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Liu T, Asif IM, Bai C, Huang Y, Li B, Wang L. The effectiveness and safety of natural food and food-derived extract supplements for treating functional gastrointestinal disorders-current perspectives. Nutr Rev 2024:nuae047. [PMID: 38908001 DOI: 10.1093/nutrit/nuae047] [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] [Indexed: 06/24/2024] Open
Abstract
Functional gastrointestinal disorders (FGIDs) were highly prevalent and involve gastrointestinal discomfort characterized by non-organic abnormalities in the morphology and physiology of the gastrointestinal tract. According to the Rome IV criteria, irritable bowel syndrome and functional dyspepsia are the most common FGIDs. Complementary and alternative medicines are employed by increasing numbers of individuals around the world, and they include herbal and dietary supplements, acupuncture, and hypnosis. Of these, herbal and dietary supplements seem to have the greatest potential for relieving FGIDs, through multiple modes of action. However, despite the extensive application of natural extracts in alternative treatments for FGIDs, the safety and effectiveness of food and orally ingested food-derived extracts remain uncertain. Many randomized controlled trials have provided compelling evidence supporting their potential, as detailed in this review. The consumption of certain foods (eg, kiwifruit, mentha, ginger, etc) and food ingredients may contribute to the alleviation of symptoms associated with FGID,. However, it is crucial to emphasize that the short-term consumption of these components may not yield satisfactory efficacy. Physicians are advised to share both the benefits and potential risks of these alternative therapies with patients. Furthermore, larger randomized clinical trials with appropriate comparators are imperative.
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Affiliation(s)
- Tianxu Liu
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei 430070, China
- Key Laboratory of Environment Correlative Dietology (Huazhong Agricultural University), Ministry of Education, Wuhan, Hubei 430070, China
| | - Ismail Muhammad Asif
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei 430070, China
- Key Laboratory of Environment Correlative Dietology (Huazhong Agricultural University), Ministry of Education, Wuhan, Hubei 430070, China
| | - Chengmei Bai
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei 430070, China
- Key Laboratory of Environment Correlative Dietology (Huazhong Agricultural University), Ministry of Education, Wuhan, Hubei 430070, China
| | - Yutian Huang
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei 430070, China
- Key Laboratory of Environment Correlative Dietology (Huazhong Agricultural University), Ministry of Education, Wuhan, Hubei 430070, China
| | - Bin Li
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei 430070, China
- Key Laboratory of Environment Correlative Dietology (Huazhong Agricultural University), Ministry of Education, Wuhan, Hubei 430070, China
| | - Ling Wang
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei 430070, China
- Key Laboratory of Environment Correlative Dietology (Huazhong Agricultural University), Ministry of Education, Wuhan, Hubei 430070, China
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Veraza DI, Calderon G, Jansson-Knodell C, Aljaras R, Foster ED, Xu H, Biruete A, Shin A. A systematic review and meta-analysis of diet and nutrient intake in adults with irritable bowel syndrome. Neurogastroenterol Motil 2024; 36:e14698. [PMID: 37897138 PMCID: PMC10963049 DOI: 10.1111/nmo.14698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 10/06/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Numerous individual and environmental factors including diet may play an important role in the pathophysiology of irritable bowel syndrome (IBS). It is unclear to what degree dietary intake is affected in individuals with IBS. We aimed to perform a systematic review and meta-analysis to summarize dietary intake of adults with IBS and to compare dietary intake between adults with IBS and non-IBS controls. METHODS Ovid MEDLINE, Embase, Cochrane, CINAHL, and Scopus were searched through February 2023 for clinical trials and observational studies measuring usual diet in adults with IBS. Pooled weighted averages were estimated for total energy, macronutrient, and micronutrient data. Mean differences (MD) in nutrient intake were estimated for adults with IBS versus non-IBS controls using a random effects model. Heterogeneity was assessed by the inconsistency index (I2). KEY RESULTS Sixty-three full-text articles were included in the review of which 29 studies included both IBS and control subjects. Nutrients not meeting the recommended intake level for any dietary reference values in the IBS population were fiber and vitamin D. Meta-regression by female proportion was positively correlated with total fat intake and negatively correlated with carbohydrate intake. Comparisons between participants with IBS and controls showed significantly lower fiber intake in participants with IBS with high heterogeneity (MD: -1.8; 95% CI: -3.0, -0.6; I2 = 85%). CONCLUSIONS AND INFERENCES This review suggests that fiber and vitamin D intake is suboptimal in IBS; however, overall dietary intake does not appear to be comprised. Causes and consequences of reduced fiber in IBS deserve further study. Results of this systematic review and meta-analysis suggest that fiber and vitamin D intake is suboptimal in IBS. However, overall intake of other macro- and micronutrients does not appear to be compromised. Causes and consequences of reduced fiber and Vitamin D intake in IBS deserve further study.
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Affiliation(s)
- Diego Izquierdo Veraza
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Gerardo Calderon
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Claire Jansson-Knodell
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Rawan Aljaras
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Erin D Foster
- UC Berkeley Library, University of California Berkeley, Berkeley, California, USA
| | - Huiping Xu
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Annabel Biruete
- Department of Nutrition and Dietetics, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Andrea Shin
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, California, USA
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Miedziaszczyk M, Maciejewski A, Idasiak-Piechocka I, Karczewski M, Lacka K. Effects of Isoflavonoid and Vitamin D Synergism on Bone Mineral Density-A Systematic and Critical Review. Nutrients 2023; 15:5014. [PMID: 38140273 PMCID: PMC10745652 DOI: 10.3390/nu15245014] [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: 11/18/2023] [Revised: 11/25/2023] [Accepted: 11/26/2023] [Indexed: 12/24/2023] Open
Abstract
Phytoestrogens are non-steroidal plant compounds, which bind to α and β estrogen receptors, thereby causing specific effects. The best-known group of phytoestrogens are flavonoids, including isoflavonoids-genistein and daidzein. They play a role in the metabolism of bone tissue, improving its density and preventing bone loss, which contributes to reducing the risk of fractures. Vitamin D is found in the form of cholecalciferol (vitamin D3) and ergocalciferol (vitamin D2) and is traditionally recognized as a regulator of bone metabolism. The aim of this review was to evaluate the synergistic effect of isoflavonoids and vitamin D on bone mineral density (BMD). The MEDLINE (PubMed), Scopus and Cochrane databases were searched independently by two authors. The search strategy included controlled vocabulary and keywords. Reference publications did not provide consistent data regarding the synergistic effect of isoflavonoids on BMD. Some studies demonstrated a positive synergistic effect of these compounds, whereas in others, the authors did not observe any significant differences. Therefore, further research on the synergism of isoflavonoids and vitamin D may contribute to a significant progress in the prevention and treatment of osteoporosis.
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Affiliation(s)
- Miłosz Miedziaszczyk
- Department of General and Transplant Surgery, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (M.M.); (I.I.-P.); (M.K.)
| | - Adam Maciejewski
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland;
| | - Ilona Idasiak-Piechocka
- Department of General and Transplant Surgery, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (M.M.); (I.I.-P.); (M.K.)
| | - Marek Karczewski
- Department of General and Transplant Surgery, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (M.M.); (I.I.-P.); (M.K.)
| | - Katarzyna Lacka
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland;
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Wang X, Lei L, Wang L, Huang D, Huang J, Guo E, Li J, Huang W, Zhou L, Deng J, Chen W, Li C, Qiu X, Huang D, Liu S, Zeng X. Associations between maternal serum phytoestrogens and liver function markers: a cross-sectional study from China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:122038-122050. [PMID: 37964148 DOI: 10.1007/s11356-023-30761-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/26/2023] [Indexed: 11/16/2023]
Abstract
Phytoestrogens (PEs) may harm liver function. However, studies in pregnant women are limited. Our study was conducted in pregnant women to assess the effect of serum PEs on liver function markers. We conducted a cross-sectional study focusing in the first trimester of pregnancy. A total of 352 pregnant women were enrolled in the study. We used generalized linear model (GLM) to explore the associations between each PE and each marker of liver function. We used Quantile g-computation (Qgcomp) and Bayesian kernel machine regression (BKMR) models to explore the associations between mixed exposure to all PEs and liver function markers. The GLM results showed that equol (EQU), daidzein (DAD), genistein (GEN), enterolactone (ENT), and enterodiol (END) were negatively correlated with albumin (ALB). DAD and GEN were associated with elevated alanine aminotransferase (ALT). DAD, GEN, naringin (NAR), and glycitein (GLY) were related to elevated aspartate aminotransferase (AST). Mixed exposure model results showed that the mixture of PEs was associated with reduced ALB. Our results support the existence of associations between PEs and maternal liver function in the first trimester. Emphasizing the detrimental associations between serum PEs and liver function in pregnant women is essential to ensure maternal liver health during pregnancy.
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Affiliation(s)
- Xiaogang Wang
- Department Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Lei Lei
- Department Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Lijun Wang
- Department Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Dandan Huang
- Nanning Wuming District Maternal and Child Health Care Hospital, Nanning, 530100, Guangxi, China
| | - Jianchun Huang
- Department of Obstetrics, The Third Affiliated Hospital of Guangxi Medical University, Nanning, 530031, Guangxi, China
| | - Erna Guo
- Department Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Jinxiu Li
- Department Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Weiyan Huang
- Department Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Lihong Zhou
- Department Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Jiatong Deng
- Department Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Wanling Chen
- Department Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Chanhua Li
- Department Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Xiaoqiang Qiu
- Department Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Dongping Huang
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Shun Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Xiaoyun Zeng
- Department Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China.
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Dudzińska E, Grabrucker AM, Kwiatkowski P, Sitarz R, Sienkiewicz M. The Importance of Visceral Hypersensitivity in Irritable Bowel Syndrome-Plant Metabolites in IBS Treatment. Pharmaceuticals (Basel) 2023; 16:1405. [PMID: 37895876 PMCID: PMC10609912 DOI: 10.3390/ph16101405] [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: 09/07/2023] [Revised: 09/28/2023] [Accepted: 10/02/2023] [Indexed: 10/29/2023] Open
Abstract
The visceral stimuli from the digestive tract are transmitted via afferent nerves through the spinal cord to the brain, where they are felt as pain. The overreaction observed in the brain of irritable bowel syndrome (IBS) patients may be due to increased peripheral sensitivity to stimuli from the gastrointestinal tract. Although the exact pathway is uncertain, attenuation of visceral hypersensitivity is still of interest in treating IBS. It has been shown that stress stimulates the sympathetic nervous system while inhibiting the vagus nerve (VN). In addition, stress factors lead to dysbiosis and chronic low-grade inflammation of the intestinal mucosa, which can lead to lower gastrointestinal visceral hypersensitivity. Therefore, an important goal in the treatment of IBS is the normalization of the intestinal microflora. An interesting option seems to be nutraceuticals, including Terminalia chebula, which has antibacterial and antimicrobial activity against various pathogenic Gram-positive and Gram-negative bacteria. Additionally, short-term transcutaneous vagus nerve stimulation can reduce the stress-induced increase in intestinal permeability, thereby reducing inflammation. The conducted studies also indicate a relationship between the stimulation of the vagus nerve (VN) and the activation of neuromodulatory networks in the central nervous system. Therefore, it seems reasonable to conclude that a two-way action through stimulating the VN and using nutraceuticals may become an effective therapy in treating IBS.
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Affiliation(s)
- Ewa Dudzińska
- Department of Dietetics and Nutrition Education, Medical University of Lublin, 20-093 Lublin, Poland
| | - Andreas M. Grabrucker
- Department of Biological Sciences, University of Limerick, V94 PH61 Limerick, Ireland;
- Bernal Institute, University of Limerick, V94 PH61 Limerick, Ireland
- Health Research Institute (HRI), University of Limerick, V94 PH61 Limerick, Ireland
| | - Paweł Kwiatkowski
- Department of Diagnostic Immunology, Pomeranian Medical University in Szczecin, Al. Powstancow Wlkp. 72, 70-111 Szczecin, Poland;
| | - Robert Sitarz
- Department of Human Anatomy, Medical University of Lublin, 20-090 Lublin, Poland;
- First Department of Surgical Oncology, St. John’s Cancer Center, 20-090 Lublin, Poland
| | - Monika Sienkiewicz
- Department of Pharmaceutical Microbiology and Microbiological Diagnostic, Medical University of Lodz, Muszynskiego 1, 90-151 Lodz, Poland;
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Yan C, Hu C, Chen X, Jia X, Zhu Z, Ye D, Wu Y, Guo R, Jiang M. Vitamin D improves irritable bowel syndrome symptoms: A meta-analysis. Heliyon 2023; 9:e16437. [PMID: 37260904 PMCID: PMC10227324 DOI: 10.1016/j.heliyon.2023.e16437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 04/25/2023] [Accepted: 05/16/2023] [Indexed: 06/02/2023] Open
Abstract
Background & aims Approximately 5%-10% of the population in most geographical regions suffer from irritable bowel syndrome (IBS), which creates a significant burden on individual patients, their families, and society. Recent advances in IBS therapies have indicated that vitamin D supplementation is potential to relieve its symptoms, but evidence of this is lacking. This meta-analysis aimed to estimate the effect of vitamin D on gastrointestinal (GI) symptoms in IBS patients. Methods The PubMed, Embase, and Cochrane Central Register of Controlled Trials databases were searched from their inception to March 2022. Statistical analyses were performed with Stata 12.0 and Review Manager 5.4, and statistical significance was defined as P < 0.05. The pooled results are presented as weighted mean differences (WMD) and 95% confidence intervals (CI). Results The meta-analysis including 6 randomized controlled trials (RCT) with 572 patients found a significant difference in IBS symptom severity score (WMD, -34.88; 95% CI, -62.48 to -7.27; P = 0.013; random-effects model) but no significant difference in IBS quality of life score (WMD, 3.33; 95% CI, -5.12 to -11.77; P = 0.440; random-effects model). Conclusions Overall, IBS patients may benefit from vitamin D supplementation to reduce the GI symptoms.
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Chi ZC. Progress in research of low-grade inflammation in irritable bowel syndrome. Shijie Huaren Xiaohua Zazhi 2022; 30:1051-1065. [DOI: 10.11569/wcjd.v30.i24.1051] [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] [Indexed: 12/27/2022] Open
Abstract
Irritable bowel syndrome (IBS) is a common intestinal disease with a prevalence of 10%-15%. However, its pathophysiology is still not completely clear, and it has long been considered as a functional disease. In recent years, it has been found that low-grade inflammation plays a pathogenic role in IBS. Studies have confirmed that there is persistent mucosal inflammation at the microscopic and molecular levels. This review discusses the evidence, role, and clinical relevance of mucosal inflammation in IBS. In addition to mucosal inflammation, neuroinflammation may lead to changes in neuroendocrine pathways and glucocorticoid receptor genes through the "gut-brain" axis, and thus cause IBS through proinflammatory phenotype and hypothalamic pituitary adrenal axis and 5-hydroxytryptamine dysfunction. The observation that IBS patients can benefit from anti-inflammatory therapy also confirms that IBS is associated with inflammation.
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Affiliation(s)
- Zhao-Chun Chi
- Department of Gastroenterology, Qingdao Municipal Hospital, Qingdao 266011, Shandong Province, China
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Bek S, Teo YN, Tan XH, Fan KHR, Siah KTH. Association between irritable bowel syndrome and micronutrients: A systematic review. J Gastroenterol Hepatol 2022; 37:1485-1497. [PMID: 35581170 DOI: 10.1111/jgh.15891] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/31/2022] [Accepted: 05/02/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM Irritable bowel syndrome (IBS) is a highly prevalent disorder of gut brain interaction with a multifactorial etiology. Food trigger avoidance is common among individuals with IBS and exclusion diets are gaining popularity. However, recent guidelines on IBS management cautioned regarding the use of unsupervised dietary therapy with concerns of development of poor eating habits and even nutritional deficiencies. We aimed to review the available literature on the effect of habitual and exclusion diets on micronutrient status as well as the role of micronutrient supplementation in alleviating IBS symptoms. METHODS Four electronic databases (PubMed, Embase, Cochrane, Web of Science) were searched for articles that reported micronutrient data in patients with IBS. Serum micronutrient levels and dietary intake of micronutrients in patients with IBS were collected. The extracted data were tabulated and organized by micronutrient type to observe for trends. RESULTS Twenty-six articles were included in this systematic review (12 interventional and 14 observational studies). Studies showed that generally IBS subjects had lower levels of vitamin B2, vitamin D, calcium, and iron at baseline compared with non-IBS subjects. Studies also found that exclusion diets were associated with lower intake of micronutrients especially vitamin B1, B2, calcium, iron, and zinc. There was a lack of interventional studies on micronutrients. CONCLUSION Irritable bowel syndrome patients are at risk of developing multiple micronutrient deficiencies that may have both localized gastrointestinal as well as systemic effects. Dietary management of IBS patients should include a proper dietitian review to ensure nutritional adequacy where possible.
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Affiliation(s)
- Schin Bek
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yao Neng Teo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Xin-Hui Tan
- Department of Dietetics, National University Hospital, Singapore
| | - Kristie H R Fan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,FAST and Chronic Programmes, Alexandra Hospital, Singapore.,Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore
| | - Kewin Tien Ho Siah
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore
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Al-Biltagi M, El Amrousy D, El Ashry H, Maher S, Mohammed MA, Hasan S. Effects of adherence to the Mediterranean diet in children and adolescents with irritable bowel syndrome. World J Clin Pediatr 2022; 11:330-340. [PMID: 36052114 PMCID: PMC9331406 DOI: 10.5409/wjcp.v11.i4.330] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/24/2022] [Accepted: 04/28/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder in children and adults, which increased over the past twenty years. The Mediterranean diet is a well-known diet full of antioxidants and anti-inflammatory ingredients.
AIM To evaluate the safety, tolerability, and effects of adherence to the Mediterranean diet on disease patterns in children and adolescents with IBS.
METHODS This prospective, cross-sectional case-controlled study included 100 consecutive IBS patients diagnosed according to Rome IV criteria, aged 12-18 years. Patients were subdivided into two groups (50 patients each); Group I received a Mediterranean diet, and Group II on their regular diet for six months. Besides IBS scores (IBS-SSS, IBS-QoL, and total score), different clinical and laboratory parameters were evaluated at the start and end of the study.
RESULTS The Mediterranean diet was safe and well-tolerated in IBS patients. IBS children and adolescents with good adherence to the Mediterranean diet (KIDMED Score ≥ 8 points); group I showed significant improvement in IBS scores. IBS-SSS in the Mediterranean diet group was 237.2 ± 65 at the beginning of the study and decreased to 163.2 ± 33.8 at the end of the study (P < 0.001). It did not show a significant improvement in the group with a regular diet (248.3 ± 71.1 at the beginning of the study compared to 228.5 ± 54.3 at the study end with P < 0.05). The mean IBS-SSS in the Mediterranean diet group significantly improved compared with the group with a regular diet. Mean IBS-QoL in group I improved from 57.3 ± 12.9 at the start of the study to 72.4 ± 11.2 at the study end (P < 0.001) and significantly improved when compared to its level in group II at the study end (59.2 ± 12.7 with P < 0.001), while group II showed no significant improvement in IBS-QoL at the study end when compared to the beginning of the study (59.2 ± 11.7 with P >0.05). The mean total IBS score in group I became 28.8 ± 11.2 at the end of our study compared to 24.1 ± 10.4 at the start (P < 0.05) and significantly improved when compared to its level in group II at the end of the study (22.1 ± 12.5 with P < 0.05), while in group II, non-significant improvement in the total score at the end of our study compared to its mean level at the start of the study (22.8 ± 13.5 with P > 0.05).
CONCLUSION The Mediterranean diet was safe and associated with significant improvement in IBS scores in children and adolescent patients with IBS.
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Affiliation(s)
- Mohammed Al-Biltagi
- Department of Pediatrics, University Medical center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31527, Al Gharbia, Egypt
- Department of Pediatrics, University Medical Center, Dr. Sulaiman Al-Habib Medical Group, Manama 26671, Bahrain
| | - Doaa El Amrousy
- Department of Pediatrics, Tanta University, Faculty of Medicine, Tanta 31527, Alghrabia, Egypt
| | - Heba El Ashry
- Department of Tropical Medicine, Faculty of Medicine, Tanta University, Tanta 31527, Alghrabia, Egypt
| | - Sara Maher
- Department of Immunology, Theodor Bilharz Research Institute, Cairo 12411, Egypt
| | - Mahmoud A Mohammed
- Department of Industrial Pharmacy, Faculty of Pharmacy, Assiut University, Assiut 71515, Egypt
| | - Samir Hasan
- Department of Pediatrics, Tanta University, Faculty of Medicine, Tanta 31527, Alghrabia, Egypt
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The Effect of Vitamin D Supplementation on the Severity of Symptoms and the Quality of Life in Irritable Bowel Syndrome Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2022; 14:nu14132618. [PMID: 35807798 PMCID: PMC9268238 DOI: 10.3390/nu14132618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/05/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022] Open
Abstract
Irritable bowel syndrome (IBS), a gastrointestinal disorder affecting 7–12% of the population, is characterized by abdominal pain, bloating, and alternating bowel patterns. Data on risk and protective influences have yielded conflicting evidence on the effects of alternative interventions, such as vitamin D. This review focuses on the effects of vitamin D on IBS. A systematic review and meta-analysis considered all articles published until 4 April 2022. The search for randomized controlled trials assessing vitamin D efficacy in IBS with outcomes, primary (Irritable Bowel Severity Scoring System (IBS-SSS)) and secondary (IBS quality of life (IBS-QoL) and serum level of calcifediol (25(OH)D)), was performed on six databases, Google Scholar, Web of Science, SCOPUS, EMBASE, PubMed (MEDLINE), and Cochrane Central Register of Controlled Trials. We included six trials with 616 patients. The pooled analysis found no difference between vitamin D and placebo in improving IBS-SSS (MD: −45.82 with 95% CI [−93.62, 1.98], p = 0.06). However, the pooled analysis favored vitamin D over placebo in improving the IBS-Qol (MD: 6.19 with 95% CI [0.35, 12.03], p = 0.04) and serum 25(OH)D (MD: 25.2 with 95% CI [18.41, 31.98], p = 0.00001). Therefore, further clinical trials are required to reach clinically applicable and generalizable findings.
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Kim JH, Yoon YH, Dhungana SK, Kim ID, Shin DH. Soaking Soybean Seeds with <i>Abeliophyllum distichum</i> Nakai Extract Increased the Yield and Nutritional Value of Soybean Sprouts. POL J FOOD NUTR SCI 2022. [DOI: 10.31883/pjfns/147520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Chong RIH, Yaow CYL, Loh CYL, Teoh SE, Masuda Y, Ng WK, Lim YL, Ng QX. Vitamin D supplementation for irritable bowel syndrome: A systematic review and meta-analysis. J Gastroenterol Hepatol 2022; 37:993-1003. [PMID: 35396764 DOI: 10.1111/jgh.15852] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/25/2022] [Accepted: 03/24/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM Irritable bowel syndrome (IBS) is a prevalent and complex gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits. Observational studies have suggested a relationship between serum vitamin D levels and IBS symptoms. This systematic review and meta-analysis aimed to investigate the clinical effects of vitamin D supplementation on IBS symptom severity and quality of life (QoL) measures. METHODS Medline, Embase, Scopus, Web of Science, and The Cochrane Library databases were systematically searched. Data abstraction and quality assessment were conducted by four authors independently, and discrepancies were resolved through consensus from the senior author. Continuous data were pooled with standardized mean difference (SMD) using the DerSimonian and Laird's random-effects model. Sensitivity analysis by risk of bias and potentially "predatory" publication were performed as well. RESULTS A total of 685 patients across eight studies were included in the meta-analysis. Vitamin D supplementation significantly improved IBS symptom severity scale scores, with a SMD of -0.77 (95% confidence interval [CI] -1.47 to -0.07, P = 0.04, I2 = 91%). Improvements in IBS-QoL scores were also observed, albeit not statistically significant (SMD 0.54; 95% CI -0.34 to 1.41, P = 0.15, I2 = 87%). However, small sample sizes, a relatively young study population, limited ethnicities, and varied vitamin D dosing strategies across the studies were notable limitations. CONCLUSIONS Vitamin D supplementation could be part of our clinical armamentarium when managing IBS patients due to the potential efficacy and good safety profile. Further randomized, controlled trials are required to confirm the therapeutic effects.
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Affiliation(s)
- Ryan Ian Houe Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Clyve Yu Leon Yaow
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Seth En Teoh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yoshio Masuda
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wee Khoon Ng
- Department of Gastroenterology and Hepatology, Tan Tock Seng Hospital, Singapore
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Huang H, Lu L, Chen Y, Zeng Y, Xu C. The efficacy of vitamin D supplementation for irritable bowel syndrome: a systematic review with meta-analysis. Nutr J 2022; 21:24. [PMID: 35509010 PMCID: PMC9069731 DOI: 10.1186/s12937-022-00777-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/14/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder involving gut-brain interactions with limited effective treatment options. Vitamin D deficiency is commonly observed in patients with IBS, but whether vitamin D supplementation ameliorates IBS is controversial in randomized controlled trials. The present systematic review and meta-analysis explored the efficacy of vitamin D supplementation in patients with IBS. METHODS We performed a systematic search of potentially relevant publications from PubMed, EMBASE, the Cochrane Central Register of Controlled Studies and the Web of Science up until January 2022. We assessed the weighted mean difference (WMD) and 95% confidence interval (95% CI) of the IBS severity scoring system (IBS-SSS), IBS quality of life (IBS-QoL) and IBS total score (IBS-TS) before and after vitamin D supplementation intervention. RESULTS We included four randomized, placebo-controlled trials involving 335 participants. The differences in IBS-SSS score between participants in the intervention group and the placebo group increased after intervention (WMD: -55.55, 95% CI: -70.22 to -40.87, I2 = 53.7%, after intervention; WMD: -3.17, 95% CI: -18.15 to 11.81, I2 = 0.0%, before intervention). Participants receiving vitamin D supplementation showed greater improvement in IBS-SSS after intervention than participants receiving placebo treatment (WMD: -84.21, 95% CI: -111.38 to -57.05, I2 = 73.2%; WMD: -28.29, 95% CI: -49.95 to -6.62, I2 = 46.6%, respectively). Vitamin D supplementation was also superior to placebo in IBS-QoL improvement (WMD: 14.98, 95% CI: 12.06 to 17.90, I2 = 0.0%; WMD: 6.55, 95% CI: -2.23 to 15.33, I2 = 82.7%, respectively). Sensitivity analyses revealed an unstable pooled effect on IBS-TS in participants receiving vitamin D supplementation. Therefore, we did not evaluate the efficacy of vitamin D intervention in IBS-TS. CONCLUSIONS This systematic review and meta-analysis suggested that vitamin D supplementation was superior to placebo for IBS treatment.
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Affiliation(s)
- Hangkai Huang
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, 310003, Hangzhou, China
| | - Linjie Lu
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, 310003, Hangzhou, China.,Department of Gastroenterology, Haining Branch of the First Affiliated Hospital, Zhejiang University School of Medicine, 314499, Haining, China
| | - Yishu Chen
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, 310003, Hangzhou, China
| | - Yan Zeng
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, 310003, Hangzhou, China
| | - Chengfu Xu
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, 310003, Hangzhou, China. .,Department of Gastroenterology, Haining Branch of the First Affiliated Hospital, Zhejiang University School of Medicine, 314499, Haining, China.
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Mohseni F, Agah S, Ebrahimi-Daryani N, Taher M, Nattagh-Eshtivani E, Karimi S, Rastgoo S, Bourbour F, Hekmatdoost A. The effect of low FODMAP diet with and without gluten on irritable bowel syndrome: A double blind, placebo controlled randomized clinical trial. Clin Nutr ESPEN 2022; 47:45-50. [DOI: 10.1016/j.clnesp.2021.12.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 12/16/2022]
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15
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Matthews SW, Heitkemper MM, Kamp K. Early Evidence Indicates Vitamin D Improves Symptoms of Irritable Bowel Syndrome: Nursing Implications and Future Research Opportunities. Gastroenterol Nurs 2021; 44:426-436. [PMID: 34690298 DOI: 10.1097/sga.0000000000000634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/21/2021] [Indexed: 11/26/2022] Open
Abstract
Irritable bowel syndrome (IBS) affects approximately 11.2% of the population. Yet, full understanding of its etiology and optimal treatment remains elusive. Understanding of the underlying pathophysiology of IBS has been limited. However, research is beginning to identify the cause as multifactorial (e.g., low-grade local mucosal inflammation, systemic immune activation, altered intestinal permeability, intestinal hypersensitivity, altered central nervous system processing, changes in intestinal microbiota). Understanding of the role of vitamin D in intestinal inflammation, immunity, and gastrointestinal conditions is increasing but is not yet fully understood. Growing evidence has linked vitamin D deficiency with a variety of gastrointestinal disorders, including inflammatory bowel disease, diverticulitis, colorectal cancer, and IBS. Several studies have demonstrated that individuals with IBS are more likely to have vitamin D deficiency than healthy controls. Recent vitamin D supplementation studies have shown improvement in quality of life and reduction in IBS symptoms (including abdominal pain, distention, flatulence, constipation, and visceral sensitivity) but the mechanism remains unclear. Nurses are well positioned to educate patients about the importance of sufficient vitamin D for overall health in individuals with IBS as well as participate in well-designed therapeutic studies to explore whether enhanced vitamin D status will ultimately help treat IBS more effectively.
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Affiliation(s)
- Sarah W Matthews
- Sarah W. Matthews, DNP, MN, BSN, APRN, FNP-BC, is Assistant Professor, Department of Child, Family, and Population Health Nursing, University of Washington, School of Nursing, Seattle; and Nurse Practitioner, Kaiser Permanente Washington, Bellevue
- Margaret M. Heitkemper, PhD, MN, BSN, RN, FAAN, is Professor and Chairperson, Department of Biobehavioral Nursing and Health Informatics, University of Washington, School of Nursing, Seattle
- Kendra Kamp, PhD, BSN, RN, is Assistant Professor, Department of Biobehavioral Nursing and Health Informatics, University of Washington, School of Nursing, Seattle
| | - Margaret M Heitkemper
- Sarah W. Matthews, DNP, MN, BSN, APRN, FNP-BC, is Assistant Professor, Department of Child, Family, and Population Health Nursing, University of Washington, School of Nursing, Seattle; and Nurse Practitioner, Kaiser Permanente Washington, Bellevue
- Margaret M. Heitkemper, PhD, MN, BSN, RN, FAAN, is Professor and Chairperson, Department of Biobehavioral Nursing and Health Informatics, University of Washington, School of Nursing, Seattle
- Kendra Kamp, PhD, BSN, RN, is Assistant Professor, Department of Biobehavioral Nursing and Health Informatics, University of Washington, School of Nursing, Seattle
| | - Kendra Kamp
- Sarah W. Matthews, DNP, MN, BSN, APRN, FNP-BC, is Assistant Professor, Department of Child, Family, and Population Health Nursing, University of Washington, School of Nursing, Seattle; and Nurse Practitioner, Kaiser Permanente Washington, Bellevue
- Margaret M. Heitkemper, PhD, MN, BSN, RN, FAAN, is Professor and Chairperson, Department of Biobehavioral Nursing and Health Informatics, University of Washington, School of Nursing, Seattle
- Kendra Kamp, PhD, BSN, RN, is Assistant Professor, Department of Biobehavioral Nursing and Health Informatics, University of Washington, School of Nursing, Seattle
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16
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Głąbska D, Kołota A, Lachowicz K, Skolmowska D, Stachoń M, Guzek D. Vitamin D Supplementation and Mental Health in Inflammatory Bowel Diseases and Irritable Bowel Syndrome Patients: A Systematic Review. Nutrients 2021; 13:nu13103662. [PMID: 34684663 PMCID: PMC8540769 DOI: 10.3390/nu13103662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/12/2021] [Accepted: 10/15/2021] [Indexed: 12/13/2022] Open
Abstract
Inflammatory bowel diseases (IBDs) and irritable bowel syndrome (IBS) are associated with decreased quality of life and mental health problems. Among various approaches to supportive therapy that aims to improve mental health in affected individuals, vitamin D supplementation is considered to be an effective method which may also be beneficial in alleviating the symptoms during the course of IBDs and IBS. The aim of the present study was to conduct a systematic review of the literature presenting the data regarding the influence of vitamin D supplementation on mental health in adults with inflammatory and functional bowel diseases, including IBDs and IBS. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (Registration number CRD42020155779). A systematic search of the PubMed and Web of Science databases was performed, and the intervention studies published until September 2021 were included. The human studies eligible to be included in the review should have described any intervention involving vitamin D as a supplement in a group of adult patients suffering from IBDs and/or IBS and should have assessed any component of mental health, but studies presenting the effects of combined supplementation of multiple nutrients were excluded. After eliminating the duplicates, a total of 8514 records were screened and assessed independently by two researchers. Further evaluation was carried out on the basis of title, abstract, and full text. Finally, 10 studies (four for IBDs and six for IBS) were selected for the current systematic review, and their quality was assessed using the Newcastle-Ottawa Scale (NOS). The studies analyzed the influence of various doses of vitamin D on bowel diseases, compared the results of vitamin D supplementation with placebo, or administered specific doses of vitamin D to obtain the required level in the blood. Supplementation was performed for at least 6 weeks. The analyzed mental health outcomes mainly included disease-specific quality of life/quality of life, anxiety, and depression. The majority of studies (including high-quality ones) confirmed the positive effect of vitamin D supplementation on the mental health of IBD and IBS patients, which was proven by all research works evaluating anxiety and depression and by the majority of research works evaluating quality of life. Although the studies followed different dosage regimens and supplementation protocols, the positive influence of vitamin D on mental health was found to be consistent. The number of studies on patients suffering from ulcerative colitis and the availability of trials randomized against the placebo group was low in the current review, which is considered to be a limitation of the present study and could also reflect the final outcome of the analysis. The conducted systematic review established the positive effect of vitamin D supplementation on the mental health of IBD and IBS patients, but this result requires further investigation, particularly in relation to other mental health outcomes.
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Affiliation(s)
- Dominika Głąbska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland; (A.K.); (K.L.); (D.S.); (M.S.)
- Correspondence: ; Tel.: +48-22-593-71-26
| | - Aleksandra Kołota
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland; (A.K.); (K.L.); (D.S.); (M.S.)
| | - Katarzyna Lachowicz
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland; (A.K.); (K.L.); (D.S.); (M.S.)
| | - Dominika Skolmowska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland; (A.K.); (K.L.); (D.S.); (M.S.)
| | - Małgorzata Stachoń
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland; (A.K.); (K.L.); (D.S.); (M.S.)
| | - Dominika Guzek
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland;
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17
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Vitamin D supplementation in people with IBS has no effect on symptom severity and quality of life: results of a randomised controlled trial. Eur J Nutr 2021; 61:299-308. [PMID: 34328539 PMCID: PMC8783891 DOI: 10.1007/s00394-021-02633-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/28/2021] [Indexed: 02/08/2023]
Abstract
Purpose Several small trials suggest a benefit of vitamin D supplementation in irritable bowel syndrome (IBS). The generalisability of these reports is limited by their design and scale. This study aimed to assess whether vitamin D supplementation improved IBS symptoms in a UK community setting. Methods This was a randomised, double-blind, placebo-controlled study. Participants were recruited from the community in winter months between December 2017 and March 2019. 135 participants received either vitamin D (3,000 IU p.d.) or placebo for 12 weeks. The primary outcome measure was change in IBS symptom severity; secondary outcomes included change in IBS-related quality of life. Results The participants were analysed on an intent-to-treat basis. 60% of participants were vitamin D deficient or insufficient at baseline. Although vitamin D levels increased in the intervention arm relative to placebo (45.1 ± 32.88 nmol/L vs 3.1 ± 26.15 nmol/L; p < 0.001). There was no difference in the change of IBS symptom severity between the active and placebo trial arms (− 62.5 ± 91.57 vs – 75.2 ± 84.35, p = 0.426) over time. Similarly there was no difference between trial arms in τhe change in quality of life (− 7.7 ± 25.36 vs – 11.31 ± 25.02, p = 0.427). Conclusions There is no case for advocating use of vitamin D in the management of IBS symptoms. The prevalence of vitamin D insufficiency suggests routine screening and supplementation should be implemented in this population for general health reasons. This trial was retrospectively registered with ISRCTN (ISRCTN13277340) on 24th April 2018 after recruiting had been initiated. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02633-w.
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18
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Aboushanab SA, Khedr SM, Gette IF, Danilova IG, Kolberg NA, Ravishankar GA, Ambati RR, Kovaleva EG. Isoflavones derived from plant raw materials: bioavailability, anti-cancer, anti-aging potentials, and microbiome modulation. Crit Rev Food Sci Nutr 2021; 63:261-287. [PMID: 34251921 DOI: 10.1080/10408398.2021.1946006] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Isoflavones are secondary metabolites that represent the most abundant category of plant polyphenols. Dietary soy, kudzu, and red clover contain primarily genistein, daidzein, glycitein, puerarin, formononetin, and biochanin A. The structural similarity of these compounds to β-estradiol has demonstrated protection against age-related and hormone-dependent diseases in both genders. Demonstrative shreds of evidence confirmed the fundamental health benefits of the consumption of these isoflavones. These relevant activities are complex and largely driven by the source, active ingredients, dose, and administration period of the bioactive compounds. However, the preclinical and clinical studies of these compounds are greatly variable, controversial, and still with no consensus due to the non-standardized research protocols. In addition, absorption, distribution, metabolism, and excretion studies, and the safety profile of isoflavones have been far limited. This highlights a major gap in understanding the potentially critical role of these isoflavones as prospective replacement therapy. Our general review exclusively focuses attention on the crucial role of isoflavones derived from these plant materials and critically highlights their bioavailability, possible anticancer, antiaging potentials, and microbiome modulation. Despite their fundamental health benefits, plant isoflavones reveal prospective therapeutic effects that worth further standardized analysis.
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Affiliation(s)
- Saied A Aboushanab
- Institute of Chemical Engineering, Ural Federal University named after the first President of Russia B. N. Yeltsin, Yekaterinburg, Russia
| | - Shaimaa M Khedr
- Pharmaceutical and Fermentation Industries Development Center (PFIDC), City of Scientific Research and Technological Applications, SRTA-City, Alexandria, Egypt
| | - Irina F Gette
- Institute of Chemical Engineering, Ural Federal University named after the first President of Russia B. N. Yeltsin, Yekaterinburg, Russia.,Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Sciences, Yekaterinburg, Russia
| | - Irina G Danilova
- Institute of Chemical Engineering, Ural Federal University named after the first President of Russia B. N. Yeltsin, Yekaterinburg, Russia.,Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Sciences, Yekaterinburg, Russia
| | - Natalia A Kolberg
- Integrated Laboratory Complex, Ural State University of Economics, Yekaterinburg, Russia
| | - Gokare A Ravishankar
- C. D. Sagar Centre for Life Sciences, Dayananda Sagar College of Engineering, Dayananda Sagar Institutions, Bangalore, Karnataka, India
| | - Ranga Rao Ambati
- Department of Biotechnology, Vignan's Foundation of Science, Technology and Research, Guntur, Andhra Pradesh, India
| | - Elena G Kovaleva
- Institute of Chemical Engineering, Ural Federal University named after the first President of Russia B. N. Yeltsin, Yekaterinburg, Russia
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Hagan M, Hayee BH, Rodriguez-Mateos A. (Poly)phenols in Inflammatory Bowel Disease and Irritable Bowel Syndrome: A Review. Molecules 2021; 26:1843. [PMID: 33805938 PMCID: PMC8036772 DOI: 10.3390/molecules26071843] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 12/12/2022] Open
Abstract
(Poly)phenols (PPs) may have a therapeutic benefit in gastrointestinal (GI) disorders, such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). The aim of this review is to summarise the evidence-base in this regard. Observational evidence does not give a clear indication that PP intake has a preventative role for IBD or IBS, while interventional studies suggest these compounds may confer symptomatic and health-related quality of life improvements in known patients. There are inconsistent results for effects on markers of inflammation, but there are promising reports of endoscopic improvement. Work on the effects of PPs on intestinal permeability and oxidative stress is limited and therefore conclusions cannot be formed. Future work on the use of PPs in IBD and IBS will strengthen the understanding of clinical and mechanistic effects.
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Affiliation(s)
- Marilyn Hagan
- Department of Nutrition and Dietetics, Royal Papworth Hospital NHS Foundation Trust, Cambridge CB2 0AY, UK;
| | - Bu' Hussain Hayee
- Department of Gastroenterology, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK;
| | - Ana Rodriguez-Mateos
- Department of Nutritional Sciences, Faculty of Life Sciences and Medicine, King’s College London, London WC2R 2LS, UK
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20
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Sohn SI, Pandian S, Oh YJ, Kang HJ, Cho WS, Cho YS. Metabolic Engineering of Isoflavones: An Updated Overview. FRONTIERS IN PLANT SCIENCE 2021; 12:670103. [PMID: 34163508 PMCID: PMC8216759 DOI: 10.3389/fpls.2021.670103] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/21/2021] [Indexed: 05/04/2023]
Abstract
Isoflavones are ecophysiologically active secondary metabolites derived from the phenylpropanoid pathway. They were mostly found in leguminous plants, especially in the pea family. Isoflavones play a key role in plant-environment interactions and act as phytoalexins also having an array of health benefits to the humans. According to epidemiological studies, a high intake of isoflavones-rich diets linked to a lower risk of hormone-related cancers, osteoporosis, menopausal symptoms, and cardiovascular diseases. These characteristics lead to the significant advancement in the studies on genetic and metabolic engineering of isoflavones in plants. As a result, a number of structural and regulatory genes involved in isoflavone biosynthesis in plants have been identified and characterized. Subsequently, they were engineered in various crop plants for the increased production of isoflavones. Furthermore, with the advent of high-throughput technologies, the regulation of isoflavone biosynthesis gains attention to increase or decrease the level of isoflavones in the crop plants. In the review, we begin with the role of isoflavones in plants, environment, and its benefits in human health. Besides, the main theme is to discuss the updated research progress in metabolic engineering of isoflavones in other plants species and regulation of production of isoflavones in soybeans.
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Affiliation(s)
- Soo In Sohn
- Biosafety Division, Department of Agricultural Biotechnology, National Institute of Agricultural Sciences, Jeonju, South Korea
- *Correspondence: Soo-In Sohn,
| | - Subramani Pandian
- Biosafety Division, Department of Agricultural Biotechnology, National Institute of Agricultural Sciences, Jeonju, South Korea
| | - Young Ju Oh
- Institute for Future Environmental Ecology Co., Ltd., Jeonju, South Korea
| | - Hyeon Jung Kang
- Biosafety Division, Department of Agricultural Biotechnology, National Institute of Agricultural Sciences, Jeonju, South Korea
| | - Woo Suk Cho
- Biosafety Division, Department of Agricultural Biotechnology, National Institute of Agricultural Sciences, Jeonju, South Korea
| | - Youn Sung Cho
- Biosafety Division, Department of Agricultural Biotechnology, National Institute of Agricultural Sciences, Jeonju, South Korea
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21
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Parsonidis P, Vlachou I, Mamagkaki A, Bouris I, Daikopoulou V, Papasotiriou I. Evaluation of Tegaran Formula ZhenHua cytotoxicity against human cancer cell lines. PLoS One 2020; 15:e0240969. [PMID: 33085705 PMCID: PMC7577469 DOI: 10.1371/journal.pone.0240969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 10/02/2020] [Indexed: 11/18/2022] Open
Abstract
The aim of this study is to evaluate the potential health effects of Tegaran Formula ZhenHua, a nutritional supplement used mainly by cancer patients. Its active ingredients and cytotoxicity was assessed with analytical methods and viability assays, respectively. The analytical methods consisted of dissolution, disintegration, HPLC, LC/MS, GC/MS and NMR. Cytotoxicity was assessed by MTT, SRB, CVE colorimetric viability assays in 0, 24, 48 and 72h time points. The results indicate that Tegaran Formula ZhenHua supplement did not present any cytotoxic effects due to issues related to the capsules' solubility, distribution and identification of the active ingredient.
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Affiliation(s)
| | - Ioanna Vlachou
- Research Genetic Cancer Centre S.A., Industrial Area of Florina, Florina, Greece
| | - Alexandra Mamagkaki
- Research Genetic Cancer Centre S.A., Industrial Area of Florina, Florina, Greece
| | - Ioannis Bouris
- Research Genetic Cancer Centre S.A., Industrial Area of Florina, Florina, Greece
| | - Vasiliki Daikopoulou
- Research Genetic Cancer Centre S.A., Industrial Area of Florina, Florina, Greece
| | - Ioannis Papasotiriou
- Research Genetic Cancer Centre International GmbH Headquarters, Baarerstrasse, Zug, Switzerland
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22
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Khalighi Sikaroudi M, Mokhtare M, Shidfar F, Janani L, Faghihi Kashani A, Masoodi M, Agah S, Dehnad A, Shidfar S. Effects of vitamin D3 supplementation on clinical symptoms, quality of life, serum serotonin (5-hydroxytryptamine), 5-hydroxy-indole acetic acid, and ratio of 5-HIAA/5-HT in patients with diarrhea-predominant irritable bowel syndrome: A randomized clinical trial. EXCLI JOURNAL 2020; 19:652-667. [PMID: 33013260 PMCID: PMC7527498 DOI: 10.17179/excli2020-2247] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 05/13/2020] [Indexed: 12/12/2022]
Abstract
Vitamin D deficiency, common in the population with irritable bowel syndrome (IBS), can induce the main factors that lead to IBS clinical symptoms, such as depression, anxiety, and inflammation. Serotonin (5-HT) plays an important role in the pathophysiology of IBS, and its production and secretion are increased from the lumen due to stress and inflammation. The aim of this study was to evaluate the effect of vitamin D3 supplementation on the pathogenesis of diarrhea-predominant IBS (IBS-D). Seventy-four IBS-D patients (age: 18-65 y) participated in a randomized, double-blind, placebo-controlled trial study from February 2017 to May 2018, at Rasoul-e-Akram Hospital, Tehran, Iran. Subjects were allocated into two groups receiving 50,000 IU/week of vitamin D3 or placebo for 9 weeks. IBS severity score system (IBS-SSS), IBS-quality of life questionnaire (QoL), hospital anxiety and depression Scale (HADs), visceral sensitivity index (VSI) and serum 25(OH) vitamin D3, serotonin, 5-hydroxy-indole acetic acid and ratio of 5-HIAA/5-HT were evaluated before and after the interventions. Symptoms severity, QoL, HADs-depression, and VSI score improved significantly in the vitamin D group as compared to the placebo group (P-values: <0.001, 0.049, 0.023, and 0.008; respectively). There were no significant differences in abdominal bloating, HADs-anxiety, serum 5-HT, 5-HIAA, and 5-HIAA/5-HT between the two groups at the end of the study. Based on our results, we recommend serum vitamin D be evaluated in the process of treatment of these patients to ameliorate symptoms and quality life of IBS-D patients with vitamin D deficiency and/or insufficiency.
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Affiliation(s)
| | - Marjan Mokhtare
- Colorectal Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Colorectal Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Janani
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mohsen Masoodi
- Colorectal Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Shahram Agah
- Colorectal Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Dehnad
- Department of English Language, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Shidfar
- Worcester Memorial Hospital, University of Massachusetts, Worcester, U.S.A
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Khalighi Sikaroudi M, Mokhtare M, Janani L, Faghihi Kashani AH, Masoodi M, Agah S, Abbaspour N, Dehnad A, Shidfar F. Vitamin D3 Supplementation in Diarrhea-Predominant Irritable Bowel Syndrome Patients: The Effects on Symptoms Improvement, Serum Corticotropin-Releasing Hormone, and Interleukin-6 - A Randomized Clinical Trial. Complement Med Res 2020; 27:302-309. [PMID: 32203968 DOI: 10.1159/000506149] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 01/26/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVES This study aimed to evaluate whether vitamin D deficiency is associated with the severity of symptoms of irritable bowel syndrome (IBS) patients. Stress and gut inflammation can increase the serum level of corticotropin-releasing hormone (CRH) and interleukin-6 (IL-6), leading to a change in bowel movements. The aim of this study was to evaluate the anti-inflammatory and psychological effects of vitamin D3 supplementation on the symptom improvement of patients with a diarrhea-predominant form of IBS (IBS-D). METHODS Eighty-eight IBS-D patients (age: 18-65 years) based on Rome IV criteria who suffered from vitamin D deficiency and/or insufficiency were enrolled in this randomized, placebo-controlled trial from February 2017 to May 2018 at Rasoul-e-Akram Hospital, Tehran, Iran. Participants were randomly divided into two groups. The intervention group received 50,000 IU vitamin D3 weekly and the control group received a placebo for 9 weeks. All patients received Mebeverine 135 mg twice a day besides supplementation. The IBS Severity Score System (IBS-SSS), serum 25(OH) vitamin D3, CRH, and IL-6 were measured before and after interventions. RESULTS Seventy-four patients completed the study. The severity of IBS symptoms (p < 0.01) and IL-6 (p = 0.02) decreased significantly in the intervention group as compared to the control group, but there was no significant difference in the serum level of CRH. Also, in the treatment group, IBS-SSS and IL-6 were significantly reduced at the end of the study from baseline (p < 0.01 and p < 0.03, respectively). CONCLUSION Our findings indicate that vitamin D3 supplementation can modulate the serum level of CRH and IL-6 and can improve symptoms in IBS-D patients. Vitamin D3 supplementation should be considered in IBS-D patients who suffer from vitamin D deficiency and/or insufficiency.
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Affiliation(s)
| | - Marjan Mokhtare
- Colorectal Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Janani
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mohsen Masoodi
- Colorectal Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Shahram Agah
- Colorectal Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Narjes Abbaspour
- Department of Nutrition, Islamic Azad University, Science and Research Branch, Tehran, Iran
| | - Afsaneh Dehnad
- Department of English Language, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Shidfar
- Colorectal Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran,
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Vitamin D Deficiency and Unclear Abdominal Pain in Patients from Low- and Middle-Income Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234607. [PMID: 31757059 PMCID: PMC6926624 DOI: 10.3390/ijerph16234607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 11/17/2019] [Accepted: 11/18/2019] [Indexed: 12/12/2022]
Abstract
Background: Abdominal pain is one of the commonest symptoms in emergency departments (EDs). Diagnosis demands full attention and critical thinking, since many diseases manifest atypically and the consequences of overlooking the symptoms may be disastrous. Despite intensive diagnostic procedures, some cases remain elusive and unclear abdominal pain (UAP) is not infrequent. Emerging evidence supports the hypothesis that functional pain might be attributed to vitamin D deficiency (VDD). People with darker or covered skin are predisposed to developing VDD. Patients in Switzerland stemming from low- and middle-income countries (LMIC) are such a population. Aim: To identify cases with UAP in LMIC patients and to compare vitamin D status with a control group. Methods: A retrospective single-center case-control study was carried out from 1 January 2013 to 31 August 2016 in all adult patients (more than 16 years old) stemming from LMIC and presenting at the university ED of Bern with abdominal pain. Vitamin D status was retrieved from these cases when available. The control group consisted of patients without abdominal pain or metabolic diseases and was matched (1:1) to the cases for age, gender, body mass index, geographic distribution, and season of vitamin D estimation. Results: A total of 10,308 cases from LMIC were reported to the ED. In total, 223 cases were identified with UAP. The status of vitamin D was available for 27 patients; 27 matched individuals were subsequently retrieved for the control group. Women made up 56.7% of the UAP group and 43.3% of the control group. The most common origin of the LMIC subjects was southern Europe (20.4%), followed by southern Asia (16.7%) and Eastern Europe (13%). Fourteen UAP patients exhibited severe VDD (<25 nmol/L) versus one in the control group (p = 0.001). The difference remained significant if the patients were identified as having VDD (<50 nmol/L) or not (p = 0.024). Comparison of the means indicated that the UAP group had lower vitamin D levels than the control group (41.3 vs. 53.7 nmol/L, respectively), but this difference was marginal (p = 0.060) and not statistically significant. After adjustment for potential confounders, including gender, mean vitamin D levels remained non-significantly different between groups. In the sub-group analysis, vitamin D levels were lower in women than in men (p = 0.037), compared to the respective controls. Conclusion: This study showed for the first time that patients from LMIC who presented to ED with UAP displayed VDD. Validation from larger studies is warranted to evaluate the linkage of VDD with UAP.
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Soy isoflavones and cholecalciferol reduce inflammation, and gut permeability, without any effect on antioxidant capacity in irritable bowel syndrome: A randomized clinical trial. Clin Nutr ESPEN 2019; 34:50-54. [PMID: 31677711 DOI: 10.1016/j.clnesp.2019.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 09/01/2019] [Accepted: 09/08/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND & AIMS Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that is more prevalent in women. Vitamin D deficiency and hormonal disorders are also prevalent in Iranian women, and may influence the severity of clinical outcomes mediated by microinflammation, oxidative stress and intestinal permeability pathways. Our objective was to investigate the effects of co-administration of soy and vitamin D on some inflammatory, antioxidant and gut permeability markers in women with IBS. METHODS In a randomized clinical trial, women (18-75 years of age) were randomly allocated into four groups to receive soy isoflavones (40 mg/day), cholecalciferol (50,000 IU/15 days), both soy isoflavones and cholecalciferol, or placebo for six weeks. The outcomes were plasma inflammatory markers, antioxidant status and fecal protease activity at week 0 and week 6. RESULTS After the intervention, plasma inflammatory markers and fecal protease activity were reduced significantly in all treatment groups compared to the placebo group; however, there was no significant effect on antioxidant status. CONCLUSION This study suggests combined supplementation of soy isoflavones and active vitamin D can improve some biochemical parameters regarding inflammation and intestinal permeability of IBS in women. TRIAL REGISTRATION Clinical.Trials.govNCT02026518.
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26
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Roudsari NM, Lashgari NA, Momtaz S, Farzaei MH, Marques AM, Abdolghaffari AH. Natural polyphenols for the prevention of irritable bowel syndrome: molecular mechanisms and targets; a comprehensive review. ACTA ACUST UNITED AC 2019; 27:755-780. [PMID: 31273572 DOI: 10.1007/s40199-019-00284-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 06/14/2019] [Indexed: 12/12/2022]
Abstract
Irritable bowel syndrome (IBS) is a well diagnosed disease, thoroughly attributed to series of symptoms criteria that embrace a broad range of abdominal complainers. Such criteria help to diagnosis the disease and can guide controlled clinical trials to seek new therapeutic agents. Accordingly, a verity of mechanisms and pathophysiological conditions including inflammation, oxidative stress, lipid peroxidation and different life styles are involved in IBS. Predictably, diverse therapeutic approaches are available and prescribed by clinicians due to major manifestations (i.e., diarrhea-predominance, constipation-predominance, abdominal pain and visceral hypersensitivity), psychological disturbances, and patient preferences between herbal treatments versus pharmacological therapies, dietary or microbiological approaches. Herein, we gathered the latest scientific data between 1973 and 2019 from databases such as PubMed, Google Scholar, Scopus and Cochrane library on relevant studies concerning beneficial effects of herbal treatments for IBS, in particular polyphenols. This is concluded that polyphenols might be applicable for preventing IBS and improving the IBS symptoms, mainly through suppressing the inflammatory signaling pathways, which nowadays are known as novel platform for the IBS management. Graphical abstract.
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Affiliation(s)
- Nazanin Momeni Roudsari
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Naser-Aldin Lashgari
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Saeideh Momtaz
- Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran.,Toxicology and Diseases Group, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Toxicology and Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hosein Farzaei
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran. .,Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - André M Marques
- Oswaldo Cruz Foundation (FIOCRUZ), Institute of Technology in Pharmaceuticals (Farmanguinhos), Rio de Janeiro, RJ, Brazil
| | - Amir Hossein Abdolghaffari
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran. .,Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran. .,Toxicology and Diseases Group, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran. .,Department of Toxicology and Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran. .,Gastrointestinal Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
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Lehmann S, Ferrie S, Carey S. Nutrition Management in Patients With Chronic Gastrointestinal Motility Disorders: A Systematic Literature Review. Nutr Clin Pract 2019; 35:219-230. [PMID: 30989698 DOI: 10.1002/ncp.10273] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The aim of this study was to systematically review effects of nutrition interventions on outcomes in patients with chronic gastrointestinal (GI) motility disorders. There is currently a lack of evidence-based guidelines for nutrition management in this group, likely a result of the rarity of the conditions. METHODS A systematic review of all study types to evaluate current evidence-based nutrition interventions was performed using Medline, Embase, and CINAHL databases. Two independent reviewers participated in the process of this systematic review. A total of 15 studies and a total of 524 subjects were included. RESULTS Best treatment of this population group was found to include a stepwise process, progressing from oral nutrition to jejunal nutrition and lastly to parenteral nutrition. Small particle, low-fat diets were significantly better tolerated than the converse, with jejunal nutrition prior to consuming oral food significantly improving oral intake and motility. In more progressive cases, percutaneous endoscopic gastrostomy with jejunal extension nutrition had lower reported symptoms than other enteral routes. Exclusive long-term parenteral nutrition is a feasible option for advanced cases, with a 68% survival rate at 15 years duration, though oral intake with parenteral nutrition is associated with higher survival rates. CONCLUSION Treatment of patients with GI motility disorders should first trial oral nutrition. For patients who progress to jejunal or parenteral feeds, the primary aim should be to maintain or reinstate oral intake to reduce morbidity and mortality risk. Higher-quality studies are still required in this area, particularly in the areas of chronic intestinal pseudo-obstruction and systemic sclerosis.
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Affiliation(s)
- Sara Lehmann
- University of Sydney, School of Life and Environmental Sciences, Sydney, Australia
| | - Suzie Ferrie
- University of Sydney, School of Life and Environmental Sciences, Sydney, Australia.,Department of Nutrition & Dietetics, Royal Prince Alfred Hospital, Sydney, Australia
| | - Sharon Carey
- University of Sydney, School of Life and Environmental Sciences, Sydney, Australia.,Department of Nutrition & Dietetics, Royal Prince Alfred Hospital, Sydney, Australia
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Barbalho SM, Goulart RDA, Araújo AC, Guiguer ÉL, Bechara MD. Irritable bowel syndrome: a review of the general aspects and the potential role of vitamin D. Expert Rev Gastroenterol Hepatol 2019; 13:345-359. [PMID: 30791775 DOI: 10.1080/17474124.2019.1570137] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Irritable Bowel Syndrome (IBS) is a bowel disorder leading to symptoms such as abdominal pain, modifications in the motility and bowel habits, distention, bloating, and gas. Vitamin D (VD) may interfere in a plethora of cellular mechanisms, and act directly or indirectly in the regulation of the microbiome, the release of anti-microbial peptides, modulation of the immune system and inflammation processes; which in turn, may positively interfere with the altered gut function. The main purpose of this review was to survey studies involving the impacts of VD on IBS. Area covered: Eligible studies including the term VD and IBS were searched in the MEDLINE-PubMed and EMBASE (2009-2018). VD may act direct or indirectly in the regulation of the gut microbiome, immune response, and psychosocial factors that may be included in the list of IBS triggering factors. Expert opinion: Once VD plays an essential role in many processes associated with IBS, its deficiency may be associated with IBS, and the supplementation could help in the therapeutic approach for this condition. For these reasons, the understanding of the association of VD in IBS is indispensable for the development of new strategies that could improve the quality of life of the patient.
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Affiliation(s)
- Sandra Maria Barbalho
- a Medical School of Marília , UNIMAR , São Paulo , Brazil.,b Department of Nutrition , Food Technology School , São Paulo , Brazil
| | | | | | - Élen Landgraf Guiguer
- a Medical School of Marília , UNIMAR , São Paulo , Brazil.,b Department of Nutrition , Food Technology School , São Paulo , Brazil
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Jalili M, Vahedi H, Poustchi H, Hekmatdoost A. Effects of Vitamin D Supplementation in Patients with Irritable Bowel Syndrome: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Int J Prev Med 2019; 10:16. [PMID: 30820303 PMCID: PMC6390425 DOI: 10.4103/ijpvm.ijpvm_512_17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/15/2018] [Indexed: 12/13/2022] Open
Abstract
Objective: There are some evidence that Vitamin D supplementation may be beneficial for patients with irritable bowel syndrome (IBS). The aim of this study was to evaluate the effects of Vitamin D supplementation on symptoms and quality of life (QOL) in patients with IBS. Methods: In a randomized, double-blind, placebo-controlled clinical trial, 116 patients with IBS were supplemented weekly with either a pearl of 50,000 IU Vitamin D or an identical pearl of placebo containing medium chain triglyceride for 6 weeks. Results: Mean age of patients was 42.24 ± 12.26, and 40.06 ± 13.37 in Vitamin D and placebo groups, respectively. Dietary intakes were similar between and within groups. Serum concentration of 25-hydroxy Vitamin D increased significantly from 21.10 ± 5.23 to 36.43 ± 12.34 in the Vitamin D group (P < 0.001), while it was not significantly different before and after the trial in placebo group. The IBS symptoms severity scores (SSSs), disease-specific QOL, and total score were evaluated at weeks 0 and 6. IBS-SSS, IBS-QOL, and the total score were improved significantly more in Vitamin D group in comparison to the placebo group (P < 0.05). Conclusions: This study indicates that Vitamin D therapy can improve the severity of symptoms and QOL in patients with IBS; however, the long-term effects remained to be elucidated. Trial registration at IRCT: IRCT201402234010N11 IRB Number: 116/3976
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Affiliation(s)
- Mahsa Jalili
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Homayoon Vahedi
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Azita Hekmatdoost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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El Amrousy D, Hassan S, El Ashry H, Yousef M, Hodeib H. Vitamin D supplementation in adolescents with irritable bowel syndrome: Is it useful? A randomized controlled trial. Saudi J Gastroenterol 2018; 24:109-114. [PMID: 29637918 PMCID: PMC5900470 DOI: 10.4103/sjg.sjg_438_17] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND/AIM Vitamin D deficiency is common in irritable bowel syndrome (IBS). There is growing interest in the role of vitamin D in pediatric IBS. We aimed to evaluate the effect of vitamin D supplementation in adolescents with IBS and vitamin D deficiency. PATIENTS AND METHODS One hundred and twelve adolescents with IBS and vitamin D deficiency were randomly divided into two groups of matched age and sex. The first group received oral vitamin D3 2000IU/day for 6 months and the second group received placebo for 6 months. Vitamin D status as well as different IBS score systems (IBS-SSS, IBS-QoL, and total score) were evaluated before and 6 months after treatment. RESULTS IBS patients who received vitamin D supplementation for 6 months showed significant improvement in IBS-SSS (P < 0.001), IBS-QoL (P < 0.001), and total score (P = 0.02) compared to IBS placebo group. IBS patients treated with vitamin D showed two folds increase in their serum vitamin D levels (from 17.2 ± 1.3 to 39 ± 3.3) ng/ml with P < 0.001. While in the placebo group, their serum vitamin D levels were not significantly changed (P = 0.66). Vitamin D was tolerated well without any recorded adverse effects during the study period. CONCLUSION Vitamin D supplementation can be effective in treating adolescents with IBS and vitamin D deficiency.
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Affiliation(s)
- Doaa El Amrousy
- Department of Pediatrics, Faculty of Medicine, Tanta University, Egypt
- Address for correspondence: Prof. Doaa El Amrousy, Department of Pediatrics, Faculty of Medicine, Tanta University, Egypt. E-mail:
| | - Samir Hassan
- Department of Pediatrics, Faculty of Medicine, Tanta University, Egypt
| | - Heba El Ashry
- Tropical Medicine, Faculty of Medicine, Tanta University, Egypt
| | - Mohamed Yousef
- Tropical Medicine, Faculty of Medicine, Tanta University, Egypt
| | - Hossam Hodeib
- Clinical Pathology, Faculty of Medicine, Tanta University, Egypt
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Vitamin D status in irritable bowel syndrome and the impact of supplementation on symptoms: what do we know and what do we need to know? Eur J Clin Nutr 2018; 72:1358-1363. [PMID: 29367731 DOI: 10.1038/s41430-017-0064-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND Low vitamin D status is associated with risk of colorectal cancer and has been implicated in inflammatory bowel disease. Irritable bowel syndrome (IBS) is a chronic, relapsing, functional bowel disorder. A nascent literature suggests a role for vitamin D in IBS, but this has not been collated or critiqued. To date, seven studies have been published: four observational studies and three randomised controlled trials (RCTs). All observational studies reported that a substantial proportion of the IBS population was vitamin D deficient. Two intervention studies reported improvement in IBS symptom severity scores and quality of life (QoL) with vitamin D supplementation. There are limited data around the role of vitamin D in IBS. CONCLUSIONS The available evidence suggests that low vitamin D status is common among the IBS population and merits assessment and rectification for general health reasons alone. An inverse correlation between serum vitamin D and IBS symptom severity is suggested and vitamin D interventions may benefit symptoms. However, the available RCTs do not provide strong, generalisable evidence; larger and adequately powered interventions are needed to establish a case for therapeutic application of vitamin D in IBS.
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Hosseini Oskouie F, Vahedi H, Shahrbaf MA, Sadeghi A, Rashidkhani B, Hekmatdoost A. Dietary fiber and risk of irritable bowel syndrome: a case-control study. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH 2018; 11:S20-S24. [PMID: 30774803 PMCID: PMC6347982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 09/22/2018] [Indexed: 11/12/2022]
Abstract
AIM The purpose of this study was to determine the relationship between dietary fiber intake and risk of irritable bowel syndrome (IBS). BACKGROUND Patients with IBS are usually concerned about their diet, which can exacerbate or relieve their symptoms. METHODS In this case-control study, ninety cases and 355 controls were selected from a gastroenterology clinic. Dietary intakes of participants were assessed using a validated and reliable food frequency questionnaire (FFQ). Dietary fiber was calculated according to United States Department of Agriculture (USDA) food composition table. RESULTS Dietary total fiber intake was significantly associated with lower risk of IBS. The adjusted odds ratio (OR) comparing the highest tertile of dietary total fiber with the lowest tertile was 0.14 (95% CI = 0.71-0.28; P-test for trend <0.001); however, there was no significant association or dose-response trend for higher intakes of soluble, and insoluble fiber separately with risk of IBS. CONCLUSION Our data indicate that dietary fiber is inversely associated with the risk of IBS. Further prospective studies are needed to confirm these data.
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Affiliation(s)
- Fatemeh Hosseini Oskouie
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homayoun Vahedi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran, Iran
| | - Mohammad Amin Shahrbaf
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Sadeghi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahram Rashidkhani
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azita Hekmatdoost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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