Effect of dietary fiber on constipation: A meta analysis

Association between defecation status and the habit of eating vinegar-based dishes in community-dwelling Japanese individuals: a cross-sectional study

Vinegar intake reportedly has an antihypertensive effect and reduces visceral fat. Nonetheless, studies on the form of vinegar intake and its effect on defecation are scarce. This cross-sectional study aimed to investigate the association between the frequency of vinegar-based dish intake and defecation status using data from the Tarumizu cohort study. The participants (n = 1024, 634 women) responded to a health check survey in 2019 using a brief-type self-administered diet history questionnaire. The association between the frequency of vinegar-based dish intake and defecation status was examined using a multivariate logistic regression analysis. Considering confounding factors influencing the defecation status such as sex, age, dietary fiber intake, and medication history, individuals with a habit of eating vinegar-based dishes, such as "sour main dishes" (odds ratio [OR]: 1.38; p = 0.039), "sunomono" (OR: 1.49; p = 0.035), and "salad with sour dressing" (OR: 1.41; p = 0.049), had a significantly higher defecation frequency. No significant association was observed between the habit of eating vinegar-based dishes and the time required for defecation or straining during defecation. Our study showed that the habit of eating vinegar-based dishes was positively associated with defecation status. Our findings may suggest a novel approach for defecation improvement in people with defecation problems.

Dietary fermentable carbohydrate consumption and association with cardiometabolic risk markers in college students: A cross-sectional study

Objective: Determine fermentable carbohydrates (FCs) consumption and health parameter differences between high and low FC consumers in US college students. Participants: Consented students (n = 571; 18-22 years) in a general nutrition course. Methods: Diet History Questionnaire quantified total FC plus subclasses, soluble dietary fibers (SDF), and polyols. Anthropometrics, blood pressure, and blood glucose were collected by standard measures. Median split classified FC intakes; multiple linear regression evaluated differences in health parameters between low and high FC consumers. Results: Average FC intakes for low and high FC consumers were 4.6 ± 1.4gand 10.9 ± 4.0g, with most coming from soluble dietary fibers. After controlling for confounders, low FCs showed higher diastolic blood pressure (β = 2.95, p = 0.04), blood glucose (β = 2.65 mg/dL; p = 0.02*), and BMI (β = 0.99, p = 0.050*, R2=0.04) than high consumers. Conclusions: Despite low intakes, these college students showed inverse associations between FC and diastolic blood pressure, blood glucose, and BMI. Long-term mechanistic studies are needed to evaluate potential relationships.

Applying quality improvement methods to reduce antibiotic use in neonates: a systematic review and meta-analysis

BACKGROUND

This study aims to explore effective interventions and observation indicators for reducing antibiotic use in neonates through quality improvement (QI) methods, while quantitatively analysing whether these methods increase the risk of neonatal mortality and serious adverse outcomes.

METHODS

By 27 August 2024, we reviewed all pertinent literature. A descriptive statistical analysis was conducted on all intervention measures, outcome indicators, process indicators, and balance indicators. The group utilizing QI interventions was designated as the intervention group, with the baseline period serving as the control group. The mortality rates and incidence of serious adverse outcomes were treated as dichotomous variables. The risk ratio (RR) and 95% CIs were effect indicators.

RESULTS

In total, 57 studies published between 2016 and 2024 were included. All studies were uncontrolled before-and-after studies. The most studied country was the United States of America. From these 57 studies, 27 effective intervention measures were identified, and all observation indicators and main results were presented in tabular form. According to the meta-analysis, the mortality rate in the intervention group decreased by 30% compared with the control group (RR = 0.7; 95% CI: 0.604-0.81; P < 0.001), while there was no statistically significant difference in the risk of serious adverse outcomes between the two groups.

CONCLUSIONS

QI methods can safely and effectively reduce the use of antibiotics in neonates, highlighting their potential for clinical applications.

Gut Microbiome and Bile Acid Interactions: Mechanistic Implications for Cholangiocarcinoma Development, Immune Resistance, and Therapy

Cholangiocarcinoma (CCA) is a rare but highly malignant carcinoma of bile duct epithelial cells with a poor prognosis. The major risk factors of CCA carcinogenesis and progression are cholestatic liver diseases. The key feature of primary sclerosing cholangitis and primary biliary cholangitis is chronic cholestasis. It indicates a slowdown of hepatocyte secretion of biliary lipids and metabolites into bile as well as a slowdown of enterohepatic circulation (bile acid recirculation) of bile acids with dysbiosis of the gut microbiome. This leads to enterohepatic recirculation and an increase of toxic secondary bile acids. Alterations of serum and liver bile acid compositions via the disturbed enterohepatic circulation of bile acids and the disturbance of the gut microbiome then activate a series of hepatic and cancer cell signaling pathways that promote CCA carcinogenesis and progression. This review focuses on the mechanistic roles of bile acids and the gut microbiome in the pathogenesis and progression of CCA. It also evaluates the therapeutic potential of targeting the gut microbiome and bile acid-mediated signaling pathways for the therapy and prophylaxis of CCA.

Efficacy of an Iranian herbal medicine formula for postoperative constipation in trauma patients with hip and lower limb fractures: A triple-blind, placebo-controlled randomized clinical trial

AIM OF THE STUDY

This trial aimed to evaluate the efficacy of the "Herbal Laxative Capsule" (HLC) formulation in alleviating symptoms of postoperative constipation (POC) in patients undergoing surgeries for traumatic fractures of the hip or lower extremities. The HLC is a novel polyherbal formulation that integrates both scientifically validated botanicals, such as Cassia angustifolia and Aloe barbadensis, with traditionally employed herbs like Foeniculum vulgare, Coriandrum sativum, and Carum carvi, all of which are recognized for their laxative properties.

MATERIALS AND METHODS

A triple-blind, placebo-controlled, randomized clinical trial was conducted at an academic hospital in Kashan, Iran. A total of 61 orthopedic patients with POC were randomized to receive either HLC (n = 31) in the treatment group or a placebo (n = 30) in the placebo group. Both were administered as 520 mg capsules, taken twice daily for one week. The primary outcomes included assessments of constipation severity and stool consistency, while the secondary outcomes evaluated patient satisfaction using validated clinical scales.

RESULTS

The treatment group demonstrated a statistically significant reduction in constipation severity and improvement in stool consistency compared with the placebo group (P < 0.001). No significant adverse effects were reported. Additionally, patient satisfaction was notably higher in the treatment group (P < 0.001).

CONCLUSION

The HLC formulation demonstrated significant efficacy in effectively managing POC, which is often opioid-induced constipation (OIC), in orthopedic patients. These findings suggest that HLC could serve as a promising alternative to conventional laxatives, warranting further investigation in larger-scale clinical trials.

Novel insights into carbohydrate-to-fiber ratio and constipation: NHANES findings suggest a turning point

BACKGROUND

Constipation, a widespread global issue, prompted an investigation into the intricate relationship between dietary factors and this condition. This study delves into the association between carbohydrate-to-fiber (CF) ratio and constipation, employing data from the National Health and Nutrition Examination Survey (NHANES) and a comprehensive meta-analysis.

METHODS

Utilizing NHANES data (2005-2010) from 7752 adults, constipation was defined based on stool type (Bristol Stool Form Scale types 1 or 2). The CF ratio was calculated, revealing an L-shaped, non-linear association with constipation. A meta-analysis of 16 studies (1626 participants) confirmed a positive effect of dietary fiber on constipation, emphasizing the robustness of the findings.

RESULTS

Among participants, constipation prevalence stood at 13.98%. The CF ratio exhibited a turning point at 26.92/day, with adjusted odds ratios for constipation indicating a decrease with higher CF ratios. Meta-analysis results supported these findings, demonstrating a significant positive effect of dietary fiber on constipation.

CONCLUSION

This study illuminates a nuanced relationship between CF ratio and constipation, suggesting a critical turning point at 26.92/day. These findings underscore the importance of dietary assessment, offering valuable insights for clinicians and individuals. Further prospective research is warranted to validate the CF ratio as a robust dietary assessment tool.

Daily sodium intake and constipation in US adult males: an uncommon negative association revealed by national health and nutrition examination survey data from the United States (2005-2010)

BACKGROUND

High sodium intake has been linked to various health outcomes; however, its association with constipation remains unclear, particularly in adult males. This population-based study aimed to investigate the association between daily sodium intake and constipation using data from the National Health and Nutrition Examination Survey (NHANES) 2005-2010.

METHODS

Using data from the NHANES database spanning from 2005 to 2010, a cross-sectional study including 7116 adult male participants from the United States was performed to assess the relationship between daily sodium intake and constipation. Multivariable logistic regression models were used, adjusting for various potential confounders, to evaluate this association. Restricted cubic spline (RCS) methods were applied to explore potential nonlinear trends in the association, and subgroup analyses were conducted through forest plots to examine interactions among different subgroups (P for interaction).

RESULTS

The study found that an increase in daily sodium intake was significantly associated with a reduced risk of constipation. Trend analysis indicated a statistically significant trend across all models, where increased daily sodium intake was associated with lower constipation risk, with (OR: 0.78, 95% CI: 0.71 ~ 0.85; P < 0.001) in Model 1; (OR: 0.79, 95% CI: 0.73 ~ 0.87; P < 0.001) in Model 2; and (OR: 0.82, 95% CI: 0.69 ~ 0.97; P = 0.023) in Model 3 (P for trend < 0.05 in all models). On the contrary, RCS analysis did not reveal a nonlinear association between daily sodium intake and constipation risk (P = 0.528). Subgroup analysis further supported a consistent negative association between daily sodium intake and constipation risk across different subgroups, with no significant interactions found (all P values > 0.05).

CONCLUSIONS

This study demonstrates a negative association between daily sodium intake and constipation risk among adult males, suggesting that sodium intake might influence intestinal function.

The Efficacy of Lubiprostone in Patients of Constipation: An Updated Systematic Review and Meta-Analysis

Background and Aim

Lubiprostone increases chloride and water secretion in the intestines, and several studies have demonstrated the efficacy of lubiprostone in treating functional constipation. Several new clinical trials have emerged since the previous meta-analysis conducted in 2020. We conducted this updated meta-analysis to assess clinical efficacy of lubiprostone in these patients.

Methods

A systematic search was conducted on MEDLINE, Cochrane, and Scopus. Randomized controlled trials published between July 2019 and June 2024 were selected. Cochrane's RoB 2 tool was used to assess the risk of bias. A meta-analysis was performed and findings were presented using forest plots.

Results

A total of 14 studies, comprising 4550 patients, were included in the review. Only 12 studies were pooled in the meta-analysis. Lubiprostone was associated with greater spontaneous bowel movements (SBM) per week (RR 1.454, 95% CI 1.193-1.771) and SBM within 24 h (RR 1.790, 95% CI 1.491-2.150) in patients with chronic idiopathic constipation (CIC). However, it was not associated with abdominal pain in either arm (RR 1.415, 95% CI 0.873-2.294). In opioid-induced constipation (OIC), lubiprostone increased SBM within 24 h (RR 1.277, 95% CI 1.105-1.475) but did not significantly affect abdominal pain (RR 4.321, 95% CI 0.624-29.941). Lubiprostone improved all selected SBM-related and abdominal pain outcomes in patients with irritable bowel syndrome with constipation (IBS-C).

Conclusion

Lubiprostone significantly improves all SBM-related outcomes. Owing to its good safety and efficacy profile, lubiprostone can be used in the combination regimens for management of CIC, IBS-C, and OIC.

Role of blood lipids in mediating the effect of dietary factors on gastroesophageal reflux disease: a two-step mendelian randomization study

BACKGROUND

Growing studies have indicated an association between dietary factors and gastroesophageal reflux disease (GERD). However, whether these associations refer to a causal relationship and the potential mechanism by which dietary factors affect GERD is still unclear.

METHODS

A two-step mendelian randomization analysis was performed to obtain causal estimates of dietary factors, blood lipids on GERD. Independent genetic variants associated with 13 kinds of dietary factors and 5 kinds of blood lipids at the genome-wide significance level were selected as instrumental variables. The summary statistics for GERD were obtained from European Bioinformatics Institute, including 129,080 cases and 473,524 controls. Inverse variance weighted was utilized as the main statistical method. MR-Egger intercept test, Cochran's Q test, and leave-one-out analysis were performed to evaluate possible heterogeneity and pleiotropy. And the potential reverse causality was assessed using Steiger filtering.

RESULTS

The results of the inverse variance weighted method indicated that genetically predicted total pork intake (OR = 2.60, 95% CI: 1.21-5.58, p = 0.0143), total bread intake (OR = 0.68, 95% CI: 0.46-0.99, p = 0.0497), total cereal intake (OR = 0.42, 95% CI: 0.31-0.56, p = 2.98E-06), and total cheese intake (OR = 0.41, 95% CI: 0.27-0.61, p = 1.06E-05) were associated with the risk of GERD. Multivariable Mendelian randomization analysis also revealed a negative association between total cereal intake, total cheese intake and the risk of GERD, but the effect of total pork intake and total bread intake on GERD disappeared after adjustment of smoking, alcohol consumption, use of calcium channel blockers, BMI, physical activity levels, and biological sex (age adjusted). Furthermore, the concentration of low-density lipoprotein cholesterol (LDL-C) is negatively correlated with total cheese intake, which mediates the impact of total cheese intake on GERD. The proportion mediated by LDL-C is 2.27% (95%CI: 1.57%, 4.09%).

CONCLUSIONS

This study provides evidence that an increase in total cereal intake and total cheese intake will decrease the risk of GERD. Additionally, LDL-C mediates the causal effect of total cheese intake on GERD. These results provide new insights into the role of dietary factors and blood lipids in GERD, which is beneficial for disease prevention.

Vegetable Salad Improves Lipid and Glucose Metabolism and Enhances Absorption of Specific Nutrients in Vegetables

Vegetables are low in energy and rich in vitamins, minerals, and dietary fiber; various health benefits associated with their intake have been reported. Salads are one of the most convenient ways to consume vegetables and can be made simply by pouring mayonnaise, dressing, olive oil, or other condiments over a selection of vegetables. There are also many reports on the ways in which vegetable intake can improve health. However, there is no comprehensive review summarizing the health functions of vegetables when consumed as a salad. The effects of vegetable salads on amounts of vegetable intake, lifestyle-related diseases, and the absorption of specific nutrients through mayonnaise, as well as the effects of the order in which vegetable salad and carbohydrates are consumed, have been reported. In this review, the health functions of vegetable salad consumption are reported.

Dietary contributors to fermentable carbohydrate intake in healthy American college students

OBJECTIVE

The study explored food items that contribute most toward increased fermentable carbohydrate (FC) intake and its association with diet quality in college students.

METHOD

This cross-sectional study included 571 consented college students (≥18 years) with reported energy intakes (500-3500 kcal/day for women; 800-4000 kcal/day for men). FC intake and healthy eating index-2015 (HEI-2015) scores were assessed by diet history questionnaire-II. Data were analyzed by unadjusted bivariate linear regression and Pearson correlation tests.

RESULTS

The mean intakes of total FC (β = 1.24; 95% Confidence Interval: 1.02, 1.47) significantly predicted HEI-2015 scores. Positive correlations were found between FC intake and red and orange vegetables (r = 0.62), whole fruits (r = 0.63), and dark green vegetables (r = 0.58). Conclusions: Higher FC intake was associated with higher diet quality; vegetables and fruits are primary contributors to FC content. Efforts are required to promote these food items to improve diet quality and FC intake to shape eating choices in college students.

Effectiveness of Abdominal Massage Versus Kinesio Taping in Women With Chronic Constipation: A Randomized Controlled Trial

Background/Aims

Chronic constipation is an important public health problem and significantly affects women's lives. It is important to investigate nonpharmacological applications that can be used in the treatment of chronic constipation. The aim is to assess how abdominal massage and Kinesio taping impact constipation severity, quality of life (QOL), and perception of subjective improvement in women with chronic constipation.

Methods

Following the Rome IV diagnostic criteria, women with constipation were randomly sorted into 3 distinct groups for study: massage group (lifestyle recommendations + abdominal massage, n = 22), taping group (lifestyle recommendations + Kinesio taping, n = 22), and control group (lifestyle recommendations, n = 22). Constipation Severity Instrument (CSI) (for constipation severity), 7 days bowel diary (for bowel function), Patient Assessment of Constipation QOL (PAC-QOL) questionnaire (for QOL), 4-item Likert-type scale (for perception of subjective improvement) was used.

Results

The group x time interaction effect was significant in all CSI, bowel diary and PAC-QQL parameters, except for incomplete evacuation and PAC-QOL-worries/concerns, and a large effect size was found (Partial η2 > 0.14). Improvement scores of all parameters (except CSI-obstructive defecation, incomplete evacuation, PAC-QOL-worries/concerns) were similar in the massage and taping groups and were better than the control group. Noteworthy perceptions of subjective improvement and normalization of stool type predominantly manifested in the massage group (P < 0.05).

Conclusion

Abdominal massage and Kinesio taping are recommended as initial conservative interventions for managing chronic constipation within the therapeutic spectrum.

Exploration of the complex origins of primary constipation

Constipation is a common gastrointestinal disorder characterized by infrequent bowel movements and difficulty in passing stools. It can significantly affect an individual's quality of life and overall well-being. Understanding the causes of constipation is important for its effective management and treatment. In this paper, we have reviewed the primary causes of constipation or functional constipation. Primary constipation is a bowel disorder associated with colonic or anorectal sensorimotor or neuromuscular dysfunction. As per the literature, it is multifactorial and involves factors such as decreased interstitial cells of Cajal, altered colonic motility, enteric nervous system dysfunction, intestinal flora disturbances, and psychological influences. Clinical symptoms include difficulty in defecation, decreased frequency of defecation, or a feeling of incomplete evacuation. A comprehensive evaluation and management of constipation require an interdisciplinary approach incorporating dietary modifications, lifestyle changes, pharmacotherapy, and psychological interventions. Further research is imperative to explain the intricate mechanisms underlying constipation and develop targeted therapies for improved patient outcomes.

Effect of Physical Activity on the Association Between Diet and Constipation: Evidence From the National Health and Nutrition Examination Survey 2007-2010

Background/Aims

Previous studies have shown that diet and physical activity can influence constipation. However, the combined effect of diet and physical activity on constipation remains unclear.

Methods

Constipation was defined based on stool consistency and frequency, while overall diet quality was assessed using Healthy Eating Index (HEI)-2015 scores. Participants were categorized into low (metabolic equivalent [MET]-min/wk < 500) and high physical activity groups (MET-min/wk ≥ 500). The association between diet and constipation across physical activity groups was analyzed using survey logistic regression and restricted cubic splines.

Results

Higher HEI-2015 scores were associated with reduced constipation risk in the high physical activity group when constipation was defined by stool consistency (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97-0.99). However, in the low physical activity group, increased HEI-2015 scores did not significantly affect constipation risk (OR, 1.01; 95% CI, 0.97-1.05). Similar results were found when constipation was defined based on stool frequency. In the high physical activity group, increased HEI-2015 scores were significantly associated with a reduced constipation risk (OR, 0.96; 95% CI, 0.94-0.98). Conversely, in the low physical activity group, increased HEI-2015 scores did not affect the risk of constipation (OR, 0.96; 95% CI, 0.90-1.03).

Conclusions

Our findings suggest that a higher HEI-2015 score is negatively associated with constipation among individuals with high physical activity levels but not among those with low physical activity levels. This association was consistent when different definitions of constipation were used. These results highlight the importance of combining healthy diet with regular physical activity to alleviate constipation.

[Phytotherapeutic recommendations in medical guidelines for the treatment of gastroenterological diseases - a systematic review]

Phytotherapeutics are gaining influence in the treatment of gastroenterological diseases. Their popularity and growing evidence of efficacy contribute to their integration into medical guidelines. A systematic screening identified recommended phytotherapeutic approaches. Based on current scientific data, some recommendations for the use of phytotherapeutic agents are given. For irritable bowel syndrome the use of peppermint oil is "strongly recommended", especially for pain and flatulence. Other phytotherapeutics such as STW-5, Tibetan Padma Lax or warm caraway oil pads have proven effective in alleviating symptoms. It is "recommended" to integrate them into the treatment concept. For chronic constipation, 30g of fiber per day is recommended. Best data exists for plantago psyllium with moderate evidence and chicory inulin. In case of ulcerative colitis, plantago psyllium as well as the combination of myrrh, chamomile flower extract, and coffee charcoal can be used as a complementary treatment in maintaining remission. There is also an "open recommendation" for curcumin for both, remission induction and maintenance. Some phytotherapeutic treatments (e.g., Artemisia absintium, Boswellia serata) show evidence of effectiveness for the treatment of Crohn's disease, but data are not yet sufficient for recommendations. Cannabis-based medicines can be considered for abdominal pain and clinically relevant appetite loss if standard therapy is ineffective or contraindicated, but they should not be used for acute inflammation in active Crohn's disease. Further recommendations for other gastroenterological diseases are discussed. The safety and tolerability of the phytotherapeutics were rated as predominantly "very good" to "acceptable". Some clear recommendations for the use of phytotherapeutics to treat gastroenterological diseases show their great potential. Due to their wide range of effects, phytotherapeutics can be used very well as a complement to conventional medicines in case of complex regulatory disorders. However, further methodologically well-conducted impact studies would be helpful in order to be able to make further recommendations.

Short-term dietary fiber interventions produce consistent gut microbiome responses across studies

The composition of the human gut microbiome varies tremendously among individuals, making the effects of dietary or treatment interventions difficult to detect and characterize. The consumption of fiber is important for gut health, yet the specific effects of increased fiber intake on the gut microbiome vary across studies. The variation in study outcomes might be due to inter-individual (or inter-population) variation or to the details of the interventions including the types of fiber, length of study, size of cohort, and molecular approaches. Thus, to identify generally (on average) consistent fiber-induced responses in the gut microbiome of healthy individuals, we re-analyzed 16S rRNA sequencing data from 21 dietary fiber interventions from 12 human studies, which included 2,564 fecal samples from 538 subjects across all interventions. Short-term increases in dietary fiber consumption resulted in highly consistent gut bacterial community responses across studies. Increased fiber consumption explained an average of 1.5% of compositional variation (vs 82% of variation attributed to the individual), reduced alpha-diversity, and resulted in phylogenetically conserved responses in relative abundances among bacterial taxa. Additionally, we identified bacterial clades, at approximately the genus level, that were highly consistent in their response (on average, increasing or decreasing in their relative abundance) to dietary fiber interventions across the studies.

IMPORTANCE

Our study is an example of the power of synthesizing and reanalyzing 16S rRNA microbiome data from many intervention studies. Despite high inter-individual variation of the composition of the human gut microbiome, dietary fiber interventions cause a consistent response both in the degree of change and the particular taxa that respond to increased fiber.

Plant-based diet associated with better quality of life in prostate cancer survivors

BACKGROUND

Plant-based diets have many health benefits, including a lower risk of fatal prostate cancer, and greater environmental sustainability. However, less is known regarding the impact of plant-based diets on quality of life among individuals diagnosed with prostate cancer. The authors' objective was to examine the relationship between plant-based diet indices postdiagnosis with quality of life.

METHODS

This prospective cohort study included 3505 participants in the Health Professionals Follow-Up Study (1986-2016) with nonmetastatic prostate cancer. Food-frequency questionnaires were used to calculate overall and healthful plant-based diet indices. Quality-of-life scores were calculated using the Expanded Prostate Cancer Index Composite. Generalized estimating equations were used to examine associations over time between plant-based diet indices and quality-of-life domains (sexual functioning, urinary irritation/obstruction, urinary incontinence, bowel functioning, hormonal/vitality), adjusted for demographics, oncologic history, body mass index, caloric intake, health-related behaviors, and comorbidities.

RESULTS

The median age at prostate cancer diagnosis was 68 years; 48% of patients underwent radical prostatectomy, and 35% received radiation as primary therapy. The median time from diagnosis/treatment to first the quality-of-life questionnaire was 7.0 years. A higher plant-based diet index was associated with better scores for sexual function, urinary irritation/obstruction, urinary incontinence, and hormonal/vitality. Consuming more healthful plant-based foods was also associated with better sexual and bowel function, as well as urinary incontinence and hormonal/vitality scores in the age-adjusted analysis, but not in the multivariable analysis.

CONCLUSIONS

This prospective study provides supportive evidence that greater consumption of healthful plant-based foods is associated with modestly higher scores in quality-of-life domains among patients with prostate cancer.

Associations Between Lifestyle Factors and Constipation Among Survivors After the Great East Japan Earthquake: A 9-year Follow-up Study

BACKGROUND

Disaster survivors experience deterioration in lifestyles and an increase in constipation. After the Great East Japan Earthquake in 2011, some survivors were evacuated for a long term, even after moving to temporary housing and public reconstruction housing. However, annual changes in constipation and the association between lifestyles and constipation among the survivors are still unknown.

METHODS

Overall, 9,234 survivors aged 18 years or older participated in this 9-year follow-up survey after the disaster. Information about the prevalence of constipation and lifestyle factors (diet, physical activity, and mental health) was collected using a self-reported questionnaire. Their dietary intake was categorized into the following two dietary patterns: prudent (fish and shellfish, soybean products, vegetables, fruits, and dairy products) and meat (meat and eggs). Odds ratios for constipation according to lifestyle factors were calculated using a generalized linear mixed model.

RESULTS

In women, the prevalence of constipation was the highest at baseline (8.7%) and remained around 5% afterward. In both men and women, older age, poor mental health, and poor physical activity were significantly associated with higher odds ratios of constipation. Moreover, a lower frequency of meals and a lower prudent dietary score were significantly associated with women's constipation.

CONCLUSION

The prevalence of constipation was the highest at baseline and remained around 5% in women. Lifestyle factors, such as poor mental health, physical inactivity, and low frequency of meals were associated with constipation. Our findings suggest continuous support for the survivors with constipation for medium- to long-term after disasters.

Effects of natural products on functional constipation: analysis of active ingredient and mechanism

Constipation is a prevalent clinical ailment of the gastrointestinal system, yet its pathogenesis remains ambiguous. Despite the availability of numerous treatment modalities, they are insufficient in resolving the issue for patients. This work conducted a comprehensive review of the existing literature pertaining to the utilization of natural products for the treatment of constipation, with a focus on the efficacy of natural products in treating constipation, and to provide a comprehensive summary of their underlying mechanisms of action. Upon conducting a thorough review of the extant literature, we found that natural products can effectively treat constipation as modern synthetic drugs and compounded drugs with acetylcholinesterase (AChE) effects, rich in fiber and mucus, and the effects of increasing the tension of the ileum and gastrointestinal tract muscle, mediating signaling pathways, cytokine, excitability of the smooth muscle of the gastrointestinal tract, and regulating the homeostasis of intestinal flora. However, there is a wide variety of natural products, and there are still relatively few studies; the composition of natural products is complex, and the mechanism of action of natural products cannot be clarified. In the future, we need to further improve the detailed mechanism of natural products for the treatment of constipation.

The differential effect of two cereal foods on gut environment: a randomized, controlled, double-blind, parallel-group study

Background and aims

Cereal-based foods such as fruit granola (FG) and corn flakes (CF) form part of a fiber-rich diet. Dietary fiber has a good effect on human health. However, changes in gut microbiota and intestinal immunity have not been investigated. We conducted a randomized, double-blind, placebo-controlled trial to investigate the effects of FG and CF intake on gut microbiota, metabolome, and the immune system.

Methods

Subjects continuously consume CF or FG for 4 weeks. Stool samples, and questionnaires on defecation were collected before, 2 weeks after, and 4 weeks after intake. Gut microbiota was analyzed using 16S rRNA gene amplicon sequencing. Fecal metabolomes were analyzed using GC/MS and CE-TOF/MS. Fecal IgA was analyzed using ELISA.

Results

The defecation frequency after cereal based food intake was improved. The different cereal-based foods had different effects on gut microbiome. The increase in intestinal IgA levels was positively correlated with the relative abundance of Dialister and the Lachnospiraceae ND3007 group in CF and FG group, respectively. SCFAs showed a positive correlation with Prevotella 9 in the FG group.

Conclusion

This study showed that the supplement in dietary fiber contained in CF and FG improves bowel movements. CF and FG each had different effects on gut microbes, metabolites and different relationships between fecal IgA or SCFAs and gut microbiota.

Comparative profiles of lubiprostone, linaclotide, and elobixibat for chronic constipation: a systematic literature review with meta-analysis and number needed to treat/harm

OBJECTIVE

To comprehensively evaluate the efficacy, safety, patient symptoms, and quality-of-life (QoL) of lubiprostone, linaclotide, and elobixibat as treatment for chronic constipation (CC).

DESIGN

Systematic literature review (SLR) and meta-analysis (MA). Literature searches were conducted on PubMed and Embase using the Ovid platform.

METHODS

SLR including randomized controlled trials (RCTs) and observational studies was conducted to identify the overall efficacy and safety of lubiprostone, linaclotide, and elobixibat. Thereafter, MA was performed using only RCTs. The number needed to treat (NNT) and number needed to harm (NNH) analyses were additionally conducted.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was efficacy regarding change in spontaneous bowel movements. Secondary outcomes included safety, constipation-related symptoms, and QoL.

RESULTS

Twenty-four studies met the inclusion criteria for the SLR: 17 RCTs, 4 observational studies, and 3 single-arm trials. Feasibility assessment for the MA resulted in 14 studies available for safety data analysis, and 8 available for efficacy analysis, respectively. Three drugs showed similar efficacy in the MA and NNT analysis. However, the NNH analysis revealed distinct safety profiles: lubiprostone, linaclotide, and elobixibat were linked to the highest risk of nausea, diarrhea, and abdominal pain, respectively.

CONCLUSION

The current study provides an updated overview of the efficacy, safety, patient symptoms, and QoL of the three drugs with different mechanisms of action for CC treatment.The findings could help physicians adopt an individualized approach for treating patients with CC in clinical practice.

Bioactive Exploration in Functional Foods: Unlocking Nature's Treasures

BACKGROUND

Functional foods offer an appealing way to improve health and prevent chronic diseases, and this subject has received much attention lately. They are effective in preventing chronic diseases like cancer, diabetes, heart disease, and obesity, according to research.

OBJECTIVE

This work presents an in-depth analysis of functional foods, covering key challenges from a scientific, legal, and commercial perspective.

METHODS

Multiple databases were searched to find studies on functional foods included in the systematic literature review. Various aspects of functional foods, from their classification, impact on human wellness, effectiveness in inhibiting chronic diseases, the regulatory environment, global market trends, and industry challenges, are all clarified in this thorough review.

RESULTS

This study aims to enhance understanding and establish a pathway for functional foods to be acknowledged as valid choices in the field of dietary supplements. It provides a thorough investigation of bioactive compounds present in functional foods, including but not limited to polyphenols, carotenoids, omega fatty acids, prebiotics, probiotics, and dietary fiber, along with an overview of their potential to mitigate chronic illnesses. We engage in an in-depth exploration of regulatory frameworks, shed light on groundbreaking research advancements, and meticulously examine strategies for commercialization and the variety of global challenges that accompany them. Establishing scientific consensus, navigating complex regulatory processes, dealing with skeptical consumers, and rising levels of competition are all problems that need to be solved in this field.

CONCLUSION

The field of functional foods can advance further, promoting better public health outcomes, by deeply comprehending and addressing these complex dimensions.

Parents' Knowledge, Attitude, and Practice Related to Childhood Constipation in Makkah, Saudi Arabia

Introduction Functional constipation in children is described as irregular or difficult bowel motions without underlying systemic or anatomical causes. Although constipation can have a serious negative impact on a child's health and the lives of their parents. This study aimed to assess the knowledge of parents about childhood constipation, intending to reduce morbidity and mortality through increased public health education in Makkah, Saudi Arabia. Methods The current study was a web-based, descriptive cross-sectional study. The data were obtained from May 2023 to November 2023 through an online questionnaire directed to parents in Makkah, Saudi Arabia, and analyzed using SPSS version 27.0.1 (Armonk, NY: IBM Corp.). Results A total of 796 participants were included in the present study, of which 205 (25.8%) were males and 591 (74.2%) were females. The knowledge levels among them varied, with 11.1% correctly defining constipation and 63.6% recognizing it as a symptom. Common causes like organic and functional constipation were acknowledged by 88.4% and 81.3% of participants, respectively. Regarding practices, 27.9% recommended high-fiber foods for initial home treatment, and 42.8% acknowledged that an enema is effective for fecal impaction. In the dietary recommendations, 71.7% suggested fruits and 68.8% mentioned vegetables. Concerning attitudes, 65.1% expressed fear of childhood constipation continuing into adulthood, while 30.9% feared severe medical conditions. The internet (25.5%) and friends/relatives (23.6%) were the primary sources of information. Knowledge was significantly higher among females and those with postgraduate education. Conclusion This study highlights the variability in knowledge levels among parents, with an overall moderate understanding of childhood constipation. It emphasizes a moderate level of adherence to recommended practices related to childhood constipation, with some room for improvement in Makkah, Saudi Arabia.

Dual functional roles of nutritional additives in nutritional fortification and safety of thermally processed food: Potential, limitations, and perspectives

The Maillard reaction (MR) has been established to be a paramount contributor to the characteristic sensory property of thermally processed food products. Meanwhile, MR also gives rise to myriads of harmful byproducts (HMPs) (e.g., advanced glycation end products (AGEs) and acrylamide). Nutritional additives have attracted increasing attention in recent years owing to their potential to simultaneously improve nutritional quality and attenuate HMP formation. In this manuscript, a brief overview of various nutritional additives (vitamins, minerals, fatty acids, amino acids, dietary fibers, and miscellaneous micronutrients) in heat-processed food is provided, followed by a summary of the formation mechanisms of AGEs and acrylamide highlighting the potential crosstalk between them. The main body of the manuscript is on the capability of nutritional additives to modulate AGE and acrylamide formation besides their traditional roles as nutritional enhancers. Finally, limitations/concerns associated with their use to attenuate dietary exposure to HMPs and future perspectives are discussed. Literature data support that through careful control of the addition levels, certain nutritional additives possess promising potential for simultaneous improvement of nutritional value and reduction of AGE and acrylamide content via multiple action mechanisms. Nonetheless, there are some major concerns that may limit their wide applications for achieving such dual functions, including influence on sensory properties of food products, potential overestimation of nutrition enhancement, and introduction of hazardous alternative reaction products or derivatives. These could be overcome through comprehensive assay of dose-response relationships and systematic evaluation of the diverse combinations from the same and/or different categories of nutritional additives to establish synergistic mixtures.

Activation of Immune and Antiviral Effects by Euglena Extracts: A Review

Influenza is an acute respiratory illness caused by influenza virus infection, which is managed using vaccines and antiviral drugs. Recently, the antiviral effects of plants and foods have gained attention. Euglena is a motile unicellular alga and eukaryotic photosynthetic microorganism. It has secondary chloroplasts and is a mixotroph able to feed by photosynthesis or phagocytosis. This review summarizes the influenza treatment effects of Euglena from the perspective of a functional food that is attracting attention. While it has been reported that Euglena contributes to suppressing blood sugar levels and ameliorates symptoms caused by stress by acting on the autonomic nervous system, the immunostimulatory and antiviral activities of Euglena have also been reported. In this review, I focused on the immunostimulation of antiviral activity via the intestinal environment and the suppression of viral replication in infected cells. The functions of specific components of Euglena, which also serves as the source of a wide range of nutrients such as vitamins, minerals, amino acids, unsaturated fatty acids, and β-1,3-glucan (paramylon), are also reviewed. Euglena has animal and plant properties and natural compounds with a wide range of functions, providing crucial information for improved antiviral strategies.

Nutritional Management of Oncological Symptoms: A Comprehensive Review

Throughout their experience of illness and during the course of treatment, a substantial proportion of cancer patients are prone to develop nutritional and/or metabolic disturbances. Additionally, cancer patients often encounter long-term side effects from therapies, which may lead to impaired digestion, nutrient absorption or bowel motility. Therefore, the preservation and maintenance of an optimal and balanced nutritional status are pivotal to achieving a better prognosis, increasing the tolerance and adherence to cancer therapies and improving the overall quality of life. In this context, personalized nutritional programs are essential for addressing conditions predisposing to weight loss, feeding difficulties, digestion problems and intestinal irregularity, with the goal of promoting adequate nutrient absorption and minimizing the detrimental effects of treatment regimens. The focus of this research is to examine the most common clinical conditions and metabolic changes that cancer patients may experience, including stomatitis, xerostomia, diarrhea, nausea, vomiting, dysphagia, sub-occlusion, dysgeusia, dysosmia, anorexia, and cachexia. Furthermore, we present a pragmatic example of a multidisciplinary workflow that incorporates customized recipes tailored to individual clinical scenarios, all while maintaining the hedonic value of the meals.

Effectiveness of a high fiber diet in improving constipation in patients with defecatory dyssynergy under treatment with anorrectal biofeedback. Exploratory, randomized clinical trial

INTRODUCTION

Fiber is the initial treatment in chronic functional constipation. However, its role in the group of patients with defecatory dyssynergy is not well established. The objective of the study is to evaluate the efficacy and safety of a high fiber diet in patients with defecatory dyssynergy in the treatment with anorectal biofeedback.

PATIENTS AND METHODS

An exploratory, randomized (1:1), double-blind, controlled «add-on» clinical trial was carried out in a reference center in Spain in patients with functional constipation and defecatory dyssynergy according to the ROMEIV criteria.

CONTROL GROUP

treatment with biofeedback and low-fiber diet (15-20g/day). Experimental group: treatment with biofeedback and high fiber diet (25-30g/day). Analyzed: responder (primary endpoint), patient whose defecatory dyssynergy had been corrected (>20% reduction in anal pressure during the defecation maneuver and normal balloon expulsion test); anorectal parameters (anal relaxation, reduced straining); safety (abdominal symptoms: flatulence, pain, borborygmus, bloating).

RESULTS

A total of 44 patients were randomized: 22 per group. The percentage of responders was 75% (15/20; 95%CI: 53 89%) control group and 70% (14/20; 95%CI: 48-85%) experimental group, P=.225. Differences in favor of the control group were only observed in abdominal symptoms: flatulence (P=.028), abdominal distension (P=.041) and digestive comfort (P=.043).

CONCLUSIONS

In patients with defecatory dyssynergy, a high-fiber diet not only does not improve the efficacy of anorectal biofeedback but is associated with a loss of improvement in abdominal symptoms.

Perioperative Factors Affecting the Healing of Rectovaginal Fistula

Rectovaginal fistula is rare, but a severe complication in gynecology, which despite the effort of clinicians is still not treated successfully in many cases. According to statistics, the healing rates of surgery in patients with RVF range from 20 to 100%. The treatment effectiveness depends on the etiology of fistula, the age of the patients, the presence of comorbidities, the type of surgery and many other factors. Considering the low efficiency of treatment and the high risk of recurrence, the question of possible methods to improve the results occurs. In our review, we analyzed both modifiable and non-modifiable factors which may influence the treatment, healing rate and future fate of the patients. Taking into account all analyzed risk factors, including age, comorbidities, smoking status, microbiology, medications, stoma and stool features, we are aware that rectovaginal fistula's treatment must be individualized and holistic. In cases of poorly healing RVF, the drainage of feces, the use of antibiotic prophylaxis or the implementation of estrogen therapy may be useful. Moreover, microbiome research in women with RVF and towards estrogen therapy should be performed in order to create treatment algorithms in women with fistulae. Those interventions, in our opinion, may significantly improve the outcome of the patients.

Zhishi Daozhi decoction alleviates constipation induced by a high-fat and high-protein diet via regulating intestinal mucosal microbiota and oxidative stress

Background

A growing body of evidence has demonstrated that a high-fat and high-protein diet (HFHPD) causes constipation. This study focuses on understanding how the use of Zhishi Daozhi decoction (ZDD) affects the intricate balance of intestinal microorganisms. The insights gained from this investigation hold the potential to offer practical clinical approaches to mitigate the constipation-related issues associated with HFHPD.

Materials and methods

Mice were randomly divided into five groups: the normal (MN) group, the natural recovery (MR) group, the low-dose ZDD (MLD) group, the medium-dose ZDD (MMD) group, and the high-dose ZDD (MHD) group. After the constipation model was established by HFHPD combined with loperamide hydrochloride (LOP), different doses of ZDD were used for intervention. Subsequently, the contents of cholecystokinin (CCK) and calcitonin gene-related peptide (CGRP) in serum, superoxide dismutase (SOD), and malondialdehyde (MDA) in the liver were determined. The DNA of intestinal mucosa was extracted, and 16S rRNA amplicon sequencing was used to analyze the changes in intestinal mucosal microbiota.

Results

After ZDD treatment, CCK content in MR group decreased and CGRP content increased, but the changes were not significant. In addition, the SOD content in MR group was significantly lower than in MLD, MMD, and MHD groups, and the MDA content in MR group was significantly higher than in MN, MLD, and MHD groups. Constipation modeling and the intervention of ZDD changed the structure of the intestinal mucosal microbiota. In the constipation induced by HFHPD, the relative abundance of pathogenic bacteria such as Aerococcus, Staphylococcus, Corynebacterium, Desulfovibrio, Clostridium, and Prevotella increased. After the intervention of ZDD, the relative abundance of these pathogenic bacteria decreased, and the relative abundance of Candidatus Arthromitus and the abundance of Tropane, piperidine, and pyridine alkaloid biosynthesis pathways increased in MHD group.

Conclusion

Constipation induced by HFHPD can increase pathogenic bacteria in the intestinal mucosa, while ZDD can effectively relieve constipation, reduce the relative abundance of pathogenic bacteria, and alleviate oxidative stress injury. In addition, high-dose ZDD can increase the abundance of beneficial bacteria, which is more conducive to the treatment of constipation.

Short-term dietary fiber interventions produce consistent gut microbiome responses across studies

Background

The composition of the human gut microbiome varies tremendously among individuals, making the effects of dietary or treatment interventions difficult to detect and characterize. The consumption of fiber is important for gut health, yet the specific effects of increased fiber intake on the gut microbiome vary across studies. The variation in study outcomes might be due to inter-individual (or inter-population) variation or to the details of the interventions including the types of fiber, length of study, size of cohort, and molecular approaches. Thus, to identify consistent fiber-induced responses in the gut microbiome of healthy individuals, we re-analyzed 16S rRNA sequencing data from 21 dietary fiber interventions from 12 human studies, which included 2564 fecal samples from 538 subjects across all interventions.

Results

Short-term increases in dietary fiber consumption resulted in highly consistent gut microbiome responses across studies. Increased fiber consumption explained an average of 1.5% of compositional variation (versus 82% of variation attributed to the individual), reduced alpha diversity, and resulted in phylogenetically conserved responses in relative abundances among bacterial taxa. Additionally, we identified bacterial clades, at approximately the genus level, that were highly consistent in their response (increasing or decreasing in their relative abundance) to dietary fiber interventions across the studies.

Conclusions

Our study is an example of the power of synthesizing and reanalyzing microbiome data from many intervention studies. Despite high inter-individual variation of the composition of the human gut microbiome, dietary fiber interventions cause a consistent response both in the degree of change as well as the particular taxa that respond to increased fiber.

The relative role of soil, climate, and genotype in the variation of nutritional value of Annona senegalensis fruits and leaves

Annona senegalensis Pers is a multipurpose tree species valued for food and medicinal uses in Africa. Although there have been attempts to document the proximate composition of fruits and leaves, little is known about the relative role of soil, climate, and genotype on the nutritional quality. The present study evaluated the variation of the proximate composition of fruits and leaves in populations from Benin and Mozambique. It further assessed the impact of soil, climate and genotype on the proximate composition. Data were collected from four populations genetically different and analyzed using descriptive statistics, analysis of variance (ANOVA), principal component analysis, redundancy analysis (RDA), and variance partitioning. Results revealed significant variation in the proximate composition of fruits and leaves among the studied populations. Ashes and fibers in fruits, and lipids in leaves were 4.8-fold, 2.5- fold, and 1.25-fold higher respectively, in populations from Mozambique. Fruits moisture and lipids content were rather 1.4-fold and 1.10-fold higher in populations from Benin. Moisture and lipids were respectively 6-fold and 1.27-fold higher in fruits than in leaves, while ashes, fibers and proteins were approximately twice higher in the leaves than in the fruits. Genetic groups, climate and soils were found to influence this variation. All three factors explained 74.4% of the variation of nutritional value of fruits and leaves, 31.9% of which was exclusively due to genetic variation, 2.8% to the interaction of climate and soils, 24.1% to the interaction of soil and genetic variation, and 15.5% to the interaction of all three factors. Our study shows that genetic variation and soil properties better than climate, explain the variation of nutritional value of A. senegalensis fruits and leaves and further provides essential information that could be harnessed in the domestication and breeding program of the species for its edible parts.

Parkinson's disease: Are gut microbes involved?

INTRODUCTION

Parkinson's disease (PD) is a neurodegenerative disorder that affects more than 10 million individuals worldwide. It is characterized by motor and sensory deficits. Research studies have increasingly demonstrated a correlation between Parkinson's disease and alternations in the composition of the gut microbiota in affected patients. Also, the significant role of prebiotics and probiotics in gastrointestinal and neurological conditions is imperative to understand their relation to Parkinson's disease.

METHOD

To explore the scientific interaction of the gut-microbiota-brain axis and its association with Parkinson's disease, a comprehensive narrative review of the relevant literature was conducted. Articles were retrieved systematically from reputable sources, including PubMed, Science Direct, World Health Organization (WHO), and Advanced Google Scholar. Key search terms included are "Parkinson's Disease", "Gut Microbiome", "Braak's Theory", "Neurological Disorders", and "Gut-brain axis". Articles included in our review are published in English and they provide detailed information on the relationship between Parkinson's disease and gut microbiota RESULTS: This review highlights the impact of gut microbiota composition and associated factors on the progression of Parkinson's disease. Evidence-based studies highlighting the existing evidence of the relationship between Parkinson's disease and alteration in gut microbiota are discussed. Consequently, the potential mechanisms by which the gut microbiota may affect the composition of the gut microbiota were revealed, with a particular emphasis on the role of the gut-brain axis in this interplay.

CONCLUSION

Understanding the complex interplay between gut microbiota and Parkinson's disease is a potential implication for the development of novel therapeutics against Parkinson's disease. Following the existing relationship demonstrated by different evidence-based studies on Parkinson's disease and gut microbiota, our review concludes by providing recommendations and suggestions for future research studies with a particular emphasis on the impact of the microbiota-brain axis on Parkinson's disease.

Dietary Fiber Intake and Related Factors in Community-Based Iranian's Elderly

Background

There are considerable documents suggesting that inadequate fiber intake (FI) is a key risk factor for various chronic diseases. The aim of this study was to investigate Dietary FI in the Persian elderly.

Methods

This descriptive-analytic study was performed to investigate FI in a sample of the elderly who received free services from healthcare centers in Karaj, Iran. For sampling method: at first, the names of 36 centers were written on small pieces of paper and poured into a container, then another person was asked to randomly select the names of 10 centers, then referring to each of the centers and preparing a list of elderly people, the study subjects were selected, The study was conducted between September 2018, and April 2019Several questionnaires were used to collect data regarding DF: characteristics, daily FI , knowledge, SE (self-efficacy), perceived benefits, and barriers towards FI as well as stage of readiness of FI. t-test and ANOVA were used to compare independent mean values. Data were checked for normality before analysis by using Kolmogorov-Smirnov (K-S) test to check data normality.

Results

Totally of 400 elderly individuals entered the study with the average amount of fiber per day. The data analysis indicated they did not know the recommended intake of at least 25 gr each day. feeling less hungry and fiber's price was the most frequent perceived benefits and barriers towards FI , respectively. Gastrointestinal diseases ( P < 0.001), smoking (P < 0.001), and perceived barriers (P < 0.001), were statistically significant independent positive predictors of FI.

Conclusion

The findings of the current study indicated that FI among elderly people in Iran was very low and varied a great by gender, education, marital status, income level, employment status, smoking, stage of change, and gastrointestinal disease.

Curated and harmonized gut microbiome 16S rRNA amplicon data from dietary fiber intervention studies in humans

Next generation amplicon sequencing has created a plethora of data from human microbiomes. The accessibility to this scientific data and its corresponding metadata is important for its reuse, to allow for new discoveries, verification of published results, and serving as path for reproducibility. Dietary fiber consumption has been associated with a variety of health benefits that are thought to be mediated by gut microbiota. To enable direct comparisons of the response of the gut microbiome to fiber, we obtained 16S rRNA sequencing data and its corresponding metadata from 11 fiber intervention studies for a total of 2,368 samples. We provide curated and pre-processed genetic data and common metadata for comparison across the different studies.

Effects of Four Different Dietary Fibre Supplements on Weight Loss and Lipid and Glucose Serum Profiles during Energy Restriction in Patients with Traits of Metabolic Syndrome: A Comparative, Randomized, Placebo-Controlled Study

Obesity and its associated complications require various lifestyle changes and treatment options. Dietary supplements are considered an attractive alternative to traditional therapy, mainly because they are accessible to the general population. The aim of this study was to investigate the additive effects of a combination of energy restriction (ER) and four dietary supplements on changes in the anthropometric and biochemical parameters in 100 overweight or obese participants who were randomly assigned one of the dietary fibre supplements containing different dietary fibres or a placebo for 8 weeks. The results confirmed that fibre supplements plus ER significantly (p < 0.01) reduced the body weight, body mass index (BMI), fat mass, and visceral fat and ameliorated the lipid profile and inflammation at 4 and 8 weeks after the start of the study, while in the placebo group, significant differences in some parameters were observed only after 8 weeks of ER. A fibre supplement containing glucomannan, inulin, psyllium, and apple fibre was the most effective at reducing the BMI, body weight, and CRP (p = 0.018 for BMI and body weight and p = 0.034 for CRP compared to placebo at the end of the intervention). Overall, the results suggest that dietary fibre supplements in combination with ER may have additional effects on weight loss and the metabolic profile. Therefore, taking dietary fibre supplements may be a feasible approach to improve weight and metabolic health in obese and overweight individuals.

Apple juice relieves loperamide-induced constipation in rats by downregulating the intestinal apical sodium-dependent bile acid transporter ASBT

Apples are known to exhibit various beneficial effects on human health. In the present study, we investigated the effect of continuous intake of apple juice (AJ) on constipation status. A single dose of loperamide in rats as the constipation model markedly decreased the weight and number of fecal pellets compared to saline-administered rats as a control. After the administration of AJ twice a day for seven days, recovery of defecation close to that of the control was observed in loperamide-treated rats. In addition, the total bile acid content in the feces increased from day 4 after the administration of AJ. Among hepatic and intestinal transporters and enzymes that regulate bile acids, the mRNA expression of the apical sodium-dependent bile acid transporter (Asbt, slc10a2) was decreased by AJ in rats. Furthermore, the Asbt-mediated bile acid transport activity in the rat ileum decreased after AJ administration. Moreover, in human colonic cancer-derived Caco-2 cells, AJ exposure for 24 and 48 h decreased the expressions of ASBT mRNA and protein, and the uptake activity of taurocholic acid in both 7- and 21-d cultures. Several components of AJ, such as procyanidins, decreased the expression of ASBT in Caco-2 cells. In conclusion, ASBT downregulation is a possible mechanism responsible for the constipation-relieving effect of apples, and procyanidins may play a role in downregulating ASBT, which leads to the beneficial effects of apples against constipation. Although it is generally agreed that the common dietary compositions play a role in constipation relief, the novel specific mechanism of apples found in this study would facilitate understanding food functions.

Exploration of the nutritional and carotenoids profiles of vegetables in Thai cuisine as potential nutritious ingredients

Missing information on plant origin control and nutritional data on herbs, spices and vegetables could lead to sample quality deficit and misusage of the plant database. In this study, twenty vegetables that were collected and managed based on the recommendations of the Department of Agriculture, Ministry of Agriculture and Cooperatives, Thailand, were investigated regarding their proximate mineral, vitamin and carotenoid contents using the standard procedures of the Association of Official Analytical Chemists (AOAC). The results showed that these plants (100 g dry weight) exhibited similar energy levels (337.11-420.48 kcal), which were mainly distributed from high carbohydrate content (21.01-88.17 g), while protein (3.14-66.07 g) and fat (0.00-10.33 g) levels were quite low. As a form of carbohydrate, dietary fiber was found to be high in Cymbopogon citratus (DC.) Stapf (Cy. citratus) and Solanum torvum Sw. (So. torvum) (57.00-59.54 g). Interestingly, Senegalia pennata subsp. insuavis (Lace) Maslin, Seigler & Ebinger (S. pennata) exhibited exceptionally high protein content, which was between 2.3 and 3.1 times higher than its carbohydrates. High mineral contents were detected in S. pennata, Ocimum africanum Lour. (O. africanum), Ocimum basilicum L. (O. basilicum), Ocimum gratissimum L. var. macrophyllum Briq. (O. gratissimum) and Coriandrum sativum L. (Co. sativum), while Mentha cordifolia Opiz ex Fresen (M. cordifolia) was observed to be a good source of vitamin C (381.36-547.47 mg). High carotenoids were mostly found in Eryngium foetidum L. (E. foetidum), O. gratissimum, Co. sativum and O. basilicum (75.23-119.96 mg). Interestingly, the location of sample collection seemed to have minimal effect on the nutritional and carotenoid compositions. The results of this study provide reliable information concerning the nutritional and carotenoid contents in plant sources with control of origin, which could be used in the future for food development with specific nutritional requirements.

Regional and seasonal variations in functional abdominal pain and functional constipation prevalence among Saudi children

Objectives

This study aimed to evaluate functional abdominal pain disorders and functional constipation prevalence in the central region of Saudi Arabia, and compare it to that of the western region.

Methods

This was a cross-sectional study using online questionnaires targeting the general population of Riyadh region of Saudi Arabia. Subjects were randomly selected by sharing links on social media groups. Any parent with a 3-18-year-old child was included, and children with chronic medical illnesses or symptoms of organic GI disorders were excluded.

Results

Three hundred nineteen subjects were included in the final analysis; the prevalence of functional abdominal pain disorders overall was 6.2% and the prevalence of functional constipation was 8.1%.

Conclusions

Functional constipation diagnosis seems to be affected by life stressors or a previous viral illness. Seasonal variations had minimal effect on functional abdominal pain disorder and functional constipation symptom frequency and severity.

The effects of fresh mango consumption on gut health and microbiome - Randomized controlled trial

Some individual fruits have been widely researched for their effects on overall health and correlations with chronic diseases. The beneficial effects of mango supplementation on metabolic diseases have been detected. However, research into mango consumption on gut health, including the microbiome, is limited to processed mango preparations or peels. Our goal was to examine the effects of fresh mango consumption on the gut microbiome, gut permeability proteins, and bowel movement habits in overweight/obese individuals. In a 12-week crossover design study, 27 participants consumed 100 kcal/day of either mangos or low-fat cookies with a washout period of 4 weeks. The mango intervention showed higher Shannon-Wiener and Simpson alpha diversity indices of the microbiome than the low-fat cookie intervention in week 4. Significant differences in beta diversity of the microbiome were found between diet interventions at week 12. Mango consumption increased the abundance of Prevotella maculosa, Corynebacterium pyruviciproducens, and Mogibacterium timidum while it decreased Prevotella copri. Low-fat cookie intake increased Cyanobacterium aponinum and Desulfovibrio butyratiphilus and reduced Alloscardovia omnicolens. There were no significant differences in circulating gut permeability protein (ZO-1, claudin-2, and occludin) levels. There was a slight increase in the amount of bowel movement with mango consumption, but no significant findings for frequency, consistency, strain, pain, and constipation in bowel movement between trials. Given these results, it can be concluded that consumption of mango may have positive effects on the gut health, which may yield possible health benefits for chronic disease that deserve further study.

Association between Fiber Intake and Risk of Incident Chronic Kidney Disease: The UK Biobank Study

OBJECTIVES

Dietary fiber intake is associated with a lower risk of diabetes, cardiovascular disease, and cancer. However, it is unknown whether dietary fiber has a beneficial effect on preventing the development of chronic kidney disease (CKD).

DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS

Using the UK Biobank prospective cohort, 110,412 participants who completed at least one dietary questionnaire and had an estimated glomerular filtration rate ≥60 mL/min/1.73 m2, urinary albumin-to-creatinine ratio <30 mg/g, and no history of CKD were included. The primary exposure was total dietary fiber density, calculated by dividing the absolute amount of daily total fiber intake by total energy intake (g/1,000 kcal). We separately examined soluble and insoluble fiber densities as additional predictors. The primary outcome was incident CKD based on diagnosis codes.

RESULTS

A total of 3,507 (3.2%) participants developed incident CKD during a median follow-up of 9.9 years. In a multivariable cause-specific model, the adjusted hazard ratios (aHRs; 95% confidence intervals [CIs]) for incident CKD were 0.85 (0.77-0.94), 0.78 (0.70-0.86), and 0.76 (0.68-0.86), respectively, for the second, third, and highest quartiles of dietary fiber density (reference: lowest quartile). In a continuous model, the aHR for each +∆1.0g/1,000 kcal increase in dietary fiber density was 0.97 (95% CI, 0.95-0.99). This pattern of associations was similar for both soluble and insoluble fiber densities and did not differ across subgroups of sex, age, body mass index, hypertension, diabetes, smoking, and inflammation.

CONCLUSION

Increased fiber intake was associated with a lower risk of CKD in this large well-characterized cohort.

Shimanami Leaf Intake Affects Bowel Movement and Intestinal Microbiota in Mice

The Shimanami Leaf^®, produced at Innoshima Island in Onomichi City, Hiroshima Prefecture, Japan, is a leafy vegetable that does not require pesticide use and has a high nutritional value. Although the leaf has abundant dietary fiber and other nutrients, reports on its biological regulatory functions are lacking. Therefore, this study aimed to elucidate the effects of Shimanami leaf intake on bowel movement and gut microbiota in mice. We examined the effects of Shimanami leaves on fecal weight, fecal water content, and intestinal microbiota composition. On day 10 of administration, the Shimanami leaf-treated group exhibited significantly higher fecal weight and water content than the control group. Next-generation sequencing analysis revealed that the ingestion of Shimanami leaf increased the abundances and diversity of intestinal bacteria, including members from Lactococcus, Streptococcus, and Muribaculaceae. Our findings suggest that Shimanami leaf supplementation improves bowel movement and promotes defecation.

Incorporating dietary fiber from fruit and vegetable waste in meat products: a systematic approach for sustainable meat processing and improving the functional, nutritional and health attributes

Background

Every year, the food business produces a sizeable amount of waste, including the portions of fruits and vegetables that are inedible, and those that have reached a stage where they are no longer suitable for human consumption. These by-products comprise of components such as natural antioxidants (polyphenols, carotenoid etc.), dietary fiber, and other trace elements, which can provide functionality to food. Due to changing lifestyles, there is an increased demand for ready-to-eat products like sausages, salami, and meat patties. In this line, meat products like buffalo meat sausages and patties are also gaining the interest of consumers because of their rich taste. Meat, however, has a high percentage of fat and is totally deprived of dietary fiber, which poses severe health problems like cardiovascular (CV) and gastrointestinal diseases. The health-conscious consumer is becoming increasingly aware of the importance of balancing flavor and nutrition. Therefore, to overcome this problem, several fruit and vegetable wastes from their respective industries can be successfully incorporated into meat products that provide dietary fiber and play the role of natural antioxidants; this will slow down lipid oxidation and increase the shelf-life of meat products.

Methodology

Extensive literature searches have been performed using various scientific search engines. We collected relevant and informative data from subject-specific and recent literature on sustainable food processing of wasted food products. We also looked into the various applications of waste fruit and vegetable products, including cereals, when they are incorporated into meat and meat products. All relevant searches meeting the criteria were included in this review, and exclusion criteria were also set.

Results

The pomace and peels of fruits like grapes, pomegranates, cauliflower, sweet lime, and other citrus are some of the most commonly used fruit and vegetable by-products. These vegetable by-products help inhibit oxidation (of both lipids and proteins) and the growth of pathogenic and spoilage bacteria, all without altering the consumer's acceptability of the product on a sensory level. When included in meat products, these by-products have the potential to improve the overall product quality and lengthen its shelf-life under certain circumstances.

Conclusion

Cost-effective and easily accessible by-products from the fruit and vegetable processing industries can be used in meat products to enhance their quality features (physicochemical, microbial, sensory, and textural aspects) and health benefits. Additionally, this will provides environmental food sustainability by lowering waste disposal and improving the food's functional efficacy.

Gut dysmotility in children with neurological impairment: the nutritional management

Intestinal motility disorders represent a frequent problem in children with neurological impairment. These conditions are characterized by abnormal movements of the gut, which can result in symptoms such as constipation, diarrhea, reflux, and vomiting. The underlying mechanisms leading to dysmotility are various, and the clinical manifestations are often nonspecific. Nutritional management is an important aspect of care for children with gut dysmotility, as it can help to improve their quality of life. Oral feeding, when safe and in the absence of risk of ingestion or severe dysphagia, should always be encouraged. When oral nutrition is insufficient or potentially harmful, it is necessary to switch to an enteral by tube or parenteral nutrition before the onset of malnutrition. In most cases, children with severe gut dysmotility may require feeding via a permanent gastrostomy tube to ensure adequate nutrition and hydration. Drugs may be necessary to help manage gut dysmotility, such as laxatives, anticholinergics and prokinetic agents. Nutritional management of patients with neurological impairment often requires an individualized care plan to optimize growth and nutrition and to improve overall health outcomes. This review tries to sum up most significant neurogenetic and neurometabolic disorders associated with gut dysmotility that may require a specific multidisciplinary care, identifying a proposal of nutritional and medical management.

All Fiber is Not Fiber

PURPOSE OF REVIEW

Epidemiologic studies and clinical trials have demonstrated the benefits of dietary fiber. This occurs through a combination of the physiochemical properties of fiber and through microbial fermentation that occurs in the colon which result in the production of short-chain fatty acids (SCFA). The purpose of this review is to highlight the physiochemical properties of fiber that result in the range of physiologic effects and to review the literature on the health benefits of acetate, propionate, and butyrate.

RECENT FINDINGS

Of the variety of properties and functions exerted by dietary fibers, the fermentability and production of SCFA's are emphasized in this review. Studies done in both animal and humans reveal the anti-obesity, anti-inflammatory, and possible anti-neoplastic roles SCFAs exert at the mucosal level. Many clinical questions remain regarding the optimal dose, type, and method of delivery of fiber to exert the desired beneficial effects. It has the potential to be used in the management of clinical symptoms, prevention of disease, and improvement in human health. Further studies to address this novel use of fiber has the potential to make a large impact in clinical practice.

The role of the gut microbiome in colonization resistance and recurrent Clostridioides difficile infection

The species composition of the human gut microbiota is related to overall health, and a healthy gut microbiome is crucial in maintaining colonization resistance against pathogens. Disruption of gut microbiome composition and functionality reduces colonization resistance and has been associated with several gastrointestinal and non-gastrointestinal diseases. One prime example is Clostridioides difficile infection (CDI) and subsequent recurrent infections that occur after the development of systemic antibiotic-related dysbiosis. Standard-of-care antibiotics used for both acute and recurrent infections do not address dysbiosis and often worsen the condition. Moreover, monoclonal antibodies, recommended in conjunction with standard-of-care antibiotics for the prevention of recurrent CDI in patients at high risk of recurrence, reduce recurrences but do not address the underlying dysbiosis. Fecal microbiota transplantation (FMT) is an evolving therapeutic strategy in which microbes are harvested from healthy donor stool and transplanted into the gut of a recipient to restore the gut microbiome. Although effective in the prevention of recurrent CDI, some existing challenges include screening and the standardization of stool acquisition and processing. Recent safety alerts by the US Food and Drug Administration raised concern about the possibility of transmission of multidrug-resistant organisms or severe acute respiratory syndrome coronavirus 2 via FMT. Increased knowledge that microbes are beneficial in restoring the gut microbiome has led to the clinical development of several newer biotherapeutic formulations that are more regulated than FMT, which may allow for improved restoration of the gut microbiome and prevention of CDI recurrence. This review focuses on mechanisms by which gut microbiome restoration could influence colonization resistance against the pathogen C. difficile.

Plain language summary

The Role of the Gut Microbiome in Clostridioides difficile Infection Introduction: A rich and diverse gut microbiome is key to immune system regulation and colonization resistance against pathogens.A disruption in the gut microbiome composition can make the gut more vulnerable to diseases such as Clostridioides difficile infection (CDI), caused by the bacterium C. difficile.CDI management presents a therapeutic dilemma, as it is usually treated with antibiotics that can treat the infection but also can damage the microbiome.Treatment of CDI using antibiotics can further reduce microbial diversity and deplete beneficial bacteria from the gut leading to a condition called dysbiosis.Antibiotic treatment can be followed by therapies that restore the gut microbiota, boost colonization resistance, and prevent the development of antimicrobial resistance.It is important to evaluate treatment options to determine their safety and effectiveness. Methods: The researchers provided an overview of the mechanisms that the gut microbiome uses to prevent colonization of the gut by pathogens.They subsequently reviewed the efficacy and shortcomings of the following treatments for CDI: - Antibiotics- Monoclonal antibodies- Fecal microbiota transplantation (FMT) Results: Commensal intestinal bacteria prevent colonization of the gut by pathogens using mechanisms such as: - Competition for key nutrients- Production of inhibitory bile acids- Short-chain fatty acid production- Lowering the luminal pH- Production of bacteriocinsAntibiotic therapy is recommended as a standard treatment for CDI. However, patients are vulnerable to recurrent CDI after discontinuation of the therapy.Monoclonal antibodies that inactivate C. difficile toxins may be recommended along with antibiotics to prevent recurrent CDI. However, this approach does not restore the microbiome.FMT is one method of microbial restoration, where stool is harvested from a healthy donor and transplanted into a patient's colon.Although FMT has shown some efficacy in the treatment of recurrent CDI, the procedure is not standardized.Safety concerns have been raised about the possibility of transmission of multidrug-resistant pathogens via FMT. Conclusion: Treatment methods that can efficiently restore the diversity of the gut microbiome are crucial in preventing recurrence of CDI.

Factors Associated with Functional Constipation among Students of a Chinese University: A Cross-Sectional Study

Functional constipation (FC) is prevalent worldwide and is an increasingly prominent problem among university students. However, there is a paucity of research on FC in university students. This study aimed to assess the prevalence of FC among Chinese university students by the Rome III criteria and investigate its associated factors. This cross-sectional study was conducted by online questionnaires among 929 university students at a Chinese university. Food consumption was assessed with the Semi-Quantitative Food Frequency Questionnaire (SQFFQ) and dietary patterns were analyzed using factor analysis. A binary logistic regression model was applied to clarify FC-associated factors. The prevalence of FC among university students was 5.1%. Interestingly, among university students, the prevalence of FC with “complex” dietary pattern was significantly higher than those with “vegetable, fruit, egg and milk-based” and “livestock and aquatic product-based” dietary pattern (9.9% vs. 3.1% vs. 2.8%, p < 0.001). The prevalence of FC was significantly higher among university students with moderate to severe sleep disorders than those with the other sleep status (χ2 = 18.100, p < 0.001). Furthermore, after adjusting the covariates, “complex” dietary pattern (OR = 4.023, p < 0.001), moderate to severe sleep disorders (OR = 3.003, p = 0.006), overeating (OR = 2.502, p = 0.032), long mealtime (>30 min) (OR = 6.001, p = 0.007), and poor defecation habits (OR = 3.069, p = 0.042) were positively associated with FC among university students. Based on the above-associated factors for FC, improving dietary patterns and sleep status and developing good bowel and dietary habits are essential to prevent and alleviate university students’ FC.

Nanocrystalline Cellulose Cures Constipation via Gut Microbiota Metabolism

Constipation can seriously affect the quality of life and increase the risk of colorectal cancer. The present strategies for constipation therapy have adverse effects, such as causing irreversible intestinal damage and affecting the absorption of nutrients. Nanocrystalline cellulose (NCC), which is from natural plants, has good biocompatibility and high safety. Herein, we used NCC to treat constipation assessed by the black stool, intestinal tissue sections, and serum biomarkers. We studied the effect of NCC on gut microbiota and discussed the correlation of gut microbiota and metabolites. We evaluated the long-term biosafety of NCC. NCC could effectively treat constipation through gut microbiota metabolism, which required a small dosage and did not affect the organs and intestines. NCC could be used as an alternative to medications and dietary fiber for constipation therapy.