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Nikolaki MD, Kasti AN, Katsas K, Petsis K, Lambrinou S, Patsalidou V, Stamatopoulou S, Karlatira K, Kapolos J, Papadimitriou K, Triantafyllou K. The Low-FODMAP Diet, IBS, and BCFAs: Exploring the Positive, Negative, and Less Desirable Aspects-A Literature Review. Microorganisms 2023; 11:2387. [PMID: 37894045 PMCID: PMC10609264 DOI: 10.3390/microorganisms11102387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/14/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
The literature about the association of branched short-chain fatty acids (BCFAs) and irritable bowel syndrome (IBS) is limited. BCFAs, the bacterial products of the catabolism of branched-chain amino acids, are proposed as markers for colonic protein fermentation. IBS is a gastrointestinal disorder characterized by low-grade inflammation and intestinal dysbiosis. The low-FODMAP diet (LFD) has increasingly been applied as first-line therapy for managing IBS symptoms, although it decreases the production of short-chain fatty acids (SCFA), well known for their anti-inflammatory action. In parallel, high protein consumption increases BCFAs. Protein fermentation alters the colonic microbiome through nitrogenous metabolites production, known for their detrimental effects on the intestinal barrier promoting inflammation. Purpose: This review aims to explore the role of BCFAs on gut inflammation in patients with IBS and the impact of LFD in BCFAs production. Methods: A literature search was carried out using a combination of terms in scientific databases. Results: The included studies have contradictory findings about how BCFAs affect the intestinal health of IBS patients. Conclusions: Although evidence suggests that BCFAs may play a protective role in gut inflammation, other metabolites of protein fermentation are associated with gut inflammation. Further research is needed in order to clarify how diet protein composition and, consequently, the BCFAs are implicated in IBS pathogenesis or in symptoms management with LFD+.
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Affiliation(s)
- Maroulla D. Nikolaki
- Department of Nutrition and Dietetics, ATTIKON University General Hospital, 12462 Athens, Greece; (M.D.N.); (A.N.K.); (K.K.); (K.P.); (V.P.); (S.S.); (K.K.)
- Department of Nutrition and Dietetics Sciences, Hellenic Mediterranean University, 72300 Crete, Greece
| | - Arezina N. Kasti
- Department of Nutrition and Dietetics, ATTIKON University General Hospital, 12462 Athens, Greece; (M.D.N.); (A.N.K.); (K.K.); (K.P.); (V.P.); (S.S.); (K.K.)
| | - Konstantinos Katsas
- Department of Nutrition and Dietetics, ATTIKON University General Hospital, 12462 Athens, Greece; (M.D.N.); (A.N.K.); (K.K.); (K.P.); (V.P.); (S.S.); (K.K.)
- Institute of Preventive Medicine Environmental and Occupational Health Prolepsis, 15125 Athens, Greece
| | - Konstantinos Petsis
- Department of Nutrition and Dietetics, ATTIKON University General Hospital, 12462 Athens, Greece; (M.D.N.); (A.N.K.); (K.K.); (K.P.); (V.P.); (S.S.); (K.K.)
| | - Sophia Lambrinou
- Department of Clinical Nutrition & Dietetics, General Hospital of Karpathos “Aghios Ioannis o Karpathios”, 85700 Karpathos, Greece;
| | - Vasiliki Patsalidou
- Department of Nutrition and Dietetics, ATTIKON University General Hospital, 12462 Athens, Greece; (M.D.N.); (A.N.K.); (K.K.); (K.P.); (V.P.); (S.S.); (K.K.)
| | - Sophia Stamatopoulou
- Department of Nutrition and Dietetics, ATTIKON University General Hospital, 12462 Athens, Greece; (M.D.N.); (A.N.K.); (K.K.); (K.P.); (V.P.); (S.S.); (K.K.)
| | - Katerina Karlatira
- Department of Nutrition and Dietetics, ATTIKON University General Hospital, 12462 Athens, Greece; (M.D.N.); (A.N.K.); (K.K.); (K.P.); (V.P.); (S.S.); (K.K.)
| | - John Kapolos
- Department of Food Science and Technology, University of Peloponnese, 24100 Kalamata, Greece;
| | - Konstantinos Papadimitriou
- Laboratory of Food Quality Control and Hygiene, Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece;
| | - Konstantinos Triantafyllou
- Hepatogastroenterology Unit, 2nd Department of Internal Propaedeutic Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 12462 Athens, Greece
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Kasti AN, Nikolaki MD, Synodinou KD, Katsas KN, Petsis K, Lambrinou S, Pyrousis IA, Triantafyllou K. The Effects of Stevia Consumption on Gut Bacteria: Friend or Foe? Microorganisms 2022; 10:microorganisms10040744. [PMID: 35456796 PMCID: PMC9028423 DOI: 10.3390/microorganisms10040744] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/26/2022] [Accepted: 03/27/2022] [Indexed: 02/04/2023] Open
Abstract
Stevia, a zero-calorie sugar substitute, is recognized as safe by the Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA). In vitro and in vivo studies showed that stevia has antiglycemic action and antioxidant effects in adipose tissue and the vascular wall, reduces blood pressure levels and hepatic steatosis, stabilizes the atherosclerotic plaque, and ameliorates liver and kidney damage. The metabolism of steviol glycosides is dependent upon gut microbiota, which breaks down glycosides into steviol that can be absorbed by the host. In this review, we elucidated the effects of stevia’s consumption on the host’s gut microbiota. Due to the lack of randomized clinical trials in humans, we included in vitro using certain microbial strains and in vivo in laboratory animal studies. Results indicated that stevia consumption has a potential benefit on the microbiome’s alpha diversity. Alterations in the colonic microenvironment may depend on the amount and frequency of stevia intake, as well as on the simultaneous consumption of other dietary components. The anti-inflammatory properties of stevioside were confirmed in vitro by decreasing TNF-α, IL-1β, IL-6 synthesis and inhibiting of NF-κB transcription factor, and in vivo by inhibiting NF-κB and MAPK in laboratory animals.
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Affiliation(s)
- Arezina N. Kasti
- Department of Nutrition and Dietetics, Attikon University General Hospital, 12462 Athens, Greece; (A.N.K.); (M.D.N.); (K.D.S.); (K.N.K.); (K.P.); (S.L.); (I.A.P.)
| | - Maroulla D. Nikolaki
- Department of Nutrition and Dietetics, Attikon University General Hospital, 12462 Athens, Greece; (A.N.K.); (M.D.N.); (K.D.S.); (K.N.K.); (K.P.); (S.L.); (I.A.P.)
| | - Kalliopi D. Synodinou
- Department of Nutrition and Dietetics, Attikon University General Hospital, 12462 Athens, Greece; (A.N.K.); (M.D.N.); (K.D.S.); (K.N.K.); (K.P.); (S.L.); (I.A.P.)
| | - Konstantinos N. Katsas
- Department of Nutrition and Dietetics, Attikon University General Hospital, 12462 Athens, Greece; (A.N.K.); (M.D.N.); (K.D.S.); (K.N.K.); (K.P.); (S.L.); (I.A.P.)
- Institute of Preventive Medicine Environmental and Occupational Health Prolepsis, 15125 Athens, Greece
| | - Konstantinos Petsis
- Department of Nutrition and Dietetics, Attikon University General Hospital, 12462 Athens, Greece; (A.N.K.); (M.D.N.); (K.D.S.); (K.N.K.); (K.P.); (S.L.); (I.A.P.)
| | - Sophia Lambrinou
- Department of Nutrition and Dietetics, Attikon University General Hospital, 12462 Athens, Greece; (A.N.K.); (M.D.N.); (K.D.S.); (K.N.K.); (K.P.); (S.L.); (I.A.P.)
| | - Ioannis A. Pyrousis
- Department of Nutrition and Dietetics, Attikon University General Hospital, 12462 Athens, Greece; (A.N.K.); (M.D.N.); (K.D.S.); (K.N.K.); (K.P.); (S.L.); (I.A.P.)
- Medical School, University of Patras, 26504 Patras, Greece
| | - Konstantinos Triantafyllou
- Hepatogastroenterology Unit, 2nd Department of Propaedeutic Internal Medicine, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
- Correspondence: ; Tel.: +30-2105832090
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