reduce the glycemic index of foods when added to a meal (Frati-Munari et al., 1998). The effect of psyllium or placebo on postprandial serum glucose and insulin concentrations was tested in 18 type 2 diabetic patients in a crossover design (Pastors et al., 1991). Compared to placebo, postprandial glucose elevation was reduced by 14 percent at breakfast and 20 percent at dinner, and postprandial serum insulin concentration was reduced by 12 percent after breakfast. However, this depression of the normal postprandial increase in serum glucose and insulin concentrations seen with psyllium does not appear to be due to a delay in gastric emptying (Rigaud et al., 1998).

Laxation. There are no human studies to support a laxative benefit from ingestion of indigestible dextrins.

Normalization of Blood Lipid Concentrations. The intake of 60 g/d of resistant maltodextrin was shown to reduce serum total cholesterol and triacylglycerol concentrations in type 2 diabetics as compared with type 2 diabetics or healthy adults who consumed 30 g/d of resistant maltodextrin (Ohkuma and Wakabayashi, 2001). No difference was observed in the concentration of HDL cholesterol.

Attenuation of Blood Glucose Responses. Reduced blood glucose concentrations and insulin secretion were observed when rats were given resistant maltodextrins after sucrose or maltose loading (Wakabayashi et al., 1993, 1995). Furthermore, an intake of 5 g of resistant maltodextrin reduced the postprandial blood glucose concentrations in healthy men and women (Tokunaga and Matsuoka, 1999). The ingestion of 60 g/d, but not 30 g/d, of resistant maltodextrin resulted in a significant reduction of fasting blood glucose concentrations in type 2 diabetics (Ohkuma and Wakabayashi, 2001).

Laxation. Increased fecal bulk due to increased starch intake has been reported (Shetty and Kurpad, 1986). The impact of resistant starch (RS₃) from a corn-based cereal on colonic function was measured in eight male volunteers (Tomlin and Read, 1990). After consuming 10.33 g/d of RS₃ for 1 week, there was no significant difference in fecal output, stool frequency, ease of defecation, whole-gut transit time, or degree of flatulence compared to an intake of 0.86 g/d of RS₃ from a rice-based cereal. A

Front Matter (R1-R26)

Summary (1-20)

1. Introduction to Dietary Reference Intakes (21-37)

2. Methods and Approaches Used (38-52)

3. Relationship of Macronutrients and Physical Activity to Chronic Disease (53-83)

4. A Model for the Development of Tolerable Upper Intake Levels (84-106)

5. Energy (107-264)

6. Dietary Carbohydrates: Sugars and Starches (265-338)

7. Dietary, Functional, and Total Fiber (339-421)

8. Dietary Fats: Total Fat and Fatty Acids (422-541)

9. Cholesterol (542-588)

10. Protein and Amino Acids (589-768)

11. Macronutrients and Healthful Diets (769-879)

12. Physical Activity (880-935)

13. Applications of Dietary Reference Intakes for Macronutrients (936-967)

14. A Research Agenda (968-971)

Appendix A: Glossary and Acronyms (972-977)

Appendix B: Origin and Framework of the Development of Dietary Reference Intakes (978-984)

Appendix C: Acknowledgments (985-987)

Appendix D: Dietary Intake Data from the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994 (988-1027)

Appendix E: Dietary Intake Data from the Continuing Survey of Food Intakes by Individuals (CSFII) 1994-1996, 1998 (1028-1065)

Appendix F: Canadian Dietary Intake Data, 1990-1997 (1066-1075)

Appendix G: Special Analyses for Dietary Fats (1076-1077)

Appendix H: Body Composition Data Based on the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994 (1078-1103)

Appendix I: Doubly Labeled Water Data Used to Predict Energy Expenditure (1104-1202)

Appendix J: Association of Added Sugar Intake and Intake of Other Nutrients (1203-1225)

Appendix K: Data Comparing Carbohydrate Intake to Intake of Other Nutrients from the Continuing Survey of Food Intakes by Individuals (CSFII), 1994-1996, 1998 (1226-1243)

Appendix L: Options for Dealing with Uncertainties (1244-1249)

Appendix M: Nitrogen Balance Studies Used to Estimate the Protein Requirements in Adults (1250-1258)

Biographical Sketches of Panel and Subcommittee Members (1259-1274)

Index (1275-1318)

Summary Tables, Dietary Reference Intakes (1319-1331)