Dichotomous effect of dietary fiber in pediatrics: a narrative review of the health benefits and tolerance of fiber

Dietary fibers are associated with favorable gastrointestinal, immune, and metabolic health outcomes when consumed at sufficient levels. Despite the well-described benefits of dietary fibers, children and adolescents continue to fall short of daily recommended levels. This gap in fiber intake (i.e., "fiber gap") might increase the risk of developing early-onset pediatric obesity and obesity-related comorbidities such as type 2 diabetes mellitus into adulthood. The structure-dependent physicochemical properties of dietary fiber are diverse. Differences in solubility, viscosity, water-holding capacity, binding capability, bulking effect, and fermentability influence the physiological effects of dietary fibers that aid in regulating appetite, glycemic and lipidemic responses, and inflammation. Of growing interest is the fermentation of fibers by the gut microbiota, which yields both beneficial and less favorable end-products such as short-chain fatty acids (e.g., acetate, propionate, and butyrate) that impart metabolic and immunomodulatory properties, and gases (e.g., hydrogen, carbon dioxide, and methane) that cause gastrointestinal symptoms, respectively. This narrative review summarizes (1) the implications of fibers on the gut microbiota and the pathophysiology of pediatric obesity, (2) some factors that potentially contribute to the fiber gap with an emphasis on undesirable gastrointestinal symptoms, (3) some methods to alleviate fiber-induced symptoms, and (4) the therapeutic potential of whole foods and commonly marketed fiber supplements for improved health in pediatric obesity.

Improvement of sleep by resistant dextrin prebiotic in type 2 diabetic women coincides with attenuation of metabolic endotoxemia: involvement of gut-brain axis

BACKGROUND

Resistant dextrin, as a prebiotic and functional food, may possess favorable effects in type 2 diabetes. This study was conducted to assess whether supplementation with resistant dextrin can improve sleep and quality of life in obese type 2 diabetic women.

RESULTS

In this randomized controlled trial, female obese type 2 diabetic patients (n = 76) were randomly assigned into intervention group (n = 38) and placebo group (n = 38), and received 10 g day^-1 of resistant dextrin or maltodextrin for a period of 8 weeks, respectively. Sleep quality and quality of life (QOL) were assessed by Pittsburgh Sleep Quality Index (PSQI) and SF-36 health survey, respectively. Fasting blood samples were driven to measure serum bacterial endotoxin, fasting blood sugar, glycosylated hemoglobin (HbA1c), pro-inflammatory/anti-inflammatory biomarkers (IL-18, IL-6, IL-10, TNF-α), and biomarkers of hypothalamic-pituitary-adrenal (HPA) axis function [tryptophan (TRP), adrenocorticotropic hormone (ACTH), kynurenine (KYN), cortisol]. Supplementation with resistant dextrin improved sleep (P < 0.001) and QOL (P < 0.001) significantly. It also caused a significant decrease in levels of endotoxin, HbA1c, IL-18, IL-6, TNF-α and a significant increase in IL-10 levels. Significant and positive correlations were found between endotoxin (r = 0.488, P = 0.003), IL-6 (r = 0.436, P = 0.008), IL-18 (r = 0.475, P = 0.003), cortisol (r = 0.545, P = 0.048), KYN/TRP (r = 0.527, P = 0.001), and PSQI scores.

CONCLUSIONS

It is concluded that resistant dextrin improves sleep and QOL in obese women with type 2 diabetes. Its beneficial effects may be attributed in part to modulation of glycemia, metabolic endotoxemia and subsequently a decrease in biomarkers of inflammation and HPA axis activity. © 2022 Society of Chemical Industry.

Diet Supplementation with NUTRIOSE, a Resistant Dextrin, Increases the Abundance of Parabacteroides distasonis in the Human Gut

SCOPE

An imbalance of the gut microbiota ("dysbiosis") is associated with numerous chronic diseases, and its modulation is a promising novel therapeutic approach. Dietary supplementation with soluble fiber is one of several proposed modulation strategies. This study aims at confirming the impact of the resistant dextrin NUTRIOSE (RD), a soluble fiber with demonstrated beneficial health effects, on the gut microbiota of healthy individuals.

METHODS AND RESULTS

Fifty healthy women are enrolled and supplemented daily with either RD (n = 24) or a control product (n = 26) during 6 weeks. Characterization of the fecal metagenome with shotgun sequencing reveals that RD intake dramatically increases the abundance of the commensal bacterium Parabacteroides distasonis. Furthermore, presence in metagenomes of accessory genes from P. distasonis, coding for susCD (a starch-binding membrane protein complex) is associated with a greater increase of the species. This suggests that response to RD might be strain-dependent.

CONCLUSION

Supplementation with RD can be used to specifically increase P. distasonis in gut microbiota of healthy women. The magnitude of the response may be associated with fiber-metabolizing capabilities of strains carried by subjects. Further research will seek to confirm that P. distasonis directly modulates the clinical effects observed in other studies.

Tapioca Resistant Maltodextrin as a Carbohydrate Source of Oral Nutrition Supplement (ONS) on Metabolic Indicators: A Clinical Trial

Tapioca resistant maltodextrin (TRM) is a novel non-viscous soluble resistant starch that can be utilized in oral nutrition supplements (ONS). This study aims to evaluate acute and long-term metabolic responses and the safe use of ONS containing TRM. This study comprised of two phases: In Phase I, a randomized-cross over control study involving 17 healthy adults was conducted to evaluate three ONS formulations: original (tapioca maltodextrin), TRM15 (15% TRM replacement), and TRM30 (30% TRM replacement). Plasma glucose, serum insulin, and subjective appetite were evaluated postprandially over 180 min. In Phase II, 22 participants consumed one serving/day of ONS for 12 weeks. Blood glucose, insulin, lipid profile, and body composition were evaluated. Gastrointestinal tolerability was evaluated in both the acute and long-term period. During phase I, TRM30 decreased in area under the curve of serum insulin by 33.12%, compared to the original formula (2320.71 ± 570.76 uIU × min/mL vs. 3470.12 ± 531.87 uIU × min/mL, p = 0.043). In Phase II, 12-week TRM30 supplementation decreased HbA1C in participants (from 5.5 ± 0.07% to 5.2 ± 0.07%, p < 0.001), without any significant effect on fasting glucose, insulin, lipid profile, and body composition. The ONS was well-tolerated in both studies. TRM is therefore, a beneficial functional fiber for various food industries.

Efficiency of Resistant Starch and Dextrins as Prebiotics: A Review of the Existing Evidence and Clinical Trials

In well-developed countries, people have started to pay additional attention to preserving healthy dietary habits, as it has become common knowledge that neglecting them may easily lead to severe health impairments, namely obesity, malnutrition, several cardiovascular diseases, type-2 diabetes, cancers, hypertensions, and inflammations. Various types of functional foods were developed that are enriched with vitamins, probiotics, prebiotics, and dietary fibers in order to develop a healthy balanced diet and to improve the general health of consumers. Numerous kinds of fiber are easily found in nature, but they often have a noticeable undesired impact on the sensory features of foods or on the digestive system. This led to development of modified dietary fibers, which have little to no impact on taste of foods they are added to. At the same time, they possess all the benefits similar to those of prebiotics, such as regulating gastrointestinal microbiota composition, increasing satiety, and improving the metabolic parameters of a human. In the following review, the evidence supporting prebiotic properties of modified starches, particularly resistant starches and their derivatives, resistant dextrins, was assessed and deliberated, which allowed drawing an interesting conclusion on the subject.

Effects of resistant starch interventions on circulating inflammatory biomarkers: a systematic review and meta-analysis of randomized controlled trials

Purpose

This study aimed to summarize earlier studies on the effects of RS consumption on the serum levels of inflammatory biomarkers.

Methods

A comprehensive search was done in the electronic databases that published from 1988 up to May 2019. Two reviewers independently performed screening, data extraction, and risk-of-bias assessment. We used from the effect size, as estimated by the mean difference to perform the fixed method meta-analysis.

Results

Overall, 13 studies with 14 effect sizes met the inclusion criteria and were included in the final analysis. Sample size of these studies ranged from 15 to 75 and intervention duration ranged from 4 to 14 weeks. Meta-analysis revealed that higher consumption of resistant starch caused a significant reduction in the interleukin 6 (weighted mean difference = − 1.11 pg/mL; 95% CI: − 1.72, − 0.5 pg/mL; P = < 0.001) and tumor necrosis factor alpha (weighted mean difference = − 2.19 pg/mL; 95% CI: − 3.49, − 0.9 pg/mL; P = 0.001) levels. However, no significant changes were found in C-reactive protein concentration (weighted mean difference = − 0.21 mg/L; 95% CI: − 1.06, 0.63 mg/L; P = 0.61). Moreover, the changes in interleukin 6 concentration was dependent on study quality and intervention duration.

Conclusion

The current meta-analysis indicated that RS intake can improve some inflammatory biomarkers. More research, with a large sample sizes and accurate design is recommended.

Effects of resistant dextrin for weight loss in overweight adults: a systematic review with a meta-analysis of randomized controlled trials

BACKGROUND

Randomized controlled trials (RCTs) reported that resistant dextrin (RD) exerted pleiotropic effects on humans. However, limited information is available on the effects of RD for weight loss. We conducted a systematic review with a meta-analysis to summarize the available literature and compare the efficacy of RD for weight loss with that of a placebo in overweight adults.

METHODS

We searched the electronic databases MEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, Web of Science, ClincalTrials.gov, and Japana Centra Revuo Medicina (Ichushi-web) for studies from their onset to November 2016, and there was no language restriction. Trials were included if they were RCTs (1) comparing the effects of RD with a placebo in adults (18 years or older), (2) reporting body mass index, and (3) including overweight/obese subjects as defined by the authors of RCTs. The weighted mean difference with a 95% confidence interval (CI) was calculated using a random-effects model.

RESULTS

Of the 484 studies retrieved, 3 RCTs involving 275 subjects were included in our review. The durations of RCTs ranged between 8 and 12 weeks. All RCTs were conducted in Asian countries. RD significantly improved body mass index [mean difference -0.39 (95% CI -0.57 to -0.21) kg/m², p < 0.01] and body weight [mean difference -0.81 (95% CI -0.93 to -0.69) kg, p < 0.01] in overweight adults.

CONCLUSION

Our review suggests that RD exerts beneficial effects for weight loss in overweight adults. More RCTs with different populations and longer follow-ups are needed in order to confirm that supplementation with RD has beneficial effects for weight loss in overweight adults. We consider this review to provide important information for the future submission of food with health claims.

Resistant dextrin, as a prebiotic, improves insulin resistance and inflammation in women with type 2 diabetes: a randomised controlled clinical trial

Improvement of insulin resistance and inflammation is a basic strategy in the management of type 2 diabetes. There is limited evidence that prebiotics improve insulin resistance and inflammation. However, the ameliorating effect of resistant dextrin, as a prebiotic, on insulin resistance and inflammation in patients with type 2 diabetes has not been investigated so far. Therefore, the present study aimed to examine the effects of resistant dextrin on insulin resistance and inflammation in type 2 diabetic patients. In a randomised controlled clinical trial, fifty-five women with type 2 diabetes were assigned to two groups: the intervention group (n 30) and the control group (n 25). The intervention group received a daily supplement of 10 g resistant dextrin and the control group received a similar amount of maltodextrin as placebo for 8 weeks. Fasting plasma glucose (FPG), HbA1c, insulin, high-sensitivity C-reactive protein (hs-CRP), IL-6, TNF-α, malondialdehyde (MDA) and serum endotoxin concentrations were measured before and after the intervention. Data were analysed using SPSS (version 13). Paired and unpaired t tests and ANCOVA were used to compare quantitative variables after the intervention. Patients supplemented with resistant dextrin exhibited a significant decrease in fasting insulin (20.1 pmol/l, 22.8%), homeostasis model assessment of insulin resistance (1.3, 24.9%), quantitative insulin sensitivity check index (0.2, 7.2%), IL-6 (1.4 pg/ml, 28.4 %), TNF-α (5.4 pg/ml, 18.8 %), MDA (1.2 nmol/ml, 25.6 %) and endotoxin (6.2 endotoxin units/ml, 17.8%) concentrations than those supplemented with maltodextrin (P< 0.05). Decreases in FPG (0.05 mmol/l, 0.6%), HbA1c (0.5%, 9.6%) and hs-CRP (2.7 ng/ml, 35.1%) concentrations in the resistant dextrin group were not significant when compared with the maltodextrin group. In conclusion, resistant dextrin supplementation can modulate inflammation and improve insulin resistance in women with type 2 diabetes.