Background Higher dietary fibre intakes are associated with a reduced risk of developing cardiovascular disease (CVD), and increasing intake has been shown to reduce blood pressure and other cardiometabolic risk factors. The extent to which dietary fibre can further reduce risk for those with CVD and treated with cardioprotective drugs has not been clearly established. We have examined the evidence for dietary fibre as adjunct therapy in those with CVD or hypertension. Methods Ovid MEDLINE, Embase, PubMed, and CENTRAL were searched to June 2021. Prospective observational studies reporting on fibre intakes and mortality in those with pre-existing CVD and controlled trials of increasing fibre intakes on cardiometabolic risk factors in those with CVD or hypertension were eligible. Outcomes were mortality (studies) and cardiometabolic risk factors (trials). Data synthesis was with random effects and dose response. Certainty of evidence was assessed using GRADE. Results Three prospective studies including 7469 adults with CVD, and 12 trials of 878 adults with CVD or hypertension were identified. Moderate certainty evidence indicates reduced all-cause mortality (relative risk, RR0.75 (95% confidence interval, CI 0.58–0.97)) when comparing higher with lower fibre intakes. Low certainty evidence from trials of adults with cardiovascular disease indicates increasing fibre intakes reduced total (mean difference, MD − 0.42 mmol/L (95%CI − 0.78 to − 0.05) and low-density lipoprotein (LDL) cholesterol (MD − 0.47mmol/L (95%CI − 0.85 to − 0.10)). High certainty evidence from trials of adults with hypertension indicates increasing fibre intakes reduces systolic (MD 4.3 mmHg (95% CI 2.2 to 5.8)) and diastolic blood pressure (MD 3.1 mmHg (95% CI 1.7 to 4.4)). Moderate and low certainty evidence indicated improvements in fasting blood glucose (MD 0.48 mmol/L (− 0.91 to − 0.05)) and LDL cholesterol (MD 0.29 mmol/L (95% CI 0.17 to 0.40)). Benefits were observed irrespective of cardioprotective drug use. Conclusions These findings emphasise the likely benefits of promoting greater dietary fibre intakes for patients with CVD and hypertension. Further trials and cohort analyses in this area would increase confidence in these results.

Aim: To determine whether higher fibre intakes during childhood or adolescence effect a broad range of intermediate markers of cardiometabolic risk or other health related issues. Materials and Methods: We used online searches up to January 2020 and manual searches to identify prospective observational studies reporting on childhood or adolescent intakes of dietary fibre, vegetables, fruit and refined or whole grains. Outcomes measured later in life were body weight, blood lipids, blood pressure, glycaemia, bone health, cognition, growth and bowel habits. Potential age-specific ranges for dietary fibre were extrapolated from published adult data. Results: We identified 45 publications reporting on 44 354 participants from 30 cohort studies. Mean age at dietary assessment varied from 1 to 19.3 years. Follow-up duration varied from 4 months to 27 years. Although well-conducted studies reported improvements in body weight, blood lipids and glycaemia, the diverse nature of studies precluded meta analysis. The quality of evidence was very low to low given the limited data available per outcome and the inability to synthesize results from multiple studies. Potential dietary fibre intake begins at 13-16 g a day for 2-year-olds and increases until the age of 10 years, when values are comparable with an adult range of 25-30 g a day. Conclusions: Given the inconsistency in findings from cohort studies other than an absence of detrimental effects, it seems appropriate that recommendations regarding childhood fibre intake are extrapolated from relevant adult data.

We compared hunger and satiety outcomes following two-week interventions of less or more processed wholegrain foods.

Objectives Research suggests that high adherence to Mediterranean dietary pattern significantly improve depression and anxiety symptoms. Thus, the objective was to utilize the novel and validated Mediterranean Diet Serving Score (MDSS) method to assess habitual intake of a study cohort, which evaluated SunGold® kiwifruit and psyllium powder interventions, against the Mediterranean diet recommendations. The link between the MDSS and mental wellbeing were then explored. Methods The project's data was collected during the randomized cross-over controlled trial Christchurch Irritable Bowel Syndrome cohort to investigate mechanisms for gut relief and improved transit - Psyllium and Kiwifruit translation study (COMFORT-PSYKI). Participants were randomized into two interventions: psyllium powder or SunGold® kiwifruit. MDSS was evaluated from dietary records with the recommended serving sizes obtained from the New Zealand Food Composition Database. Depression and anxiety score were collected through the Patient-Reported Outcomes Measurement Information System (PROMIS) survey. Results The habitual diet of the participants (n = 45, mean age 39 ± 15 years) had a low MDSS (mean 5.04 ± 2.38, out of 24 points) when compared against the Mediterranean pyramid recommendations. Their MDSS improved with daily consumption of two SunGold® kiwifruit significantly (mean 6.27 ± 2.81, P-value < 0.05) compared to Psyllium powder (mean 5.58 ± 3.05, P-value = 0.906). Moreover, mean depression (42.33 ± 6.08, P-value) and anxiety (43.24 ± 7.71) scores were reported lower with the higher MDSS of SunGold® intervention at 42.33 ± 6.08 (P-value = 0.315) and 43.24 ± 7.71 (P-value = 0.906), respectively. Conclusions This project suggests that consuming two SunGold® kiwifruit daily could significantly enhance participants’ habitual diet to meet the Mediterranean diet recommendations and healthy eating guideline. This improvement could potentially lead to a reduction in depression and anxiety symptoms. The feasibility of the novel MDSS method was also demonstrated to be suitable for dietary pattern assessment among adult New Zealanders. Future investigations are warranted to confirm the association between dietary pattern and mental wellbeing. Funding Sources This project was funded by Zespri International Limited (Zespri) and Callaghan Innovation R&D Experience Grant.