Consumption of 2 Green Kiwifruits Daily Improves Constipation and Abdominal Comfort-Results of an International Multicenter Randomized Controlled Trial.

Cesare Cremon, Lynley Drummond, Kumi Nakaya, Motoyori Kanazawa, Michiko Kano, Mikiko Fuda, Tomoko Okamoto, Tomohiko Muratubaki, Yohei Okawa, Isabella Pagano, Maria Raffaella Barbaro, Naoki Nakaya, Christine Butts, Alison Wallace, Sarah Eady, Paul Blatchford, Juliet Ansell, Barbara Kuhn-Sherlock, Shin Fukudo, Richard Gearry, Giovanni Barbara, Yuka Endo

Journal: The American journal of gastroenterology 2023;118(6):1058-1068

PMID: 36537785

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Plain Language Summary

Functional gastrointestinal disorders (FGID) are now termed disorders of gut-brain interaction. Several studies support the consumption of individual foods to improve laxation and gastrointestinal (GI) comfort. The aim of this study was to investigate the effects of the daily consumption of 2 Zespri green kiwifruits compared with those of 7.5 g of psyllium for 4 weeks on parameters of bowel habit and GI comfort. This study was a prospective randomised, single-blinded, crossover, controlled 16-week trial undertaken in 3 countries. The participants were randomised to consume either of the interventions. Results showed that consumption of 2 Zespri green kiwifruits per day is associated with a clinically significant increase in complete spontaneous bowel movements, improvements in abdominal comfort, straining and stool form, and increases in quality of life. Authors concluded that consumption of 2 green kiwifruits can be safely recommended as an effective treatment for constipation in those with functional GI disorders that will also provide improvements in symptoms of GI comfort.

Abstract

INTRODUCTION

Consumption of green kiwifruit is known to relieve constipation. Previous studies have also reported improvements in gastrointestinal (GI) comfort. We investigated the effect of consuming green kiwifruit on GI function and comfort.

METHODS

Participants included healthy controls (n = 63), patients with functional constipation (FC, n = 60), and patients with constipation-predominant irritable bowel syndrome (IBS-C, n = 61) randomly assigned to consume 2 green kiwifruits or psyllium (7.5 g) per day for 4 weeks, followed by a 4-week washout, and then the other treatment for 4 weeks. The primary outcome was the number of complete spontaneous bowel movements (CSBM) per week. Secondary outcomes included GI comfort which was measured using the GI symptom rating scale, a validated instrument. Data (intent-to-treat) were analyzed as difference from baseline using repeated measures analysis of variance suitable for AB/BA crossover design.

RESULTS

Consumption of green kiwifruit was associated with a clinically relevant increase of ≥ 1.5 CSBM per week (FC; 1.53, P < 0.0001, IBS-C; 1.73, P = 0.0003) and significantly improved measures of GI comfort (GI symptom rating scale total score) in constipated participants (FC, P < 0.0001; IBS-C, P < 0.0001). No significant adverse events were observed.

DISCUSSION

This study provides original evidence that the consumption of a fresh whole fruit has demonstrated clinically relevant increases in CSBM and improved measures of GI comfort in constipated populations. Green kiwifruits are a suitable dietary treatment for relief of constipation and associated GI comfort.

Address: Department of Medicine, University of Otago, Christchurch, New Zealand.; Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.; Department of Psychosomatic Medicine, Tohoku University Hospital, Sendai, Japan.; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.; BKS Consulting Limited, Hamilton, Waikato, New Zealand.; Zespri International Limited, Tauranga, New Zealand.; The New Zealand Institute for Plant and Food Research Limited, Palmerston North and Christchurch, New Zealand.; Department of Nutrition, Sapporo University of Health Sciences, Sapporo, Japan.; Department of Clinical Nutrition, Tohoku University Hospital, Sendai, Japan.; Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.; Drummond Food Science Advisory Limited, Killinchy, Canterbury, New Zealand.

DOI: 10.14309/ajg.0000000000002124