Modulating a prebiotic food source influences inflammation and immune-regulating gut microbes and metabolites: insights from the BE GONE trial

BACKGROUND

Accessible prebiotic foods hold strong potential to jointly target gut health and metabolic health in high-risk patients. The BE GONE trial targeted the gut microbiota of obese surveillance patients with a history of colorectal neoplasia through a straightforward bean intervention.

METHODS

This low-risk, non-invasive dietary intervention trial was conducted at MD Anderson Cancer Center (Houston, TX, USA). Following a 4-week equilibration, patients were randomized to continue their usual diet without beans (control) or to add a daily cup of study beans to their usual diet (intervention) with immediate crossover at 8-weeks. Stool and fasting blood were collected every 4 weeks to assess the primary outcome of intra and inter-individual changes in the gut microbiome and in circulating markers and metabolites within 8 weeks. This study was registered on ClinicalTrials.gov as NCT02843425, recruitment is complete and long-term follow-up continues.

FINDINGS

Of the 55 patients randomized by intervention sequence, 87% completed the 16-week trial, demonstrating an increase on-intervention in diversity [n = 48; linear mixed effect and 95% CI for inverse Simpson index: 0.16 (0.02, 0.30); p = 0.02] and shifts in multiple bacteria indicative of prebiotic efficacy, including increased Faecalibacterium, Eubacterium and Bifidobacterium (all p < 0.05). The circulating metabolome showed parallel shifts in nutrient and microbiome-derived metabolites, including increased pipecolic acid and decreased indole (all p < 0.002) that regressed upon returning to the usual diet. No significant changes were observed in circulating lipoproteins within 8 weeks; however, proteomic biomarkers of intestinal and systemic inflammatory response, fibroblast-growth factor-19 increased, and interleukin-10 receptor-α decreased (p = 0.01).

INTERPRETATION

These findings underscore the prebiotic and potential therapeutic role of beans to enhance the gut microbiome and to regulate host markers associated with metabolic obesity and colorectal cancer, while further emphasizing the need for consistent and sustainable dietary adjustments in high-risk patients.

FUNDING

This study was funded by the American Cancer Society.

Dry beans (Phaseolus vulgaris L.) modulate the kinetics of lipid digestion in vitro: Impact of the bean matrix and processing

The lipid-lowering effect of dry beans and their impact on lipid and cholesterol metabolism have been established. This study investigates the underlying mechanisms of this effect and explore how the structural integrity of processed beans influences their ability to modulate lipolysis using the INFOGEST static in vitro digestion model. Dietary fiber (DF) fractions were found to decrease lipolysis by increasing the digesta viscosity, leading to depletion-flocculation and/or coalescence of lipid droplets. Bean flours exhibited a more pronounced reduction in lipolysis compared to DF. Furthermore, different levels of bean structural integrity showed varying effects on modulating lipolysis, with medium-sized bean particles demonstrating a stronger reduction. Hydrothermal treatment compromised the ability of beans to modulate lipid digestion, while hydrostatic-pressure treatment (600 MPa/5min) enhanced the effect. These findings highlight that the lipid-lowering effect of beans is not solely attributed to DF but also to the overall bean matrix, which can be manipulated through processing techniques.

Cradle-to-grave life cycle assessment of production and consumption of pulses in the United States

Environmental impact associated with production and consumption of pulses in the United States was evaluated using life cycle assessment (LCA). The system boundary was set to cradle-to-grave with a functional unit of 60 g (dry basis) of pulses consumed in a US household. Varieties of pulses modeled in the study included field pea (Pisum sativum), lentil (Lens culinaris), chickpea (Cicer arietinum), and dry bean. Three methods of cooking pulses at the consumer stage tested in the study were cooking in open vessel on electric cooking range (OVC), cooking in stovetop pressure cooker on electric cooking range (SPC), and cooking in electric pressure cooker (EPC). OVC formed the base scenario against which all other scenarios were compared. The environmental impact of pulses varied with type of pulse crop, cooking method, and the batch size. Consumption of approximately 60 g of dry pulses resulted in the greatest environmental impact for OVC. The consumer stage contributed at least 83, 81, 76, 75, and 87 percent for global warming potential (GWP), fossil resource scarcity (FRS), water consumption (WC), freshwater eutrophication (FE), and marine eutrophication (ME), respectively for this scenario. EPC resulted in the greatest decrease in the environmental impact, compared to OVC, for GWP, FRS, FE, and ME for all pulse varieties, which was validated in the uncertainty analysis. SPC, on the other hand, decreased the impact across these categories only for chickpea and dry bean. The uncertainty analysis suggested that the differences associated with cooking methods in the mean land use and water consumption scores of pulses were statistically non-significant. The impact categories were also highly sensitive to the mass of pulses cooked in a batch. Increasing the reference flow in OVC to 1 kg decreased the environmental impact of pulses by 49-87 percent for all impact categories, excluding land use. Overall, the study identified the consumer stage as the hotspot for environmental impact in the supply chain of pulses in the United States. The large contribution of the consumer stage to the overall environmental impact of pulses was attributed to electricity consumption for cooking and associated upstream emissions.

Pulse processing affects gas production by gut bacteria during in vitro fecal fermentation

Flatulence is one barrier to pulse consumption for many people. Therefore, we examined how processing affects gas production by the microbiome in three classes of pulses. Processing did not affect gas production from Navy beans. However, in Pardina lentils and green peas, (-1.9 ± 0.3 mL/24 h, p < 0.001; -2.3 ± 0.3 mL/24 h, p < 0.001, respectively). In Pardina lentils and green peas, germination diminished carbohydrate utilization by the microbiome compared with unprocessed samples. In Pardina lentils germination reduced abundance germination resulted in the greatest reduction in gas production among six processing methods of amplicon sequence variants (ASVs) from Bacteroides and Lachnospiraceae and reduced propionate production compared with unprocessed samples. In green peas, germination reduced ASVs from Lachnospiraceae, including one from Roseburia, and reduced proportion of butyrate production during fermentation. Three ASVs from Clostridium sensu stricto (cluster 1), Megasphaera elsdenii, and unclassified Veillonellaceae, were strongly associated with increased gas production across all samples (ρ = 0.67-0.69, p < 0.001). This study showed that processing can reduce gas production by the microbiome in some pulses, but also reduces saccharolytic fermentation and production of beneficial microbial metabolites.

The BE GONE trial study protocol: a randomized crossover dietary intervention of dry beans targeting the gut microbiome of overweight and obese patients with a history of colorectal polyps or cancer

BACKGROUND

Mouse and human studies support the promise of dry beans to improve metabolic health and to lower cancer risk. In overweight/obese patients with a history of colorectal polyps or cancer, the Beans to Enrich the Gut microbiome vs. Obesity's Negative Effects (BE GONE) trial will test whether and how an increase in the consumption of pre-cooked, canned dry beans within the context of usual diet and lifestyle can enhance the gut landscape to improve metabolic health and reduce cancer risk.

METHODS/DESIGN

This randomized crossover trial is designed to characterize changes in (1) host markers spanning lipid metabolism, inflammation, and obesity-related cancer risk; (2) compositional and functional profiles of the fecal microbiome; and (3) host and microbial metabolites. With each subject serving as their own control, the trial will compare the participant's usual diet with (intervention) and without (control) dry beans. Canned, pre-cooked dry beans are provided to participants and the usual diet continually assessed and monitored. Following a 4-week run-in and equilibration period, each participant provides a total of 5 fasting blood and 6 stool samples over a total period of 16 weeks. The intervention consists of a 2-week ramp-up of dry bean intake to 1 cup/d, which is then continued for an additional 6 weeks. Intra- and inter-individual outcomes are assessed across each crossover period with consideration of the joint or modifying effects of the usual diet and baseline microbiome.

DISCUSSION

The BE GONE trial is evaluating a scalable dietary prevention strategy targeting the gut microbiome of high-risk patients to mitigate the metabolic and inflammatory effects of adiposity that influence colorectal cancer risk, recurrence, and survival. The overarching scientific goal is to further elucidate interactions between diet, the gut microbiome, and host metabolism. Improved understanding of the diet-microbiota interplay and effective means to target these relationships will be key to the future of clinical and public health approaches to cancer and other major diet- and obesity-related diseases.

TRIAL REGISTRATION

This protocol is registered with the U.S. National Institutes of Health trial registry, ClinicalTrials.gov, under the identifier NCT02843425. First posted July 25, 2016; last verified January 25, 2019.

Manipulation of the dry bean (Phaseolus vulgaris L.) matrix by hydrothermal and high-pressure treatments: Impact on in vitro bile salt-binding ability

The capacity of high-fiber foods to sequester BS during digestion is considered a mechanism to lower serum-cholesterol. We investigated the effect of hydrothermal (HT) and high-hydrostatic-pressure (HHP) on the bile salt (BS)-binding ability of dry beans, and how this relates to changes in bean microstructure, fiber content (insoluble-IDF/soluble-SDF), and viscosity. HT and HHP-600 MPa led to significant IDF reduction, including resistant starch (RS), whereas 150-450 MPa significantly increased RS, without modifying IDF/SDF content. Microscopy analysis showed that heating disrupted the bean cell wall integrity, protein matrix and starch granules more severely than 600 MPa; however, tightly-packed complexes of globular starch granules-protein-cell wall fiber formed at HHP ≤ 450 MPa. While HT significantly reduced BS-binding efficiency despite no viscosity change, HHP-treatments maintained or enhanced BS-retention. 600 MPa-treatment induced the maximum BS-binding ability and viscosity. These results demonstrate that BS-binding by beans is not solely based on their fiber content or viscosity, but is influenced by additional microstructural factors.