RO C ZN . PZH , 2000, 51. N R 2, 141-147
M ARIA BORAW SKA, A N N A WITKOWSKA, R EN ATA M ARKIEW ICZ, K A TA RZYN A H U K AŁO W IC Z
T H E E V A L U A T IO N O F T O T A L D IE T A R Y F IB R E C O N T E N T IN S T A N D A R D H O S P IT A L D IE T S D U R I N G T H E W I N T E R A N D S U M M E R
S E A S O N S
O CEN A ZA W A RTOŚCI BŁONNIKA PO K A R M O W EG O
W STA N D AR D OW Y CH D IETA C H SZPITALNYCH W O K R ESIE ZIM OW YM I LETNIM
Samodzielna Pracownia Bromatologii Akadem ia Medyczna w Białymstoku,
15-230 Białystok, ul. Kilińskiego 1 Kierownik: dr hab. M. Borawska
The main aim o f the study was to determine the total dietary fiber in standard diets fo r hospitalized patients in winter and summer. In the randomized trial performed in the winter o f 1995/1996 and summer 1997, we assessed the dietary fiber content in 12 standard diets with A O A C method. We also made a simula tion, where white bread, present in every diet, was replaced by dark bread. The change induced statistically significant differences between diets containing white bread and dark bread (p < 0.001).
IN TR O D U CTIO N
R e g u la r s u p p le m e n ta tio n in en erg y , n u tritiv e e le m e n ts a n d d ie ta ry fib e r in fo o d , esp ec ially in th e d ie ts o f p a tie n ts in p u b lic h o sp itals, m ay so m e tim e s b e p ro b le m a tic a l. It m ain ly d e p e n d s o n th e a m o u n t o f m oney a llo tte d daily fo r e a ch p a tie n t. A c c o rd in g to T h e W o rld H e a lth O rg a n iz a tio n th e d ie t sh o u ld p ro v id e 2 7 -4 0 g o f d ie ta ry fib e r p e r day [7]. T h is is c o n s id e re d as an o p tim a l a m o u n t to p re v e n t so m e g a s tro in te s tin a l d ise ase s, a th e ro sc le ro sis, c o ro n a ry h e a rt d ise ase a n d d ia b e te s [2, 3, 4, 5, 6]. T h e co m p o sitio n o f th e m eals in p u b lic b o a rd in g in stitu tio n s is e s ta b lish e d by d ie te tic ia n s a c c o rd in g to th e n a tio n a l index o f co m p o sitio n a n d n u tritiv e v alu es o f fo o d p ro d u c ts.
T h e goal o f o u r stu d y w as to e s tim a te th e to ta l d ie ta ry fib e r in s ta n d a rd d ie ts p r e p a re d in w in te r a n d s u m m e r fo r p a tie n ts in a c e rta in te a c h in g h o sp ital. B e ca u se g ra in p ro d u c ts w e re p ro v id e d in every h o sp ital d ie t, w e also sim u la te d a c h a n g e in to ta l d ie ta ry fib e r in d u c e d by r e p la c e m e n t o f w h ite b r e a d fo r d a rk b re a d . T h is le t us d e te r m in e th e d e g re e to w hich th e a lte rn a tiv e fo o d p ro d u c t in flu e n c e s th e d ie t’s c o m p o sitio n .
142 M. Borawska i in. N r 2
MATERIAL AND METHODS
Food samples were collected from one of the major hospitals in the city of Białystok: 6 samples in the winter - the time period from December 1995 to January 1996 and 6 samples in summer - from June to July 1997. Tested material consisted of normal hospital diets for adults which were composed of breakfast, dinner, afternoon meal and supper taken from the “patient’s plate”. Products were divided into three main sources of fiber: grains, vegetables and fruits. Diets were homogenized and oven-dried at a temp. 700°C.
Six samples of commercially baked dark bread, which were prepared from wholemeal rye flour were sliced into slices of 7 x 8 x 0.7 cm. Six samples of white bread (made from fine wheat and rye flours), available in the shops, were cut into slices of size 8 x 12 x 0.7 cm. Both kinds of bread samples were oven-dried at temperature 105°C.
Dried products were ground with a commercial mill and stored in a desiccator. Subsequently, the material was defatted with petroleum ether. The loss of weight was recorded for final correction of total dietary fiber content. The samples were examined with Association of Official Analytical Chemists method [1] in duplicate.
All statistical calculations were based on the software statistical program Statistica v.5.0. and Student’s T-test was performed for dependent and independent samples to estimate the p value.
RESULTS AND DISCUSSION
T a b le I show s th e re su lts o f to ta l d ie ta ry fib e r d e te r m in a tio n in w h ite b re a d a n d d a r k b re a d .
T a b l e I . Mean total dietary fibre content (g/100 g) in white bread and dark bread
T h is p a r t o f m a te ria l allo w ed us to e s tim a te to ta l d ie ta ry fib e r c o n te n ts in w h ite b re a d , w hich w as an ev ery d ay c o m p o n e n t o f th e te s te d h o sp ita l d ie ts, a n d to ta l d ie ta ry f ib e r c o n te n t in d a r k b re a d , w hich s u b s titu te d th e w h ite b r e a d in s im u la te d c h a n g e s o f o n e k in d o f b r e a d to a n o th e r . M e a n fib e r c o n te n t in w h ite b r e a d a m o u n ts 4.58g/100g, a n d 9.53g/100g in d a r k b re a d . S tu d e n t’s T -te s t d isp lay e d sig n ific an t d istin c tio n in d a r k b re a d in c o m p a riso n to w h ite b re a d (p < 0.001). T h e s e re su lts d e m o n s tra te d th a t d a rk b r e a d is a very g o o d fib e r-ric h p r o d u c t a n d ca n b e u se d to in c re a se th e d ie ta ry fib e r c o n te n t in th e n o rm a l d ie t, esp ecially in th e d ie t o f h o sp ita liz e d p a tie n ts.
T h e d e te rm in e d m e a n d ie ta ry fib e r c o n te n ts (Fig. 1) in e x a m in e d h o sp ita l daily d ie ts ra n g e d :
- in w in te r fro m 16.9 to 35.4 g /d ie t (m e a n v a lu e 27.5), - in s u m m e r fro m 21.4 to 33.9 g /d ie t (m e a n 26.2).
A f te r th e re p la c e m e n t o f w h ite to d a r k b re a d , th e re su lts v a rie d resp ectiv ely : - in w in te r fro m 25.4 to 47.9 g /d ie t,
- in s u m m e r fro m 33.3 to 47.4 g/d iet.
W e o b se rv e d th e p re s e n c e o f a sta tistica lly sig n ific an t d iffe re n c e b e tw e e n th e to ta l d ie ta ry fib e r in th e a n a ly z ed daily d ie ts a n d sim u la te d c h a n g e o f w h ite b re a d to d a r k b r e a d (p < 0.001). T h e g r e a te r a m o u n t o f fib e r in d a r k b re a d th a n in w h ite b re a d c a u se s a sig n ific an t in c re a se o f d ie ta ry fib er, w h a t w as show n by th e sim u la tio n .
N r 2 Błonnik całkowity w diecie 145
T h e to ta l d ie ta ry fib e r c o n te n ts in h o sp ita l d ie ts (Fig. 2), w e re ex p re sse d in g/day fo r in d iv id u al g ro u p s o f p ro d u c ts (g rain s, v eg e ta b les, fru its). T h e d ie ta ry fib e r in th e te s te d h o sp ita l d ie ts w as d e riv e d m ainly fro m g rain s - a v e ra g e v alu e 12.2 g/day in w in te r a n d 15.8 g/day in su m m e r. T h e se co n d g ro u p o f p la n t p ro d u c ts to su p p ly fib er in th e d ie t w e re v eg e ta b les. F o o d p o rtio n s c o v e red a n a v e ra g e o f 11.5 g d ie ta ry fib e r p e r d a y in w in te r a n d 8.5 g in su m m e r. In sp ite o f th e v ariety o f c h e a p v e g e ta b le s on sale, a significantly low er c o n te n t o f fib er w as o b se rv e d in s u m m e r (p < 0.05). F ru its a n d fru it p ro d u c ts in h o sp ita l fo o d c o n ta in e d 1.4 g/day o f fib e r in w in te r a n d 1.7g/day in s u m m e r resp ectiv ely .
A c c o rd in g to th e list o f p ro d u c ts, d eliv e re d fro m th e h o sp ita l sto re s fo r p re p a rin g m eals, a g r e a te r m e a n w eig h t o f fib e r-c o n ta in in g p ro d u c ts (g ra in s, v e g e ta b le s a n d fru its) w as fo u n d in th e w in te r d ie t - o n an av e ra g e o f 1040 g/day in c o n tra s t to s u m m e r - 890 g/day. C o n c e rn in g th e m e a n d ie ta ry fib e r c o n te n t a n d th e m e a n w eig h t o f th e d ie ts, th e d ie ta ry fib e r w as rela tiv e ly d e c re a s e d in w in te r - 2.6 g o n 100 g th a n in su m m e r - 2.9 g/100 g. In o u r stu d y w e o b se rv e d th a t th e te s te d h o sp ita l d ie ts w e re u n v a rie d in so u rc e s o f d ie ta ry fib e r in d e p e n d e n t o f th e se aso n . G ra in p ro d u c ts w e re se rv e d a t m o st o f th e m e als, b u t v e g e ta b le s only fo r d in n e r. G ra in s w e re r e p r e s e n te d m ain ly in b re a d , g ro a ts a n d n o o d le s. V e g e ta b le s w e re th e m o st v a rie d g ro u p o f fo o d p ro d u c ts , w h e re a s p o ta to e s w e re se rv e d fre q u e n tly . A lso b e e tro o ts , c a b b a g e an d c a rro ts w e re se rv e d d u rin g b o th se a so n s, a n d se a so n a l v e g e ta b le s ( le ttu c e , to m a to e s ) only in su m m e r. F ru its w e re m ainly fo r b re a k fa s t in th e fo rm o f ja m , o r in w in te r d ie ts fo r d in n e r as c o n g e a le d c u rra n ts in d rin k s. F re s h a p p le s w e re s o m e tim e s se rv e d fo r a fte rn o o n m e a ls d u rin g b o th se aso n s.
O u r te s tin g also h as show n th a t th e re w as n o t a c o n sid e ra b ly g re a t d iffe re n c e b e tw e e n th e p e r c e n ta g e p r o p o rtio n in d ie ta ry fib e r c o n te n t in in d iv id u al fo o d stu ffs. H o w e v e r s u m m e r d ie ts c o n ta in e d less fib e r fro m v e g e ta b le s a n d fru its th a n w in te r d iets. F u rth e rm o re , a b o u t 30 % o f g rain s su p p lie d by th e h o sp ita l sto re s m ay m e e t th e d ie ta ry fib e r r e q u ir e m e n t ra n g in g fro m a b o u t 50 to 60% . T h is o b se rv a tio n show s th a t g rain s a re a la rg e g ro u p o f p ro d u c ts w hich m ay in flu e n c e to a g r e a t e x te n t d ie ta ry fib e r c o n te n ts o f daily fo o d ra tio n s in h o sp itals.
CONCLUSIONS
T h e re su lts d e m o n s tr a te th a t th e re p la c e m e n t ev eryday o f e a te n fo o d p ro d u c ts m ay ev o k e sig n ific an t c h a n g e s in d ie ta ry fib er c o n te n ts . It is only th e re p la c e m e n t o f th e o n e c o m p o n e n t o f th e daily m e a ls m ay in flu e n ce th e w h o le d ie t c o m p o sitio n a n d e n h a n c e th e a d v e n ta g e o u s in flu e n c e o f fib er-ric h p ro d u c ts to th e h e a lth a n d w ell-b e in g o f th e h o sp ita l p a tie n ts . O bviously, w e have show n only th e ex a m p le o f p o ssib le c h a n g e s in h o sp ita l n u tritio n . In so m e c a se s o f sim u la tio n , th e d ie ta ry fib e r c o n te n ts ex ceed r e c o m m e n d e d daily allo w an ces. H o w ev er, an easy way to in c re a se th e d ie ta ry fib e r c o n te n ts in th e n o rm a l d ie t, in th is case, is to en ric h h o sp ital m e als in p ro d u c e . A s w e fo u n d , th e asse sse d daily c o n te n ts o f d ie ta ry fib e r in th e te s te d h o sp ita l d ie ts w ere c a lc u la te d co rre c tly , h o w ev e r th e c o m p o sitio n o f th e m e a ls sh o u ld b e im p ro v e d . V e g e ta b le s a n d fru its o u g h t to b e serv ed a t a g re a te r n u m b e r o f m eals. U ltim a te ly , th e so u rc e s o f th e d ie ta ry fib e r in th e te ste d d ie ts n e e d to b e m o re v a rie d , in p a rtic u la r in fo o d s c o n ta in in g so lu b le fib er, such as fru its an d le g u m in o u s p la n ts.
146 M. Borawska i in. N r 2
T H E E V A LU A TIO N O F TO TA L D IETA R Y FIB R E C O N TEN T IN STA N D AR D H O SPITA L DIETS D U R IN G T H E W IN TER AN D SU M M ER SEASONS
Summary
The main aim of the study was to determ ine the total dietary fiber in standard diets for hospitalized patients in winter and summer. In the randomized trial perform ed in the winter of 1995/1996 and sum m er 1997, we assessed the dietary fiber content in 12 standard diets with A O A C m ethod. The dietary fiber in the tested hospital diets was derived mainly from grains - average value 12.2g/day in winter and 15.8g/day in summer. The second group of plant products to supply fiber in the diet were vegetables. Food portions covered an average of 11.5g dietary fiber per day in winter and 8.5g in summer. In spite of the variety of cheap vegetables on sale, a significantly lower content of fiber was observed in sum m er (p < 0.05). Fruits and fruit products in hospital food contained 1.4g/day of fiber in winter and 1.7g/day in sum m er respectively.
W e also made a simulation, where white bread, present in every diet, was replaced by dark bread. This let us determ ine the degree to which the alternative food product influences the diet’s composition. The results dem onstrate that the replacem ent everyday of eaten foodproducts may evoke significant changes in dietary fiber contents. The change induced statistically signi ficant differences between diets containing white bread and dark bread (p < 0.001).
M . B o r a w s k a , A . W i t k o w s k a , R . M a r k i e w i c z , K. H u k a ł o w i c z
M . B o r a w s k a , A . W i t k o w s k a , R . M a r k i e w i c z , К . H u k a ł o w i c z O C EN A ZAW A RTOŚCI BŁONNIKA PO K A RM O W EG O W STA N D A R D O W Y CH
D IETA C H SZPITALNYCH W O K R ESIE ZIM OW Y M I LETNIM
Streszczenie
Celem badań było oznaczenie zawartości błonnika pokarmowego m etodą A O A C w 12 standardowych dietach szpitalnych w okresie zimowym na przełomie roku 1995/1996 i w okresie letnim w roku 1997. Najwyższą średnią zawartość błonnika pokarmowego wykazano w produk tach zbożowych - 12,2 g/dzień w dietach zimowych i 15,8 g/dzień w dietach w okresie letnim. Warzywa dostarczały 11,5 g/dzień błonnika pokarmowego zimą i 8,5 g/dzień latem. Owoce i ich przetwory dostarczały średnio 1,4 g błonnika dziennie w diecie zimą i 1,7 g/dzień w lecie. Pomimo większej dostępności w sprzedaży tanich warzyw, stwierdzono znamiennie niższą zawar tość błonnika pokarmowego w dietach letnich (p < 0,05).
Wykazano, że symulowana zamiana białego pieczywa na razowe powoduje znamienny wzrost zawartości błonnika pokarmowego w diecie (p < 0,001).
R EFEREN CES
1. A O A C M ethod 985.29. Total Dietary Fibre in Foods. Enzymatic-Gravimetric M ethod. Official M ethods of Analysis, 15th Ed. AOAC, Arlington, VA, 1990, vol. II, sec. 985.29, 1105.
2. Durrington P.N., Manning A.P., Bolton C.H., Hartog М.: Effects of pectin on serum lipids and lipoproteins, whole gut transit time and stool weight. Lancet 1976, 2, 394-396.
3. Guevin N.. Jacques //., Nadeau A., Galibois I.: Postprandial glucose, insulin, and lipid responses to four meals containing unpurified dietary fiber in non-insulin-dependent diabe tes mellitus (N ID D M ), hypertriglyceridemic subjects. J. Am. Coll. Nutr. 1996, 15, 389-396.
Btonnik całkowity w diecie 147 4. Kritchevsky D., Tepper S.A.: Influence of dietary fiber on establishment and progression of
atherosclerosis in rabbits. J. Nutr. Biochem. 1995, 6, 509-512.
5. Pietinen P., Rim m E.B., Korhonen P., Hartman A.M., Willett W.C., Albanes D., Virtamo J.: Intake o f dietary fiber and risk of coronary heart disease in a cohort of Finnish men. Circulation 1996, 94, 2720-2727.
6. Roberts D.C., Tmswell A.S., Bencke A., Dewar H.M., Farmakaiidis E .: The cholesterol-low ering effect of a breakfast cereal containing psyllium fibre. Med. J. Aus. 1994, 161, 660-664. 7. W H O Reports: R eports No 797, Geneva 1990.
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