From the Academy Position Paper| Volume 115, ISSUE 11, P1861-1870, November 2015

Download started.


Position of the Academy of Nutrition and Dietetics: Health Implications of Dietary Fiber

Published:October 26, 2015DOI:


      It is the position of the Academy of Nutrition and Dietetics that the public should consume adequate amounts of dietary fiber from a variety of plant foods. Dietary fiber is defined by the Institute of Medicine Food Nutrition Board as “nondigestible carbohydrates and lignin that are intrinsic and intact in plants.” Populations that consume more dietary fiber have less chronic disease. Higher intakes of dietary fiber reduce the risk of developing several chronic diseases, including cardiovascular disease, type 2 diabetes, and some cancers, and have been associated with lower body weights. The Adequate Intake for fiber is 14 g total fiber per 1,000 kcal, or 25 g for adult women and 38 g for adult men, based on research demonstrating protection against coronary heart disease. Properties of dietary fiber, such as fermentability and viscosity, are thought to be important parameters influencing the risk of disease. Plant components associated with dietary fiber may also contribute to reduced disease risk. The mean intake of dietary fiber in the United States is 17 g/day with only 5% of the population meeting the Adequate Intake. Healthy adults and children can achieve adequate dietary fiber intakes by increasing their intake of plant foods while concurrently decreasing energy from foods high in added sugar and fat, and low in fiber. Dietary messages to increase consumption of whole grains, legumes, vegetables, fruits, and nuts should be broadly supported by food and nutrition practitioners.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Institute of Medicine, Food Nutrition Board
        Dietary Reference Intakes for Energy, Carbohydrates, Fiber, Fat, Fatty acids, Cholesterol, Protein, and Amino Acids.
        The National Academies Press, Washington, DC2005
        • American Pediatric Association
        Breastfeeding and the use of human milk.
        Pediatrics. 2012; 129: e827-e841
        • Jeong K.
        • Nguyen V.
        • Kim J.
        Human milk oligosaccharides: The novel modulator of intestinal microbiota.
        BMB Rep. 2012; 45: 433-441
        • Butte N.F.
        • Fox M.K.
        • Briefel R.R.
        • et al.
        Nutrient intakes of US infants, toddlers, and preschoolers meet or exceed dietary reference intakes.
        J Am Diet Assoc. 2010; 110: S27-S37
        • US Department of Agriculture, US Department of Health and Human Services
        Dietary Guidelines for Americans, 2010.
        7th ed. US Government Printing Office, Washington DC2010
      1. US Department of Agriculture. Updated 2014. Accessed September 9, 2014.

      2. American Association of Cereal Chemists International (AACC). Definition of whole grain. Updated 2015. Accessed May 10, 2015.

      3. US Department of Agriculture, Agricultural Research Service. USDA national nutrient database for standard reference, release 27. Nutrient data laboratory home page. Updated 2014. Accessed November 13, 2014.

        • Reicks M.
        • Jonnalagadda S.
        • Albertson A.M.
        • Joshi N.
        Total dietary fiber intakes in the US population are related to whole grain consumption: Results from the national health and nutrition examination survey 2009 to 2010.
        Nutr Res. 2014; 34: 226-234
        • Westenbrink S.
        • Brunt K.
        • van der Kamp J.W.
        Dietary fibre: Challenges in production and use of food composition data.
        Food Chem. 2013; 140: 562-567
      4. US Department of Agriculture, Agricultural Research Services. Nutrient data: Frequently asked questions. Published 2014. Updated 2014. Accessed October 8, 2014.

        • Institute of Medicine, Food Nutrition Board
        Dietary Reference Intakes: Proposed definition of dietary fiber.
        The National Academies Press, Washington, DC2001
        • Threapleton D.E.
        • Greenwood D.C.
        • Evans C.E.
        • et al.
        Dietary fibre intake and risk of cardiovascular disease: Systematic review and meta-analysis.
        BMJ. 2013; 347: f6879
        • Ye E.Q.
        • Chacko S.A.
        • Chou E.L.
        • Kugizaki M.
        • Liu S.
        Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain.
        J Nutr. 2012; 142: 1304-1313
        • Cho S.S.
        • Qi L.
        • Fahey Jr., G.C.
        • Klurfeld D.M.
        Consumption of cereal fiber, mixtures of whole grains and bran, and whole grains and risk reduction in type 2 diabetes, obesity, and cardiovascular disease.
        Am J Clin Nutr. 2013; 98: 594-619
        • Ning H.
        • Van Horn L.
        • Shay C.M.
        • Lloyd-Jones D.M.
        Associations of dietary fiber intake with long-term predicted cardiovascular disease risk and C-reactive protein levels (from the national health and nutrition examination survey data [2005-2010]).
        Am J Cardiol. 2014; 113: 287-291
        • Yao B.
        • Fang H.
        • Xu W.
        • et al.
        Dietary fiber intake and risk of type 2 diabetes: A dose-response analysis of prospective studies.
        Eur J Epidemiol. 2014; 29: 79-88
        • Wannamethee S.G.
        • Whincup P.H.
        • Thomas M.C.
        • Sattar N.
        Associations between dietary fiber and inflammation, hepatic function, and risk of type 2 diabetes in older men: Potential mechanisms for the benefits of fiber on diabetes risk.
        Diabetes Care. 2009; 32: 1823-1825
      5. World Cancer Research Fund/American Institute for Cancer. Continuous update project report: Food, nutrition, and physical activity and the prevention of colorecal cancer. Published 2011. Updated 2011. Accessed October 8, 2014.

        • Park Y.
        • Subar A.F.
        • Hollenbeck A.
        • Schatzkin A.
        Dietary fiber intake and mortality in the NIH-AARP diet and health study.
        Arch Intern Med. 2011; 171: 1061-1068
        • Baer H.J.
        • Glynn R.J.
        • Hu F.B.
        • et al.
        Risk factors for mortality in the nurses' health study: A competing risks analysis.
        Am J Epidemiol. 2011; 173: 319-329
        • Buil-Cosiales P.
        • Zazpe I.
        • Toledo E.
        • et al.
        Fiber intake and all-cause mortality in the prevencion con dieta mediterranea (PREDIMED) study.
        Am J Clin Nutr. 2014; 100: 1498-1507
      6. Academy of Nutrition and Dietetics. Fiber evidence analysis project: Evidence analysis library website. Updated 2008. Accessed November 12, 2014.

        • Wu K.
        • Bowman R.
        • Welch A.A.
        • et al.
        Apolipoprotein E polymorphisms, dietary fat and fibre, and serum lipids: The EPIC Norfolk study.
        Eur Heart J. 2007; 28: 2930-2936
        • Ruottinen S.
        • Lagstrom H.K.
        • Niinikoski H.
        • et al.
        Dietary fiber does not displace energy but is associated with decreased serum cholesterol concentrations in healthy children.
        Am J Clin Nutr. 2010; 91: 651-661
        • Bradbury K.E.
        • Crowe F.L.
        • Appleby P.N.
        • Schmidt J.A.
        • Travis R.C.
        • Key T.J.
        Serum concentrations of cholesterol, apolipoprotein A-I and apolipoprotein B in a total of 1694 meat-eaters, fish-eaters, vegetarians and vegans.
        Eur J Clin Nutr. 2014; 68: 178-183
        • Bazzano L.A.
        • Thompson A.M.
        • Tees M.T.
        • Nguyen C.H.
        • Winham D.M.
        Non-soy legume consumption lowers cholesterol levels: A meta-analysis of randomized controlled trials.
        Nutr Metab Cardiovasc Dis. 2011; 21: 94-103
        • Goff L.M.
        • Cowland D.E.
        • Hooper L.
        • Frost G.S.
        Low glycaemic index diets and blood lipids: A systematic review and meta-analysis of randomised controlled trials.
        Nutr Metab Cardiovasc Dis. 2013; 23: 1-10
        • Dikeman C.L.
        • Fahey G.C.
        Viscosity as related to dietary fiber: A review.
        Crit Rev Food Sci Nutr. 2006; 46: 649-663
        • Gunness P.
        • Gidley M.J.
        Mechanisms underlying the cholesterol-lowering properties of soluble dietary fibre polysaccharides.
        Food Funct. 2010; 1: 149-155
        • Xu H.
        • Huang X.
        • Riserus U.
        • et al.
        Dietary fiber, kidney function, inflammation, and mortality risk.
        Clin J Am Soc Nephrol. 2014; 9: 2104-2110
        • Gaskins A.J.
        • Mumford S.L.
        • Rovner A.J.
        • et al.
        Whole grains are associated with serum concentrations of high sensitivity C-reactive protein among premenopausal women.
        J Nutr. 2010; 140: 1669-1676
        • Goletzke J.
        • Buyken A.E.
        • Joslowski G.
        • et al.
        Increased intake of carbohydrates from sources with a higher glycemic index and lower consumption of whole grains during puberty are prospectively associated with higher IL-6 concentrations in younger adulthood among healthy individuals.
        J Nutr. 2014; 144: 1586-1593
        • Vernay M.
        • Aidara M.
        • Salanave B.
        • et al.
        Diet and blood pressure in 18-74-year-old adults: The French Nutrition and Health Survey (ENNS, 2006-2007).
        J Hypertens. 2012; 30: 1920-1927
        • Gopinath B.
        • Flood V.M.
        • Rochtchina E.
        • Baur L.A.
        • Smith W.
        • Mitchell P.
        Influence of high glycemic index and glycemic load diets on blood pressure during adolescence.
        Hypertension. 2012; 59: 1272-1277
        • Dorgan J.F.
        • Liu L.
        • Barton B.A.
        • et al.
        Adolescent diet and metabolic syndrome in young women: Results of the dietary intervention study in children (DISC) follow-up study.
        J Clin Endocrinol Metab. 2011; 96: E1999-2008
        • Carlson J.J.
        • Eisenmann J.C.
        • Norman G.J.
        • Ortiz K.A.
        • Young P.C.
        Dietary fiber and nutrient density are inversely associated with the metabolic syndrome in US adolescents.
        J Am Diet Assoc. 2011; 111: 1688-1695
        • Bhupathiraju S.N.
        • Tobias D.K.
        • Malik V.S.
        • et al.
        Glycemic index, glycemic load, and risk of type 2 diabetes: Results from 3 large US cohorts and an updated meta-analysis.
        Am J Clin Nutr. 2014; 100: 218-232
        • Aune D.
        • Chan D.S.
        • Lau R.
        • et al.
        Dietary fibre, whole grains, and risk of colorectal cancer: Systematic review and dose-response meta-analysis of prospective studies.
        BMJ. 2011; 343: d6617
        • Ben Q.
        • Sun Y.
        • Chai R.
        • Qian A.
        • Xu B.
        • Yuan Y.
        Dietary fiber intake reduces risk for colorectal adenoma: A meta-analysis.
        Gastroenterology. 2014; 146: 689-699.e6
        • Murphy N.
        • Norat T.
        • Ferrari P.
        • et al.
        Dietary fibre intake and risks of cancers of the colon and rectum in the European Prospective Investigation into Cancer and Nutrition (EPIC).
        PLoS One. 2012; 7: e39361
        • Hansen L.
        • Skeie G.
        • Landberg R.
        • et al.
        Intake of dietary fiber, especially from cereal foods, is associated with lower incidence of colon cancer in the HELGA cohort.
        Int J Cancer. 2012; 131: 469-478
        • Uchida K.
        • Kono S.
        • Yin G.
        • et al.
        Dietary fiber, source foods and colorectal cancer risk: The Fukuoka Colorectal Cancer Study.
        Scand J Gastroenterol. 2010; 45: 1223-1231
      7. World Cancer Research Fund/American Institute for Cancer Research Continuous update project report: Diet, nutrition, physical activity, and breast cancer survivors.;. Published 2014. Updated 2014. Accessed October 8, 2014.

      8. World Cancer Research Fund/American Institute for Cancer Research. Continuous update project report: Food, nutrition, physical activity, and the prevention of breast cancer. Published 2010. Updated 2010. Accessed October 8, 2014.

        • Aune D.
        • Chan D.S.
        • Greenwood D.C.
        • et al.
        Dietary fiber and breast cancer risk: A systematic review and meta-analysis of prospective studies.
        Ann Oncol. 2012; 23: 1394-1402
        • Ferrari P.
        • Rinaldi S.
        • Jenab M.
        • et al.
        Dietary fiber intake and risk of hormonal receptor-defined breast cancer in the European Prospective Investigation into Cancer and Nutrition study.
        Am J Clin Nutr. 2013; 97: 344-353
        • Zhang Z.
        • Xu G.
        • Ma M.
        • Yang J.
        • Liu X.
        Dietary fiber intake reduces risk for gastric cancer: A meta-analysis.
        Gastroenterology. 2013; 145: 113-120.e3
        • King D.E.
        • Mainous 3rd, A.G.
        • Lambourne C.A.
        Trends in dietary fiber intake in the United States, 1999-2008.
        J Acad Nutr Diet. 2012; 112: 642-648
        • Shay C.M.
        • Van Horn L.
        • Stamler J.
        • et al.
        Food and nutrient intakes and their associations with lower BMI in middle-aged US adults: The international study of macro-/Micronutrients and blood pressure (INTERMAP).
        Am J Clin Nutr. 2012; 96: 483-491
        • Mozaffarian D.
        • Hao T.
        • Rimm E.B.
        • Willett W.C.
        • Hu F.B.
        Changes in diet and lifestyle and long-term weight gain in women and men.
        N Engl J Med. 2011; 364: 2392-2404
        • Wanders A.J.
        • van den Borne J.J.
        • de Graaf C.
        • et al.
        Effects of dietary fibre on subjective appetite, energy intake and body weight: A systematic review of randomized controlled trials.
        Obes Rev. 2011; 12: 724-739
        • Clark M.J.
        • Slavin J.L.
        The effect of fiber on satiety and food intake: A systematic review.
        J Am Coll Nutr. 2013; 32: 200-211
        • Li S.S.
        • Kendall C.W.
        • de Souza R.J.
        • et al.
        Dietary pulses, satiety and food intake: A systematic review and meta-analysis of acute feeding trials.
        Obesity (Silver Spring). 2014; 22: 1773-1780
      9. American Gastroenterological Association. AGA governing board approves new definition of digestive health. Published September 26, 2013. Updated 2013. Accessed May 17, 2015.

        • Anderson J.W.
        • Baird P.
        • Davis Jr., R.H.
        • et al.
        Health benefits of dietary fiber.
        Nutr Rev. 2009; 67: 188-205
        • Eswaran S.
        • Muir J.
        • Chey W.D.
        Fiber and functional gastrointestinal disorders.
        Am J Gastroenterol. 2013; 108: 718-727
        • Cummings J.H.
        The effect of dietary fiber on fecal weight and composition.
        in: Spiller G.A. CRC Handbook of Dietary Fiber in Human Nutrition. 3rd ed. CRC Press, Boca Raton, FL2001: 183-241
        • Stewart M.L.
        • Schroeder N.M.
        Dietary treatments for childhood constipation: Efficacy of dietary fiber and whole grains.
        Nutr Rev. 2013; 71: 98-109
        • Grabitske H.A.
        • Slavin J.L.
        Gastrointestinal effects of low-digestible carbohydrates.
        Crit Rev Food Sci Nutr. 2009; 49: 327-360
        • Cummings J.H.
        • Englyst H.N.
        Fermentation in the human large intestine and the available substrates.
        Am J Clin Nutr. 1987; 45: 1243-1255
        • Hosseini E.
        • Grootaert C.
        • Verstraete W.
        • Van de Wiele T.
        Propionate as a health-promoting microbial metabolite in the human gut.
        Nutr Rev. 2011; 69: 245-258
        • Meijer K.
        • de Vos P.
        • Priebe M.G.
        Butyrate and other short-chain fatty acids as modulators of immunity: What relevance for health?.
        Curr Opin Clin Nutr Metab Care. 2010; 13: 715-721
        • David L.A.
        • Maurice C.F.
        • Carmody R.N.
        • et al.
        Diet rapidly and reproducibly alters the human gut microbiome.
        Nature. 2014; 505: 559-563
        • Roberfroid M.
        • Gibson G.R.
        • Hoyles L.
        • et al.
        Prebiotic effects: Metabolic and health benefits.
        Br J Nutr. 2010; 104: S1-63
        • Slavin J.
        Fiber and prebiotics: Mechanisms and health benefits.
        Nutrients. 2013; 5: 1417-1435
        • Costabile A.
        • Klinder A.
        • Fava F.
        • et al.
        Whole-grain wheat breakfast cereal has a prebiotic effect on the human gut microbiota: A double-blind, placebo-controlled, crossover study.
        Br J Nutr. 2008; 99: 110-120
        • Langkamp-Henken B.
        • Nieves Jr., C.
        • Culpepper T.
        • et al.
        Fecal lactic acid bacteria increased in adolescents randomized to whole-grain but not refined-grain foods, whereas inflammatory cytokine production decreased equally with both interventions.
        J Nutr. 2012; 142: 2025-2032
        • Dahl W.J.
        • Foster L.M.
        • Tyler R.T.
        Review of the health benefits of peas (pisum sativum L.).
        Br J Nutr. 2012; 108: S3-S10
        • Ukhanova M.
        • Wang X.
        • Baer D.J.
        • Novotny J.A.
        • Fredborg M.
        • Mai V.
        Effects of almond and pistachio consumption on gut microbiota composition in a randomised cross-over human feeding study.
        Br J Nutr. 2014; 111: 2146-2152
        • Maccaferri S.
        • Klinder A.
        • Cacciatore S.
        • et al.
        In vitro fermentation of potential prebiotic flours from natural sources: Impact on the human colonic microbiota and metabolome.
        Mol Nutr Food Res. 2012; 56: 1342-1352
        • Briet F.
        • Achour L.
        • Flourie B.
        • et al.
        Symptomatic response to varying levels of fructo-oligosaccharides consumed occasionally or regularly.
        Eur J Clin Nutr. 1995; 49: 501-507
        • Rizzo N.S.
        • Jaceldo-Siegl K.
        • Sabate J.
        • Fraser G.E.
        Nutrient profiles of vegetarian and nonvegetarian dietary patterns.
        J Acad Nutr Diet. 2013; 113: 1610-1619
        • Conlon M.A.
        • Bird A.R.
        The impact of diet and lifestyle on gut microbiota and human health.
        Nutrients. 2014; 7: 17-44
        • Tzounis X.
        • Rodriguez-Mateos A.
        • Vulevic J.
        • Gibson G.R.
        • Kwik-Uribe C.
        • Spencer J.P.
        Prebiotic evaluation of cocoa-derived flavanols in healthy humans by using a randomized, controlled, double-blind, crossover intervention study.
        Am J Clin Nutr. 2011; 93: 62-72
        • Nauta A.J.
        • Ben Amor K.
        • Knol J.
        • Garssen J.
        • van der Beek E.M.
        Relevance of pre- and postnatal nutrition to development and interplay between the microbiota and metabolic and immune systems.
        Am J Clin Nutr. 2013; 98: 586S-593S