The Effect of Gum Arabic (Acacia Senegal) on Cardiovascular Risk Factors and Gastrointestinal Symptoms in Adults at Risk of Metabolic Syndrome: A Randomized Clinical Trial

Perspective: Revisiting the Concepts of Prebiotic and Prebiotic Effect in Light of Scientific and Regulatory Progress - A Consensus Paper from the Global Prebiotic Association (GPA)

The term prebiotic has been used for almost three decades and has undergone numerous updates over the years. The scientific literature reveals that despite continuous efforts to establish a globally unified definition to guide jurisdictional regulations and product innovations, ambiguity continues to surround the terms prebiotic and prebiotic effect, leading to products that lack in full regulatory adherence being marketed worldwide. Thus, to reflect the current state of scientific research and knowledge and for the continuous advancement of the category, an update to the current prebiotic definition is warranted. This update includes removing the term selectivity, considering additional locations of action besides the gut, highlighting prebiotic performance benefits such as cognitive and athletic, and providing a clear standalone definition for prebiotic effect. The Global Prebiotic Association (GPA) is a leading information and industry hub committed to raising awareness about prebiotics, their emerging and well-established health benefits, and prebiotic product integrity and efficacy. In this position paper, GPA builds on previous prebiotic definitions to propose the following expanded definition for prebiotic: "a compound or ingredient that is utilized by the microbiota producing a health or performance benefit." In addition to prebiotic, GPA also defines prebiotic effect as: "a health or performance benefit that arises from alteration of the composition and/or activity of the microbiota, as a direct or indirect result of the utilization of a specific and well-defined compound or ingredient by microorganisms." With these two definitions, GPA aims to paint a clearer picture for the term prebiotic, and by incorporating an industry point of view, these updated definitions may be used alongside current scientific and regulatory perspectives to move the category forward. STATEMENT OF SIGNIFICANCE: The purpose of this paper is to revisit the concepts of prebiotic and prebiotic effect by providing a scientific-based industry perspective. The proposed definitions of prebiotic and prebiotic effect reflect the recent discoveries in metagenomics and prebiotic research after the International Scientific Association for Probiotics and Prebiotics' (ISAPP's) 2017 prebiotic definition and propose terminology changes that are timely and necessary. These changes aim to maintain the clarity and usefulness of the prebiotic definition to the scientific community, industry, healthcare providers, and consumers, while ensuring scientific validity, comprehensiveness, and justification of each part of the prebiotic definition, including abandoning the term selectivity and introducing concepts of performance benefits and prebiotic effect.

Therapeutic Potential of Gum Arabic (Acacia senegal) in Chronic Kidney Disease Management: A Narrative Review

Chronic kidney disease (CKD) poses significant health challenges globally, particularly in regions like the Middle East. This review evaluates the potential efficacy and safety of Gum Arabic (Acacia senegal), a traditional remedy, in managing CKD. A comprehensive literature review was conducted using databases including PubMed and Scopus, focusing on the biochemical, physiological, and therapeutic impacts of Gum Arabic on renal health. Gum Arabic has demonstrated antioxidative and anti-inflammatory properties that may benefit renal function, as shown in animal studies. Clinical trials suggest improvements in renal biomarkers, though these are limited by scope and methodology. While promising, the clinical application of Gum Arabic requires cautious interpretation due to gaps in understanding its mechanisms of action. Gum Arabic shows potential as an adjunct treatment for CKD, reflecting both traditional use and preliminary scientific evidence. Future research should focus on its long-term efficacy, safety, and underlying biochemical pathways to better guide its therapeutic use.

Contamination levels of toxic metals in selected traditional plants incense (gum)

Gums are polysaccharides, proteins, and minerals that occur naturally in seed coverings and as exudative resinous substance from woody plants. It is reported to have antibacterial, anticancer, blood sugar regulation, and immune system boosting properties. However, the presence of toxic metals in gum is caused for caution as these metals can be harmful if taken in high quantities. The purpose of this study was to determine the amounts of toxic metals in gums collected from the local market, as many consumers tend to use them daily for incense or food ingredients. Gum samples were extracted from several parts of 10 selected medicinal plants (bark, sap, root, latex, leaf glue, and gum). Two fractions of each sample were produced using nitric acid (NHO3), followed by hydrochloric acid (HCl) at first and then hydrogen peroxide (H2O2). The presence of toxic metals in the solutions was determined using an Inductively Coupled Plasma Atomic Emission Spectrometer (ICP OES). The results showed that most of the elements were detected in high concentrations in Commiphora myrrha (Cd, Cu, Fe, K, Mn, Ni, Pb, and Zn) followed by Benzoin resin (Jawi Oud) and Paeonia officinalis. The most prevalent elements detected in all of the herbal gums were potassium (K) and iron (Fe). Fortunately, the sampled herbal gums were found to be within the WHO/FAO permitted range. This study may provide insights about the safety of the selected gums to be used for food applications. Further in vitro and in vivo toxicity studies should be performed to identify the safe dose.

Gum acacia dietary fiber: Significance in immunomodulation, inflammatory diseases, and cancer

Gum arabic/acacia (GA), derived from Acacia trees, is a versatile natural product offering a broad spectrum of applications. Its rich content of soluble dietary fibers, coupled with a low caloric profile, renders GA a valuable dietary component associated with numerous health benefits. Furthermore, its fermentation by gut microbiota yields short-chain fatty acids, renowned for their positive impact on health. Immunomodulation, a crucially regulated mechanism in the body, serves to fend off pathogenic infections by releasing pro-inflammatory cytokines. However, prolonged synthesis of these cytokines can lead to chronic inflammation, tissue damage, and potentially contribute to the development of autoimmune diseases and cancer. Hence, there is an urgent need to identify plant-based biomolecules that can effectively reduce inflammation and inhibit inflammation-induced complications or disorders. In this context, edible biomolecules like GA are gaining prominence for their noteworthy immunomodulatory properties. Therefore, in the present review we have explored the role of GA in immunomodulation, inflammation, and inflammation-associated metabolic diseases, and cancer.

Pharmacological benefits of Acacia against metabolic diseases: intestinal-level bioactivities and favorable modulation of gut microbiota

CONTEXT

Obesity-associated chronic metabolic disease is a leading contributor to mortality globally. Plants belonging to the genera Acacia are routinely used for the treatment of diverse metabolic diseases under different ethnomedicinal practices around the globe.

OBJECTIVE

The current review centres around the pharmacological evidence of intestinal-level mechanisms for metabolic health benefits by Acacia spp.

RESULTS

Acacia spp. increase the proportions of gut commensals (Bifidobacterium and Lactobacillus) and reduces the population of opportunistic pathobionts (Escherichia coli and Clostridium). Acacia gum that is rich in fibre, can also be a source of prebiotics to improve gut health. The intestinal-level anti-inflammatory activities of Acacia are likely to contribute to improvements in gut barrier function that would prevent gut-to-systemic endotoxin translocation and limit "low-grade" inflammation associated with metabolic diseases.

CONCLUSION

This comprehensive review for the first time has emphasised the intestinal-level benefits of Acacia spp. which could be instrumental in limiting the burden of metabolic disease.

ITC study on the interaction of some bile salts with tragacanth, Arabic, and guar gums with potential cholesterol-lowering ability

Introduction

The urge of designing new safe and natural functional foods to control blood lipids and dispensable without the need of physician supervision, has increased especially after the coming into effect of the recent EU Commission regulation 2022/860, that regulates the consumption of "red yeast rice," made by fermentation of rice with Monascus purpureus, and perceived as a natural functional food, due to a health risk for frail consumers. The results of the present work are a part of the systematic study we are carrying out of the binding ability of some soluble dietary fibers (SDF) from different natural sources toward selected bile salts (BS).

Methods

Measurements were carried out by isothermal titration calorimetry (ITC) with the idea to shed light on the mechanism, if any, by which they show cholesterol-lowering activity.

Results and discussion

Epidemiological studies are sometimes conflicting and offer only hypothesis about the mechanism of action, the most accredited being the reduction of reabsorption of BS in the gut. Previous measurements done on negatively charged pectin and alginate, showed specific binding interaction with monomer NaDC for pectin and no interaction at all for alginate. Chitosan, positively charged and soluble only at low pH, in 100 mM acetate buffer at pH = 3 shows strong exothermic interactions with NaTC and NaTDC. Here we considered two plant exudates (Arabic gum and tragacanth gum) and guar gum, extracted from guar beans, and their interaction with the same bile salts. ITC measurements do not evidence specific interactions between gums and the studied BS, so that their cholesterol lowering ability, if any, is due to a different mechanism very probably bound to the viscosity increase. Moreover, the addition of NaC, the most abundant BS in the bile, at very low concentration (under the cmc) causes a structural change of the solution. The obtained results seem to corroborate the hypothesis that the cholesterol lowering activity is related to the increase in viscosity of guar solution favored by NaC, the major component of the bile.

The Relationship Between Dietary Fiber Intake and Blood Pressure Worldwide: A Systematic Review

Cardiovascular diseases (CVDs) are a significant global health concern, necessitating effective preventive measures. Dietary fiber has gained attention as a potential cardiovascular risk factor modifier. Although its effects on various CVD risk markers such as cholesterol levels and blood glucose levels have been explored, the relationship between dietary fiber and blood pressure remains somewhat elusive across the different studies conducted worldwide. In this systematic review, we conducted an extensive analysis of recent research from a global perspective, aiming to elucidate the relationship between dietary fiber intake and blood pressure. From an initial pool of more than 24,500 articles retrieved from PubMed and Google Scholar, we rigorously selected 11 studies published in the last decade (post-2013) to ensure up-to-date insights. These selected studies encompass diverse populations from different regions worldwide, allowing for a comprehensive global assessment. Our analysis revealed a positive overall impact of increased dietary fiber intake on blood pressure levels. Despite variations in study parameters, consistent trends were observed across multiple continents. This systematic review underscores the potential of dietary fiber intake to reduce blood pressure and improve cardiovascular health globally. This review serves as a global analysis and updates on the developments about the potential association between dietary fiber and blood pressure levels. While the findings are promising, further research is essential to elucidate underlying mechanisms and ensure global consistency. Collaborative efforts and ongoing investigation are crucial for harnessing the cardiovascular benefits of dietary fiber and addressing the worldwide burden of hypertension.

Assessing Gastrointestinal Tolerance in Healthy Adults: Reliability and Validity of a Weekly Questionnaire

When examining gastrointestinal tolerance to nondigestible carbohydrates, a weekly vs. daily symptoms questionnaire may lessen participant burden. This secondary analysis examined the reliability and validity of the Gastrointestinal Symptom Rating Scale (GSRS) in healthy adults. The internal consistency reliability of the GSRS syndromes and a daily questionnaire (DQ) comparator were determined. The GSRS syndromes prediction of slow transit stool form was assessed by ROC analysis. The DQ (α = 0.76) and GSRS syndromes of constipation (α = 0.73; ω = 0.74), and diarrhea (α = 0.76; ω = 0.77) exhibited acceptable reliability, as did the GSRS overall (α = 0.76; ω = 0.87) but not the syndromes of abdominal pain (α = 0.54; ω = 0.54), reflux (α = 0.69; ω = 0.67), or indigestion (α = 0.64; ω = 0.67). The GSRS syndromes predicted slow transit stools (AUC = 0.855), and the GSRS items of stomach pain, nausea, flatus, constipation, and diarrhea were moderately correlated (ρ = 0.55-0.64; P < 0.001) with the corresponding DQ items. The GSRS may be useful to assess gastrointestinal tolerance and efficacy of nondigestible carbohydrates given its performance at predicting slow transit stools, suggestive of constipation.

Soluble Dietary Fibers as Antihyperlipidemic Agents: A Comprehensive Review to Maximize Their Health Benefits

The number of hypercholesterolemic people is increasing rapidly worldwide, with elevated lipid profiles representing a major risk factor of coronary heart diseases. Dietary intervention was shown to improve the lipid profile, thus enhancing the quality of life. Dietary fiber is a nondigestible form of carbohydrates, due to the lack of the digestive enzyme in humans required to digest fiber, and is classified according to its water solubility properties as either soluble (SDF) or insoluble dietary fiber (IDF). Consumption of SDF is associated with several health benefits such as reduced lipid levels, lower blood pressure, improved blood glucose control, improved immune function, and reduced inflammation. SDF has been shown to lower blood cholesterol by several action mechanisms including directly due to the gelling, mucilaginous, and viscous fiber nature, and indirectly due to its fermented products and modulation of the gut microbiome. This review aims to provide a holistic overview on how SDF impacts the lipid profile. We start by providing an overview of the chemical structure of the major SDFs including mucilage, gums (gum arabic and guar gum), pectin, and inulin.

The Efficacy of Gum Arabic in Managing Diseases: A Systematic Review of Evidence-Based Clinical Trials

Gum arabic (GA) is a natural product commonly used as a household remedy for treating various diseases in the Sub-Saharan Africa region. Despite its claimed benefits, there has been a lack of research on the findings of current clinical trials (CTs) that investigated its efficacy in the treatment of various medical diseases. The aim of this systematic review was to study CTs which focused on GA and its possible use in the management of various medical diseases. A search of the extant literature was performed in the PubMed, Scopus, and Cochrane databases to retrieve CTs focusing on evidence-based clinical indications. The databases were searched using the keywords ("Gum Arabic" OR "Acacia senegal" OR "Acacia seyal" OR "Gum Acacia" OR "Acacia Arabica") AND ("Clinical Trial" OR "Randomized Controlled Trial" OR "Randomized Clinical Trial"). While performing the systematic review, data were obtained on the following parameters: title, authors, date of publication, study design, study aim, sample size, type of intervention used, targeted medical diseases, and main findings. Twenty-nine papers were included in this systematic review. The results showed that ingestion of GA altered lipid profiles, renal profiles, plaque, gingival scores, biochemical parameters, blood pressure, inflammatory markers, and adiposity. GA exhibited anti-inflammatory, prebiotic, and antibacterial properties. GA has been successfully used to treat sickle cell anemia, rheumatoid arthritis, metabolic disorders, periodontitis, gastrointestinal conditions, and kidney diseases. Herein, we discuss GA with respect to the underlying mechanisms involved in each medical disease, thereby justifying GA's future role as a therapeutic agent.

Ameliorations in dyslipidemia and atherosclerotic plaque by the inhibition of HMG-CoA reductase and antioxidant potential of phytoconstituents of an aqueous seed extract of Acacia senegal (L.) Willd in rabbits

The assigned work was aimed to examine the capability of phytoconstituents of an aqueous seed extract of Acacia senegal (L.) Willd to inhibit HMG-CoA reductase and regression of the atherosclerotic plaque. The chemical fingerprinting of the test extract was assessed by LC-MS/MS. Consequently, the analyses of in-vitro, in-vivo, and in-silico were executed by using the standard protocols. The in-vitro assessment of the test extract revealed 74.1% inhibition of HMG-CoA reductase. In-vivo assessments of the test extract indicated that treated hypercholesterolemic rabbits exhibited a significant (P≤0.001) amelioration in the biomarker indices of the dyslipidaemia i.e., atherogenic index, Castelli risk index(I&II), atherogenic coefficient along with lipid profile. Subsequently, significant reductions were observed in the atherosclerotic plaque and antioxidant levels. The in-silico study of molecular docking shown interactions capabilities of the leading phytoconstituents of the test extract i.e., eicosanoic acid, linoleic acid, and flavan-3-ol with target protein of HMG-CoA reductase. The values of RSMF and potential energy of top docked complexes were show significant interactions. Accordingly, the free energy of solvation, interaction angle, radius of gyration and SASA were shown significant stabilities of top docked complex. The cumulative data of results indicate phytoconstituents of an aqueous seed extract of Acacia senegal have capabilities to inhibit the HMG-CoA reductase and improve the levels of antioxidants.

A Review on the Main Phytoconstituents, Traditional Uses, Inventions, and Patent Literature of Gum Arabic Emphasizing Acacia seyal

Acacia seyal is an important source of gum Arabic. The availability, traditional, medicinal, pharmaceutical, nutritional, and cosmetic applications of gum acacia have pronounced its high economic value and attracted global attention. In addition to summarizing the inventions/patents applications related to gum A. seyal, the present review highlights recent updates regarding its phytoconstituents. Traditional, cosmetic, pharmaceutical, and medicinal uses with the possible mechanism of actions have been also reviewed. The patent search revealed the identification of 30 patents/patent applications of A. seyal. The first patent related to A. seyal was published in 1892, which was related to its use in the prophylaxis/treatment of kidney and bladder affections. The use of A. seyal to treat cancer and osteoporosis has also been patented. Some inventions provided compositions and formulations containing A. seyal or its ingredients for pharmaceutical and medical applications. The inventions related to agricultural applications, food industry, cosmetics, quality control of gum Arabic, and isolation of some chemical constituents (L-rhamnose and arabinose) from A. seyal have also been summarized. The identification of only 30 patents/patent applications from 1892 to 15 November 2021 indicates a steadily growing interest and encourages developing more inventions related to A. seyal. The authors recommend exploring these opportunities for the benefit of society.

Acacia pycnantha and gum arabic an alternative to antacids and proton pump inhibitors in the management of gastroesophageal and laryngopharyngeal reflux

A case report is presented where a patient with long-term gastroesophageal reflux and recently diagnosed laryngopharyngeal reflux (LPR) underwent an 8-week treatment with proton pump inhibitors (PPIs). On discontinuation of the PPIs, symptoms of LPR remained and the patient’s reflux symptoms returned with increased severity. Consumption of acacia gum exudates from Acacia pycnantha resolved the LPR. Acacia pycnantha or gum arabic were both found to reduced reflux symptoms to a manageable level. An evaluation of the therapeutic effect of acacia gums using questionnaires to evaluate reflux symptoms, quality of life and global refluxogenic scores was undertaken. It was found acacia gums can be taken after the evening meal in the same way as antacids to manage reflux symptoms but with more sustained overnight relief.

A Meta-Analysis of Microbial Therapy Against Metabolic Syndrome: Evidence From Randomized Controlled Trials

Background and aims: Metabolic syndrome (MetS), accompanied with significant intestinal dysbiosis, causes a great public health burden to human society. Here, we carried out a meta-analysis to qualify randomized controlled trials (RCTs) and to systematically evaluate the effect of microbial therapy on MetS. Methods and results: Forty-two RCTs were eligible for this meta-analysis after searching the PubMed, Cochrane, and Embase databases. Pooled estimates demonstrated that treatment with microbial therapy significantly reduced the waist circumference (WC) (SMD = -0.26, 95% CI -0.49, -0.03), fasting blood glucose (FBG) (SMD = -0.35, 95% CI -0.52, -0.18), total cholesterol (TC) (SMD = -0.36, 95% CI -0.55, -0.17), low-density lipoprotein cholesterol (LDL-C) (SMD = -0.42, 95% CI -0.61, -0.22), and triacylglycerol (TG)(SMD = -0.38, 95% CI -0.55, -0.20), but increased the high-density lipoprotein cholesterol (HDL-C) (SMD = 0.28, 95% CI.03, 0.52). Sensitivity analysis indicated that after eliminating one study utilizing Bifidobacteriumlactis, results became statistically significant in diastolic blood pressure (DBP) (SMD = -0.24, 95% CI -0.41, -0.07) and in Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) (SMD = -0.28, 95% CI -0.54, -0.03), while the body mass index (BMI) showed significant difference after eliminating one study utilizing oat bran (SMD = -0.16, 95% CI -0.31, -0.01). There was still no significant effect in systolic blood pressure (SBP) and in hemoglobin A1c (HbA1c%). Conclusion: In patients with MetS, the conditioning with microbial therapy notably improves FBG, TC, TG, HDL-C, LDL-C, WC, BMI (except for the study using oat bran), HOMA-IR, and DBP (except for the Study using Bifidobacteriumlactis), however, with no effect in SBP and in HbA1c%.