Diet and cholesterol metabolism in the gut - implications for coronary heart disease and large bowel cancer

Abstract

The effects of the interactions between different dietary factors and the enterohepatic circulation of cholesterol and bile acids in the small bowel, could be studied in ileostomy subjects. Two different mechanisms of high-fibre products could be separated. 1) A specific bile acid-binding effect, resulting in an increased bile acid excretion from the small bowel and a reduction of serum cholesterol, caused by certain viscous components as -glucanes in oat and citrus pectin. 2) An effect associated to high fibre food and products with increased cholesterol and reduced bile acid excretion from the small bowel. This effect is suggested to be due to plant sterols. Such bioactive substances to be metabolised by the colonic flora may reduce the risk of colonic cancer. Ileostomy studies have also been used in order to analyse and measure the amount of substances delivered to the colon.