Consumption of a Fermented Milk Product Containing Bifidobacterium lactis CNCM I-2494 in Women Complaining of Minor Digestive Symptoms: Rapid Response Which Is Independent of Dietary Fibre Intake or Physical Activity.

Background. Minor digestive symptoms are common and dietary approaches such as probiotic administration or fibre and fermentable carbohydrate intake adjustments are often recommended. A Fermented Milk Product (FMP) containing Bifidobacterium animalis subsp. lactis CNCM I-2494 and lactic acid bacteria has been shown to improve digestive symptoms after 4 weeks of consumption, but the speed of onset of this effect and its dependence on fibre intake or physical activity is unknown. To answer these questions, data from two previously published trials on FMP for minor digestive symptoms were combined. Methods. In total, 538 participants provided weekly assessments of bloating, abdominal pain/discomfort, flatulence, borborygmi/rumbling stomach from which a composite score was calculated. At baseline in one study (n = 336), dietary fibre consumption was recorded and physical activity classified as high, moderate or low. The speed of the FMP's effect was assessed by a repeated measure analysis of variance measuring the change from baseline for the composite score of digestive symptoms. Results. FMP consumption resulted in a significant decrease in the composite score of symptoms after only 2 weeks in both studies and the pooled data at week 1 (-0.35 [-0.69, 0.00]; p = 0.05), week 2 (-0.66 [-1.04, -0.27]; p < 0.001), week 3 (-0.49 [-0.89, -0.10]; p = 0.01) and week 4 (-0.46 [-0.88, -0.04]; p = 0.03). The interactions fibre intake-by-product group, physical activity-by-product group and time-by-product group were not statistically significant. Conclusion. FMP consumption leads to a rapid improvement in symptoms which is likely to encourage adherence to this dietary intervention. This effect is independent of dietary fibre and physical activity.

Whats 'App-ening': the help of new technologies in nutrition in digestive diseases.

PURPOSE OF REVIEW: The aim of this study is to review the basic concepts of electronic health (eHealth), with a focus on its nutritional applications and its usefulness for digestive diseases. RECENT FINDINGS: eHealth applications for the treatment and monitoring of digestive disease are growing in number. ehealth helps patients in coping with their disease by promoting self-management, which increases adherence to medical treatment and diets, and leads to an improved quality of life. For irritable bowel syndrome (IBS), there are multiple applications that provide dietary advice, for example, a low FODMAP (Fermentable Oligo, Mono, Disaccharides And Polyols) diet. However, many applications lack a symptom scoring function and do not include a module for assisting the essential reintroduction of high FODMAP foods. In general, there are very few applications that enable direct patient communication with healthcare professionals. A more holistic approach that educates patients and enables them to communicate directly with eCare provider through a web application is one of the functions most requested by patients. SUMMARY: eHealth solutions for digestive diseases have a supportive function and a positive impact on patients. However, there is a need to increase patient education and further develop the possibility for care team-patient communication within eHealth solutions.

Effect of a low-flatulogenic diet in patients with flatulence and functional digestive symptoms.

BACKGROUND: Diets rich in fermentable residues increase intestinal gas production. Our aim was to demonstrate the potential effects of diet on gas-related symptoms. METHODS: The effect of a low-flatulogenic test diet (restricted to foodstuffs low in fermentable residues; n = 15) was compared to that of a balanced control diet (Mediterranean type; n = 15) in 30 patients complaining of flatulence and other abdominal symptoms using a randomized parallel design. The following outcomes were measured daily: number of anal gas evacuations by an event marker, severity of gas-related symptoms by 0-10 scales, and sensation of digestive comfort by a -5 (unpleasant) to +5 (pleasant) scale. Measurements were taken pretreatment for 3 days on their habitual diet and for 7 days during the treatment phase. KEY RESULTS: No pretreatment differences were detected between patients allocated to the control or test diets. The test diet significantly reduced the number of gas evacuations (by 54 ± 10%; p = 0.002 vs basal diet) whereas the control diet had a lesser effect (reduction by 28 ± 9%; p = 0.059 vs basal diet; p = 0.089 vs test diet). Compared to the control diet, the test diet significantly reduced flatulence (by 48 ± 7% vs 27 ± 8%, respectively; p = 0.018), abdominal distension (by 48 ± 4% vs 22 ± 12%, respectively; p = 0.038), and enhanced digestive well-being (by 149 ± 18% vs 58 ± 22%, respectively; p = 0.006). CONCLUSIONS & INFERENCES: In patients with gas-related symptoms, a low-flatulogenic diet produces immediate beneficial effects with digestive, cognitive, and emotive dimensions. The number of gas evacuations is an objective biological marker of response to dietary treatment.

A randomized, double-blind, controlled study and pooled analysis of two identical trials of fermented milk containing probiotic Bifidobacterium lactis CNCM I-2494 in healthy women reporting minor digestive symptoms.

BACKGROUND: The probiotic fermented milk (PFM) containing Bifidobacterium lactis CNCM I-2494 improved gastrointestinal (GI) well-being and digestive symptoms in a previous trial involving women reporting minor digestive symptoms. Our objective is to confirm these findings in a second study and in a pooled analysis of both studies. METHODS: In this double-blind, controlled, parallel design study, subjects without diagnosed GI disorders consumed PFM or control dairy product daily for 4 weeks. Endpoints comprised weekly assessment of GI well-being (primary endpoint), rate of responders and digestive symptoms. Data were analyzed on full analysis set population (n = 324) and on the pooled data of randomized subjects of this study with those of the first study (n = 538). KEY RESULTS: In this second study, no significant difference was observed in the percentage of women reporting an improvement in GI well-being [OR = 1.20 (95% CI 0.87, 1.66)] and rate of responders [OR = 1.38 (95% CI 0.89, 2.14)]. Composite score of digestive symptoms was significantly (P < 0.05) reduced in PFM when compared to the control group [LSmean = -0.42 (95% CI -0.81, -0.03)]. In the pooled analysis, significant differences were observed in favor of PFM group for all endpoints: percentage of women with improved GI well-being [OR = 1.36 (95% CI 1.07, 1.73)], rate of responders [OR = 1.53 (95% CI 1.09, 2.16)] and composite score of digestive symptoms [LSmean = -0.48 (95% CI -0.80, -0.16)]. CONCLUSIONS & INFERENCES: This second study did not confirm improvement on the primary endpoint. However, a pooled analysis of the two trials showed improvement in GI well-being and digestive symptoms in women reporting minor digestive symptoms.

Progress of enteral feeding practice over time: moving from energy supply to patient- and disease-adapted formulations.

Enteral nutrition comprises the delivery of a liquid formula beyond the esophagus via a feeding tube in a patient with insufficient oral intake, as well as the provision of specialized nutritional formula irrespective of the route of delivery. Pediatric formulae have been designed for different age groups, and for children with certain diseases; examples are special formulations for regurgitating infants, metabolic diseases, cow's milk or multiple food allergies, intestinal, pancreatic, renal, and hepatic insufficiency. Exclusive enteral nutrition is a therapeutic concept to induce remission in children and adolescents with active Crohn's disease. A new area of nutritional research in pediatrics is potential immunonutrition in critically ill children. Formulae are enriched with single components or a combination of key substrates that might play a crucial role during intermediary metabolism in sepsis, inflammation, tissue healing, and growth. For pharmaconutrition, single components are investigated in a scientific stepwise procedure in order to identify effective disease-dedicated nutrition therapy. Any new formula needs to be evaluated, if possible in comparison to a normal diet or the reference formulation to demonstrate its safety and efficacy (equal or superior to standard formula).

Aspectos nutricionales y del aparato digestivo de los niños inmigrantes / Nutritional and gastrointestinal findings in immigrant children

La mayoría de los niños que llegan a España generalmente no presentan las tasas de desnutrición del país de origen, aunque sí determinadas carencias nutricionales específicas (hierro, vitamina A) y raquitismo. En la actualidad, el hecho de pertenecer a una minoría étnica no debería ser un factor de riesgo para padecer desnutrición carencial y, con la excepción de los hijos de los inmigrantes recién llegados, el estado nutricional y el crecimiento de estos niños han de ser similares a los de los niños con el mismo nivel socioeconómico del país de destino. Para un mejor control de los niños inmigrantes, los profesionales sanitarios deben conocer el estado nutricional de base(con la obtención de las distintas medidas antropométricas) y los aspectos genéticos y socioculturales, a fin de poder prevenir sus posibles alteraciones a largo plazo, ya que se están registrando importantes problemas de sobrepeso, especialmente en la segunda generación de esta población. También repasamos la patología abdominal en el niño inmigrante desde el punto de vista sindrómico, para poder orientar el diagnóstico y el tratamiento. Aunque en general es similar a la observada en la población autóctona, debido a las características propias ambientales y a la carga genética de estos niños podemos hallar diferencias en la prevalencia de algunas enfermedades, aparte de las afecciones propias del trópico. Además, son frecuentes las patologías reactivas o de adaptación, que se expresan fundamentalmente con somatizaciones y síntomas vagos que indican una problemática relacional, y el dolor abdominal es el síntoma más común en estos niños(AU)

In general, most of the children who arrive in Spain do not reflect the rates of malnutrition observed in their countries of origin, although certain specific nutritional deficiencies (iron, rickets, vitamin A) may be detected. At the present time, being a member of an ethnic minority should not be a risk factor for malnutrition owing to deficiency disease, and, with the exception of children of newly arrived immigrants, the nutritional status and growth of these children should be similar to that of children of the same socioeconomic status in the country of destination. For a more effective monitoring of immigrant children, health professionals should be aware of the baseline nutritional status(using different anthropometric measurements) and genetic and sociocultural aspects in order to prevent possible long-term disturbances, since these individuals are experiencing significant problems with overweight, especially those of the second generation. We also reviewed the gastrointestinal diseases that can be found in the immigrant child from the syndromic point of view in order to guide their diagnosis and treatment. Although, in general, they are similar to those observed in the native population, given the particular environmental characteristics and the genetic load of these children, we do detect differences in the prevalence of certain diseases, aside from those associated with the tropics. In addition, coping problems or adjustment disorders frequently occur and are expressed mainly in the form of somatization and vague symptoms that indicate relational problems, with abdominal pain being the most common symptom in these children(AU)

[Maldigestion syndrome ( to 50th anniversary of discovery of the membranous digestion by A. M. Ugolev)].

Definition, classification and pathophysiology infringements of intestinal digestion are stated. At the description of maldigestion symptoms clinical features of infringements [Cyrillic word: see text] digestion and membranous digestion are described. Cliniko-laboratory methods of differential diagnostics maldigestion and malobsorbtion are resulted. Features of treatment of patients with pancreatogenous, hepatogenous and gastrogenic maldigestion are stated.

[Malnutrition in gastroenterological diseases]. / Malnutrition: häufiges Problem bei Erkrankungen des Magen-Darm-Trakts. Ernährungstherapien verbessern Prognose und Lebensqualität.

Significant weight loss, a body mass index of less than 18.5, hypoalbuminemia, and a deficiency in specific nutrients are major criteria. Depending on the underlying diagnosis, maldigestion, malabsorption, catabolism, dysphagia, anorexia and intestinal obstruction are possible causes of malnutrition. In the majority of cases, malnutrition is associated with a poorer prognosis, a reduced general health status, and poorer quality of life. This means that in addition to treatment of the underlying disease, specific nutritional support, preferably by the enteral route, with the aim of providing an adequate supply of nutrients and improving the patient's general nutritional status is of importance.

Kefir: a symbiotic yeasts-bacteria community with alleged healthy capabilities.

Kefir is a fermented milk beverage. The milk fermentation is achieved by the of kefir grains, a cluster of microorganisms held together by a polysaccharide matrix named kefiran. Kefir grains are an example of symbiosis between yeast and bacteria. They have been used over years to produce kefir, a fermented beverage that is consumed all over the world, although its origin is Caucasian. A vast variety of different species of organisms forming the kefir grains, comprising yeast and bacteria, have been isolated and identified. Kefir is a probiotic food. Probiotics have shown to be beneficial to health, being presently of great interest to the food industry. Kefir has been accredited with antibacterial, antifungal and antitumoural activities among other beneficial attributes. This review includes a critical revision of the microbiological composition of kefir along with its beneficial properties to human health.

Kefir: a symbiotic yeasts-bacteria community with alleged healthy capabilities

El kéfir es una bebida láctea fermentada. Los gránulo de kéfir, comunidades de microorganismos que se agrupan en una matriz polisacárida denominada kefirano, son los responsables de esta fermentación. Estos gránulos son un ejemplo de simbiosis entre levaduras y bacterias y se han utilizado a través del tiempo para producir el kéfir, que es consumido por todo el mundo a pesar de su origen caucásico. En esa relación simbiótica, que son los gránulos de kéfir, se han aislado e identificado una amplia variedad de especies microbianas que comprenden levaduras y bacterias. El kéfir es un alimento prebiótico. Los prebióticos han demostrado ser beneficiosos para la salud, siendo de gran interés para la industria alimentaria en la actualidad. Según se afirma, el kéfir ha mostrado actividades antibacterianas, antifúngicas y antitumorales, entre otros atributos beneficiosos. Este trabajo incluye una revisión crítica de la composición microbiológica del kéfir junto con sus propiedades beneficiosas para la salud humana(AU)

Kefir is a fermented milk beverage. The milk fermentation is achieved by the of kefir grains, a cluster of microorganisms held together by a polysaccharide matrix named kefiran. Kefir grains are an example of symbiosis between yeast and bacteria. They have been used over years to produce kefir, a fermented beverage that is consumed all over the world, although its origin is Caucasian. A vast variety of different species of organisms forming the kefir grains, comprising yeast and bacteria, have been isolated and identified. Kefir is a probiotic food. Probiotics have shown to be beneficial to health, being presently of great interest to the food industry. Kefir has been accredited with antibacterial, antifungal and antitumoural activities among other beneficial attributes. This review includes a critical revision of the microbiological composition of kefir along with its beneficial properties to human health(AU)

Probiotics and medical nutrition therapy.

Probiotics have been defined by The Food Agricultural Organization/World Health Organization (FAO/WHO) as "live microorganisms which when administered in adequate amounts confer a health benefit to the host." They have been used for centuries in the form of dairy-based fermented products, but the potential use of probiotics as a form of medical nutrition therapy has not received formal recognition. A detailed literature review (from 1950 through February 2004) of English-language articles was undertaken to find articles showing a relationship between probiotic use and medical conditions. Medical conditions that have been reportedly treated or have the potential to be treated with probiotics include diarrhea, gastroenteritis, irritable bowel syndrome, and inflammatory bowel disease (Crohn's disease and ulcerative colitis), cancer, depressed immune function, inadequate lactase digestion, infant allergies, failure-to-thrive, hyperlipidemia, hepatic diseases, Helicobacter pylori infections, genitourinary tract infections, and others. The use of probiotics should be further investigated for possible benefits and side-effects in patients affected by these medical conditions.