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Fujiwara A, Fukunaga A, Murakami K, Inoue Y, Nakagawa T, Yamamoto S, Konishi M, Mizoue T. Cross-Sectional Association between Estimated Hardness of the Habitual Diet and Depressive Symptoms in Older Japanese Men. Nutrients 2023; 15:3034. [PMID: 37447360 DOI: 10.3390/nu15133034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/18/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
This cross-sectional study aimed to investigate the association between dietary hardness and depressive symptoms in older Japanese men. Participants were 1487 men aged 60-69 years enrolled in the baseline survey of the Hitachi Health Study II (2017-2020). Habitual dietary intake was estimated by a brief-type, self-administered diet history questionnaire. Dietary hardness was defined as the magnitude of masticatory muscle activity necessary to consume solid foods. The participants who scored ≥ 9 points on a short version of the Center for Epidemiologic Studies Depression Scale were considered to have depressive symptoms. The prevalence of depressive symptoms was 12.7%. The ORs (95% CIs) for depressive symptoms in the third tertile of dietary hardness were significantly lower after adjustment for sociodemographic and lifestyle-related variables and mood-modulating nutrients (ORs [95% CIs]: 0.93 [0.63, 1.36] and 0.58 [0.35, 0.97] for the second and third tertile, respectively [p-value for trend = 0.04]). Dietary hardness was inversely associated with the prevalence of depressive symptoms in older Japanese men. Future studies should confirm these findings and clarify the role of consuming a hard diet in preventing depressive disorders.
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Affiliation(s)
- Aya Fujiwara
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senriokashinmachi, Settsu-shi 566-0002, Osaka, Japan
| | - Ami Fukunaga
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Kentaro Murakami
- Department of Nutritional Epidemiology and Behavioural Nutrition, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Tohru Nakagawa
- Hitachi Health Care Center, Hitachi, Ltd., 4-3-16 Osecho, Hitachi-shi 317-0076, Ibaraki, Japan
| | - Shuichiro Yamamoto
- Department of Nutritional Epidemiology and Behavioural Nutrition, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Maki Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
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Hashimoto A, Nozaki A, Inoue H, Kuwano T. High masticatory ability attenuates psychosocial stress: A cross-sectional study. PLoS One 2023; 18:e0279891. [PMID: 36652405 PMCID: PMC9847911 DOI: 10.1371/journal.pone.0279891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/16/2022] [Indexed: 01/19/2023] Open
Abstract
Mastication interventions have previously been shown to alleviate acute stress. However, the relationship between masticatory performance and stress response among individuals remains unclear. This study aimed to examine the relationship between masticatory ability and stress response in young women by measuring the autonomic nerve function and salivary α-amylase activity during psychosocial stress. Eighty women (aged 20.0 ± 1.9 years) were divided into either a low or high masticatory performance group, and the Trier Social Stress Test was conducted. Moreover, the autonomic function was measured at rest, immediately before stress, immediately after stress, and 10 min after stress. The salivary α-amylase activity was also measured at rest, 5 min after stress, and 15 min after stress. The visual analog scale (VAS) was used for subjective stress evaluation. There was a significant increase in the autonomic balance of both groups immediately before stress loading, but whilst the high masticatory ability group showed a return to resting-state levels after stress loading, the low masticatory ability group showed elevated levels after stress loading. Salivary α-amylase activity significantly increased 5 min after stress loading in the low, but not high, masticatory ability group. Furthermore, the VAS scores for tension and confusion after stress were significantly higher in the low masticatory ability group than in the high masticatory ability group. Our findings suggest that high masticatory performance may contribute to alleviating psychosocial stress. This is the first study to clarify the relationship between habitual masticatory performance and psychosocial stress suppression in young women.
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Affiliation(s)
- Ayako Hashimoto
- Department of Food and Nutrition, Faculty of Home Economics, Kyoto Women’s University, Kyoto, Japan
| | - Aya Nozaki
- Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan
| | - Hiroko Inoue
- Department of Nutrition and Health Sciences, Faculty of Food and Nutritional Sciences, Toyo University, Gunma, Japan
| | - Toshiko Kuwano
- Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan
- School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan
- * E-mail:
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Can KC, Tugba Ozel-Kizil E, Colak B, Duman B. Effects of gum chewing and repetitive motor activity on sustained attention in adults with attention deficit-hyperactivity disorder. JOURNAL OF COGNITIVE PSYCHOLOGY 2022. [DOI: 10.1080/20445911.2022.2096623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Kazım Cihan Can
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | | | - Burcin Colak
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Berker Duman
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
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Chewing Behavior Attenuates the Tumor Progression-Enhancing Effects of Psychological Stress in a Breast Cancer Model Mouse. Brain Sci 2021; 11:brainsci11040479. [PMID: 33918787 PMCID: PMC8069186 DOI: 10.3390/brainsci11040479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/03/2021] [Accepted: 04/07/2021] [Indexed: 12/24/2022] Open
Abstract
We examined whether chewing behavior affects the tumor progression-enhancing impact of psychological stress. Human breast cancer cell line (MDA-MB-231) cells were inoculated into the mammary fat pads of athymic nude mice. The mice were assigned randomly to control, stress, and stress+chewing groups. Psychological stress was created by keeping mice in a transparent restraint cylinder for 45 min, three times a day, for 35 days after cell inoculation. Animals in the stress+chewing group were provided with a wooden stick for chewing on during the psychological stress period. Chewing behavior remarkably inhibited the tumor growth accelerated by the psychological stress. Immunohistochemical and Western blot findings revealed that chewing behavior during psychological stress markedly suppressed tumor angiogenesis and cell proliferation. In addition, chewing behavior decreased serum glucocorticoid levels and expressions of glucocorticoid and β2-adrenergic receptors in tumors. Chewing behavior decreased expressions of inducible nitric oxide synthase and 4-hydroxynonenal, and increased expression of superoxide dismutase 2 in tumors. Our findings suggest that chewing behavior could ameliorate the enhancing effects of psychological stress on the progression of breast cancer, at least partially, through modulating stress hormones and their receptors, and the subsequent signaling pathways involving reactive oxygen and nitrogen species.
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Ong S, Bondonno NP, Downey LA, Scholey A, Smith MA, Stough C, Blekkenhorst LC, Woodman R, Croft KD, Hodgson JM, Bondonno CP. Effects of Chewing Gum on Nitric Oxide Metabolism, Markers of Cardiovascular Health and Neurocognitive Performance after a Nitrate-Rich Meal. J Am Coll Nutr 2021; 41:178-190. [PMID: 33600287 DOI: 10.1080/07315724.2020.1869119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Cardiovascular and neurocognitive responses to chewing gum have been reported, but the mechanisms are not well understood. Chewing gum after a nitrate-rich meal may upregulate the reduction of oral nitrate to nitrite and increase nitric oxide (NO), a molecule important to cardiovascular and neurocognitive health. We aimed to explore effects of chewing gum after a nitrate-rich meal on nitrate metabolism (through the enterosalivary nitrate-nitrite-NO pathway), endothelial function, blood pressure (BP), neurocognitive performance, mood and anxiety. METHODS Twenty healthy men (n = 6) and women (n = 14) with a mean age of 48 years (range: 23-69) were recruited to a randomized controlled cross-over trial. After consumption of a nitrate-rich meal (180 mg of nitrate), we assessed the acute effects of chewing gum, compared to no gum chewing, on (i) salivary nitrate, nitrite and the nitrate reductase ratio (100 x [nitrite]/([nitrate] + [nitrite]); (ii) plasma nitrite, S-nitrosothiols and other nitroso species (RXNO); (iii) endothelial function (measured by flow mediated dilatation); (iv) BP; (v) neurocognitive performance; (vi) mood; and (vii) anxiety. RESULTS Consumption of the nitrate-rich meal resulted in a significant increase in markers of nitrate metabolism. A significantly higher peak flow mediated dilatation was observed with chewing compared to no chewing (baseline adjusted mean difference: 1.10%, 95% CI: 0.06, 2.14; p = 0.038) after the nitrate-rich meal. A significant small increase in systolic BP, diastolic BP and heart rate were observed with chewing compared to no chewing after the nitrate-rich meal. The study did not observe increased oral reduction of nitrate to nitrite and NO, or improvements in neurocognitive performance, mood or anxiety with chewing compared to no chewing. CONCLUSION Chewing gum after a nitrate-rich meal resulted in an acute improvement in endothelial function and a small increase in BP but did not result in acute effects on neurocognitive function, mood or anxiety.
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Affiliation(s)
- Sharon Ong
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Nicola P Bondonno
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Biomedical Sciences, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Luke A Downey
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, Victoria, Australia.,Institute for Breathing & Sleep, Austin Hospital, Heidelberg, Victoria, Australia
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, Victoria, Australia
| | - Michael A Smith
- Department of Psychology, University of Northumbria, Newcastle, UK
| | - Con Stough
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, Victoria, Australia
| | - Lauren C Blekkenhorst
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Richard Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, South Australia, Australia
| | - Kevin D Croft
- School of Biomedical Sciences, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Jonathan M Hodgson
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Catherine P Bondonno
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
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Nishigawa K, Suzuki Y, Matsuka Y. Masticatory performance alters stress relief effect of gum chewing. J Prosthodont Res 2015; 59:262-7. [PMID: 26342527 DOI: 10.1016/j.jpor.2015.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/27/2015] [Accepted: 07/29/2015] [Indexed: 11/19/2022]
Abstract
PURPOSE We evaluated the effects of gum chewing on the response to psychological stress induced by a calculation task and investigated the relationship between this response and masticatory performance. METHODS Nineteen healthy adult volunteers without dental problems undertook the Uchida-Kraepelin (UK) test (30 min of reiterating additions of one-digit numbers). Before and immediately after the test, saliva samples were collected from the sublingual area of the participants. Three min after the UK test, the participants were made to chew flavorless gum for 3 min, and the final saliva samples were collected 10 min after the UK test. The experiment was performed without gum chewing on a different day. Masticatory performance was evaluated using color-changing chewing gum. RESULTS Salivary CgA levels at immediately and 10 min after the UK test were compared with and without gum chewing condition. Two-way repeated measures analysis of variance revealed significant interaction between gum chewing condition and changes in CgA levels during post 10 min UK test period. A significant correlation was found between changes in CgA levels and masticatory performance in all participants. CONCLUSION Our results indicate that gum chewing may relieve stress responses; however, high masticatory performance is required to achieve this effect.
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Affiliation(s)
- Keisuke Nishigawa
- Department of Stomatognathic Function and Occlusal Reconstruction, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
| | - Yoshitaka Suzuki
- Department of Stomatognathic Function and Occlusal Reconstruction, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yoshizo Matsuka
- Department of Stomatognathic Function and Occlusal Reconstruction, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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Mastication as a Stress-Coping Behavior. BIOMED RESEARCH INTERNATIONAL 2015; 2015:876409. [PMID: 26090453 PMCID: PMC4450283 DOI: 10.1155/2015/876409] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 12/21/2014] [Accepted: 01/05/2015] [Indexed: 11/29/2022]
Abstract
Exposure to chronic stress induces various physical and mental effects that may ultimately lead to disease. Stress-related disease has become a global health problem. Mastication (chewing) is an effective behavior for coping with stress, likely due to the alterations chewing causes in the activity of the hypothalamic-pituitary-adrenal axis and autonomic nervous system. Mastication under stressful conditions attenuates stress-induced increases in plasma corticosterone and catecholamines, as well as the expression of stress-related substances, such as neurotrophic factors and nitric oxide. Further, chewing reduces stress-induced changes in central nervous system morphology, especially in the hippocampus and hypothalamus. In rodents, chewing or biting on wooden sticks during exposure to various stressors reduces stress-induced gastric ulcer formation and attenuates spatial cognitive dysfunction, anxiety-like behavior, and bone loss. In humans, some studies demonstrate that chewing gum during exposure to stress decreases plasma and salivary cortisol levels and reduces mental stress, although other studies report no such effect. Here, we discuss the neuronal mechanisms that underline the interactions between masticatory function and stress-coping behaviors in animals and humans.
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Chewing gum: cognitive performance, mood, well-being, and associated physiology. BIOMED RESEARCH INTERNATIONAL 2015; 2015:654806. [PMID: 26075253 PMCID: PMC4449949 DOI: 10.1155/2015/654806] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 01/26/2015] [Accepted: 01/29/2015] [Indexed: 01/24/2023]
Abstract
Recent evidence has indicated that chewing gum can enhance attention, as well as promoting well-being and work performance. Four studies (two experiments and two intervention studies) examined the robustness of and mechanisms for these effects. Study 1 investigated the acute effect of gum on mood in the absence of task performance. Study 2 examined the effect of rate and force of chewing on mood and attention performance. Study 3 assessed the effects of chewing gum during one working day on well-being and performance, as well as postwork mood and cognitive performance. In Study 4, performance and well-being were reported throughout the workday and at the end of the day, and heart rate and cortisol were measured. Under experimental conditions, gum was associated with higher alertness regardless of whether performance tasks were completed and altered sustained attention. Rate of chewing and subjective force of chewing did not alter mood but had some limited effects on attention. Chewing gum during the workday was associated with higher productivity and fewer cognitive problems, raised cortisol levels in the morning, and did not affect heart rate. The results emphasise that chewing gum can attenuate reductions in alertness, suggesting that chewing gum enhances worker performance.
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9
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New data on psychological traits and sleep profiles of patients affected by nocturnal eating. Sleep Med 2015; 16:746-53. [PMID: 25934540 DOI: 10.1016/j.sleep.2014.12.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 11/23/2014] [Accepted: 12/04/2014] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Nocturnal eating behavior is shared by patients affected by a parasomnia, sleep-related eating disorder (SRED), and several eating disorders such as night eating syndrome (NES) and binge-eating disorder (BED); however, the differential clinical features of these patients have been poorly studied, with persisting difficulties in defining the borders between these pathologies. The aim of this study was to evaluate polysomnographic and personality characteristics of nocturnal eaters to further differentiate the syndromes. METHODS During a period of six months, consecutive patients complaining of nocturnal eating were asked to participate to the study. Twenty-four patients who were found to eat during the polysomnographic recording (PSG) study, and gender-matched control subjects were included. All subjects underwent a full-night video-PSG study and a psychometric assessment including the Eating Disorder Inventory (EDI-2), the self-rating Bulimic Investigatory Test-Edinburgh (BITE), the Temperament and Character Inventory (TCI), and the Barratt Impulsivity Scale (BIS). RESULTS Nocturnal eaters showed a mild reduction in sleep efficiency and duration due to a moderate sleep fragmentation, whereas the percentage of each sleep stage was not significantly affected. Nocturnal eaters scored higher at many subscales of the EDI-2, at the BITE symptoms subscale, and at the BIS attentional impulsivity subscale. CONCLUSION The psychological characteristics found in our patients with NES seem to be typical for patients affected by eating disorders, and support the hypothesis that the nocturnal behavior of these individuals is due to an eating disorder; however, specific traits also allow differentiation of NES from BED.
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Allen AP, Jacob TJC, Smith AP. Effects and after-effects of chewing gum on vigilance, heart rate, EEG and mood. Physiol Behav 2014; 133:244-51. [PMID: 24857722 DOI: 10.1016/j.physbeh.2014.05.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 04/03/2014] [Accepted: 05/14/2014] [Indexed: 10/25/2022]
Abstract
Research has shown that chewing gum improves attention, although the mechanism for this effect remains unclear. This study investigated the effects and after-effects of chewing gum on vigilance, mood, heart rate and EEG. Participants completed a vigilance task four times; at baseline, with or without chewing gum, and twice post-chewing. EEG alpha and beta power at left frontal and temporal lobes, subjective mood and heart rate were assessed. Chewing gum shortened reaction time and increased the rate of hits, although hits fell during the second post-chewing task. Chewing gum heightened heart rate, but only during chewing. Gum also increased beta power at F7 and T3 immediately post-chewing, but not following the post-chewing tasks. The findings show that chewing gum affects several different indicators of alertness.
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Affiliation(s)
- Andrew P Allen
- Centre for Occupational and Health Psychology, School of Psychology, Cardiff University, 63 Park Place, CF10 3AS, United Kingdom.
| | - Tim J C Jacob
- School of Biosciences, Cardiff University, Life Sciences Building, Museum Avenue, CF10 3AX, United Kingdom.
| | - Andrew P Smith
- Centre for Occupational and Health Psychology, School of Psychology, Cardiff University, 63 Park Place, CF10 3AS, United Kingdom.
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Ergül B, Filik L, Koçak E, Doğan Z, Sarıkaya M. Efficacy and safety of gum chewing in adjunct to high-dose senna for bowel cleansing before colonoscopy: a single-blind randomized controlled trial. Saudi J Gastroenterol 2014; 20:356-9. [PMID: 25434316 PMCID: PMC4271010 DOI: 10.4103/1319-3767.145325] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/AIMS Inadequate bowel cleaning leads to a suboptimal colonoscopic examination. Gum chewing has been reported to have a favorable effect on postoperative bowel functions. We conducted this study to establish if gum chewing added to high-dose senna before colonoscopy promotes bowel cleaning. PATIENTS AND METHODS In this randomized controlled study, consecutive outpatients scheduled for elective colonoscopy were randomized into two groups. Group 1 patients (n = 65) used senna solution 150 mL (300 mg senna) the night before colonoscopy. The patients also used sennoside tablet 80 mg daily for 3 days before the colonoscopy. Patients in group 2 (n = 64) were additionally advised to chew sugarless gum half an hour three-times daily after meals for these 3 days. The overall quality of colonoscopy cleaning was evaluated using the Aronchick scale by a single endoscopist who was blinded to the intervention. Difficulty of procedure, patients' tolerance, and adverse events were also evaluated. RESULTS A total 129 patients were enrolled in the study. Superior cleaning was found in gum chewing group when compared with other group particularly in the cecum and ascending colon. Cecal intubation time was significantly shorter in the gum-chewing group (8.6 ± 5.1 and 7.1 ± 2.8 min, P = 0.03). Adverse events were more common in group 1 compared to the gum-chewing group. CONCLUSIONS Gum chewing enhances colonoscopy bowel preparation quality. Moreover, it is a physiologically sound, safe, and an inexpensive part of the colonoscopy bowel preparation. Gum chewing could be advised in addition to high-dose senna containing bowel preparation.
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Affiliation(s)
- Bilal Ergül
- Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey,Address for correspondence: Dr. Bilal Ergül, Ostim Mah. 1288.Sok, Nevbahar Konutları No: A4/6, Yenimahalle, Ankara, Turkey. E-mail:
| | - Levent Filik
- Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Erdem Koçak
- Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Zeynal Doğan
- Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Murat Sarıkaya
- Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey
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