Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 111
Filtrar
1.
Nutrients ; 11(8)2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31394793

RESUMO

Diet plays an important role not only in the pathophysiology of irritable bowel syndrome (IBS), but also as a tool that improves symptoms and quality of life. The effects of diet seem to be a result of an interaction with the gut bacteria and the gut endocrine cells. The density of gut endocrine cells is low in IBS patients, and it is believed that this abnormality is the direct cause of the symptoms seen in IBS patients. The low density of gut endocrine cells is probably caused by a low number of stem cells and low differentiation progeny toward endocrine cells. A low fermentable oligo-, di-, monosaccharide, and polyol (FODMAP) diet and fecal microbiota transplantation (FMT) restore the gut endocrine cells to the level of healthy subjects. It has been suggested that our diet acts as a prebiotic that favors the growth of a certain types of bacteria. Diet also acts as a substrate for gut bacteria fermentation, which results in several by-products. These by-products might act on the stem cells in such a way that the gut stem cells decrease, and consequently, endocrine cell numbers decrease. Changing to a low-FODMAP diet or changing the gut bacteria through FMT improves IBS symptoms and restores the density of endocrine cells.


Assuntos
Dieta , Hormônios Gastrointestinais/fisiologia , Microbioma Gastrointestinal/fisiologia , Síndrome do Intestino Irritável/dietoterapia , Síndrome do Intestino Irritável/etiologia , Diferenciação Celular , Dieta com Restrição de Carboidratos , Células Enteroendócrinas/patologia , Transplante de Microbiota Fecal , Fermentação , Humanos , Síndrome do Intestino Irritável/patologia , Monossacarídeos/administração & dosagem , Polissacarídeos/administração & dosagem , Prebióticos/administração & dosagem , Qualidade de Vida , Células-Tronco/citologia
2.
World J Gastroenterol ; 25(24): 2973-2976, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31293334

RESUMO

Until recently, with the exception of coeliac disease, gastroenterologists have not been particularly interested in the role of diet in the management of gastrointestinal disorders. However, patients have always felt that diet must play a part in their symptoms and, in the absence of any medical interest, have turned to alternative dietary practitioners for help, which can often have no evidence base. Fortunately, with the advent of the FODMAP diet (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) and the realisation that diet can have a profound effect on the microbiome, medical opinion is now changing. Nevertheless, research on the various diets that are now available is often completely lacking. Lectins are carbohydrate binding proteins which are widely distributed in nature and are found in a whole variety of commonly consumed foods. It seems likely that the exclusion of lectins from the diet could become the next "food fashion" for alternative practitioners to promote, especially as there is some evidence to suggest that certain lectins may be harmful to health. It is, therefore, the purpose of this viewpoint to try and stimulate research on the dietary effects of lectins, which is currently minimal, so that we can pre-empt a situation where we are unable to give patients or the public evidence based advice on this topic.


Assuntos
Dietas da Moda , Dieta com Restrição de Proteínas/efeitos adversos , Proteínas na Dieta/efeitos adversos , Gastroenteropatias/dietoterapia , Lectinas/efeitos adversos , Terapias Complementares/métodos , Terapias Complementares/tendências , Dieta com Restrição de Carboidratos/efeitos adversos , Dieta com Restrição de Carboidratos/métodos , Dieta com Restrição de Proteínas/métodos , Proteínas na Dieta/administração & dosagem , Glutens/administração & dosagem , Glutens/efeitos adversos , Humanos , Lectinas/administração & dosagem , Monossacarídeos/administração & dosagem , Monossacarídeos/efeitos adversos , Oligossacarídeos/administração & dosagem , Oligossacarídeos/efeitos adversos
3.
Nutrients ; 11(7)2019 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-31336747

RESUMO

Several studies have reported some efficacy of diets low in fermentable carbohydrates (Fermentable Oligo-, Di-, Monosaccharides and Polyols (FODMAPs)) in Irritable Bowel Syndrome (IBS). There is no evidence of its superiority compared to gluten-free and balanced diets in improving IBS patients' quality of life (QoL). The aim of this study is to assess whether different diets can improve QoL in IBS. Forty-two patients with IBS, according to Rome IV criteria, were enrolled. Low-FODMAP, gluten-free and balanced diets were proposed to each patient in the same succession. Each diet was followed for 4 weeks. The Bristol Stool Scale, the Visual Analogue Scale (VAS) for bloating and abdominal pain, and the SF12 questionnaire for health-related quality of life were applied at the beginning and at the end of each diet. Twenty-eight of the forty-two patients completed all the three diets. All the three diets reduced symptom severity (p < 0.01), bloating (p < 0.01) and abdominal pain (p < 0.01), and improved quality of life (p < 0.05); 3% of patients expressed a preference for the low-FODMAP diet, 11% for the gluten-free and 86% for the balanced diet (p < 0.01). The balanced diet improves QoL and VAS pain, provides an adequate quantity of FODMAPs and is more appreciated by patients. For these reasons, the balanced diet could be recommended to patients with irritable bowel syndrome.


Assuntos
Dieta Livre de Glúten , Dieta Mediterrânea , Síndrome do Intestino Irritável/dietoterapia , Monossacarídeos/administração & dosagem , Dor Abdominal , Adulto , Fezes , Feminino , Humanos , Masculino , Qualidade de Vida , Adulto Jovem
4.
Nutrients ; 11(3)2019 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-30889844

RESUMO

Being overweight has been identified as the main risk factor for the development of metabolic disorders in adults and children. However, recent studies suggest that normal weight individuals are also frequently affected by metabolic abnormalities with underlying mechanisms not yet fully understood. The aim of the present study was to determine if dietary pattern and markers of intestinal permeability, as well as inflammation, differ between normal weight healthy children and normal weight children suffering from metabolic abnormalities. In total, 45 normal weight children aged 5⁻9 years were included in the study, of whom nine suffered from metabolic abnormalities. Anthropometric data, dietary intake and markers of inflammation, as well as intestinal permeability, were assessed in fasting blood samples. Neither BMI nor BMI-SDS differed between groups; however, children with metabolic abnormalities had a significantly larger waist circumference (+~5 cm) and a higher leptin to adiponectin ratio. While plasma leptin levels are significantly higher in normal weight children with metabolic abnormalities, neither TNF α nor sCD14, adiponectin, PAI-1 or IL-6 plasma levels differed between groups. Despite similar total calorie and macronutrient intake between groups, mean total fructose and total glucose intake (resulting mainly from sugar sweetened beverages, fruits and sweets) were higher in children with metabolic abnormalities than in healthy children. Time spent physically active was significantly higher in healthy normal weight children whereas time spent physically inactive was similar between groups. Furthermore, bacterial endotoxin levels were significantly higher in the peripheral plasma of normal weight children with metabolic abnormalities than in healthy normal weight children. Our results suggest that metabolic disorders in normal weight children are associated with a high monosaccharide intake and elevated bacterial endotoxin as well as leptin plasma levels, the latter also discussed as being indicative of visceral adiposity.


Assuntos
Índice de Massa Corporal , Endotoxinas/sangue , Glucose/efeitos adversos , Gordura Intra-Abdominal/metabolismo , Doenças Metabólicas/etiologia , Monossacarídeos/efeitos adversos , Circunferência da Cintura , Adiponectina/sangue , Criança , Pré-Escolar , Dieta , Açúcares da Dieta/administração & dosagem , Açúcares da Dieta/efeitos adversos , Ingestão de Energia , Comportamento Alimentar , Feminino , Frutose/administração & dosagem , Frutose/efeitos adversos , Glucose/administração & dosagem , Humanos , Interleucina-6/sangue , Intestinos , Leptina/sangue , Masculino , Doenças Metabólicas/sangue , Monossacarídeos/administração & dosagem , Inibidor 1 de Ativador de Plasminogênio/sangue , Valores de Referência , Fator de Necrose Tumoral alfa/sangue
5.
JAAPA ; 32(3): 38-42, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30817479

RESUMO

Irritable bowel syndrome (IBS) is a chronic functional disorder with no organic cause. Risk factors are multifactorial and treatment typically consists of antimotility or stimulant laxatives and antidepressants. This article reviews several newer areas of interest: probiotics, fecal microbiota transplant, a low FODMAP diet, and cognitive behavioral therapy.


Assuntos
Terapia Cognitivo-Comportamental , Carboidratos da Dieta/administração & dosagem , Transplante de Microbiota Fecal , Síndrome do Intestino Irritável/terapia , Probióticos/uso terapêutico , Dissacarídeos/administração & dosagem , Microbioma Gastrointestinal , Humanos , Síndrome do Intestino Irritável/diagnóstico , Síndrome do Intestino Irritável/etiologia , Monossacarídeos/administração & dosagem , Polímeros/administração & dosagem , Fatores de Risco , Estresse Psicológico/complicações
6.
Z Gastroenterol ; 57(6): 740-744, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30873577

RESUMO

BACKGROUND: FODMAP reduced diet (fermentable oligo-, di-, monosaccharide, and polyols) belongs to the established therapy strategies in irritable bowel syndrome (IBS). However, disadvantages of this diet are significant and may lead to weight loss and insufficient patient adherence. Reports from Germany are not available yet. MATERIAL AND METHODS: In a prospective study, 93 patients with IBS according to Rom III were investigated. Sixty-three patients were recruited for the study and received standardized investigation, informed consent, and structured dietary instructions about the FODMAP reduced diet. Patients complaints were documented by a validated questionnaire and a standardized Lickert scale before and 8 weeks after the start of the diet. Stool characteristics were documented by the Bristol stool form scale. RESULTS: Patients adherence was low because 30 patients (47 %) stopped the diet. Of the remaining 33 patients, 36 % (n = 12) developed significant weight loss during the FODMAP therapy. Patients completing the study reported significant global improvement of symptoms in 79 % of cases (abdominal pain 85 %, meteorism 79 %, flatulence 69 %, borbogymi 69 %, nausea 46 %, fatigue 69 %). In addition, the severity of symptoms was significantly reduced. Fourteen patients developed changes of their stool characteristics according to the Bristol stool form scale, 11 of whom improved diarrhea and 3 improved constipation. CONCLUSION: FODMAP reduced diet is an efficient therapy in IBS. However, adherence of the patients is poor and the therapy bears the risk of significant weight loss.


Assuntos
Dissacarídeos/administração & dosagem , Síndrome do Intestino Irritável/dietoterapia , Monossacarídeos/administração & dosagem , Cooperação do Paciente , Polímeros/administração & dosagem , Perda de Peso , Adulto , Idoso , Peso Corporal , Dieta , Fermentação , Alemanha , Humanos , Síndrome do Intestino Irritável/diagnóstico , Síndrome do Intestino Irritável/psicologia , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento
7.
Nutrients ; 11(3)2019 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-30866491

RESUMO

Maternal hypercaloric exposure during pregnancy and lactation is a risk factor for developing diseases associated with inflammation such as obesity, diabetes and, neurological diseases in the offspring. Neuroinflammation might modulate neuronal activation and flavonoids are dietary compounds that have been proven to exert anti-inflammatory properties. Thus, the aim of the present study is to evaluate the effect of maternal supplementation with flavonoids (kaempferol-3-O-glucoside and narirutin) on the prevention of depression-like behaviour in the female offspring of dams fed with an obesogenic diet during the perinatal period. Maternal programming was induced by high fat (HFD), high sugar (HSD), or cafeteria diets exposure and depressive like-behaviour, referred to as swimming, climbing, and immobility events, was evaluated around postnatal day 56⁻60 before and after 30 mg/kg i.p. imipramine administration in the female offspring groups. Central inflammation was analyzed by measuring the TANK binding kinase 1 (TBK1) expression. We found that the offspring of mothers exposed to HSD programming failed to show the expected antidepressant effect of imipramine. Also, imipramine injection, to the offspring of mothers exposed to cafeteria diet, displayed a pro-depressive like-behaviour phenotype. However, dietary supplementation with flavonoids reverted the depression-like behaviour in the female offspring. Finally, we found that HSD programming increases the TBK1 inflammatory protein marker in the hippocampus. Our data suggest that maternal HSD programming disrupts the antidepressant effect of imipramine whereas cafeteria diet exposure leads to depressive-like behaviour in female offspring, which is reverted by maternal flavonoid supplementation.


Assuntos
Antidepressivos/farmacologia , Comportamento Animal/efeitos dos fármacos , Depressão/metabolismo , Flavonoides/farmacologia , Fenômenos Fisiológicos da Nutrição Materna/efeitos dos fármacos , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Animais , Antidepressivos/administração & dosagem , Dieta , Dissacarídeos/administração & dosagem , Dissacarídeos/farmacologia , Interações Medicamentosas , Feminino , Flavanonas/administração & dosagem , Flavanonas/farmacologia , Flavonoides/administração & dosagem , Imipramina/administração & dosagem , Imipramina/farmacologia , Inflamação/metabolismo , Inflamação/prevenção & controle , Quempferóis/administração & dosagem , Quempferóis/farmacologia , Masculino , Monossacarídeos/administração & dosagem , Monossacarídeos/farmacologia , Gravidez , Proteínas Serina-Treonina Quinases/metabolismo , Ratos , Ratos Wistar
8.
Biomed Pharmacother ; 112: 108624, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30784921

RESUMO

Rheumatoid arthritis (RA) is a chronic autoimmune disease of synovial inflammation and joint destruction. This study reports anti-arthritic potential of opuntioside-I opuntiol, and its gold and silver nanoparticles (NPs) against Complete Freund's Adjuvant (CFA)-induced arthritic rats. The mechanistic studies were performed targeting TLRs (TLR-2 and TLR-4) and cytokines (IL-1ß and TNF-α) expressions to validate their anti-inflammatory and immuno-modulatory response. The nano-formulations were successfully characterized employing Atomic Force Microscopy (AFM) and Dynamic Light Scattering (DLS) analysis. Opuntiol and opuntioside (OP and OPG: 10, 50 and 100 mg/kg) and opuntiol-coated silver and gold NPs (OP-AgNPs and OP-AuNPs: 0.5, 1 and 3 mg/kg) treatments in arthritic rat have shown minimal arthritic score exhibiting mild to moderate articular changes and tissue swelling in ankle joints. Radiographic examination reveals significant reduction in synovitis with improvement in joints degenarative changes in the presence of aforementioned treatments. Likewise, histology of rat ankle joints depicted comparatively lesser influx of inflammatory cells and diminished granulamatous inflammation. Moreover, treatment groups suppressed protein and mRNA expressions of TLRs (TLR-2 and TLR-4) and cytokines (IL-1ß and TNF-α) levels were also significantly declined in the presence of OPG, OP and its NPs comparing to arthritic control. This investigation concludes, the tested compounds and nano-formulations successfully restored the disease progression in CFA-induced arthritic rat owing to their immunomodulatory and anti-inflammatory potentials and can be considered for RA targeted therapy to address the utmost challenges of the disease.


Assuntos
Antirreumáticos/uso terapêutico , Artrite Experimental/tratamento farmacológico , Ácidos Cumáricos/uso terapêutico , Nanopartículas Metálicas/uso terapêutico , Monossacarídeos/uso terapêutico , Receptor 2 Toll-Like/antagonistas & inibidores , Receptor 4 Toll-Like/antagonistas & inibidores , Animais , Antirreumáticos/administração & dosagem , Antirreumáticos/química , Artrite Experimental/imunologia , Artrite Experimental/metabolismo , Ácidos Cumáricos/administração & dosagem , Ácidos Cumáricos/química , Feminino , Adjuvante de Freund , Ouro/química , Nanopartículas Metálicas/administração & dosagem , Nanopartículas Metálicas/química , Monossacarídeos/administração & dosagem , Monossacarídeos/química , Ratos Wistar , Prata/química
9.
J Int Soc Sports Nutr ; 16(1): 1, 2019 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-30646926

RESUMO

BACKGROUND: Research has demonstrated that low fermentable oligiosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diets improve gastrointestinal (GI) symptoms in irritable bowel syndrome sufferers. Exercise-related GI issues are a common cause of underperformance, with current evidence focusing on the use of FODMAP approaches with recreationally competitive or highly trained athletes. However, there is a paucity of research exploring the potential benefit of FODMAP strategies to support healthy, recreational athletes who experience GI  issues during training. This study therefore aimed to assess whether a short-term LOWFODMAP diet improved exercise-related GI symptoms and the perceived ability to exercise in recreational runners. METHODS: Sixteen healthy volunteers were randomly assigned in a crossover design manner to either a LOWFODMAP (16.06 ± 1.79 g·d- 1) or HIGHFODMAP (38.65 ± 6.66 g·d- 1) diet for 7 days, with a one week washout period followed by a further 7 days on the alternate diet. Participants rated their gastrointestinal symptoms on an adapted version of the Irritable Bowel Syndrome-Severity Scoring System (IBS-SSS) questionnaire before and at the end of each dietary period. Perceived ability to exercise (frequency, intensity and duration) in relation to each dietary period was also rated using a visual analogue scale. Resting blood samples were collected prior to and on completion of each diet to determine plasma intestinal fatty acid binding protein (I-FABP) as a marker of acute GI injury. RESULTS: Overall IBS-SSS score significantly reduced in the LOWFODMAP condition from 81.1 ± 16.4 to 31.3 ± 9.2 (arbitrary units; P = 0.004). Perceived exercise frequency (z = 2.309, P = 0.02) and intensity (z = 2.687, P = 0.007) was significantly improved following a short-term LOWFODMAP approach compared to HIGHFODMAP. No significant differences were reported between dietary conditions for plasma I-FABP (P > 0.05). CONCLUSIONS: A short-term LOWFODMAP diet under free-living conditions reduced exercise-related GI symptoms and improved the perceived ability to exercise in otherwise healthy, recreational runners. These findings may be explained by a reduction in indigestible carbohydrates available for fermentation in the gut. The therapeutic benefits of LOWFODMAP diets in recreational and trained athletes during sustained training periods warrants further investigation.


Assuntos
Dieta , Carboidratos da Dieta/administração & dosagem , Exercício Físico , Gastroenteropatias/prevenção & controle , Adulto , Atletas , Estudos Cross-Over , Dissacarídeos/administração & dosagem , Feminino , Fermentação , Trato Gastrointestinal/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Monossacarídeos/administração & dosagem , Corrida , Fenômenos Fisiológicos da Nutrição Esportiva
10.
An Pediatr (Barc) ; 90(3): 180-186, 2019 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-29685830

RESUMO

INTRODUCTION: The low FODMAP diet (fermentable oligosaccharides, monosaccharides, disaccharides, and polyols) has shown to be effective in adult patients with irritable bowel syndrome, but there are few studies on paediatric patients. The aim of this study is to assess the implementation and the outcomes of a low FODMAP diet in the treatment of functional abdominal pain in children from a Mediterranean area. MATERIAL AND METHODS: A table was designed in which foods were classified according to their FODMAP content, as well as a 'Symptoms and Stools Diary'. A prospective study was conducted on children with functional abdominal pain in our Paediatric Gastroenterology Unit. RESULTS: A total of 22 patients were enrolled in the trial, and 20 completed it. Data were collected of the abdominal pain features over a period of 3 days, and then patients followed a two-week low FODMAP diet. Afterwards, information about abdominal pain features was collected again. After the diet, they showed fewer daily abdominal pain episodes compared to baseline (1.16 [IQR: 0.41-3.33] versus 2 [IQR: 1.33-6.33] daily episodes, P=.024), less pain severity compared to baseline (1.41cm [IQR: 0.32-5.23] versus 4.63cm [IQR: 2.51-6.39] measured by 10-cm Visual Analogue Scale, P=.035), less interference with daily activities, and less gastrointestinal symptoms. Only 15% of patients found it difficult to follow the diet. CONCLUSIONS: The implementation of a low FODMAP diet for 2 weeks in a Mediterranean paediatric population diagnosed with functional abdominal pain is possible with adapted diets. It was highly valued by patients, and they showed an improvement in abdominal pain symptoms assessed by objective methods.


Assuntos
Dor Abdominal/dietoterapia , Dissacarídeos/administração & dosagem , Monossacarídeos/administração & dosagem , Oligossacarídeos/administração & dosagem , Polímeros/administração & dosagem , Criança , Feminino , Fermentação , Humanos , Masculino , Medição da Dor , Estudos Prospectivos , Resultado do Tratamento
11.
Nutr Hosp ; 35(6): 1450-1466, 2018 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-30525861

RESUMO

This paper summarizes the contents of a consensus document on exclusion diets in irritable bowel disease that was developed by a task force from SEPD, FEAD, SENPE, FESNAD, SEÑ, SEEN, SEGHNP, SEDCA and ADENYD. The complete document is available at the FEAD and in SENPE websites. Irritable bowel syndrome is a highly prevalent functional digestive disorder where, in addition to drugs, therapy includes diet and acquisition of healthy habits as basic elements for its control. In order to facilitate dietary counseling for these patients in daily practice, the present consensus document on the role of exclusion diets was developed. To this end, consensus opinions were collected from various experts in the national scientific societies aiming at establishing recommendations applicable to the health care of patients with irritable bowel syndrome.


Assuntos
Consenso , Dieta , Síndrome do Intestino Irritável/dietoterapia , Dieta Livre de Glúten , Carboidratos da Dieta/metabolismo , Gorduras na Dieta/metabolismo , Proteínas na Dieta/metabolismo , Fermentação , Microbioma Gastrointestinal , Humanos , Lactose/administração & dosagem , Monossacarídeos/administração & dosagem , Oligossacarídeos/administração & dosagem , Educação de Pacientes como Assunto
12.
Nutrients ; 10(11)2018 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-30445688

RESUMO

Our aim was to evaluate the intake of foods containing fermentable oligo/di/mono-saccharides and polyols (FODMAP) as a possible factor that induces gastrointestinal symptoms in treated celiac disease (CD) patients. We collected seven-day weighed food records for 104 CD patients and 91 healthy volunteers. All evaluated food items were from sources with high and low content of FODMAP, which were divided into cereals and sweets, sweeteners and soft drinks, fruits, dried fruits, and vegetables. Nutrient intake was calculated using the food database of the European Institute of Oncology. The symptoms reported were assessed by a Rome IV Irritable bowel syndrome (IBS) diagnostic questionnaire and by specific questions for the evaluation of functional gastrointestinal disorders (FGIDs). The 12% of CD patients met IBS symptoms criteria as opposed to 6% of controls (p = 0.09) and 27% of patients reported FGIDs symptoms vs. 22% of healthy controls (p = 0.42). The intake by CD patients was significantly higher than healthy volunteers for: sweeteners and sugars with low content of FODMAP (p = 0.0007), fruits, dried fruits, and vegetables high in FODMAP (p = 0.003) and low in FODMAP (p = 0.04) when compared to controls. CD patients had a lower intake of cereals and sweets with a high content of FODMAP (p = 0.00001). Healthy volunteers consumed significantly higher alcoholic beverages and fats high in FODMAP (both p < 0.044). The mean daily intake of other food categories did not differ between both groups. Even though CD patients had a low intake of gluten-free cereals high in FODMAP, they still consumed a significant amount of fruits and vegetables high in FODMAP. The clinical effect of a concomitant gluten-free diet and low-FODMAP diet should be prospectively evaluated as a supportive therapy in CD patients.


Assuntos
Doença Celíaca/dietoterapia , Dieta Livre de Glúten/efeitos adversos , Açúcares da Dieta/efeitos adversos , Gastroenteropatias/etiologia , Síndrome do Intestino Irritável/etiologia , Adulto , Registros de Dieta , Dieta Livre de Glúten/métodos , Açúcares da Dieta/administração & dosagem , Açúcares da Dieta/análise , Dissacarídeos/administração & dosagem , Dissacarídeos/efeitos adversos , Dissacarídeos/análise , Ingestão de Energia , Feminino , Fermentação , Frutas/química , Humanos , Masculino , Monossacarídeos/administração & dosagem , Monossacarídeos/efeitos adversos , Monossacarídeos/análise , Oligossacarídeos/administração & dosagem , Oligossacarídeos/efeitos adversos , Oligossacarídeos/análise , Estudos Retrospectivos , Verduras/química
13.
Aliment Pharmacol Ther ; 48(10): 1061-1073, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30306603

RESUMO

BACKGROUND: Therapeutic diets for infantile colic lack evidence. In breastfed infants, avoiding "windy" foods by the breastfeeding mother is common. AIM: To examine the effects of a maternal low-FODMAP (Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, And Polyols) diet compared to a typical-Australian diet on infant crying-fussing durations of infants with colic in a randomised, double-blind, crossover feeding study. METHODS: Between 2014 and 2016 exclusively breastfed infants aged ≤9 weeks meeting Wessel criteria for colic were recruited. Mothers were provided a 10-day low-FODMAP or typical-Australian diet, then alternated without washout. Infants without colic (controls) were observed prospectively and mothers remained on habitual diet. Infant crying-fussing durations were captured using a Barr Diary. Measures of maternal psychological status and samples of breast milk and infant faeces were collected. RESULTS: Mean crying-fussing durations were 91 min/d in seven controls compared with 269 min/d in 13 colicky infants (P < 0.0001), which fell by median 32% during the low-FODMAP diet compared with 20% during the typical-Australian diet (P = 0.03), confirmed by a two-way mixed-model analyses-of-variance (ƞp 2  = 0.719; P = 0.049) with no order effect. In breast milk, lactose concentrations remained stable and other known dietary FODMAPs were not detected. Changes in infant faecal calprotectin were similar between diets and groups, and faecal pH did not change. Median maternal anxiety and stress fell with the typical-Australian diet (P < 0.01), but remained stable on the low-FODMAP diet. CONCLUSIONS: Maternal low-FODMAP diet was associated with enhanced reduction in crying-fussing durations of infants with colic. This was not related to changes in maternal psychological status, gross changes in breast milk or infant faeces. Mechanisms require elucidation. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR): 12616000512426 - anzctr.org.au.


Assuntos
Aleitamento Materno/métodos , Cólica/dietoterapia , Cólica/diagnóstico , Dieta com Restrição de Carboidratos/métodos , Adulto , Austrália/epidemiologia , Aleitamento Materno/tendências , Cólica/epidemiologia , Estudos Cross-Over , Dieta com Restrição de Carboidratos/tendências , Dissacarídeos/administração & dosagem , Dissacarídeos/efeitos adversos , Método Duplo-Cego , Feminino , Humanos , Lactente , Recém-Nascido , Complexo Antígeno L1 Leucocitário , Masculino , Monossacarídeos/administração & dosagem , Monossacarídeos/efeitos adversos , Oligossacarídeos/administração & dosagem , Oligossacarídeos/efeitos adversos
14.
Dig Dis Sci ; 63(2): 429-436, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29302878

RESUMO

BACKGROUND: A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) may relieve symptoms of irritable bowel syndrome (IBS). However, nutritional counseling is resource-demanding and not all patients will benefit. AIMS: To explore whether gut microbial composition may identify symptom response to a low-FODMAP diet in patients with IBS. METHODS: Patients were recruited consecutively to participate in a 4-week FODMAP-restricted diet. Response to diet was defined as ≥ 50% decrease in IBS symptom severity scores (IBS-SSS) compared to baseline. Fecal microbiota were analyzed by a commercially available method (the GA-map™ Dysbiosis Test), assessing 54 bacterial markers targeting more than 300 bacteria at different taxonomic levels. RESULTS: Sixty-one patients (54 F; 7 M) were included: 32 (29 F; 3 M) classified as responders and 29 (25 F; 4 M) as non-responders. Ten of the 54 bacterial markers differed significantly between responders and non-responders. Based on median values (used as cutoff) of responders for these 10 bacterial markers, we constructed a Response Index (RI): Each patient was given a point when the value for each selected bacterial marker differed from the cutoff. These points were summed up, giving an RI from 0 to 10. Patients with RI > 3 were 5 times more likely to respond (OR = 5.05, 95% CI [1.58; 16.10]), and the probability to respond was 83.4%, 95% CI [61.2-94%]. CONCLUSIONS: Gut microbial composition, assessed by using a new RI, may constitute a tool to identify patients that are likely to respond to dietary FODMAP restriction.


Assuntos
Bactérias/classificação , Dieta , Carboidratos da Dieta/administração & dosagem , Microbioma Gastrointestinal , Síndrome do Intestino Irritável/microbiologia , Adulto , Idoso , Dissacarídeos/administração & dosagem , Dissacarídeos/química , Dissacarídeos/metabolismo , Fezes/microbiologia , Feminino , Fermentação , Humanos , Masculino , Pessoa de Meia-Idade , Monossacarídeos/administração & dosagem , Monossacarídeos/química , Monossacarídeos/metabolismo , Oligossacarídeos/administração & dosagem , Oligossacarídeos/química , Oligossacarídeos/metabolismo , Polímeros/administração & dosagem , Polímeros/química , Polímeros/metabolismo , Adulto Jovem
15.
Nutrition ; 45: 24-31, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29129233

RESUMO

OBJECTIVES: The aim of this review was to systematically assess and meta-analyze the effects of a low fermentable, oligo-, di-, mono-saccharides and polyol (FODMAP) diet (LFD) on the severity of symptoms, quality of life, and safety in patients with irritable bowel syndrome (IBS). METHODS: The MEDLINE/PubMed, Scopus, and Cochrane Library databases were screened through January 19, 2016. Randomized controlled trials (RCTs) that compared LFD to other diets were included if they assessed symptoms of IBS or abdominal pain in patients with IBS. Safety, quality of life, anxiety, depression, and effect on gut microbiota were defined as secondary outcomes. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated. RESULTS: Nine RCTs with a total of 596 subjects were included. Three RCTs compared LFD with a habitual diet, two RCTs provided all meals and compared LFD with a western diet, one RCT each compared LFD with a diet high in FODMAPs or a sham diet, and two RCTs compared with other diet recommendations for IBS. A meta-analysis revealed significant group differences for LFD compared with other diets with regard to gastrointestinal symptoms (SMD = -0.62; 95% CI = -0.93 to -0.31; P = 0.0001), abdominal pain (SMD = -0.50; 95% CI = -0.77 to -0.22; P = 0.008), and health-related quality of life (SMD = 0.36; 95% CI = 0.10-0.62; P = 0.007). Three studies reported a significant reduction in luminal bifidobacteria after LFD. Adverse events were assessed in three RCTs only and no intervention-related adverse events were reported. CONCLUSIONS: This meta-analysis found evidence of the short-term efficacy and safety of LFD in patients with IBS. However, only a preliminary recommendation for LFD can be made until long-term effects are investigated.


Assuntos
Dieta com Restrição de Carboidratos , Fermentação , Síndrome do Intestino Irritável/dietoterapia , Polímeros/administração & dosagem , Polímeros/química , Dor Abdominal , Dissacarídeos/administração & dosagem , Dissacarídeos/química , Microbioma Gastrointestinal , Trato Gastrointestinal/metabolismo , Trato Gastrointestinal/microbiologia , Humanos , Monossacarídeos/administração & dosagem , Monossacarídeos/química , Oligossacarídeos/administração & dosagem , Oligossacarídeos/química , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
16.
J Gastroenterol Hepatol ; 33(6): 1192-1199, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29159993

RESUMO

BACKGROUND AND AIM: Recent evidence indicates that new approach of the diet with low fermentable oligo-di-mono-saccharides and polyols (FODMAPs) may have an effective role in management of the patients with irritable bowel syndrome (IBS). We compared the results of low FODMAP diet with current dietary treatment, general dietary advices (GDA), on the clinical response in patients with diarrhea subtype of IBS (IBS-D). METHODS: In this randomized, controlled, single-blind trial, we included 110 patients with IBS-D in two intervention groups. Participants were randomly assigned to the low FODMAP diet (n = 55) and GDA (n = 55) for 6 weeks after a 10-day screening period. Gastrointestinal symptoms and bowel habit status were evaluated using a symptom severity scoring system and Bristol stool form scale pre-intervention and post-intervention. Patients completed 3-day food diary before and after the intervention. RESULTS: Of 110 patients, 101 completed the dietary interventions. At the baseline, the nutrient intake, severity of symptoms, and demographic data were similar between two groups. After 6 weeks, the low FODMAP diet improves significantly overall gastrointestinal symptoms scores, stool frequency, and consistency versus GDA group (P < 0.001, P < 0.001, and P = 0.003, respectively). Compared with the baseline, both intervention groups expressed a significant reduction in overall scores of symptom severity scoring system, abdominal pain, distension, consistency, and frequency, but this reduction is greater in low FODMAP diet group. CONCLUSIONS: Both low FODMAP diet and GDA in patients with IBS-D led to adequate improvement of gastrointestinal symptoms for 6 weeks. However, the low FODMAP diet has greater benefits in IBS improvement.


Assuntos
Diarreia/dietoterapia , Diarreia/etiologia , Dieta com Restrição de Carboidratos/métodos , Aconselhamento Diretivo , Dissacarídeos/administração & dosagem , Síndrome do Intestino Irritável/dietoterapia , Monossacarídeos/administração & dosagem , Polímeros/administração & dosagem , Adulto , Feminino , Fermentação , Humanos , Síndrome do Intestino Irritável/complicações , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Método Simples-Cego , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
17.
Nutr Neurosci ; 21(5): 337-340, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28276261

RESUMO

OBJECTIVE: The aim of this research is to evaluate if intake of 20% fructose solution is able to change the anorexigenic hypothalamic insulin action. METHODS: Thirty day-old male Wistar rats were randomly assigned to one of the following groups: standard chow and water for the rats (Control group, C) and standard chow and 20% fructose solution for the rats (Fructose group, F).These treatments lasted 8 weeks. Three-month-old rats from group C and F received insulin or saline intracerebroventricular injections for evaluation of 24 h food intake, phosphorylated forms of the IR (p-IR) and Akt (p-Akt) proteins and quantified hypothalamic insulin receptor (IR) and insulin receptor substrate 1 (IRS-1) proteins. RESULTS: Insulin injection was able to decrease food intake in group C compared to 0.9% saline. However, insulin infusion failed to inhibit 24 h food intake in group F compared to 0.9% saline. The hypothalamic content of the IRS-1 was 37% higher in group F as well as p-Akt protein was significant higher vs. group C. CONCLUSION: We concluded that the 20% fructose solution compromised insulin signaling considering that it inhibited the anorexigenic hypothalamic response to acute injection of this hormone and increase of IRS-1 and p-Akt content.


Assuntos
Frutose/administração & dosagem , Hipotálamo/fisiologia , Insulina/fisiologia , Monossacarídeos/administração & dosagem , Animais , Infusões Intraventriculares , Proteínas Substratos do Receptor de Insulina/genética , Proteínas Substratos do Receptor de Insulina/metabolismo , Masculino , Fosforilação , Proteínas Proto-Oncogênicas c-akt/genética , Proteínas Proto-Oncogênicas c-akt/metabolismo , Ratos , Ratos Wistar
18.
J Gastroenterol Hepatol ; 33(2): 365-374, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28700090

RESUMO

The low Fermentable Oligosaccharides, Disaccharides, and Monosaccharides And Polyols (FODMAP) diet has been described, evaluated, and found efficacious for the treatment of patients with irritable bowel syndrome primarily in Western countries. The aim of this review was to address the applicability of this diet to South Asia. The high prevalence of irritable bowel syndrome in South Asia and its associated effects of quality of life and economics warrant the introduction of efficacious therapies. The considerable heterogeneity of dietary patterns and methods of food preparation across South Asian countries and a paucity of food analysis limit precision in defining foods that are high or low in FODMAPs. Spices and condiments are commonly consumed and mostly have a low FODMAP content. However, major high FODMAP sources are frequently used and include onion, garlic, shallots, legumes/pulses, and wheat-based products, as well as coconut and milk products, offering an opportunity for dietary management to reduce the symptom load. The feasibility of instituting a restrictive diet in which foods with a high FODMAP content are replaced by foods low in FODMAPs must be addressed as a substantial proportion of the nutritional intake including energy, proteins, and micronutrients, is often obtained from FODMAP-rich food. Furthermore, limited knowledge of health professionals together with a paucity of dietitians further challenge the practicality of introducing the diet. Thus, while the use of the low FODMAP diet in South Asia may be more limited than in westernized countries, it does offer potential therapeutic opportunities, the efficacy, and impact of which require further investigation.


Assuntos
Dieta com Restrição de Carboidratos , Síndrome do Intestino Irritável/dietoterapia , Ásia Sudeste/epidemiologia , Carboidratos da Dieta/administração & dosagem , Dissacarídeos/administração & dosagem , Humanos , Síndrome do Intestino Irritável/epidemiologia , Monossacarídeos/administração & dosagem , Oligossacarídeos/administração & dosagem , Polímeros/administração & dosagem , Prevalência
19.
Curr Opin Clin Nutr Metab Care ; 20(6): 456-463, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28872467

RESUMO

PURPOSE OF REVIEW: The aim is to review the most recent advances in the evidence supporting the use of various dietary interventions for the management of irritable bowel syndrome (IBS). RECENT FINDINGS: There is insufficient evidence of the effect of fibres other than psyllium in IBS, whereas the recent studies on prebiotics suggest a limited effect in IBS. Recent probiotic trials continue to provide varying results, with some probiotic strains exhibiting beneficial effects, whereas others show no effect. Recent trials have also confirmed the clinical effectiveness of a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (i.e. low FODMAP diet) in IBS. Although gluten sensitivity has also been recently investigated, its presence cannot be confirmed yet because of the presence of other potential contributing compounds in wheat. Studies also suggest a potential beneficial effect of peppermint oil, which warrants further research. SUMMARY: It is clear that a low FODMAP diet has a beneficial effect in a majority of patients with IBS. Probiotics also have great potential in the management of IBS; however, it is still unclear which strains and doses are the most beneficial. Further research is needed on the effect of different fibres, or combinations of fibres, in IBS.


Assuntos
Dieta , Síndrome do Intestino Irritável/dietoterapia , Dieta Livre de Glúten , Fibras na Dieta/administração & dosagem , Dissacarídeos/administração & dosagem , Humanos , Metanálise como Assunto , Monossacarídeos/administração & dosagem , Oligossacarídeos/administração & dosagem , Óleos Vegetais/administração & dosagem , Prebióticos/administração & dosagem , Probióticos/administração & dosagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Triticum/química , Hipersensibilidade a Trigo/diagnóstico , Hipersensibilidade a Trigo/dietoterapia
20.
Int J Mol Med ; 40(4): 943-952, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28849091

RESUMO

Irritable bowel syndrome (IBS) is a common chronic gastrointestinal (GI) disorder that is characterized by a combination of abdominal pain or discomfort, bloating and alterations in bowel movements. This review presents recent developments concerning the roles of diet and GI endocrine cells in the pathophysiology of IBS and of individual dietary guidance in the management of IBS. Patients with IBS typically report that food aggravates their IBS symptoms. The interactions between specific types of foodstuffs rich in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) and GI endocrine cells induce changes in cell densities. Providing individual dietary guidance about a low FODMAP intake, high soluble­fiber intake, and changing the proportions of protein, fat and carbohydrates helps to reduce the symptoms experienced by patients with IBS and to improve their quality of life. These improvements are due to restoring the densities of the GI endocrine cells back to normal. The reported observations emphasize the role of GI endocrine cells in the pathophysiology of IBS and support the provision of dietary guidance as a first-line treatment for managing IBS.


Assuntos
Carboidratos da Dieta/administração & dosagem , Fibras na Dieta/administração & dosagem , Células Enteroendócrinas/metabolismo , Síndrome do Intestino Irritável/dietoterapia , Recomendações Nutricionais , Contagem de Células , Dieta/métodos , Carboidratos da Dieta/metabolismo , Fibras na Dieta/metabolismo , Dissacarídeos/administração & dosagem , Dissacarídeos/metabolismo , Células Enteroendócrinas/efeitos dos fármacos , Células Enteroendócrinas/patologia , Fermentação , Hormônios Gastrointestinais/genética , Hormônios Gastrointestinais/metabolismo , Regulação da Expressão Gênica , Humanos , Síndrome do Intestino Irritável/genética , Síndrome do Intestino Irritável/metabolismo , Síndrome do Intestino Irritável/fisiopatologia , Monossacarídeos/administração & dosagem , Monossacarídeos/metabolismo , Oligossacarídeos/administração & dosagem , Oligossacarídeos/metabolismo , Qualidade de Vida
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA