RESUMO
Hematopoietic stem cell transplantation (HCT) survivors are burdened by a high prevalence and early onset of chronic diseases. Healthy dietary patterns have been associated with lower risks of chronic health conditions in the general population. HCT survivors are susceptible to multiple complications that may result in chronic illness. Unfortunately, no study to date has comprehensively documented the adherence of HCT survivors to the Dietary Guidelines for Americans (DGA), which are designed specifically to provide guidance for making healthy food choices. The primary aim of this study was to evaluate diet quality and nutrient intake adequacy of HCT survivors. A secondary aim was to assess these survivors' willingness to take part in a future dietary intervention. The dietary intake of adults who had undergone autologous or allogeneic HCT for a hematologic disease and were at least 1 year post-transplantation was assessed using the Block 2014 food frequency questionnaire, and diet quality was estimated using the Healthy Eating Index 2015. Nutrient intake adequacies of the group were estimated by the estimated average requirement cutpoint method. Survivors' (n = 90) HEI-2015 scores averaged 61.6 ± 1.1. Adherence to a good-quality diet was reported by only 10% of survivors. Intakes of vitamins A, C, and D, as well as magnesium and calcium, suggested inadequacy. Fiber intake at 8.9 g per 1000 kcal/day fell below the recommended adequate intake. "Change in taste" was associated with lower quality of diet (P = .02). HCT survivors within 2 years post-transplantation were more receptive than survivors beyond 2 years to participating in a dietary intervention (95% versus 65%; P = .0013). Adult HCT survivors reported less-than-optimal adherence to the 2015-2020 DGA and had numerous shortfall nutrient intakes; however, their willingness to participate in a dietary intervention was relatively high. These findings reinforce the need to incorporate nutrition into HCT survivor care.
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Dieta , Transplante de Células-Tronco Hematopoéticas , Adulto , Ingestão de Alimentos , Ingestão de Energia , Humanos , SobreviventesRESUMO
Research has explored the link between exposure to marketing of foods high in energy and low in nutrients, and obesity in Western countries. The prevalence of obesity in Arab Gulf countries is similar to that of Western countries, yet the influence of advertising and frequency of exposure to advertising of foods on subsequent food choices and health is largely unexplored. This project sought to examine the number and quality of foods advertised on television during Ramadan in Arab Gulf countries. Television programming (36 h total), 12 h each for three stations, Alwatan, Dubai and MBC, was recorded. Food and restaurant advertisements (ads) were classified, totaled and analysed for dietary healthfulness using the Model SSCg3d. Of the total ads aired (n = 1473), food and restaurant ads were the most common (20.4%). The ad type and frequency varied among channels with restaurant ads most common on Alwatan, drinks and soda ads on Dubai, and sweet snacks and desserts ads on MBC (p < 0.001). Channels also differed regarding the frequency of dairy food ads (p < 0.001). Most food ads promoted less healthy foods similar to marketing practices in other countries with high rates of obesity. Many ads promoted foods high in energy, saturated fat, sodium and added sugar. This work signals the need to further understand the relationship between advertising of nutrient-poor foods, food behaviours and obesity in Arab Gulf countries and how advertising regulations may address this public health issue.
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Publicidade , Árabes , Bebidas , Alimentos , Indústria Alimentícia , Humanos , Valor Nutritivo , Lanches , TelevisãoRESUMO
The high prevalence of constipation in long-term care (LTC) residents has been a long-standing issue for caregivers, attending health professionals, and the residents themselves. The traditional medical response has been to utilize pharmaceutical laxatives, enemas, and suppositories for treatment. The purpose of this review was to determine if fibre supplementation (including fibre added to foods) is effective in increasing stool frequency, improving stool consistency, and decreasing laxative use in LTC residents. A systematic search was conducted using PubMed and CINAHL databases, inclusive to March 2017. Search terms included: "long-term care" or "nursing home" AND "fiber (fibre)," "bran," "psyllium," "inulin," or "prebiotic." Intervention trials of fibre supplementation with ≥5 LTC residents were included. The search generated 456 articles following removal of duplicates; 8 studies met the inclusion criteria. Three additional trials were identified through a hand search of references of pertinent articles. Current evidence suggests that added fibre may be effective in increasing stool frequency and/or decreasing laxative use in LTC residents and, thus, may lessen the burden of constipation. However, randomized controlled trials are needed to clearly demonstrate the effects of adding fibre to foods, particularly insoluble and less fermentable sources, on constipation in LTC residents.
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Constipação Intestinal/terapia , Fibras na Dieta/administração & dosagem , Laxantes/administração & dosagem , Assistência de Longa Duração/métodos , Canadá/epidemiologia , Constipação Intestinal/epidemiologia , Constipação Intestinal/etiologia , Suplementos Nutricionais , Humanos , Estado Nutricional , Qualidade de VidaRESUMO
Although fiber is well recognized for its effect on laxation, increasing evidence supports the role of fiber in the prevention and treatment of chronic disease. The aim of this review is to provide an overview of the health benefits of fiber and its fermentation, and describe how the products of fermentation may influence disease risk and treatment. Higher fiber intakes are associated with decreased risk of cardiovascular disease, type 2 diabetes, and some forms of cancer. Fiber may also have a role in lowering blood pressure and in preventing obesity by limiting weight gain. Fiber is effective in managing blood glucose in type 2 diabetes, useful for weight loss, and may provide therapeutic adjunctive roles in kidney and liver disease. In addition, higher fiber diets are not contraindicated in inflammatory bowel disease or irritable bowel syndrome and may provide some benefit. Common to the associations with disease reduction is fermentation of fiber and its potential to modulate microbiota and its activities and inflammation, specifically the production of anti-inflammatory short chain fatty acids, primarily from saccharolytic fermentation, versus the deleterious products of proteolytic activity. Because fiber intake is inversely associated with all-cause mortality, mechanisms by which fiber may reduce chronic disease risk and provide therapeutic benefit to those with chronic disease need further elucidation and large, randomized controlled trials are needed to confirm causality.Teaching Points⢠Strong evidence supports the association between higher fiber diets and reduced risk of cardiovascular disease, type 2 diabetes, and some forms of cancer.⢠Higher fiber intakes are associated with lower body weight and body mass index, and some types of fiber may facilitate weight loss.⢠Fiber is recommended as an adjunctive medical nutritional therapy for type 2 diabetes, chronic kidney disease, and certain liver diseases.⢠Fermentation and the resulting shifts in microbiota composition and its activity may be a common means by which fiber impacts disease risk and management.
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Fibras na Dieta/administração & dosagem , Alimentos Fermentados , Doença Crônica/prevenção & controle , Fermentação , HumanosRESUMO
PURPOSE: It is commonly suggested that calcium supplementation contributes to constipation; however, little research has explored the effects of calcium supplementation on gut motility. METHODS: In an 8-week, randomized, double-blind, crossover pilot study, healthy females (n = 27, aged 43.0 ± 10.6 years) received a split dose of 500 mg/d of elemental calcium from calcium carbonate or calcium phosphate each for 2 weeks, after a 2-week baseline and separated by a 2-week washout. Participants completed daily questionnaires of stool frequency, Bristol Stool Form Scale (BSFS), and supplement intake compliance. RESULTS: There were no differences among periods. Mean ± SE stool frequency averaged 1.3 ± 0.1 stools/d in each period. Participants reported 34%, 34%, 37%, and 29% of stools were indicative of slow transit or constipation (BSFS of 1 or 2) during baseline, calcium carbonate, calcium phosphate, and washout periods, respectively. Participants also reported from 6% to 10% of stools as fast transit or diarrhea (BSFS of 6 or 7) during the periods. CONCLUSION: This study suggests that neither calcium carbonate nor calcium phosphate, providing 500 mg/d of calcium, affects stool frequency or form. Although stool frequency was normal, the healthy females participating in the study experienced stools indicating slow (constipation) and fast (diarrhea) transit.
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Cálcio da Dieta/administração & dosagem , Cálcio da Dieta/efeitos adversos , Constipação Intestinal/diagnóstico , Suplementos Nutricionais , Adulto , Índice de Massa Corporal , Carbonato de Cálcio/administração & dosagem , Carbonato de Cálcio/efeitos adversos , Fosfatos de Cálcio/administração & dosagem , Fosfatos de Cálcio/efeitos adversos , Constipação Intestinal/etiologia , Estudos Cross-Over , Relação Dose-Resposta a Droga , Método Duplo-Cego , Fezes/química , Feminino , Voluntários Saudáveis , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Inquéritos e QuestionáriosRESUMO
Acute psychological stress is positively associated with a cold/flu. The present randomised, double-blind, placebo-controlled study examined the effect of three potentially probiotic bacteria on the proportion of healthy days over a 6-week period in academically stressed undergraduate students (n 581) who received Lactobacillus helveticus R0052, Bifidobacterium longum ssp. infantis R0033, Bifidobacterium bifidum R0071 or placebo. On each day, participants recorded the intensity (scale: 0 = not experiencing to 3 = very intense) for nine cold/flu symptoms, and a sum of symptom intensity >6 was designated as a day of cold/flu. B. bifidum resulted in a greater proportion of healthy days than placebo (P≤ 0·05). The percentage of participants reporting ≥ 1 d of cold/flu during the 6-week intervention period was significantly lower with B. bifidum than with placebo (P< 0·05). There were no effects of B. infantis or L. helveticus compared with placebo on either outcome. A predictive model accounted for influential characteristics and their interactions on daily reporting of cold/flu episodes. The proportion of participants reporting a cold on any given day was lower at weeks 2 and 3 with B. bifidum and B. infantis than with placebo for the average level of stress and the most commonly reported number of hours of sleep. Daily intake of bifidobacteria provides benefit related to cold/flu outcomes during acute stress.
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Bifidobacterium , Nível de Saúde , Influenza Humana/prevenção & controle , Probióticos/administração & dosagem , Estresse Psicológico/imunologia , Estudantes/psicologia , Índice de Massa Corporal , Método Duplo-Cego , Feminino , Humanos , Influenza Humana/epidemiologia , Influenza Humana/imunologia , Lactobacillus helveticus , Masculino , Placebos , Adulto JovemRESUMO
OBJECTIVE: To determine the effects of supplemental fiber on plasma p-cresol, stool frequency, and quality of life (QoL) in chronic kidney disease (CKD) patients. DESIGN AND SETTING: In a 12-week single-blind study, participants were provided with control muffins and supplements (5.5 g sucrose/day) for 2 weeks, muffins containing 10 g/day pea hull fiber and control supplements for 4 weeks, and muffins with 10 g/day pea hull fiber and 15 g/day inulin as a supplement for 6 weeks. SUBJECTS: Individuals with CKD (n = 13; 6 males, 7 females; aged 65 ± 3 years; estimated glomerular filtration rate <50 mL/minute/1.73(2)) completed the study. MAIN OUTCOME MEASURES: Plasma p-cresol was determined by gas chromatography-mass spectrometry, stool frequency by 5-day journals, and QoL by the KDQOL-36™. RESULTS: Plasma p-cresol decreased from 7.25 ± 1.74 mg/L during week 1 to 5.82 ± 1.72 mg/L during week 12 (P < .05), and in participants with high compliance (>70% inulin intake), from 6.71 ± 1.98 mg/L to 4.22 ± 1.16 mg/L (P < .05). Total fiber intake increased from 16.6 ± 1.7 g/day during control to 26.5 ± 2.4 g/day (P < .0001) with the added pea hull and to 34.5 ± 2.2 g/day with pea hull and inulin (P < .0001). Stool frequency increased from 1.4 ± 0.2 stools/day during control to 1.9 ± 0.3 stools/day during both fiber periods (P < .05). No change in overall QoL was observed. CONCLUSIONS: Supplementing the diet of CKD patients with fiber may be a dietary therapy to reduce p-cresol and improve stool frequency.
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Cresóis/sangue , Fibras na Dieta/administração & dosagem , Insuficiência Renal Crônica/sangue , Idoso , Defecação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Uremia/sangue , Uremia/prevenção & controleRESUMO
PURPOSE: Although puréed foods are commonly recommended for individuals with dysphagia and the acceptability of these foods is often a concern, few sensory studies on puréed foods have been carried out. The aim of this study was to evaluate the impact of serving style (i.e., scooped vs molded), on identification and acceptability of puréed foods in younger and older adults. METHODS: Acceptability of scooped versus molded puréed meats and vegetables was evaluated using the hedonic general Labeled Magnitude Scale. The younger adult panelists (n = 97; 55 F, 42 M) were recruited from the University of Florida staff and students, and the older adult panelists (n = 70; 59 F, 11 M) were recruited from the community. RESULTS: The younger panelists correctly identified a higher percentage of puréed foods than did the older panelists. Scooped puréed foods were more acceptable than molded. CONCLUSIONS: The results suggest that puréed foods may be more acceptable and identifiable when served without molding for both younger and older adults.
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Envelhecimento , Transtornos de Deglutição/dietoterapia , Preferências Alimentares , Alimentos Especializados/efeitos adversos , Alimentos Congelados/efeitos adversos , Adulto , Idoso , Fenômenos Químicos , Feminino , Florida , Manipulação de Alimentos , Alimentos Especializados/análise , Alimentos Congelados/análise , Humanos , Masculino , Produtos da Carne/efeitos adversos , Produtos da Carne/análise , Fenômenos Mecânicos , Sensação , Verduras/efeitos adversos , Verduras/químicaRESUMO
PURPOSE: Consumption of pulses is recommended to improve diet quality and decrease the risk of chronic disease. However, their constituent α-galactosides, including raffinose, are commonly thought to contribute to unpleasant gastrointestinal symptoms. METHODS: Using a random crossover design, healthy adults (n = 12) received control foods, control foods with 5 g raffinose, and foods with 200 g of canned chickpea (11 g fibre per day), each for three weeks following a 3-day diet rotation. Gastrointestinal symptoms (rating 0 = none to 3 = severe), compliance, and stool frequency were recorded daily. RESULTS: No change in daily stool frequency (mean ± SD) was found with chickpea (1.7 ± 0.3) or raffinose (1.7 ± 0.4) compared with control (1.5 ± 0.3). Reported flatulence (mean ± SD) was rated higher with chickpea (1.0 ± 0.2, P < 0.001) and raffinose (0.7 ± 0.2, P < 0.001) compared with control (0.4 ± 0.1). Although bloating was infrequent, ratings were higher with chickpea (0.2 ± 0.1, P < 0.001) and raffinose (0.3 ± 0.1, P < 0.001) compared with control (0.0). No differences were found for diarrhea or abdominal pain. CONCLUSIONS: As gastrointestinal symptoms were mild for most participants, canned chickpea may be a feasible way of increasing pulse intake and improving overall diet quality.
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Cicer/efeitos adversos , Alimentos em Conserva/efeitos adversos , Alimento Funcional/efeitos adversos , Mucosa Gástrica/fisiopatologia , Gastroenterite/etiologia , Trato Gastrointestinal/fisiopatologia , Sementes/efeitos adversos , Adolescente , Adulto , Estudos Cross-Over , Fibras na Dieta/efeitos adversos , Feminino , Flatulência/etiologia , Mucosa Gástrica/imunologia , Gastroenterite/imunologia , Gastroenterite/fisiopatologia , Trato Gastrointestinal/imunologia , Humanos , Masculino , Cooperação do Paciente , Rafinose/efeitos adversos , Índice de Gravidade de Doença , Método Simples-Cego , Adulto JovemRESUMO
Extra virgin olive oil (EVOO) is thought to contribute to neuroprotection and, thus, may influence pain symptoms experienced by adults with demyelination-related trigeminal neuralgia (TN). This study aimed to determine the feasibility of daily intake of EVOO and its potential to alleviate facial pain of TN. Adults, self-reporting as female and affected by TN, were enrolled in a 16-week nonblinded, parallel study. After a 4-week baseline, participants were randomized to 60 mL/day EVOO or control (usual diet and no supplemental EVOO) for 12 weeks. Participants completed a daily questionnaire on pain intensity and compliance, the Penn Facial Pain Scale weekly, the 36-Item Short Form Survey monthly, and dietary assessment during baseline and intervention. Participants (n = 52; 53.3 ± 12.9 years) were recruited nationally; 42 completed the study. The EVOO group, with 90% intake compliance, showed significant decreases in the Penn Facial Pain Scale items of interference with general function, interference with orofacial function, and severity of pain from baseline, whereas the control group showed no improvements. EVOO benefit, compared with control, trended for the interference with orofacial function (P = .05). The 36-Item Short Form Survey items of role limitations resulting from emotional problems and role limitations from physical health favored EVOO. The EVOO group significantly improved their Healthy Eating Index 2015 component scores of fatty acids (primarily from increased oleic acid), sodium, and refined grains. EVOO intake of 60 mL/day was feasible for participants experiencing TN and may mitigate pain and improve quality of life. This trial was registered at clinicaltrials.gov (NCT05032573).
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Neuralgia do Trigêmeo , Adulto , Humanos , Feminino , Azeite de Oliva , Projetos Piloto , Qualidade de Vida , Dor Facial/prevenção & controleRESUMO
OBJECTIVE: To determine the effect of foods with added fiber on blood urea nitrogen (BUN) and serum creatinine concentrations in patients with chronic kidney disease (CKD). DESIGN: Participants were enrolled in a 6-week single-blind crossover study. SETTING: Free living with partial dietary intervention. PATIENTS: Thirteen CKD patients with Modification of Diet in Renal Disease formula-based estimated glomerular filtration rate (eGFR) ≤50 mL/minute/1.73 m(2) at the time of screening (5 men, 8 women; mean age, 67.0 ± 14.8 years) completed the study. INTERVENTION: Patients consumed control foods (cereal, cookies, and bars) providing 1.6 g/day fiber daily for 2 weeks, followed by similar foods providing 23 g/day fiber daily for 4 weeks, incorporated into their usual diets. MAIN OUTCOME: The main outcome of the study was the determination of the impact of foods with added fiber on BUN and serum creatinine levels. RESULTS: Consuming foods with added fiber resulted in a 10.6% decrease in mean BUN concentration (13.8 ± 2.0 to 12.1 ± 1.8 mmol/L or 38.5 ± 5.6 to 34.0 ± 5.1 mg/dL; P < .05). Serum creatinine level decreased from a baseline value of 216 ± 26 to 201 ± 23 mmol/L (2.44 ± 0.30 to 2.27 ± 0.26 mg/dL; P < .05) after 2 weeks of fiber-containing food consumption, and remained significantly lower at 195 ± 23 mmol/L (2.21 ± 0.26 mg/dL) after 4 weeks of the intervention (P < .05). Calculated eGFR increased from a baseline value of 29.6 ± 3.5 to 31.4 ± 3.8 mL/minute/1.73 m(2) at the end of 2 weeks, and remained higher at 32.5 ± 3.6 mL/minute/1.73 m(2) after 4 weeks of fiber intervention (P < .05). CONCLUSION: We conclude that increasing fiber intake in CKD patients through the consumption of foods with added fiber may reduce serum creatinine levels and improve eGFR. Additional studies are warranted to confirm these findings and to determine whether the changes are due to direct effects on kidney function.
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Creatinina/sangue , Fibras na Dieta/administração & dosagem , Insuficiência Renal Crônica/sangue , Idoso , Idoso de 80 Anos ou mais , Nitrogênio da Ureia Sanguínea , Estudos Cross-Over , Dieta , Feminino , Taxa de Filtração Glomerular/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Insuficiência Renal Crônica/fisiopatologia , Método Simples-CegoRESUMO
When examining gastrointestinal tolerance to nondigestible carbohydrates, a weekly vs. daily symptoms questionnaire may lessen participant burden. This secondary analysis examined the reliability and validity of the Gastrointestinal Symptom Rating Scale (GSRS) in healthy adults. The internal consistency reliability of the GSRS syndromes and a daily questionnaire (DQ) comparator were determined. The GSRS syndromes prediction of slow transit stool form was assessed by ROC analysis. The DQ (α = 0.76) and GSRS syndromes of constipation (α = 0.73; ω = 0.74), and diarrhea (α = 0.76; ω = 0.77) exhibited acceptable reliability, as did the GSRS overall (α = 0.76; ω = 0.87) but not the syndromes of abdominal pain (α = 0.54; ω = 0.54), reflux (α = 0.69; ω = 0.67), or indigestion (α = 0.64; ω = 0.67). The GSRS syndromes predicted slow transit stools (AUC = 0.855), and the GSRS items of stomach pain, nausea, flatus, constipation, and diarrhea were moderately correlated (ρ = 0.55-0.64; P < 0.001) with the corresponding DQ items. The GSRS may be useful to assess gastrointestinal tolerance and efficacy of nondigestible carbohydrates given its performance at predicting slow transit stools, suggestive of constipation.
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Background/Aims: Motility, stool characteristics, and microbiota composition are expected to modulate probiotics' passage through the gut but their effects on persistence after intake cessation remain uncharacterized. This pilot, open-label study aims at characterizing probiotic fecal detection parameters (onset, persistence, and duration) and their relationship with whole gut transit time (WGTT). Correlations with fecal microbiota composition are also explored. Methods: Thirty healthy adults (30.4 ± 13.3 years) received a probiotic (30 × 109 CFU/capsule/day, 2 weeks; containing Lactobacillus helveticus R0052, Lacticaseibacillus paracasei HA-108, Bifidobacterium breve HA-129, Bifidobacterium longum R0175, and Streptococcus thermophilus HA-110). Probiotic intake was flanked by 4-week washout periods, with 18 stool collections throughout the study. WGTT was measured using 80% recovery of radio-opaque markers. Results: Tested strains were detected in feces ~1-2 days after first intake and persistence after intake cessation was not significantly different for R0052, HA-108, and HA-129 (~3-6 days). We identified 3 WGTT subgroups within this population (named Fast, Intermediate, and Slow), which could be classified by machine learning with high accuracy based on differentially abundant taxa. On average, R0175 persisted significantly longer in the intermediate WGTT subgroup (~8.5 days), which was mainly due to 6 of the 13 Intermediate participants for whom R0175 persisted ≥ 15 days. Machine learning classified these 13 participants according to their WGTT cluster (≥ 15 days or < 5 days) with high accuracy, highlighting differentially abundant taxa potentially associated with R0175 persistence. Conclusion: These results support the notion that host-specific parameters such as WGTT and microbiota composition should be considered when designing studies involving probiotics, especially for the optimization of washout duration in crossover studies but also for the definition of enrollment criteria or supplementation regimen in specific populations.
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Background: Fiber is a potential therapeutic to suppress microbiota-generated uremic molecules. This study aimed to determine if fiber supplementation decreased serum levels of uremic molecules through the modulation of gut microbiota in adults undergoing hemodialysis. Methods: A randomized, double-blinded, controlled crossover study was conducted. Following a 1-week baseline, participants consumed muffins with added pea hull fiber (PHF) (15 g/d) and control muffins daily, each for 4 weeks, separated by a 4-week washout. Blood and stool samples were collected per period. Serum p-cresyl sulfate (PCS), indoxyl sulfate (IS), phenylacetylglutamine (PAG), and trimethylamine N-oxide (TMAO) were quantified by LC-MS/MS, and fecal microbiota profiled by 16S rRNA gene amplicon sequencing and specific taxa of interest by qPCR. QIIME 2 sample-classifier was used to discover unique microbiota profiles due to the consumption of PHF. Results: Intake of PHF contributed an additional 9 g/d of dietary fiber to the subjects' diet due to compliance. No significant changes from baseline were observed in serum PCS, IS, PAG, or TMAO, or for the relative quantification of Akkermansia muciniphila, Faecalibacterium prausnitzii, Bifidobacterium, or Roseburia, taxa considered health-enhancing. Dietary protein intake and IS (r = -0.5, p = 0.05) and slow transit stool form and PCS (r = 0.7, p < 0.01) were significantly correlated at baseline. PHF and control periods were not differentiated; however, using machine learning, taxa most distinguishing the microbiota composition during the PHF periods compared to usual diet alone were enriched Gemmiger, Collinsella, and depleted Lactobacillus, Ruminococcus, Coprococcus, and Mogibacteriaceae. Conclusion: PHF supplementation did not mitigate serum levels of targeted microbial-generated uremic molecules. Given the high cellulose content, which may be resistant to fermentation, PHF may not exert sufficient effects on microbiota composition to modulate its activity at the dose consumed.
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Oral nutrition supplements (ONS) are widely recommended for the management of unintentional weight loss in patient populations, long-term care residents, and community-dwelling older adults. Most marketed ONS are ultra-processed, with precision nutrition and aseptic composition, as well as convenience and availability, driving their selection. However, therapeutic effectiveness is mixed and the potential health risks of consuming ultra-processed ONS long-term in lieu of less-processed foods have received little attention. A diverse and balanced microbiota supporting immunity and wellness is maintained by a diet rich in plant-sourced foods. The implications of ultra-processed ONS displacing plant-sourced foods, and specifically the potential for undesirable impacts on the gut microbiota, require consideration. Most ONS are either devoid of fiber or are supplemented with isolated or purified fibers that may contribute to adverse gastrointestinal symptoms and appetite suppression. In contrast, the diversity of microbial-available, nondigestible carbohydrates, together with the array of phytochemicals found in plant-sourced foods, support microbial diversity and its resiliency. This review outlines the clinical dilemma of recommending commercial ultra-processed ONS vs nutritionally adequate (eg, high-energy/high-protein) foods and beverages that contribute to diet quality, maintenance of a diverse and stable gut microbiota composition, and support nutrition status and health. Ultra-processed ONS may fall short of expected health benefits, and overreliance may potentially contribute to the risk for patient and older adult populations because of the displacement of a variety of healthful foods.
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Dieta , Estado Nutricional , Humanos , Idoso , Suplementos Nutricionais/efeitos adversos , Redução de Peso , Apoio Nutricional , Fast Foods , Manipulação de AlimentosRESUMO
A previous double-blind, randomized clinical trial of 42 healthy individuals conducted with Lactobacillus johnsonii N6.2 found that the probiotic's mechanistic tryptophan pathway was significantly modified when the data was stratified based on the individuals' lactic acid bacteria (LAB) stool content. These results suggest that confounding factors such as dietary intake which impact stool LAB content may affect the response to the probiotic treatment. Using dietary intake, serum metabolite, and stool LAB colony forming unit (CFU) data from a previous clinical trial, the relationships between diet, metabolic response, and fecal LAB were assessed. The diets of subject groups with high vs. low CFUs of LAB/g of wet stool differed in their intakes of monounsaturated fatty acids, vegetables, proteins, and dairy. Individuals with high LAB consumed greater amounts of cheese, fermented meats, soy, nuts and seeds, alcoholic beverages, and oils whereas individuals with low LAB consumed higher amounts of tomatoes, starchy vegetables, and poultry. Several dietary variables correlated with LAB counts; positive correlations were determined for nuts and seeds, fish high in N-3 fatty acids, soy, and processed meats, and negative correlations to consumption of vegetables including tomatoes. Using machine learning, predictors of LAB count included cheese, nuts and seeds, fish high in N-3 fatty acids, and erucic acid. Erucic acid alone accurately predicted LAB categorization, and was shown to be utilized as a sole fatty acid source by several Lactobacillus species regardless of their mode of fermentation. Several metabolites were significantly upregulated in each group based on LAB titers, notably polypropylene glycol, caproic acid, pyrazine, and chondroitin sulfate; however, none were correlated with the dietary intake variables. These findings suggest that dietary variables may drive the presence of LAB in the human gastrointestinal tract and potentially impact response to probiotic interventions.
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Next generation amplicon sequencing has created a plethora of data from human microbiomes. The accessibility to this scientific data and its corresponding metadata is important for its reuse, to allow for new discoveries, verification of published results, and serving as path for reproducibility. Dietary fiber consumption has been associated with a variety of health benefits that are thought to be mediated by gut microbiota. To enable direct comparisons of the response of the gut microbiome to fiber, we obtained 16S rRNA sequencing data and its corresponding metadata from 11 fiber intervention studies for a total of 2,368 samples. We provide curated and pre-processed genetic data and common metadata for comparison across the different studies.
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Microbioma Gastrointestinal , Microbiota , Humanos , Fibras na Dieta , Microbiota/genética , Reprodutibilidade dos Testes , RNA Ribossômico 16S/genéticaRESUMO
The intake of whole-grain (WG) foods by adolescents is reported to be approximately one-third the recommended intake of 48 g/d. This 6-wk randomized interventional study determined the effect of replacing grains within the diet with refined-grain (RG; n = 42) or WG (n = 41) foods/d on gastrointestinal and immune health in adolescents (aged 12.7 ± 0.1 y). A variety of grain-based foods were delivered weekly to participants and their families. Participants were encouraged to eat 3 different kinds of study foods (e.g., bread, cereals, snacks)/d with goals of 0 g/d (RG) and 80 g/d (WG). Stool samples were obtained during the prebaseline and final weeks to measure bifidobacteria and lactic acid bacteria (LAB) using qPCR. Stool frequency was recorded daily. Blood was drawn at baseline and at final visits for immune markers. Across groups, total-grain intake increased by one serving. The intake of WG was similar at baseline (18 ± 3 g) between groups but increased to 60 ± 5 g in the WG group and decreased to 4 ± 1 g in the RG group. Fecal bifidobacteria increased from baseline with both interventions, but LAB increased (P < 0.05) from baseline [2.4 ± 0.2 log(10) genome equivalents (eq)] to wk 6 (3.0 ± 0.2 log(10) genome eq) in the WG group but not in the RG group (baseline: 2.9 ± 0.2 log(10) genome eq; wk 6: 3.0 ± 0.1 log(10) genome eq). There was no difference in stool frequency, serum antioxidant potential, or in vitro LPS-stimulated mononuclear cell production of inflammatory cytokines between groups. However, across both groups the number of daily stools tended to increase (P = 0.08) by 0.0034 stools/g WG or by 0.2 stools with 60 g WG, mean antioxidant potential increased by 58%, and mean production of TNF-α, IL-1ß, and IL-6 decreased by 24, 22, and 42%, respectively, between baseline and wk 6. Overall, incorporating either WG or RG foods increased serum antioxidant concentrations and decreased inflammatory cytokine production; however, WG study foods had more of an effect on aspects of gastrointestinal health.
Assuntos
Citocinas/metabolismo , Fezes/microbiologia , Análise de Alimentos , Manipulação de Alimentos , Lactobacillus/isolamento & purificação , Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente , Citocinas/genética , Dieta , Grão Comestível , Fabaceae , Feminino , Frutas , Humanos , Masculino , VerdurasRESUMO
Pulses, including peas, have long been important components of the human diet due to their content of starch, protein and other nutrients. More recently, the health benefits other than nutrition associated with pulse consumption have attracted much interest. The focus of the present review paper is the demonstrated and potential health benefits associated with the consumption of peas, Pisum sativum L., specifically green and yellow cotyledon dry peas, also known as smooth peas or field peas. These health benefits derive mainly from the concentration and properties of starch, protein, fibre, vitamins, minerals and phytochemicals in peas. Fibre from the seed coat and the cell walls of the cotyledon contributes to gastrointestinal function and health, and reduces the digestibility of starch in peas. The intermediate amylose content of pea starch also contributes to its lower glycaemic index and reduced starch digestibility. Pea protein, when hydrolysed, may yield peptides with bioactivities, including angiotensin I-converting enzyme inhibitor activity and antioxidant activity. The vitamin and mineral contents of peas may play important roles in the prevention of deficiency-related diseases, specifically those related to deficiencies of Se or folate. Peas contain a variety of phytochemicals once thought of only as antinutritive factors. These include polyphenolics, in coloured seed coat types in particular, which may have antioxidant and anticarcinogenic activity, saponins which may exhibit hypocholesterolaemic and anticarcinogenic activity, and galactose oligosaccharides which may exert beneficial prebiotic effects in the large intestine.
Assuntos
Dieta , Promoção da Saúde , Valor Nutritivo , Pisum sativum , Sementes , Amilose/análise , Animais , Antioxidantes/análise , Fibras na Dieta/análise , Proteínas Alimentares/análise , Digestão , Índice Glicêmico , Humanos , Minerais/análise , Pisum sativum/química , Sementes/química , Amido/análise , Amido/metabolismo , Vitaminas/análiseRESUMO
Human intestinal enzymes do not hydrolyze nondigestible carbohydrates (NDCs), and thus, they are not digested and absorbed in the small intestine. Instead, NDCs are partially to completely fermented by the intestinal microbiota. Select NDCs are associated with health benefits such as laxation and lowering of blood cholesterol and glucose. NDCs provide functional attributes to processed foods, including sugar or fat replacers, thickening agents, and bulking agents. Additionally, NDCs are incorporated into processed foods to increase their fiber content. Although consumption of NDCs can benefit health and contribute functional characteristics to foods, they can cause gastrointestinal symptoms, such as flatulence and bloating. As gastrointestinal symptoms negatively affect consumer well-being and their acceptance of foods containing NDC ingredients, it is crucial to consider tolerance when designing food products and testing their physiological health benefits in clinical trials. This perspective provides recommendations for the approach to assess gastrointestinal tolerance to NDCs, with a focus on study design, population criteria, intervention, comparator, and outcome. Special issues related to studies in children and implications for stakeholders are also discussed. It is recommended that the evaluation of gastrointestinal tolerance to NDCs be conducted in randomized, blinded, controlled crossover studies using standard gastrointestinal questionnaires, with attention to study participant background diets, health status, lifestyle, and medications.