The active fraction of psyllium seed husk

Psyllium: A Nutraceutical and Functional Ingredient in Foods

Psyllium is an excellent natural source of soluble and insoluble dietary fiber. It has been used as a nutraceutical and functional ingredient in foods. Many efforts have been made to understand and improve its physicochemical, biological, and functional properties to promote its food applications. This manuscript reviews and discusses the current knowledge of psyllium, focusing on its health benefits, utilizations as a functional additive in foods and hydrogel delivery carrier, approaches to modify its molecular and chemical structures, nonfood utilizations, and potential side effects and toxicity. Perspectives on future research and development of psyllium are also provided. This review may serve as a scientific foundation for improved food application of psyllium to enhance human health and food quality.

Editorial: Interaction between fibre and colonic fermentation assessed with a novel gas-sensing capsule

This article is linked to So et al papers. To view these articles, visit https://doi.org/10.1111/apt.17629 and https://doi.org/10.1111/apt.17704

Replacing Animal Fat with Gels of Psyllium Fiber and Combined Linseed Oil-Psyllium Fiber in Salamis: Impacts on Technological, Nutritional, Oxidative, and Sensory Properties

This study produced two gels: one solely using psyllium fiber (GP) and another combining this fiber with linseed oil (GL+P). Both gels replaced 15% and 30% of the animal fat content of salamis. The objective was to evaluate the impact of this lipid reformulation on the technological, nutritional, oxidative, and sensory properties of the salamis. The lipid reformulation did not alter the evolution of pH and lactic acid bacteria during processing. The addition of GL+P did not interfere with the product's drying process. However, replacing 30% of animal fat with the GP resulted in greater weight loss and a lower final Aw value. The lipid reformulation minimally affected the color of the salamis but significantly enhanced their nutritional profile. This improvement was marked by a decrease in fat content and an increase in protein. Specifically, in the samples with GL+P, there was a rise in linolenic acid content and a reduction in the n-6/n-3 PUFA ratio. Adding GP did not affect the salamis' oxidative stability and sensory profile. However, substituting 30% of the animal fat with GL+P increased the TBARS values, and volatile compounds derived from lipid oxidation hampered the products' sensory profiles. A reduction in these negative effects was observed when replacing 15% of the fat with GL+P, suggesting this to be the ideal dosage for balancing the nutritional benefits with maintaining the product's oxidative stability.

Constipation-Predominant Irritable Bowel Syndrome (IBS-C): Effects of Different Nutritional Patterns on Intestinal Dysbiosis and Symptoms

Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by abdominal pain associated with defecation or a change in bowel habits. The pathogenesis of IBS is not completely clear, but it is known to be multifactorial and complex. Endogenous and exogenous factors such as abnormal GI motility, low-grade inflammation, increased epithelial permeability and visceral hypersensitivity, but diet and psychosocial aspects are also recognized as important actors. Furthermore, the interaction between diet and gut microbiota has gained interest as a potential contributor to the pathophysiology of IBS. To date, there is no specific diet for IBS with constipation (IBS-C); however, many studies show that fiber intake, especially soluble fiber such as inulin, could have a positive effect on symptoms. This review aims to evaluate the effects of some nutritional components such as fibers but also functional foods, prebiotics, probiotics and symbiotics on symptoms and microbiota in IBS-C subjects.

Psyllium Fiber Protects Against Colitis Via Activation of Bile Acid Sensor Farnesoid X Receptor

BACKGROUND & AIMS

Fiber-rich foods promote health, but mechanisms by which they do so remain poorly defined. Screening fiber types, in mice, revealed psyllium had unique ability to ameliorate 2 chronic inflammatory states, namely, metabolic syndrome and colitis. We sought to determine the mechanism of action of the latter.

METHODS

Mice were fed grain-based chow, which is naturally rich in fiber or compositionally defined diets enriched with semi-purified fibers. Mice were studied basally and in models of chemical-induced and T-cell transfer colitis.

RESULTS

Relative to all diets tested, mice consuming psyllium-enriched compositionally defined diets were markedly protected against both dextran sulfate sodium- and T-cell transfer-induced colitis, as revealed by clinical-type, histopathologic, morphologic, and immunologic parameters. Such protection associated with stark basal changes in the gut microbiome but was independent of fermentation and, moreover, maintained in mice harboring a minimal microbiota (ie, Altered Schaedler Flora). Transcriptomic analysis revealed psyllium induced expression of genes mediating bile acids (BA) secretion, suggesting that psyllium's known ability to bind BA might contribute to its ability to prevent colitis. As expected, psyllium resulted in elevated level of fecal BA, reflecting their removal from enterohepatic circulation but, in stark contrast to the BA sequestrant cholestyramine, increased serum BA levels. Moreover, the use of BA mimetics that activate the farnesoid X receptor (FXR), as well as the use of FXR-knockout mice, suggested that activation of FXR plays a central role in psyllium's protection against colitis.

CONCLUSIONS

Psyllium protects against colitis via altering BA metabolism resulting in activation of FXR, which suppresses pro-inflammatory signaling.

Synthesis and characterization of modified bioactive arabinoxylan-psyllium: Evaluation of molecular interactions, physiochemical and biomedical properties

Keeping in view the future prospectus of carbohydrate polymers, present research report is an elaboration, exploration and execution of the research expectancy in area of these polymers by researchers like John F. Kennedy. Herein, molecular interactions and physiochemical properties of modified bioactive arabinoxylan-psyllium have been evaluated for drug delivery applications. Arabinoxylan-psyllium was modified with sulphated and amide copolymers and co-polymers were characterized by SEMs, AFM, FTIR, XRD, solid state ¹³C NMR, TGA-DSC and water absorption studies. The ¹³C-NMR and FTIR confirmed grafted copolymers. The polymer-blood interactions revealed non-thrombogenic nature with thrombose percentage 63.17 ± 5.61 % and polymer-mucous membrane interactions showed detachment force 0.237 ± 0.078Nwith bio-membrane in mucoadhesion test. The pH responsible gels exhibited 44.49 ± 3.12 % inhibitions of free radicals in DPPH assay. The polymer-drug interactions demonstrated sustained diffusion of methotrexate with non-Fickian diffusion and Korsmeyer-Peppas kinetic model. Overall, co-polymeric network structure was found useful in colon specific drug delivery.

The structure-activity mechanism of the changes in the physicochemical properties of Flammulina velutipes polysaccharides during ultrasonic extraction

BACKGROUND

The high yield of ultrasonic extraction has been widely studied. However, the effects of ultrasound on the properties of products has generally been ignored. In this study, the structural characteristics, rheological properties, and thermal stability of Flammulina velutipes polysaccharides (FVPs) under different ultrasonic power (200, 600, 1000 W) and time (10, 20, 30 min) were investigated to explore the effects of ultrasonic extraction on FVPs and the structure-physicochemical properties relationship. The ultrasonic intensity at the corresponding rated power was also measured.

RESULTS

The results showed that the molecular weight, particle size, and zeta potential of FVPs decreased as the ultrasonic intensity or time increased. The galactose, mannose, and fucose contents were increased, but the glucose content was decreased by ultrasonic extraction. Viscosity and weak gel strength were positively correlated with molecular weight. Thermal degradation enthalpy was positively correlated with the galactose and fucose contents.

CONCLUSIONS

Ultrasound reduced the viscosity and gel strength of FVPs by breaking the polysaccharide chain and improving the galactose and fucose contents, which improved the thermal stability of FVPs. This work provides a theoretical basis for the development of FVP foods with a clear structure-function relationship, which makes it possible to directionally produce FVPs by adjusting ultrasonic parameters during extraction. © 2021 Society of Chemical Industry.

Dietary fibres and IBS: translating functional characteristics to clinical value in the era of personalised medicine

Clinical guidelines in the use of fibre supplementation for patients with IBS provide one-size-fits-all advice, which has limited value. This narrative review addresses data and concepts around the functional characteristics of fibre and subsequent physiological responses induced in patients with IBS with a view to exploring the application of such knowledge to the precision use of fibre supplements. The key findings are that first, individual fibres elicit highly distinct physiological responses that are associated with their functional characteristics rather than solubility. Second, the current evidence has focused on the use of fibres as a monotherapy for IBS symptoms overall without attempting to exploit these functional characteristics to elicit specific, symptom-targeted effects, or to use fibre types as adjunctive therapies. Personalisation of fibre therapies can therefore target several therapeutic goals. Proposed goals include achieving normalisation of bowel habit, modulation of gut microbiota function towards health and correction of microbial effects of other dietary therapies. To put into perspective, bulking fibres that are minimally fermented can offer utility in modulating indices of bowel habit; slowly fermented fibres may enhance the activities of the gut microbiota; and the combination of both fibres may potentially offer both benefits while optimising the activities of the microbiota throughout the different regions of the colon. In conclusion, understanding the GI responses to specific fibres, particularly in relation to the physiology of the individual, will be the future for personalising fibre therapy for enhancing the personalised management of patients with IBS.

Psyllium husk intake and risk of type 2 diabetes: an evidence-based scientific and regulatory review of a qualified health claim conducted by the US Food and Drug Administration

The US Food and Drug Administration (FDA) received a petition from a company requesting that FDA issue an authorized health claim for the relationship between psyllium husk and a reduced risk of type 2 diabetes. After an initial assessment of the available scientific evidence, FDA determined that significant scientific agreement was lacking for this substance-disease relationship, whereupon the company agreed to have its petition reviewed as a qualified health claim. This article describes the process FDA used in conducting an evidence-based review of the science underpinning the proposed claim and addresses certain safety issues associated with psyllium husk that FDA considered in its review of the petition. Of the 6 studies from which scientific conclusions could be drawn, as identified through FDA's review, psyllium husk significantly improved plasma glucose levels and insulin sensitivity in only 1 study. Therefore, FDA's enforcement discretion letter for this qualified health claim stated: "Psyllium husk may reduce the risk of type 2 diabetes, although the FDA has concluded that there is very little scientific evidence for this claim."

Chrysobalanus icaco: A review of its phytochemistry and pharmacology

The genus Chrysobalanus is one of the classes of medicinal plants used in the treatment and management of several diseases. This study is aimed at providing up-to-date information on the phytochemical composition and pharmacological uses of Chrysobalanus icaco. Current literature on the Chrysobalanus species was obtained by searching electronic databases such as PubMed, Google Scholar and Web of Science. Of the species in this genus, four have been reported in the literature, but only one (C. icaco) has been extensively studied. C. icaco is rich in several minerals, including potassium, magnesium, calcium and sodium. The plant also contains a host of phytochemicals, such as flavonoids, diterpenes and triterpenes, which have been shown to have pharmacological activity. It can be concluded that C. icaco is a good source of phytochemicals that contribute to its therapeutic uses. However, bioassay-guided isolation of its bioactive compounds is necessary for promoting the development of drugs from this medicinal plant.

The Effect of Probiotics on the Production of Short-Chain Fatty Acids by Human Intestinal Microbiome

The relationship between diet and the diversity and function of the intestinal microbiome and its importance for human health is currently the subject of many studies. The type and proportion of microorganisms found in the intestines can determine the energy balance of the host. Intestinal microorganisms perform many important functions, one of which is participation in metabolic processes, e.g., in the production of short-chain fatty acids—SCFAs (also called volatile fatty acids). These acids represent the main carbon flow from the diet to the host microbiome. Maintaining intestinal balance is necessary to maintain the host’s normal health and prevent many diseases. The results of many studies confirm the beneficial effect of probiotic microorganisms on the balance of the intestinal microbiome and produced metabolites, including SCFAs. The aim of this review is to summarize what is known on the effects of probiotics on the production of short-chain fatty acids by gut microbes. In addition, the mechanism of formation and properties of these metabolites is discussed and verified test results confirming the effectiveness of probiotics in human nutrition by modulating SCFAs production by intestinal microbiome is presented.

The impact of dietary fiber and probiotics in infectious diseases

Although antibiotics are commonly used to treat infectious diseases, emergence of antibiotic resistant strains highlights the necessity for developing novel alternative approaches. Meanwhile, clinically, antibiotics can destroy the gut microbes balance, which is not conducive to the recovery of infectious disorders. As a result, recent studies have begun to explore potential prevention and treatment methods for infectious diseases, starting with more readily available dietary fiber and probiotics. Moreover, researches have shown the personalized nature of host responses to dietary fiber intervention, with outcomes being dependent on individual pre-treatment gut microbes. In this review, we will focus on the roles of dietary fiber and probiotics on infectious diseases, how probiotics and dietary fiber work on infectious diseases and then explore their mechanisms, so as to guide clinical consideration of new therapies for infectious diseases.

Anti-Respiratory Syncytial Virus Activity of Plantago asiatica and Clerodendrum trichotomum Extracts In Vitro and In Vivo

The herbs Plantago asiatica and Clerodendrum trichotomum have been commonly used for centuries in indigenous and folk medicine in tropical and subtropical regions of the world. In this study, we show that extracts from these herbs have antiviral effects against the respiratory syncytial virus (RSV) in vitro cell cultures and an in vivo mouse model. Treatment of HEp2 cells and A549 cells with a non-cytotoxic concentration of Plantago asiatica or Clerodendrum trichotomum extract significantly reduced RSV replication, RSV-induced cell death, RSV gene transcription, RSV protein synthesis, and also blocked syncytia formation. Interestingly, oral inoculation with each herb extract significantly improved viral clearance in the lungs of BALB/c mice. Based on reported information and a high-performance liquid chromatography (HPLC) analysis, the phenolic glycoside acteoside was identified as an active chemical component of both herb extracts. An effective dose of acteoside exhibited similar antiviral effects as each herb extract against RSV in vitro and in vivo. Collectively, these results suggest that extracts of Plantago asiatica and Clerodendrum trichotomum could provide a potent natural source of an antiviral drug candidate against RSV infection.

Nondigestible carbohydrates, butyrate, and butyrate-producing bacteria

Nondigestible carbohydrates (NDCs) are fermentation substrates in the colon after escaping digestion in the upper gastrointestinal tract. Among NDCs, resistant starch is not hydrolyzed by pancreatic amylases but can be degraded by enzymes produced by large intestinal bacteria, including clostridia, bacteroides, and bifidobacteria. Nonstarch polysaccharides, such as pectin, guar gum, alginate, arabinoxylan, and inulin fructans, and nondigestible oligosaccharides and their derivatives, can also be fermented by beneficial bacteria in the large intestine. Butyrate is one of the most important metabolites produced through gastrointestinal microbial fermentation and functions as a major energy source for colonocytes by directly affecting the growth and differentiation of colonocytes. Moreover, butyrate has various physiological effects, including enhancement of intestinal barrier function and mucosal immunity. In this review, several representative NDCs are introduced, and their chemical components, structures, and physiological functions, including promotion of the proliferation of butyrate-producing bacteria and enhancement of butyrate production, are discussed. We also describe the strategies for achieving directional accumulation of colonic butyrate based on endogenous generation mechanisms.

Dietary fiber in irritable bowel syndrome (Review)

Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder. It is widely believed that IBS is caused by a deficient intake of dietary fiber, and most physicians recommend that patients with IBS increase their intake of dietary fiber in order to relieve their symptoms. However, different types of dietary fiber exhibit marked differences in physical and chemical properties, and the associated health benefits are specific for each fiber type. Short-chain soluble and highly fermentable dietary fiber, such as oligosaccharides results in rapid gas production that can cause abdominal pain/discomfort, abdominal bloating/distension and flatulence in patients with IBS. By contrast, long-chain, intermediate viscous, soluble and moderately fermentable dietary fiber, such as psyllium results in a low gas production and the absence of the symptoms related to excessive gas production. The effects of type of fiber have been documented in the management of IBS, and it is known to improve the overall symptoms in patients with IBS. Dietary fiber acts on the gastrointestinal tract through several mechanisms, including increased fecal mass with mechanical stimulation/irritation of the colonic mucosa with increasing secretion and peristalsis, and the actions of fermentation byproducts, particularly short-chain fatty acids, on the intestinal microbiota, immune system and the neuroendocrine system of the gastrointestinal tract. Fiber supplementation, particularly psyllium, is both safe and effective in improving IBS symptoms globally. Dietary fiber also has other health benefits, such as lowering blood cholesterol levels, improving glycemic control and body weight management.

Psyllium Fiber Reduces Abdominal Pain in Children With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial

BACKGROUND & AIMS

We sought to determine the efficacy of psyllium fiber treatment on abdominal pain and stool patterns in children with irritable bowel syndrome (IBS). We evaluated effects on breath hydrogen and methane production, gut permeability, and microbiome composition. We also investigated whether psychological characteristics of children or parents affected the response to treatment.

METHODS

We performed a randomized, double-blind trial of 103 children (mean age, 13 ± 3 y) with IBS seen at primary or tertiary care settings. After 2 weeks on their habitual diet, children began an 8-day diet excluding carbohydrates thought to cause symptoms of IBS. Children with ≥75% improvement in abdominal pain were excluded (n = 17). Children were assigned randomly to groups given psyllium (n = 37) or placebo (maltodextrin, n = 47) for 6 weeks. Two-week pain and stool diaries were compared at baseline and during the final 2 weeks of treatment. We assessed breath hydrogen and methane production, intestinal permeability, and the composition of the microbiome before and after administration of psyllium or placebo. Psychological characteristics of children were measured at baseline.

RESULTS

Children in the psyllium group had a greater reduction in the mean number of pain episodes than children in the placebo group (mean reduction of 8.2 ± 1.2 after receiving psyllium vs mean reduction of 4.1 ± 1.3 after receiving placebo; P = .03); the level of pain intensity did not differ between the groups. Psychological characteristics were not associated with response. At the end of the study period, the percentage of stools that were normal (Bristol scale scores, 3-5), breath hydrogen or methane production, intestinal permeability, and microbiome composition were similar between groups.

CONCLUSIONS

Psyllium fiber reduced the number of abdominal pain episodes in children with IBS, independent of psychological factors. Psyllium did not alter breath hydrogen or methane production, gut permeability, or microbiome composition. ClinicalTrials.gov no: NCT00526903.

Evaluation of the Effect of Psyllium on the Viability of Lactobacillus Acidophilus in Alginate-Polyl Lysine Beads

Purpose: Psylliumseeds are used in traditional herbal medicine to treat various disorders. Moreover, as a soluble fiber, psyllium has potential to stimulate bacterial growth in digestive system. We aimed to substitute alkali-extractable polysaccharides of psyllium for alginate in beads with second coat of poly-l-lysine to coat Lactobacillus acidophilus. Methods: Beads were prepared using extrusion technique. Poly-l-lysine as second coat was incorporated on optimum alginate/psyllium beads using immersion technique. Beads were characterized in terms of size, encapsulation efficiency, integrity and bacterial survival in harsh conditions. Results: Beads with narrow size distribution ranging from 1.85 ± 0.05 to 2.40 ± 0.18 mm with encapsulation efficiency higher than 96% were achieved. Psyllium concentrations in beads did not produce constant trend in bead sizes. Surface topography by SEM showed that substitution of psyllium enhanced integrity of obtained beads. Psyllium successfully protected the bacteria against acidic condition and lyophilization equal to alginate in the beads. Better survivability with beads of alginate/psyllium-poly-l-lysine was achieved with around 2 log rise in bacterial count in acid condition compared to the corresponding single coat beads. Conclusion: Alginate/psyllium (1:2) beads with narrow size distribution and high encapsulation efficiency of the bacteria have been achieved. Presence of psyllium produced a much smoother and integrated surface texture for the beads with sufficient protection of the bacteria against acidic condition as much as alginate. Considering the health benefits of psyllium and its prebiotic activity, psyllium can be beneficially replaced in part for alginate in probiotic coating.

Systematic review with meta-analysis: effect of fibre supplementation on chronic idiopathic constipation in adults

BACKGROUND

Chronic idiopathic constipation is a common symptom-based gastrointestinal disorder responsible for a substantial economic health service burden. Current guidelines recommend the use of fibre as a first-line treatment.

AIM

To investigate the effect of fibre (including prebiotic) supplementation on global symptom response, stool output, gut microbiota composition and adverse events in adults with chronic idiopathic constipation.

METHODS

Medline, EmBase, Web of Science, Scopus and the Cochrane central register of controlled trials were searched through to February 2016. Conference proceedings from 2003 to 2015 were hand-searched. There were no language restrictions. Forest plots with 95% CIs were generated using a random-effects model.

RESULTS

The search strategy generated 1072 citations, of which seven individual randomised controlled trials were eligible. Overall, 113 of 147 (77%) patients assigned to fibre responded to therapy, compared with 61 of 140 (44%) allocated to placebo (RR of success to respond 1.71, 95% CI 1.20-2.42, P = 0.003). Fibre significantly increased stool frequency (SMD, standardised mean difference = 0.39; 95% CI 0.03-0.76; P = 0.03) and softened stool consistency (SMD = 0.35; 95% CI 0.04-0.65; P = 0.02) compared with placebo. Flatulence was significantly higher with fibre compared to placebo (SMD 0.56, 0.12-1.00, P = 0.01). Overall quality of evidence was low.

CONCLUSIONS

This meta-analysis demonstrates that fibre is moderately effective, but also causes moderate gastrointestinal side effects. However, these findings need to be treated with caution due to a high risk of bias. Accordingly, further large, methodologically rigorous trials are required, before any definitive recommendation regarding its risk-benefit profile can be made. PROSPERO registration number CRD42014007005.

Anticoccidial effects of the Plantago asiatica extract on experimental Eimeria tenella infection

Anticoccidial effects of the Plantago asiatica extract (PAE) were evaluated in chickens following oral infection with Eimeria (E.) tenella. This study was conducted on the 3-day-old chickens (n=30). Those animals were divided with 3 groups; PAE 0.1% treated/infected (n=10), PAE untreated/infected (n=10) and non-infected control (n=10). Chickens were fed a standard diet supplemented with or without PAE for 1 week prior to infection with E. tenella (10,000 sporulated oocysts per chicken). The effects of PAE on E. tenella infection were assessed by two parameters; fecal oocysts shedding and body weights gain. The PAE-fed chickens produced significantly reduced fecal oocysts (P<0.05) when compared to the E. tenella-infected group fed standard diet. Also, PAE-based diet, improved body weight loss caused by E. tenella infection. Our data demonstrated that PAE had remarkable anticoccidial activities against E. tenella. This finding might have implications for the development of anticoccidial drug. This study is the first to demonstrate anticoccidial effect of PAE on Eimeria parasites.

Developing consumer acceptable biscuits enriched with Psyllium fibre

Consumer's demand for functional food is a trend of the last decades. Nowadays, the attention is focused on the development of products with health claims on the label, which can result in value-added products for the producers companies. Cookies are popular staple foods in the human diet in many countries and are generally well accepted by consumers due to their sensory attributes, long shelf life and convenience. The incorporation of solid components on the biscuit dough, such as dietary fibre, could have serious implications on its structure and perceived texture which explains the technological limitations for the fibre incorporation. The aim of this work is to develop an enriched functional biscuit with Psyllium fibre and understand the impact of the new ingredient on physicochemical and sensorial properties of the dough and biscuits. The optimum biscuit's formulation was determined using the response surface methodology (RSM). Effects of wheat flour (48-52 %) and Psyllium (3-9 %) contents on the dimensional features (spread ratio, expansion factor), water activity, colour parameters (L*, a*, b*), texture characteristics (firmness, adhesiveness, cohesiveness, springiness) and sensory properties (colour, flavour, texture, overall acceptability) of dough and biscuits were investigated. The most representative parameters evaluated were used to develop biscuits with similar features to commercial references. An optimum formulation was obtained by incorporating 6 % Psyllium and 50 % flour. This biscuit has the enough amount of Psyllium soluble fibre recommended by Food and Drug Administration (FDA) to prevent the risk of coronary heart disease and to bear a health claim on the label.

Dietary fiber supplementation for fecal incontinence: a randomized clinical trial

Dietary fiber supplements are used to manage fecal incontinence (FI), but little is known about the fiber type to recommend or the level of effectiveness of such supplements, which appears related to the fermentability of the fiber. The aim of this single-blind, randomized controlled trial was to compare the effects of three dietary fiber supplements (carboxymethylcellulose [CMC], gum arabic [GA], or psyllium) with differing levels of fermentability to a placebo in community-living individuals incontinent of loose/liquid feces. The primary outcome was FI frequency; secondary outcomes included FI amount and consistency, supplement intolerance, and quality of life (QoL). Possible mechanisms underlying supplement effects were also examined. After a 14-day baseline, 189 subjects consumed a placebo or 16 g total fiber/day of one of the fiber supplements for 32 days. FI frequency significantly decreased after psyllium supplementation versus placebo, in both intent-to-treat and per-protocol mixed model analyses. CMC increased FI frequency. In intent-to-treat analysis, the number of FI episodes/week after supplementation was estimated to be 5.5 for Placebo, 2.5 for Psyllium, 4.3 for GA, and 6.2 for CMC. Only psyllium consumption resulted in a gel in feces. Supplement intolerance was low. QoL scores did not differ among groups. Patients with FI may experience a reduction in FI frequency after psyllium supplementation, and decreased FI frequency has been shown to be an important personal goal of treatment for patients with FI. Formation of a gel in feces appears to be a mechanism by which residual psyllium improved FI.

Comparison of 3% sorbitol vs psyllium fibre as oral contrast agents in MR enterography

OBJECTIVE

To compare the degree of small bowel distension achieved by 3% sorbitol, a high osmolarity solution, and a psyllium-based bulk fibre as oral contrast agents (OCAs) in MR enterography (MRE).

METHODS

This retrospective study was approved by our institutional review board. A total of 45 consecutive normal MRE examinations (sorbitol, n = 20; psyllium, n = 25) were reviewed. The patients received either 1.5 l of 3% sorbitol or 2 l of 1.6 g kg(-1) psyllium prior to imaging. Quantitative small bowel distension measurements were taken in five segments: proximal jejunum, distal jejunum, proximal ileum, distal ileum and terminal ileum by two independent radiologists. Distension in these five segments was also qualitatively graded from 0 (very poor) to 4 (excellent) by two additional independent radiologists. Statistical analysis comparing the groups and assessing agreement included intraclass coefficients, Student's t-test and Mann-Whitney U-test.

RESULTS

Small bowel distension was not significantly different in any of the five small bowel segments between the use of sorbitol and psyllium as OCAs in both the qualitative (p = 0.338-0.908) and quantitative assessments (p = 0.083-0.856). The mean bowel distension achieved was 20.1 ± 2.2 mm for sorbitol and 19.8 ± 2.5 mm for psyllium (p = 0.722). Visualization of the ileum was good or excellent in 65% of the examinations in both groups.

CONCLUSION

Sorbitol and psyllium are not significantly different at distending the small bowel and both may be used as OCAs for MRE studies.

ADVANCES IN KNOWLEDGE

This is the first study to directly compare the degree of distension in MRE between these two common, readily available and inexpensive OCAs.

Mechanisms and efficacy of dietary FODMAP restriction in IBS

IBS is a debilitating condition that markedly affects quality of life. The chronic nature, high prevalence and associated comorbidities contribute to the considerable economic burden of IBS. The pathophysiology of IBS is not completely understood and evidence to guide management is variable. Interest in dietary intervention continues to grow rapidly. Ileostomy and MRI studies have demonstrated that some fermentable carbohydrates increase ileal luminal water content and breath hydrogen testing studies have demonstrated that some carbohydrates also increase colonic hydrogen production. The effects of fermentable carbohydrates on gastrointestinal symptoms have also been well described in blinded, controlled trials. Dietary restriction of fermentable carbohydrates (popularly termed the 'low FODMAP diet') has received considerable attention. An emerging body of research now demonstrates the efficacy of fermentable carbohydrate restriction in IBS; however, limitations still exist with this approach owing to a limited number of randomized trials, in part due to the fundamental difficulty of placebo control in dietary trials. Evidence also indicates that the diet can influence the gut microbiota and nutrient intake. Fermentable carbohydrate restriction in people with IBS is promising, but the effects on gastrointestinal health require further investigation.

Fiber and functional gastrointestinal disorders

Despite years of advising patients to alter their dietary and supplementary fiber intake, the evidence surrounding the use of fiber for functional bowel disease is limited. This paper outlines the organization of fiber types and highlights the importance of assessing the fermentation characteristics of each fiber type when choosing a suitable strategy for patients. Fiber undergoes partial or total fermentation in the distal small bowel and colon leading to the production of short-chain fatty acids and gas, thereby affecting gastrointestinal function and sensation. When fiber is recommended for functional bowel disease, use of a soluble supplement such as ispaghula/psyllium is best supported by the available evidence. Even when used judiciously, fiber can exacerbate abdominal distension, flatulence, constipation, and diarrhea.

Major cereal grain fibers and psyllium in relation to cardiovascular health

Numerous studies reveal the cardiovascular benefits of consuming dietary fiber and, especially, cereal fiber. Cereal fiber is associated with cardiovascular risk reduction through multiple mechanisms and consuming a variety of cereal fiber sources offers health benefits specific to the source. Certain cereal fibers have been studied more extensively than others and provide greater support for their incorporation into a healthful diet. β-glucan from oats or barley, or a combination of whole oats and barley, and soluble fiber from psyllium reduces the risk of coronary heart disease; inulin-type fructans added to foods and beverages may modestly decrease serum triacylglycerols; arabinoxylan and resistant starch may improve glycemic control. Individuals with low cereal fiber intake should increase their intake of whole grains in order to receive the benefits of whole grains in addition to fiber. For those adjusting to the texture and palatability of whole grains, turning to added-fiber products rich in β-glucan and psyllium may allow them to reach their fiber goals without increasing caloric intake.

Effects of psyllium on metabolic syndrome risk factors

High-fibre intake has been shown to reduce the risk of metabolic syndrome (MS), cardiovascular disease and type 2 diabetes. Psyllium is one of the most widely used fibre supplements because it is reasonably cheap and is better tolerated than other fibre supplements. The review of the literature supports the notion that the consumption of psyllium provides benefits to many components of the MS. Psyllium supplementation does improve glucose levels and insulin response, blood pressure, as well as lipid profile in both animals and humans, thereby reducing metabolic risk factors. Appetite has also been reported to decrease after the consumption of psyllium in most studies. Collectively, psyllium supplementation could be promoted to patients who present MS risk factors, such as hypercholesterolaemia, hypertriglyceridaemia and hyperglycaemia. It may also play a role in controlling body weight, body composition, appetite and hypertension, but further investigation is still required.

Immunomodulatory activity of the seeds of Plantago asiatica L

ETHNOPHARMACOLOGICAL RELEVANCE

The seeds of Plantago asiatica L. were often used as a traditional Chinese medicine for some immunologically weak patients suffering from chronic illness. These uses could be related to immunomodulatory properties of the plant.

AIM OF THE STUDY

In this study, effects of extract of the seeds of Plantago asiatica L. (ES-PL) were investigated on the maturation of dendritic cells (DCs), which play significant role in primary immune system.

MATERIALS AND METHODS

The phenotypes of DCs were analyzed by using flow cytometry while phagocytosis was assessed by the uptake of FITC-dextran. Antigen presenting ability to allogeneically naïve or syngeneically primed T lymphocytes was examined by the lymphocyte proliferation of mixed lymphocyte reaction (MLR). In addition, the level of chemokine receptor CCR7 mRNA was determined by RT-PCR.

RESULTS

DCs treated with ES-PL expressed higher levels of MHC class II molecules and major costimulatory molecules such as CD80 and CD86. Functional maturation of DCs treated with ES-PL was confirmed by decreased mannose receptor-mediated endocytosis and increased antigen presenting abilities to allogeneically naïve or syngeneically primed T lymphocytes. The CCR7 mRNA expression in DCs treated with ES-PL was also enhanced.

CONCLUSIONS

These results indicated that ES-PL could induce the maturation of murine DCs.

Effect of heat treatment of digestion-resistant fraction from soybean on retarding of bile acid transport in vitro

In this study, we investigated the heat effect of digestion-resistant fraction (RF) from soybean on retarding bile acid transport in vitro. The RFs from soybean retarded bile acid transport. A raw, unheated RF of soybean (RRF-SOY) was significantly more effective than the heated RF of soybean (HRF-SOY). The RS1 which physically trapped in milled grains and inaccessible to digestive enzyme after 18 hrs incubation level of content in RRF-SOY was found to be as high as 24.1% and after heating the RS1 of HRF-SOY was significantly reduced to 16.8%. The X-ray diffraction pattern of RF from soybean was altered after heat treatment. The RFs from soybean were characterized by peak at diffraction angles of 12.0° and 20.0° corresponding to RS content. Cellulose contents of RRF-SOY was 5% higher than that of HRF-SOY and pentosan contents of RRF-SOY was 5% higher than that of HRF-SOY, too. Whereas the hemicellulose content of RRF-SOY was 13% lower than HRF-SOY.

Ball milling improves extractability and affects molecular properties of psyllium (Plantago ovata Forsk) seed husk arabinoxylan

Psyllium (Plantago ovata Forsk) seed husk (PSH) is very rich in arabinoxylan (AX). However, its high gelling capacity and the complex nature of the AX make it difficult to process. In this study, ball milling was investigated as a tool for enhancing PSH AX water extractability and molecular mass (MM). A 48 h laboratory-scale ball mill treatment under standardized optimal conditions reduced the PSH average particle size from 161 microm for the untreated sample to 6 microm. Concurrently, it increased the water-extractable AX (WE-AX) level from 13 (untreated PSH) to 90% of the total PSH AX. While the WE-AX of the untreated PSH had a peak MM of 216 kDa and an arabinose to xylose (A/X) ratio of 0.20, WE-AX fragments from ball mill-pretreated PSH had a peak MM of 22 kDa and an A/X ratio of 0.31. Ball milling further drastically reduced the intrinsic viscosity of PSH extracts and their water-holding capacity. Prolonged treatment brought almost all AX (98%) in solution and yielded WE-AX fragments with an even higher A/X ratio (0.42) and a lower peak MM (11 kDa). While impact and jet milling of PSH equally led to significant reductions in particle size, these technologies only marginally affected the water extractability of PSH AX. This implies that ball milling affects PSH particles and their constituent molecules differently than impact and jet milling.

Evaluation of prebiotic potential of refined psyllium (Plantago ovata) fiber in healthy women

GOAL

To assess the effects of the consumption of psyllium seed husk on fecal bifidobacteria in healthy women and the ability of fecal bifidobacteria to metabolize psyllium seed husk in vitro.

BACKGROUND

Poor microbiologic evidences are nowadays available concerning the ability of psyllium seed husk to promote the growth of bifidobacteria in human gut.

STUDY

Eleven healthy women consumed 7.0 g/d of psyllium seed husk for 1 month. Viability of bifidobacteria in feces was assessed at different time points.

RESULTS

In vivo results showed that the average fecal content of viable bifidobacteria was not significantly affected even if fecal counts were found to increase significantly after treatment in 6 out of 11 women having low initial concentration. In vitro trials conducted on bifidobacteria strains isolated from treated women failed to confirm the prebiotic potential of undigested psyllium seed husk, whereas treatment with simulated gastric and pancreatic juices and mimicking physical and chemical alterations during human gut transit allowed fecal Bifidobacterium isolates to metabolize psyllium seed husk as carbon source in a growth medium deprived of sugar.

CONCLUSIONS

Psyllium seed husk can be metabolized by bifidobacteria only after partial hydrolysis. Bifidogenic potential can be detected in healthy women only in case of low level of fecal bifidobacteria before treatment.

Cholesterol reduction using psyllium husks - do gastrointestinal adverse effects limit compliance? Results of a specific observational study

PURPOSE

Despite known cholesterol lowering effects the use of psyllium husk (Plantaginis ovatae testa) in Germany for hypercholesterolemia is limited compared to their use as a laxative. To investigate whether use in hypercholesterolemia is limited due to adverse effects on the gastrointestinal system, a prospective observational study was conducted.

METHODS

Sixty-two outpatients with documented hypercholesterolemia and complaints of constipation were identified from an academic clinical center. Treatment with 3.5g psyllium husk preparation administered three times daily was initiated and patients were monitored at weekly intervals. Gastrointestinal symptoms were quantified using a validated Nepean Dyspepsia Index modified to identify both upper and lower abdominal symptoms. Diaries and study medication records were used to evaluate compliance.

RESULTS

Fifty-four of 62 patients enrolled in the study completed the study protocol with 4 subjects discontinuing due to adverse reactions associated with psyllium husks. Total cholesterol was significantly decreased from 252+/-39mg/dl before treatment to 239+/-37mg/dl after 3 weeks of treatment. Similarly, low density lipoprotein (LDL)-cholesterol decreased from 174+/-34 to 162+/-31mg/dl during the study. Triglycerides and high density lipoprotein (HDL) were unchanged. Gastrointestinal symptoms were rated lower at the end than at the beginning of the study. In week 1 most of the patients reported gastrointestinal symptoms and also gastrointestinal adverse reactions, which however, showed a decrease from week 1 to weeks 2 and 3 in the diaries. Patient response to study medication was positive for patients completing the study.

CONCLUSIONS

Psyllium husk preparations may be a therapeutic option for patients with mild to moderately elevated cholesterol levels. Adverse gastrointestinal symptoms associated with the preparation appear to be transient in some of the patients. Compliance may be optimized with adequate patient counseling.

Water-soluble dietary fibers and cardiovascular disease

One well-established way to reduce the risk of developing cardiovascular disease (CVD) is to lower serum LDL cholesterol levels by reducing saturated fat intake. However, the importance of other dietary approaches, such as increasing the intake of water-soluble dietary fibers is increasingly recognized. Well-controlled intervention studies have now shown that four major water-soluble fiber types-beta-glucan, psyllium, pectin and guar gum-effectively lower serum LDL cholesterol concentrations, without affecting HDL cholesterol or triacylglycerol concentrations. It is estimated that for each additional gram of water-soluble fiber in the diet serum total and LDL cholesterol concentrations decrease by -0.028 mmol/L and -0.029 mmol/L, respectively. Despite large differences in molecular structure, no major differences existed between the different types of water-soluble fiber, suggesting a common underlying mechanism. In this respect, it is most likely that water-soluble fibers lower the (re)absorption of in particular bile acids. As a result hepatic conversion of cholesterol into bile acids increases, which will ultimately lead to increased LDL uptake by the liver. Additionally, epidemiological studies suggest that a diet high in water-soluble fiber is inversely associated with the risk of CVD. These findings underlie current dietary recommendations to increase water-soluble fiber intake.

Dietary fibers affect viscosity of solutions and simulated human gastric and small intestinal digesta

Two experiments were conducted to determine the viscosities of both soluble and insoluble dietary fibers. In Expt. 1, corn bran, defatted rice bran, guar gum, gum xanthan, oat bran, psyllium, soy hulls, stabilized rice bran, wheat bran, wood cellulose, and 2 methylcellulose controls (Ticacel 42, Ticacel 43) were hydrated in water overnight at 0.5, 1, 1.5, or 2% concentrations. In Expt. 2, guar gum, oat bran, psyllium, rice bran, wheat bran, and wood cellulose were subjected to a 2-stage in vitro gastric and small intestinal digestion simulation model. Viscosity was measured every 2 and 3 h during gastric and small intestinal simulation, respectively. Viscosities in both experiments were measured at multiple shear rates. Viscosities of all fiber solutions were concentration- and shear rate-dependent. Rice brans, soy hulls, and wood cellulose had the lowest viscosities, whereas guar gum, psyllium, and xanthan gum had the highest viscosities, regardless of concentration. During gastric simulation, viscosity was higher (P < 0.05) at 4 h than at 0 h for guar gum, psyllium, rice bran, and wheat bran. During small intestinal simulation, viscosities were higher (P < 0.05) between 3 and 9 h compared with 18 h for guar gum, oat bran, and rice bran. Guar gum, psyllium, and oat bran exhibited viscous characteristics throughout small intestinal simulation, indicating potential for these fibers to elicit blood glucose and lipid attenuation. Wheat and rice brans and wood cellulose did not exhibit viscous characteristics throughout small intestinal digestion; thus, they may be beneficial for laxation.

Carbohydrates and dietary fiber

The most widely spread eating habit is characterized by a reduced intake of dietary fiber, an increased intake of simple sugars, a high intake of refined grain products, an altered fat composition of the diet, and a dietary pattern characterized by a high glycemic load, an increased body weight and reduced physical activity. In this chapter the effects of this eating pattern on disease risk will be outlined. There are no epidemiological studies showing that the increase of glucose, fructose or sucrose intake is directly and independently associated with an increased risk of atherosclerosis or coronary heart disease (CHD). On the other hand a large number of studies has reported a reduction of fatal and non-fatal CHD events as a function of the intake of complex carbohydrates--respectively 'dietary fiber' or selected fiber-rich food (e.g., whole grain cereals). It seems that eating too much 'fast' carbohydrate [i.e., carbohydrates with a high glycemic index (GI)] may have deleterious long-term consequences. Indeed the last decades have shown that a low fat (and consecutively high carbohydrate) diet alone is not the best strategy to combat modern diseases including atherosclerosis. Quantity and quality issues in carbohydrate nutrient content are as important as they are for fat. Multiple lines of evidence suggest that for cardiovascular disease prevention a high sugar intake should be avoided. There is growing evidence of the high impact of dietary fiber and foods with a low GI on single risk factors (e.g., lipid pattern, diabetes, inflammation, endothelial function etc.) as well as also the development of the endpoints of atherosclerosis especially CHD.