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Development of the digestive system in early infancy and nutritional management of digestive problems in breastfed and formula-fed infants.
Jiang, H, Gallier, S, Feng, L, Han, J, Liu, W
Food & function. 2022;(3):1062-1077
Abstract
Food digestion and absorption in infants are closely related to early growth and long-term health. Human milk and infant formula are the main food sources for 0-6 month-old infants. Due to the immature gastrointestinal tract of newborns, mild digestive problems, such as inefficient digestion and impaired absorption of proteins, lipids and lactose, and gut dysbiosis, are often seen in infancy. The differences in composition between infant formula and human milk make mild digestive problems more likely to occur in formula-fed infants. In recent years, several types of infant formulas have been developed to treat or reduce gastrointestinal digestive problems in infants. This review summarizes the gastrointestinal environment of infants and the digestion of human milk and different infant formulas. We particularly focus on the common digestive problems and appropriate nutritional solutions that may occur in healthy term infants during the first six months of life.
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2.
Impact of Maillard reaction products on nutrition and health: Current knowledge and need to understand their fate in the human digestive system.
ALjahdali, N, Carbonero, F
Critical reviews in food science and nutrition. 2019;(3):474-487
Abstract
The Maillard Reaction (MR) is a non-enzymatic chemical reaction which results in the linkage between the amino group of amino acids and the carbonyl group of reduced sugars. MR products (MRPs) are common components of processed foods, mainly as a result of heating, especially in the Western diet. MRPs are classified as into three stages: initial, intermediate, and final stages, indicative of increased complexity and size, incurring different flavor, aroma, and texture. MRPs presence is known to reduce the nutritional quality of foods, particularly by reducing protein digestibility. Early reports have linked MRPs, especially advanced glycation end-products (AGEs) present in high concentration in the typical Western diet, to health conditions and diseases. However conflicting data has since been reported, and only a few (acrylamide, heterocyclic amines and 5-Hydroxymethylfurfural) MRPs have documented potential toxic or carcinogenic effects. High molecular weight MRPs are not available for direct absorption in the higher gastrointestinal tract, and are thus mostly metabolized by resident colonic microbes. MRPs have been the subject of sparse research interest in comparison with other non-digestible dietary elements. In this review, we outline the state of knowledge on MRPs in nutrition and health, and highlight the need to develop the limited knowledge on their impact on the gut microbiota and which metabolites derive from MRPs fermentation.
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3.
Effects of new and emerging therapies on gastrointestinal outcomes in cystic fibrosis.
Houwen, RHJ, van der Woerd, WL, Slae, M, Wilschanski, M
Current opinion in pulmonary medicine. 2017;(6):551-555
Abstract
PURPOSE OF REVIEW Several new therapeutic modalities have recently become available to be used in patients with cystic fibrosis such as potentiators, modulators, and probiotics. Although the effects on pulmonary function have been well documented, gastrointestinal outcomes have been addressed only rarely. RECENT FINDINGS Both the potentiator (ivacaftor) and the potentiator/modulator combination (ivacaftor/lumacaftor) that are currently on the market have a positive effect on BMI. Young patients (2-5 years of age) with a gating mutation may show improvement of exocrine pancreatic function on ivacaftor. In this specific patient population this agent also seems to improve intestinal pH and reflux. The effect of these medications on other gastrointestinal outcomes, such as intestinal inflammation and cystic fibrosis liver disease, has not been described so far. Furthermore, the results of several trials suggest that probiotics might reduce intestinal inflammation. Finally, organoids might be used to predict in vitro the clinical effect of potentiators and modulators. SUMMARY The effect of new interventions on the gastrointestinal outcomes studied so far is favourable. Future studies should address the effect on other gastrointestinal parameters.
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4.
Action and Function of Vitamin D in Digestive Tract Physiology and Pathology.
Peppelenbosch, MP, Fuhler, GM, Verhaar, AP, van der Laan, LJW
Current medicinal chemistry. 2017;(9):928-936
Abstract
BACKGROUND The body of biomedical literature on Vitamin D effector mechanisms in gastrointestinal biology and pathophysiology is rapidly expanding. Accordingly, new possibilities of vitamin D biology-based therapeutical intervention in gastroenterological disease are being identified. However, the literature lacks a concise review on these developments, hampering comprehension of the possibilities involved for many in the community. RESULTS Genetic vitamin D receptor (VDR) polymorphisms and other VDR biology regulation are involved in predisposition to gastrointestinal cancers and might allow tailored strategies for managing those individuals especially at risk, e.g. through vitamin D supplementation. Likewise, modulation of Hedgehog signaling by vitamin D analogues may have promise in combating gastrointestinal cancers or improving barrier function in IBD, but shortage in vitamin D levels may also influence inflammatory conditions of the gut through direct interaction with the mucosal immune system. Evidence justifying population-wide monitoring for vitamin D status is accumulating. CONCLUSION There is kaleidoscopic interaction of vitamin D biology with many aspects of gastrointestinal tract biology. Vitamin D appears an attractive target for personalized approaches like precision and P4 medicine.
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5.
Physiological role of dietary free glutamate in the food digestion.
Uneyama, H, San Gabriel, A, Kawai, M, Tomoe, M, Torii, K
Asia Pacific journal of clinical nutrition. 2008;:372-5
Abstract
Gustatory and anticipatory cephalic stimuli during a meal yield nutritional information and aid efficient food digestion. Mammals, including humans, can detect the amount of dietary protein and its quality via cephalic relay to initiate proper digestion in the upper gastrointestinal (GI) tract. In addition to gustatory stimuli, visceral sensing by the abdominal vagus conveys primary afferent nutritional information from the digestive system to the brain. Electrophysiological studies indicated that abdominal vagal afferents, which were innervated into the stomach and intestine sending information to the brain, were activated by luminal glutamate. Histochemical analysis also revealed the existence of a glutamate signalling system (metabotrophic glutamate receptors) in the GI tract. Luminal glutamate in the stomach and intestine provides the efferent reflection of the abdominal vagus, supporting the modulation of exocrine and endocrine excretion during digestion. These results strongly indicate that glutamate has regulatory effects on the food digestive processes through the gut nutrient-sensing system. It plays physiological and nutritional roles and initiates digestion in the stomach as well as anticipates subsequent processes in the small intestine and the liver. We reviewed recent studies on glutamate physiology in the gut including our research, and discussed the physiological significance of dietary free glutamate in the regulation of gut function, focusing on the visceral sensation from the stomach.
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6.
The patient with circulatory shock: to feed or not to feed?
Cresci, G, CĂșe, J
Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition. 2008;(5):501-9
Abstract
Controversy continues to surround the appropriate form and timing of nutrition support for the patient with circulatory shock. Clinical studies have demonstrated improvements in outcome with the administration of enteral nutrition to critically ill patients; however, the provision of enteral nutrition to critically ill patients with ongoing shock remains controversial. This article reviews gut perfusion during normal states and during circulatory shock as well as alterations in perfusion when enteral feeding is provided. Pharmaconutrients studied during ischemia and reperfusion are discussed.
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7.
Vascular lesions of the gastrointestinal tract.
Regula, J, Wronska, E, Pachlewski, J
Best practice & research. Clinical gastroenterology. 2008;(2):313-28
Abstract
Classification of vascular abnormalities of the gastrointestinal tract on the basis of anatomy and pathophysiology has recently been suggested. Angiodysplasia, an example of an arteriovenous lesion, may cause either acute or chronic bleeding. Diagnosis may be difficult. High-quality standard endoscopy, capsule endoscopy, and double-balloon enteroscopy are most efficacious. Therapy using argon plasma coagulation is currently preferred. Pharmacological therapy has been employed, but a final conclusion about its efficacy cannot yet be drawn. Dieulafoy lesion, an arterial type of vascular abnormality, is rare but serious. It can be responsible for severe haemorrhage. Mechanical endoscopic methods are the most efficacious. Gastric antral vascular ectasia (GAVE), a capillary lesion, can be safely biopsied; it coincides with several diseases (including liver cirrhosis), may cause chronic iron-deficiency anaemia, and is best treated by argon plasma coagulation. Haemangiomas, benign neoplastic lesions, usually occur as part of other specific syndromes; they are difficult to manage due to the multiplicity and size of the lesions.
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8.
Probiotics: a critical review of their potential role as antihypertensives, immune modulators, hypocholesterolemics, and perimenopausal treatments.
Liong, MT
Nutrition reviews. 2007;(7):316-28
Abstract
The conventional use of probiotics to modulate gastrointestinal health, such as in improving lactose intolerance, increasing natural resistance to infectious diseases in the gastrointestinal tract, suppressing traveler's diarrhea, and reducing bloating, has been well investigated and documented. Most of the mechanisms reported to date are mainly caused by the suppression of pathogenic bacteria. Currently, the potential applications of probiotics are being expanded beyond alleviating gastrointestinal disorders to include benefits involving antihypertension, immunomodulation, improving serum lipid profiles, and the alleviation of postmenopausal disorders. Although they seem promising, most of these postulated benefits are based on in vitro evaluations, and the lack of in vivo evidence and/or incompatible outcomes between in vitro experiments and in vivo trials has led to inconclusive claims. This present review highlights some of the previous roles of probiotics on gut health and addresses several potential roles currently being investigated.
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9.
Gastrointestinal digestion of food allergens: effect on their allergenicity.
Moreno, FJ
Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie. 2007;(1):50-60
Abstract
This paper reviews the in vitro digestion models developed to assess the stability digestion of food allergens, as well as the factors derived from the methodology and food structure that may affect the assay results. The adequacy of using the digestion stability of food allergens as a criterion for assessing potential allergenicity is also discussed. Data based on the traditional pepsin digestibility test in simulated gastric fluid are discussed in detail, with special attention to the influence of the pH and pepsin: allergen ratio in the pepsinolysis rate. This review points out the importance of using physiologically relevant in vitro digestion systems for evaluating digestibility of allergens. This would imply the sequential use of digestive enzymes in physiological concentrations, simulation of the stomach/small intestine environment (multi-phase models) with addition of surfactants such as phospholipids or bile salts, as well as the consideration of the gastrointestinal transit and the effect of the food matrices on the allergen digestion and subsequent absorption through the intestinal mucosa. In vitro gastrointestinal digestion protocols should be preferably combined with immunological assays in order to elucidate the role of large digestion-resistant fragments and the influence of the food matrix on the stimulation of the immune system.
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10.
The digestive system and nutritional considerations for individuals with Rett syndrome.
Lotan, M, Zysman, L
TheScientificWorldJournal. 2006;:1737-49
Abstract
Rett syndrome (RS) is a neurodevelopmental syndrome of genetic origin that mainly affects females. Individuals diagnosed with RS exhibit a variety of functional difficulties that impair their quality of life. One of the affected systems is the digestive system, where 74% of persons with RS have abnormal functioning. The affected digestive system causes this population to present an array of problems, such as gastroesophageal reflux (GER), constipation, and malnutrition, leading to failure to thrive (FTT), which resolves in reduced functional ability. Due to the severe effects of the dysfunctional digestive system of individuals with RS, this article will describe the problems common to this population, as well as propose some clinical suggestions for intervention.