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MARK H. BOWLES, MD, FACC, FACG • Cardiologist, Gastroenterologist

Mark Bowles FiberPasta

My name is Mark H Bowles, MD, FACC, FACG, and I'm a cardiologist and gastroenterologist with a keen interest in nutrition. For the past 30 years my practice primarily involved coronary and peripheral vascular intervention, pacemakers, and a wide spectrum of gastrointestinal disorders.

“Garbage in, garbage out” was a term applied to computing a few years ago. The same could be said about our bodies: if we don’t take in proper fuel and building blocks, our bodies suffer. Of course, there is the genetic component which may be unalterable: we can’t pick our parents. However, disease processes can be potentially modified, attenuated or prevented by optimal behavior.

We know that increasing rates of obesity in the US has led to a greater incidence of diabetes. Additionally, 12-30% of the US population is estimated to be prediabetic. This involves approximately 85 million persons (including non-obese).

Prediabetes is defined by the American Diabetes Association (ADA) as a fasting glucose of 100-125 mg/dL. while the World Health Organization says 110-125. The ADA further defines pre-diabetes as an HgbA1C of 5.7-6.4 mg% while another respected organization, the IEC, gives a cutoff of 6.0-6.4. A blood sugar of 140-199 mg/dL, two hours after a meal, puts a person in pre-diabetic category.

So, what is the implication of being “pre-diabetic?” Does the condition invariably lead to frank diabetes. No. However, compared to an agematched population with normal HgbA1C, pre diabetics are more likely to develop kidney disease, arteriosclerotic cardiovascular disease and die from any cause.

An initial approach to this condition is risk factor modification and therapeutic lifestyle changes: achieve ideal weight; increase aerobic activity; smart food choices and amounts; reduce stress and catecholamine/cortisol levels (which are counter-regulatory to insulin).

Foods that are sugary or have a high conversion rate to sugars are considered high-glycemic foods. For example, pineapple and grape juice have a high index while a baked sweet potato is more slowly absorbed an converted to sugars. In a Quixotic search for better culinary health, many have eliminated gluten in their diets and gone to rice-based foodstuffs which have a higher glycemic index (not to mention arsenic!).

We also know now that consumption of artificial colors and flavors (petroleum-based products); highly processed foods (high-fructose corn syrup, white bleached flour); and genetically modified (GMO) products can lead to dysbiosis or unfavorable alteration of our gut flora. Garbage in, garbage out.

Enter FiberPasta. This product was developed in Italy and has the following features: very palatable, high in protein and fiber, low glycemic index of 23-28/100. The fiber content delays stomach emptying and makes a person feel full for a longer period of time. This may curb a tendency for overeating and excessive calorie consumption. The product contains Inulin which is derived from Chicory root and is the major contributor to the fiber content. Inulin is also a “pre-biotic” and a food source for bacteria in our gut or those we are trying to get there. Shelf-stable “pro-biotics” may not be effective without a “pre-biotic” carrier. Favorable bacterial cultures or probiotics can be found in kefir, organic, raw apple cider, or plain yogurt.

One caveat here might be the occasional person with small intestinal bacterial overgrowth (SIBO). Such a condition could be manifest as abdominal bloating, cramps, diarrhea. This condition could be diagnosed by breath hydrogen test after ingesting certain sugars. In this condition, Inulin could potentially allow bad bacteria, like Klebsiella, to proliferate in the gut.

Ordinarily, undigestible food fiber is fermented and partially digested by gut bacteria creating gas. So, a certain amount of gas is expected with beans and cruciferous vegetables (broccoli, brussel sprouts) because of their high fiber content. The average American consumes 8-15 Grams of fiber/day with at least 25 Grams per day recommended. Ideally, such fiber should come from whole food sources: fruits, vegetables, minimally processed grain (like whole oats). I one is accustomed to a low-fiber diet, it may take a while for the gut to adapt.

In summary, we have a diabetic and pre-diabetic epidemic in our country that can have many cardiovascular and gastrointestinal expressions. FiberPasta can fill a niche for this population by virtue of its relatively low glycemic index. It’s protein content (derived from plant sources*) can potentially help to maintain muscle mass during weight loss programs. Mary Rose Deraco, RN, BSN, a diabetic educator for thirty years, frames this product as “culinary medicine:” a tasty product that improves your health without guilt.

- MARK H. BOWLES, MD, FACC FACG