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Effects of a Synbiotic on Plasma Immune Activity Markers and Short-Chain Fatty Acids in Children and Adults with ADHD-A Randomized Controlled Trial.
Yang, LL, Stiernborg, M, Skott, E, Xu, J, Wu, Y, Landberg, R, Arefin, S, Kublickiene, K, Millischer, V, Nilsson, IAK, et al
Nutrients. 2023;15(5)
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Attention deficit hyperactivity disorder (ADHD) is a common childhood-onset neurodevelopmental psychiatric disorder. The core symptoms of the disorder are inattention and hyperactivity/impulsivity. The aim of this study was to explore the effects of Synbiotic 2000 on concentrations of plasma immune activity markers and short-chain fatty acids (SCFAs) in ADHD. This study is a double-blind randomised controlled trial over a period of 9-weeks. Patients (n= 248) were randomly allocated to one of the two treatments: Synbiotic 2000 or placebo. Results show that there was no statistically significant overall effect of Synbiotic 2000 compared to placebo on any analyte analysing all the paediatric and all adult participants as one group. However, age-group stratified analyses showed that plasma levels of several of the analytes were at baseline different in the children compared to in the adults. Authors conclude that Synbiotic 2000, in children with ADHD, reduces markers of intestinal and vascular inflammation, the latter in part through increasing SCFAs levels. Furthermore, they suggest that the findings warrant further studies to determine if persons with ADHD would benefit inflammation-wise from dietary intake of Synbiotic 2000 or a similar synbiotic.
Abstract
Synbiotic 2000, a pre + probiotic, reduced comorbid autistic traits and emotion dysregulation in attention deficit hyperactivity disorder (ADHD) patients. Immune activity and bacteria-derived short-chain fatty acids (SCFAs) are microbiota-gut-brain axis mediators. The aim was to investigate Synbiotic 2000 effects on plasma levels of immune activity markers and SCFAs in children and adults with ADHD. ADHD patients (n = 182) completed the 9-week intervention with Synbiotic 2000 or placebo and 156 provided blood samples. Healthy adult controls (n = 57) provided baseline samples. At baseline, adults with ADHD had higher pro-inflammatory sICAM-1 and sVCAM-1 and lower SCFA levels than controls. Children with ADHD had higher baseline sICAM-1, sVCAM-1, IL-12/IL-23p40, IL-2Rα, and lower formic, acetic, and propionic acid levels than adults with ADHD. sICAM-1, sVCAM-1, and propionic acid levels were more abnormal in children on medication. Synbiotic 2000, compared to placebo, reduced IL-12/IL-23p40 and sICAM-1 and increased propionic acid levels in children on medication. SCFAs correlated negatively with sICAM-1 and sVCAM-1. Preliminary human aortic smooth-muscle-cell experiments indicated that SCFAs protected against IL-1β-induced ICAM-1 expression. These findings suggest that treatment with Synbiotic 2000 reduces IL12/IL-23p40 and sICAM-1 and increases propionic acid levels in children with ADHD. Propionic acid, together with formic and acetic acid, may contribute to the lowering of the higher-than-normal sICAM-1 levels.
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Blueberries Improve Abdominal Symptoms, Well-Being and Functioning in Patients with Functional Gastrointestinal Disorders.
Wilder-Smith, CH, Materna, A, Olesen, SS
Nutrients. 2023;15(10)
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Functional gastrointestinal disorders (FGID) are the most common cause of recurring, chronic digestive upsets. Irritable bowel syndrome (IBS) and functional dyspepsia (FD), or persistent indigestion, are the most prevalent types of those disorders. Typical symptoms include pain or discomfort in the abdomen, changes in stool patterns or bloating and may also manifest in symptoms not directly relating to the digestive tract. It remains uncertain what the exact mechanisms of those disorders are. However, scientists identified various factors involved, including immune system activation, sensitisation of the nervous system, dysregulated permeability of the gut walls, and changes in the microbiota, their composition and metabolic activity. Polyphenols are natural compounds found abundantly in plants and are most known for their antioxidant qualities. One frequently studied and rich-source of phenols is Blueberries (Vaccinium spp). Blueberries have antioxidant, anti-inflammatory, and neuroprotective properties, and are known to reverse the permeability of the gut membrane. Hence their use in the management of FGID appeared promising. This double-blind, randomized, cross-over study assessed the benefit of blueberries in 43 people with IBS or FD, between 18–60 years of age. The candidates were given 30g freeze-dried blueberries, the equivalent of 180g of fresh blueberries, or a sugar-based placebo of similar calorific value for 6-weeks each. When receiving the blueberries, greater symptom relief was observed when compared to the placebo group. Blueberry intake also positively reflected in experienced improvement in quality of life. No notable differences were observed between groups in stool patterns and fructose digestion. Blueberries and their beneficial compounds such as polyphenols and fiber appear to have a wide range of benefits that can help manage some of the FGID-associated symptoms. Further studies are needed to understand why, despite some notable benefits, some of the other GI markers remained unaffected. As blueberries are generally well tolerated, they can be a simple and helpful food intervention to complement other FGID management strategies.
Abstract
Blueberries beneficially modulate physiologic mechanisms relevant to the pathogenesis of functional gastrointestinal disorders (FGID). Forty-three patients with FGID received freeze-dried blueberries (equivalent to 180 g fresh blueberries) or sugar and energy-matched placebo in a double-blind, randomized, cross-over study. After 6 weeks of treatment, the differences in Gastrointestinal Clinical Rating Scale (GSRS) scores and abdominal symptom relief were compared as primary outcome measures. The quality of life and life functioning ratings (OQ45.2 questionnaire), Bristol stool scales, and fructose breath test results constituted secondary outcome measures. Blueberry treatment resulted in more patients with relevant abdominal symptom relief compared to placebo (53% vs. 30%, p = 0.03). Total and pain GSRS scores improved insignificantly (mean treatment differences [95% CI]: -3.4 [-7.4 to 0.6] (p = 0.09) and -1.0 [-2.2 to 0.1] (p = 0.08), respectively). OQ45.2 scores improved during blueberry treatment compared to placebo (treatment difference -3.2 [95% CI: -5.6 to -0], p = 0.01). Treatment effect differences for the further measures did not reach statistical significance. Blueberries relieved abdominal symptoms and improved general markers of well-being, quality of life, and life functioning more than placebo in patients with FGID. Consequently, the polyphenol and fiber components of blueberries exert broad beneficial effects separate from the sugars present in both treatments.
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A Low-FODMAP Diet Provides Benefits for Functional Gastrointestinal Symptoms but Not for Improving Stool Consistency and Mucosal Inflammation in IBD: A Systematic Review and Meta-Analysis.
Peng, Z, Yi, J, Liu, X
Nutrients. 2022;14(10)
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The low-FODMAP diet eliminates carbohydrates that cannot be easily digested in order to reduce functional gastrointestinal symptoms associated with irritable bowel disease (IBD). The symptoms of irritable bowel disease include abdominal pain and bloating. This systematic review and meta-analysis aimed to evaluate whether a low-FODMAP diet can alleviate functional gastrointestinal symptoms in individuals with inflammatory bowel disease. In comparison with a regular diet, a low-FODMAP diet significantly reduced symptoms of bloating, wind, flatulence, abdominal pain, fatigue, and lethargy in patients with IBD. In addition, patients with Crohn's disease have achieved remission or reduced symptoms after following a low-FODMAP diet. Healthcare professionals can use this study to understand better the effects of a low-FODMAP diet on patients with IBD who have functional gastrointestinal symptoms. Further robust studies are, however, required to evaluate the evidence's robustness and identify the mechanism behind the improvement of symptoms.
Expert Review
Conflicts of interest:
None
Take Home Message:
- LFD use in IBD improved symptoms of bloating, wind or flatulence, borborygmi, abdominal pain, and fatigue or lethargy, but not nausea and vomiting.
Evidence Category:
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X
A: Meta-analyses, position-stands, randomized-controlled trials (RCTs)
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B: Systematic reviews including RCTs of limited number
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C: Non-randomized trials, observational studies, narrative reviews
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D: Case-reports, evidence-based clinical findings
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E: Opinion piece, other
Summary Review:
Introduction
This meta-analysis assesses the efficacy of a low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet (LFD) in inflammatory bowel disease [IBD: ulcerative colitis (UC) and Crohn’s disease (UC)] participants with functional gastrointestinal symptoms (FGSs).
Methods
A search was performed on PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure (CNKI), WanFang (Chinese) Database up to March 2022. Quality assessment of all included studies was performed.
Results
9 studies (4 randomised controlled trials, 5 non-randomised studies) with a total of 351 participants diagnosed with IBD were included, and compared LFD with a placebo diet or normal diet (ND), overall and individual
LFD Effects of FGS:
- Overall 9 studies: an improvement (0.47, 0.33–0.66, p = 0.0000)
- No difference in the subgroup classified by disease type
- CD and UC: no improvement
Individual improvement:
- Bloating (0.37, 0,24-0,57, p=0.0000); wind or flatulence (0.38, 0,28-0,51, p=0.0000); borborygmi (0.48, 0,26-0,89, p=0.0000), abdominal pain (0.5, 0,37-0,68, p=0.0000), fatigue/lethargy (0.71, 0,61-0,82, p=0.0000)
- No difference in nausea and vomiting (0.54, 0,22-1,32, p=018)
IBS Quality of Life Score:
- 2 studies: reduced Short IBD Questionnaire (SIBDQ) score (11.24, 6.61-15.87, p=0.0000)
Bristol Stool Form Chart:
- 2 studies: normal stool consistency (type 3-4); no difference (5.99, 0.17-216.51, p=0.33)
- 2 other studies: no difference (-0.17, 0.48 - 0.15, p=0.30)
Diseases activity (Harvey-Bradshaw index):
- 2 studies using the Mayo score: no difference (-32, -1,09-0.45, p=0.41)
- 3 studies using BHi score: reduction (-1.09, -1,77-0.42, p=0.002)
Faecal calprotectin:
- 2 studies: no change (-16.03, -36,78-4.73, p=0.13)
Limitations
- Comparison diets were not standardised, suggesting the potential of different dietary habits to bias results..
- Heterogeneity of included studies, and the relatively small sample size of the studies can reduce the reliability of the results.
Conclusion
While the study found inconsistent definition standards for FGS, all the nine studies showed that LFD was associated with an improvement in some symptoms.
Clinical practice applications:
- This study suggests that IBD patients with FGSs may benefit from LFD treatment with the assistance of a healthcare professional.
Considerations for future research:
- This study has shown that LFD can improve FGSs in IBD, but further research with a larger sample size and more comprehensive analysis is warranted to replicate the results.
- The description of the findings and Quality of Life data are a little unclear. The impact on Quality of Life warrants further investigation, as clinicians need to consider the impact of following a restrictive diet on Quality of Life.
Abstract
BACKGROUND A low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet (LFD) is claimed to improve functional gastrointestinal symptoms (FGSs). However, the role of LFD in inflammatory bowel disease (IBD) patients with FGSs remains unclear. OBJECTIVE To systematically assess the efficacy of LFD in IBD patients with FGSs. METHODS Six databases were searched from inception to 1 January 2022. Data were synthesized as the relative risk of symptoms improvement and normal stool consistency, mean difference of Bristol Stool Form Scale (BSFS), Short IBD Questionnaire (SIBDQ), IBS Quality of Life (IBS-QoL), Harvey-Bradshaw index (HBi), Mayo score, and fecal calprotectin (FC). Risk of bias was assessed based on study types. A funnel plot and Egger's test were used to analyze publication bias. RESULTS This review screened and included nine eligible studies, including four randomized controlled trials (RCTs) and five before-after studies, involving a total of 446 participants (351 patients with LFD vs. 95 controls). LFD alleviated overall FGSs (RR: 0.47, 95% CI: 0.33-0.66, p = 0.0000) and obtained higher SIBDQ scores (MD = 11.24, 95% CI 6.61 to 15.87, p = 0.0000) and lower HBi score of Crohn's disease (MD = -1.09, 95% CI -1.77 to -0.42, p = 0.002). However, there were no statistically significant differences in normal stool consistency, BSFS, IBS-QoL, Mayo score of ulcerative colitis, and FC. No publication bias was found. CONCLUSIONS LFD provides a benefit in FGSs and QoL but not for improving stool consistency and mucosal inflammation in IBD patients. Further well-designed RCTs are needed to develop the optimal LFD strategy for IBD.
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Association of Migraine with Its Comorbidities and Food Specific Immunoglobulin G Antibodies and Inflammatory Cytokines: Cross-Sectional Clinical Research.
Zhao, Z, Jin, H, Yin, Y, Hou, Y, Wang, J, Tang, C, Fu, J
Journal of pain research. 2021;14:2359-2368
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Migraine is a chronic, multifactorial headache with multiple comorbid conditions. Previous studies have shown a correlation between food-specific IgG antibodies and chronic inflammation in migraineurs. IgG antibody detection may therefore be a biomarker for migraine since it plays a crucial role in the pathogenesis of the disease. This cross-sectional clinical trial investigated the relationship between IgG antibodies against food antigens and headaches, gastrointestinal symptoms, anxiety, depression, sleep disorders, dermatosis and inflammatory cytokines such as IL-6, TNFα, and IL-10. In this study, migraine patients who had positive food-specific IgG antibodies had severe migraine, anxiety, gastrointestinal symptoms, and elevated levels of proinflammatory cytokines such as IL-6 and TNFα, indicating a causal relationship. However, further studies are required to determine the immune reaction to food antigens and the effect of eliminating IgG positive foods on migraine and its associated comorbidities. Nevertheless, this study can help healthcare professionals understand how food-specific antibodies play a role in diagnosing and treating migraine.
Abstract
PURPOSE The relationship between food allergy caused by food specific IgG antibodies and migraine has received increased attention in recent years. Here, we aimed to evaluate the effects of food specific IgG antibodies on headache, gastrointestinal symptoms, anxiety, depression, sleep disorders, dermatosis, and serum inflammatory cytokines in migraine patients, and to quantitatively assess the effect of IgG levels on the severity of headache and its comorbidities. METHODS Of 89 migraine patients, those who had one or more food specific IgG antibodies ≥50 U/mL were classified into the IgG positive group, which was then further divided into subgroups based on differing numbers of food allergens. All other subjects were classified into the IgG negative group. We compared the frequency and severity of migraine, anxiety, depression, sleep disorders, dermatosis, and inflammatory cytokines between groups. A regression model was performed to further assess the effect of overall positive IgG concentration and the mediation effect of inflammatory cytokines. RESULTS Participants in the positive IgG group (n = 67) were more likely to have longer time elapsed since diagnosis, more frequent and severe migraine, a higher risk of developing anxiety and gastrointestinal symptoms, along with higher IL-6 and TNF-α. Subgroups with more food allergens generally had worse conditions as well. After adjusting for the inflammatory cytokines, the effect of IgG was reduced. CONCLUSION Migraine patients with positive food specific IgG antibodies had worse migraine, anxiety, and gastrointestinal symptoms. Inflammatory cytokines partially mediate the causal pathway between food specific IgG antibodies, migraine, and migraine comorbidities.
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Ultra-Processed Foods and Health Outcomes: A Narrative Review.
Elizabeth, L, Machado, P, Zinöcker, M, Baker, P, Lawrence, M
Nutrients. 2020;12(7)
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Ultra-processed food (UPF) is prevalent in diets world-wide. This review aims to look at the results of studies that have investigated associations between levels of UPF consumption and health outcomes on healthy participants. 43 studies were reviewed; studies covered all age groups (including children and adolescents) in a number of different countries. Studies looked at overweight, obesity and cardio-metabolic risks as outcomes as well as cancer, cardiovascular disease, type 2 diabetes, mortality, gastrointestinal disorders, depression, frailty and asthma. In 37 studies, there was at least one statistically significant association between UPF exposure and at least one adverse health outcome. No study reported an association between UPF exposure and beneficial health outcomes. This review has shown that a high intake of UPFs is associated with a range of adverse health outcomes, disorders and conditions. This has the potential to significantly influence the global burden of disease. As well as this; evidence suggests a higher risk of all-cause mortality with high consumption of UPFs. No study reported an association between UPF and beneficial health outcomes. The review has also shown beneficial outcomes were associated with diets higher in unprocessed and minimally processed foods.
Abstract
The nutrition literature and authoritative reports increasingly recognise the concept of ultra-processed foods (UPF), as a descriptor of unhealthy diets. UPFs are now prevalent in diets worldwide. This review aims to identify and appraise the studies on healthy participants that investigated associations between levels of UPF consumption and health outcomes. This involved a systematic search for extant literature; integration and interpretation of findings from diverse study types, populations, health outcomes and dietary assessments; and quality appraisal. Of 43 studies reviewed, 37 found dietary UPF exposure associated with at least one adverse health outcome. Among adults, these included overweight, obesity and cardio-metabolic risks; cancer, type-2 diabetes and cardiovascular diseases; irritable bowel syndrome, depression and frailty conditions; and all-cause mortality. Among children and adolescents, these included cardio-metabolic risks and asthma. No study reported an association between UPF and beneficial health outcomes. Most findings were derived from observational studies and evidence of plausible biological mechanisms to increase confidence in the veracity of these observed associations is steadily evolving. There is now a considerable body of evidence supporting the use of UPFs as a scientific concept to assess the 'healthiness' of foods within the context of dietary patterns and to help inform the development of dietary guidelines and nutrition policy actions.
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A Review of Microbiota and Irritable Bowel Syndrome: Future in Therapies.
Rodiño-Janeiro, BK, Vicario, M, Alonso-Cotoner, C, Pascua-García, R, Santos, J
Advances in therapy. 2018;35(3):289-310
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Irritable bowel syndrome (IBS) is a common functional gut disorder characterised by abdominal pain and associated changes in bowel habits. Increasing evidence points to altered gut microbiota, dysbiosis, as a predominant factor in IBS development and has therefore become a primary target for therapeutic options in patients with IBS. This review evaluates existing literature on IBS interventions targeting the gut microbiota and suggests future approaches useful for diagnosis, prevention and treatment of IBS. Based on the current literature, this review suggests there is a strong role of dysbiosis in the pathophysiology of IBS. The authors conclude that there are promising therapeutic options available but further evidence is needed from larger controlled studies.
Abstract
Irritable bowel syndrome (IBS), one of the most frequent digestive disorders, is characterized by chronic and recurrent abdominal pain and altered bowel habit. The origin seems to be multifactorial and is still not well defined for the different subtypes. Genetic, epigenetic and sex-related modifications of the functioning of the nervous and immune-endocrine supersystems and regulation of brain-gut physiology and bile acid production and absorption are certainly involved. Acquired predisposition may act in conjunction with infectious, toxic, dietary and life event-related factors to enhance epithelial permeability and elicit mucosal microinflammation, immune activation and dysbiosis. Notably, strong evidence supports the role of bacterial, viral and parasitic infections in triggering IBS, and targeting microbiota seems promising in view of the positive response to microbiota-related therapies in some patients. However, the lack of highly predictive diagnostic biomarkers and the complexity and heterogeneity of IBS patients make management difficult and unsatisfactory in many cases, reducing patient health-related quality of life and increasing the sanitary burden. This article reviews specific alterations and interventions targeting the gut microbiota in IBS, including prebiotics, probiotics, synbiotics, non-absorbable antibiotics, diets, fecal transplantation and other potential future approaches useful for the diagnosis, prevention and treatment of IBS.
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Prebiotic Potential of Herbal Medicines Used in Digestive Health and Disease.
Peterson, CT, Sharma, V, Uchitel, S, Denniston, K, Chopra, D, Mills, PJ, Peterson, SN
Journal of alternative and complementary medicine (New York, N.Y.). 2018;24(7):656-665
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Triphala, licorice and slippery elm are key treatments for gastrointestinal health and disease in traditional systems of medicine. Prebiotics are defined as undigested dietary carbohydrates that alter the gut microbiota and promote human health. They reach the site of action in the colon mostly unmetabolized and are broken down by enzymes. The aim of the study was to find out whether the complex carbohydrates present in herbal medicine may be strong drivers to modulate gut microbiota composition. The study recruited 12 healthy men and women, aged between 30-60 years who had previously followed a vegan or vegetarian diet for more than 1 year, to donate a single stool sample. Results show that both the sugar and protein content of these herbal medicines drive alterations in gut microbiota profiles. Each of these herbal medicines studied, uniquely altered gut bacteria communities. Authors conclude that the health benefits of these herbs are mostly due to their ability to alter the gut microbiota in a manner that is predicted to improve colonic epithelium function, reduce inflammation, and promote protection from bacterial pathogenic infection.
Abstract
INTRODUCTION The prebiotic potential of herbal medicines has been scarcely studied. METHODS The authors therefore used anaerobic human fecal cultivation to investigate whether three herbal medicines commonly used in gastrointestinal health and disease in Ayurveda alter the growth and abundance of specific bacterial species. RESULTS Profiling of cultures supplemented with Glycyrrhiza glabra, Ulmus rubra, or triphala formulation by 16S rDNA sequencing revealed profound changes in diverse taxa in human gut microbiota. Principal coordinate analysis highlights that each herbal medicine drives the formation of unique microbial communities. The relative abundance of approximately one-third of the 299 species profiled was altered by all 3 medicines, whereas additional species displayed herb-specific alterations. Herb supplementation increased the abundance of many bacteria known to promote human health, including Bifidobacterium spp., Lactobacillus spp., and Bacteroides spp. Herb supplementation resulted in the reduced relative abundance of many species, including potential pathogens such as Citrobacter freundii and Klebsiella pneumoniae. Herbal medicines induced blooms of butyrate- and propionate-producing species. U. rubra and triphala significantly increased the relative abundance of butyrate-producing bacteria, whereas G. glabra induced the largest increase in propionate-producing species. To achieve greater insight into the mechanisms through which herbal medicines alter microbial communities, the authors assessed the shifts in abundance of glycosyl hydrolase families induced by each herbal medicine. Herb supplementation, particularly G. glabra, significantly increased the representation and potential expression of several glycosyl hydrolase families. DISCUSSION These studies are novel in highlighting the significant prebiotic potential of medicinal herbs and suggest that the health benefits of these herbs are due, at least in part, to their ability to modulate the gut microbiota in a manner predicted to improve colonic epithelium function, reduce inflammation, and protect from opportunistic infection. Forthcoming studies in human clinical trials will test the concordance of the results generated in vitro and the predictions made by genome analyses.
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A Low FODMAP Gluten-Free Diet Improves Functional Gastrointestinal Disorders and Overall Mental Health of Celiac Disease Patients: A Randomized Controlled Trial.
Roncoroni, L, Bascuñán, KA, Doneda, L, Scricciolo, A, Lombardo, V, Branchi, F, Ferretti, F, Dell'Osso, B, Montanari, V, Bardella, MT, et al
Nutrients. 2018;10(8)
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Coeliac disease (CD) is an autoimmune disorder in which gluten ingestion induces inflammation in the small intestines. While a gluten-free diet (GFD) alleviates gastrointestinal (GI) symptoms in the majority of CD patients, there is a subset of patients following a strict GFD that still experience GI symptoms. The aim of this study is to determine if a low fermentable, oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet would help reduce persistent symptoms in 44 CD patients following a strict GFD. Participants were randomised to receive a structured 21-day dietary plan of either a low-FODMAP GFD or a high-FODMAP GFD and were evaluated for GI symptoms, psychological wellbeing and quality of life at baseline and the end of the intervention. This study found quality of life and abdominal pain improved significantly in the low-FODMAP group compared to the high-FODMAP group. Based on these findings, the authors conclude a short-term low-FODMAP diet helps to improve persistent GI symptoms and enhance general wellbeing in this subgroup of CD patients. Further evaluation is recommended to better understand the long-term clinical effects of FODMAPs in CD patients.
Abstract
A subset of patients with celiac disease (CD) on a gluten-free diet (GFD) reported the persistence of functional gastrointestinal disorders. Foods containing fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) can trigger a broad range of gastrointestinal symptoms in sensitive individuals. We evaluated the effects of a low FODMAP diet (LFD) on gastrointestinal and psychological symptomatology in CD patients. A total of 50 celiac patients on GFDs and with persistence of gastrointestinal symptoms were included. The patients were randomly allocated to one of two dietary groups-one on a low FODMAP GFD (LF-GFD, n = 25) and the other on a regular GFD (R-GFD, n = 25)-for 21 days. Psychological symptomatology and quality of life were evaluated by the Symptom Checklist-90-R (SCL-90) and the Short Form (36) Health Survey (SF-36) questionnaires, respectively. Gastrointestinal symptomatology and general well-being were evaluated by visual analogue scale (VAS) scores. After 21 days, 21 and 23 patients completed the dietary treatment on LF-GFD and R-GFD, respectively. A reduced global SCL-90 index (p < 0.0003) was found in the LF-GFD group but not in the R-GFD one. However, the SF-36 scores did not differ between groups after treatment. The VAS for abdominal pain was much lower, and the VAS for fecal consistency enhanced after treatment in the LF-GFD group. General well-being increased in both groups but with a much higher improvement in the LF-GFD (p = 0.03). A short-term LFD regimen helps to improve the psychological health and gastrointestinal symptomatology with enhanced well-being of CD patients with persisting functional gastrointestinal symptomatology. The long-term clinical effects of LFD in particular subgroups of CD patients need further evaluation.
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Bifidobacterium bifidum YIT 10347 fermented milk exerts beneficial effects on gastrointestinal discomfort and symptoms in healthy adults: A double-blind, randomized, placebo-controlled study.
Gomi, A, Yamaji, K, Watanabe, O, Yoshioka, M, Miyazaki, K, Iwama, Y, Urita, Y
Journal of dairy science. 2018;101(6):4830-4841
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Probiotics have been found to have beneficial effects in adults with functional gastrointestinal (GI) disorders, however little evidence exists regarding its effects on healthy adults. The aim of this prospective, randomised, double-blind, placebo-controlled, parallel-group trial was to clarify the beneficial effects of Bifidobacterium bifidum (B bifidum) on gastric symptoms in 100 healthy Japanese adults who experience temporary GI symptoms. Participants were randomised to consume active fermented milk or placebo milk matched for colour, taste and packaging daily for four weeks and various qualitative and quantitative measurements were assessed. This trial found the group consuming B bifidum experienced significantly better relief from upper GI symptoms compared with the placebo group. These findings suggest daily consumption of milk fermented with B bifidum helps relive GI discomfort and symptoms in healthy adults with no risk of side effects. Based on these results, the authors conclude fermented milk drinks can be recommended to patients who experience temporary GI pain.
Abstract
In a preliminary open-label trial by our group, Bifidobacterium bifidum YIT 10347 (YIT10347) relieved gastric symptoms in patients with functional gastrointestinal disorders. Hence, in this study, we investigated the effects of YIT10347 on gastrointestinal symptoms in healthy adults. In this prospective double-blind, randomized, placebo-controlled trial (UMIN000024654), 100 healthy Japanese adults were randomly assigned to a YIT10347 group or placebo group and consumed 100 mL of YIT10347-fermented milk or placebo fermented milk, respectively, every day for 4 wk. Gastrointestinal symptoms were evaluated by using the modified Frequency Scale for Symptoms of Gastroesophageal Reflux Disease (m-FSSG) and Gastrointestinal Symptom Rating Scale (GSRS) as primary endpoints. Mental symptoms, quality of life, salivary stress markers, and gastric emptying were evaluated as secondary endpoints. Effectiveness and safety were analyzed in a per-protocol set (YIT10347 group, n = 39; placebo group, n = 40) and full analysis set (YIT10347 group, n = 50; placebo group, n = 50), respectively. In the m-FSSG evaluation, the YIT10347 group had a significantly higher relief rate of postprandial discomfort and greater changes in postprandial epigastric pain score from baseline than the placebo group. In the GSRS evaluation, the YIT10347 group had significantly higher relief rates of overall gastrointestinal symptoms, upper gastrointestinal symptoms, flatus, and diarrhea than the placebo group. We detected no significant differences in scores or relief rates of mental symptoms and quality of life, a salivary stress marker, or gastric emptying between the 2 groups. No severe adverse events associated with test beverage consumption were observed in either group. These findings suggest that daily consumption of YIT10347-fermented milk exerts beneficial effects on gastrointestinal discomfort and symptoms such as postprandial discomfort and epigastric pain in healthy adults.