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The Korean Journal of Gastroenterology... May 2024Chronic constipation is a common disease that can impair the quality of life, with a prevalence of 14% globally and 16.5% in South Korea. Straining, hard stools, the... (Review)
Review
Chronic constipation is a common disease that can impair the quality of life, with a prevalence of 14% globally and 16.5% in South Korea. Straining, hard stools, the sensation of incomplete evacuation, the sensation of anorectal blockage, and manual maneuvers to facilitate defecation are the related symptoms of chronic constipation. On the other hand, medications commonly referred to as laxatives are the essentials of treatment for constipation compared to non-pharmacological treatment, such as lifestyle modifications, biofeedback, or surgery. Unfortunately, there is still an unmet need to determine if pharmacological treatment for constipation is being administered appropriately. Therefore, there are many disadvantages as to whether the indications and side effects of laxatives are adequately considered and prescribed as the primary treatment modality for constipation in a real clinical situation in Korea. Laxatives are generally recommended as the next step for patients in whom organic causes have been excluded and have not responded to initial non-pharmacologic therapies such as dietary fiber intake and exercise. Laxatives can be classified as bulk-forming laxatives, osmotic laxatives, stimulant laxatives, and other novel laxatives. On the other hand, there are distinct mechanisms underlying constipation, and appropriate administration is the most decisive. Therefore, the present investigators prepared this review to discuss appropriate pharmacological strategies for chronic constipation in Korea. Moreover, this paper also includes suggestions for appropriate pharmacological treatment options for special patient populations.
Topics: Constipation; Humans; Laxatives; Chronic Disease; Dietary Fiber
PubMed: 38783619
DOI: 10.4166/kjg.2024.045 -
MBio Jun 2021Most dietary fibers used to shape the gut microbiota present different and unpredictable responses, presumably due to the diverse microbial communities of people....
Most dietary fibers used to shape the gut microbiota present different and unpredictable responses, presumably due to the diverse microbial communities of people. Recently, we proposed that fibers can be classified in a hierarchical way where fibers of high specificity (i.e., structurally complex and utilized by a narrow group of gut bacteria) could have more similar interindividual responses than those of low specificity (i.e., structurally simple and utilized by many gut bacteria). To test this hypothesis, we evaluated microbiota fermentation of fibers tentatively classified as low (fructooligosaccharides), low-to-intermediate (type 2 resistant starch), intermediate (pectin), and high (insoluble β-1,3-glucan) specificity, utilizing fecal inoculum from distinct subjects, regarding interindividual similarity/dissimilarity in fiber responses. Individual shifts in target bacteria (as determined by linear discriminant analysis) confirmed that divergent fiber responses occur when utilizing both of the low-specificity dietary fibers, but fibers of intermediate and high specificity lead to more similar responses across subjects in support of targeted bacteria. The high-specificity insoluble β-glucan promoted a large increase of the target bacteria (from 0.3 to 16.5% average for sp. and 2.5 to 17.9% average for Bacteroides uniformis), which were associated with increases in ratios of related metabolites (butyrate and propionate, respectively) in every microbial community in which these bacteria were present. Also, high-specificity dietary fibers promoted more dramatic changes in microbial community structure than low-specificity ones relative to the initial microbial communities. In the face of interindividual variability and complexity of gut microbial communities, prediction of outcomes from a given fiber utilized by many microbes would require a sophisticated comprehension of all competitive interactions that occur in the gut. Results presented here suggest that high-specificity fibers potentially circumvent the competitive scope in the gut for fiber utilization, providing a promising path to targeted and predictable microbial shifts in different individuals. These findings are the first to indicate that fiber specificity is related to similarity and intensity of response in distinct human gut microbiota communities.
Topics: Adult; Bacteria; Butyrates; Carbohydrates; Dietary Fiber; Fatty Acids, Volatile; Feces; Female; Fermentation; Gastrointestinal Microbiome; Healthy Volunteers; Humans; Male
PubMed: 34182773
DOI: 10.1128/mBio.01028-21 -
The American Journal of Clinical... Nov 2020Higher intakes of whole grains and dietary fiber have been associated with lower risk of insulin resistance, hyperinsulinemia, and inflammation, which are known... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Higher intakes of whole grains and dietary fiber have been associated with lower risk of insulin resistance, hyperinsulinemia, and inflammation, which are known predisposing factors for cancer.
OBJECTIVES
Because the evidence of association with bladder cancer (BC) is limited, we aimed to assess associations with BC risk for intakes of whole grains, refined grains, and dietary fiber.
METHODS
We pooled individual data from 574,726 participants in 13 cohort studies, 3214 of whom developed incident BC. HRs, with corresponding 95% CIs, were estimated using Cox regression models stratified on cohort. Dose-response relations were examined using fractional polynomial regression models.
RESULTS
We found that higher intake of total whole grain was associated with lower risk of BC (comparing highest with lowest intake tertile: HR: 0.87; 95% CI: 0.77, 0.98; HR per 1-SD increment: 0.95; 95% CI: 0.91, 0.99; P for trend: 0.023). No association was observed for intake of total refined grain. Intake of total dietary fiber was also inversely associated with BC risk (comparing highest with lowest intake tertile: HR: 0.86; 95% CI: 0.76, 0.98; HR per 1-SD increment: 0.91; 95% CI: 0.82, 0.98; P for trend: 0.021). In addition, dose-response analyses gave estimated HRs of 0.97 (95% CI: 0.95, 0.99) for intake of total whole grain and 0.96 (95% CI: 0.94, 0.98) for intake of total dietary fiber per 5-g daily increment. When considered jointly, highest intake of whole grains with the highest intake of dietary fiber showed 28% reduced risk (95% CI: 0.54, 0.93; P for trend: 0.031) of BC compared with the lowest intakes, suggesting potential synergism.
CONCLUSIONS
Higher intakes of total whole grain and total dietary fiber are associated with reduced risk of BC individually and jointly. Further studies are needed to clarify the underlying mechanisms for these findings.
Topics: Aged; Diet; Dietary Fiber; Female; Humans; Male; Middle Aged; Prospective Studies; Risk Factors; Urinary Bladder Neoplasms; Whole Grains
PubMed: 32778880
DOI: 10.1093/ajcn/nqaa215 -
American Journal of Physiology. Heart... Feb 2021Heart failure (HF) is one of the leading causes of mortality and morbidity in the modern world whose increasing prevalence is associated with "Western" diet and... (Review)
Review
Heart failure (HF) is one of the leading causes of mortality and morbidity in the modern world whose increasing prevalence is associated with "Western" diet and sedentary lifestyles. Of particular concern is the increasing burden of HF with preserved ejection fraction (HFpEF) that involves complex pathophysiology and is difficult to treat. Pressure overload caused by hypertension (HTN) is the predominant driver of cardiac injury, left ventricular hypertrophy, and fibrosis that progresses to diastolic dysfunction and ultimately HFpEF. Although pharmacological control of blood pressure may affect the degree of pressure overload, such therapies are largely ineffective in established HFpEF, and there is a need to modulate the festering inflammatory and fibrotic response to injury to halt and perhaps reverse pathology. An emerging literature indicates potentially important links between the gut microbiota, dietary soluble fiber, and microbiota-derived metabolites that modulate blood pressure and the immune response. In particular, high-fiber diets demonstrate protective properties in systemic hypertension and left-sided cardiac pathology, and this action is closely associated with short-chain fatty acid (SCFA)-producing bacteria. Mechanisms underlying the beneficial action of SCFAs in immunity and the systemic circulation could potentially be applied to the treatment of hypertension and the cardiac damage it causes. In this review, we discuss the potential beneficial effects of SCFAs, with an emphasis on mechanisms that are involved in cardiac responses to pressure overload.
Topics: Animals; Blood Pressure; Diet; Dietary Fiber; Fatty Acids, Volatile; Heart Failure; Humans; Microbiota
PubMed: 33306446
DOI: 10.1152/ajpheart.00573.2020 -
Nutrients Feb 2022High-fiber diet interventions have been proven to be beneficial for gut microbiota and glycemic control in diabetes patients. However, the effect of a low level of fiber...
High-fiber diet interventions have been proven to be beneficial for gut microbiota and glycemic control in diabetes patients. However, the effect of a low level of fiber in habitual diets remains unclear. This study aims to examine the associations of habitual dietary fiber intake with gut microbiome profiles among Chinese diabetes patients and identify differential taxa that mediated associations of dietary fiber with HbA1c level. Two cross-sectional studies and one longitudinal study were designed based on two follow-up surveys in a randomized trial conducted during 2015−2017. The study included 356 and 310 participants in the first and second follow-ups, respectively, with 293 participants in common in both surveys. Dietary fiber intake was calculated based on a 3-day 24-h diet recall at each survey and was classified into a lower or a higher group according to the levels taken based on the two surveys using 7.2 g/day as a cut-off value. HbA1c was assayed to assess glycemic status using a cut-off point of 7.0% and 8.0%. Microbiome was profiled by 16S rRNA sequencing. A high habitual dietary fiber intake was associated with a decrease in α-diversity in both the cross-sectional and longitudinal analyses. At the first follow−up, phylum Firmicutes and Fusobacteria were negatively associated with a higher dietary fiber intake (p < 0.05, Q < 0.15); at the second follow-up, genus Adlercreutzia, Prevotella, Ruminococcus, and Desulfovibrio were less abundant in patients taking higher dietary fiber (p < 0.05, Q < 0.15); genus Desulfovibrio and Ruminococcaceae (Unknown), two identified differential taxa by HbA1c level, were negatively associated with dietary fiber intake in both the cross-sectional and longitudinal analyses, and mediated the dietary fiber-HbA1c associations among patients taking dietary fiber ≥ 7.2 g/day (mediation effect β [95%CI]: −0.019 [−0.043, −0.003], p = 0.018 and −0.019 [−0.046, −0.003], p = 0.016). Our results suggest that habitual dietary fiber intake has a beneficial effect on gut microbiota in Chinese diabetes patients. Further studies are needed to confirm our results.
Topics: China; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Dietary Fiber; Gastrointestinal Microbiome; Glycated Hemoglobin; Humans; Longitudinal Studies; RNA, Ribosomal, 16S
PubMed: 35267978
DOI: 10.3390/nu14051003 -
Frontiers in Immunology 2022Transforming the gut microbiota has turned into the most intriguing target for interventions in multiple gastrointestinal and non-gastrointestinal disorders. Fecal...
Transforming the gut microbiota has turned into the most intriguing target for interventions in multiple gastrointestinal and non-gastrointestinal disorders. Fecal microbiota transplantation (FMT) is a therapeutic tool that administers feces collected from healthy donors into patients to help replenish the gut microbial balance. Considering the random donor selection, to maintain the optimal microbial ecosystem, post-FMT is critical for therapy outcomes but challenging. Aiming to study the interventions of different diets on recipients' gut microbiota post-FMT that originated from donors with different diets, we performed FMT from domestic vs. wild pigs that are living on low-fiber vs. high-fiber diets into the pseudo-GF mouse, followed with fiber-free (FF) or fiber-rich (FR) diets post-FMT. Different patterns of gut microbiota and metabolites were observed when mice FMT from different donors were paired with different dietary fiber contents. Enrichment of bacteria, including and , together with alteration of metabolites, including palmitic acid, stearic acid, and nicotinic acid, was noted to improve crypt length and mucus layer in the gut in mice FMT from wild pigs fed an FR diet. The results provide novel insight into the different responses of reconstructed gut microbiota by FMT to dietary fiber. Our study highlighted the importance of post-FMT precise dietary interventions.
Topics: Animals; Bacteria; Dietary Fiber; Fecal Microbiota Transplantation; Feces; Gastrointestinal Microbiome; Gastrointestinal Tract; Male; Mice; Swine
PubMed: 35185934
DOI: 10.3389/fimmu.2022.842669 -
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =... Feb 2020Chronic kidney disease (CKD) can result in alteration of intestinal flora and damage of intestinal barrier function. Intestinal dysbios is contributes to the generation... (Review)
Review
Chronic kidney disease (CKD) can result in alteration of intestinal flora and damage of intestinal barrier function. Intestinal dysbios is contributes to the generation of colon-derived uremic solutes and the translocation of bacteria and endotoxins from gut lumen into the bloodstream, subsequently increasing uremic toxicity and triggering systemic inflammation, which is related to CKD progression and many complications. Studies have revealed that dietary fiber can reduce uremic toxin levels and systemic inflammation in CKD through targeting the "gut-kidney axis". Dietary fiber seems to be a promising measure for CKD treatment.
Topics: Dietary Fiber; Gastrointestinal Microbiome; Humans; Inflammation; Kidney; Renal Insufficiency, Chronic
PubMed: 32386047
DOI: 10.11817/j.issn.1672-7347.2020.180758 -
Nutrients Oct 2020The etiology of inflammatory bowel disease (IBD) is complex but is thought to be linked to an intricate interaction between the host's immune system, resident gut... (Review)
Review
The etiology of inflammatory bowel disease (IBD) is complex but is thought to be linked to an intricate interaction between the host's immune system, resident gut microbiome and environment, i.e., diet. One dietary component that has a major impact on IBD risk and disease management is fiber. Fiber intakes in pediatric IBD patients are suboptimal and often lower than in children without IBD. Fiber also has a significant impact on beneficially shaping gut microbiota composition and functional capacity. The impact is likely to be particularly important in IBD patients, where various studies have demonstrated that an imbalance in the gut microbiome, referred to as dysbiosis, occurs. Microbiome-targeted therapeutics, such as fiber and prebiotics, have the potential to restore the balance in the gut microbiome and enhance host gut health and clinical outcomes. Indeed, studies in adult IBD patients demonstrate that fiber and prebiotics positively alter the microbiome and improve disease course. To date, no studies have been conducted to evaluate the therapeutic potential of fiber and prebiotics in pediatric IBD patients. Consequently, pediatric IBD specific studies that focus on the benefits of fiber and prebiotics on gut microbiome composition and functional capacity and disease outcomes are required.
Topics: Adolescent; Adult; Child; Child, Preschool; Diet; Dietary Fiber; Dysbiosis; Gastrointestinal Microbiome; Humans; Infant; Inflammatory Bowel Diseases; Prebiotics
PubMed: 33092150
DOI: 10.3390/nu12103204 -
TheScientificWorldJournal 2023Oats ( L.) are a popular functional cereal grain due to their numerous health benefits. This review article summarized the information on the chemical composition and... (Review)
Review
Oats ( L.) are a popular functional cereal grain due to their numerous health benefits. This review article summarized the information on the chemical composition and phytonutrients of oats grown in different countries. It also reviewed recently developed fermented oat products to highlight their potential for human health. Oats have an interesting nutritional profile that includes high-quality protein, unsaturated fats, soluble fiber, polyphenolic compounds, and micronutrients. Oat grain has a unique protein composition, with globulins serving as the primary storage protein, in contrast to other cereals, where prolamins are the main storage proteins. Oats have the highest fat content of any cereal, with low saturated fatty acids and high essential unsaturated fatty acid content, which can help reduce the risk of cardiovascular diseases. Oats are a good source of soluble dietary fiber, particularly -glucan, which has outstanding functional properties and is extremely important in human nutrition. -Glucan has been shown to lower blood cholesterol and glucose absorption in the intestine, thereby preventing diseases such as cardiovascular injury, dyslipidemia, hypertension, inflammatory state, and type 2 diabetes. Oats also contain high concentration of antioxidant compounds. Avenanthramides, which are unique to oats, are powerful antioxidants with high antioxidative activity in humans. Recognizing the nutritional benefits of oats, oat-based fermented food products are gaining popularity as functional foods with high probiotic potential.
Topics: Humans; Edible Grain; Avena; Diabetes Mellitus, Type 2; Antioxidants; Phytochemicals; beta-Glucans; Dietary Fiber
PubMed: 37492342
DOI: 10.1155/2023/2730175 -
Nutrients Dec 2022Obesity and type II diabetes are closely related to the rapid digestion of starch. Starch is the major food-energy source for most humans, and thus knowledge about the... (Review)
Review
Obesity and type II diabetes are closely related to the rapid digestion of starch. Starch is the major food-energy source for most humans, and thus knowledge about the regulation of starch digestion can contribute to prevention and improved treatment of carbohydrate metabolic disorders such as diabetes. Pectins are plant polysaccharides with complex molecular structures and ubiquitous presence in food, and have diverse effects on starch digestion. Pectins can favorably regulate in vivo starch digestion and blood glucose level responses, and these effects are attributed to several reasons: increasing the viscosity of digesta, inhibiting amylase activity, and regulating some in vivo physiological responses. Pectins can influence starch digestion via multiple mechanisms simultaneously, in ways that are highly structure-dependent. Utilizing the multi-functionalities of pectin could provide more ways to design low glycemic-response food and while avoiding the unpalatable high viscosity in food by which is commonly caused by many other dietary fibers.
Topics: Humans; Starch; Pectins; Digestion; Diabetes Mellitus, Type 2; Dietary Fiber
PubMed: 36501138
DOI: 10.3390/nu14235107