1
|
Limketkai BN, Godoy-Brewer G, Shah ND, Maas L, White J, Parian AM, Mullin GE. Prebiotics for Induction and Maintenance of Remission in Inflammatory Bowel Disease: Systematic Review and Meta-Analysis. Inflamm Bowel Dis 2024:izae115. [PMID: 38781004 DOI: 10.1093/ibd/izae115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Prebiotics are nondigestible carbohydrates fermented by gut bacteria into metabolites that confer health benefits. However, evidence on their role for inflammatory bowel disease (IBD) is unclear. This study systematically evaluated the research on prebiotics for treatment of IBD. METHODS A search was performed in PubMed, Embase, Cochrane, and Web of Science. Eligible articles included randomized controlled trials or prospective observational studies that compared a prebiotic with a placebo or lower-dose control in patients with IBD. Meta-analyses were performed using random-effects models for the outcomes of clinical remission, clinical relapse, and adverse events. RESULTS Seventeen studies were included. For induction of clinical remission in ulcerative colitis (UC), the fructooligosaccharide (FOS) kestose was effective (relative risk, 2.75, 95% confidence interval, 1.05-7.20; n = 40), but oligofructose-enriched inulin (OF-IN) and lactulose were not. For maintenance of remission in UC, germinated barley foodstuff trended toward preventing clinical relapse (relative risk, 0.40; 95% confidence interval, 0.15-1.03; n = 59), but OF-IN, oat bran, and Plantago ovata did not. For Crohn's disease, OF-IN and lactulose were no different than controls for induction of remission, and FOS was no different than controls for maintenance of remission. Flatulence and bloating were more common with OF-IN; reported adverse events were otherwise similar to controls for other prebiotics. CONCLUSION Prebiotics, particularly FOS and germinated barley foodstuff, show potential as effective and safe dietary supplements for induction and maintenance of remission in UC, respectively. The overall certainty of evidence was very low. There would be benefit in further investigation on the role of prebiotics as treatment adjuncts for IBD.
Collapse
Affiliation(s)
- Berkeley N Limketkai
- Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Division of Clinical Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Gala Godoy-Brewer
- Department of Medicine, University of Miami School of Medicine, Miami, FL, USA
| | - Neha D Shah
- Colitis and Crohn's Disease Center, Division of Gastroenterology, UCSF School of Medicine, San Francisco, CA, USA
| | - Laura Maas
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jacob White
- Welch Library, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alyssa M Parian
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gerard E Mullin
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
2
|
Moura de Oliveira Beltrame D, Simmons TJ, Jenkins AL, Dinan T, Nicholson TJ. Gastrointestinal Tolerability and Acute Glycemic Response of Oligosaccharides and Polysaccharides from Cellulose and Xylan in Healthy Adults: Two Double-Blinded, Randomized, Controlled, Cross-over Trials. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:305-314. [PMID: 38032277 DOI: 10.1080/27697061.2023.2282615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/06/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the gastrointestinal tolerability, glycemic and insulinemic responses of Plant Fiber Extract (PFE), a mixture comprising of oligosaccharides and polysaccharides derived from cellulose and xylan. METHODS Two double-blind, randomized, controlled, cross-over trials were conducted in healthy adults. In the first trial, participants (n = 29) consumed either 25, 35 or 45 g per day of PFE or resistant maltodextrin (Control) for 14 days. The occurrence and severity of gastrointestinal (GI) symptoms, stool parameters, and safety outcomes were evaluated with a combination of surveys and blood analysis respectively. In the second trial (n = 20), the post-prandial glycemic and insulinemic responses after the ingestion of 20 g of PFE diluted in water or incorporated into chocolate chips was measured and then compared to that of glucose and regular chocolate, respectively. RESULTS For all timepoints (0, 7 and 14 days), within any given dose group, there was no statistically significant difference in the GI symptoms score between PFE and Control. Further, for each test product (PFE or Control), no difference was observed in the same dose group from days 0 and 14. Stool consistency score and number of participants experiencing loose or watery stools was similar between products. No serious adverse events were reported and neither PFE nor Control significantly altered blood or urine safety parameters. The glycemic and insulinemic responses after PFE ingestion in comparison to glucose were 12% and 8% respectively. The glycemic and insulinemic responses after consuming chocolate containing PFE were 20% of that of regular chocolate. CONCLUSION PFE was well-tolerated by healthy volunteers in doses up to 45 g/day and it elicited comparatively low glycemic and insulinemic responses when consumed alone or when incorporated into a food product.
Collapse
|
3
|
Qiao Y, Shen Y, Jiang H, Li D, Li B. Structural characterization, antioxidant and antibacterial activity of three pectin polysaccharides from blueberry. Int J Biol Macromol 2024; 262:129707. [PMID: 38272416 DOI: 10.1016/j.ijbiomac.2024.129707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/02/2024] [Accepted: 01/22/2024] [Indexed: 01/27/2024]
Abstract
In this study, three pectin polysaccharides BP1, BP2 and BP3, were purified from blueberries. The weight-average molecular weight (Mw) of BP1, BP2, and BP3 were detected to be 9.027 × 104, 9.313 × 104, and 1.223 × 106 Da, respectively. The structures of the three pectin polysaccharides were characterized and compared based on the results of molecular weight, monosaccharide composition, GC-MS and NMR analysis. Structural characterization revealed that BP1, BP2, and BP3 all contain homogalacturonan (HG) and rhamnogalacturonan I (RG-I) domains, and the rhamnose residues in RG-I domains are substituted at C-4 with side chains such as araban and galactosan. BP2 had the highest degree of esterification and HG domain ratio, followed by BP3 and BP1. In addition, BP1, BP2 and BP3 showed great antioxidant and antibacterial activities, and could destroy the cell membrane of Staphylococcus aureus and Escherichia coli. Moreover, the better DPPH and ABTS free radical scavenging and antibacterial activities of BP1 and BP2 than BP3 might be related to their lower molecular weight. The results of this study will provide essential information for the structure-activity relationship of pectin polysaccharides and research basis for development and application of blueberry pectin polysaccharides.
Collapse
Affiliation(s)
- Yanyan Qiao
- Food Science College, Shenyang Agricultural University, Shenyang 110866, PR China
| | - Yixiao Shen
- Food Science College, Shenyang Agricultural University, Shenyang 110866, PR China
| | - Hongzhou Jiang
- Anhui Ziyue Biotechnology Co., LTD, Wuhu, Anhui 238300, PR China
| | - Dongnan Li
- Food Science College, Shenyang Agricultural University, Shenyang 110866, PR China.
| | - Bin Li
- Food Science College, Shenyang Agricultural University, Shenyang 110866, PR China.
| |
Collapse
|
4
|
Gong L, Liu F, Liu J, Wang J. Dietary fiber (oligosaccharide and non-starch polysaccharide) in preventing and treating functional gastrointestinal disorders - Challenges and controversies: A review. Int J Biol Macromol 2024; 258:128835. [PMID: 38128805 DOI: 10.1016/j.ijbiomac.2023.128835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
Functional gastrointestinal disorders (FGIDs) are a group of chronic or recurrent gastrointestinal functional diseases, including functional dyspepsia, irritable bowel syndrome, and functional constipation. A lack of safe and reliable treatments for abdominal pain-related FGIDs has prompted interest in new therapies. Evidence has shown that supplementation with dietary fiber may help treat FGIDs. Dietary fibers (DFs) have been demonstrated to have regulatory effects on the gut microbiota, microbiota metabolites, and gastrointestinal movement and have important implications for preventing and treating FGIDs. However, the adverse effects of some DFs, such as fermentable oligosaccharides, on FGIDs are unclear. This review provides an overview of the DFs physiological properties and functional characteristics that influence their use in management of FGIDs, with emphasis on structural modification technology to improve their therapeutic activities. The review highlights that the use of appropriate or novel fibers is a potential therapeutic approach for FGIDs.
Collapse
Affiliation(s)
- Lingxiao Gong
- Key Laboratory of Geriatric Nutrition and Health (Beijing Technology and Business University), Ministry of Education, Key Laboratory of Special Food Supervision Technology for State Market Regulation, School of Food and Health, Beijing Technology & Business University (BTBU), Beijing 100048, China
| | - Feiyue Liu
- Key Laboratory of Geriatric Nutrition and Health (Beijing Technology and Business University), Ministry of Education, Key Laboratory of Special Food Supervision Technology for State Market Regulation, School of Food and Health, Beijing Technology & Business University (BTBU), Beijing 100048, China
| | - Jie Liu
- Key Laboratory of Geriatric Nutrition and Health (Beijing Technology and Business University), Ministry of Education, Key Laboratory of Special Food Supervision Technology for State Market Regulation, School of Food and Health, Beijing Technology & Business University (BTBU), Beijing 100048, China
| | - Jing Wang
- Key Laboratory of Geriatric Nutrition and Health (Beijing Technology and Business University), Ministry of Education, Key Laboratory of Special Food Supervision Technology for State Market Regulation, School of Food and Health, Beijing Technology & Business University (BTBU), Beijing 100048, China.
| |
Collapse
|
5
|
N M, Deshpande R, Maurya DK, Jamdar SN. Modifying rheological properties of psyllium by gamma irradiation enables development of low glycaemic index food with a predicted gastrointestinal tolerance. Int J Biol Macromol 2024; 257:128625. [PMID: 38065450 DOI: 10.1016/j.ijbiomac.2023.128625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/01/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023]
Abstract
Gel forming dietary fibre like psyllium (PS) is effective in slowing down rate of digestion as well as absorption of glucose thereby reducing the postprandial glucose level and hence is used to develop functional foods for diabetic patients. The fortification level is however limited which otherwise elicit unwanted rheological response and poor sensorial quality in final product. In the present study this limitation was overcome by improving the functionality of the fibre by gamma radiation processing of the polysaccharides. We assessed the changes in rheological properties of radiation processed PS (RPPS) at different doses which enabled us to optimise the irradiation dose and levels of fortification of the RPPS in wheat flour for preparation of Indian unleavened bread (chapati). We observed that PS processed at a dose of 25 kGy could be incorporated to a level as high as 14 % in wheat flour yielding a sensorially better product compared to unfortified wheat flour. Further, the most striking effect observed for RPPS fortified chapati was reduction in the release of glucose upon subjecting to simulated gastrointestinal digestion. Finally, clinical and in vitro fermentation studies also confirmed a low GI value and high gastrointestinal tolerance of RPPS fortified chapati.
Collapse
Affiliation(s)
- Mallikarjunan N
- Food Technology Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400 085, India; Homi Bhabha National Institute, Anushakti Nagar, Mumbai 400 094, India
| | - Rajalakshmi Deshpande
- Food Technology Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400 085, India
| | - Dharmendra K Maurya
- Radiation Biology & Health Sciences Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400 085, India
| | - Sahayog N Jamdar
- Food Technology Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400 085, India; Homi Bhabha National Institute, Anushakti Nagar, Mumbai 400 094, India.
| |
Collapse
|
6
|
Deehan EC, Zhang Z, Nguyen NK, Perez-Muñoz ME, Cole J, Riva A, Berry D, Prado CM, Walter J. Adaptation to tolerate high doses of arabinoxylan is associated with fecal levels of Bifidobacterium longum. Gut Microbes 2024; 16:2363021. [PMID: 38860973 PMCID: PMC11174067 DOI: 10.1080/19490976.2024.2363021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/29/2024] [Indexed: 06/12/2024] Open
Abstract
Dietary fiber supplements are a strategy to close the 'fiber gap' and induce targeted modulations of the gut microbiota. However, higher doses of fiber supplements cause gastrointestinal (GI) symptoms that differ among individuals. What determines these inter-individual differences is insufficiently understood. Here we analyzed findings from a six-week randomized controlled trial that evaluated GI symptoms to corn bran arabinoxylan (AX; n = 15) relative to non-fermentable microcrystalline cellulose (MCC; n = 16) at efficacious supplement doses of 25 g/day (females) or 35 g/day (males) in adults with excess weight. Self-reported flatulence, bloating, and stomach aches were evaluated weekly. Bacterial taxa involved in AX fermentation were identified by bioorthogonal non-canonical amino acid tagging. Associations between GI symptoms, fecal microbiota features, and diet history were systematically investigated. AX supplementation increased symptoms during the first three weeks relative to MCC (p < 0.05, Mann-Whitney tests), but subjects 'adapted' with symptoms reverting to baseline levels toward the end of treatment. Symptom adaptations were individualized and correlated with the relative abundance of Bifidobacterium longum at baseline (rs = 0.74, p = 0.002), within the bacterial community that utilized AX (rs = 0.69, p = 0.006), and AX-induced shifts in acetate (rs = 0.54, p = 0.039). Lower baseline consumption of animal-based foods and higher whole grains associated with less severity and better adaptation. These findings suggest that humans do 'adapt' to tolerate efficacious fiber doses, and this process is linked to their microbiome and dietary factors known to interact with gut microbes, providing a basis for the development of strategies for improved tolerance of dietary fibers.
Collapse
Affiliation(s)
- Edward C. Deehan
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
- Department of Food Science and Technology, University of Nebraska, Lincoln, NE, USA
- Nebraska Food for Health Center, University of Nebraska, Lincoln, NE, USA
| | - Zhengxiao Zhang
- Department of Medicine, University of Alberta, Edmonton, Canada
- College of Food and Biological Engineering, Jimei University, Xiamen, China
| | - Nguyen K. Nguyen
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
- Metabolism and Nutrition Research Group (MNUT), Louvain Drug Research Institute (LDRI), UCLouvain, Université catholique de Louvain, Brussels, Belgium
- Walloon Excellence in Life Sciences and Biotechnology (WELBIO), WEL Research Institute, Wavre, Belgium
| | - Maria Elisa Perez-Muñoz
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Janis Cole
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Alessandra Riva
- Centre for Microbiology and Environmental Systems Science, Department of Microbiology and Ecosystem Science, Division of Microbial Ecology, University of Vienna, Vienna, Austria
- Chair of Nutrition and Immunology, School of Life Sciences, Technical University of Munich, Freising-Weihenstephan, Germany
| | - David Berry
- Centre for Microbiology and Environmental Systems Science, Department of Microbiology and Ecosystem Science, Division of Microbial Ecology, University of Vienna, Vienna, Austria
- Joint Microbiome Facility of the Medical University of Vienna, University of Vienna, Vienna, Austria
| | - Carla M. Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Jens Walter
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
- Department of Biological Sciences, University of Alberta, Edmonton, Canada
- APC Microbiome Ireland, School of Microbiology, and Department of Medicine, University College Cork – National University of Ireland, Cork, Ireland
| |
Collapse
|
7
|
Chen X, Hou Y, Wang Z, Liao A, Pan L, Zhang M, Xue Y, Wang J, Liu Y, Huang J. A Comparative Study of Resistant Dextrins and Resistant Maltodextrins from Different Tuber Crop Starches. Polymers (Basel) 2023; 15:4545. [PMID: 38231993 PMCID: PMC10708145 DOI: 10.3390/polym15234545] [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: 11/15/2023] [Revised: 11/23/2023] [Accepted: 11/23/2023] [Indexed: 01/19/2024] Open
Abstract
The anti-digestibility of resistant dextrin (RD) and resistant maltodextrin (RMD) is usually significantly affected by processing techniques, reaction conditions, and starch sources. The objective of this investigation is to elucidate the similarities and differences in the anti-digestive properties of RD and RMD prepared from three different tuber crop starches, namely, potato, cassava, and sweet potato, and to reveal the associated mechanisms. The results show that all RMDs have a microstructure characterized by irregular fragmentation and porous surfaces, no longer maintaining the original crystalline structure of starches. Conversely, RDs preserve the structural morphology of starches, featuring rough surfaces and similar crystalline structures. RDs exhibite hydrolysis rates of approximately 40%, whereas RMDs displaye rates lower than 8%. This disparity can be attributed to the reduction of α-1,4 and α-1,6 bonds and the development of a highly branched spatial structure in RMDs. The indigestible components of the three types of RDs range from 34% to 37%, whereas RMDs vary from 80% to 85%, with potato resistant maltodextrin displaying the highest content (84.96%, p < 0.05). In conclusion, there are significant differences in the processing performances between different tuber crop starches. For the preparation of RMDs, potato starch seems to be superior to sweet potato and cassava starches. These attributes lay the foundation for considering RDs and RMDs as suitable components for liquid beverages, solid dietary fiber supplements, and low glycemic index (low-GI) products.
Collapse
Affiliation(s)
- Xinyang Chen
- Henan Key Laboratory of Wheat Bioprocessing and Nutritional Function, School of Biological Engineering, Henan University of Technology, Zhengzhou 450001, China; (X.C.); (Y.X.)
- Food Laboratory of Zhongyuan, Luohe 462300, China
| | - Yinchen Hou
- School of Food and Bioengineering, Henan University of Animal Husbandry and Economy, Zhengzhou 450046, China
- Food Laboratory of Zhongyuan, Luohe 462300, China
| | - Zhen Wang
- State Key Laboratory of Crop Stress Adaptation and Improvement, College of Agriculture, Henan University, Kaifeng 475004, China
- Food Laboratory of Zhongyuan, Luohe 462300, China
| | - Aimei Liao
- Henan Key Laboratory of Wheat Bioprocessing and Nutritional Function, School of Biological Engineering, Henan University of Technology, Zhengzhou 450001, China; (X.C.); (Y.X.)
- Food Laboratory of Zhongyuan, Luohe 462300, China
| | - Long Pan
- Henan Key Laboratory of Wheat Bioprocessing and Nutritional Function, School of Biological Engineering, Henan University of Technology, Zhengzhou 450001, China; (X.C.); (Y.X.)
- Food Laboratory of Zhongyuan, Luohe 462300, China
| | - Mingyi Zhang
- Henan Key Laboratory of Wheat Bioprocessing and Nutritional Function, School of Biological Engineering, Henan University of Technology, Zhengzhou 450001, China; (X.C.); (Y.X.)
- Food Laboratory of Zhongyuan, Luohe 462300, China
| | - Yingchun Xue
- Henan Key Laboratory of Wheat Bioprocessing and Nutritional Function, School of Biological Engineering, Henan University of Technology, Zhengzhou 450001, China; (X.C.); (Y.X.)
- Food Laboratory of Zhongyuan, Luohe 462300, China
| | - Jingjing Wang
- Henan Key Laboratory of Wheat Bioprocessing and Nutritional Function, School of Biological Engineering, Henan University of Technology, Zhengzhou 450001, China; (X.C.); (Y.X.)
- Food Laboratory of Zhongyuan, Luohe 462300, China
| | - Yingying Liu
- Henan Key Laboratory of Wheat Bioprocessing and Nutritional Function, School of Biological Engineering, Henan University of Technology, Zhengzhou 450001, China; (X.C.); (Y.X.)
- Food Laboratory of Zhongyuan, Luohe 462300, China
| | - Jihong Huang
- Henan Key Laboratory of Wheat Bioprocessing and Nutritional Function, School of Biological Engineering, Henan University of Technology, Zhengzhou 450001, China; (X.C.); (Y.X.)
- State Key Laboratory of Crop Stress Adaptation and Improvement, College of Agriculture, Henan University, Kaifeng 475004, China
- Food Laboratory of Zhongyuan, Luohe 462300, China
- School of Food and Pharmacy, Xuchang University, Xuchang 461000, China
| |
Collapse
|
8
|
Schönknecht YB, Moreno Tovar MV, Jensen SR, Parschat K. Clinical Studies on the Supplementation of Manufactured Human Milk Oligosaccharides: A Systematic Review. Nutrients 2023; 15:3622. [PMID: 37630811 PMCID: PMC10458772 DOI: 10.3390/nu15163622] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Human milk oligosaccharides (HMOs) are a major component of human milk. They are associated with multiple health benefits and are manufactured on a large scale for their addition to different food products. In this systematic review, we evaluate the health outcomes of published clinical trials involving the supplementation of manufactured HMOs. We screened the PubMed database and Cochrane Library, identifying 26 relevant clinical trials and five publications describing follow-up studies. The clinical trials varied in study populations, including healthy term infants, infants with medical indications, children, and adults. They tested eight different HMO structures individually or as blends in varying doses. All trials included safety and tolerance assessments, and some also assessed growth, stool characteristics, infections, gut microbiome composition, microbial metabolites, and biomarkers. The studies consistently found that HMO supplementation was safe and well tolerated. Infant studies reported a shift in outcomes towards those observed in breastfed infants, including stool characteristics, gut microbiome composition, and intestinal immune markers. Beneficial gut health and immune system effects have also been observed in other populations following HMO supplementation. Further clinical trials are needed to substantiate the effects of HMO supplementation on human health and to understand their structure and dose dependency.
Collapse
|
9
|
Maiya M, Adorno A, Toulabi SB, Tucker WJ, Patterson MA. Resistant starch improves cardiometabolic disease outcomes: A narrative review of randomized trials. Nutr Res 2023; 114:20-40. [PMID: 37149926 DOI: 10.1016/j.nutres.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/27/2023] [Accepted: 04/01/2023] [Indexed: 05/09/2023]
Abstract
Healthy dietary patterns with adequate fiber improve cardiometabolic (CM) outcomes and attenuate disease progression. Resistant starch (RS) is a fermentable fiber that affects CM outcomes; however, studies are heterogeneous and inconsistent. Thus, the purpose of this narrative review is to assess the impact of RS intake by type and amount on CM outcomes while considering subject characteristics and trial duration. Randomized crossover or parallel studies (n = 31) were selected and compared according to acute (1 day; n = 12), medium (>1-30 days; n = 8), or long (>30 days; n = 11) duration. Most acute trials in healthy adults showed improvements in postprandial glycemic outcomes irrespective of RS type or amount. However, a more pronounced reduction occurred when test meals did not match for available carbohydrate. Daily RS intake had a minimal effect on CM outcomes in medium duration trials, but insulin resistant adults had better glycemic control at 4 weeks. Several longer duration trials (8-12 weeks) showed favorable CM outcomes with daily RS intake in adults with type 2 diabetes (T2D), but not in those at risk for T2D. Furthermore, some studies reported improved lipids, inflammatory biomarkers, and heart rate. Future studies should consider matching for available carbohydrates between the RS and control groups to understand the gut microbiome's role. Furthermore, energy and fiber should be considered. Overall, the acute intake of RS improves glycemic outcomes, and consuming RS at for least 4 and up to 8 to 12 weeks in adults with prediabetes and T2D, respectively, appears to improve CM outcomes.
Collapse
Affiliation(s)
- Madhura Maiya
- Department of Health and Kinesiology, The University of Texas at Tyler, Tyler, Texas, USA
| | - Andrew Adorno
- Department of Nutrition and Food Sciences, Texas Woman's University Institute of Health Sciences, Houston, Texas, USA
| | - Sahar B Toulabi
- College of Agriculture Science, Colorado State University, Fort Collins, Colorado, USA
| | - Wesley J Tucker
- Department of Nutrition and Food Sciences, Texas Woman's University Institute of Health Sciences, Houston, Texas, USA; Institute for Women's Health, Texas Woman's University, Houston, Texas USA
| | - Mindy A Patterson
- Department of Nutrition and Food Sciences, Texas Woman's University Institute of Health Sciences, Houston, Texas, USA; Institute for Women's Health, Texas Woman's University, Houston, Texas USA.
| |
Collapse
|
10
|
Ghavami A, Ziaei R, Talebi S, Barghchi H, Nattagh-Eshtivani E, Moradi S, Rahbarinejad P, Mohammadi H, Ghasemi-Tehrani H, Marx W, Askari G. Soluble Fiber Supplementation and Serum Lipid Profile: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2023; 14:465-474. [PMID: 36796439 DOI: 10.1016/j.advnut.2023.01.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 12/13/2022] [Accepted: 01/11/2023] [Indexed: 02/04/2023] Open
Abstract
To present a comprehensive synthesis of the effect of soluble fiber supplementation on blood lipid parameters in adults, a systematic search was undertaken in PubMed, Scopus, and ISI Web of Science of relevant articles published before November 2021. Randomized controlled trials (RCTs) evaluating the effects of soluble fibers on blood lipids in adults were included. We estimated the change in blood lipids for each 5 g/d increment in soluble fiber supplementation in each trial and then calculated the mean difference (MD) and 95% CI using a random-effects model. We estimated dose-dependent effects using a dose-response meta-analysis of differences in means. The risk of bias and certainty of the evidence was evaluated using the Cochrane risk of bias tool and the Grading Recommendations Assessment, Development, and Evaluation methodology, respectively. A total of 181 RCTs with 220 treatment arms (14,505 participants: 7348 cases and 7157 controls) were included. There was a significant reduction in LDL cholesterol (MD: -8.28 mg/dL, 95% CI: -11.38, -5.18), total cholesterol (TC) (MD: -10.82 mg/dL, 95% CI: -12.98, -8.67), TGs (MD: -5.55 mg/dL, 95% CI: -10.31, -0.79), and apolipoprotein B (Apo-B) (MD: -44.99 mg/L, 95% CI: -62.87, -27.12) after soluble fiber supplementation in the overall analysis. Each 5 g/d increase in soluble fiber supplementation had a significant reduction in TC (MD: -6.11 mg/dL, 95% CI: -7.61, -4.61) and LDL cholesterol (MD: -5.57 mg/dl, 95% CI: -7.44, -3.69). In a large meta-analysis of RCTs, results suggest that soluble fiber supplementation could contribute to the management of dyslipidemia and the reduction of cardiovascular disease risk.
Collapse
Affiliation(s)
- Abed Ghavami
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rahele Ziaei
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sepide Talebi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh Barghchi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elyas Nattagh-Eshtivani
- Nutrition, Food Sciences and Clinical Biochemistry Department, School of Medicine, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Sajjad Moradi
- Nutritional Sciences Department, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Pegah Rahbarinejad
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Wolfgang Marx
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| |
Collapse
|