(P19-008-23) Physiological Effects of Isolated or Synthetic Fiber in Children: A Scoping Review

Objectives: This scoping review aims to analyze and integrate the available evidence on the physiological impact of synthetic or isolated fiber consumption on health outcomes in children.

Methods: We conducted a systematic search in Ovid Medline, Ovid Global Health, Embase, and Cochrane Library via Wiley aimed at identifying randomized controlled trials (RCTs) in children aged 1-18 years with varying health statuses at baseline who consumed isolated or synthetic dietary fiber. Exclusion criteria included if the fiber exposure was derived from foods or infant formula. Our search covered a range of databases, and a gray literature search targeting relevant work in progress was also performed. The outcomes of interest were categorized based on the FDA's Guidance for Industry on non-digestible carbohydrates and the Vahouny Fiber Symposium criteria, which included reduced fasting blood, total and/or LDL cholesterol levels, attenuation of postprandial glycemia/insulinemia, increased fecal bulk/laxation, reduced transit time, weight loss/reduction in adiposity, reduced energy intake from food consumption, increased satiety, bone health/enhanced mineral absorption, blood pressure.

Results: Of 3,338 studies screened at the abstract level, 190 were eligible for full-text review, and 76 were included for data extraction. Most studies were parallel designs (59%). This scoping review presents an analysis of data from 31 fiber RCTs in children who were healthy (n=21), overweight/obese (n=5), or had mild hypercholesterolemia (n=5). Inulin-type fructans (45%) and psyllium (19%) were the most frequently administered fiber types, with weight/adiposity (39%), markers of lipid metabolism (35%), and bone-related markers (32%) being the most frequently reported health outcomes. Only a few RCTs have investigated the effects of laxation (10%), and none have specifically studied the impact of fiber on reducing postprandial glycemia/insulinemia.

Conclusions: This scoping review demonstrates sufficient evidence for conducting systematic reviews and meta-analyses for several outcomes. Future research should also focus on the impact of isolated fibers on outcomes such as laxation and postprandial glycemia/insulinemia in children.

Funding Sources: The Institute for the Advancement of Food and Nutrition Sciences