energy losses associated with each step. This is true of
human whole-body calorimetric measurements since
analysis requires a complete energy balance profile
for each subject (see below). A more simplistic ap-
proach involves the construction of a mathematical
model of the digestive events in the large intestine.
This approach has most commonly been applied to
the energy value of sugar alcohols but can also be
extended to other partially or completely fermentable
carbohydrates.
0017 Common dietary sugars (such as glucose, galact-
ose, and fructose) have a ketone or aldehyde group
that allows cyclization to a hexose or pentose ring
structure. Reduction of this carbonyl group to an
alcohol produces a sugar alcohol that cannot cyclize.
The resulting sugar alcohols are not well absorbed in
the small intestine so that a significant percentage
can pass intact into the large intestine. Isomalt (Pala-
tinit
1
), an equimolar mixture of two disaccharide
alcohols ( a-d-glucopyranosyl-1,1-d-mannitol and a-
d-glucopyranosyl-1,6-d-sorbitol), is an example of a
sugar alcohol that is virtually unabsorbed in the small
intestine. It passes intact into the large intestine,
where it is rapidly and completely fermented by the
bacterial population that resides there. As such, it
represents a model for a theoretical dietary fiber
that is completely fermented in the large intestine
and can be used as a basis for constructing a math-
ematical model.
0018 A good mathematical model seeks to define all
losses that occur during fermentation of ingested
material and assign reasonable factors to these losses.
Figure 2 presents the scheme for such a model.
Fermentable substances provide carbon units for
bacterial growth and reproduction and serve as
metabolizable substrates to meet the colonic bacterial
population’s energy requirements for maintenance
and growth. Four major products result from anaer-
obic colonic fermentation: increased bacterial mass
(factor a, Figure 2), heat energy loss due to fermenta-
tion (factor b, Figure 2), methane and hydrogen gas
(factor c, Figure 2), and short-chain fatty acids
(SCFAs). Humans can only use SCFAs as an energy
source. Thus, the metabolic energy yield of the sugar
alcohol has been reduced by the losses to bacterial
mass, as well as the heat and gas produced during
fermentation. It has also been reported that SCFAs
may produce significantly less ATP per gram of
absorbed SCFA than glucose, so an additional energy
loss to this difference in metabolic efficiency should
also be included (factor d, Figure 2).
0019 The fermentation model of Figure 2 can be
expressed as an equation that incorporates the four
major processes by which energy is lost during fer-
mentation. The equation describing the scheme of
Figure 2, as it applies to sugar alcohols, was first
developed for the Nutrition Council of Holland and
has been recognized by several authors as an alterna-
tive method for calculating the energy value of sugar
alcohols. For partly fermentable substances, it can be
written as:
NME ¼H
c
½ðA BÞþ a ð1 A CÞ b,
ð11Þ
where, DH
c
is the heat of combustion of the substance
in question, A represents the fraction of the ingested
substance absorbed in the small intestine, B repre-
sents the fraction of absorbed substance that is
metabolized, and C represents the fraction of the
ingested substance that is excreted intact in feces
(Figure 2). The factor a represents the proportion of
energy derived from fermentation of the substance. It
can be calculated from eqn (12):
a ¼ð1 a b c Þd :ð12Þ
The factor b was not present in the original equation
and represents the extra energy lost due to the pres-
ence of the fermentable carbohydrate. This can come
about through binding to macronutrients, changes in
osmotic balance, alterations in transit time, changes
in intestinal viscosity, inhibition of digestive enzymes,
inhibition of macronutrient uptake, or increased
sloughing of intestinal cells. As discussed above (see
section on DE
part
and ME
part
), measuring the appear-
ance of an undigested food component in the feces is
not sufficient to account for all of the energy losses
that can occur when a diet is supplemented with a
fermentable carbohydrate. In a practical sense, it is
impossible to differentiate between any ‘extra’ energy
lost to the feces (b) and the energy lost due to in-
creased bacterial mass that results from fermentation
(factor a). The solution is to set b ¼ 0 in eqn (11) and
measure total fecal output.
0020Using the mathematical model of eqns (11) and
(12) requires a knowledge of factors A, B,andC,
which are obtained from experimental evidence. For
sugaralcohols, valuesfor factorA have been obtained
from ileostomy patients or by direct sampling using
multiple lumen tubes. Factor B (the amount of sugar
alcohol metabolized) has been estimated indirectly by
measuring urinary sugar alcohol content (the amount
of sugar alcohol not metabolized).
0021In the original factorial model paper, the Nutrition
Council of Holland held a to be constant for all sugar
alcohols and estimated it at 0.5. This value included
fermentation energy losses resulting from increased
microbial mass excreted in the feces (a 0.2), loss
of H
2
and CH
4
(c ¼0.03–0.08), heat produced by
microbes (b ¼0.02–0.05), and higher heat loss during
utilization of short-chain fatty acids as compared
1854 DIETARY FIBER/Energy Value