Effects of oat beta-glucan intake on blood cholesterol: a review

Authors

  • Aránzazu Aparicio Vizuete Departamento de Nutrición y Bromatología I (Nutrición), Facultad de Farmacia, Universidad Complutense de Madrid, Grupo de Investigación VALORNUT-UCM (92030), Madrid.
  • Rosa María Ortega Anta Departamento de Nutrición y Bromatología I (Nutrición), Facultad de Farmacia, Universidad Complutense de Madrid, Grupo de Investigación VALORNUT-UCM (92030), Madrid.

DOI:

https://doi.org/10.14306/renhyd.20.2.183

Keywords:

Beta-Glucans, Glucans, Avena, Oat, Avena Sativa, Dietary Fiber, Soluble fiber, Cholesterol, LDL Cholesterol, Review

Abstract

Elevated total and low density lipoprotein (LDL) cholesterol levels are considered major risk factors for coronary heart disease. Oat is a cereal that is a good source of proteins, fat, minerals and vitamins, as well as soluble fiber, including beta-glucans. Due to the physicochemical characteristics of the beta-glucan, it has been proposed that oats may help reduce blood cholesterol levels and help control postprandial plasma glucose and insulin response. A large body of clinical studies suggests that the consumption of at least 3 g per day of oat betaglucan, as part of a diet low in saturated fat and cholesterol, may reduce the risk of coronary heart disease, which has been approved by several regulatory agencies, as the Food and Drug Administration in the USA and the European Food Safety Authority in Europe.

References

(1) Clemens R, van Klinken BJ. Oats, more than just a whole grain: an introduction. Br J Nutr. 2014; 112(Suppl 2): S1-3. doi: 10.1017/S0007114514002712

(2) Singh R, De S, Belkheir A. Avena sativa (Oat), a potential neutraceutical and therapeutic agent: an overview. Crit Rev Food Sci Nutr. 2013; 53(2): 126-44. doi: 10.1080/10408398.2010.526725

(3) Koskinen O, Villanen M, Korponay-Szabo I, Lindfors K, Maki M, Kaukinen K. Oats do not induce systemic or mucosal autoantibody response in children with coelical disease. J Pediatr Gastroenterol Nutr. 2009; 48(5): 559-65. doi: 10.1097/MPG.0b013e3181668635

(4) Sadiq Butt M, Tahir-Nadeem M, Khan MK, Shabir R, Butt MS. Oat: unique among the cereals. Eur J Nutr. 2008; 47(2): 68-79. doi: 10.1007/s00394-008-0698-7

(5) Ortega RM, Aparicio Vizuete A, Jimenez Ortega AI, Rodriguez Rodriguez E. [Wholegrain cereals and sanitary benefits]. Nutr Hosp. 2015; 32(Suppl 1): 25-31. doi: 10.3305/nh.2015.32.sup1.9475

(6) Whitehead A, Beck EJ, Tosh S, Wolever TM. Cholesterol-lowering effects of oat beta-glucan: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2014; 100(6): 1413-21. doi: 10.3945/ajcn.114.086108

(7) Tiwari U, Cummins E. Meta-analysis of the effect of beta-glucan intake on blood cholesterol and glucose levels. Nutrition. 2011; 27(10): 1008-16. doi: 10.1016/j.nut.2010.11.006

(8) Wolever TM, Tosh SM, Gibbs AL, Brand-Miller J, Duncan A M, Hart V, et al. Physicochemical properties of oat beta-glucan influence its ability to reduce serum LDL cholesterol in humans: a randomized clinical trial. Am J Clin Nutr. 2010; 92(4): 723-32. doi: 10.3945/ajcn.2010.29174

(9) United States Department of Agriculture (USDA). Dietary Guidelines for Americans,2010 [portal en internet]. Estados Unidos; USDA; 2011; [citado 17 Ago 2015]. Disponible en: http://www.cnpp.usda.gov/publications/dietaryguidelines/2010/policydoc/policydoc.pdf

(10) Aparicio A, Ortega RM, Requejo AM. Guías en alimentación: consumo aconsejado de alimentos. En: Ortega RM, Requejo AM, editores. Nutriguía. Manual de Nutrición Clínica. Madrid: Editorial Médica Panamericana; 2015. p. 27-42.

(11) Volman JJ, Mensink RP, Ramakers JD, de Winther MP, Carlsen H, Blomhoff R, et al. Dietary (1→3), (1→4)-beta-D-glucans from oat activate nuclear factor-kappaB in intestinal leukocytes and enterocytes from mice. Nutr Res. 2010; 30(1): 40-8. doi: 10.1016/j.nutres.2009.10.023

(12) Cui W, Wood PJ, Blackwell B, Nikiforuk J. Physicochemical properties and structural characterization by two-dimensional NMR spectroscopy of wheat β-D-glucan—comparison with other cereal β-D-glucans. Carbohydr Polym. 2000; 41(3): 249-58. doi: 10.1016/S0144-8617(99)00143-5

(13) Miller SS, Fulcher RG, Sen A, Arnason JT. Oat endosperm cell walls. Isolation, compostition and comparison with other tissues. Cereal Chem. 1995; 72: 421-7.

(14) Wang Q, Ellis PR. Oat beta-glucan: physico-chemical characteristics in relation to its blood-glucose and cholesterollowering properties. Br J Nutr. 2014; 112(Suppl 2): S4-13. doi: 10.1017/S0007114514002256

(15) Miller SS, Wood PJ, Pietrzak LN, Flucher RG. Mixed linkage β-glucan, protein content, and kernel weight in Avena species. Cereal Chem. 1993; 70(2): 231-3.

(16) Ajithkumar A, Andersson R, Aman P. Content and molecular weight of extractable beta-glucan in American and Swedish oat samples. J Agric Food Chem. 2005; 53(4): 1205-9. doi: 10.1021/jf040322c

(17) Peterson DM, Wesenberg DM, Burrup DE. β-Glucan Content and Its Relationship to Agronomic Characteristics in Elite Oat Germplasm. Crop Sci. 1995; 35(4): 965-70. doi: 10.2135/cropsci1995.0011183X003500040005x

(18) Stuart IM, Loi L, Fincher GB. Inmunological comparison of (1→3, 1→4)-b-glucan endohydrolases in germinating cereals. J Cereal Sci. 1987; 6(1): 45-52. doi: 10.1016/0014-5793(82)80602-9

(19) Áman P, Rimsten L, Andersson R. Molecular weight distribution of beta-glucan in oat-based foods. Cereal Chem. 2004; 81(3): 356-60. doi: 10.1094/CCHEM.2004.81.3.356

(20) Decker EA, Rose DJ, Stewart D. Processing of oats and the impact of processing operations on nutrition and health benefits. Br J Nutr. 2014; 112(Suppl 2): S58-64. doi: 10.1017/S000711451400227X

(21) Saastamiunen M, Hietaniemi V, Pihlava JM. β-Glucan contents of groats of different oat cultivars in official variety, in organic cultivation, and in nitrogen fertilization trials in Finland. Agr Food Sci. 2004; 13(1-2): 68-79. doi: 10.2137/1239099041838076

(22) Dvončová D, Havrlentová M, Hlinková A, Hozlár P. Effect of fertilization and variety on the β-glucan content in the grain of oats. Food Sci Tech Quality. 2010; 17(70): 108-16.

(23) Wood PJ. Cereal β-glucans in diet and health. J Cereal Sci. 2007; 46(3): 230-8.

(24) Erkkila AT, Lichtenstein AH. Fiber and cardiovascular disease risk: how strong is the evidence? J Cardiovasc Nurs. 2006; 21(1): 3-8.

(25) Andersson M, Ellegard L, Andersson H. Oat bran stimulates bile acid synthesis within 8 h as measured by 7alpha-hydroxy-4-cholesten-3-one. Am J Clin Nutr. 2002; 76(5): 1111-6.

(26) Kim HJ, White PJ. Interactional effects of beta-glucan, starch, and protein in heated oat slurries on viscosity and in vitro bile acid binding. J Agric Food Chem. 2012; 60(24): 6217-22. doi: 10.1021/jf300786f

(27) European Food Safety Agency (EFSA). Scientific Opinion on the substantiation of a health claim related to oat beta glucan and lowering blood cholesterol and reduced risk of (coronary) heart disease pursuant to Article 14 of Regulation (EC) No 1924/2006. EFSA J. 2010: 1885-99.

(28) Food and Drug Administration (FDA). Soluble fibre from whole oats and coronary heart disease health claim Fed Regist. 1997; 62: 3583-601.

(29) Wang Q, Ellis PR, Ross-Murphy SB. Dissolution kinetics of guargum powders-II. Efects of concentration and molecular weight. Carbohydr Polym. 2003; 53(1): 75-83. doi:10.1016/S0144-8617(03)00009-2

(30) Lazaridou A, Biliaderis CG, Izydorrczyk MS. Molecular size effects on rheological properties of beta-glucans in solution and gels. Food Hydrocolloid. 2003; 17: 693-712.

(31) Kim SY, Song HJ, Lee YY, Cho KH, Roh YK. Biomedical issues of dietary fiber beta-glucan. J Korean Med Sci. 2006; 21(5): 781-9. doi: 10.3346/jkms.2006.21.5.781

(32) Othman RA, Moghadasian MH, Jones PJ. Cholesterol-lowering effects of oat β-glucan. Nutr Rev. 2011; 69(6): 299-309. doi: 10.1111/j.1753-4887.2011.00401.x

(33) Serna-Saldivar SO. Cereal Grains: Properties, Processing, and Nutritional Attributes. Monterrey, Mexico: Bota Raton, FL; 2010.

(34) Tosh SM, Brummer Y, Miller SS, Regand A, Defelice C, Duss R, et al. Processing affects the physicochemical properties of beta-glucan in oat bran cereal. J Agric Food Chem. 2010; 58(13): 7723-30. doi: 10.1021/jf904553u

(35) Zhang M, Bai X, Zhang Z. Extrusion process improves the functionality of soluble dietary fiber in oat bran. J Cereal Sci. 2011; 54(1): 98-103. doi:10.1016/j.jcs.2011.04.001

(36) Regand A, Tosh SM, Wolever TM, Wood PJ. Physicochemical properties of beta-glucan in differently processed oat foods influence glycemic response. J Agric Food Chem. 2009; 57(19): 8831-8. doi: 10.1021/jf901271v

(37) Kerckhoffs DA, Hornstra G, Mensink RP. Cholesterollowering effect of beta-glucan from oat bran in mildly hypercholesterolemic subjects may decrease when betaglucan is incorporated into bread and cookies. Am J Clin Nutr. 2003; 78(2): 221-7.

(38) Frank J, Sundberg B, Kamal-Eldin A, Vessby B, Aman P. Yeastleavened oat breads with high or low molecular weight betaglucan do not differ in their effects on blood concentrations of lipids, insulin, or glucose in humans. J Nutr. 2004; 134(6): 1384-8.

(39) Charlton KE, Tapsell LC, Batterham MJ, O’Shea J, Thorne R, Beck E, et al. Effect of 6 weeks’ consumption of betaglucan-rich oat products on cholesterol levels in mildly hypercholesterolaemic overweight adults. Br J Nutr. 2012; 107(7): 1037-47. doi: 10.1017/S0007114511003850

(40) Onning G, Wallmark A, Persson M, Akesson B, Elmstahl S, Oste R. Consumption of oat milk for 5 weeks lowers serum cholesterol and LDL cholesterol in free-living men with moderate hypercholesterolemia. Ann Nutr Metab. 1999; 43(5): 301-9.

(41) Naumann E, van Rees AB, Onning G, Oste R, Wydra M, Mensink RP. Beta-glucan incorporated into a fruit drink effectively lowers serum LDL-cholesterol concentrations. Am J Clin Nutr. 2006; 83(3): 601-5.

(42) Queenan KM, Stewart ML, Smith KN, Thomas W, Fulcher RG, Slavin JL. Concentrated oat beta-glucan, a fermentable fiber, lowers serum cholesterol in hypercholesterolemic adults in a randomized controlled trial. Nutr J. 2007; 6: 6. doi: 10.1186/1475-2891-6-6

(43) Beer MU, Wood PJ, Weisz J, Fillion N. Effect of cooking and storage on the amount and molecular weight of (1→3) (1→4)-β-D-glucan extracted from oat products by an in vitro digestion system. Cereal Chem. 1997; 74(6): 705-9. doi: 10.1094/CCHEM.1997.74.6.705

(44) Lan-Pidhainy X, Brummer Y, Tosh SM, Wolever TM, Wood PJ. Reducing beta-glucan solubility in oat bran muffins by freezethaw treatment attenuates its hypoglycemic effect. Cereal Chem. 2007;84(5):512-7. doi: 10.1094/CCHEM-84-5-0512

(45) Chen J, Huang XF. The effects of diets enriched in beta-glucans on blood lipoprotein concentrations. J Clin Lipidol. 2009; 3(3): 154-8. doi: 10.1016/j.jacl.2009.04.054

(46) Ellegard L, Andersson H. Oat bran rapidly increases bile acid excretion and bile acid synthesis: an ileostomy study. Eur J Clin Nutr. 2007; 61(8): 938-45. doi: 10.1038/sj.ejcn.1602607

(47) Reihner E, Angelin B, Rudling M, Ewerth S, Bjorkhem I, Einarsson K. Regulation of hepatic cholesterol metabolism in humans: stimulatory effects of cholestyramine on HMGCoA reductase activity and low density lipoprotein receptor expression in gallstone patients. J Lipid Res. 1990; 31(12): 2219-26.

(48) Murray CJ, Lopez AD. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet. 1997; 349(9061): 1269-76. doi: 10.1016/S0140-6736(96)07493-4

(49) Reiner Z, Catapano AL, De Baker G, Graham I, Taskinen MR, Wiklund O, et al. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J. 2011; 32(14): 1769-818. doi: 10.1093/eurheartj/ehr158

(50) Expert Panel on Detection E, Treatment of High Blood Cholesterol in A. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001; 285(19): 2486-97. doi: 10.1001/jama.285.19.2486

(51) Ballantyne C, Arroll B, Shepherd J. Lipids and CVD management: towards a global consensus. Eur Heart J. 2005; 26(21): 2224-31. doi: 10.1093/eurheartj/ehi373

(52) Bazzano LA, He J, Ogden LG, Loria CM, Whelton PK; National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Dietary fiber intake and reduced risk of coronary heart disease in US men and women: the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Arch Intern Med. 2003; 163(16): 1897-904. doi: 10.1001/archinte.163.16.1897

(53) Threapleton DE, Greenwood DC, Evans CE, Cleghorn C L, Nykjaer C, Woodhead C, et al. Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ. 2013; 347: f6879. doi: 10.1136/bmj.f6879

(54) Chen ZY, Jiao R, Ma KY. Cholesterol-lowering nutraceuticals and functional foods. J Agric Food Chem. 2008; 56(19): 8761-73. doi: 10.1021/jf801566r

(55) Bureau of Nutritional Sciences FD, Health Products and Food Branch, Health Canada. Oat products and blood cholesterol lowering: summary of assessment of a health claim about oat products and blood cholesterol lowering [portal en internet]. Ottawa, Ontario: Health Canada; 2010 [actualizado 25 Nov 2010; citado 23 Agos 2015]. Disponible en: http://www.hc-sc.gc.ca/fn-an/alt_formats/pdf/label-etiquet/claims-reclam/assess-evalu/oat_avoine-eng.pdf

(56) Food Standards Australian and New Zealand. Standard 1.2.7: Nutrition, health and related claims. Food Standards Gazette [revista en internet]. 2013 [consulta 25/08/2015]. Disponible en: http://www. foodstandards.gov.au/code/changes/gazette_138.pdf

(57) Ministry of Health Malaysia. Malaysian dietary guidelines-Key Message14-make effective use of nutrition information on food labels [portal en internet]. Putrajaya, Malasia: Ministry of Health Malaysia; 2010 [actualizado 27 Nov 2011; citado 24 Agos 2015]. Disponible en: http://www2.moh.gov.my/images/gallery/Garispanduan/diet/km14.pdf

(58) Joint Health Claims Initiative. Final report on a Generic health claim for oats and reduction of blood cholesterol [portal en internet]. Reino Unido; 2004 [actualizado 2 Jun 2006, citado 24 Agos 2015]. Disponible en: http://webarchive. nationalarchives.gov.uk/nobanner/20130404135254/http:/www.jhci.org.uk/approv/oats.htm

(59) Lovegrove JA, Clohessy A, Milon H, Williams CM. Modest doses of beta-glucan do not reduce concentrations of potentially atherogenic lipoproteins. Am J Clin Nutr. 2000; 72(1): 49-55.

(60) Van Horn L, Liu K, Gerber J, Garside D, Schiffer L, Gernhofer N, et al. Oats and soy in lipid-lowering diets for women with hypercholesterolemia: is there synergy? J Am Diet Assoc. 2001; 101(11): 1319-25. doi: 10.1016/S0002-8223(01)00317-0

(61) Davy BM, Davy KP, Ho RC, Beske SD, Davrath LR, Melby CL. High-fiber oat cereal compared with wheat cereal consumption favorably alters LDL-cholesterol subclass and particle numbers in middle-aged and older men. Am J Clin Nutr. 2002; 76(2): 351-8.

(62) Keenan JM, Pins JJ, Frazel C, Moran A, Turnquist L. Oat ingestion reduces systolic and diastolic blood pressure in patients with mild or borderline hypertension: a pilot trial. J Fam Pract. 2002; 51(4): 369.

(63) Pins JJ, Geleva D, Keenan JM, Frazel C, O’Connor PJ, Cherney LM. Do whole-grain oat cereals reduce the need for antihypertensive medications and improve blood pressure control? J Fam Pract. 2002; 51(4): 353-9.

(64) Kabir M, Oppert JM, Vidal H, Bruzzo F, Fiquet C, Wursch P, et al. Four-week low-glycemic index breakfast with a modest amount of soluble fibers in type 2 diabetic men. Metabolism. 2002; 51(7): 819-26. doi: 10.1053/meta.2002.33345

(65) Berg A, Konig D, Deibert P, Grathwohl D, Berg A, Baumstark M W, et al. Effect of an oat bran enriched diet on the atherogenic lipid profile in patients with an increased coronary heart disease risk. A controlled randomized lifestyle intervention study. Ann Nutr Metab. 2003; 47(6): 306-11. doi: 10.1159/000072404

(66) Amundsen AL, Haugum B, Andersson H. Changes in serum cholesterol and sterol metabolites after intake of products enriched with an oat bran concentrate within a controlled diet. Scand J Nutr. 2003; 47(2): 68-74. doi: 10.1080/11026480310009573

(67) Karmally W, Montez MG, Palmas W, Martinez W, Branstetter A, Ramakrishnan R, et al. Cholesterol-lowering benefits of oat-containing cereal in Hispanic americans. J Am Diet Assoc. 2005; 105(6): 967-70. doi: 10.1016/j.jada.2005.03.006

(68) Biörklund M, van Rees A, Mensink RP, Onning G. Changes in serum lipids and postprandial glucose and insulin concentrations after consumption of beverages with betaglucans from oats or barley: a randomised dose-controlled trial. Eur J Clin Nutr. 2005; 59(11): 1272-81. doi:10.1038/sj.ejcn.1602240

(69) Chen J, He J, Wildman RP, Reynolds K, Streiffer RH, Whelton PK. A randomized controlled trial of dietary fiber intake on serum lipids. Eur J Clin Nutr. 2006; 60(1): 62-8. doi:10.1038/sj.ejcn.1602268

(70) Theuwissen E, Mensink RP. Simultaneous intake of beta-glucan and plant stanol esters affects lipid metabolism in slightly hypercholesterolemic subjects. J Nutr. 2007; 137(3): 583-8.

(71) Biörklund M, Holm J, Onning G. Serum lipids and postprandial glucose and insulin levels in hyperlipidemic subjects after consumption of an oat beta-glucan-containing ready meal. Ann Nutr Metab. 2008; 52(2): 83-90. doi: 10.1159/000121281

(72) Liatis S, Tsapogas P, Chala E, Dimosthenopoulos C, Kyriakopoulos K, Kapantais E, et al. The consumption of bread enriched with betaglucan reduces LDL-cholesterol and improves insulin resistance in patients with type 2 diabetes. Diabetes Metab. 2009; 35(2): 115-20. doi: 10.1016/j.diabet.2008.09.004

(73) Maki KC, Beiseigel JM, Jonnalagadda SS, Gugger CK, Reeves MS, Farmer MV, et al. Whole-grain ready-to-eat oat cereal, as part of a dietary program for weight loss, reduces low-density lipoprotein cholesterol in adults with overweight and obesity more than a dietary program including low-fiber control foods. J Am Diet Assoc. 2010; 110(2): 205-14. doi: 10.1016/j.jada.2009.10.037

(74) Beck EJ, Tapsell LC, Batterham MJ, Tosh SM, Huang XF. Oat betaglucan supplementation does not enhance the effectiveness of an energy-restricted diet in overweight women. Br J Nutr. 2010; 103(8): 1212-22. doi: 10.1017/S0007114509992856

(75) Cugnet-Anceau C, Nazare JA, Biörklund M, Le Coquil E, Sassolas A, Sothier M, et al. A controlled study of consumption of betaglucan-enriched soups for 2 months by type 2 diabetic freeliving subjects. Br J Nutr. 2010; 103(3): 422-8. doi: 10.1017/S0007114509991875

(76) Kristensen M, Bugel S. A diet rich in oat bran improves blood lipids and hemostatic factors, and reduces apparent energy digestibility in young healthy volunteers. Eur J Clin Nutr. 2011; 65(9): 1053-8. doi: 10.1038/ejcn.2011.102

(77) Zhang J, Li L, Song P, Wang C, Man Q, Meng L, et al. Randomized controlled trial of oatmeal consumption versus noodle consumption on blood lipids of urban Chinese adults with hypercholesterolemia. Nutr J. 2012; 11: 54. doi: 10.1186/1475-2891-11-54

(78) Ibrügger S, Kristensen M, Poulsen MW, Mikkelsen MS, Ejsing J, Jespersen BM, et al. Extracted oat and barley beta-glucans do not affect cholesterol metabolism in young healthy adults. J Nutr. 2013; 143(10): 1579-85. doi: 10.3945/jn.112.173054

(79) Thongoun P, Pavadhgul P, Bumrungpert A, Satitvipawee P, Harjani Y, Kurilich A. Effect of oat consumption on lipid profiles in hypercholesterolemic adults. J Med Assoc Thai. 2013; 96(Suppl 5): S25-32.

(80) Thies F, Masson LF, Boffetta P, Kris-Etherton P. Oats and CVD risk markers: a systematic literature review. Br J Nutr. 2014; 112(Suppl 2): S19-30. doi: 10.1017/S0007114514002281

(81) National Cholesterol Education Program Expert Panel on Detection E, Treatment of High Blood Cholesterol in A. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002; 106(25): 3143-421.

(82) Ripsin CM, Keenan JM, Jacobs DR, Jr., Elmer P J, Welch RR, Van Horn L, et al. Oat products and lipid lowering. A meta-analysis. JAMA. 1992; 267(24): 3317-25. doi:10.1001/jama.1992.03480240079039

(83) Zhu X, Sun X, Wang M, Zhang C, Cao Y, Mo G, et al. Quantitative assessment of the effects of beta-glucan consumption on serum lipid profile and glucose level in hypercholesterolemic subjects. Nutr Metab Cardiovasc Dis. 2015; 25(8): 714-23. doi: 10.1016/j.numecd.2015.04.008

(84) Horward BV, Robbins DC, Sievers ML, Lee ET, Rhoades D, Devereux RB, et al. LDL cholesterol as a strong predictor of coronary heart disease in diabetic individuals with insulin resistance and low LDL: the Strong Heart Study. Arterioscler Thromb Vasc Biol. 2000; 20(3): 830-5.

Published

2015-11-17

How to Cite

Aparicio Vizuete, A., & Ortega Anta, R. M. (2015). Effects of oat beta-glucan intake on blood cholesterol: a review. Spanish Journal of Human Nutrition and Dietetics, 20(2), 127–139. https://doi.org/10.14306/renhyd.20.2.183