ABSTRACT
Epidemiological studies have consistently demonstrated the benefits of dietary fibre on gastrointestinal health through consumption of unrefined whole foods, such as wholegrains, legumes, vegetables and fruits. Mechanistic studies and clinical trials on isolated and extracted fibres have demonstrated promising regulatory effects on the gut (for example, digestion and absorption, transit time, stool formation) and microbial effects (changes in gut microbiota composition and fermentation metabolites) that have important implications for gastrointestinal disorders. In this Review, we detail the major physicochemical properties and functional characteristics of dietary fibres, the importance of dietary fibres and current evidence for their use in the management of gastrointestinal disorders. It is now well-established that the physicochemical properties of different dietary fibres (such as solubility, viscosity and fermentability) vary greatly depending on their origin and processing and are important determinants of their functional characteristics and clinical utility. Although progress in understanding these relationships has uncovered potential therapeutic opportunities for dietary fibres, many clinical questions remain unanswered such as clarity on the optimal dose, type and source of fibre required in both the management of clinical symptoms and the prevention of gastrointestinal disorders. The use of novel fibres and/or the co-administration of fibres is an additional therapeutic approach yet to be extensively investigated.
Subject(s)
Dietary Fiber/metabolism , Gastrointestinal Microbiome , Gastrointestinal Transit , Intestinal Mucosa/metabolism , Micronutrients/metabolism , Biological Availability , Constipation/diet therapy , Diarrhea/diet therapy , Dietary Fiber/therapeutic use , Diverticular Diseases/diet therapy , Fermentation , Humans , Inflammatory Bowel Diseases/diet therapy , Irritable Bowel Syndrome/diet therapy , Prebiotics , Solubility , ViscosityABSTRACT
La enfermedad diverticular corresponde a una condición habitual en el territorio occidental, siendo el hallazgo más frecuente en población de zonas urbanizadas. Respecto a su origen, se ha planteado la influencia de factores ambientales y genéticos, incluyendo en su etiología una inadecuada ingesta de fibra dietética, disbiosis de la microbiota intestinal y niveles alterados de vitamina D. A su vez, la enfermedad diverticular sintomática no complicada (EDNC) corresponde a un tipo de diverticulosis crónica cuyas características asemejan al síndrome de intestino irritable, lo que resalta la importancia en la comprensión de esta condición. Recientemente, se ha discutido la forma en que se aborda la enfermedad diverticular y en el siguiente escrito se expondrá evidencia sobre la patogénesis y su actual manejo.
Diverticular disease corresponds to a habitual condition in the western territory, being frequently found among the population of urban areas. Regarding its origin, the influence of environmental and genetic factors, including the etiology of dietary fiber intake, intestinal microbiota dysbiosis and altered levels of vitamin D have been recognized. Symptomatic uncomplicated diverticular disease corresponds to a type of chronic diverticulosis whose characteristics resemble irritable bowel syndrome, highlighting the importance of understanding this condition. Recently, the treatment of the disease has been discussed and the following review presents evidence on pathogenesis and its management.
Subject(s)
Humans , Dietary Fiber/therapeutic use , Diverticular Diseases/diet therapy , Diverticulitis/diet therapy , Diverticular Diseases/classification , Diverticular Diseases/etiology , Diverticular Diseases/physiopathology , InflammationABSTRACT
BACKGROUNDS AND AIMS: High intake of dietary fibres has been associated with a reduced risk of DD. However, reports on which type of dietary fibre intake that is most beneficial have been conflicting. The aim of this study was to investigate the association between different dietary fibres and hospitalisation due to diverticular disease (DD) of the colon. METHODS: This was a major cohort study. The Swedish Mammography Cohort and the Cohort of Swedish Men were linked to the Swedish Inpatient Register and the Causes of Death Register. Data on the intake of dietary fibre were collected through questionnaires. The effect of intake (in quartiles) of different types of dietary fibre on the incidence of hospitalisation due to DD was investigated using multivariable Cox regression. Estimates were adjusted according to age, BMI, physical activity, co-morbidity, intake of corticosteroids, smoking, alcohol intake and education level. RESULTS: Women with intake of fruit and vegetable fibres in the highest quartile (median 12.6 g/day) had a 30% decreased risk of hospitalisation compared to those with the lowest intake (4.1 g/day). Men within the highest quartile (10.3 g/day) had a 32% decreased risk compared to those with a low intake (2.9 g/day). High intake of fibres from cereals did not affect the risk. CONCLUSION: A high intake of fruits and vegetables may reduce the risk of hospitalisation due to DD. Intake of cereals did not influence the risk.
