Influence of Short-Chain Fructo-Oligosaccharides (sc-FOS) on Absorption of Cu, Zn, and Se in Healthy Postmenopausal Women

Evaluation of Lactocare® Synbiotic Administration on the Serum Electrolytes and Trace Elements Levels in Psoriasis Patients: a Randomized, Double-Blind, Placebo-Controlled Clinical Trial Study

BACKGROUND

Despite the exact etiopathogenesis of psoriasis remains unknown, the increasing or decreasing of some trace elements and oxidative stress status are considered to play a role. In this study, the effect of Lactocare® synbiotic on the serum levels of trace elements including Zn, Cu, Mg, Na, Fe, P, Ca, and K in the patients with mild to moderate psoriasis was investigated.

METHODS

Sixty-four patients with mild to moderate psoriasis were included. Patients were randomly divided into treatment (n═32) and control (n═32) groups. The treatment group received Lactocare® and the control group received a placebo (two times daily for 12 weeks). Eight patients from the intervention group and 18 patients from the control group discontinued the study because of the recent COVID-19 condition. For routine trace element analysis, the blood samples were collected from all patients at the baseline as well as week 12 post-treatment. The serum was then isolated and the serum levels of trace elements including Fe, K, Ca, Mg, P, Zn, Na, and Cu were measured using an automatic electrolyte analyzer. For confirmation of the effect of Lactocare® on the alteration of serum levels of trace elements, intra-group analysis was performed at two interval times: baseline and week 12 post-treatment.

RESULTS

The serum levels of K, P, and Ca in the placebo group were significantly higher than that of the treatment group at baseline. Serum levels of Zn and Ca were significantly higher in the treatment group compared to the placebo group at week 12 post-treatment. Moreover, a significantly lower serum level of K, P, and Ca in the treatment group at the baseline compared to the placebo group was compensated on week 12 post-treatment. Intra-group analysis in the treatment group showed that the serum levels of Fe, Ca, Mg, P, Zn, and Na was significantly increased at week 12 post-treatment compared to baseline levels. Whereas, intra-group analysis in the control group showed only Ca has a significant difference between baseline and week 12 post-treatment.

CONCLUSION

The serum levels of Fe, Zn, P, Mg, Ca, and Na are increased significantly 12 weeks after oral administration of Lactocare® in psoriatic patients. The serum level of Fe and Cu is affected by sex at pre- and post-treatment. This study supports the concept that Lactocare® exerts beneficial effects in the gastrointestinal tract to improve mineral absorption in psoriatic patients.

Systematic review of the ingestion of fructooligosaccharides on the absorption of minerals and trace elements versus control groups

BACKGROUND & AIMS

Fructooligosaccharides (FOS) are non-caloric and unconventional sugars that are not metabolized by the human body, but can be fermented by the colonic microbiota, leading to some beneficial effects on the absorption of minerals and trace elements. There is, however, a lack of research that describes the continued consumption of FOS in the diet between healthy and ill individuals and their impact. The objective of this systematic review was to evaluate the evidence behind the role of FOS in the absorption of minerals and trace elements in the human body.

METHODS

The bibliographic research covered the period from January 2000 to August 2020. Four databases were investigated. We follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA). The systematic review protocol was recorded in PROSPERO (139621). Two reviewers examined and extracted data from qualitative and quantitative studies published in the main databases, through a careful analysis. The risk of bias was assessed by four reviewers.

RESULTS

Of a total of 1494 texts, 30 complete articles composed this review. Two overarching categories represented the results: animal models and human models (randomized crossover design). Regarding human models, the results showed an improvement in minerals, especially the absorption of calcium, magnesium and iron after the ingestion of FOS, and specifically the absorption of minerals and trace elements in postmenopausal women was improved.

CONCLUSIONS

The use of FOS to improve the absorption of minerals and trace elements seems to be beneficial with evidence corroborating both in human and animal studies. However, the literature lacks articles exploring the daily dose and duration for FOS benefits, as well as long-term side effects in healthy or unhealthy subjects. Future research should focus on addressing the extent of the functional effect of this fiber and identifying the impact on overall health.

Barriers impairing mineral bioaccessibility and bioavailability in plant-based foods and the perspectives for food processing

Plant-based foods gain more importance since they play a key role in sustainable, low-meat and healthy diets. In developing countries, these food products, especially legumes and cereals, are important staple foods. Nevertheless, the question arises on how efficient they are to deliver minerals and if it is useful to encourage their consumption to reduce the prevalence of mineral deficiencies? This review paper focuses on the discrepancy between the mineral content and the amount of minerals that can be released and absorbed from plant-based foods during human digestion which can be attributed to several inherent factors such as the presence of mineral antinutrients (phytic acid, polyphenols and dietary fiber) and physical barriers (surrounding macronutrients and cell wall). Further, this review paper summarizes the effects of different processing techniques (milling, soaking, dehulling, fermentation, germination and thermal processing) on mineral bioaccessibility and bioavailability of plant-based foods. The positive impact of these techniques mostly relies on the fact that antinutrients levels are reduced due to removal of fractions rich in antinutrients and/or due to their leaching into the processing liquid. Although processing can have a positive effect, it also can induce leaching out of minerals and a reduced mineral bioaccessibility and bioavailability.

Dietary copper restriction in Wilson's disease

Dietary copper restriction has long been considered an important aspect of treatment for Wilson's disease (WD). However, evidence supporting this approach is limited. There are no published randomised controlled trials examining this recommendation due to rarity of the disease and variable presentation. This review summarises current knowledge on the absorption and regulation of copper in humans and its relevance to patients with WD. Studies have demonstrated that as the level of dietary copper increases, the proportion absorbed decreases. This observation implies that 'high copper' foods that WD patients are generally advised to avoid would need to be consumed in large amounts to impact markedly on the quantity absorbed. Dietary copper restriction is unlikely to reduce the amount absorbed significantly and is not only difficult to manage but restricts food groups unnecessarily, detracting from the provision of substrates essential for improving nutritional status in a nutritionally compromised group. Medical management for WD is effective in compliant patients, allowing stabilisation of the liver disease. Based on current evidence, dietary copper restrictions in stable WD patients who are adherent to medical therapy are unnecessary with two food exceptions (shellfish and liver).

Maternal Prebiotic Ingestion Increased the Number of Fecal Bifidobacteria in Pregnant Women but Not in Their Neonates Aged One Month

Fructooligosaccharides (FOS) can selectively stimulate the growth of bifidobacteria. Here, we investigated the effect of maternal FOS ingestion on maternal and neonatal gut bifidobacteria. In a randomized, double-blind, placebo-controlled study, we administered 8 g/day of FOS or sucrose to 84 women from the 26th week of gestation to one month after delivery. The bifidobacteria count was detected using quantitative PCR in maternal (26 and 36 weeks of gestation) and neonatal (one month after delivery) stools. Maternal stool frequency was recorded from 24 to 36 weeks of gestation. The number of fecal Bifidobacterium spp. and Bifidobacterium longum in the FOS group was significantly higher than that in the placebo group at 36 weeks of gestation (2.7 × 10¹⁰/g vs. 1.1 × 10¹⁰/g and 2.3 × 10¹⁰/g vs. 9.7 × 10⁹/g). In their neonates, these numbers did not differ between the groups. Also, stool frequency in the FOS group was slightly higher than that in the placebo group two weeks after the intervention (1.0 vs. 0.8 times/day), suggesting a potential constipation alleviation effect. In conclusion, the maternal FOS ingestion showed a bifidogenic effect in pregnant women but not in their neonates.

The relevance of the colon to zinc nutrition

Globally, zinc deficiency is widespread, despite decades of research highlighting its negative effects on health, and in particular upon child health in low-income countries. Apart from inadequate dietary intake of bioavailable zinc, other significant contributors to zinc deficiency include the excessive intestinal loss of endogenously secreted zinc and impairment in small intestinal absorptive function. Such changes are likely to occur in children suffering from environmental (or tropical) enteropathy (EE)—an almost universal condition among inhabitants of developing countries characterized by morphologic and functional changes in the small intestine. Changes to the proximal gut in environmental enteropathy will likely influence the nature and amount of zinc delivered into the large intestine. Consequently, we reviewed the current literature to determine if colonic absorption of endogenous or exogenous (dietary) zinc could contribute to overall zinc nutriture. Whilst we found evidence that significant zinc absorption occurs in the rodent colon, and is favoured when microbially-fermentable carbohydrates (specifically resistant starch) are consumed, it is unclear whether this process occur in humans and/or to what degree. Constraints in study design in the few available studies may well have masked a possible colonic contribution to zinc nutrition. Furthermore these few available human studies have failed to include the actual target population that would benefit, namely infants affected by EE where zinc delivery to the colon may be increased and who are also at risk of zinc deficiency. In conducting this review we have not been able to confirm a colonic contribution to zinc absorption in humans. However, given the observations in rodents and that feeding resistant starch to children is feasible, definitive studies utilising the dual stable isotope method in children with EE should be undertaken.

Yacon effects in immune response and nutritional status of iron and zinc in preschool children

OBJECTIVE

The aim of this study was to evaluate the effect of yacon flour on iron and zinc nutritional status and immune response biomarkers in preschool children.

METHODS

Preschool children ages 2 to 5 y were selected from two nurseries and were placed into a control group (n = 58) or a yacon group (n = 59). The yacon group received yacon flour in preparations for 18 wk at a quantity to provide 0.14 g of fructooligosaccharides/kg of body weight daily. Anthropometric parameters were measured before and after the intervention and dietary intake was measured during the intervention. To assess iron and zinc status, erythrograms, serum iron, ferritin, and plasma, and erythrocyte zinc were evaluated. Systemic immune response was assessed by the biomarkers interleukin IL-4, IL-10, IL-6, and tumor necrosis factor-alfa (TNF-α). Intestinal immune response was analyzed by secretory IgA (sIgA) levels before and after the intervention. Statistical significance was evaluated using the paired t test (α = 5%).

RESULTS

Before and after the study, the children presented a high prevalence of overweight and an inadequate dietary intake of zinc and fiber. The yacon group presented with lower hemoglobin, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration at the end of the study (P < 0.05). Erythrocyte zinc was reduced in both groups at the end of the study (P < 0.05). Yacon intake increased the serum levels of IL-4 and fecal sIgA (P < 0.05). The control group had lower serum TNF-α after the study period (P < 0.05).

CONCLUSION

Yacon improved intestinal immune response but demonstrated no effect on the nutritional status of iron and zinc in preschool children.

Risks and benefits of copper in light of new insights of copper homeostasis

Copper is an essential micronutrient involved in a variety of biological processes indispensable to sustain life. At the same time, it can be toxic when present in excess, the most noticeable chronic effect being liver damage. Potent, efficient regulatory mechanisms control copper absorption in the digestive tract and copper biliary excretion; absorption ranges between 12 and 60% in humans, depending on Cu intake, presence of other factors in the diet that may promote or inhibit its absorption and on the copper status of the individual. Current evidence suggests that copper deficiency may be more prevalent than previously thought, while copper toxicity is uncommon under customary daily life conditions. Menkes syndrome and Wilson disease are genetic conditions associated with severe copper deficiency and severe copper toxicity, respectively. Effects of milder degrees of copper deficiency and excess copper exposure are not well described, mainly due to lack of sensitive and specific indicators; serum copper concentration and ceruloplasmin are the most frequently used indicators, but they only detect rather intense changes of copper status. Of the many proteins assessed as potential markers of copper status the chaperone of Zn-Cu superoxide dismutase (CCS1) has yielded promising results; data on its performance under different conditions are needed to confirm its use as an indicator of early copper deficiency. Defining copper requirements and upper safe limits of consumption (UL) is a complex process since there are adverse health consequences from both copper deficiency and copper excess (U shape curve). The regulatory framework for risk assessment of essential trace elements introduced by the International Programme on Chemical Safety (IPCS) has proposed a homeostatic model to determine the Adequate Range of Oral Intake (AROI) of essential trace elements; the nadir of the resulting U shape curve serves to define the AROI. At this range of intake physiological mechanisms allow for normal homeostasis and basically, there are no detectable adverse effects. At present, Recommended Dietary Intakes (DRIs) and Adequate Intakes (AIs) are used to recommend copper intakes at different ages and life situations. Evidence obtained in humans and non-human primates presented here suggest that current copper UL should be re evaluated. Developing the scientific basis for a copper UL and evaluating the relevance of copper deficiency globally are future key challenges for copper researchers.

Prebiotic effects: metabolic and health benefits

The different compartments of the gastrointestinal tract are inhabited by populations of micro-organisms. By far the most important predominant populations are in the colon where a true symbiosis with the host exists that is a key for well-being and health. For such a microbiota, 'normobiosis' characterises a composition of the gut 'ecosystem' in which micro-organisms with potential health benefits predominate in number over potentially harmful ones, in contrast to 'dysbiosis', in which one or a few potentially harmful micro-organisms are dominant, thus creating a disease-prone situation. The present document has been written by a group of both academic and industry experts (in the ILSI Europe Prebiotic Expert Group and Prebiotic Task Force, respectively). It does not aim to propose a new definition of a prebiotic nor to identify which food products are classified as prebiotic but rather to validate and expand the original idea of the prebiotic concept (that can be translated in 'prebiotic effects'), defined as: 'The selective stimulation of growth and/or activity(ies) of one or a limited number of microbial genus(era)/species in the gut microbiota that confer(s) health benefits to the host.' Thanks to the methodological and fundamental research of microbiologists, immense progress has very recently been made in our understanding of the gut microbiota. A large number of human intervention studies have been performed that have demonstrated that dietary consumption of certain food products can result in statistically significant changes in the composition of the gut microbiota in line with the prebiotic concept. Thus the prebiotic effect is now a well-established scientific fact. The more data are accumulating, the more it will be recognised that such changes in the microbiota's composition, especially increase in bifidobacteria, can be regarded as a marker of intestinal health. The review is divided in chapters that cover the major areas of nutrition research where a prebiotic effect has tentatively been investigated for potential health benefits. The prebiotic effect has been shown to associate with modulation of biomarkers and activity(ies) of the immune system. Confirming the studies in adults, it has been demonstrated that, in infant nutrition, the prebiotic effect includes a significant change of gut microbiota composition, especially an increase of faecal concentrations of bifidobacteria. This concomitantly improves stool quality (pH, SCFA, frequency and consistency), reduces the risk of gastroenteritis and infections, improves general well-being and reduces the incidence of allergic symptoms such as atopic eczema. Changes in the gut microbiota composition are classically considered as one of the many factors involved in the pathogenesis of either inflammatory bowel disease or irritable bowel syndrome. The use of particular food products with a prebiotic effect has thus been tested in clinical trials with the objective to improve the clinical activity and well-being of patients with such disorders. Promising beneficial effects have been demonstrated in some preliminary studies, including changes in gut microbiota composition (especially increase in bifidobacteria concentration). Often associated with toxic load and/or miscellaneous risk factors, colon cancer is another pathology for which a possible role of gut microbiota composition has been hypothesised. Numerous experimental studies have reported reduction in incidence of tumours and cancers after feeding specific food products with a prebiotic effect. Some of these studies (including one human trial) have also reported that, in such conditions, gut microbiota composition was modified (especially due to increased concentration of bifidobacteria). Dietary intake of particular food products with a prebiotic effect has been shown, especially in adolescents, but also tentatively in postmenopausal women, to increase Ca absorption as well as bone Ca accretion and bone mineral density. Recent data, both from experimental models and from human studies, support the beneficial effects of particular food products with prebiotic properties on energy homaeostasis, satiety regulation and body weight gain. Together, with data in obese animals and patients, these studies support the hypothesis that gut microbiota composition (especially the number of bifidobacteria) may contribute to modulate metabolic processes associated with syndrome X, especially obesity and diabetes type 2. It is plausible, even though not exclusive, that these effects are linked to the microbiota-induced changes and it is feasible to conclude that their mechanisms fit into the prebiotic effect. However, the role of such changes in these health benefits remains to be definitively proven. As a result of the research activity that followed the publication of the prebiotic concept 15 years ago, it has become clear that products that cause a selective modification in the gut microbiota's composition and/or activity(ies) and thus strengthens normobiosis could either induce beneficial physiological effects in the colon and also in extra-intestinal compartments or contribute towards reducing the risk of dysbiosis and associated intestinal and systemic pathologies.

Preparation of high-purity fructo-oligosaccharides by Aspergillus japonicus beta-fructofuranosidase and successive cultivation with yeast

The short-chain FOSs with high purity were prepared using a two-step strategy: Aspergillus japonicus extracellular beta-fructofuranosidase-catalyzed synthesis of FOSs followed by cultivation with Pichia pastoris (P. pastoris). The higher FOSs content was obtained after 8 h under the catalysis of beta-fructofuranosidase at pH 5.5 and 55 degrees C. Successive P. pastoris cultivation exhausts almost all monosugars in 12 h at 30 degrees C, which increases the purity of FOSs, and also recovers beta-fructofuranosidase activity by ceasing the inhibition of glucose from catalysis of the enzyme, yielding more FOSs. Finally, the FOSs purity was increased from 56.55 to 84.45% (26.47% 1-kestose and 57.98% nystose).

Use of stable isotopes to evaluate the functional effects of nutrients

PURPOSE OF REVIEW

Lifestyle, particularly dietary habits, plays a major role in the increasing prevalence of obesity, type 2 diabetes and atherosclerosis. Understanding how diet and specific foods can modify important functions of the body, in a beneficial or detrimental way, is therefore important. This review presents recent advances in the use of stable isotopes to investigate how nutrients can influence pathways of glucose, lipids and protein metabolism, and also intestinal absorption, body composition and fat mass turnover.

RECENT FINDINGS

Recent developments have focused mainly on the measurement of intratissular metabolic pathways, particularly in lipids and proteins. Advances in the field of cell proliferation rates, body composition and energy expenditure have also been made. Many of these developments rely on the use of deuterated water to trace multiple metabolic pathways.

SUMMARY

Stable isotopes can now be used to measure the kinetics and oxidation rate of circulating metabolites and also body composition, colonic fermentation, intestinal absorption, and important intratissular metabolic pathways, such as gluconeogenesis, lipogenesis, cholesterol synthesis, the turnover rate of triglycerides, individual protein synthesis and cell proliferation. Deuterated water has emerged as a powerful and versatile tool, allowing the simultaneous investigation of several aspects of protein, lipid and glucose metabolism.

Review article: prebiotics in the gastrointestinal tract

BACKGROUND

Prebiotics are short-chain carbohydrates that alter the composition, or metabolism, of the gut microbiota in a beneficial manner. It is therefore expected that prebiotics will improve health in a way similar to probiotics, whilst at the same time being cheaper, and carrying less risk and being easier to incorporate into the diet than probiotics.

AIM

To review published evidence for prebiotic effects on gut function and human health.

METHODS

We searched the Science Citation Index with the terms prebiotic, microbiota, gut bacteria, large intestine, mucosa, bowel habit, constipation, diarrhoea, inflammatory bowel disease, Crohn's disease, ulcerative colitis, pouchitis, calcium and cancer, focussing principally on studies in humans and reports in the English language. Search of the Cochrane Library did not identify any clinical study or meta-analysis on this topic.

RESULTS

Three prebiotics, oligofructose, galacto-oligosaccharides and lactulose, clearly alter the balance of the large bowel microbiota by increasing bifidobacteria and Lactobacillus numbers. These carbohydrates are fermented and give rise to short-chain fatty acid and intestinal gas; however, effects on bowel habit are relatively small. Randomized-controlled trials of their effect in a clinical context are few, although animal studies show anti-inflammatory effects in inflammatory bowel disease, while calcium absorption is increased.

CONCLUSIONS

It is still early days for prebiotics, but they offer the potential to modify the gut microbial balance in such a way as to bring direct health benefits cheaply and safely.

Dietary inulin intake and age can affect intestinal absorption of zinc and copper in rats

Nondigestible inulin-type fructan intake can stimulate intestinal mineral absorption in both humans and animals. However, this stimulatory effect may depend on experimental conditions such as the duration of the experience, mineral levels in the diet, and the animal's physiological status. The aim of this study was to determine the effect of inulin intake on Zn and Cu absorption in rats at different ages. Male Wistar rats (n = 80) of 4 different ages (2,5, 10, and 20 mo) were randomly assigned to a control group or a group administered 3.75% inulin in their diet for 4 d followed by 7.5% inulin for 26 d. Absorption of Zn67 and Cu65 was determined on d 21 of the experiment by fecal monitoring using Zn67 and Cu65 isotopes. Zn and Cu status was also assessed. Absorption of Zn67 and Cu65 was significantly lower in 11- and 21-mo-old rats than in 3- and 6 mo-old-rats. Moreover, inulin intake significantly increased Zn67 and Cu65 absorption. In conclusion, age and dietary inulin intake can significantly affect intestinal absorption of zinc and copper in rats. Further studies are required to explore this effect over longer periods of inulin intake and to test the effects of inulin in humans.

Impact of micronutrient dietary intake and status on intestinal zinc absorption in late middle-aged men: the ZENITH study

BACKGROUND

Adjustments in intestinal absorption and losses of zinc (Zn) are thought to maintain Zn homeostasis when dietary intake levels are altered. Zn status may also influence efficiency of intestinal Zn absorption.

OBJECTIVES

To determine the impact of dietary intake and status of some micronutrients on Zn absorption in late middle-aged men.

DESIGN AND PARTICIPANTS

Dietary intake and status of Zn, Cu, Fe, vitamin A, C and fibre, and absorption of Zn were measured in 48 men, aged 58-68 y, confined to a metabolic unit and consuming a typical French diet. Dietary intake was estimated using 4-day food-intake records (including the weekend) and the GENI program. To assess Zn status, serum, erythrocyte, urine Zn levels and serum alkaline phosphatase activity were determined. Zn absorption was determined using the isotope double-labelling method. Zn stable isotopic ratios were measured in plasma samples collected before and 48 h after isotope administration using ICP/MS.

RESULTS

Zn intake within the group of men varied from 5.7 to 20.5 mg/day and averaged 12.9 mg/day. Serum Zn level varied from 10 to 18 micromol/l and averaged 12.9 micromol/l. Zn absorption varied from 12 to 46% and averaged 29.7%. Zn absorption was not significantly (P > 0.05) correlated with Zn intake or with any of the Zn status parameters. Zn absorption was only slightly negatively correlated with serum and erythrocyte Zn levels and with serum Fe and ferritin levels in this study.

CONCLUSION

Zn dietary intake and Zn absorption were satisfactory and led to an adequate Zn status in this population.

Energy value of a low-digestible carbohydrate, NUTRIOSE FB, and its impact on magnesium, calcium and zinc apparent absorption and retention in healthy young men

BACKGROUND

Long-term consumption of imbalanced diets, poor in dietary fibres, resulted in the prevalence of several nutritional pathologies. However, low digestible carbohydrates (LDC) have many beneficial effects, especially on energy intake, digestive physiology, and mineral absorption.

AIM OF THE STUDY

To determine the digestive effects of a LDC, called NUTRIOSE FB, its metabolisable energy (ME) value, and its effects on mineral absorption in humans.

METHODS

Ten healthy young men were fed for 31 d periods a maintenance diet supplemented with either dextrose or the LDC at a level of 100 g DM/d, in six equal doses per d according to a cross-over design. After a 20 d adaptation period, food intake was determined for 11 days using the duplicate meal method, and faeces and urine were collected for 10 d for further analyses.

RESULTS

Ingestion of the LDC did not cause severe digestive disorders, except excessive gas emission, and flatulence and slight abdominal pain in some subjects for intakes above 50 g DM/d. Wet and dry stool outputs increased by 45 and 70%, respectively (P<0.02). In vitro enzymatic digestibility of the LDC was 15 (SD 1.5) %, and 9.2 (SD 8.3) % of the LDC was excreted in faeces (P<0.001). The ME value of the LDC was 14.1 (SD 2.3) kJ/g DM, that is 14 % less than the tabulated values of sucrose and starch. Its net energy value (NEV), estimated using three prediction equations, was 8.7, 8.9, and 11.4 kJ/g DM. Ingestion of the LDC significantly increased the relative apparent absorption of Mg, and Mg retention by 67% and 31 mg/d, respectively, tended to increase Ca apparent absorption (P=0.110) and Ca retention (P=0.059), but did not significantly alter Zn parameters.

CONCLUSION

NUTRIOSE FB can be used as a "bulking" agent, and substituted up to 50 g/d for usual maltodextrins without causing digestive disorders in healthy subjects. It would reduce intestinal transit disorders and energy intake, and improve magnesium and calcium absorption and retention.