776550 http://www.amazon.com/exec/obidos/ASIN/0824776550/icongroupinterna

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Medical aspects of dietary fiber: a report Author: Royal College of Physicians of London.; Year: 1980; Turnbridge Wells, Kent: Pitman Medical, c1980

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In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

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Chapters on Dietary Fiber In order to find chapters that specifically relate to dietary fiber, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and dietary fiber using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “dietary fiber” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on dietary fiber: •

Carbohydrate Assimilation Source: in Textbook of Gastroenterology. 4th ed. [2-volume set]. Hagerstown, MD: Lippincott Williams and Wilkins. 2003. p. 389-413. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-6423. Fax: (301) 223-2400. Website: www.lww.com. PRICE: $289.00. ISBN: 781728614. Summary: Carbohydrates are the most abundant of the four major biomolecules, which also include proteins, nucleic acids, and lipids (fats). Carbohydrates include sugars, starch, and fiber, and they constitute between 40 and 50 percent of the total daily calories as a source of fuel for humans. Carbohydrate absorption occurs along the entire length of the alimentary tract. After absorption, the liver, endocrine pancreas, muscle, and fat become the principal sites of carbohydrate homeostasis. This chapter on carbohydrate assimilation is from a lengthy, two-volume textbook that integrates the various demands of science, technology, expanding information, good judgment, and common sense into the diagnosis and management of gastrointestinal patients. Topics include the chemistry and structure of carbohydrates, dietary carbohydrates, dietary fiber, carbohydrate assimilation, the luminal phase of digestion (starch hydrolysis), brush border carbohydrates, absorption of monosaccharides, the spatial location of hydrolysis and transport along the crypt-villus axis, and efficiency and rate-limiting steps of carbohydrate assimilation. 9 figures. 5 tables. 277 references.

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Diverticular Diseases Source: in Bonci, L. American Dietetic Association Guide to Better Digestion. Hoboken, NJ: John Wiley and Sons, Inc. 2003. p. 114-126. Contact: Available from John Wiley and Sons, Inc. Customer Care Department, One Wiley Drive, Somerset, NJ 08875. (800) 762-2974 or (317) 572-3993. Fax (317) 572-4002. Website: www.wiley.com. PRICE: $14.95 plus shipping and handling. ISBN: 0471442232. Summary: Coping with a gastrointestinal disorder, whether it is irritable bowel syndrome (IBS), gas (flatulence), constipation, heartburn, or another condition, can be embarrassing and debilitating. While medical treatments and prescriptions can offer relief, one of the most important ways patients can help themselves is in their dietary choices. This chapter on diverticular diseases is from a book that describes how patients can self-manage their digestive disorders through dietary choices. Diverticular disease is characterized by the presence of small, bulging, abnormal pouches in the intestinal wall. In this chapter, the author defines diverticular diseases (diverticulosis and diverticulitis), including their symptoms, then discusses the diagnostic tests that are used to confirm diverticular problems, treatment options, the use of nutritional supplements (notably

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dietary fiber), the impact of diet on diverticular symptoms, foods to choose for diverticulosis, and foods to choose for diverticulitis. The author notes that the treatment for diverticular disease is a combination of specialized diet to increase fecal mass, medications, surgery, stress management, and exercise. Diverticulitis is an acute disease, which means that patients may need to make temporary changes in eating to allow their bodies a chance to heal, but once improvement is seen, patients should go right back on a maintenance eating plan to keep the gut healthy and to decrease the risk of future diverticula forming. 4 figures. •

Diverticular Disease Source: in King, J.E., ed. Mayo Clinic on Digestive Health. Rochester, MN: Mayo Clinic. 2000. p. 125-132. Contact: Available from Mayo Clinic Health Information. 5505 36th Street, SE, Grand Rapids, MI 49512. (800) 291-1128. Website: www.mayoclinic.com. PRICE: $14.95 plus shipping and handling. ISBN: 1893005046. Summary: Diverticular disease is the general term for the development of small, bulging pouches in the digestive tract. The most common site for diverticula is the large intestine (colon), particularly the lower part of the colon called the sigmoid colon. This chapter on diverticular disease is from a comprehensive guidebook from the Mayo Clinic that focuses on a variety of digestive symptoms, including heartburn, abdominal pain, constipation, and diarrhea, and the common conditions that are often responsible for these symptoms. Written in nontechnical language, the book includes practical information on how the digestive system works, factors that can interfere with its normal functioning, and how to prevent digestive problems. This chapter first reviews the key signs and symptoms of diverticular disease, including pain in the lower left abdomen, abdominal tenderness, fever, nausea, and constipation or diarrhea. The authors describe the two forms of diverticular disease: diverticulosis, which refers to the presence of diverticula in the digestive tract, and is very common; and diverticulitis, which is inflammation or infection in a diverticulum. Three factors seem to contribute to diverticula: weak spots in the colon wall, aging, and too little dietary fiber. Because diverticula usually do not cause problems, most people first learn they have diverticulosis during routine screening exams for colorectal cancer or during tests for another intestinal condition. Treatment begins with self care strategies, including increasing the amount of fiber in one's diet, drinking plenty of fluids, avoiding constipation, and exercising regularly. The authors outline how to know when medical care is necessary for diverticular disease, and review the care that may be provided, including rest and a restricted diet, antibiotics, painkillers (analgesics), and surgery. The chapter concludes by reminding readers that there is no evidence that diverticular disease increases one's risk of colon or rectal cancer; however, diverticular disease can make cancer more difficult to diagnose. 1 figure.

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Gluten-Free Diet Source: in Case, S. Gluten-Free Diet: A Comprehensive Resource Guide. Regina, Saskatchewan, Canada: Case Nutrition Consulting. 2002. p. 9-43. Contact: Available from Case Nutrition Consulting. 1940 Angley Court, Regina, Saskatchewan, S4V 2V2 Canada. PRICE: $19.95 plus shipping and handling. (306)7511000. E-mail: [email protected]. Website: www.glutenfreediet.ca. ISBN: 1894022793. Summary: Gluten is the general name for the storage proteins in wheat, rye, and barley. These storage proteins damage the small intestine in people with celiac disease (gluten

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intolerance) and dermatitis herpetiformis. Gluten is the substance in flour responsible for forming the structure of dough, holding products together, and leavening. This chapter, from a comprehensive resource guide on the gluten-free diet, offers an introduction to this special way of eating. The author cautions that while the presence of gluten is evident in baked goods and pasta, it is often a hidden ingredient in many other items such as sauces, seasonings, soups, salad dressings, and candy, as well as some vitamins and pharmaceuticals. The challenge for individuals on a gluten-free diet is to avoid these hidden sources. This chapter also reviews in depth the food labeling requirements for both the United States and Canada. Additional sections list and discuss gluten-free additive and ingredients, the gluten-free diet by food groups, the food guide pyramid (U.S.) and Canada's food guide to healthy eating, the role of dietary fiber, the dietary fiber content of gluten-free foods, the role of iron, the presence of lactose (milk sugar) intolerance, and the role of dietary calcium. The chapter concludes with a section of gluten-free meal planning ideas. •

Count On Fiber Source: in Hiser, E. Other Diabetes: Living and Eating Well with Type 2 Diabetes. New York, NY: William Morrow. 1999. p. 46-52. Contact: Available from William Morrow. 39 Plymouth Street, Fairfield, NJ 07004. (800) 843-9389. Fax (888) 775-3260. PRICE: $23.00 plus shipping and handling. Summary: This chapter discusses the importance of fiber in the diet of people who have type 2 diabetes. Eating more dietary fiber helps promote weight loss in order to lower blood sugar. Refining foods removes important nutrients and chemicals and provides more calories than are found in unrefined foods. Studies have shown that restoring fiber to the diet helps control type 2 diabetes because soluble fiber slows down the rise of blood glucose after a meal. Benefits include feeling more satisfied for a longer period of time following a meal rich in soluble fiber and lowering blood cholesterol levels. A recent study has demonstrated the clear benefit of oat bran in helping to control type 2 diabetes. During periods when participants ate high fiber meals, both blood glucose and insulin response were lower, total cholesterol and low density lipoprotein (LDL) cholesterol were lower, and the ratio of LDL to high density lipoprotein was reduced by 24 percent. Another recent study found that men with the highest fiber intake had a 30 percent lower risk of dying from heart disease than men with the lowest fiber intake. Researchers were able to identify the consumption of rye bread as a protective factor among men in this study. Two major health studies have also found a strong association between eating insoluble fiber and reduced risk of developing type 2 diabetes. The chapter concludes with a list of fiber rich foods and the number of grams of total and soluble fiber in them. 1 reference.

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Body Imperfect, Part II Source: in Morris, V. How to Care for Aging Parents. New York, NY: Workman Publishing Company. 1996. p. 87-112. Contact: Available from Workman Publishing Company. 708 Broadway, New York, NY 10003-9555. (212) 254-5900. Fax (212) 254-8098. Website: www.workman.com. PRICE: $15.95 plus shipping and handling; bulk copies available. ISBN: 1563054353. Summary: This chapter is from a book that addresses the needs of both caregivers and their elderly family members who have concerns regarding medical, emotional, legal, or financial issues. In this chapter, the second to deal with health issues, the author reviews medical concerns related to bones and joints, incontinence, constipation, other digestive

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disorders, depression, delirium, and anxiety. The author encourages readers to learn the warning signs of these conditions and address problems as early as possible. The section on constipation lists the symptoms that should alert caregivers to the need for medical care: blood in stools, dark or oddly colored stools, a sudden change in bowel habits, or pain in the lower abdomen. Treatment options for constipation focus on the use of adequate dietary fiber, adequate fluids, movement (exercise), bathroom routines, and monitoring for drug side effects. Other digestive disorders and problems with digestive ramifications that are covered in the chapter are difficulty swallowing (dysphagia), heartburn, indigestion (dyspepsia), ulcers, diverticular disease, hemorrhoids, gas, diarrhea, anemia (usually due to iron deficiency in the elderly), and diabetes. For each disorder, the author reviews the typical symptoms, suggests some practical behavior or lifestyle changes for treatment, reviews medical treatment options, and outlines symptoms that should trigger a call to the physician. One sidebar offers the telephone numbers of some resource organizations; other sidebars summarize the information being presented. •

Ineffective Therapies Source: in Manu, P. Pharmacotherapy of Common Functional Syndromes: EvidenceBased Guidelines for Primary Care Practice. Binghamton, NY: Haworth Medical Press. 2000. p. 153-167. Contact: Available from Haworth Medical Press, an imprint of Haworth Press, Inc. 10 Alice Street, Binghamton, New York 13904-1580. (800) HAWORTH or (800) 429-6784. Outside United States and Canada (607) 722-5857. Fax (800) 895-0582. E-mail: [email protected]. Website: www.haworthpressinc.com. PRICE: $69.95 plus shipping and handling. ISBN: 0789005883. Summary: This chapter is from a book that evaluates drug therapies for each of the four major functional disorders: chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome (IBS), and premenstrual syndrome. In this chapter, the fourth of six short chapters that focus on IBS, the author introduces and reviews the ineffective therapies presently in use for the condition. The author focuses on dietary fiber, lactase, and ondansetron. The author's evidence based analysis of a number of studies demonstrates that research performed in the past two decades has established with a high degree of certainty that the administration of dietary fiber is not useful for treating IBS. Lactose (milk sugar) maldigestion can be identified in close to one third of patients diagnosed with IBS, and the symptoms of lactose intolerance or maldigestion are so close to those for IBS as to prevent the clinical identification of this subgroup. Treatment with lactase provided no statistical improvement over placebo. The author reports on a study of ondansetron, in which the drug treatment did not decrease significantly the severity of abdominal pain or the total number of symptoms experienced during the trial. Stool consistency increased after ondansetron therapy. In another study, ondansetron was similar to placebo with regard to its effect on abdominal pain, abdominal distention, backache, urinary symptoms, and depression and anxiety. The only symptoms improved by ondansetron in this population with IBS were postprandial (after a meal) discomfort, belching, and heartburn.

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Digestive System: Keeping it Efficient Source: in Mattox, R. Fifty and Holding: Slow the Aging Process. Winter Haven, FL: Fifty and Holding. 1992. p. 115-117.

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Contact: Available from Fifty and Holding. P.O. Box 917, Winter Haven, FL 33882. PRICE: $7 plus $3 shipping and handling. Summary: This chapter is from a book that explains the diseases that are affected by nutrition and exercise, as well as the rest required during the aging process. The author considers the digestive system and presents suggestions for keeping it at peak efficiency. Specific topics include the role of dietary fiber; problems with constipation; the importance of exercise; limiting the use of antacids and laxatives; diarrhea; flatulence; gastritis; and diverticular disease. The chapter concludes with a list of warning symptoms for problems associated with the digestive system. The book is written in clear, easy-to-understand language and designed for an audience of people who are 50 years of age or older. •

More Benefits of Fiber are Discovered Source: Kimball, C.T., ed. Vegetarian Sourcebook. 1st ed. Detroit, MI: Omnigraphics. 2002. p. 105-110. Contact: Available from Omnigraphics. 615 Griswold Street, Detroit, MI 48226. (313) 961-1340. Fax: (313) 961-1383. E-mail: [email protected]. www.omnigraphics.com. PRICE: $78.00; plus shipping and handling. ISBN: 780804392. Summary: This chapter on dietary fiber is from a Sourcebook that describes various types of vegetarian diets and gives practical advice for safely incorporating them into everyday life, including creating a vegetarian pantry and obtaining sufficient amounts of various nutrients, vitamins, and minerals. The authors provide details to help readers understand the advantages and disadvantages of eating vegetarian. In this chapter, the author discusses the health benefits of fiber, in the areas of cancer prevention, digestive disorders, diabetes, heart disease, and obesity; how to increase the amount of fiber in the daily diet; and the types of foods that have high amounts of fiber. The chapter also notes the food labeling requirements for fiber, including the food claims that are permitted by the United States Food and Drug Administration (FDA) about the health benefits of dietary fiber.

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Diarrhea and Constipation Source: in Janowitz, H.D. Good Food for Bad Stomachs. New York, NY: Oxford University Press. 1997. p. 110-127. Contact: Available from Oxford University Press. Order Department, 2001 Evans Road, Cary, NC 27513. (800) 451-7556. Fax (919) 677-1303. PRICE: $12.95 plus shipping and handling. ISBN: 0195126556. Summary: This chapter on diarrhea and constipation is from a book that presents a detailed look at present knowledge about the role of eating habits in preventing, causing, and treating the many disorders that plague the gastrointestinal tract and its associated digestive glands, the liver, the gallbladder, and the pancreas. Diarrhea is defined as bowel movements that occur too often and are too loose, constipation as difficulty in moving one's bowels. To put these definitions into proper perspective, the author notes that the number of bowel movements that normal people in good health can pass varies tremendously, ranging from two to three a day to two to three a week. Therefore, instead of comparing themselves with others, people should look for deviations from their ordinary routines both in number and consistency of the stool. Topics include acute diarrhea, its symptoms, causes, and treatment; what to eat during acute episodes of diarrhea; food poisoning; traveler's diarrhea and how to avoid it;

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parasites in the stool; secretory diarrhea; food intolerance as a cause of diarrhea; antibiotic associated diarrhea; constipation, its causes and treatments; the role of dietary fiber and treatment with a high fiber diet; the unique role of bran; lubricants; enemas; and fluid intake. 2 tables. •

Diverticula, Diverticulosis, and Diverticulitis Source: in Janowitz, H.D. Good Food for Bad Stomachs. New York, NY: Oxford University Press. 1997. p. 128-134. Contact: Available from Oxford University Press. Order Department, 2001 Evans Road, Cary, NC 27513. (800) 451-7556. Fax (919) 677-1303. PRICE: $12.95 plus shipping and handling. ISBN: 0195126556. Summary: This chapter on diverticula, diverticulosis, and diverticulitis is from a book that presents a detailed look at present knowledge about the role of eating habits in preventing, causing, and treating the many disorders that plague the gastrointestinal tract and its associated digestive glands, the liver, the gallbladder, and the pancreas. The author addresses the role of diet in preventing and treating the intestinal pouches called diverticula. Topics include the incidence of diverticulosis, including risk factors; the part of the colon most likely to be involved; ways dietary fiber affects diverticula; complications of diverticulosis of the colon; a high fiber diet; and the relationship between irritable bowel syndrome (IBS) and colonic diverticula. The current evidence is far from complete, but it suggests that people raised on a diet high in fiber seem to have a much better chance of avoiding diverticula and their complications than people who consume a low fiber diet.

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What Should We Feed the Inflamed Intestine? Ulcerative Colitis and Crohn's Disease Source: in Janowitz, H.D. Good Food for Bad Stomachs. New York, NY: Oxford University Press. 1997. p. 135-161. Contact: Available from Oxford University Press. Order Department, 2001 Evans Road, Cary, NC 27513. (800) 451-7556. Fax (919) 677-1303. PRICE: $12.95 plus shipping and handling. ISBN: 0195126556. Summary: This chapter on inflammatory bowel disease (ulcerative colitis and Crohn's disease) is from a book that presents a detailed look at present knowledge about the role of eating habits in preventing, causing, and treating the many disorders that plague the gastrointestinal tract and its associated digestive glands, the liver, the gallbladder, and the pancreas. Ulcerative colitis is an inflammation of unknown origin that can attack any or all parts of the large bowel or colon. Crohn's disease is a different type of inflammation that can occur anywhere along the intestinal tract, from the mouth to the rectum. The author notes that information about the role of food and inflammatory bowel disease is limited, emphasizing the need for a well balanced, satisfactory, normal diet, perhaps somewhat richer in protein to balance the protein that can leak from the inflamed intestinal lining. Topics include the role of smoking, caffeine, and alcohol; lactose and dairy products; dietary fiber; vitamin supplements; trace elements; food supplements; enteral nutrition (supplying the patient's nutrition by mouth in a liquid form that can be easily absorbed by the small intestine); and the prevention of oxalate kidney stones. One table outlines the components of a low residue diet. 1 table.

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10 Food Steps to Freedom Source: in Magee, E. Tell Me What to Eat If I Have Diabetes. Franklin Lakes, NJ: Career Press, Inc. 1999. p. 43-82. Contact: Available from Career Press, Inc. 3 Tice Road, P.O. Box 687, Franklin Lakes, NJ 07417. (800) 227-3371. Website: www.careerpress.com or www.newpagebooks.com. PRICE: $10.99 plus shipping and handling. Summary: This chapter on ten food steps to freedom is from a book that offers eating and nutrition guidelines for people who have been diagnosed with diabetes mellitus. The author focuses on type 2 diabetes, noting that diabetes can manifest differently in different patients and sometimes even changing throughout its course within one person. The author encourages readers to learn as much as they can about their disease and to utilize nutrition as an adjunct therapy and a vital component of their diabetes care. Although there are definitely individual differences, there are 10 things all people with type 2 diabetes can do to improve their health, reduce their risk of heart disease and other health risks, and make normal blood glucose (sugar) more likely. Two of the ten recommended 'food' steps actually do not involve food: one involves monitoring the blood glucose levels; the other the need for regular exercise. The eight remaining recommended food steps are: make dietary fiber a part of almost every meal; count carbohydrates; emphasize heart-protective fats; keep saturated fat and cholesterol low; count caloric intake; eat more fruits and vegetables; avoid eating large meals; and improve the diet with supplements as necessary.

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Nutrients: The Big Three Source: in Warshaw, H.S. and Webb, R. Diabetes Food and Nutrition Bible: A Complete Guide to Planning, Shopping, Cooking, and Eating. Alexandria, VA: American Diabetes Association. 2001. p. 1-5. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $18.95 plus shipping and handling. ISBN: 158040037. Summary: This chapter on the Big Three nutrients (carbohydrate, protein, fat) is from a book that offers a complete food and nutrition resource for people with diabetes. The book brings readers up to date on meal planning, carbohydrate counting, vitamins, minerals, and the best ways to prepare healthy delicious meals. In this chapter, the authors describes how each of the primary nutrients have an impact on blood glucose levels: nearly all of the carbohydrate eaten ends up as glucose in the bloodstream, which protein and fat have little direct impact on blood glucose levels. Therefore, for adequate blood glucose control, people with diabetes need to pay close attention to the total amount of carbohydrate they eat. Other topics discussed include measuring carbohydrate, the role of insulin, dietary fiber, the different types of protein, recommended amounts of protein, and the role of dietary fats. 2 tables.

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Your Digestive System Source: in Larson, D.E., ed. Mayo Clinic Family Health Book. 2nd ed. New York, NY: William Morrow and Company, Inc. 1996. p. 737-824. Contact: Available from Mayo Clinic. 200 First Street, S.W., Rochester, MN 55905. (800) 291-1128 or (507) 284-2511. Fax (507) 284-0161. Website: www.mayo.edu. PRICE: $39.95 plus shipping and handling. ISBN: 0688144780.

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Summary: This chapter on the digestive system is from a family health guide published by the Mayo Clinic. The lengthy chapter features nine sections: the digestive system at work, esophageal problems, stomach problems, disorders of the small and large intestines, anorectal disorders, liver disease, gallbladder and bile duct disorders, pancreatic diseases, and hernias. Within each section, multiple entries each begin with a review of signs and symptoms of the problem. This is followed by a description of the disease and a discussion on how the physician might make a diagnosis. The authors often include reviews of the real or potential seriousness of the problem. Each section then discusses treatment options, including medications or surgery, and, when appropriate, self help strategies. Topics covered include heartburn, hiatal hernia, hiccups, swallowing problems, gastrostomy, esophageal stricture, foreign bodies, esophageal tumors, esophageal varices, esophageal rupture, indigestion, peptic ulcer, Zollinger Ellison syndrome, gastritis, drug induced stomach problems, gastrointestinal tract bleeding, stomach tumors, stomach dilation, Menetrier disease, eosinophilic gastroenteritis, infections of the gastrointestinal tract, antibiotic associated diarrhea, malabsorption problems, acute appendicitis, Meckel diverticulum, intussusception, protein losing enteropathy, primarily (idiopathic) intestinal pseudo-obstruction, carcinoid syndrome, Crohn's disease, ulcerative colitis, colostomy and ileostomy, tumors of the small intestine, ileo anal anastomosis, diverticulosis and diverticulitis, irritable bowel syndrome, chronic constipation, dietary fiber, laxative abuse, intestinal gas, fecal impaction, colon polyps, colonoscopy, colon cancer, megacolon, peritonitis, familial Mediterranean fever, intestinal obstruction, vascular problems of the bowel, hemorrhoids, anal itch, anal fissures and fistulas, rectal bleeding, anorectal abscess, anal pain, proctitis, fecal incontinence, acute viral hepatitis, alcoholic (and other drug related) hepatitis, chronic hepatitis, cirrhosis, liver biopsy, liver tumors, liver abscess, liver transplantation, gallstones, bile duct obstruction, choledochal cysts, acute and chronic pancreatitis, malignant pancreatic tumors, congenital pancreatic abnormalities, inguinal hernia, and other abdominal hernias. The chapter features line drawings, black and white photographs, and sidebars for additional information. •

What Type of Diabetes Do You Have? Source: in Rubin, A.L. Diabetes for Dummies. Foster City, CA: IDG Books Worldwide, Inc. 1999. p. 25-42. Contact: Available from IDG Books Worldwide, Inc. 919 E. Hillsdale Blvd., Suite 400, Foster City, CA 94404-2112. (800) 762-2974 or (416) 293-8464. Website: www.idgbooks.com. PRICE: $19.99 plus shipping and handling. ISBN: 076455154X. Summary: This chapter provides people who have diabetes with information on the functions of the pancreas and the symptoms, causes, and prevention of type 1 and type 2 diabetes. Type 1 diabetes is an autoimmune disease. In some genetically predisposed people, an environmental trigger may be needed to cause type 1 diabetes, whereas in others, the disease is an entirely autoimmune destruction of the beta cells. Symptoms of type 1 diabetes include frequent urination, increased thirst, weight loss, increased hunger, and weakness. Although primary methods for preventing type 1 diabetes are still being investigated, some of the more promising secondary prevention approaches include steroid drugs, cytotoxic drugs, nicotinamide, and insulin. Type 2 diabetes is a disease of gradual onset in which the body resists the normal, healthy functioning of insulin. Symptoms may be mild at first, so they may be ignored. Symptoms include fatigue; frequent urination and thirst; blurred vision; slow healing of skin, gum, and urinary tract infections; genital itching; numbness in the feet or legs; heart disease; and obesity. Although genetic inheritance causes type 2 diabetes, environmental factors

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trigger it. Major environmental factors include high body mass index, physical inactivity, central distribution of fat, and low intake of dietary fiber. Type 1 and type 2 diabetes differ with regard to age of onset, body weight, level of glucose, and severity of onset. Pregnant women may develop gestational diabetes. In addition, other types of diabetes include diabetes due to loss or disease of pancreatic tissue, diabetes due to other diseases, diabetes due to hormone treatments for other diseases, and diabetes due to medications. 1 figure. •

Managing Constipation Source: in King, B.D. and Harke, J. Coping with Bowel and Bladder Problems. San Diego, CA: Singular Publishing. 1994. p. 149-161. Contact: Available from Singular Publishing Group, Inc. 401 West A Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. PRICE: $18.95. ISBN: 1565930681. Summary: This chapter, from a book in the Coping with Aging Series, a group of books written for men and women coping with the challenges of aging, addresses the management of constipation. The authors focus on three main areas: diet and fluid intake, exercise, and toilet habits. Specific topics in the chapter include the role of dietary fiber; sources of fiber; fiber supplements; fluid intake; the role of regular exercise; toilet habits; and laxative use, including stimulant laxatives, saline cathartics, lubricants, hyperosmotic laxatives, enemas, and suppositories. The authors stress that the simple measures of adequate fiber and fluid intake and exercise, as well as good toilet habits, can often eliminate constipation. 4 tables.

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Fiber Metabolism and Use in Diabetes Therapy Source: in Powers, M.A., ed. Handbook of Diabetes Medical Nutrition Therapy. Gaithersburg, MD: Aspen Publishers, Inc. 1996. p. 397-421. Contact: Available from Aspen Publishers. P.O. Box 990, Frederick, MD 21705-9727. (800) 638-8437. Fax (301) 695-7931. PRICE: $89.00. ISBN: 0834206315. Summary: This chapter, from a handbook on diabetes medical nutrition therapy (MNT), discusses fiber metabolism and the use of dietary fiber in diabetes therapy. Topics include a definition of dietary fiber, the differences between soluble and insoluble fiber, the effect of processing (milling, cooking) on fiber, how to find fiber analysis figures, the effect of fiber on diabetes control and complications, fiber levels in the typical American diet, recommended amounts of fiber for a high-fiber diet, Federal regulations that control fiber labeling, the use of fiber supplements, and the risks and benefits of increasing fiber in the diet. The authors encourage dietitians to assess the health needs of each client when determining whether to rely on food sources of dietary fiber or add fiber supplements. 1 figure. 5 tables. 104 references.

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Diverticular Disease of the Colon Source: in Danzi, J.T.; Scopelliti, J.A., eds. Office Management of Digestive Diseases. Malvern, PA: Lea and Febiger. 1992. p. 53-57. Contact: Available from Lea and Febiger. Box 3024, Malvern, PA 19355-9725. (215) 2512230. PRICE: $39.50. ISBN: 0812114361. Summary: This chapter, from a medical textbook about the office management of common gastrointestinal diseases, focuses on diverticular disease of the colon. Topics

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include diverticulosis, the causes of diverticular disease of the colon, the role of dietary fiber, signs and symptoms of diverticulosis and diverticulitis, the management of uncomplicated diverticular disease, the presence of co-existing irritable bowel syndrome, diverticular hemorrhage and colonic bleeding, diverticulitis, and complications of acute diverticulitis, including pericolonic abscess, fistula, and bowel obstruction. 18 references.

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CHAPTER 7. MULTIMEDIA ON DIETARY FIBER Overview In this chapter, we show you how to keep current on multimedia sources of information on dietary fiber. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on dietary fiber is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “dietary fiber” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “dietary fiber” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on dietary fiber: •

Bottom Line on Hemorrhoids Source: Madison, WI: University of Wisconsin Hospitals and Clinics, Department of Outreach Education. 1996. (videocassette). Contact: Available from University of Wisconsin Hospital and Clinics. Picture of Health, 702 North Blackhawk Avenue, Suite 215, Madison, WI 53705-3357. (800) 757-4354 or (608) 263-6510. Fax (608) 262-7172. PRICE: $19.95 plus shipping and handling; bulk copies available. Order number 051997A. Summary: Straining when going to the bathroom, constipation, prolonged sitting, and infection can all contribute to hemorrhoids, defined as enlarged veins around the anus. This videotape is one in a series of health promotion programs called 'Picture of Health,' produced by the University of Wisconsin. In this program, moderated by Mary Lee and featuring gastroenterologist John Wyman, the common symptoms, diagnosis, and management of hemorrhoids are covered. Dr. Wyman explains the difference between internal and external hemorrhoids (merely an anatomical distinction), and prolapsed

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hemorrhoids, which are enlarged internal hemorrhoids that drop (prolapse) outside the anus. Symptoms include pain and bleeding; pain because of blood clots and bleeding due to trauma to the thin walled veins in that area. The causes of hemorrhoids include straining during defecation, pregnancy, prolonged sitting, constipation, childbirth, and obesity. Dr. Wyman recommends that anyone over the age of 40 who experiences rectal bleeding should consult a physician; younger people who experience recurrent bleeding should also see their physician (to rule out inflammatory bowel disease). Treatment options for hemorrhoids include changes in habits, such as not straining, not wiping vigorously, softening the stool with dietary changes (usually the addition of dietary fiber), and not prolonging sitting on the toilet. Surgery is used for external hemorrhoids, to remove the veins and tributaries; for internal hemorrhoids, rubber band ligation is very effective. The program also explores the problem of perianal dermatitis, including its risk factors and treatment options (which focus on keeping the area clean and dry, and not using over the counter creams that are petroleum based). The program reiterates the importance of having any rectal bleeding investigated by one's health care provider. The program concludes by referring viewers to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Bibliography: Multimedia on Dietary Fiber The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in dietary fiber (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on dietary fiber: •

Dietary fiber, good or bad, food or fad? [videorecording] Source: Marshfield Clinic, Saint Joseph's Hospital; Year: 1994; Format: Videorecording; Marshfield, WI: The Clinic, [1994]

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CHAPTER 8. PERIODICALS AND NEWS ON DIETARY FIBER Overview In this chapter, we suggest a number of news sources and present various periodicals that cover dietary fiber.

News Services and Press Releases One of the simplest ways of tracking press releases on dietary fiber is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “dietary fiber” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to dietary fiber. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “dietary fiber” (or synonyms). The following was recently listed in this archive for dietary fiber: •

Dietary fiber intake at least three times too low among most US adults Source: Reuters Medical News Date: June 05, 2000

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Dietary fiber intake more strongly linked to CVD risk factors than fat intake Source: Reuters Medical News Date: October 27, 1999

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Dietary fiber intake inversely associated with colorectal cancer mortality Source: Reuters Medical News Date: April 12, 1999

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High dietary fiber intake can reduce coronary heart disease risk Source: Reuters Medical News Date: September 09, 2003

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Latest dietary fiber data support protective effect against colon cancer Source: Reuters Medical News Date: May 01, 2003 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “dietary fiber” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “dietary fiber” (or synonyms). If you know the name of a company that is relevant to dietary fiber, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/.

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BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “dietary fiber” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “dietary fiber” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on dietary fiber: •

Dietary Recommendations for Diverticular Disease Source: Intestinal Fortitude. 9(4): 4. 1999. Contact: Available from Intestinal Disease Foundation. 1323 Forbes Avenue, Suite 200, Pittsburgh, PA 15219. (412) 261-5888. Summary: Diverticular disease occurs when outpouches or bulges appear in the intestinal membrane. These bulges are known as diverticula and are not typically a problem unless they become infected (diverticulitis). This article offers dietary recommendations for patients with diverticular disease. The standard diet therapy for diverticular disease is an increase in dietary fiber, to increase stool bulk, speed up transit time, and decrease the accumulation of residue in the diverticuli. The current recommendations are 25 grams of fiber per day. The article recommends that readers keep a food diary for a few days to assess their baseline fiber intake and then develop a plan to increase fiber as necessary. The author notes that many people with diverticular disease have been cautioned against consuming nuts, seeds, hulls (popcorn), and berries because it had been assumed that these foods could get caught in the diverticuli and cause pain. However, the author maintains that if the patient is ingesting a high fiber diet on a regular basis, the likelihood of these foods getting trapped is greatly diminished. The author also recommends that readers eat slowly and chew their food well, which will increase the pleasure of eating and help the body be more able to tolerate a variety of foods.

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Management of Laxative Abuse in Eating Disorders Source: SCAN'S PULSE. 18(3): 7-8. Fall 1999. Contact: Available from American Dietetic Association. SCAN Office, 90 S. Cascade Avenue, Suite 1230, Colorado Springs, CO 80903. (719) 475-7751. Fax (719) 475-8748. Summary: Health professionals who treat eating disorders eventually encounter clients with anorexia nervosa or bulimia who use laxatives as a method of weight control. This article reviews the management of laxative abuse in patients with eating disorders. Women who abuse laxatives believe that taking laxatives after food consumption prevents the absorption of calories in the intestine. However, studies show that laxative

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use only decreases caloric absorption by 12 percent, because laxatives primarily exert their effect in the large intestine. In addition to being ineffective in weight control, chronic laxative use is also medically dangerous. Serious problems that may occur include electrolyte and fluid imbalance leading to metabolic acidosis or alkalosis, permanent structural and functional damage to the colon, interstitial renal (kidney) disease, and rectal prolapse. The successful management of chronic laxative abuse requires a team of professionals that includes a physician, nutrition therapist, and psychotherapist. The author reviews the treatment protocol for these patients, which includes adequate dietary fiber and fluids intake, limited consumption of high sodium and gas forming foods, regular exercise, and patient education. During weekly appointments, the nutrition therapist should evaluate the client's compliance with the prescribed treatment plan. The author cautions that discontinuing long term laxative abuse is extremely difficult, and some clients may require inpatient treatment to be successful. Body image issues become predominant as the client experiences severe fluid retention, often in the range of 10 to 20 pounds, until natural diuresis occurs after about 4 to 6 weeks of laxative abstinence. 9 references. •

Fiber Therapy in IBS and Other GI Disorders Source: Participate. 8(1): 2-4. Spring 1999. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217. (888) 964-2001 or (414) 9641799. Fax (414) 964-7176. E-mail: [email protected]. Website: www.iffgd.org. Summary: Irritable bowel syndrome (IBS) is one of the most common and most troublesome conditions for which individuals seek medical therapy. This newsletter article offers suggestions for individuals with IBS who wish to use fiber therapy and other dietary adjustments to manage their disease. The author cautions that dietary fiber can be a double edged sword for people with intestinal disorders. While fiber alleviates constipation, certain high fiber foods, such as bran, may increase gas production and bloating. However, it seems likely that most persons with IBS will benefit from at least a moderate increase in dietary fiber intake. The author stresses the need for a gradual increase in dietary fiber, to modify, improve, and (in some people) eliminate the abnormal bowel habits and painful symptoms associated with IBS. Persons who have difficulty obtaining the goal of 20 to 35 grams per day through diet alone may find fiber supplementation helpful. The author notes that dietary fiber also offers advantages for persons at risk for hypertension, diabetes, or obesity. The author reviews the differences between soluble and insoluble dietary fiber, children and dietary fiber, where to find a variety of fiber types, and nutrition therapy (including fiber). The article includes a sidebar on the different types of fiber supplements, and a brief list of practical tips for adding fiber to the diet.

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Does Fiber Help Prevent Cancer? Source: American Institute for Cancer Research Newsletter. Issue 69, p.1,3. Fall 2000. Contact: American Institute for Cancer Research. 1759 R St. NW, Washington, DC 20009. (202)328-7744. Summary: This article explains the reasons behind recent headlines that announced that dietary fiber does not prevent colon cancer. Two studies published in the New England Journal of Medicine found that eating more fiber for several years did not prevent recurrence of colorectal polyps. These tiny growths may precede colorectal cancer. One of the studies tested a low-fat, high-fiber diet emphasizing vegetables and fruits while

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the other tested a wheat bran fiber supplement. In both of the studies, consumption of the fiber containing foods was lower than what it should have been. The American Institute for Cancer Research (AICR) recommends not abandoning a low-fat, high-fiber diet on the basis of these two studies. The AICR states that the scientific evidence linking consumption of high-fiber foods to cancer prevention is clear and convincing. •

Controlling Incontinence by Controlling Diarrhea: The Role of Diet Source: Intestinal Fortitude. 6(3): 7-10. Winter 1995-1996. Contact: Available from Intestinal Disease Foundation. 1323 Forbes Avenue, Suite 200, Pittsburgh, PA 15219. (412) 261-5888. Summary: This article helps patients understand the role of diet in controlling fecal incontinence, notably by controlling diarrhea. Topics include diarrhea and nutritional deficiencies; the role of meal size and composition; preservatives, alcohol, and caffeine; dietary fat, dietary fiber, and adequate fluids; the special role of pectin; and meal time recommendations. For each topic, the author provides specific suggestions for readers to incorporate into their meal habits.

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Irritable Bowel Syndrome: The Bottom Line Source: Fibromyalgia Frontiers. 7(2): 4-8, 13. March-April 1999. Contact: Available from Fibromyalgia Association of Greater Washington, Inc. 13203 Valley Drive, Woodbridge, VA 22191-1531. (703) 790-2324. Fax (703) 494-4103. E-mail: [email protected]. Summary: This article on irritable bowel syndrome (IBS) is from a newsletter for people with fibromyalgia (a pain disorder). IBS is known as a functional gastrointestinal (GI) disorder because it involves a healthy bowel, without inflammation or disease, that does not perform normally. In IBS, the bowel tends to have an unusual sensitivity to such events as the passage of food particles, fluids, or gas. IBS symptoms, which are usually intermittent rather than constant, are abdominal discomfort, cramping or pain, bloating, abnormal bowel movements (i.e., diarrhea, constipation, or the two alternating), mucus in the stools, and a sensation of incomplete evacuation. IBS is quite common among persons with fibromyalgia; its incidence is estimated at approximately 40 percent among patients with diagnosed fibromyalgia (compared with only 16 percent in normal controls). However, some GI signs are not part of IBS and should be investigated. The author then discusses the pathophysiology of IBS and the treatment options for the syndrome. Although admittedly not high tech, modifying the diet and eating habits and learning to control stress are the most potent weapons available against IBS. Dietary fiber has a central role, and it is important to increase one's intake of fiber slowly to allow the body to adjust and to drink plenty of water as fiber intake increases. The article concludes with the contact information for the International Foundation for Functional Gastrointestinal Disorders and for the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health. 18 references.

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Sympathetic Approach to Fecal Incontinence in the Elderly Source: Participate. 1(4): 3. Winter 1992. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217. (888) 964-2001 or (414) 9641799. Fax (414) 964-7176. E-mail: [email protected]. Website: www.iffgd.org.

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Summary: This brief article reminds readers of the importance of a sympathetic approach to fecal incontinence in older adults. The author notes that fecal soiling can have a devastating impact on the older patient, leading to isolation. The author explores the prevalence of this problem; the multifaceted nature of fecal continence; problems with fecal impaction; the use of anal manometry and defocography; and management options including an increase in dietary fiber, the use of enemas, the use of antidiarrheal agents, biofeedback, and surgery. The author concludes that there are often simple non-surgical methods that can help improve patients' quality of life. •

10 Tips on How to Fend Off Embarrassing Flatulence Source: Environmental Nutrition. 22(10): 2. October 1999. Contact: Available from Environmental Nutrition, Inc. 52 Riverside Drive, New York, NY 10024-6599. (800) 829-5384. Summary: This brief newsletter article reviews the issue of flatulence (gas) and offers strategies to prevent the problem. The author first reassures readers that flatulence is as normal a physiologic function as blinking or sneezing. Nonetheless, it is still socially unacceptable, so the author lists 10 suggestions on how to reduce flatulence problems. The suggestions are incorporate dietary fiber increases gradually, learn about which foods are trigger foods, soak and cook gassy foods in water, check for lactose intolerance, try the product named Beano (a digestive enzyme), try Pepto Bismol (the bismol acts as a binder with the odiferous sulfur in intestinal gas), avoid swallowing air, do not use activated charcoal (it does not help the flatulence and it can interfere with the absorption of some medications), do not rely on simethicone (it may help reduce gas, but does nothing to prevent or reduce odor), and skip antacids (they do not relieve gas and those that contain carbonate or bicarbonate may even add to the discomfort of flatulence). One sidebar briefly reviews natural remedies that may sooth the digestive tract, including peppermint and chamomile teas, and seasonings including anise, caraway, coriander, fennel, and turmeric.

•

Clay Therapy for Encopresis Source: Messenger. 8(3): 7. 1997. Contact: Available from American Pseudo-obstruction and Hirschsprung's Disease Society (APHS). 158 Pleasant Street, North Andover, MA 01845. (978) 685-4477. Fax (978) 685-4488. E-mail: [email protected]. Summary: This newsletter article describes the use of modeling clay therapy for treating children with encopresis (fecal soiling). The author reports on a study in which researchers examined the effect of this clay therapy on encopretic children who had not benefited from traditional behavioral (laxatives, enemas, dietary fiber, toilet sitting) and psychological (reinforcement, positive practice, overcorrection, biofeedback) interventions. The researchers describe clay therapy as an Ericksonian intervention, meaning that there is no need for the patient to recognize the problem as such for it to be resolved. Erickson helped patients by using modeling clay as a metaphor for feces to treat a small sample of six boys (ages 4 to 12) who had failed to respond to other therapies. The children were placed together for 1 hour for 3 months and were given no instructions on how to play with the modeling clay; the children eagerly interacted with one another. The author notes that the treatment of encopresis must include an explanation to the child, in terms he or she can understand, of why the body is producing feces and the problems that can accompany this process (e.g., impaction, overflow incontinence). Modeling clay is an effective tool to help children realize what is

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happening to them. The author also describes using the Playdoh Fun Factory to help children understand the movement of feces through the bowel. The author contends that group therapy is an effective way to demystify encopresis, and that some children may be more willing to accept information from peers than from an adult authority figure, especially if they are engaged in an emotional power struggle for control of defecation. •

Diverticular Disease (Diverticulosis and Diverticulitis) Source: Intestinal Fortitude. 9(4): 1-3. 1999. Contact: Available from Intestinal Disease Foundation. 1323 Forbes Avenue, Suite 200, Pittsburgh, PA 15219. (412) 261-5888. Summary: This patient education article reviews diverticular disease (diverticulosis and diverticulitis) and its management. Diverticulosis is a condition in which pouches of intestinal lining balloon out through weak areas of the wall of the large intestine (colon). If the diverticula become infected, the condition is called diverticulitis, which can lead to serious complications. Diverticulosis is very common in North America, where diets tend to be low in fiber. Once formed, diverticula are permanent and cannot be reversed. The goal of management is to keep new diverticula from forming and to prevent complications. Patients with diverticulosis should follow the same advice given to people with constipation: eat regular meals that are high in fiber, drink plenty of fluids, exercise daily, respond right away to the urge to move the bowels, and avoid laxatives. High fiber diets are recommended because they help to create heavier, softer stools which move through the lower part of the gastrointestinal tract more easily than do small, hard stools. The goal is to consume 25 to 40 grams of dietary fiber per day. The article offers suggestions for increasing the amount of dietary fiber, noting that it is a good idea to increase fiber intake slowly (too much fiber too quickly can cause gas and bloating). Symptoms of diverticulitis may include fever and chills, abdominal pain (particularly on the lower left side), disruption of normal bowel activity, and abdominal tenderness. Infection can lead to complications such as rupturing of the diverticula, abscesses, bowel blockage, or leaks through the bowel wall. The article concludes by discussing the treatment options for diverticulitis, including surgical techniques that may be used.

Academic Periodicals covering Dietary Fiber Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to dietary fiber. In addition to these sources, you can search for articles covering dietary fiber that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

11

These publications are typically written by one or more of the various NIH Institutes.

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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

12

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.

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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database

A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “dietary fiber” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “dietary fiber” (or synonyms) into the “For these words:” box. The following is a sample result: •

Healthy lifestyles: Nutrition and physical activity Source: Washington, DC: International Life Science Institute. 1998. 59 pp. Contact: Available from ILSI Press, 1126 16th Street, N.W, Washington, DC 20036-4810. Telephone: (202) 659-0074 / fax: (202) 659-8654. Summary: This report provides current information on the relationship between nutrition and a healthy lifestyle. It includes an overview of concepts that play a role in health status. Individual chapters based on research studies cover the following topics: dietary fat and energy balance; dietary fat and coronary heart disease; antioxidant nutrients; dietary fiber; fluid intake; alcohol consumption and health; physical activity; and oral health. A glossary of dietary and health terms is included.

The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “dietary fiber” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category.

14 15

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH).

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Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 8967 76 746 3 2 9794

HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “dietary fiber” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

16

Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.

17

The HSTAT URL is http://hstat.nlm.nih.gov/.

18

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 19 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 20

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on dietary fiber can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to dietary fiber. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to dietary fiber. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “dietary fiber”:

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•

Guides on dietary fiber Dietary Fiber http://www.nlm.nih.gov/medlineplus/dietaryfiber.html

•

Other guides Child Nutrition http://www.nlm.nih.gov/medlineplus/childnutrition.html Dietary Fats http://www.nlm.nih.gov/medlineplus/dietaryfats.html Dietary Supplements http://www.nlm.nih.gov/medlineplus/dietarysupplements.html Spinal Cord Injuries http://www.nlm.nih.gov/medlineplus/spinalcordinjuries.html Vitamin and Mineral Supplements http://www.nlm.nih.gov/medlineplus/vitaminandmineralsupplements.html

Within the health topic page dedicated to dietary fiber, the following was listed: •

General/Overviews Fiber: Start Roughing It! Source: Harvard School of Public Health http://www.hsph.harvard.edu/nutritionsource/fiber.html JAMA Patient Page: Are You Getting Enough Fiber? Source: American Medical Association http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZ5NACZMAC &sub_cat=377

•

Nutrition Fiber: How to Increase the Amount in Your Diet Source: American Academy of Family Physicians http://familydoctor.org/handouts/099.html Roughing It: Fitting More Fiber into Your Diet Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=NU00033 Using Bread, Cereals, Rice, and Pasta Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=NU00204 Using Vegetables and Fruits Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=NU00203

Patient Resources

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Specific Conditions/Aspects Fiber Facts: Soluble Fiber and Heart Disease Source: American Dietetic Association http://webdietitians.org/Public/NutritionInformation/92_11809.cfm Fiber Supplements: OK to Use Long Term? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00130 Fiber: Can It Affect Mineral Absorption? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ00685 Flax: What Are the Health Benefits? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ00653 Get on the Grain Train http://www.usda.gov/cnpp/Pubs/Brochures/GrainTrainPamphlet.pdf Low-Residue Diet Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00361 Orange Juice: Nutrition Powerhouse! Source: American Dietetic Association http://webdietitians.org/Public/NutritionInformation/92_nfs1002.cfm Power of Potatoes; Positively Nutritious! Source: American Dietetic Association http://webdietitians.org/Public/NutritionInformation/92_nfs0902c.cfm Psyllium (Fiber Supplement) Source: American Cancer Society http://www.cancer.org/docroot/ETO/content/ETO_5_3X_Psyllium.asp?sitearea= ETO Tomatoes: Even Better for You Than You Thought! Source: American Dietetic Association http://webdietitians.org/Public/NutritionInformation/92_nfs1102b.cfm

•

Children Nutrients Your Child Needs: Calcium, Iron, Fiber Source: Nemours Foundation http://kidshealth.org/parent/nutrition_fit/nutrition/nutrients.html

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Organizations American Cancer Society http://www.cancer.org/ American Dietetic Association http://webdietitians.org/Public/index.cfm American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=1200000

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Research Fiber May Not Reduce Colon Cancer Risk, But It's Still Good for You Source: American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Fiber_May_Not_Redu ce_Colon_Cancer_Risk.asp

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on dietary fiber. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Low Fiber, Low Residue Diet Source: Camp Hill, PA: Chek-Med Systems, Inc. 199x. [3 p.]. Contact: Available from Chek-Med Systems, Inc. 200 Grandview Avenue, Camp Hill, PA 17011-1706. (800) 451-5797 or (717) 761-0216. Fax (717) 761-0216. PRICE: $0.55 each; plus shipping and handling; bulk copies available. Booklets must be ordered in quantities of 10. Order number: D02. Summary: Dietary fiber is the indigestible part of plants that maintains the structure of the plant. In certain medical conditions, it is important to restrict fiber. These conditions include acute or subacute diverticulitis, the acute phases of certain inflammatory conditions of the bowel (ulcerative colitis or Crohn's disease), and the postoperative phases after colostomy or ileostomy. This brochure outlines a recommended low-fiber, low-residue diet, noting that if the diet must be strict and followed over a long period of time, the intake of fruits and vegetables may not be adequate or not enough calcium may be included. In these cases, a multivitamin supplement or liquid nutritional supplement may be needed. The brochure outlines the recommended foods and foods to avoid in each of these food groups: milk and milk products, starches (bread and grains), vegetables, fruits, meat and meat substitutes, fats and oils, and sweets and desserts. The brochure includes blank space for special instructions and concludes with a sample 1-day menu for the low-fiber diet.

•

Getting More Fiber In Your Diet Source: Kalamazoo, MI: Hope Publications. 199x. [4 p.]. Contact: Available from Hope Publications. Marketing and Distribution, International Health Awareness Center, Inc. 350 East Michigan Avenue, Suite 301, Kalamazoo, MI

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49007-3851. (616) 343-0770. Website: www.hithope.com. PRICE: $8.31 for a single copy; $0.55 each for 10 to 55 copies; discounts available for larger orders. Summary: If one's daily diet includes a lot of plant foods, such as fruits, vegetables, cereals, and grains, it probably comes close to 25 to 30 grams of fiber a day, which is the amount recommended. However, if one's diet follows the typical American pattern and centers around meats, sugars, and fats, it is probably not adequate when it comes to fiber. This brochure provides basic information about dietary fiber and how it can help maintain a healthy weight and prevent heart disease and cancer. The brochure unfolds to a miniposter, which provides a wealth of information about dietary fiber and how to incorporate more of it in one's daily diet. Adequate fiber promotes good bowel function, which in turn reduces the risk of colon cancer and colon diseases such as diverticulitis. Soluble fiber also promotes clearance of cholesterol from the blood, which reduces the risk of cardiovascular disease. The brochure offers simple strategies for each meal and snack, including the idea of using meat for garnish and flavoring, leaving the skins on potatoes, vegetables, and fruits, and using whole grains. The brochure outlines the fiber information that can be found on the nutritional labeling required on foods. One chart lists the amounts of fiber found in typical servings of breads and crackers, cereals, legumes, fruits and vegetables, and grains. The brochure is illustrated with simple, cartoon-like graphics. •

Irritable Bowel Syndrome Source: Bethesda, MD: American Gastroenterological Association. 199x. [4 p.]. Contact: American Gastroenterological Association (AGA). 7910 Woodmont Avenue, Seventh Floor, Bethesda, MD 20814. (800) 668-5237 or (301) 654-2055. Fax (301) 652-3890. Website: www.gastro.org. PRICE: Single copy free; bulk copies available. Summary: Irritable bowel syndrome (IBS) is a common disorder of the intestines that leads to crampy pain, gassiness, bloating, and changes in bowel habits. Some people with IBS have constipation, others have diarrhea, and some people experience both. This brochure from the American Gastroenterological Association (AGA) reviews the problem of IBS. Topics include a description of IBS and its causes, the symptoms of IBS, diagnostic tests used to confirm the condition, and treatment options, notably diet therapy and medications. The brochure emphasizes that although IBS causes a great deal of discomfort and distress, it does not cause permanent harm to the intestines and does not lead to intestinal bleeding of the bowel or to a serious disease such as cancer. While stress may worsen IBS symptoms, research is looking more into colon motility and the brain gut relationship when searching for causes of IBS. IBS usually is diagnosed after doctors exclude the more serious diseases that could cause similar symptoms. For many people, eating a proper diet lessens IBS symptoms; dietary fiber may lessen IBS symptoms. The brochure recommends the use of a food diary, before and during any dietary changes. The brochure includes a diagram of the digestive tract, with organs labeled. 1 figure.

•

Your Renal Guide to the New Food Label Source: New York, NY: National Kidney Foundation. 199x. [4 p.]. Contact: Available from National Kidney Foundation. 30 East 33rd Street, Suite 1100, New York, NY 10016. (800) 622-9010 or (212) 889-2210. Fax (212) 689-9261. E-mail: [email protected]. Website: www.kidney.org. PRICE: $7.00 for 25 copies.

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Summary: Most food packages now contain the Nutrition Facts Label that is intended to help consumers understand how every food product contributes (for better or worse) to one's daily diet. The Food and Drug Administration (FDA) introduced the new label in 1994. This fact sheet guides readers in understanding the new food label and how they can use the information from the food label in their own meal and nutrition planning. The fact sheet first describes each section of the food label and how to understand the information provided there. The fact sheet then offers specific guidelines for readers who are following certain dietary modifications, including less total fat, saturated fat, and calories; less sodium; more total fat and calories; more total fat and calories and less saturated fat; more dietary fiber; more added sugars and calories; or less added sugars and calories. It is suggested that readers work with their dietitian to determine which section of the fact sheet is most appropriate for their individual situation. The fact sheet then provides a listing of the FDA definitions for comparative nutrition content claims per serving (as compared to the 'regular product'); claims discussed include light or lite, lite in sodium, reduced, less or lower, more, fortified, enriched or added, fiber, calorie free, fat free, saturated fat free, cholesterol free, low calorie, low fat, low saturated fat, low cholesterol, extra lean meat, lean meat, sodium free or salt free, very low sodium, low sodium, no salt added, sugar free, no sugar added, 100 percent juice, good source of fiber, high source of fiber, rich in, excellent source, healthy. 1 figure. 1 table. •

Your High Fiber Diet Source: Birmingham, AL: University of Alabama at Birmingham Hospital. 1992. 8 p. Contact: Available from University of Alabama at Birmingham Hospital. University Hospital. Department of Food and Nutrition Services, 619 South 19th Street, Birmingham, AL 35233. (205) 934-8055. Fax (205) 934-2987. PRICE: $1.00 plus shipping and handling; bulk copies available. Summary: Recent studies demonstrate a variety of health benefits that can result from eating a diet rich in fiber, defined as the residue that is not digested by the intestinal tract. This booklet offers an introduction to a high fiber diet, that is, a well balanced diet that emphasizes additional sources of fiber. Generally, a diet high in fiber contains 30 to 40 grams of fiber per day. Dietary fiber is found only in plant products such as fruits, vegetables, nuts, legumes, and whole grains. There are two main types: soluble fiber, the type that may help lower cholesterol levels, and insoluble fiber, the type that helps relieve constipation and may prevent diverticular disease and certain types of cancer. The booklet reviews the foods that contain these fibers and then lists strategies to add fiber to the diet. Any increase in fiber intake should be accomplished gradually. In addition, when a high fiber diet is consumed, fluid intake should also be increased. Without fluid, fiber cannot do its job. The booklet recommends drinking 8 to 10 glasses of water or other fluid a day and concludes with a sample menu. Space is provided for recording the name and telephone number of the patient's dietitian.

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High-Fiber Foods Source: Journal of Renal Nutrition. 6(1): 52-55. January 1996. Contact: Available from W.B. Saunders Company, Periodicals Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 654-2452. Summary: This article on high-fiber foods includes a patient education handout that was created to assist the dialysis patient in selecting 25 g of dietary fiber per day without increasing potassium and phosphorus levels beyond the diet prescription. The text reviews procedures for dietitians and nutritionists to follow in selecting cereals. The

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author provides specific suggestions for helping patients access high-fiber foods. 2 figures. 1 table. •

What's New on the Label?: What You Need to Know About Food Labels and Their Nutrition Facts Source: Waco, TX: Health Edco. 1995. 18 p. Contact: Available from Health Edco. P.O. Box 21207, Waco, TX 76702-1207. (800) 2993366, ext. 295. Fax (817) 751-0221. PRICE: $2.00 each for 1-49 copies, $1.40 each for 50-99 copies. Summary: This booklet is designed to help readers understand and use the updated food labels called 'Nutrition Facts' (older labels were called 'Nutrition Information Per Serving'). The Food and Drug Administration now requires that certain nutrients be displayed on the labels because of their link to conditions such as heart disease, high blood pressure, stroke, obesity, diabetes, osteoporosis, and some forms of cancer. These nutrients include total fat, saturated fat, cholesterol, sodium, total carbohydrate, dietary fiber, sugars, protein, vitamins A and C, iron, and calcium. Nutrients such as B-vitamins are no longer shown because most people get a sufficient amount of them in their diets. The booklet points out that eating a variety of foods in moderation allows all types of food to fit into a healthful diet. Information specific to understanding terms on the labels, using the information on the labels, selecting a healthy diet, believing the claims on the label, and understanding the nutrient content claims are presented in question and answer format.

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Constipation and You Source: Cincinnati, OH: Marion Merrell Dow, Inc. 1990. 3 p. Contact: Available from SmithKline Beecham Consumer Brands. P.O. Box 1467, Pittsburgh, PA 15230. (800) 245-1040. Bulk order available to physicians by calling (800) 233-2426. PRICE: Free. Summary: This booklet is designed to serve as an easy guide to the understanding and treatment of constipation. Guidelines are included to rule out serious causes of constipation (diabetes, uremia, abnormal bowel structure, constipating drugs), and to prevent ordinary constipation with dietary fiber. A commercially available product (Citrucel) for treating constipation also is described.

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What You Can Do About Irritable Bowel Syndrome Source: Cincinnati, OH: Procter and Gamble Company. 1992. 14 p. Contact: Available from Procter and Gamble Company. P.O. Box 86, Cincinnati, OH 45201-0086. (800) 428-8363. PRICE: Single copy free. Summary: This booklet was created to help patients understand irritable bowel syndrome (IBS) and to provide some general guidelines. Written in a question-andanswer format, the booklet includes a definition of IBS and provides information about symptoms; the causes of IBS-related pain; the anatomy of the digestive tract; recommendations for lifestyle changes to ease symptoms; the role of dietary fiber and how to change one's diet to increase the amount of fiber; the amount of fiber in various foods; and the different kinds of fiber. The booklet concludes with a description of the uses of Metamucil, a fiber supplement.

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Carbohydrate Counting: Moving On (Level 2) Source: Alexandria, VA, and Chicago, IL: American Diabetes Association and The American Dietetic Association. 1995. 32 p. Contact: Available from American Diabetes Association. Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (404) 442-9742. PRICE: $15 (members) or $18 (nonmembers) for package of 10 booklets plus accompanying professional information (2 pages). Order Number CCCL2. Also available from The American Dietetic Association. 216 W. Jackson Boulevard, Chicago, IL 60606-6995. (800) 877-1600, ext. 5000. Summary: This booklet, the second in a series of three, builds on the basic concepts of carbohydrate counting as introduced in the first booklet. Readers develop their record keeping skills and learn to identify patterns in their blood glucose levels that are related to the food they eat, diabetes medications, and their physical activity levels. This technique, called pattern management, is presented in detail. Topics include food labels and carbohydrate counting; eating at restaurants; considerations about fat and protein; weight gain and hypoglycemia; and dietary fiber. The booklet includes examples and practice exercises for readers to practice their skills at pattern management. The series is designed for people with IDDM, NIDDM, and gestational diabetes mellitus (GDM). 9 references.

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Irritable Bowel Syndrome (IBS) Source: Milwaukee, WI: International Foundation for Functional Gastrointestinal Disorders. 1998. 8 p. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217. (888) 964-2001 or (414) 9641799. Fax (414) 964-7176. E-mail: [email protected]. Website: www.iffgd.org. PRICE: Free for members; $1.00 for nonmembers; plus shipping and handling. Order number: 101IBS. Summary: This brochure describes irritable bowel syndrome (IBS), a disturbance of intestinal function with symptoms of abdominal discomfort, bloating, and abnormal bowel movements. Diarrhea may often alternate with constipation. The typical features of IBS are recognizable to a physician, but need not all be present and may appear with some variation in different patients. The most important step in diagnosis is to rule out other diseases; this is done through a detailed history, physical examination, laboratory tests, x-rays, and endoscopy. Although the cause of IBS is not known, symptoms appear to be the result of increased sensitivity to distension of the gastrointestinal (GI) tract by gas or fecal material and a tendency for the bowel to be overly reactive to almost anything: eating, stress, emotional arousal, or gaseous distension. Lactose (milk sugar) intolerance can have similar symptoms to IBS, and while they can occur at the same time in a patient, they are different problems. The brochure discusses remissions and prognosis, the causes of bloating and gas, colitis and how it differs from IBS, treatment options, the impact of the menstrual cycle on IBS symptoms, and the relationship of stress and IBS. Treatment options discussed include evaluation of stress level and diet, diet therapy (increasing dietary fiber, avoiding laxatives, reducing trigger foods), lifestyle changes, drug therapy, biofeedback, and psychological counseling. The brochure summarizes seven strategies for coping with IBS. The brochure includes a brief description of the International Foundation for Functional Gastrointestinal Disorders. 1 figure.

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What Can Digestion Tell You About Your Health? Source: Asheville, NC: Great Smokies Diagnostic Laboratory. 1998. [2 p.]. Contact: Available from Great Smokies Diagnostic Laboratory. 63 Zillicoa Street, Asheville, NC 28801-1074. (800) 522-4762 or (704) 253-0621. Fax (704) 252-9303. E-mail: [email protected]. Website: www.greatsmokies-lab.com. PRICE: Single copy free. Summary: This brochure describes the Comprehensive Digestive Stool Analysis (CDSA), a group of 25 tests performed on a stool sample, which can reveal information about a patient's gastrointestinal health. The CDSA evaluates the digestion of food molecules and absorption of nutrients, the presence of hidden yeast or bacterial infections, intestinal flora balance, intestinal immune function, and dietary fiber intake. The brochure emphasizes that poor digestion or imbalances in the intestinal flora can result in many illnesses, from annoying complaints such as chronic constipation and abdominal pain, to more serious illnesses that may appear unrelated to digestion, such as asthma or migraines. The brochure reviews the role of some of the components of a healthy gastrointestinal tract, including stomach acid and other digestive enzymes, the bacteria in the digestive tract, and the immune system. For proper gastrointestinal health, the body must carefully coordinate the breakdown, absorption, and elimination of food. Bacteria must be in proper balance, and immune function must be adequate. The brochure includes a checklist readers can use to assess their own need for a CDSA. 1 figure.

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Easy Food Tips for Heart-Healthy Eating Source: Easy Food Tips for Heart-Healthy Eating. 16 pp. Contact: The American Heart Association. National Center. 7272 Greenville Avenue, Dallas, TX 75231-4596. (800) 242-8721. Summary: This brochure discusses the rationale for eating heart healthy and provides guidance for doing so. Its nine steps include using nonfat products; choosing low-fat foods; eating lean meats; switching to skim, nonfat, or fat-free milk; enjoying low-fat and nonfat cheeses and dairy products; using nonfat and low-fat puddings and frozen desserts; enjoying low-fat breads, cereals, and pastas; eating egg whites or egg substitutes; and using less fat in cooking. Next, the brochure defines food labeling claims such as 'fat free' and 'reduced calories.' The author discusses a sample food label and its terminology: serving size, calories, daily value, total fat, saturated fat, cholesterol, sodium, total carbohydrate, dietary fiber, protein, and vitamins and minerals.

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Understanding Fiber Source: Pittsburgh, PA: SmithKline Beecham. 199x. 6 p. Contact: Available from SmithKline Beecham. Consumer Brands, P.O. Box 1467, Pittsburgh, PA 15230. (800) 245-1040. PRICE: Single copy free. Bulk orders available to physicians, (800) 233-2426. Summary: This brochure familiarizes readers with the role of fiber in treating irritable bowel syndrome (IBS), diverticular disease, constipation, and other digestive disorders. Topics include the role of fiber in the physiology of digestion and nutrient absorption; how to determine the right amount of fiber for a particular individual; the role of fiber supplements, including Citrucel; sources of dietary fiber; and facts about fiber. A chart summarizes common digestive ailments, who tends to be affected by them, treatment

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options, and how fiber can help. Ailments covered are hemorrhoids, anal fissures, IBS, diverticular disease, and constipation. The brochure is produced by the manufacturer of Citrucel; a coupon for the product is included. •

Diet and Nutrition in Porphyria Source: Houston, TX: American Porphyria Foundation. 199x. 10 p. Contact: Available from American Porphyria Foundation. P.O. Box 22712, Houston, TX 77227-2712. (713) 266-9617. Fax (713) 871-1788. Website: www.enterprise.net/apf/. PRICE: Single copy free to members only ($30.00 membership fee); online version available for $5.00 access fee. Summary: This brochure for health professionals and people with porphyria discusses the importance of diet and nutrition, and explains why diet influences the manifestations of certain types of porphyria. The brochure provides general nutritional recommendations for patients with acute porphyrias, including consuming enough of carbohydrates, dietary fiber, vitamins, and minerals; avoiding alcoholic beverages; and maintaining a normal body weight. Other topics are devising a plan to achieve the goals of a dietary prescription, weight reduction in patients with acute porphyria, nutritional management in acute attacks, additive effects of other factors causing acute attacks, and abnormal eating attitudes and behaviors. The brochure also presents some dietary recommendations for types of porphyria other than the acute varieties. It concludes with a discussion of diet and food choices, focusing on the composition of the diet, nutritional requirements, guidelines for healthy people, and strategies for changing one's diet. 1 table.

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Facts About Fiber Source: Waco, TX: Health Edco. 1992. 2 p. Contact: Available from Health Edco. P.O. Box 21207, Waco, TX 76702-1207. (800) 2993366, ext. 295. Fax (817) 751-0221. PRICE: $2.00 each for 1-99 copies, $0.44 each for 100 or more copies. Summary: This brochure offers a question and answer format to provide information on dietary fiber. The questions are posed on the outside of the brochure, with the answers on a sliding tab answer card. Topics include definitions of the different types of fiber and where it can be found, recommendations on the amount of fiber that should be included in the diet, the role of fiber in lowering cholesterol, how fiber prevents cancer (particularly cancer of the colon or rectum), and the role of fiber in reducing the incidence of hemorrhoids. There are two kinds of fiber: soluble and insoluble. Only soluble fiber produces significant reductions in blood cholesterol and blood sugar. However, insoluble fiber seems to protect against intestinal cancers. Fiber is thought to prevent cancer by weakening or deactivating cancer-causing substances in the bowel. Fiber also speeds the passage of food through the bowel, reducing the time that the bowel is exposed to potential cancer-causing agents. Fiber has been proven to reduce the chance of developing cancer of the colon or rectum and may prevent diverticulitis as well.

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When Your Doctor Says You Have Irritable Bowel Syndrome Source: Milwaukee, WI: Schwarz Pharma. 1993. 6 p.

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Contact: Available from Schwarz Pharma. P.O. Box 2038, Milwaukee, WI 53201. (800) 558-5114, (414) 354-4300. PRICE: Free (packs of 50); single copy also available. Order number SP0599B 5/93. Summary: This brochure presents a brief overview for newly-diagnosed patients with irritable bowel syndrome (IBS). Topics include the symptoms of IBS; the normal function of the digestive system; how the digestive system works in IBS; managing IBS; IBS and the diet, including common foods that may aggravate IBS; dietary fiber intake; and drug therapy for IBS. Simple line drawings illustrate some of the concepts presented. •

Nutrition in the Fast Lane: A Guide to Nutrition and Dietary Exchange Values for Fast-Food Source: Indianapolis, IN: Franklin Publishing, Inc. 1997. 97 p. Contact: Available from Franklin Publishing, Inc. 310 N. Alabama Street, Suite 110, Indianapolis, IN 46204. (800) 634-1993 or (317) 634-5001. Fax (317) 634-8558. PRICE: $4.95 plus $2.00 shipping and handling; bulk prices available. Summary: This brochure provides a convenient and easy-to-understand guide to nutrition and dietary exchange values for nearly 1,500 menu items offered by 39 of the most popular fast-food chains. While fast food may be loaded with calories, fat, cholesterol, and sodium, the guide points out that it can be part of a healthy meal plan if a person chooses wisely. Information on how to use the booklet, including information about each of the column guides, precedes the menu items. The guide lists restaurants alphabetically and provides information similar to that found on labels of canned and packaged foods. The nutritional information about each menu item includes calories, carbohydrates, protein, total fat, saturated fat, cholesterol, sodium, dietary fiber, and suggested exchange values for each item. The authors conclude that achieving overall good health includes eating a variety of foods, maintaining a healthy weight, exercising regularly, and avoiding excessive amounts of fat, saturated fat, cholesterol, sugar, and sodium. (AA-M).

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IBS: Irritable Bowel Syndrome. Do You Have It? How Serious Is It? How Can You Get Rid of It? Source: Fort Worth, TX: Konsyl Pharmaceuticals, Inc. 1994. 2 p. Contact: Available from Konsyl Pharmaceuticals, Inc. 4200 South Hulen Street, Fort Worth, TX 76109. (800)356-6795 or (817) 763-8011. PRICE: Single copy free. Summary: This brochure provides a general introduction to irritable bowel syndrome (IBS). The brochure reviews primary symptoms, including abdominal pain, diarrhea, and constipation; complications; diagnostic tests; the role of lifestyle, including exercise; and the importance of adequate dietary fiber to control symptoms.

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Common Gastrointestinal Problems: A Consumer Health Guide. Volume II Source: Arlington, VA: American College of Gastroenterology. 1996. 23 p. Contact: Available from American College of Gastroenterology. 4900B South 31st Street, Arlington, VA 22206. (703) 820-7400. Price: Single copy free. Summary: This brochure provides an overview of common gastrointestinal problems, including constipation, gallstones, hemochromatosis, inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), viral liver disease, and alcoholic liver disease. Each topic

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is addressed by a specialist in the field and the information is provided in a question and answer format. The section on constipation covers normal digestive function, normal bowel habits, a definition of constipation, how to know when to consult a health care provider, diagnostic tests that may be performed, treatment options, and dietary fiber. The section on gallstones describes the gallbladder and its functions, how gallstones are formed, risk factors for developing gallstones, the symptoms of gallstones, diagnostic tests used to confirm gallstones, treatment options, and prevention. The section on hemochromatosis describes the condition and its symptoms, diagnostic tests, treatment options, how hemochromatosis can be confused with other liver diseases, and the indications for screening of family members. The chapter on IBD covers the difference between ulcerative colitis and Crohn's disease, how IBD differs from IBS, the causes of IBD, how stress affects IBD, diagnostic tests, complications of IBD, medication treatments available, complications from medical treatment, diet therapy for patients with IBD, and surgical options for IBD. The section on IBS focuses on recommended treatment strategies, including consulting a health care provider, reducing stress, watching dietary intake, and using medications. The section on viral liver disease describes the liver and its function, a definition of hepatitis and its symptoms, the different viruses and how they are transmitted, prevention issues, treatment options, and the longterm consequences of hepatitis. The final section, on alcoholic liver disease, covers the impact of alcohol consumption on the liver, gender differences in alcoholic liver disease, fatty liver, alcoholic hepatitis, alcohol-induced cirrhosis, differentially diagnosis, complications of alcoholic liver disease, and treatment options. 3 figures. 1 table. (AA-M). •

Fiber Facts Source: Fort Worth, TX: Konsyl Pharmaceuticals, Inc. 1999. [2 p.]. Contact: Available from Konsyl Pharmaceuticals, Inc. 4200 South Hulen Street, Suite 513, Fort Worth, TX 76109-4912. (800) 356-6795 or (817) 763-8011. Fax (817) 731-9389. Website: www.konsyl.com. PRICE: Single copy free. Summary: This brochure provides basic information about dietary fiber, defined as the part of the plant that cannot be digested by humans. Fiber is found in grains, cereals, fruits, vegetables, nuts, seeds, and legumes (dried beans, peas, and lentils). There are two kinds of fiber and most sources of fiber contain a mixture of both types. Soluble fiber absorbs water and promotes good intestinal health by increasing bowel motility which enhances transit through the intestinal tract. Insoluble fiber absorbs little water but is still important because it improves the transit time necessary to move fecal material through the colon. The National Cancer Institute has recommended eating 25 to 35 grams of fiber a day as a step toward preventing colon cancer. Most Americans consume only 10 to 15 grams of fiber per day. The brochure reviews strategies that readers can implement to increase their fiber intake, but notes that it is important to increase the level slowly. A chart is provided for readers to determine their present level of dietary fiber intake. The author discusses the use of fiber supplements, such as Konsyl (the manufacturer of which is the producer of this brochure). The brochure summarizes how increased fiber will benefit each of six disease areas: constipation, hemorrhoids, diverticular disease, irritable bowel syndrome (IBS), colon cancer, and cardiovascular disease. The brochure is illustrated with full color drawings and photographs. 1 table. 4 figures.

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Filling Up on Fiber Source: Washington, DC: Sugar Association, Inc. 1992. 4 p.

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Contact: Available from Sugar Association, Inc. 1101 15th Street NW, Suite 600, Washington, DC 20005. (202) 785-1122. PRICE: Free (up to 50 copies). Summary: This brochure provides readers with information about dietary fiber and how to increase daily intake to achieve the Dietary Guidelines for Americans. Topics include how fiber is used in the body, good sources of soluble and insoluble fiber, the role of high fiber foods in weight control, and daily fiber intake. The brochure lists nine suggestions for increasing daily fiber intake. The brochure also provides eight recipes: tomato zucchini pesto, soda bread, apple bulghur salad, gazpacho, cantaloupe strawberry shake, spiced oranges, spinach chickpea salad, and chicken and vegetable couscous. •

Healthy Habits for the Best of Your Life Source: Washington, DC: Egg Nutrition Center. 1996. 8 p. Contact: Available from Egg Nutrition Center. 1819 H Street, NW, Suite 520, Washington, DC 20006. (202) 833-8850. Fax (202) 463-0102. E-mail: [email protected]. PRICE: Single copy free. Summary: This brochure reminds readers of the relationship between lifestyle and illness and provides guidelines for healthy eating and activity levels. Topics include reducing heart disease risk; a healthy weight control regimen; the benefits of exercise; suggestions for increasing one's activity level; blood cholesterol and the impact of reduction of dietary fats; hypertension and suggestions for controlling it; women and heart disease; osteoporosis; dietary fiber; the use of vitamin supplements; and the role of eggs in the diet. For each section, the brochure provides a sidebar listing practical recommendations for readers to implement in their everyday activities. Simple line drawings and colorful printing characterize the brochure.

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Help for Common Digestive Problems Source: Zetland, New South Wales, Australia: Multicultural Health Communication Service. 1998. (web brochure). Contact: Available from Multicultural Health Communication Service. Royal South Sydney Community Health Complex, Joynton Avenue, Zetland, New South Wales, Australia 2107. (02) 9382 8111. E-mail: [email protected]. Website: mhcs.health.nsw.gov.au/. Item is available only through the website and can be found under Diseases and Conditions. Summary: This brochure, available online through the Multicultural Health Communication Service, is one of a series of health information publications available in languages other than English. The Service facilitates the communication of quality information about health issues and services to people of non-English-speaking backgrounds. This brochure offers suggestions for handling common digestive problems, including heartburn, peptic ulcer, irritable bowel syndrome (IBS), and constipation. A burning pain (heartburn) just behind the breastbone is usually a symptom of acid reflux, a condition where gastric acid backs up into the esophagus. The brochure describes the differences in the sensations caused by heartburn and the symptoms of a heart attack. Acid reflux can be caused by some foods and drinks or by a stomach ulcer. The brochure discusses the role of Helicobacter pylori in stomach ulcers. The brochure then briefly describes IBS, including the symptoms and risk factors, and encourages readers to contact their health care providers when certain symptoms (blood in the bowel movements, weight loss, or family history of bowel cancer) are present. The

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section on constipation warns readers not to rely on laxatives, but instead to increase their consumption of dietary fiber and fluids and to exercise regularly. The brochure concludes by reminding readers of the importance of following a balanced diet that includes plenty of cereals and grains, and of the positive impact on the digestive system of ceasing to smoke. The brochure is not illustrated and is written in straightforward, nontechnical language. •

Nutrition in the Fast Lane; the Fast-Food Dining Guide Source: Indianapolis: Franklin Publishing, Inc. 2000. 145 p. Contact: Franklin Publishing Incorporated. 310 N. Alabama Street, Suite 110, Indianapolis, IN 46204. 800-634-1993. www.FastFoodFacts.com. Summary: This brochure/guide provides nutrition information on nearly 2,400 menu items provided by 54 of the most popular fast food and casual dining restaurants in the United States. The restaurants are listed in alphabetical order. The number of calories, carbohydrate, protein, total fat, saturated fat, cholesterol, sodium, and dietary fiber found in each food is provided. A total carbohydrate exchange rating for each food provides help in substituting one food for another equivalent in carbohydrates. In addition, a system of suggested exchange values offers guidance in the control of portion sizes, calories, carbohydrates, protein, and fat. Introductory pages provide basic nutrition information and discuss the food guide pyramid and number of calories burned during various activities.

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An Introduction to the New Food Label: Read the Label, Set a Healthy Table Source: Rockville, MD: U.S. Department of Health and Human Services, Food and Drug Administration, 8 p., 1993. Contact: Food and Drug Administration, Office of Consumer Affairs, 5600 Fishers Lane, HFE-50, Rockville, MD 20857. (301) 443-3170. Publication number (FDA) 94-2271. Summary: This brochure/poster introduces the new food labels, describing the detailed information included in these new labels. The Federal Government has revamped the food label so that it includes information on current health concerns, such as dietary fiber and fat content. These labels also reflect new guidelines in their use of terms such as "low fat" and "high fiber." One side of the brochure folds out into a poster (approx. 17 x 18 inches) of a sample of the new food label, with explanations of its different parts.

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Introduction to Fiber Source: in Kerestes-Smith, J.; Chua, G.; Sullivan, K. Guidelines for Nutritional Care. Ann Arbor, MI: Food and Nutrition Services, University of Michigan Medical Center. 1995. Chapter 33, p. 33.1-33.7. Contact: Available from Guidelines for Nutritional Care. Food and Nutrition Services, 2C227-0056, University of Michigan Hospitals, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0056. (313) 936-5199. Fax (313) 936-5195. PRICE: $79.00 including shipping and handling (as of 1996). ISBN: 0964799405. Summary: This chapter, from a manual that outlines the impact nutrition has on promoting health and preventing and treating disease, provides a general introduction to the role of dietary fiber. After a brief section describing the potential benefits of a higher fiber diet, the chapter consists mainly of tables listing the fiber and caloric content of various common foods. An additional chart summarizes the classification of

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plant fiber, the food sources from which each type can be obtained, and the probable physiologic effects. 8 references. •

Go With the Grain Source: Chicago, IL: The Quaker Oats Company, 8 p., 1992. Contact: The Quaker Oats Company, PO Box 9003, Chicago, IL 60604-9003. Summary: This consumer education booklet offers suggestions for adding grains to the diet. The grain food group is a good source of dietary fiber, B vitamins, and key minerals. The two basic types of fiber (soluble fiber and insoluble fiber) are described. The three parts of the grain are defined. The booklet highlights the main grains and their products, including barley, oats, wheat, corn, and rice.

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Taking Care of Your Colon Source: Santa Cruz, CA: ETR Associates. 1999. 6 p. Contact: Available from ETR Associates. 4 Carbonero Way, Scotts Valley, CA 950664200. (800) 321-4407. Fax (800) 435-8433. Website: www.etr.org. PRICE: Single copy free; $16.00 for 50 copies, discounts for larger orders. Order number R362. Summary: This educational brochure offers information about the role of the colon (large intestine) and strategies for maintaining colon health. The colon reabsorbs most of the water from undigested food, then moves solid waste out of the body. Most colon problems have clear symptoms, such as cramps, constipation, or diarrhea. The brochure briefly defines some common problems, including diverticulosis (colon pockets), irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), colon polyps, and infections of the colon. The brochure then focuses on prevention of problems, with an emphasis on including enough dietary fiber and fluids in one's daily intake. Fiber in the diet promotes regular bowel movements, makes constipation and cramping less likely, reduces the time that waste remains in the colon, eases diverticulosis and IBS, may reduce the risk of colon cancer and some other cancers, and lowers levels of low density cholesterol (LDL). The brochure recommends that readers avoid laxatives, high fat foods, colonics or enemas, and too much caffeine or alcohol. The brochure offers suggestions for treating minor problems with diarrhea and constipation, then concludes with a discussion of colon cancer and the screening tests used to diagnose colon cancer (including a digital rectal exam, a stool blood test, a flexible sigmoidoscopy, and colonoscopy). 1 figure. 1 table.

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Functional Diarrhea: Some Answers to Often Asked Questions Source: Milwaukee, WI: International Foundation for Functional Gastrointestinal Disorders. 1994. 2 p. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217. (888) 964-2001 or (414) 9641799. Fax (414) 964-7176. E-mail: [email protected]. Website: www.iffgd.org. PRICE: $0.50. Summary: This fact sheet answers common questions about functional diarrhea. Diarrhea is defined as an abnormal looseness of stools and or an increase in frequency of bowel movements. On the basis of surveys of normal populations, more than three bowel movements per day may be defined as diarrhea. If diarrhea lasts longer than three weeks, it is classified as chronic. If no specific cause is found after a thorough investigation, and if certain criteria are met, a diagnosis of functional diarrhea may be

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considered. Patients with functional diarrhea may represent a subgroup of patients with irritable bowel syndrome (IBS). The most important aspect of the workup for the patient is a thorough medical history, including use of medicines and dietary habits, and a careful physical examination. Patients may have celiac disease (gluten intolerance) or lactose (milk sugar) intolerance as the underlying cause of their diarrhea. In these cases, dietary therapy is indicated. Although there is no consensus regarding the cause of functional diarrhea, it is thought that patients with functional diarrhea have different gastrointestinal motility (movement) patterns than do patients without diarrhea. Treatments often include an increase in dietary fiber. The fact sheet also briefly mentions drugs that can be used for a limited period to manage diarrheal episodes. (AA-M). •

Bellyaches in Children Source: Milwaukee, WI: International Foundation for Functional Gastrointestinal Disorders (IFFGD). 2002. [4 p.]. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217-8076. (888) 964-2001 or (414) 964-1799. E-mail: [email protected]. Website: www.iffgd.org. PRICE: $1.00 for nonmembers; single copy free to members. Summary: This fact sheet helps parents understand the various causes for abdominal pain (belly aches) in children and know when to consult with a health care provider for a child's abdominal pain. The fact sheet begins with clues that can help decide if the bellyache is a medical problem: intensity, duration, chronicity, position, the number of symptoms, and loss of function. Most chronic bellyaches are functional, meaning that the pain is real, but it is not due to any disease (the pain is due to an altered way in which the body is working, not due to a disease characterized by tissue damage, inflammation, or a structural abnormality). The fact sheet also outline the diagnostic criteria for pediatric functional disorders associated with bellyaches: functional dyspepsia, irritable bowel syndrome, functional abdominal pain syndrome, abdominal migraine, aerophagia (swallowing air), and functional fecal retention. The fact sheet concludes with the answers to some common questions about bellyaches in children, including pain management, drug therapy, and the role of dietary fiber. The fact sheet includes the contact information for the International Foundation for Functional Gastrointestinal Disorders (IFFGD, www.iffgd.org).

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Focus on Fiber Source: Chicago, IL: National Center for Nutrition and Dietetics of the American Dietetic Association. 1994. 2 p. Contact: Available from American Dietetic Association. 216 W. Jackson Boulevard, Chicago, IL 60606-6995. (800) 877-1600, ext. 5000. Fax (312) 899-4899. PRICE: $19 for set of 12 fact sheets (ADA members); $22.50 (nonmembers). Summary: This fact sheet provides basic information about dietary fiber and recommendations for levels of fiber intake. Patients learn what fiber is and why it is important along with tips for increasing their fiber intake. One chart lists fiber-rich foods, their recommended serving sizes, and grams of fiber in each. A recipe for blueberry bran flake muffins is also included.

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Evaluation and Treatment of Constipation Source: Milwaukee, WI: International Foundation for Functional Gastrointestinal Disorders. 1994. 4 p. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217. (888) 964-2001 or (414) 9641799. Fax (414) 964-7176. E-mail: [email protected]. Website: www.iffgd.org. PRICE: $0.50. Summary: This fact sheet reviews the evaluation and treatment of constipation, one of the most common gastrointestinal complaints in the United States. Although constipation represents an abnormality of bowel function, the author notes that it is difficult to present a definition of 'normal' bowel function. The author first reviews the physiology of the colon and anorectal area, focusing on the function of the colon in reducing fluid from the digestive tract. Dietary fiber retains water in the stool and is responsible for stools that are bulkier, softer, and easier to pass. Continence is promoted by the pelvic floor muscles and contraction of the internal and external anal sphincters. Both nerves and muscles regulate the transit time of the colon; changes in either element may seriously disturb colonic function. The fact sheet lists conditions associated with constipation (colonic disorders, hormonal changes, and neurological conditions) and medications that may cause constipation. Diagnosis involves a detailed history and physical examination, as well as diagnostic tests that investigate the structure and function of the colon (including endoscopy and anorectal manometry). The management of constipation includes patient education about bowel function and diet, behavior modification, drug therapy, and infrequently, surgery. Patients should be encouraged to exercise regularly, eat a diet high in fiber, and respond to the urge to defecate. Patients should also be educated about laxatives and their side effects. 1 figure. 2 tables. (AA-M).

•

Dietary Concerns Source: Portland, OR: Vestibular Disorders Association (VEDA). 199x. 3 p. Contact: Available from Vestibular Disorders Association (VEDA). P.O. Box 4467, Portland, OR 97208-4467. (503) 229-7705. Fax (503) 229-8064. E-mail: [email protected]. Website: www.vestibular.org. PRICE: $0.50 plus shipping and handling. Order number S-3. Summary: This fact sheet suggests that some people with balance disorders may need to be aware of the hidden sodium and sugars in food in order to control the amount of these substances that they eat. The publication offers guidelines for controlling sodium and sugar intake and for maintaining a well-balanced diet. A list of the sodium content of some foods, categorized by food group, is provided. The fact sheet also provides nutritional guidelines on how to decrease total fat, increase dietary fiber, maintain ideal body weight, and decrease alcohol intake. 1 table.

•

Insulin Resistance Syndrome Source: American Family Physician. 63(6): 1165-1166. March 15, 2001. Contact: Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237. Website: www.aafp.org. Summary: This fact sheet uses a question and answer format to provide people who have insulin resistance syndrome with information on the diagnosis and treatment of the syndrome. Insulin resistance occurs when the tissues stop responding to insulin, allowing insulin to accumulate in the blood. There is no test for insulin resistance

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syndrome, but a doctor may suspect the syndrome in a patient who has a history of diabetes in first degree relatives; patients with a personal history of gestational diabetes, polycystic ovary syndrome, or impaired glucose tolerance; and obese patients, particularly those with abdominal obesity. Insulin resistance syndrome may be prevented by maintaining a healthy weight, exercising, and eating a lot of dietary fiber. 1 figure. 1 table. •

Diabetes Meal Planning Source: Seattle, WA: King County Courthouse. 200x. 2 p. Contact: Available from King County Courthouse. 516 Third Avenue, Seattle, WA 98104. (206) 296-0100 or (800) 325-6165. Website: www.metrokc.gov/. PRICE: Full-text available online at no charge. Summary: This fact sheet, available in many different languages, explains the diabetes food pyramid and its use in meal planning for people with diabetes. The fact sheet reprints the food pyramid on one page, and suggestions for its use on the second sheet. The suggestions are printed in both English and the specific foreign language requested. Information is provided for each food category: fats, sweets, alcohol, milk and calciumrich foods, meat and protein-rich foods, vegetables, fruits, and grains, beans and starchy vegetables. The fact sheet also provides tips to increase dietary fiber and tips to limit salt. Foods specific to different cultures are mentioned. For example, on the Korean language fact sheet, suggestions are provided to lower the salt in kimchi. 1 figure.

•

About Fiber in Your Diet Source: South Deerfield, MA: Channing L. Bete Co., Inc. 1997. 15 p. Contact: Available from Channing L. Bete, Co., Inc. 200 State Road, South Deerfield, MA 01373-0200. (800) 628-7733. PRICE: $1.25 each for 1-24 copies; $0.89 each for 25-99 copies; $0.64 each for 100-499 copies. Summary: This illustrated brochure outlines the role and importance of two types of dietary fiber: waterinsoluble and watersoluble fiber. Waterinsoluble fiber is the structural part of plants that does not dissolve in water; it is found mainly in wholegrain products, wheat bran, vegetables, and nuts. Watersoluble fiber, a plant substance that forms a gel in water, is found mainly in oats, beans, fruits, and some vegetables. The brochure then outlines the importance of fiber in a healthy diet. Fiber helps the body's digestive system work well and can help prevent or treat constipation, diverticulosis, irritable bowel syndrome, and hemorrhoids. Fiber may also help lower cholesterol levels, prevent colon cancer, control weight, and prevent or treat diabetes. The brochure discusses how much fiber should be in the diet and the importance of increasing the level gradually. Other topics are how to read a nutrition label; foods high in dietary fiber; specific suggestions for adding fiber to meals and snacks; and other dietary components such as fat and cholesterol, simple carbohydrates, salt, alcohol, and vitamins and minerals. Also discussed are weight maintenance and exercise. The brochure concludes with the answers to some basic questions about fiber.

•

FDA Backgrounder: The New Food Label Source: Rockville, MD: U.S. Department of Health and Human Services, Food and Drug Administration, 17 p., 1994. Contact: Food and Drug Administration, Office of Consumer Affairs, 5600 Fishers Lane, HFE-50, Rockville, MD 20857. (301) 443-3170.

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Summary: This information package introduces the newly mandated food labeling system aimed to clear up confusion and help consumers make educated food purchases. The Food and Drug Administration has revamped the food label; each label must now provide information on dietary fiber, sodium, cholesterol, and fat content. The regulations for labels are summarized, and each label component (i.e., serving size, nutrition information) is described. These labels also reflect guidelines for the use of terms such as "low fat," "fresh," "healthy," and "high fiber." Sample labels are included for baby food, frozen vegetables, soda, candy, canned fish, bread, and cake mix. •

Using the Food Label: Daily Values and Percent Values Source: Washington, DC: Food Marketing Institute, 1993. Contact: Food Marketing Institute, 800 Connecticut Avenue, NW, Washington, DC 20006-2701. (202) 429-8236. Summary: This is a series of bound, reproducible, black-and-white factsheets that all relate to the food label. Each factsheet begins with a simple quiz and contains basic information on a variety of nutrition topics. These include daily values, dietary fat, dietary fiber, saturated fat, reducing cancer risk, diabetes, and salt and sodium.

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Eating for good health: A nutrition handbook for caretakers of the handicapped child Source: Baltimore, MD: John F. Kennedy Institute for Handicapped Children, The Nutrition Division. n.d. 18 pp. Contact: Available from Jackie Krick, John F. Kennedy Institute for Handicapped Children, Nutrition Division, 707 North Broadway, Room 20, Baltimore, MD 21205. Telephone: (410) 522-5441. 1-9 copies: $5.50 each ($4.00 + $1.50 handling); 10 or more: $3.00 includes shipping and handling. Summary: This packet provides information that ties together the relationship of nutrition factors and clinical strategies to disabilities. Topics are covered by both a scientific based description for professionals and a nutrition education fact sheet for families and parents, and include: feeding, dental health, fluids, diet and underweight, diet and weight control, dietary fiber and constipation, lead poisoning, megavitamin therapy, nutritional effects of drug therapy, and hyperactivity.

•

How to Read the New Food Label Source: Dallas, TX: American Heart Association, 8p., 1993. Contact: American Heart Association, National Center, 7272 Greenville Avenue, Dallas, TX 75321-4596. Summary: This pamphlet is designed help consumers understand and utilize the new food labels. The new label helps consumers choose foods that make up a healthful diet. Each element of the new label is highlighted and its purpose is explained (i.e. serving size, dietary fiber, daily value, cholesterol, and saturated fat). The key terms and claims that are used on product labels are also defined.

•

Hemorrhoids: Steps to Finding Relief Source: San Bruno, CA: StayWell Company. 1999. [2 p.].

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Contact: Available from StayWell Company. Order Department, 1100 Grundy Lane, San Bruno, CA 94066-9821. (800) 333-3032. Fax (650) 244-4512. E-mail: [email protected]. Website: www.staywell.com. PRICE: $17.95 for pack of 50; plus shipping and handling. Summary: This patient education brochure describes hemorrhoids and their treatment. Written in nontechnical language, the brochure first defines hemorrhoids as cushions of swollen veins in the anal canal. Hemorrhoids are a very common problem and can affect all kinds of people, including those who sit for long periods, pregnant women, and others. Symptoms of hemorrhoids can include pain, itching, irritation, burning, and bleeding of the rectal area. Constipation (dry, hard to pass stool) is a major cause of hemorrhoids. Other causes include heavy lifting, lack of exercise, too much strenuous exercise, chronic cough, and poor bowel habits (such as sitting on the toilet for long periods of time). Diagnosis is important to rule out more serious diseases and will include the patient's medical history and some diagnostic tests, such as sigmoidoscopy. Most treatment plans focus on steps that the patient can follow at home, including sitz baths, nonprescription medications, and good bowel habits. The brochure reminds readers that steps to ease constipation include increasing fluid intake and undertaking regular exercise. One section of the brochure illustrates and describes the physiology of the anal canal and the types of hemorrhoids that can occur (external or internal). The last page of the brochure summarizes the recommendations for increasing dietary fiber. The brochure is illustrated with full color line drawings. 6 figures. •

Irritable Bowel Syndrome: Tips on Controlling Your Symptoms Source: Kansas City, MO: American Academy of Family Physicians. 2001. 4 p. Contact: Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237. Website: www.aafp.org. PRICE: $12.50 for 50 copies for members, $18.75 for 50 copies for nonmembers. Order number: 1521. Summary: This patient education brochure helps readers understand irritable bowel syndrome (IBS) and how they can control the symptoms it may cause. In IBS, the intestines squeeze too hard or not hard enough and cause food to move too fast or too slowly through the gastrointestinal (GI) tract. IBS can cause diarrhea, constipation, or both. The symptoms may get worse when the patient experiences stress, including that associated with travel, social events, menstrual cycles, or a change in daily routine. The brochure outlines diagnostic and treatment options, the role of dietary fiber, the impact of diet on IBS symptoms, the role of milk and milk products and the issue of lactose intolerance, managing stress, and drug therapy. The brochure notes that because IBS is a chronic disease, health care providers are hesitant to prescribe long term drug therapy. However, for acute attacks, antispasmodic drugs, loperamide, sedatives, or antidepressants may be prescribed. The brochure encourages readers to find new freedom from IBS by following a management plan that includes a healthy diet, learning new ways to deal with stress, and avoiding foods that make symptoms worse. 2 tables. (AA-M).

•

Understanding: Irregularity Source: Pittsburgh, PA: SmithKline Beecham Consumer Brands. 1991. 4 p. Contact: Available from SmithKline Beecham. Consumer Brands, P.O. Box 1467, Pittsburgh, PA 15230. (800) 245-1040. PRICE: Single copy free. Bulk orders available to physicians by calling (800) 233-2426.

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Summary: This patient education brochure provides basic information about constipation (irregularity). Topics include a definition of constipation; causes, including medication, changes in diet, lack of exercise, inadequate fluid intake, pregnancy, and medical conditions; the role of dietary fiber in preventing constipation; two types of therapeutic fiber, soluble and insoluble; and the importance of exercise. The brochure concludes with a section summarizing facts about fiber. The brochure, produced by the manufacturers of CITRUCEL, a fiber product, describes the use of CITRUCEL as part of a therapeutic program to prevent constipation. 3 references. •

What's in a High-Fiber Diet Source: Patient Care. 30(7): 149-150. April 15, 1996. Contact: Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956. Summary: This patient information fact sheet provides strategies for increasing dietary fiber. The fact sheet outlines the reasons to eat a high fiber diet and presents a chart of high fiber foods and their recommended serving amounts for daily intake. The chart lists foods in five groups: breads and starchy vegetables, cereals, beans, vegetables, and fruits and nuts. The fact sheet also provides 1 day's sample menu for a high fiber diet. The fact sheet is designed to be photocopied and distributed by health care professionals to their patients.

•

Issues in Weight Control: Causes of Obesity Source: Battle Creek, MI: Kellogg Company Food and Nutrition Communications, 6 p., N.D. Contact: Kellogg Company Food and Nutrition Communications, PO Box 3447, Department B-2, Battle Creek, MI 49016-3447. Summary: This promotional brochure reviews research into the causes and treatment of obesity. Research suggests that there are many different reasons for obesity, such as social, genetic, dietary, metabolic, and psychological factors. These are discussed along with dietary fiber and its effect on weight loss. This publication suggests ways to lose weight, including physical activity, support from family and friends, internal motivation, focusing on positive changes, and cutting out fat from diets. Inserted in this pamphlet is an article by John P. Foreyt, Ph.D., on predictors of success and failure for long-term weight maintenance. A list of selected sources is provided.

•

What's Your Nutrition I.Q.? Source: Chicago, IL: National Center for Nutrition and Dietetics, 2p., 1991. Contact: National Center for Nutrition and Dietetics, 216 W. Jackson Boulevard, Suite 800, Chicago, IL 60606-6995. Summary: This two-sided factsheet contains a quiz that tests the reader's knowledge of proper nutrition and fitness. The answers to the 10 questions on the quiz provide information about dietary fiber, dietary fat, physical fitness, calcium, iron, and the link between nutrition and heart health.

•

Gas in the Digestive Tract Source: Bethesda, MD: American Gastroenterological Association. 199x. [4 p.].

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Contact: American Gastroenterological Association (AGA). 7910 Woodmont Avenue, Seventh Floor, Bethesda, MD 20814. (800) 668-5237 or (301) 654-2055. Fax (301) 652-3890. Website: www.gastro.org. PRICE: Single copy free; bulk copies available. Summary: When gas in the digestive tract does not pass out of the body easily, it can collect, causing bloating and discomfort. This brochure from the American Gastroenterological Association (AGA) reviews the problem of gas in the digestive tract (flatulence). Topics include the major causes of flatulence, the symptoms of the condition, repetitive belching, the causes of abdominal pain and bloating, and treatment strategies. A common source of upper intestinal gas is swallowed air. Sometimes belching accompanies movement of stomach contents backup (reflux) into the esophagus. Another cause of repeated belching is gastritis (inflammation of the stomach), including that caused by the Helicobacter pylori bacteria. The brochure explores the role of food in the production of gas in the lower intestine, including dietary fiber and problems with lactose (milk sugar) intolerance. Some over the counter drugs, such as simethicone, activated charcoal, and digestive enzymes, are prescribed as helpful for relieving gassiness. Sometimes doctors also prescribe a treatment plan designed to help move gas through the intestines more readily. One sidebar reminds readers of steps that can be taken to prevent excessive belching or flatus. The brochure includes a list of references and a diagram of the digestive tract, with organs labeled. 1 figure. 3 references. The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “dietary fiber” (or synonyms). The following was recently posted: •

American Gastroenterological Association medical position statement: impact of dietary fiber on colon cancer occurrence Source: American Gastroenterological Association - Medical Specialty Society; 1999 November 15 (reviewed 2001); 2 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3070&nbr=2296&a mp;string=dietary+AND+fiber The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to dietary fiber. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html.

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Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/specific.htm

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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

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Med Help International: http://www.medhelp.org/HealthTopics/A.html

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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

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WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to dietary fiber. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with dietary fiber. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about dietary fiber. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “dietary fiber” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received

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your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “dietary fiber”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “dietary fiber” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “dietary fiber” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.22

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

22

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)23: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

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California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

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California: Gateway Health Library (Sutter Gould Medical Foundation)

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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

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Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

23

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

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Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries

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•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

227

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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DIETARY FIBER DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal fat: Fat (adipose tissue) that is centrally distributed between the thorax and pelvis and that induces greater health risk. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Abscess: Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. [NIH] Acacia: Any leguminous woody vine or tree of the genus Acacia, also called locust or wattle. The gums and tanning agents obtained from Acacia are called gum arabic. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acculturation: Process of cultural change in which one group or members of a group assimilates various cultural patterns from another. [NIH] Acetate Kinase: An enzyme that catalyzes reversibly the phosphorylation of acetate in the presence of a divalent cation and ATP with the formation of acetylphosphate and ADP. It is important in the glycolysis process. EC 2.7.2.1. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH] Acute Disease: Disease having a short and relatively severe course. [NIH] Acyl: Chemical signal used by bacteria to communicate. [NIH] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenoma: A benign epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH]

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Adenosine Diphosphate: Adenosine 5'-(trihydrogen diphosphate). An adenine nucleotide containing two phosphate groups esterified to the sugar moiety at the 5'-position. [NIH] Adenosine Triphosphate: Adenosine 5'-(tetrahydrogen triphosphate). An adenine nucleotide containing three phosphate groups esterified to the sugar moiety. In addition to its crucial roles in metabolism adenosine triphosphate is a neurotransmitter. [NIH] Adenylate Kinase: An enzyme that catalyzes the phosphorylation of AMP to ADP in the presence of ATP or inorganic triphosphate. EC 2.7.4.3. [NIH] Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adolescent Nutrition: Nutrition of children aged 13-18 years. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerobic Exercise: A type of physical activity that includes walking, jogging, running, and dancing. Aerobic training improves the efficiency of the aerobic energy-producing systems that can improve cardiorespiratory endurance. [NIH] Aerophagia: A condition that occurs when a person swallows too much air. Causes gas and frequent belching. [NIH] Aetiology: Study of the causes of disease. [EU] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age of Onset: The age or period of life at which a disease or the initial symptoms or

Dictionary 231

manifestations of a disease appear in an individual. [NIH] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Aldehydes: Organic compounds containing a carbonyl group in the form -CHO. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkalosis: A pathological condition that removes acid or adds base to the body fluids. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergens: Antigen-type substances (hypersensitivity, immediate). [NIH]

that

produce

immediate

hypersensitivity

Aloe: A genus of the family Liliaceae containing anthraquinone glycosides such as aloinemodin or aloe-emodin (emodin). [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alpha-Amylase: An enzyme that catalyzes the endohydrolysis of 1,4-alpha-glycosidic linkages in starch, glycogen, and related polysaccharides and oligosaccharides containing 3 or more 1,4-alpha-linked D-glucose units. EC 3.2.1.1. [NIH] Alpha-Linolenic Acid: A fatty acid that is found in plants and involved in the formation of prostaglandins. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Ameliorating: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (-

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COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amoxicillin: A broad-spectrum semisynthetic antibiotic similar to ampicillin except that its resistance to gastric acid permits higher serum levels with oral administration. [NIH] Ampicillin: Semi-synthetic derivative of penicillin that functions as an orally active broadspectrum antibiotic. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amylase: An enzyme that helps the body digest starches. [NIH] Amylopectin: A highly branched glucan in starch. [NIH] Amylose: An unbranched glucan in starch. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Anal Fissure: A small tear in the anus that may cause itching, pain, or bleeding. [NIH] Analgesics: Compounds capable of relieving pain without the loss of consciousness or without producing anesthesia. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Angina: Chest pain that originates in the heart. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or

Dictionary 233

company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]

Anovulation: Suspension or cessation of ovulation in animals and humans. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antifoaming Agents: Agents used to prevent the formation of foam or to treat flatulence or bloat. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-infective: An agent that so acts. [EU] Anti-Infective Agents: Substances that prevent infectious agents or organisms from spreading or kill infectious agents in order to prevent the spread of infection. [NIH] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipruritic: Relieving or preventing itching. [EU] Antispasmodic: An agent that relieves spasm. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU]

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Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Aqueous: Having to do with water. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Aromatic: Having a spicy odour. [EU] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] ATP: ATP an abbreviation for adenosine triphosphate, a compound which serves as a carrier of energy for cells. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmune Hepatitis: A liver disease caused when the body's immune system destroys liver cells for no known reason. [NIH]

Dictionary 235

Autonomic: Self-controlling; functionally independent. [EU] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Infections: Infections by bacteria, general or unspecified. [NIH] Bacterial Translocation: The passage of viable bacteria from the gastrointestinal tract to extra-intestinal sites, such as the mesenteric lymph node complex, liver, spleen, kidney, and blood. Factors that promote bacterial translocation include overgrowth with gram-negative enteric bacilli, impaired host immune defenses, and injury to the intestinal mucosa resulting in increased intestinal permeability. These mechanisms can act in concert to promote synergistically the systemic spread of indigenous translocating bacteria to cause lethal sepsis. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Belching: Noisy release of gas from the stomach through the mouth. Also called burping. [NIH]

Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Beta Rays: A stream of positive or negative electrons ejected with high energy from a disintegrating atomic nucleus; most biomedically used isotopes emit negative particles (electrons or negatrons, rather than positrons). Cathode rays are low-energy negative electrons produced in cathode ray tubes, also called television tubes or oscilloscopes. [NIH] Bewilderment: Impairment or loss of will power. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Binding agent: A substance that makes a loose mixture stick together. For example, binding

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agents can be used to make solid pills from loose powders. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Bioavailable: The ability of a drug or other substance to be absorbed and used by the body. Orally bioavailable means that a drug or other substance that is taken by mouth can be absorbed and used by the body. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biotin: Hexahydro-2-oxo-1H-thieno(3,4-d)imidazole-4-pentanoic acid. Growth factor present in minute amounts in every living cell. It occurs mainly bound to proteins or polypeptides and is abundant in liver, kidney, pancreas, yeast, and milk.The biotin content of cancerous tissue is higher than that of normal tissue. [NIH] Bladder: The organ that stores urine. [NIH] Blinking: Brief closing of the eyelids by involuntary normal periodic closing, as a protective measure, or by voluntary action. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood urea: A waste product in the blood that comes from the breakdown of food protein. The kidneys filter blood to remove urea. As kidney function decreases, the BUN level increases. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Burden: The total amount of a chemical, metal or radioactive substance present at any time after absorption in the body of man or animal. [NIH]

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Body Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Body Regions: Anatomical areas of the body. [NIH] Bolus: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus infusion. [NIH] Bolus infusion: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Bullous: Pertaining to or characterized by bullae. [EU] Cacao: A tree of the family Sterculiaceae (or Byttneriaceae), usually Theobroma cacao, or its seeds, which after fermentation and roasting, yield cocoa and chocolate. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH]

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Calcium Oxalate: The calcium salt of oxalic acid, occurring in the urine as crystals and in certain calculi. [NIH] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [NIH] Caloric intake: Refers to the number of calories (energy content) consumed. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Candidosis: An infection caused by an opportunistic yeasts that tends to proliferate and become pathologic when the environment is favorable and the host resistance is weakened. [NIH]

Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbamyl Phosphate: Phosphate salt of carbamic acid. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carboxy: Cannabinoid. [NIH] Carboxymethylcellulose: It is used as an emulsifier, thickener, suspending agent, etc., in cosmetics and pharmaceuticals; in research as a culture medium; in chromatography as a stabilizer for reagents; and therapeutically as a bulk laxative with antacid properties. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenesis: The process by which normal cells are transformed into cancer cells. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoid: A type of tumor usually found in the gastrointestinal system (most often in the appendix), and sometimes in the lungs or other sites. Carcinoid tumors are usually benign. [NIH]

Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardia: That part of the stomach surrounded by the esophagogastric junction, characterized by the lack of acid-forming cells. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH]

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Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Carotenoids: Substance found in yellow and orange fruits and vegetables and in dark green, leafy vegetables. May reduce the risk of developing cancer. [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Case-Control Studies: Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group. [NIH] Catabolism: Any destructive metabolic process by which organisms convert substances into excreted compounds. [EU] Catecholamines: A general class of ortho-dihydroxyphenylalkylamines derived from tyrosine. [NIH] Cathode: An electrode, usually an incandescent filament of tungsten, which emits electrons in an X-ray tube. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Cecum: The beginning of the large intestine. The cecum is connected to the lower part of the small intestine, called the ileum. [NIH] Celiac Disease: A disease characterized by intestinal malabsorption and precipitated by gluten-containing foods. The intestinal mucosa shows loss of villous structure. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH]

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Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell Physiology: Characteristics and physiological processes of cells from cell division to cell death. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cellobiose: A disaccharide consisting of two glucose units in beta (1-4) glycosidic linkage. Obtained from the partial hydrolysis of cellulose. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Chamomile: Common name for several daisy-like species native to Europe and Western Asia, now naturalized in the United States and Australia. The dried flower-heads of two species, Anthemis nobilis (Chamaemelum nobile) and Matricaria recutita, have specific use as herbs. They are administered as tea, extracts, tinctures, or ointments. Chamomile contains choline, coumarins, cyanogenic glycosides, flavonoids, salicylate derivatives, tannins, and volatile oils. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chenodeoxycholic Acid: A bile acid, usually conjugated with either glycine or taurine. It acts as a detergent to solubilize fats for intestinal absorption and is reabsorbed by the small intestine. It is used as cholagogue, a choleretic laxative, and to prevent or dissolve gallstones. [NIH] Child Nutrition: Nutrition of children aged 2-12 years. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Cholecystokinin: A 33-amino acid peptide secreted by the upper intestinal mucosa and also found in the central nervous system. It causes gallbladder contraction, release of pancreatic exocrine (or digestive) enzymes, and affects other gastrointestinal functions. Cholecystokinin may be the mediator of satiety. [NIH] Choledochal Cyst: A congenital cystic dilatation of the common bile duct; this condition may be asymptomatic, or cause vomiting, fever, jaundice, or pain in the right upper

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quadrant. [NIH] Choleretic: A choleretic agent. [EU] Cholestasis: Impairment of biliary flow at any level from the hepatocyte to Vater's ampulla. [NIH]

Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Cholestyramine: Strongly basic anion exchange resin whose main constituent is polystyrene trimethylbenzylammonium as Cl(-) anion. It exchanges chloride ions with bile salts, thus decreasing their concentration and that of cholesterol. It is used as a hypocholesteremic in diarrhea and biliary obstruction and as an antipruritic. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromium: A trace element that plays a role in glucose metabolism. It has the atomic symbol Cr, atomic number 24, and atomic weight 52. According to the Fourth Annual Report on Carcinogens (NTP85-002,1985), chromium and some of its compounds have been listed as known carcinogens. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic Fatigue Syndrome: Fatigue caused by the combined effects of different types of prolonged fatigue. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Citrus: Any tree or shrub of the Rue family or the fruit of these plants. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Claviceps: A genus of ascomycetous fungi, family Clavicipitaceae, order Hypocreales, parasitic on various grasses. The sclerotia contain several toxic alkaloids. Claviceps purpurea on rye causes ergotism. [NIH] Cleave: A double-stranded cut in DNA with a restriction endonuclease. [NIH]

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Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Cod Liver Oil: Oil obtained from fresh livers of the cod family, Gadidae. It is a source of vitamins A and D. [NIH] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognitive restructuring: A method of identifying and replacing fear-promoting, irrational beliefs with more realistic and functional ones. [NIH] Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. [NIH] Colic: Paroxysms of pain. This condition usually occurs in the abdominal region but may occur in other body regions as well. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] Colon Polyps: Small, fleshy, mushroom-shaped growths in the colon. [NIH] Colonoscopy: Endoscopic examination, therapy or surgery of the luminal surface of the colon. [NIH]

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Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Cancer: Cancer that occurs in the colon (large intestine) or the rectum (the end of the large intestine). A number of digestive diseases may increase a person's risk of colorectal cancer, including polyposis and Zollinger-Ellison Syndrome. [NIH] Colostomy: An opening into the colon from the outside of the body. A colostomy provides a new path for waste material to leave the body after part of the colon has been removed. [NIH] Common Bile Duct: The largest biliary duct. It is formed by the junction of the cystic duct and the hepatic duct. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU]

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Condiments: Aromatic substances added to food before or after cooking to enhance its flavor. These are usually of vegetable origin. [NIH] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Continence: The ability to hold in a bowel movement or urine. [NIH] Contraceptive: An agent that diminishes the likelihood of or prevents conception. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH]

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Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Coumarin: A fluorescent dye. [NIH] Coumestrol: A coumarin derivative occurring naturally in forage crops which has estrogenic activity. [NIH] Creatine: An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as creatinine in the urine. [NIH]

Creatine Kinase: A transferase that catalyzes formation of phosphocreatine from ATP + creatine. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic isoenzymes have been identified in human tissues: MM from skeletal muscle, MB from myocardial tissue, and BB from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins. EC 2.7.3.2. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Criterion: A standard by which something may be judged. [EU] Cultural Characteristics: Those aspects or characteristics which identify a culture. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytogenetics: A branch of genetics which deals with the cytological and molecular behavior of genes and chromosomes during cell division. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxic: Cell-killing. [NIH] Cytotoxic chemotherapy: Anticancer drugs that kill cells, especially cancer cells. [NIH] Dairy Products: Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo. [NIH]

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Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Defecation: The normal process of elimination of fecal material from the rectum. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment. Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia, hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]

Dermatitis: Any inflammation of the skin. [NIH] Dermatitis Herpetiformis: Rare, chronic, papulo-vesicular disease characterized by an intensely pruritic eruption consisting of various combinations of symmetrical, erythematous, papular, vesicular, or bullous lesions. The disease is strongly associated with the presence of HLA-B8 and HLA-DR3 antigens. A variety of different autoantibodies has been detected in small numbers in patients with dermatitis herpetiformis. [NIH]

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Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Developed Countries: Countries that have reached a level of economic achievement through an increase of production, per capita income and consumption, and utilization of natural and human resources. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU] Diastole: Period of relaxation of the heart, especially the ventricles. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Dietary Fats: Fats present in food, especially in animal products such as meat, meat products, butter, ghee. They are present in lower amounts in nuts, seeds, and avocados. [NIH]

Dietary Fiber: The remnants of plant cell walls that are resistant to digestion by the alimentary enzymes of man. It comprises various polysaccharides and lignins. [NIH] Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]

Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Digital rectal examination: DRE. An examination in which a doctor inserts a lubricated, gloved finger into the rectum to feel for abnormalities. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Dilatation: The act of dilating. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Diosgenin: (25R)-Spirost-5-en-3-beta-ol. A steroid sapogenin which is isolated from various plants. Can be converted to ecdysone, pregnenolone, and progesterone. Synonym: nitogenin. [NIH] Diploid: Having two sets of chromosomes. [NIH]

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Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disaccharides: Sugars composed of two monosaccharides linked by glycoside bonds. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Distention: The state of being distended or enlarged; the act of distending. [EU] Diuresis: Increased excretion of urine. [EU] Diverticula: Plural form of diverticulum. [NIH] Diverticulitis: Inflammation of a diverticulum or diverticula. [NIH] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] DNA Topoisomerase: An enzyme catalyzing ATP-independent breakage of single-stranded DNA, followed by passage and rejoining of another single-stranded DNA. This enzyme class brings about the conversion of one topological isomer of DNA into another, e.g., the relaxation of superhelical turns in DNA, the interconversion of simple and knotted rings of single-stranded DNA, and the intertwisting of single-stranded rings of complementary sequences. (From Enzyme Nomenclature, 1992) EC 5.99.1.2. [NIH] Drug Industry: That segment of commercial enterprise devoted to the design, development, and manufacture of chemical products for use in the diagnosis and treatment of disease, disability, or other dysfunction, or to improve function. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dysentery: Any of various disorders marked by inflammation of the intestines, especially of the colon, and attended by pain in the abdomen, tenesmus, and frequent stools containing blood and mucus. Causes include chemical irritants, bacteria, protozoa, or parasitic worms. [EU]

Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysphagia: Difficulty in swallowing. [EU] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in

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all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emodin: Purgative anthraquinone found in several plants, especially Rhamnus frangula. It was formerly used as a laxative, but is now used mainly as tool in toxicity studies. [NIH] Emollient: Softening or soothing; called also malactic. [EU] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]

Encephalopathy: A disorder of the brain that can be caused by disease, injury, drugs, or chemicals. [NIH] Encopresis: Incontinence of feces not due to organic defect or illness. [NIH] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxic: Of, relating to, or acting as an endotoxin (= a heat-stable toxin, associated with the outer membranes of certain gram-negative bacteria. Endotoxins are not secreted and are released only when the cells are disrupted). [EU]

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Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Energy deficit: A state in which total energy intake is less than total energy need. [NIH] Energy Intake: Total number of calories taken in daily whether ingested or by parenteral routes. [NIH] Enteral Nutrition: Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes. [NIH] Enteritis: Inflammation of the intestine, applied chiefly to inflammation of the small intestine; see also enterocolitis. [EU] Enterocolitis: Inflammation of the intestinal mucosa of the small and large bowel. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Enzyme Inhibitors: Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction. [NIH] Eosinophilic: A condition found primarily in grinding workers caused by a reaction of the pulmonary tissue, in particular the eosinophilic cells, to dust that has entered the lung. [NIH] Eosinophilic Gastroenteritis: Infection and swelling of the lining of the stomach, small intestine, or large intestine. The infection is caused by white blood cells (eosinophils). [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Ergometer: An instrument for measuring the force of muscular contraction. [NIH] Ergot: Cataract due to ergot poisoning caused by eating of rye cereals contaminated by a fungus. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food

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passes from the throat to the stomach. [NIH] Esophageal Stricture: A narrowing of the esophagus often caused by acid flowing back from the stomach. This condition may require surgery. [NIH] Esophageal Varices: Stretched veins in the esophagus that occur when the liver is not working properly. If the veins burst, the bleeding can cause death. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estrogen: One of the two female sex hormones. [NIH] Estrogen receptor: ER. Protein found on some cancer cells to which estrogen will attach. [NIH]

Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Excipient: Any more or less inert substance added to a prescription in order to confer a suitable consistency or form to the drug; a vehicle. [EU] Exhaustion: The feeling of weariness of mind and body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Extender: Any of several colloidal substances of high molecular weight, used as a blood or plasma substitute in transfusion for increasing the volume of the circulating blood. [NIH] Extracellular: Outside a cell or cells. [EU] Extraction: The process or act of pulling or drawing out. [EU] Exudate: Material, such as fluid, cells, or cellular debris, which has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation. An exudate, in contrast to a transudate, is characterized by a high content of protein, cells, or solid materials derived from cells. [EU] Failure to Thrive: A condition in which an infant or child's weight gain and growth are far below usual levels for age. [NIH] Family Health: The health status of the family as a unit including the impact of the health of one member of the family on the family as a unit and on individual family members; also, the impact of family organization or disorganization on the health status of its members. [NIH]

Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

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Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fatty Liver: The buildup of fat in liver cells. The most common cause is alcoholism. Other causes include obesity, diabetes, and pregnancy. Also called steatosis. [NIH] Fatty Liver, Alcoholic: Fatty liver in alcoholics. It is potentially reversible and may be associated with alcoholic hepatitis or cirrhosis. [NIH] Fecal Incontinence: Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fermentation: An enzyme-induced chemical change in organic compounds that takes place in the absence of oxygen. The change usually results in the production of ethanol or lactic acid, and the production of energy. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Filler: An inactive substance used to make a product bigger or easier to handle. For example, fillers are often used to make pills or capsules because the amount of active drug is too small to be handled conveniently. [NIH] Filtration: The passage of a liquid through a filter, accomplished by gravity, pressure, or vacuum (suction). [EU] Fish Products: Food products manufactured from fish (e.g., fish flour, fish meal). [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Flatulence: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus. [NIH] Flatus: Gas passed through the rectum. [NIH] Flavoring Agents: Substances added to foods and medicine to improve the quality of taste. [NIH]

Fluid Therapy: Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to water-electrolyte balance. Fluids may be administered intravenously, orally, by intermittent gavage, or by hypodermoclysis. [NIH] Focus Groups: A method of data collection and a qualitative research tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves,

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and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Food Additives: Substances which are of little or no nutritive value, but are used in the processing or storage of foods or animal feed, especially in the developed countries; includes antioxidants, food preservatives, food coloring agents, flavoring agents, anti-infective agents (both plain and local), vehicles, excipients and other similarly used substances. Many of the same substances are pharmaceutic aids when added to pharmaceuticals rather than to foods. [NIH]

Food Chain: The sequence of transfers of matter and energy from organism to organism in the form of food. Food chains intertwine locally into a food web because most organisms consume more than one type of animal or plant. Plants, which convert solar energy to food by photosynthesis, are the primary food source. In a predator chain, a plant-eating animal is eaten by a larger animal. In a parasite chain, a smaller organism consumes part of a larger host and may itself be parasitized by smaller organisms. In a saprophytic chain, microorganisms live on dead organic matter. [NIH] Food Coloring Agents: Natural or synthetic dyes used as coloring agents in processed foods. [NIH] Food Hypersensitivity: Gastrointestinal disturbances, skin eruptions, or shock due to allergic reactions to allergens ingested in food. [NIH] Food Labeling: Use of written, printed, or graphic materials upon or accompanying a food or its container or wrapper. The concept includes ingredients, nutritional value, directions, warnings, and other relevant information. [NIH] Food Preferences: The selection of one food over another. [NIH] Food Preservatives: Substances capable of inhibiting, retarding or arresting the process of fermentation, acidification or other deterioration of foods. [NIH] Foodborne Illness: An acute gastrointestinal infection caused by food that contains harmful bacteria. Symptoms include diarrhea, abdominal pain, fever, and chills. Also called food poisoning. [NIH] Foot Care: Taking special steps to avoid foot problems such as sores, cuts, bunions, and calluses. Good care includes daily examination of the feet, toes, and toenails and choosing shoes and socks or stockings that fit well. People with diabetes have to take special care of their feet because nerve damage and reduced blood flow sometimes mean they will have less feeling in their feet than normal. They may not notice cuts and other problems as soon as they should. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fractionation: Dividing the total dose of radiation therapy into several smaller, equal doses delivered over a period of several days. [NIH] Fructose: A type of sugar found in many fruits and vegetables and in honey. Fructose is used to sweeten some diet foods. It is considered a nutritive sweetener because it has calories. [NIH] Functional Disorders: Disorders such as irritable bowel syndrome. These conditions result from poor nerve and muscle function. Symptoms such as gas, pain, constipation, and diarrhea come back again and again, but there are no signs of disease or damage. Emotional stress can trigger symptoms. Also called motility disorders. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to

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those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Galactans: Polysaccharides composed of repeating galactose units. They can consist of branched or unbranched chains in any linkages. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastritis: Inflammation of the stomach. [EU] Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastroenterologist: A doctor who specializes in diagnosing and treating disorders of the digestive system. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gastrointestinal Transit: Passage of food (sometimes in the form of a test meal) through the gastrointestinal tract as measured in minutes or hours. The rate of passage through the intestine is an indicator of small bowel function. [NIH] Gastrostomy: Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression. [NIH]

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Gavage: Feeding by a tube passed into the stomach; called also tube feeding. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [NIH] Genistein: An isoflavonoid derived from soy products. It inhibits protein-tyrosine kinase and topoisomerase-ii (dna topoisomerase (atp-hydrolysing)) activity and is used as an antineoplastic and antitumor agent. Experimentally, it has been shown to induce G2 phase arrest in human and murine cell lines. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Geriatric: Pertaining to the treatment of the aged. [EU] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glucans: Polysaccharides composed of repeating glucose units. They can consist of branched or unbranched chains in any linkages. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state

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before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Glutamine: A non-essential amino acid present abundantly throught the body and is involved in many metabolic processes. It is synthesized from glutamic acid and ammonia. It is the principal carrier of nitrogen in the body and is an important energy source for many cells. [NIH] Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]

Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]

Glycerophospholipids: Derivatives of phosphatidic acid in which the hydrophobic regions are composed of two fatty acids and a polar alcohol is joined to the C-3 position of glycerol through a phosphodiester bond. They are named according to their polar head groups, such as phosphatidylcholine and phosphatidylethanolamine. [NIH] Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Glycogen Synthase: An enzyme that catalyzes the transfer of D-glucose from UDPglucose into 1,4-alpha-D-glucosyl chains. EC 2.4.1.11. [NIH] Glycolysis: The pathway by which glucose is catabolized into two molecules of pyruvic acid with the generation of ATP. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycoside: Any compound that contains a carbohydrate molecule (sugar), particularly any such natural product in plants, convertible, by hydrolytic cleavage, into sugar and a nonsugar component (aglycone), and named specifically for the sugar contained, as glucoside (glucose), pentoside (pentose), fructoside (fructose) etc. [EU] Glycosidic: Formed by elimination of water between the anomeric hydroxyl of one sugar and a hydroxyl of another sugar molecule. [NIH] Goats: Any of numerous agile, hollow-horned ruminants of the genus Capra, closely related to the sheep. [NIH] Gonadal: Pertaining to a gonad. [EU] Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Government Agencies: Administrative units of government responsible for policy making and management of governmental activities in the U.S. and abroad. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are

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different for each type of cancer. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]

Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Gum Arabic: Powdered exudate from various Acacia species, especially A. senegal (Leguminosae). It forms mucilage or syrup in water. Gum arabic is used as a suspending agent, excipient, and emulsifier in foods and pharmaceuticals. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural. [NIH] Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH] Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemicellulose: A general term to describe those polysaccharides other than cellulose which

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are constituents of vegetable cell walls. [NIH] Hemochromatosis: A disease that occurs when the body absorbs too much iron. The body stores the excess iron in the liver, pancreas, and other organs. May cause cirrhosis of the liver. Also called iron overload disease. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatitis A: Hepatitis caused by hepatovirus. It can be transmitted through fecal contamination of food or water. [NIH] Hepatitis, Chronic: A collective term for a clinical and pathological syndrome which has several causes and is characterized by varying degrees of hepatocellular necrosis and inflammation. Specific forms of chronic hepatitis include autoimmune hepatitis, chronic hepatitis B, chronic hepatitis C, chronic hepatitis D, indeterminate chronic viral hepatitis, cryptogenic chronic hepatitis, and drug-related chronic hepatitis. [NIH] Hepatobiliary: Pertaining to the liver and the bile or the biliary ducts. [EU] Hepatocellular: Pertaining to or affecting liver cells. [EU] Hepatocyte: A liver cell. [NIH] Hepatovirus: A genus of Picornaviridae causing infectious hepatitis naturally in humans and experimentally in other primates. It is transmitted through fecal contamination of food or water. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]

Heterotrophic: Pertaining to organisms that are consumers and dependent on other organisms for their source of energy (food). [NIH] Hiatal Hernia: A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird

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and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Homozygotes: An individual having a homozygous gene pair. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydration: Combining with water. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hyperammonemia: Metabolic disorder characterized by elevated level of ammonia in blood. [NIH] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hyperlipoproteinemia: Metabolic disease characterized by elevated plasma cholesterol and/or triglyceride levels. The inherited form is attributed to a single gene mechanism. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertriglyceridemia: Condition of elevated triglyceride concentration in the blood; an inherited form occurs in familial hyperlipoproteinemia IIb and hyperlipoproteinemia type IV. It has been linked to higher risk of heart disease and arteriosclerosis. [NIH] Hyperuricemia: A buildup of uric acid (a byproduct of metabolism) in the blood; a side effect of some anticancer drugs. [NIH] Hypoglycaemia: An abnormally diminished concentration of glucose in the blood, which may lead to tremulousness, cold sweat, piloerection, hypothermia, and headache, accompanied by irritability, confusion, hallucinations, bizarre behaviour, and ultimately, convulsions and coma. [EU] Hypoglycemia: Abnormally low blood sugar [NIH] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypoxanthine: A purine and a reaction intermediate in the metabolism of adenosine and in

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the formation of nucleic acids by the salvage pathway. [NIH] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Hysterectomy: Excision of the uterus. [NIH] Ice Cream: A frozen dairy food made from cream or butterfat, milk, sugar, and flavorings. Frozen custard and French-type ice creams also contain eggs. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Ileostomy: Surgical creation of an external opening into the ileum for fecal diversion or drainage. Loop or tube procedures are most often employed. [NIH] Ileum: The lower end of the small intestine. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Impaction: The trapping of an object in a body passage. Examples are stones in the bile duct or hardened stool in the colon. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Incubation: The development of an infectious disease from the entrance of the pathogen to the appearance of clinical symptoms. [EU] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH]

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Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infant Nutrition: Nutrition of children from birth to 2 years of age. [NIH] Infantile: Pertaining to an infant or to infancy. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inguinal: Pertaining to the inguen, or groin. [EU] Inguinal Hernia: A small part of the large or small intestine or bladder that pushes into the groin. May cause pain and feelings of pressure or burning in the groin. Often requires surgery. [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU]

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Intervention Studies: Epidemiologic investigations designed to test a hypothesized causeeffect relation by modifying the supposed causal factor(s) in the study population. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestinal Flora: The bacteria, yeasts, and fungi that grow normally in the intestines. [NIH] Intestinal Obstruction: Any impairment, arrest, or reversal of the normal flow of intestinal contents toward the anus. [NIH] Intestinal Pseudo-Obstruction: Obstruction of the intestines that is functional, not mechanical. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intraepithelial: Within the layer of cells that form the surface or lining of an organ. [NIH] Intrahepatic: Within the liver. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intrinsic Factor: A glycoprotein secreted by the cells of the gastric glands that is required for the absorption of vitamin B 12. Deficiency of intrinsic factor results in pernicious anemia. [NIH]

Intussusception: A rare disorder. A part of the intestines folds into another part of the intestines, causing blockage. Most common in infants. Can be treated with an operation. [NIH]

Inulin: A starch found in the tubers and roots of many plants. Since it is hydrolyzable to fructose, it is classified as a fructosan. It has been used in physiologic investigation for determination of the rate of glomerular function. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Irritants: Drugs that act locally on cutaneous or mucosal surfaces to produce inflammation; those that cause redness due to hyperemia are rubefacients; those that raise blisters are vesicants and those that penetrate sebaceous glands and cause abscesses are pustulants; tear gases and mustard gases are also irritants. [NIH]

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Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [NIH] Isoflavones: 3-Phenylchromones. Isomeric form of flavones in which the benzene group is attached to the 3 position of the benzopyran ring instead of the 2 position. [NIH] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]

Jejunostomy: Surgical formation of an opening through the abdominal wall into the jejunum, usually for enteral hyperalimentation. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratolytic: An agent that promotes keratolysis. [EU] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Lactation: The period of the secretion of milk. [EU] Lactoperoxidase: An enzyme derived from cow's milk. It catalyzes the radioiodination of tyrosine and its derivatives and of peptides containing tyrosine. [NIH] Lactose Intolerance: The disease state resulting from the absence of lactase enzyme in the musocal cells of the gastrointestinal tract, and therefore an inability to break down the disaccharide lactose in milk for absorption from the gastrointestinal tract. It is manifested by indigestion of a mild nature to severe diarrhea. It may be due to inborn defect genetically conditioned or may be acquired. [NIH] Lactulose: A mild laxative. [NIH] Lag: The time elapsing between application of a stimulus and the resulting reaction. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Latent period: A seemingly inactive period, as that between exposure of tissue to an injurious agent and the manifestation of response, or that between the instant of stimulation and the beginning of response. [EU] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Lead Poisoning: Disease caused by the gradual accumulation of a significant body burden of lead. [NIH] Lethal: Deadly, fatal. [EU] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]

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Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipase: An enzyme of the hydrolase class that catalyzes the reaction of triacylglycerol and water to yield diacylglycerol and a fatty acid anion. It is produced by glands on the tongue and by the pancreas and initiates the digestion of dietary fats. (From Dorland, 27th ed) EC 3.1.1.3. [NIH] Lipid: Fat. [NIH] Lipid A: Lipid A is the biologically active component of lipopolysaccharides. It shows strong endotoxic activity and exhibits immunogenic properties. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipodystrophy: A collection of rare conditions resulting from defective fat metabolism and characterized by atrophy of the subcutaneous fat. They include total, congenital or acquired, partial, abdominal infantile, and localized lipodystrophy. [NIH] Lipopolysaccharides: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Liquor: 1. A liquid, especially an aqueous solution containing a medicinal substance. 2. A general term used in anatomical nomenclature for certain fluids of the body. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Loperamide:

4-(p-Chlorophenyl)-4-hydroxy-N.N-dimethyl-alpha,alpha-diphenyl-1-

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piperidine butyramide hydrochloride. Synthetic anti-diarrheal agent with a long duration of action; it is not significantly absorbed from the gut, has no effect on the adrenergic system or central nervous system, but may antagonize histamine and interfere with acetylcholine release locally. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lubricants: Oily or slippery substances. [NIH] Lumen: The cavity or channel within a tube or tubular organ. [EU] Lycopene: A red pigment found in tomatoes and some fruits. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Macronutrients: Nutrients in the diet that are the key sources of energy, namely protein, fat, and carbohydrates. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mannans: Polysaccharides consisting of mannose units. [NIH] Manometry: Tests that measure muscle pressure and movements in the GI tract. [NIH] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]

Meat Products: Articles of food which are derived by a process of manufacture from any portion of carcasses of any animal used for food (e.g., head cheese, sausage, scrapple). [NIH] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical

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substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megacolon: Pathological enlargement of the colon. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mesenteric: Pertaining to the mesentery : a membranous fold attaching various organs to the body wall. [EU] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Methylcellulose: Methylester of cellulose. Methylcellulose is used as an emulsifying and suspending agent in cosmetics, pharmaceutics and the chemical industry. It is used therapeutically as a bulk laxative. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH]

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Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Micronutrients: Essential dietary elements or organic compounds that are required in only small quantities for normal physiologic processes to occur. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Midaxillary line: An imaginary vertical line that passes midway between the anterior and posterior axillary (armpit) folds. [NIH] Millimeter: A measure of length. A millimeter is approximately 26-times smaller than an inch. [NIH] Miscarriage: Spontaneous expulsion of the products of pregnancy before the middle of the second trimester. [NIH] Mitochondria: Parts of a cell where aerobic production (also known as cell respiration) takes place. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monounsaturated fat: An unsaturated fat that is found primarily in plant foods, including olive and canola oils. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motivations: The most compelling inner determinants of human behavior; also called drives, urges, impulses, needs, wants, tensions, and willful cravings. [NIH]

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Mucilaginous: Pertaining to or secreting mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multiparous: 1. Having had two or more pregnancies which resulted in viable fetuses. 2. Producing several ova or offspring at one time. [EU] Mung bean: A type of bean grown in warm climates. It is usually used for its seed and for bean sprouts. Mung bean may have anticancer effects. [NIH] Mustard Gas: Severe irritant and vesicant of skin, eyes, and lungs. It may cause blindness and lethal lung edema and was formerly used as a war gas. The substance has been proposed as a cytostatic and for treatment of psoriasis. It has been listed as a known carcinogen in the Fourth Annual Report on Carcinogens (NTP-85-002, 1985) (Merck, 11th ed). [NIH] Mutagen: Any agent, such as X-rays, gamma rays, mustard gas, TCDD, that can cause abnormal mutation in living cells; having the power to cause mutations. [NIH] Mutagenesis: Process of generating genetic mutations. It may occur spontaneously or be induced by mutagens. [NIH] Mutagenic: Inducing genetic mutation. [EU] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Nasogastric: The process of passing a small, flexible plastic tube through the nose or mouth into the stomach or small intestine. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH]

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Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Normotensive: 1. Characterized by normal tone, tension, or pressure, as by normal blood pressure. 2. A person with normal blood pressure. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nutrition Assessment: Evaluation and measurement of nutritional variables in order to assess the level of nutrition or the nutritional status of the individual. Nutrition surveys may be used in making the assessment. [NIH] Nutrition Surveys: A systematic collection of factual data pertaining to the nutritional status of a human population within a given geographic area. Data from these surveys are used in preparing nutrition assessments. [NIH] Nutritional Status: State of the body in relation to the consumption and utilization of nutrients. [NIH] Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include fluid therapy which normalizes body fluids to restore water-electrolyte balance. [NIH]

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Nutritive Value: An indication of the contribution of a food to the nutrient content of the diet. This value depends on the quantity of a food which is digested and absorbed and the amounts of the essential nutrients (protein, fat, carbohydrate, minerals, vitamins) which it contains. This value can be affected by soil and growing conditions, handling and storage, and processing. [NIH] Occupational Exposure: The exposure to potentially harmful chemical, physical, or biological agents that occurs as a result of one's occupation. [NIH] Occupational Health: The promotion and maintenance of physical and mental health in the work environment. [NIH] Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. [NIH] Office Management: Planning, organizing, and administering activities in an office. [NIH] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oligomenorrhea: Abnormally infrequent menstruation. [NIH] Oligosaccharides: Carbohydrates consisting of between two and ten monosaccharides connected by either an alpha- or beta-glycosidic link. They are found throughout nature in both the free and bound form. [NIH] Oncology: The study of cancer. [NIH] Ondansetron: A competitive serotonin type 3 receptor antagonist. It is effective in the treatment of nausea and vomiting caused by cytotoxic chemotherapy drugs, including cisplatin, and it has reported anxiolytic and neuroleptic properties. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]

Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Organoleptic: Of, relating to, or involving the employment of the sense organs; used especially of subjective testing (as of flavor, odor, appearance) of food and drug products. [NIH]

Osmosis: Tendency of fluids (e.g., water) to move from the less concentrated to the more concentrated side of a semipermeable membrane. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Ossification: The formation of bone or of a bony substance; the conversion of fibrous tissue or of cartilage into bone or a bony substance. [EU] Osteoporosis: Reduction of bone mass without alteration in the composition of bone,

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leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overcorrection: A complication of refractive surgery where the achieved amount of correction is more than desired. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxalate: A chemical that combines with calcium in urine to form the most common type of kidney stone (calcium oxalate stone). [NIH] Oxidants: Oxidizing agents or electron-accepting molecules in chemical reactions in which electrons are transferred from one molecule to another (oxidation-reduction). In vivo, it appears that phagocyte-generated oxidants function as tumor promoters or cocarcinogens rather than as complete carcinogens perhaps because of the high levels of endogenous antioxidant defenses. It is also thought that oxidative damage in joints may trigger the autoimmune response that characterizes the persistence of the rheumatoid disease process. [NIH]

Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidation-Reduction: A chemical reaction in which an electron is transferred from one molecule to another. The electron-donating molecule is the reducing agent or reductant; the electron-accepting molecule is the oxidizing agent or oxidant. Reducing and oxidizing agents function as conjugate reductant-oxidant pairs or redox pairs (Lehninger, Principles of Biochemistry, 1982, p471). [NIH] Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic enzymes: A group of proteins secreted by the pancreas which aid in the digestion of food. [NIH]

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Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [NIH] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Particle: A tiny mass of material. [EU] Pathogen: Any disease-producing microorganism. [EU] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pectins: High molecular weight polysaccharides present in the cell walls of all plants. Pectins cement cell walls together. They are used as emulsifiers and stabilizers in the food industry. They have been tried for a variety of therpeutic uses including as antidiarreals, where they are now generally considered ineffective, and in the treatment of hypercholesterolemia. [NIH] Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pentoses: A class of carbohydrates that contains five carbon atoms. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a

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single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide T: N-(N-(N(2)-(N-(N-(N-(N-D-Alanyl L-seryl)-L-threonyl)-L-threonyl) L-threonyl)L-asparaginyl)-L-tyrosyl) L-threonine. Octapeptide sharing sequence homology with HIV envelope protein gp120. It is potentially useful as antiviral agent in AIDS therapy. The core pentapeptide sequence, TTNYT, consisting of amino acids 4-8 in peptide T, is the HIV envelope sequence required for attachment to the CD4 receptor. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perennial: Lasting through the year of for several years. [EU] Perianal: Located around the anus. [EU] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Peristalsis: The rippling motion of muscles in the intestine or other tubular organs characterized by the alternate contraction and relaxation of the muscles that propel the contents onward. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peritonitis: Inflammation of the peritoneum; a condition marked by exudations in the peritoneum of serum, fibrin, cells, and pus. It is attended by abdominal pain and tenderness, constipation, vomiting, and moderate fever. [EU] Pernicious: Tending to a fatal issue. [EU] Pernicious anemia: A type of anemia (low red blood cell count) caused by the body's inability to absorb vitamin B12. [NIH] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied to each other. [NIH] Petrolatum: A colloidal system of semisolid hydrocarbons obtained from petroleum. It is used as an ointment base, topical protectant, and lubricant. [NIH] Petroleum: Naturally occurring complex liquid hydrocarbons which, after distillation, yield combustible fuels, petrochemicals, and lubricants. [NIH] Phagocyte: An immune system cell that can surround and kill microorganisms and remove dead cells. Phagocytes include macrophages. [NIH] Pharmaceutic Aids: Substances which are of little or no therapeutic value, but are necessary in the manufacture, compounding, storage, etc., of pharmaceutical preparations or drug dosage forms. They include solvents, diluting agents, and suspending agents, and emulsifying agents. Also, antioxidants; preservatives, pharmaceutical; dyes (coloring

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agents); flavoring agents; vehicles; excipients; ointment bases. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenolphthalein: An acid-base indicator which is colorless in acid solution, but turns pink to red as the solution becomes alkaline. It is used medicinally as a cathartic. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylated: Attached to a phosphate group. [NIH] Phosphorylating: Attached to a phosphate group. [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Fitness: A state of well-being in which performance is optimal, often as a result of physical conditioning which may be prescribed for disease therapy. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Phytic Acid: Complexing agent for removal of traces of heavy metal ions. It acts also as a hypocalcemic agent. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plague: An acute infectious disease caused by Yersinia pestis that affects humans, wild rodents, and their ectoparasites. This condition persists due to its firm entrenchment in sylvatic rodent-flea ecosystems throughout the world. Bubonic plague is the most common

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form. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Policy Making: The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polycystic Ovary Syndrome: Clinical symptom complex characterized by oligomenorrhea or amenorrhea, anovulation, and regularly associated with bilateral polycystic ovaries. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH]

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Polyp: A growth that protrudes from a mucous membrane. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Polyunsaturated fat: An unsaturated fat found in greatest amounts in foods derived from plants, including safflower, sunflower, corn, and soybean oils. [NIH] Porphyria: A group of disorders characterized by the excessive production of porphyrins or their precursors that arises from abnormalities in the regulation of the porphyrin-heme pathway. The porphyrias are usually divided into three broad groups, erythropoietic, hepatic, and erythrohepatic, according to the major sites of abnormal porphyrin synthesis. [NIH]

Porphyrins: A group of compounds containing the porphin structure, four pyrrole rings connected by methine bridges in a cyclic configuration to which a variety of side chains are attached. The nature of the side chain is indicated by a prefix, as uroporphyrin, hematoporphyrin, etc. The porphyrins, in combination with iron, form the heme component in biologically significant compounds such as hemoglobin and myoglobin. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] Postprandial Blood Glucose: Blood taken 1-2 hours after eating to see the amount of glucose (sugar) in the blood. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Pregnenolone: Steroid hormone. [NIH] Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [NIH] Premenstrual: Occurring before menstruation. [EU]

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Premenstrual Syndrome: A syndrome occurring most often during the last week of the menstrual cycle and ending soon after the onset of menses. Some of the symptoms are emotional instability, insomnia, headache, nausea, vomiting, abdominal distension, and painful breasts. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Primary Prevention: Prevention of disease or mental disorders in susceptible individuals or populations through promotion of health, including mental health, and specific protection, as in immunization, as distinguished from the prevention of complications or after-effects of existing disease. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prolapse: The protrusion of an organ or part of an organ into a natural or artificial orifice. [NIH]

Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH]

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Protein-Tyrosine Kinase: An enzyme that catalyzes the phosphorylation of tyrosine residues in proteins with ATP or other nucleotides as phosphate donors. EC 2.7.1.112. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Pruritic: Pertaining to or characterized by pruritus. [EU] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psyllium: Dried, ripe seeds of Plantago psyllium, P. indica, and P. ovata (Plantaginaceae). Plantain seeds swell in water and are used as demulcents and bulk laxatives. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Pupil: The aperture in the iris through which light passes. [NIH] Purgative: 1. Cathartic (def. 1); causing evacuation of the bowels. 2. A cathartic, particularly one that stimulates peristaltic action. [EU] Purifying: Respiratory equipment whose function is to remove contaminants from otherwise wholesome air. [NIH] Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] Purulent: Consisting of or containing pus; associated with the formation of or caused by

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pus. [EU] Pylorus: The opening in a vertebrate from the stomach into the intestine. [EU] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized Controlled Trials: Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials employing any of these techniques for patient assignment are designated simply controlled clinical trials. [NIH] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Reconstitution: 1. A type of regeneration in which a new organ forms by the rearrangement of tissues rather than from new formation at an injured surface. 2. The restoration to original form of a substance previously altered for preservation and storage, as the restoration to a

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liquid state of blood serum or plasma that has been dried and stored. [EU] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectal Prolapse: Protrusion of the rectal mucous membrane through the anus. There are various degrees: incomplete with no displacement of the anal sphincter muscle; complete with displacement of the anal sphincter muscle; complete with no displacement of the anal sphincter muscle but with herniation of the bowel; and internal complete with rectosigmoid or upper rectum intussusception into the lower rectum. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Registries: The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Rehydration: The restoration of water or of fluid content to a body or to substance which has become dehydrated. [EU] Rehydration Solutions: Fluids restored to the body in order to maintain normal waterelectrolyte balance. [NIH] Relative risk: The ratio of the incidence rate of a disease among individuals exposed to a specific risk factor to the incidence rate among unexposed individuals; synonymous with risk ratio. Alternatively, the ratio of the cumulative incidence rate in the exposed to the cumulative incidence rate in the unexposed (cumulative incidence ratio). The term relative risk has also been used synonymously with odds ratio. This is because the odds ratio and relative risk approach each other if the disease is rare ( 5 percent of population) and the number of subjects is large. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into

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the ureter, the tube that connects the kidney to the bladder. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Resting metabolic rate: RMR accounts for 65 to 75 percent of daily energy expenditure and represents the minimum energy needed to maintain all physiological cell functions in the resting state. The principal determinant of RMR is lean body mass (LBM). Obese subjects have a higher RMR in absolute terms than lean individuals, an equivalent RMR when corrected for LBM and per unit surface area, and a lower RMR when expressed per kilogram of body weight. Obese persons require more energy for any given activity because of a larger mass, but they tend to be more sedentary than lean subjects. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinoids: Derivatives of vitamin A. Used clinically in the treatment of severe cystic acne, psoriasis, and other disorders of keratinization. Their possible use in the prophylaxis and treatment of cancer is being actively explored. [NIH] Rheumatoid: Resembling rheumatism. [EU] Riboflavin: Nutritional factor found in milk, eggs, malted barley, liver, kidney, heart, and leafy vegetables. The richest natural source is yeast. It occurs in the free form only in the retina of the eye, in whey, and in urine; its principal forms in tissues and cells are as FMN and FAD. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rickets: A condition caused by deficiency of vitamin D, especially in infancy and childhood, with disturbance of normal ossification. The disease is marked by bending and distortion of the bones under muscular action, by the formation of nodular enlargements on the ends and sides of the bones, by delayed closure of the fontanelles, pain in the muscles, and sweating of the head. Vitamin D and sunlight together with an adequate diet are curative, provided that the parathyroid glands are functioning properly. [EU] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rotavirus: A genus of Reoviridae, causing acute gastroenteritis in birds and mammals, including humans. Transmission is horizontal and by environmental contamination. [NIH] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room

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temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH] Rural Population: The inhabitants of rural areas or of small towns classified as rural. [NIH] Rye: A hardy grain crop, Secale cereale, grown in northern climates. It is the most frequent host to ergot (claviceps), the toxic fungus. Its hybrid with wheat is triticale, another grain. [NIH]

Salicylate: Non-steroidal anti-inflammatory drugs. [NIH] Saline: A solution of salt and water. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sapogenins: The aglucon moiety of a saponin molecule. It may be triterpenoid or steroid, usually spirostan, in nature. [NIH] Saponin: A substance found in soybeans and many other plants. Saponins may help lower cholesterol and may have anticancer effects. [NIH] Satellite: Applied to a vein which closely accompanies an artery for some distance; in cytogenetics, a chromosomal agent separated by a secondary constriction from the main body of the chromosome. [NIH] Saturated fat: A type of fat found in greatest amounts in foods from animals, such as fatty cuts of meat, poultry with the skin, whole-milk dairy products, lard, and in some vegetable oils, including coconut, palm kernel, and palm oils. Saturated fat raises blood cholesterol more than anything else eaten. On a Step I Diet, no more than 8 to 10 percent of total calories should come from saturated fat, and in the Step II Diet, less than 7 percent of the day's total calories should come from saturated fat. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Seafood: Marine fish and shellfish used as food or suitable for food. (Webster, 3d ed) shellfish and fish products are more specific types of seafood. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Sedentary: 1. Sitting habitually; of inactive habits. 2. Pertaining to a sitting posture. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Sella: A deep depression in the shape of a Turkish saddle in the upper surface of the body of

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the sphenoid bone in the deepest part of which is lodged the hypophysis cerebri. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sepsis: The presence of bacteria in the bloodstream. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Sigmoid: 1. Shaped like the letter S or the letter C. 2. The sigmoid colon. [EU] Sigmoid Colon: The lower part of the colon that empties into the rectum. [NIH] Sigmoidoscopy: Endoscopic examination, therapy or surgery of the sigmoid flexure. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Simethicone: A mixture of dimethyl polysiloxanes and silica gel used as an antiflatulent. Without the addition of silica gel (dimethicone), it is used as an ointment base ingredient and skin protectant. [NIH] Sitz Bath: A special plastic tub. A person sits in a few inches of warm water to help relieve discomfort of hemorrhoids or anal fissures. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH]

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Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Compounds: Inorganic compounds that contain sodium as an integral part of the molecule. [NIH] Sodium Glutamate: L-Glutamic acid, sodium salt. An additive used to impart meat flavor to foods, and to enhance other natural food flavors. Medically it has been used to reduce blood ammonia levels in ammoniacal azotemia, therapy of hepatic coma, in psychosis, and mental retardation. [NIH] Sodium, Dietary: Sodium or sodium compounds used in foods or as a food. The most frequently used compounds are sodium chloride or sodium glutamate. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sonogram: A computer picture of areas inside the body created by bouncing sound waves off organs and other tissues. Also called ultrasonogram or ultrasound. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Soybean Oil: Oil from soybean or soybean plant. [NIH] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or

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Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spices: The dried seeds, bark, root, stems, buds, leaves, or fruit of aromatic plants used to season food. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Stabilizer: A device for maintaining constant X-ray tube voltage or current. [NIH] Steatosis: Fatty degeneration. [EU] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stomach Ulcer: An open sore in the lining of the stomach. Also called gastric ulcer. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stress management: A set of techniques used to help an individual cope more effectively with difficult situations in order to feel better emotionally, improve behavioral skills, and often to enhance feelings of control. Stress management may include relaxation exercises, assertiveness training, cognitive restructuring, time management, and social support. It can be delivered either on a one-to-one basis or in a group format. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH]

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Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Suppositories: A small cone-shaped medicament having cocoa butter or gelatin at its basis and usually intended for the treatment of local conditions in the rectum. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tenesmus: Straining, especially ineffectual and painful straining at stool or in urination. [EU] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex

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characteristics. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Time Management: Planning and control of time to improve efficiency and effectiveness. [NIH]

Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Plasminogen Activator: A proteolytic enzyme in the serine protease family found in many tissues which converts plasminogen to plasmin. It has fibrin-binding activity and is immunologically different from urinary plasminogen activator. The primary sequence, composed of 527 amino acids, is identical in both the naturally occurring and synthetic proteases. EC 3.4.21.68. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tooth Loss: The failure to retain teeth as a result of disease or injury. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH]

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Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Traction: The act of pulling. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translocating: The attachment of a fragment of one chromosome to a non-homologous chromosome. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Transrectal ultrasound: A procedure used to examine the prostate. An instrument is inserted into the rectum, and sound waves bounce off the prostate. These sound waves create echoes, which a computer uses to create a picture called a sonogram. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH] Tributyrin: A triglyceride drug that may inhibit cell growth and induce cell differentiation. Differentiating agents may be effective in changing cancer cells back into normal cells. [NIH] Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] Trinitrobenzenesulfonic Acid: A reagent that is used to neutralize peptide terminal amino groups. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs

Dictionary 289

from it. It has a molecular weight of less than 70,000 kDa. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Uric: A kidney stone that may result from a diet high in animal protein. When the body breaks down this protein, uric acid levels rise and can form stones. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Plasminogen Activator: A proteolytic enzyme that converts plasminogen to plasmin where the preferential cleavage is between arginine and valine. It was isolated originally from human urine, but is found in most tissues of most vertebrates. EC 3.4.21.73. [NIH]

Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Ursodeoxycholic Acid: An epimer of chenodeoxycholic acid. It is a mammalian bile acid found first in the bear and is apparently either a precursor or a product of chenodeoxycholate. Its administration changes the composition of bile and may dissolve gallstones. It is used as a cholagogue and choleretic. [NIH]

290 Dietary Fiber

Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villous: Of a surface, covered with villi. [NIH] Villus: Cell found in the lining of the small intestine. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Hepatitis: Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral fat: One of the three compartments of abdominal fat. Retroperitoneal and subcutaneous are the other two compartments. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called

Dictionary 291

retinoids. [NIH] Vitamin D: The vitamin that mediates intestinal calcium absorption, bone calcium metabolism, and probably muscle activity. It usually acts as a hormone precursor, requiring 2 stages of metabolism before reaching actual hormonal form. It is isolated from fish liver oils and used in the treatment and prevention of rickets. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Volition: Voluntary activity without external compulsion. [NIH] Waist circumference: To define the level at which the waist circumference is measured, a bony landmark is first located and marked. The subject stands, and the technician, positioned to the right of the subject, palpates the upper hip bone to locate the right ileum. Just above the uppermost lateral border of the right ileum, a horizontal mark is drawn and then crossed with a vertical mark on the midaxillary line. The measuring tape is then placed around the trunk, at the level of the mark on the right side, making sure that it is on a level horizontal plane on all sides. The tape is then tightened slightly without compressing the skin and underlying subcutaneous tissues. The measure is recorded in centimeters to the nearest millimeter. [NIH] Wakefulness: A state in which there is an enhanced potential for sensitivity and an efficient responsiveness to external stimuli. [NIH] War: Hostile conflict between organized groups of people. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xanthine: An urinary calculus. [NIH] Xanthine Oxidase: An iron-molybdenum flavoprotein containing FAD that oxidizes hypoxanthine, some other purines and pterins, and aldehydes. Deficiency of the enzyme, an autosomal recessive trait, causes xanthinuria. EC 1.1.3.22. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

293

INDEX A Abdomen, 169, 171, 229, 236, 237, 248, 250, 257, 262, 264, 285, 287 Abdominal fat, 229, 290 Abdominal Pain, 6, 73, 80, 128, 169, 171, 187, 205, 207, 212, 218, 229, 253, 254, 262, 273, 289 Aberrant, 14, 18, 229 Abscess, 175, 177, 229 Acacia, 77, 127, 229, 257 Acceptor, 229, 264, 271 Acculturation, 32, 229 Acetate Kinase, 106, 229 Acetylcholine, 229, 241, 265, 269 Acidosis, 184, 229 Acrylonitrile, 229, 282 Acute Disease, 169, 229 Acyl, 13, 229 Adenine, 229, 230, 278 Adenocarcinoma, 35, 229 Adenoma, 43, 93, 229 Adenosine, 106, 133, 229, 230, 234, 237, 259, 274 Adenosine Diphosphate, 133, 230 Adenosine Triphosphate, 106, 133, 230, 234, 274 Adenylate Kinase, 106, 230 Adipose Tissue, 24, 133, 229, 230 Adjustment, 6, 230 Adjuvant, 230, 255 Adolescence, 160, 164, 230, 272 Adolescent Nutrition, 160, 164, 230 Adrenal Cortex, 230, 251, 277 Adrenal Medulla, 230, 250, 269 Adrenergic, 9, 230, 250, 265, 286 Adverse Effect, 230, 283 Aerobic, 21, 22, 230, 267 Aerobic Exercise, 21, 230 Aerophagia, 212, 230 Aetiology, 10, 230 Affinity, 230, 284 Age of Onset, 176, 230, 289 Albumin, 231, 275 Aldehydes, 231, 291 Alertness, 231, 237 Algorithms, 231, 236 Alimentary, 137, 168, 231, 247, 250, 272, 273

Alkaline, 142, 229, 231, 232, 237, 274 Alkalosis, 184, 231 Alleles, 23, 231 Allergens, 231, 253 Aloe, 87, 89, 231 Alpha-1, 129, 231 Alpha-Amylase, 129, 231 Alpha-Linolenic Acid, 23, 231 Alternative medicine, 182, 231 Ameliorating, 128, 150, 231 Amenorrhea, 99, 231, 233, 275 Amino Acid Sequence, 231, 233, 255 Amino Acids, 25, 117, 121, 122, 231, 255, 273, 276, 277, 281, 283, 286, 287, 288, 289 Ammonia, 117, 232, 256, 259, 284, 289 Amoxicillin, 56, 232 Ampicillin, 101, 232 Ampulla, 232, 241 Amylase, 113, 114, 129, 232 Amylopectin, 114, 115, 129, 152, 232 Amylose, 114, 115, 129, 136, 140, 152, 232 Anaesthesia, 232, 261 Anal, 175, 186, 206, 213, 216, 232, 252, 280, 283 Anal Fissure, 175, 206, 232, 283 Analgesics, 169, 232 Analogous, 232, 288 Anastomosis, 175, 232 Anatomical, 179, 232, 237, 249, 260, 264 Androgens, 9, 34, 230, 232 Anemia, 171, 232, 253, 273 Anesthesia, 232 Anesthetics, 232, 250 Angina, 4, 232 Animal model, 35, 232 Anorectal, 175, 213, 232 Anorexia, 183, 232, 233, 254, 289 Anorexia Nervosa, 183, 233 Anovulation, 233, 275 Antagonism, 233, 237 Antibacterial, 233, 285 Antibiotic, 107, 173, 175, 232, 233, 237, 285 Antibodies, 120, 233, 234, 265, 275 Antibody, 120, 230, 233, 243, 259, 260, 261, 266, 279, 285 Anticoagulant, 233, 277 Antifoaming Agents, 151, 233 Antigen, 230, 231, 233, 243, 259, 261, 266

294 Dietary Fiber

Anti-infective, 233, 253, 262 Anti-Infective Agents, 233, 253 Anti-inflammatory, 70, 97, 233, 234, 282 Anti-Inflammatory Agents, 233, 234 Antineoplastic, 233, 255 Antioxidant, 13, 18, 194, 233, 234, 271 Antipruritic, 233, 241 Antispasmodic, 216, 233 Anus, 145, 179, 232, 233, 237, 252, 262, 273, 280 Anxiety, 171, 233 Anxiolytic, 233, 270 Apolipoproteins, 234, 264 Apoptosis, 13, 35, 234 Appendicitis, 42, 127, 175, 234 Aqueous, 114, 116, 134, 148, 234, 235, 245, 249, 264 Arginine, 234, 269, 289 Aromatic, 234, 244, 285, 286 Arterial, 234, 241, 259, 277, 286 Arteries, 234, 236, 244, 265, 266, 268 Arteriosclerosis, 234, 259 Ascorbic Acid, 81, 161, 234 Aspirin, 19, 234 Asymptomatic, 234, 240, 272 ATP, 106, 133, 229, 230, 234, 245, 248, 255, 256, 274, 278 Atrophy, 234, 264 Attenuated, 95, 234 Autoantibodies, 234, 246 Autodigestion, 234, 272 Autoimmune disease, 175, 234 Autoimmune Hepatitis, 234, 258 Autonomic, 229, 235, 269 B Bacterial Infections, 205, 235 Bacterial Translocation, 107, 235 Bactericidal, 235, 251 Base, 26, 28, 126, 229, 231, 235, 246, 255, 263, 273, 274, 283, 289 Belching, 171, 218, 230, 235 Benign, 229, 235, 238, 257 Benzene, 235, 263 Beta Rays, 235, 249 Bewilderment, 235, 244 Bilateral, 235, 275 Bile Acids, 4, 44, 54, 55, 57, 58, 68, 111, 235, 285 Bile Acids and Salts, 235 Bile Ducts, 235, 254 Biliary, 68, 235, 238, 241, 243, 258, 272 Biliary Tract, 235, 238, 272

Bilirubin, 231, 235, 254 Binding agent, 115, 235 Bioavailability, 56, 78, 96, 125, 135, 144, 236 Bioavailable, 139, 236 Biochemical, 13, 24, 44, 45, 231, 236, 283 Biological Transport, 236, 247 Biomarkers, 22, 69, 236 Biopsy, 34, 175, 236 Biosynthesis, 9, 236, 283 Biotechnology, 40, 41, 167, 182, 193, 236 Biotin, 161, 236 Bladder, 176, 236, 260, 261, 277, 281, 289 Blinking, 186, 236 Bloating, 128, 184, 185, 187, 201, 204, 218, 236, 260, 262 Blood Coagulation, 236, 237, 287 Blood pressure, 25, 32, 38, 45, 54, 203, 236, 238, 259, 267, 269, 284 Blood urea, 109, 236 Blood vessel, 236, 237, 238, 240, 249, 251, 265, 284, 285, 287, 290 Body Burden, 236, 263 Body Composition, 9, 12, 20, 21, 22, 23, 30, 237 Body Fluids, 231, 236, 237, 248, 252, 269, 284, 288 Body Mass Index, 6, 34, 176, 237, 271 Body Regions, 237, 242 Bolus, 157, 237 Bolus infusion, 237 Bowel, 3, 5, 6, 7, 45, 49, 55, 63, 66, 77, 78, 86, 88, 100, 111, 122, 139, 141, 145, 149, 152, 168, 171, 172, 173, 175, 176, 177, 184, 185, 187, 200, 201, 203, 204, 205, 206, 207, 208, 209, 211, 212, 213, 214, 216, 232, 237, 244, 247, 250, 253, 254, 261, 262, 263, 273, 280, 285, 289 Bowel Movement, 111, 172, 185, 204, 209, 211, 237, 244, 247, 285 Bradykinin, 237, 269, 275 Branch, 225, 237, 245, 255, 265, 272, 278, 284, 287 Breakdown, 117, 147, 151, 205, 236, 237, 247, 254 Broad-spectrum, 232, 237 Bronchi, 237, 250, 288 Buccal, 17, 27, 237 Bulimia, 183, 237 Bullous, 237, 246 C Cacao, 142, 143, 237

Index 295

Caffeine, 6, 19, 25, 161, 164, 173, 185, 211, 237, 278 Calcium Oxalate, 238, 271 Calculi, 238, 256 Caloric intake, 124, 161, 162, 163, 174, 238 Candidiasis, 141, 238 Candidosis, 238 Capsules, 30, 78, 155, 238, 252, 255 Carbamyl Phosphate, 106, 238 Carbon Dioxide, 109, 238, 274, 281 Carboxy, 24, 238 Carboxymethylcellulose, 108, 238 Carcinogen, 13, 46, 238, 268 Carcinogenesis, 27, 46, 54, 72, 238 Carcinogenic, 27, 235, 238, 277, 285 Carcinoid, 175, 238 Carcinoma, 13, 34, 72, 82, 87, 88, 238 Cardia, 61, 72, 97, 238 Cardiac, 237, 238, 249, 250, 254, 268, 285 Cardiopulmonary, 20, 238 Cardiorespiratory, 230, 238 Cardiovascular disease, 6, 13, 19, 21, 27, 41, 49, 50, 52, 95, 124, 164, 201, 208, 238 Carotene, 17, 23, 64, 101, 239 Carotenoids, 16, 23, 29, 31, 37, 40, 76, 82, 239 Carrier Proteins, 239, 275 Case report, 239, 242 Case series, 239, 242 Case-Control Studies, 27, 64, 239 Catabolism, 117, 239 Catecholamines, 9, 230, 239 Cathode, 235, 239, 249 Caudal, 239, 247, 259, 276 Causal, 239, 262 Cause of Death, 38, 239 Cecum, 239, 263 Celiac Disease, 169, 212, 239 Cell Cycle, 14, 36, 239, 241 Cell Death, 234, 239, 240, 268 Cell Differentiation, 13, 239, 288 Cell Division, 235, 239, 240, 245, 267, 275 Cell membrane, 236, 239, 240, 274 Cell Physiology, 13, 240 Cell proliferation, 14, 43, 234, 240 Cell Respiration, 240, 267, 281 Cellobiose, 240 Cellulose, 38, 108, 120, 122, 126, 138, 142, 147, 148, 240, 254, 257, 266, 275 Central Nervous System, 229, 235, 237, 240, 256, 257, 265, 283 Cerebral, 240, 246, 250, 251, 278, 284, 287

Cerebrovascular, 238, 240 Cervical, 32, 240 Cervix, 240 Chamomile, 186, 240 Character, 140, 240, 246, 256 Chenodeoxycholic Acid, 240, 289 Child Nutrition, 9, 198, 240 Chlorophyll, 240, 254 Cholecystokinin, 38, 44, 93, 240 Choledochal Cyst, 175, 240 Choleretic, 240, 241, 289 Cholestasis, 70, 241 Cholesterol Esters, 241, 264 Cholestyramine, 62, 241 Choline, 240, 241 Chromatin, 36, 234, 241, 250 Chromium, 161, 241 Chromosomal, 241, 282 Chromosome, 241, 257, 264, 282, 288 Chronic Disease, 19, 147, 164, 216, 241 Chronic Fatigue Syndrome, 171, 241 Chronic renal, 81, 241, 275, 289 Chylomicrons, 241, 264 Cisplatin, 241, 270 Citrus, 63, 140, 234, 241 Clamp, 21, 241 Claviceps, 241, 282 Cleave, 114, 241 Clinical Medicine, 242, 276 Clinical study, 40, 242, 244 Clinical trial, 8, 19, 72, 124, 193, 242, 244, 278, 279 Cloning, 236, 242 Coagulation, 236, 242, 275 Cod Liver Oil, 242, 249 Coenzyme, 234, 242 Cofactor, 242, 277, 287 Cognitive restructuring, 242, 285 Cohort Studies, 27, 242 Colic, 121, 122, 154, 242 Colitis, 72, 95, 100, 173, 204, 242, 262 Collagen, 242, 255, 275 Collapse, 237, 242 Colloidal, 148, 231, 242, 251, 273 Colon Polyps, 175, 211, 242 Colonoscopy, 26, 175, 211, 242 Colorectal, 6, 7, 14, 15, 27, 29, 43, 49, 61, 64, 72, 73, 87, 88, 93, 94, 99, 169, 182, 184, 243 Colorectal Cancer, 6, 7, 14, 15, 27, 29, 49, 61, 64, 94, 99, 169, 182, 184, 243 Colostomy, 175, 200, 243

296 Dietary Fiber

Common Bile Duct, 240, 243 Complement, 243, 275 Complementary and alternative medicine, 93, 102, 243 Complementary medicine, 93, 243 Complete remission, 243, 280 Computational Biology, 193, 243 Conception, 243, 244 Condiments, 153, 244 Cone, 244, 286 Confounding, 5, 244 Confusion, 215, 244, 248, 259, 269, 289 Conjugated, 18, 235, 240, 244, 245 Connective Tissue, 234, 242, 244, 252, 255, 265 Consciousness, 14, 232, 244, 246 Constriction, 244, 282, 290 Contamination, 12, 244, 258, 281 Continence, 186, 213, 244 Contraceptive, 37, 107, 244 Contraindications, ii, 244 Control group, 8, 11, 30, 31, 34, 39, 40, 244, 279 Controlled clinical trial, 39, 244, 279 Controlled study, 38, 244 Conventional therapy, 40, 244 Conventional treatment, 244 Coronary heart disease, 3, 4, 12, 23, 38, 50, 60, 64, 66, 67, 111, 156, 182, 194, 238, 244 Coronary Thrombosis, 244, 266, 268 Corpus, 245, 277, 287 Corpus Luteum, 245, 277 Cortex, 245, 251 Coumarin, 245 Coumestrol, 125, 144, 245 Creatine, 106, 245 Creatine Kinase, 106, 245 Creatinine, 25, 109, 245, 289 Criterion, 38, 245 Cultural Characteristics, 15, 31, 245 Curative, 245, 269, 281, 287 Cutaneous, 238, 245, 262 Cyclic, 19, 237, 245, 257, 269, 276 Cysteine, 245, 286 Cytochrome, 14, 62, 245 Cytogenetics, 245, 282 Cytoplasm, 234, 240, 245, 250, 281 Cytotoxic, 175, 245, 270 Cytotoxic chemotherapy, 245, 270 D Dairy Products, 107, 125, 153, 173, 205, 245, 282

Data Collection, 16, 246, 252 Databases, Bibliographic, 193, 246 Deamination, 246, 289 Defecation, 122, 149, 180, 187, 246 Degenerative, 246, 258 Deletion, 13, 234, 246 Delirium, 171, 246 Delivery of Health Care, 246, 257 Dementia, 27, 246 Density, 20, 115, 152, 170, 211, 237, 246, 264, 270, 284 Dental Care, 162, 246 Dental Caries, 12, 164, 246 Dermatitis, 170, 180, 246 Dermatitis Herpetiformis, 170, 246 Deuterium, 247, 259 Developed Countries, 140, 247, 253 Diabetes Mellitus, 6, 7, 80, 99, 140, 147, 160, 161, 164, 174, 204, 247, 255, 258 Diagnostic procedure, 105, 145, 182, 247 Diaphragm, 247, 258 Diarrhoea, 247, 254 Diastole, 247 Diastolic, 38, 247, 259 Diencephalon, 247, 259, 287 Dietary Fats, 132, 163, 174, 198, 209, 247, 264 Dietitian, 161, 202, 247 Diffusion, 33, 236, 247 Digestive system, 117, 138, 141, 148, 157, 169, 172, 175, 207, 210, 214, 247, 254 Digestive tract, 111, 115, 141, 142, 144, 145, 157, 169, 186, 201, 203, 205, 213, 218, 247, 284 Digital rectal examination, 34, 247 Dihydrotestosterone, 247, 280 Dilatation, 240, 247, 290 Dilation, 175, 237, 247 Dimethyl, 247, 264, 283 Diosgenin, 119, 247 Diploid, 247, 275 Direct, iii, 6, 13, 19, 25, 174, 242, 248, 280 Disaccharides, 75, 248 Disinfectant, 248, 251 Disorientation, 117, 244, 246, 248 Distention, 111, 171, 248 Diuresis, 184, 237, 248 Diverticula, 169, 173, 183, 187, 248 Diverticulitis, 3, 7, 168, 169, 173, 175, 177, 183, 187, 200, 201, 206, 248 Diverticulum, 169, 175, 248 DNA Topoisomerase, 248, 255

Index 297

Drug Industry, 119, 248 Drug Interactions, 248 Drug Tolerance, 248, 287 Duct, 175, 232, 243, 248, 251, 260, 282 Duodenum, 235, 248, 254, 285 Dysentery, 154, 248 Dyspepsia, 154, 171, 212, 248, 260 Dysphagia, 171, 248 E Eating Disorders, 162, 183, 248 Efficacy, 11, 14, 28, 36, 58, 71, 75, 248 Electrolyte, 184, 246, 248, 252, 269, 276, 280, 284, 289 Electrons, 106, 133, 233, 235, 239, 248, 262, 271, 279 Elementary Particles, 248, 249, 278 Embryo, 119, 239, 249, 261 Emodin, 231, 249 Emollient, 249, 256, 270 Emulsion, 108, 249 Enamel, 246, 249 Encapsulated, 137, 138, 139, 155, 249 Encephalopathy, 117, 249 Encopresis, 81, 186, 249 Endocarditis, 238, 249 Endocrine System, 249, 268 Endometrium, 249, 266 Endoscopy, 204, 213, 249 Endothelium, 249, 269, 275 Endothelium-derived, 249, 269 Endotoxic, 249, 264 Endotoxin, 249, 250, 288 End-stage renal, 241, 250, 275 Energy balance, 194, 250 Energy deficit, 21, 250 Energy Intake, 5, 6, 250 Enteral Nutrition, 42, 43, 45, 50, 70, 82, 97, 107, 160, 173, 250 Enteritis, 160, 164, 250 Enterocolitis, 250 Environmental Health, 192, 194, 250 Enzymatic, 115, 122, 123, 237, 239, 243, 246, 250, 258 Enzyme Inhibitors, 250, 275 Eosinophilic, 175, 250 Eosinophilic Gastroenteritis, 175, 250 Eosinophils, 250, 264 Epidemiological, 4, 8, 10, 23, 58, 107, 250 Epigastric, 250, 271 Epinephrine, 28, 230, 250, 269, 289 Epithelial, 13, 43, 229, 236, 250 Epithelial Cells, 13, 250

Ergometer, 28, 250 Ergot, 250, 282 Erythrocytes, 232, 250, 280 Esophageal, 58, 175, 250, 251 Esophageal Stricture, 175, 251 Esophageal Varices, 175, 251 Esophagus, 145, 209, 218, 247, 250, 251, 257, 274, 280, 285 Estradiol, 39, 125, 144, 251 Estrogen, 18, 19, 40, 125, 144, 251 Estrogen receptor, 18, 125, 144, 251 Ethanol, 106, 251, 252 Evacuation, 60, 185, 244, 251, 254, 263, 278 Evoke, 251, 285 Excipient, 251, 257 Exhaustion, 28, 233, 251 Exocrine, 240, 251, 271 Exogenous, 251, 289 Expiration, 251, 281 Extender, 117, 141, 251 Extracellular, 244, 251, 284 Extraction, 118, 126, 134, 143, 153, 251 Exudate, 251, 257 F Failure to Thrive, 160, 164, 251 Family Health, 174, 175, 251 Family Planning, 193, 251 Fatigue, 175, 241, 251 Fatty acids, 18, 23, 30, 32, 64, 65, 74, 75, 96, 107, 131, 132, 142, 160, 164, 231, 252, 256, 277 Fatty Liver, 208, 252 Fatty Liver, Alcoholic, 208, 252 Fecal Incontinence, 76, 95, 98, 175, 185, 186, 252, 260 Feces, 24, 41, 109, 117, 128, 149, 150, 186, 244, 249, 252, 285 Fermentation, 13, 24, 35, 74, 75, 106, 109, 128, 137, 142, 150, 237, 252, 253 Fibrin, 236, 252, 273, 275, 287 Fibrinogen, 12, 73, 252, 275, 287 Fibrosis, 59, 252 Filler, 112, 252 Filtration, 109, 121, 143, 252 Fish Products, 252, 282 Fistula, 177, 252 Flatulence, 127, 128, 154, 168, 172, 186, 218, 233, 252 Flatus, 218, 252, 254 Flavoring Agents, 121, 143, 252, 253, 274 Fluid Therapy, 164, 252, 269 Focus Groups, 24, 252

298 Dietary Fiber

Folate, 17, 18, 19, 29, 43, 60, 252, 253 Folic Acid, 252 Food Additives, 114, 134, 164, 253 Food Chain, 207, 253 Food Coloring Agents, 253 Food Hypersensitivity, 160, 164, 253 Food Labeling, 5, 156, 160, 170, 172, 205, 215, 253 Food Preferences, 8, 253 Food Preservatives, 253 Foodborne Illness, 162, 253 Foot Care, 160, 253 Forearm, 236, 253 Fractionation, 118, 119, 253 Fructose, 112, 117, 141, 253, 256, 262 Functional Disorders, 171, 212, 253 Fungi, 107, 111, 119, 141, 146, 241, 253, 254, 262, 267, 291 Fungus, 141, 238, 250, 254, 282 G Galactans, 107, 254 Gallbladder, 172, 173, 175, 208, 229, 235, 240, 247, 254 Gallstones, 6, 123, 175, 207, 235, 240, 254, 289 Gamma Rays, 254, 268, 279 Gas, 127, 128, 168, 171, 175, 184, 185, 186, 187, 204, 217, 218, 230, 232, 235, 238, 247, 252, 253, 254, 259, 260, 262, 268, 269, 286 Gastric, 4, 61, 67, 72, 78, 82, 97, 209, 232, 234, 254, 257, 258, 262, 273, 285 Gastric Acid, 209, 232, 254 Gastric Emptying, 67, 254 Gastric Juices, 254, 273 Gastric Mucosa, 254, 273 Gastrin, 254, 259 Gastritis, 172, 175, 218, 254 Gastroenteritis, 120, 254, 281 Gastroenterologist, 179, 254 Gastrointestinal Transit, 43, 60, 111, 254 Gastrostomy, 175, 250, 254 Gavage, 252, 255 Gelatin, 153, 155, 255, 286 Gene, 9, 13, 17, 18, 23, 27, 36, 76, 165, 167, 231, 236, 255, 259 Gene Expression, 13, 255 General practitioner, 160, 255 Genetic Code, 255, 269 Genistein, 125, 144, 255 Genital, 175, 255, 289 Genitourinary, 141, 255, 289

Genotype, 27, 255 Geriatric, 51, 61, 255 Germ Cells, 255, 271, 286 Gestational, 176, 204, 214, 255 Gland, 230, 255, 265, 271, 272, 274, 277, 282, 285, 287 Glomerular, 255, 262, 280 Glucans, 106, 138, 140, 255 Glucose Intolerance, 247, 255 Glucose tolerance, 21, 38, 55, 56, 67, 214, 255 Glucose Tolerance Test, 38, 55, 56, 255 Glutamic Acid, 252, 256 Glutamine, 65, 125, 144, 256 Glutathione Peroxidase, 256, 282 Gluten, 60, 169, 212, 239, 256 Glycerol, 28, 256, 274 Glycerophospholipids, 256, 274 Glycogen, 21, 231, 256 Glycogen Synthase, 21, 256 Glycolysis, 106, 229, 256 Glycoprotein, 252, 256, 262, 287, 288 Glycoside, 125, 144, 248, 256 Glycosidic, 126, 231, 240, 256, 270 Goats, 245, 256 Gonadal, 256, 285 Gout, 154, 256 Governing Board, 256, 276 Government Agencies, 35, 256, 276 Grade, 11, 113, 153, 256 Gram-negative, 235, 249, 257 Groin, 257, 261 Growth, 9, 13, 22, 34, 35, 61, 107, 119, 151, 157, 230, 232, 233, 234, 236, 239, 240, 251, 257, 265, 268, 275, 276, 287, 288 Guanylate Cyclase, 257, 269 Gum Arabic, 95, 112, 229, 257 H Habitual, 240, 257 Haploid, 257, 275 Headache, 237, 257, 259, 277 Health Behavior, 10, 12, 28, 257 Health Care Costs, 37, 257 Health Expenditures, 257 Health Promotion, 10, 25, 32, 36, 179, 257 Health Status, 37, 194, 251, 257 Heart attack, 209, 238, 257 Heartburn, 168, 169, 171, 175, 209, 257, 258, 260 Heme, 235, 245, 257, 276 Hemicellulose, 130, 138, 142, 155, 257 Hemochromatosis, 207, 258

Index 299

Hemoglobin, 20, 32, 232, 250, 257, 258, 276 Hemorrhage, 177, 257, 258, 285 Hemorrhoids, 3, 7, 162, 171, 175, 179, 206, 208, 214, 215, 216, 258, 283 Hepatic, 62, 116, 117, 231, 243, 246, 255, 258, 276, 284 Hepatitis, 175, 208, 252, 258, 290 Hepatitis A, 208, 258 Hepatitis, Chronic, 175, 258 Hepatobiliary, 164, 258 Hepatocellular, 258 Hepatocyte, 241, 258 Hepatovirus, 258 Heredity, 255, 258 Hernia, 162, 258 Heterotrophic, 253, 258 Hiatal Hernia, 7, 175, 258 Histamine, 258, 265 Homeostasis, 168, 258 Homologous, 231, 258, 288 Homozygotes, 23, 259 Hormonal, 39, 213, 234, 259, 291 Hormone, 10, 19, 22, 56, 125, 144, 176, 250, 251, 254, 259, 261, 262, 272, 276, 277, 286, 287, 291 Hormone Replacement Therapy, 10, 19, 259 Host, 235, 238, 253, 259, 260, 282, 290 Hybrid, 114, 115, 259, 282 Hydration, 131, 135, 156, 259 Hydrogen, 45, 126, 229, 235, 238, 247, 256, 259, 264, 267, 271, 278 Hydrolysis, 114, 120, 126, 129, 133, 137, 168, 240, 241, 259, 276, 278 Hydrophobic, 256, 259, 264 Hyperammonemia, 117, 259 Hypercholesterolemia, 4, 6, 8, 30, 48, 67, 100, 107, 259, 272 Hyperlipidemia, 7, 30, 124, 160, 164, 259 Hyperlipoproteinemia, 259 Hypersensitivity, 36, 231, 259 Hypertension, 26, 38, 54, 124, 160, 162, 164, 184, 209, 238, 257, 259, 289 Hypertriglyceridemia, 4, 53, 95, 259 Hyperuricemia, 256, 259 Hypoglycaemia, 246, 259 Hypoglycemia, 100, 160, 164, 204, 259 Hypothalamus, 125, 247, 259, 274, 287 Hypoxanthine, 259, 291 Hypoxia, 246, 260 Hysterectomy, 77, 260

I Ice Cream, 133, 260 Id, 90, 98, 198, 199, 218, 219, 224, 226, 260 Idiopathic, 80, 175, 260 Ileostomy, 56, 59, 76, 175, 200, 260 Ileum, 239, 260, 291 Imidazole, 236, 258, 260 Immune function, 20, 107, 117, 119, 205, 260 Immune response, 230, 233, 234, 260, 286, 290 Immune system, 128, 205, 234, 260, 265, 273, 290, 291 Immunity, 94, 107, 117, 120, 160, 260 Immunization, 260, 277 Immunogenic, 260, 264 Immunoglobulin, 107, 119, 233, 260 Impaction, 175, 186, 260 Impairment, 235, 241, 246, 260, 262, 266 In situ, 10, 260 In vitro, 13, 41, 43, 55, 63, 74, 78, 107, 260 In vivo, 13, 146, 260, 271 Incision, 260, 262 Incontinence, 24, 170, 185, 186, 249, 260 Incubation, 75, 260 Indicative, 165, 260, 272, 290 Indigestion, 107, 171, 175, 260, 263 Induction, 36, 232, 261 Infancy, 261, 281 Infant Nutrition, 160, 164, 261 Infantile, 121, 122, 261, 264 Infarction, 100, 261 Inflammatory bowel disease, 6, 173, 180, 207, 211, 261 Infusion, 58, 261, 288 Ingestion, 43, 149, 255, 261, 275 Inguinal, 175, 261 Inguinal Hernia, 175, 261 Inhalation, 261, 275 Inorganic, 129, 230, 241, 261, 268, 284 Insight, 9, 40, 261 Insomnia, 261, 277 Insulin-dependent diabetes mellitus, 71, 80, 96, 261 Intermittent, 185, 252, 261 Interstitial, 184, 261, 280 Intervention Studies, 18, 262 Intestinal Flora, 205, 262 Intestinal Obstruction, 175, 262 Intestinal Pseudo-Obstruction, 175, 262 Intestine, 4, 7, 8, 58, 86, 88, 117, 128, 129, 139, 140, 145, 150, 152, 169, 173, 175,

300 Dietary Fiber

183, 187, 211, 218, 235, 237, 239, 240, 243, 248, 250, 254, 259, 260, 261, 262, 263, 268, 273, 279, 280, 284, 290 Intoxication, 246, 262, 291 Intracellular, 237, 261, 262, 269, 276, 282 Intraepithelial, 86, 88, 262 Intrahepatic, 70, 262 Intramuscular, 262, 272 Intravenous, 38, 261, 262, 272 Intrinsic, 114, 230, 262 Intrinsic Factor, 114, 262 Intussusception, 175, 262, 280 Inulin, 53, 59, 66, 116, 119, 262 Invasive, 10, 37, 260, 262 Involuntary, 24, 236, 252, 262, 268, 280, 284 Iodine, 161, 262 Ions, 235, 241, 248, 259, 262, 267, 274 Irritants, 248, 262 Isoenzyme, 245, 263 Isoflavones, 125, 144, 263 J Jaundice, 240, 263 Jejunostomy, 250, 263 K Kb, 36, 192, 263 Keratolytic, 246, 263 Kidney Disease, 162, 163, 180, 185, 192, 263 Kidney stone, 173, 263, 271, 289 L Lactation, 10, 154, 263 Lactoperoxidase, 107, 119, 263 Lactose Intolerance, 171, 186, 216, 263 Lactulose, 117, 263 Lag, 80, 263 Latent, 18, 263, 276 Latent period, 18, 263 Laxative, 112, 117, 145, 175, 176, 183, 238, 240, 249, 263, 266 Lead Poisoning, 215, 263 Lethal, 235, 263, 268 Lethargy, 117, 263 Leucocyte, 231, 263 Leukocytes, 250, 264, 288 Libido, 232, 264 Library Services, 224, 264 Life cycle, 253, 264 Ligament, 264, 277 Ligation, 180, 264 Linkage, 10, 29, 142, 240, 264 Lipase, 55, 264

Lipid A, 21, 27, 29, 69, 142, 264 Lipid Peroxidation, 264, 271 Lipodystrophy, 30, 264 Lipopolysaccharides, 264 Lipoprotein, 7, 22, 57, 170, 257, 264, 265 Liquor, 143, 264 Liver Transplantation, 175, 264 Localized, 40, 246, 249, 261, 264, 275, 289 Locomotion, 264, 275 Loop, 153, 258, 260, 264 Loperamide, 216, 264 Low-density lipoprotein, 76, 82, 264, 265 Lubricants, 173, 176, 265, 273 Lumen, 35, 265 Lycopene, 17, 23, 29, 265 Lymph, 235, 240, 249, 265 Lymph node, 235, 240, 265 Lymphatic, 249, 261, 265, 285 Lymphatic system, 265, 285 Lymphocyte, 86, 88, 233, 265, 266 Lymphoid, 128, 150, 233, 263, 265 M Macronutrients, 25, 162, 265 Malabsorption, 122, 160, 164, 175, 239, 265 Malignant, 175, 229, 233, 265 Malnutrition, 163, 231, 234, 265 Manifest, 161, 174, 265 Mannans, 106, 254, 265 Manometry, 186, 213, 265 Meat, 18, 22, 29, 125, 153, 161, 162, 200, 201, 202, 214, 247, 265, 282, 284 Meat Products, 153, 247, 265 Mediator, 29, 240, 265, 283 Medical Records, 33, 37, 266 Medicament, 266, 286 MEDLINE, 193, 266 Megacolon, 175, 266 Melanocytes, 266 Melanoma, 37, 266 Membrane, 32, 183, 240, 243, 257, 266, 268, 270, 274, 276, 280, 281 Memory, 232, 246, 266 Menopause, 39, 266, 276 Menstrual Cycle, 204, 216, 266, 277 Menstruation, 231, 266, 270, 276 Mental Disorders, 266, 277 Mental Health, iv, 8, 192, 195, 266, 270, 277, 278 Mesenteric, 235, 266 Meta-Analysis, 47, 266 Metabolic disorder, 256, 259, 266 Methionine, 247, 266, 286

Index 301

Methylcellulose, 24, 112, 266 MI, 50, 71, 72, 97, 131, 169, 172, 200, 210, 217, 227, 266 Microbiology, 22, 267 Micronutrients, 124, 267 Microorganism, 106, 119, 242, 267, 272, 291 Micro-organism, 246, 267 Midaxillary line, 267, 291 Millimeter, 267, 291 Miscarriage, 10, 267 Mitochondria, 13, 267 Mitosis, 234, 267 Modeling, 8, 12, 186, 267 Modification, 27, 35, 160, 213, 267, 279 Molecular Structure, 125, 144, 267 Molecule, 106, 107, 119, 133, 233, 235, 242, 243, 249, 256, 259, 267, 271, 279, 282, 284 Monitor, 22, 32, 123, 245, 267, 269 Mononuclear, 267, 288 Monounsaturated fat, 32, 267 Morphological, 249, 254, 266, 267 Morphology, 150, 267 Motility, 55, 78, 201, 208, 212, 253, 267, 283 Motion Sickness, 267, 268 Motivations, 28, 267 Mucilaginous, 131, 268 Mucosa, 13, 95, 107, 235, 239, 240, 250, 254, 268 Mucus, 185, 248, 268, 289 Multiparous, 96, 268 Mung bean, 114, 268 Mustard Gas, 262, 268 Mutagen, 146, 268 Mutagenesis, 146, 268 Mutagenic, 22, 268 Mydriatic, 247, 268 Myocardial infarction, 4, 23, 244, 266, 268 Myocardium, 266, 268 N Nasogastric, 250, 268 Nausea, 6, 117, 169, 254, 260, 268, 270, 277, 289 Necrosis, 234, 258, 261, 266, 268 Neoplasia, 49, 268 Nephropathy, 263, 268 Nerve, 230, 232, 253, 266, 268, 281, 285, 288, 290 Nervous System, 240, 265, 268, 286 Networks, 32, 268 Neuroendocrine, 9, 268 Neuroleptic, 269, 270

Niacin, 161, 269 Nitric Oxide, 51, 269 Nitrogen, 109, 110, 122, 128, 150, 232, 256, 269 Norepinephrine, 28, 230, 269 Normotensive, 45, 269 Nuclear, 13, 249, 254, 268, 269 Nuclei, 249, 267, 269, 278 Nucleic acid, 133, 168, 255, 260, 269, 278 Nucleus, 234, 235, 241, 245, 247, 249, 250, 254, 267, 269, 278 Nutrition Assessment, 269 Nutrition Surveys, 40, 53, 86, 88, 269 Nutritional Status, 17, 18, 159, 164, 269 Nutritional Support, 159, 254, 269 Nutritive Value, 253, 270 O Occupational Exposure, 10, 270 Occupational Health, 10, 270 Odds Ratio, 270, 280 Office Management, 176, 270 Ointments, 240, 270 Oligomenorrhea, 270, 275 Oligosaccharides, 91, 107, 116, 117, 119, 128, 139, 141, 231, 270 Oncology, 13, 40, 49, 69, 77, 79, 270 Ondansetron, 171, 270 Opacity, 246, 270 Optic Chiasm, 259, 270 Oral Health, 12, 160, 164, 194, 270 Organoleptic, 110, 135, 270 Osmosis, 270 Osmotic, 115, 231, 270 Ossification, 270, 281 Osteoporosis, 156, 162, 164, 203, 209, 270 Outpatient, 22, 271 Ovaries, 271, 275, 283 Ovary, 120, 245, 251, 271 Overcorrection, 186, 271 Overweight, 15, 20, 32, 33, 89, 271 Ovum, 245, 264, 271, 277 Oxalate, 173, 271 Oxidants, 128, 271 Oxidation, 13, 53, 95, 151, 229, 233, 245, 256, 264, 271 Oxidation-Reduction, 271 Oxidative Stress, 20, 271 Oxygen Consumption, 271, 281 P Palliative, 271, 287 Pancreas, 55, 147, 168, 172, 173, 175, 229, 236, 247, 258, 261, 264, 271, 272, 288

302 Dietary Fiber

Pancreatic, 55, 63, 78, 100, 114, 175, 176, 240, 271, 272 Pancreatic enzymes, 55, 271 Pancreatitis, 175, 272 Parasite, 253, 272 Parasitic, 141, 241, 248, 272 Parathyroid, 272, 281 Parathyroid Glands, 272, 281 Parenteral, 42, 43, 45, 50, 70, 97, 160, 164, 250, 272 Parenteral Nutrition, 160, 164, 272 Partial remission, 272, 280 Particle, 108, 112, 115, 272, 284 Pathogen, 117, 151, 260, 272 Pathologic, 229, 234, 236, 238, 244, 259, 272, 290 Pathologic Processes, 234, 272 Pathophysiology, 38, 185, 272 Patient Education, 184, 187, 200, 202, 213, 216, 217, 222, 224, 227, 272 Pectins, 106, 272 Pediatrics, 41, 43, 48, 54, 56, 79, 122, 159, 164, 272 Pelvic, 213, 272, 277 Pentoses, 120, 272 Pepsin, 272, 273 Pepsin A, 272, 273 Peptic, 100, 167, 175, 209, 273 Peptic Ulcer, 100, 167, 175, 209, 273 Peptide, 240, 272, 273, 276, 277, 278, 288 Peptide T, 273, 288 Perception, 39, 244, 273 Perennial, 143, 273, 288 Perianal, 180, 273 Periodontal disease, 12, 273 Peristalsis, 140, 145, 273 Peritoneum, 273 Peritonitis, 175, 273 Pernicious, 262, 273 Pernicious anemia, 262, 273 Peroxide, 118, 136, 256, 264, 273 Petrolatum, 249, 273 Petroleum, 180, 273 Phagocyte, 271, 273 Pharmaceutic Aids, 253, 273 Pharmaceutical Preparations, 240, 251, 255, 273, 274 Pharmacokinetic, 96, 274 Pharmacologic, 232, 274, 287 Pharynx, 145, 274 Phenolphthalein, 249, 274 Phospholipids, 107, 251, 264, 274

Phosphorus, 109, 160, 161, 163, 164, 202, 237, 272, 274 Phosphorylated, 114, 242, 274 Phosphorylating, 114, 274 Phosphorylation, 36, 106, 229, 230, 274, 278 Physical Examination, 204, 212, 213, 274 Physical Fitness, 217, 274 Physiologic, 6, 63, 73, 107, 186, 211, 236, 262, 266, 267, 274, 279 Physiology, 166, 205, 213, 216, 274 Phytic Acid, 57, 96, 274 Pigment, 235, 265, 266, 274 Pilot study, 16, 20, 31, 32, 39, 71, 274 Pituitary Gland, 126, 274 Placenta, 251, 274, 277 Plague, 172, 173, 274 Plasma cells, 233, 275 Plasma protein, 39, 231, 275 Plasmin, 275, 287, 289 Plasminogen, 73, 275, 287, 289 Plasminogen Activators, 275 Platelet Aggregation, 269, 275 Platelets, 269, 275, 283 Platinum, 241, 264, 275 Poisoning, 172, 246, 250, 253, 254, 262, 268, 275 Policy Making, 256, 275 Polycystic, 214, 275 Polycystic Ovary Syndrome, 214, 275 Polymers, 70, 275, 277, 286 Polyp, 26, 276 Polypeptide, 231, 242, 252, 273, 275, 276, 291 Polyposis, 243, 276 Polysaccharide, 54, 129, 142, 233, 240, 276 Polyunsaturated fat, 29, 30, 132, 276 Porphyria, 206, 276 Porphyrins, 276 Posterior, 232, 267, 271, 276 Postmenopausal, 18, 39, 126, 271, 276 Postoperative, 200, 276 Postprandial, 50, 58, 63, 71, 111, 115, 157, 171, 276 Postprandial Blood Glucose, 115, 276 Potassium, 124, 126, 161, 163, 202, 276 Practice Guidelines, 195, 218, 276 Precursor, 119, 241, 250, 269, 275, 276, 289, 291 Predisposition, 33, 276 Pregnenolone, 247, 276 Premenopausal, 37, 39, 276

Index 303

Premenstrual, 171, 276, 277 Premenstrual Syndrome, 171, 277 Prenatal, 249, 277 Prevalence, 13, 32, 33, 46, 186, 270, 277 Primary Prevention, 19, 26, 27, 33, 39, 277 Progesterone, 119, 247, 277, 285 Progression, 9, 15, 40, 109, 232, 277 Progressive, 22, 147, 239, 241, 246, 248, 257, 268, 277, 280 Projection, 269, 277 Prolapse, 180, 277 Promoter, 36, 277 Prone, 149, 277 Prospective study, 37, 41, 42, 82, 277 Prostaglandins, 231, 277 Prostate, 9, 17, 29, 34, 156, 236, 277, 288 Protease, 277, 287 Protein C, 109, 134, 231, 234, 264, 277, 289 Protein S, 167, 236, 255, 277, 281 Proteins, 117, 120, 132, 137, 141, 148, 160, 164, 168, 169, 231, 232, 233, 234, 236, 239, 240, 241, 242, 243, 245, 267, 269, 271, 272, 273, 275, 277, 278, 279, 283, 288 Protein-Tyrosine Kinase, 255, 278 Proteolytic, 55, 231, 243, 252, 275, 278, 287, 289 Protocol, 26, 39, 184, 278 Protons, 259, 278, 279 Protozoa, 107, 119, 248, 267, 278 Pruritic, 246, 278 Pruritus, 70, 278, 289 Psychomotor, 246, 269, 278 Psyllium, 24, 29, 86, 87, 95, 102, 112, 131, 199, 278 Public Health, 9, 17, 19, 23, 24, 27, 37, 87, 89, 167, 195, 198, 278 Public Policy, 193, 278 Publishing, 40, 161, 162, 163, 170, 176, 207, 210, 278 Pulmonary, 236, 244, 250, 278, 286, 290 Pulmonary Artery, 236, 278, 290 Pulse, 267, 278 Pupil, 247, 268, 278 Purgative, 249, 263, 278 Purifying, 112, 121, 143, 278 Purines, 278, 283, 291 Purulent, 229, 278, 290 Pylorus, 149, 279 Q Quality of Life, 24, 31, 39, 124, 186, 279 R Radiation, 249, 253, 254, 279, 291

Radiation therapy, 253, 279 Radioactive, 236, 259, 269, 279 Radiolabeled, 72, 279 Random Allocation, 279 Randomization, 12, 32, 279 Randomized Controlled Trials, 38, 279 Reactive Oxygen Species, 41, 279 Reagent, 279, 288 Receptor, 9, 18, 233, 244, 270, 273, 279, 283 Reconstitution, 116, 279 Rectal, 6, 40, 53, 86, 88, 148, 169, 175, 180, 184, 211, 216, 280 Rectal Prolapse, 184, 280 Recurrence, 26, 39, 40, 43, 93, 184, 280 Red blood cells, 250, 280 Reductase, 34, 280 Refer, 1, 148, 237, 243, 253, 264, 269, 280, 290 Reflex, 149, 280 Reflux, 209, 218, 280 Refraction, 280, 285 Regeneration, 279, 280 Regimen, 20, 145, 209, 248, 280 Registries, 29, 280 Regurgitation, 257, 280 Rehydration, 8, 160, 280 Rehydration Solutions, 8, 280 Relative risk, 6, 280 Remission, 72, 280 Renal failure, 109, 110, 246, 280 Renal pelvis, 263, 280 Resection, 26, 281 Respiration, 117, 238, 267, 281 Resting metabolic rate, 20, 281 Restoration, 279, 280, 281 Retina, 270, 281 Retinoids, 281, 291 Rheumatoid, 271, 281 Riboflavin, 161, 281 Ribose, 133, 229, 281 Ribosome, 281, 288 Rickets, 154, 281, 291 Rigidity, 275, 281 Risk factor, 10, 13, 18, 26, 30, 37, 68, 95, 124, 134, 173, 180, 181, 208, 209, 277, 280, 281 Rod, 241, 281 Rotavirus, 120, 281 Rubber, 180, 229, 281 Rural Population, 11, 282 Rye, 115, 137, 169, 170, 241, 250, 282

304 Dietary Fiber

S Salicylate, 240, 282 Saline, 176, 282 Saliva, 282 Salivary, 114, 247, 282 Salivary glands, 247, 282 Sapogenins, 119, 282 Saponin, 282 Satellite, 165, 282 Saturated fat, 7, 16, 26, 29, 30, 37, 62, 134, 161, 162, 174, 202, 203, 205, 207, 210, 215, 282 Screening, 14, 33, 38, 145, 169, 208, 211, 242, 282 Seafood, 162, 282 Secretion, 27, 147, 258, 261, 263, 268, 282, 283 Secretory, 173, 282 Sedentary, 281, 282 Seizures, 246, 282 Selenium, 161, 282 Self Care, 169, 282 Sella, 274, 282 Semen, 277, 283 Semisynthetic, 232, 283 Senile, 271, 283 Sepsis, 235, 283 Septic, 119, 283 Serine, 283, 287 Serotonin, 270, 283 Sex Characteristics, 230, 232, 283, 287 Shock, 147, 253, 283, 288 Side effect, 7, 117, 128, 171, 213, 230, 259, 283, 287 Sigmoid, 169, 283 Sigmoid Colon, 169, 283 Sigmoidoscopy, 211, 216, 283 Signs and Symptoms, 169, 175, 177, 280, 283, 289 Simethicone, 186, 218, 283 Sitz Bath, 216, 283 Skeletal, 21, 232, 241, 245, 283, 284 Skeleton, 283 Smooth muscle, 237, 258, 284, 286 Sneezing, 186, 284 Social Environment, 279, 284 Social Support, 11, 28, 32, 284, 285 Sodium, 23, 108, 114, 124, 161, 162, 163, 184, 202, 203, 205, 207, 210, 213, 215, 256, 284 Sodium Compounds, 284 Sodium Glutamate, 284

Sodium, Dietary, 207, 284 Solvent, 115, 116, 143, 153, 157, 235, 251, 256, 270, 284 Somatic, 230, 267, 284 Sonogram, 284, 288 Sound wave, 284, 288 Soybean Oil, 23, 276, 284 Spasm, 233, 284 Spastic, 100, 262, 284 Specialist, 208, 219, 247, 284 Species, 240, 250, 254, 257, 259, 267, 272, 279, 284, 288, 290, 291 Specificity, 18, 230, 285 Spectrum, 6, 164, 285 Sperm, 232, 241, 285 Sphincter, 280, 285 Spices, 162, 285 Spinal cord, 240, 241, 268, 280, 285 Spleen, 154, 235, 265, 285 Stabilizer, 108, 238, 285 Steatosis, 252, 285 Steel, 241, 285 Steroid, 19, 42, 63, 126, 175, 235, 247, 276, 282, 285 Stimulant, 176, 237, 258, 285 Stimulus, 81, 263, 280, 285, 287 Stomach Ulcer, 209, 285 Stress, 7, 110, 169, 176, 185, 201, 204, 208, 216, 253, 254, 262, 268, 271, 276, 282, 285 Stress management, 169, 285 Stroke, 4, 12, 192, 203, 238, 285 Stupor, 263, 286 Styrene, 282, 286 Subacute, 200, 261, 286 Subclinical, 261, 282, 286 Subcutaneous, 264, 272, 286, 290, 291 Substance P, 236, 279, 282, 286 Substrate, 106, 250, 286 Suction, 252, 286 Sulfur, 186, 266, 286 Supplementation, 5, 24, 38, 42, 76, 95, 98, 135, 157, 184, 286 Support group, 160, 286 Suppositories, 176, 255, 286 Suppression, 142, 145, 146, 286 Surfactant, 110, 126, 286 Sympathomimetic, 250, 269, 286 Symphysis, 277, 286 Symptomatic, 42, 272, 286 Systemic, 107, 235, 236, 238, 246, 250, 261, 279, 286 Systolic, 38, 259, 286

Index 305

T Tenesmus, 248, 286 Testicular, 34, 286 Testis, 251, 286 Testosterone, 9, 17, 34, 280, 286 Therapeutics, 56, 287 Thermal, 115, 287 Third Ventricle, 259, 287 Thorax, 229, 287 Threshold, 259, 287 Thrombin, 252, 275, 277, 287 Thrombolytic, 275, 287 Thrombomodulin, 277, 287 Thrombosis, 277, 285, 287 Thyroid, 20, 262, 272, 287, 289 Time Management, 285, 287 Tissue Plasminogen Activator, 13, 287 Tolerance, 21, 24, 255, 287 Tonic, 154, 287 Tooth Loss, 12, 287 Topical, 251, 273, 287 Toxic, iv, 111, 120, 235, 241, 260, 282, 286, 287 Toxicity, 107, 248, 249, 287 Toxicology, 22, 35, 59, 77, 79, 194, 287 Toxins, 117, 233, 261, 288 Trace element, 64, 131, 132, 160, 164, 173, 241, 288 Trachea, 237, 274, 287, 288 Traction, 241, 288 Transfection, 36, 236, 288 Transfusion, 251, 288 Translation, 130, 155, 288 Translocating, 235, 288 Transmitter, 229, 266, 269, 288 Transplantation, 241, 260, 288 Transrectal ultrasound, 34, 288 Trauma, 180, 246, 257, 268, 272, 288 Trees, 281, 288 Tributyrin, 13, 288 Triglyceride, 13, 21, 39, 109, 259, 288 Trinitrobenzenesulfonic Acid, 51, 288 Tuberculosis, 244, 288 Tumor marker, 236, 288 Tumor Necrosis Factor, 51, 288 Type 2 diabetes, 32, 44, 46, 50, 76, 94, 98, 160, 161, 170, 174, 175, 289 Tyrosine, 239, 263, 278, 289 U Ulcer, 273, 285, 289 Ulcerative colitis, 72, 173, 175, 200, 208, 261, 289

Unconscious, 232, 260, 289 Uraemia, 272, 289 Urea, 25, 117, 236, 289 Uremia, 203, 280, 289 Ureters, 263, 289 Urethra, 277, 289 Uric, 256, 259, 278, 289 Urinary, 22, 26, 34, 81, 171, 175, 238, 255, 260, 287, 289, 291 Urinary Plasminogen Activator, 287, 289 Urinary tract, 175, 289 Urinary tract infection, 175, 289 Urine, 22, 25, 34, 128, 150, 236, 238, 244, 245, 248, 260, 263, 271, 280, 281, 289 Urogenital, 255, 289 Ursodeoxycholic Acid, 47, 55, 289 Uterus, 240, 245, 249, 260, 266, 271, 277, 290 V Vaccine, 230, 278, 290 Vagina, 238, 240, 266, 290 Vaginal, 107, 290 Vaginitis, 238, 290 Vascular, 175, 249, 261, 269, 274, 275, 290 Vasculitis, 272, 290 Vasoconstriction, 250, 290 Vasodilators, 269, 290 Vein, 28, 262, 269, 282, 290 Venous, 41, 258, 277, 290 Ventricle, 278, 286, 287, 290 Vesicular, 246, 290 Vestibular, 213, 290 Vestibule, 290 Veterinary Medicine, 154, 193, 290 Villous, 239, 290 Villus, 168, 290 Viral, 12, 175, 207, 258, 290 Viral Hepatitis, 175, 258, 290 Virulence, 234, 287, 290 Virus, 290 Visceral, 21, 273, 290 Visceral fat, 21, 290 Viscosity, 108, 111, 115, 122, 134, 138, 142, 143, 290 Vitamin A, 159, 164, 290 Vitamin D, 135, 281, 291 Vitro, 167, 291 Vivo, 53, 95, 291 Volition, 262, 291 W Waist circumference, 16, 291 Wakefulness, 246, 291

306 Dietary Fiber

War, 3, 268, 291 Weight Gain, 19, 39, 50, 51, 95, 161, 204, 251, 291 White blood cell, 233, 250, 264, 265, 268, 275, 291 Windpipe, 274, 287, 291 Withdrawal, 246, 291

X Xanthine, 87, 89, 291 Xanthine Oxidase, 87, 89, 291 Xenograft, 232, 291 X-ray, 204, 239, 254, 268, 269, 279, 285, 291 Y Yeasts, 238, 253, 254, 262, 291 Z Zymogen, 277, 291

Index 307

308 Dietary Fiber