Sex-Dependent Efficacy of Dietary Fiber in Pediatric Functional Abdominal Pain

BACKGROUND & AIMS

Functional abdominal pain disorders (FAPDs) are more prevalent in female patients. Dietary fiber may alleviate FAPD symptoms; however, whether this effect is sex dependent remains unclear. We investigated the sex dependency of dietary fiber benefit on abdominal pain in children with FAPDs and explored the potential involvement of the gut microbiome.

METHODS

In 2 cross-sectional cohorts of children with FAPDs (n = 209) and healthy control individuals (n = 105), we correlated dietary fiber intake with abdominal pain symptoms after stratifying by sex. We also performed sex-stratified and sex-interaction analyses on data from a double-blind trial in children with irritable bowel syndrome randomized to psyllium fiber (n = 39) or placebo (n = 49) for 6 weeks. Shotgun metagenomics was used to investigate gut microbiome community changes potentially linking dietary fiber intake with abdominal pain.

RESULTS

In the cross-sectional cohorts, fiber intake inversely correlated with pain symptoms in boys (pain episodes: r = -0.24, P = .005; pain days: r = -0.24, P = 0.004) but not in girls. Similarly, in the randomized trial, psyllium fiber reduced the number of pain episodes in boys (P = .012) but not in girls. Generalized linear regression models confirmed that boys treated with psyllium fiber had greater reduction in pain episodes than girls (P = .007 for fiber × sex × time interaction). Age, sexual development, irritable bowel syndrome subtype, stool form, and microbiome composition were not significant determinants in the dietary fiber effects on pain reduction.

CONCLUSIONS

Dietary fiber preferentially reduces abdominal pain frequency in boys, highlighting the importance of considering sex in future dietary intervention studies for FAPDs. (ClincialTrials.gov, Number NCT00526903).

Modifying rheological properties of psyllium by gamma irradiation enables development of low glycaemic index food with a predicted gastrointestinal tolerance

Gel forming dietary fibre like psyllium (PS) is effective in slowing down rate of digestion as well as absorption of glucose thereby reducing the postprandial glucose level and hence is used to develop functional foods for diabetic patients. The fortification level is however limited which otherwise elicit unwanted rheological response and poor sensorial quality in final product. In the present study this limitation was overcome by improving the functionality of the fibre by gamma radiation processing of the polysaccharides. We assessed the changes in rheological properties of radiation processed PS (RPPS) at different doses which enabled us to optimise the irradiation dose and levels of fortification of the RPPS in wheat flour for preparation of Indian unleavened bread (chapati). We observed that PS processed at a dose of 25 kGy could be incorporated to a level as high as 14 % in wheat flour yielding a sensorially better product compared to unfortified wheat flour. Further, the most striking effect observed for RPPS fortified chapati was reduction in the release of glucose upon subjecting to simulated gastrointestinal digestion. Finally, clinical and in vitro fermentation studies also confirmed a low GI value and high gastrointestinal tolerance of RPPS fortified chapati.

Systematic review and meta-analysis: Foods, drinks and diets and their effect on chronic constipation in adults

BACKGROUND

Dietary approaches are recommended for the management of chronic constipation. Until now, there has been no systematic review and meta-analysis on foods, drinks and diets in constipation.

AIMS

To investigate the effect of foods, drinks and diets on response to treatment, stool output, gut transit time, symptoms, quality of life, adverse events and compliance in adults with chronic constipation via a systematic review and meta-analysis.

METHODS

Studies were identified using electronic databases (12th July 2023). Intervention trials (randomised controlled trials [RCTs], non-randomised, uncontrolled) were included. Risk of bias was assessed using Cochrane 2.0 (RCTs) or JBI Critical Appraisal (uncontrolled trials). Data from RCTs only were synthesised using risk ratios (RRs), mean differences (MDs), standardised mean differences (95% CI) using random-effects.

RESULTS

We included 23 studies (17 RCTs, 6 uncontrolled; 1714 participants): kiwifruit (n = 7), high-mineral water (n = 4), prunes (n = 2), rye bread (n = 2), mango, fig, cereal, oat bran, yoghurt, water supplementation, prune juice, high-fibre diet, no-fibre diet (n = 1). Fruits resulted in higher stool frequency than psyllium (MD: +0.36 bowel movements [BM]/week, [0.25-0.48], n = 232), kiwifruits in particular (MD: +0.36 BM/week, [0.24-0.48], n = 192); there was no difference for prunes compared with psyllium. Rye bread resulted in higher stool frequency than white bread (MD: +0.43 BM/week, [0.03-0.83], n = 48). High-mineral water resulted in higher response to treatment than low-mineral water (RR: 1.47, [1.20-1.81], n = 539).

CONCLUSIONS

Fruits and rye bread may improve certain constipation-related outcomes. There is a scarcity of evidence on foods, drinks and diets in constipation and further RCTs are needed.

The Interaction of Dietary Pectin, Inulin, and Psyllium with Copper Nanoparticle Induced Changes to the Cardiovascular System

We aimed to analyze how supplementation with a standard (recommended, 6.5 mg/kg) or enhanced (two-times higher, 13 mg/kg) dose of copper (Cu), in the form of nanoparticles (NPs) along with dietary intervention via the implementation of diverse types of fiber, affects the cardiovascular system in rats. Nine-week-old male Wistar Han rats (n/group = 10) received, for an additional 6 weeks, a controlled diet with cellulose as dietary fiber and ionic Cu (in the form of carbonate salt). The experimental groups received cellulose, pectin, inulin, and psyllium as dietary fiber, together with CuNPs (6.5 or 13 mg/kg diet). After the experimental feeding, samples of blood, hearts, and thoracic arteries were collected for further analysis. Compared to pectin, and under a standard dose of CuNPs, inulin and psyllium beneficially increased the antioxidant capacity of lipid- and water-soluble compounds in the blood, and decreased heart malondialdehyde. Moreover, pectin decreased heart catalase (CAT) and cyclooxygenase (COX)-2 in the aortic rings compared to inulin and psyllium under standard and enhanced doses of copper. When the dose of CuNPs was enhanced, inulin and psyllium potentiated vasodilation to acetylcholine by up-regulation of COX-2-derived vasodilator prostanoids compared to both cellulose and pectin, and this was modulated with selective inducible nitric oxide synthase (iNOS) inhibitor for psyllium only. Moreover, inulin decreased heart CAT compared to psyllium. Our results suggest that supplementation with dietary fiber may protect the vascular system against potentially harmful metal NPs by modulating the antioxidant mechanisms.

Properties of plant-derived soluble dietary fibers for fiber-enriched foods: A comparative evaluation

Plant-derived soluble dietary fibers (SDF) have many important physiological functions and the applications of SDF vary based on their properties, which are worth further investigating for fiber-enriched food production. In this study, SDF derived from konjac, apple, chicory, flaxseed, orange, psyllium seed, soybean and oat were purified, and their structural, physicochemical and functional properties were systematically evaluated. Monosaccharide composition analysis showed that these SDF belonged to heteropolysaccharides, of which konjac, psyllium seed, apple, soybean and oat SDF were glucomannan, arabinoxylan, pectin, arabinogalactan and glucan, respectively. The molecular weight of konjac glucomannan (KGM, 5.22 × 10⁶ Da) was the highest, and inulin, soybean arabinogalactan (SA) and oat glucan (OG) had higher water solubility. Moreover, KGM, apple pectin (AP), flaxseed SDF (FS) and psyllium seed arabinoxylan (PA) exhibited better water-holding capacity, swelling capacity, emulsifying activity and stability. Rheological studies and texture profile analysis suggested that KGM had the best viscosity and gelation ability. In addition, AP and orange SDF (OS) showed better α-amylase inhibitory activity, while OS and KGM had higher pancreatic lipase inhibitory activity. Also, KGM and FS displayed fine cholesterol absorption capacity. To summary, these functional properties illustrated the feasibility of SDF to regulate blood sugar and blood lipid levels.

Modulating the structure of lamb myofibrillar protein gel influenced by psyllium husk powder at different NaCl concentrations: Effect of intermolecular interactions

In this study, a strategy involving psyllium husk powder (PHP) was proposed to alleviate the textural deterioration of protein gels under low-sodium conditions. Results revealed that myofibrillar protein (MP) in 0.3 M NaCl could accommodate more PHP to achieve better gels properties compared with that of 0.6 M NaCl. The 3 % addition of PHP could lessen the textural deterioration of gels at 0.3 M NaCl because of the insertion of PHP into the hydrophobic cavity of MP. Consequently, the reduction in protein viscoelasticity and the thermal stability of the head and tail of myosin improved. α-Helix structures unfolded, intermolecular forces formed, and proteins aggregated. Molecular docking predicted hydrogen bonds and hydrophobic interactions as the main forces to stabilize the conformation of composites. Experiments further verified that hydrophobic interactions and disulfide bonds were the main forces that stabilized the structure of MP-PHP composite gels.

Effects of psyllium fiber on in vitro digestion and structure of different types of starches

BACKGROUND

Starch digestibility in foods strongly depends on the structure, other ingredients and processing conditions used. This study aimed to investigate the effect of psyllium fiber on gelatinization, crystallinity and in vitro digestibility of starches having different crystalline structures (A, B and C). Wheat, potato and tapioca starches with and without added psyllium fiber were heated at 90 °C for 10 min at three different solid:water (w:v) ratios (1:1, 1:2 and 1:5). The added fiber content was 50% (dry base) in the solid fraction for the fiber-added samples.

RESULTS

Wheat, potato and tapioca starches showed different structural, morphological and starch digestibility properties. The effect of cooking and fiber addition on starch digestion differed for the starch types, mainly wheat starch. Psyllium addition during cooking decreased the rapidly digestible starch (RDS) fractions while increasing the slowly digestible starch (SDS) and remaining/resistant starch (RS) fractions. The effect of psyllium fiber addition was not limited to restricting the swelling and gelatinization of starch granules during heating. Psyllium fiber effectively restricted the mobility of digestive enzymes during digestion.

CONCLUSION

Understanding the relationship between psyllium and starch digestibility for different types of starch could assist in designing food formulations with lower starch digestibility. These in vitro data, however, should be confirmed by in vivo studies. © 2021 Society of Chemical Industry.

Psyllium supplementation is associated with changes in the fecal microbiota of horses

OBJECTIVE

Prophylactic supplementation of psyllium husk is recommended to enhance passage of ingested sand from the gastrointestinal tracts of horses. We hypothesized that psyllium supplementation would increase fecal sand passage and favorably alter bacterial populations in the hindgut. Six yearlings and six mature mares were fed a psyllium supplement in the diet daily for seven days. Voluntarily-voided feces were collected over the course of 29 days, prior, during, and after treatment. Feces were analyzed for acid detergent fiber (ADF) and acid detergent insoluble ash analyses. Microbial DNA was also isolated, and the V4 region of the 16S ribosomal RNA gene was PCR-amplified and sequenced using MiSeq technology.

RESULTS

Fecal ADF concentration was greater in adults while silica concentration was greater in yearlings. Mature mare fecal ADF decreased during and just after supplementation but thereafter increased. No changes in silica levels were noted in either group over time. Fecal microbial population phylogenetic diversity was greatest mid-supplementation and lowest at 11 days post-supplementation. Functional profiles of the microbial communities presented some benefits for psyllium supplementation. These findings provide compelling evidence for further detailed studies of prophylactic psyllium supplementation.

Ultrasound Lumbar Spine Clinical Training Phantom: Which is the Best Embedding Medium?

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Rheological Characteristics of Soluble Fibres during Chemically Simulated Digestion and their Suitability for Gastroparesis Patients

Dietary fibres are an integral part of a balanced diet. Consumption of a high-fibre diet confers many physiological and metabolic benefits. However, fibre is generally avoided by individuals with gastrointestinal motility disorders like gastroparesis due to increased likelihood of exacerbated symptoms. Low-viscosity soluble fibres have been identified as a possible source of fibre tolerable for these individuals. The aim of this study is to determine the rheological properties of 10 common commercially available soluble fibres in chemically simulated digestive conditions and evaluate their suitability for individuals with mild to moderate gastroparesis, a gastric motility disorder. Rheological testing under neutral condition (distilled water pH 7) and chemically simulated gastric digestion were evaluated to determine the yield point and relative viscosity of each fibre. Our results reveal two rheological categories of soluble fibres; pseudoplastic and dilatant. Simulated digestion was shown to significantly alter the yield-points of psyllium husk, iota-carrageenan, beta-glucan, apple-fibre pectin, and inulin. Gum Arabic and partially hydrolysed guar gum showed the lowest viscosities and were not affected under simulated digestion, characteristics that make them potential candidate fibres for patients with gastroparesis. Altogether, our results demonstrate that digestion can have a significant impact on fibre viscosity and should be taken into consideration when evaluating the suitability of fibres for patients with gastric motility disorders.

Evaluation of Fecal Sand Clearance in Horses With Naturally Acquired Colonic Sand Accumulation With a Product Containing Probiotics, Prebiotics, and Psyllium

Consumption of sand and dirt in horses can cause chronic diarrhea and colic because of irritation and obstruction of the gastrointestinal tract of horses. Prevention has primarily focused on changes in management to reduce the intake of sand and feeding of psyllium products. The purpose of this study was to evaluate the efficacy of a product containing probiotics, prebiotics, and psyllium in the clearance of colonic sand in horses with naturally acquired sand accumulation using a randomized, placebo-controlled, blinded clinical trial format. After identification of 10 horses with sand accumulation as determined by both auscultation and abdominal radiography, quantitative assessment of changes in colonic sand content in response to management changes combined with treatment with the probiotic/psyllium product or no treatment was assessed by blinded observers. Fecal sand output was monitored in both groups via sand sedimentation analysis of fecal samples every 3 days for 35 days and with pre- and post-treatment abdominal radiography. There was a significant reduction in sand accumulation in both treatment and control groups, but there were no significant differences between treatment and control groups in clearance of colonic sand as measured by both fecal sand sedimentation and quantitative radiography.

Cytokine changes in gastric and colonic epithelial cell in response to Planta ovata extract

Background Psyllium (Planta ovata, Ispaghul) seed and husk are used for treatment of altered bowel habit, i. e. constipation and diarrhea. We studied the effect of Ispaghul extract on secretion of interleukin-1 beta (IL-1β) by AGS (ATCC CRL 1739) and SW480 (ATCC CCL-227) epithelial cell lines and determined whether Ispaghul extract has an effect on IL-1β secretion by Helicobacter pylori (H. pylori)-stimulated AGS cell and Escherichia coli K-12 (E. coli K-12)-stimulated SW480 cells in vitro. Methods The AGS cells and SW480 cells were pretreated with Ispaghul extract in concentrations, i. e. 3.5 and 7 μg/mL prior to infection with H. pylori and E. coli K-12. Results DNA fragmentation in AGS and SW480 cells treated with Ispaghul extract was not significant (2.3±0.8 %) compared with untreated cells (2.2±0.6 %). Ispaghul extract decreased the H. pylori-stimulated secretion of IL-1β by AGS cell (p<0.0001). This effect did not increase as the concentration of extract was increased. Ispaghul extract also decreased E. coli K-12-stimulated IL-1β secretion by SW480 cell (p<0.0001). This effect increased as the concentration of extracts was increased. Conclusions Ispaghul extract had an effect on stimulated secretion of IL-1β by the AGS and SW480 cell. It decreased pro-inflammatory reaction from both cell lines stimulated by bacteria.

Role of phytochemicals in the management of metabolic syndrome

BACKGROUND

The World Health Organization (WHO) for some years has been focusing on what is now commonly referred to as an "epidemic of obesity and diabetes" ("diabesity"): behind this outbreak, there are several risk factors grouped in what is called "metabolic syndrome" (MetS). The basis of this "epidemic" is either a diet too often characterized by excessive consumption of saturated and trans-esterified fatty acids, simple sugars and salt, either a sedentary lifestyle.

PURPOSE

The aim of this review is to focus on the phytochemicals that have a more positive effect on the treatment and/or prevention of MetS.

CHAPTERS

Treatment strategies for MetS include pharmacologic and non-pharmacologic options, with varying degrees of success rate. The first is indicated for patients with high cardiovascular risk, while the second one is the most cost-effective preventive approach for subjects with borderline parameters and for patients intolerant to pharmacological therapy. MetS non-pharmacological treatments could involve the use of nutraceuticals, most of which has plant origins (phytochemicals), associated with lifestyle improvement. The chapter will discuss the available evidence on soluble fibres from psyllium and other sources, cinnamaldehyde, cinnamic acid and other cinnamon phytochemicals, berberine, corosolic acid from banaba, charantin from bitter gourd, catechins and flavonols from green tea and cocoa. Vegetable omega-3 polyunsaturated fatty acids, alliin from garlic, soy peptides, and curcumin from curcuma longa.

CONCLUSION

Some nutraceuticals, when adequately dosed, should improve a number of the MetS components.

Advances in gluten-free bread technology

The unattractive appearance of gluten-free bread still remains a challenge in gluten-free breadmaking. In response to this, additives such as dairy products, soya and eggs have been used to improve the quality of gluten-free bread, but with limited success. In recent years, enzymes (transglutaminase and cyclodextrinase) and hydrocolloids (carboxymethylcellulose and hydroxypropylmethylcellulose) have become the main focus for the improvement of gluten-free bread. Transglutaminase has been shown to improve the dough viscoelasticity and decrease crumb hardness (6.84-5.73 N) of the resulting bread. Cyclodextrinase also enhances dough viscoelasticity, resulting in an improvement of 53% in shape index and crumb firmness. Similarly, hydroxypropylmethylcellulose improves gas retention and water absorption of dough and reduces crumb hardening rate of the resulting bread, while carboxymethylcellulose significantly increases dough elasticity (60-70 BU) and bread volume (230-267 cm(3)/100 g bread).

Tongue pressure modulation for initial gel consistency in a different oral strategy

Background

In the recent hyper-aged societies of developed countries, the market for soft diets for patients with dysphagia has been growing and numerous jelly-type foods have become available. However, interrelationships between the biomechanics of oral strategies and jelly texture remain unclear. The present study investigated the influence of the initial consistency of jelly on tongue motor kinetics in different oral strategies by measuring tongue pressure against the hard palate.

Methods

Jellies created as a mixture of deacylated gellan gum and psyllium seed gum with different initial consistencies (hard, medium or soft) were prepared as test foods. Tongue pressure production while ingesting 5 ml of jelly using different oral strategies (Squeezing or Mastication) was recorded in eight healthy volunteers using an ultra-thin sensor sheet system. Maximal magnitude, duration and total integrated values (tongue work) of tongue pressure for size reduction and swallowing in each strategy were compared among initial consistencies of jelly, and between Squeezing and Mastication.

Results

In Squeezing, the tongue performed more work for size reduction with increasing initial consistency of jelly by modulating both the magnitude and duration of tongue pressure over a wide area of hard palate, but tongue work for swallowing increased at the posterior-median and circumferential parts by modulating only the magnitude of tongue pressure. Conversely, in Mastication, the tongue performed more work for size reduction with increasing initial consistency of jelly by modulating both magnitude and duration of tongue pressure mainly at the posterior part of the hard palate, but tongue work as well as other tongue pressure parameters for swallowing showed no differences by type of jelly.

Conclusions

These results reveal fine modulations in tongue-palate contact according to the initial consistency of jelly and oral strategies.

Characterization of gliclazide release from Isabgol husk hydrogel beads by validated HPLC method

Isabgol husk, a medicinally important natural polysaccharide was applied for fabrication of hydrogel beads by ionic gelation method to incorporate gliclazide. Different strengths of Isabgol husk and sodium alginate were utilized for assessing the process variables on formulation performance. Aqueous solution of calcium chloride in 2, 5 and 8% w/v strength was used as cross-linker for polymeric blends of Isabgol husk and sodium alginate. The formulations were characterized for various parameters such as particle size, swelling index, entrapment efficiency, in vitro release, and release kinetics. The quantification of gliclazide throughout the study was performed by HPLC method which was validated according to ICH guidelines for system suitability, linearity, accuracy, sensitivity, precession, robustness, and ruggedness. The surface morphology of beads was observed by scanning electron microscopy. The formed beads were brown, free flowing, spherical, and irregular in structure. The size in different formulations varied from 752.83 +/- 0.630 to 838.62 +/- 0.741 microm. The beads remained for 2-3 h in alkaline phosphate buffer (pH 7.4), after that they showed disintegration. The formulations released up to 95% of loaded gliclazide in phosphate buffer (pH 7.4) within 8 h. No significant difference was observed in parameters studied such as particle size, entrapment efficiency and swelling index for hydrogel beads during accelerated stability study (p > 0.05). The regression equation developed by HPLC method was linear (r5 > 0.9990) over the range 2.5 to 10 microg/mL. The limit of detection (LOD) and limit of quantification (LOQ) were 0.037619 microg/mL and 0.113997 microg/mL, respectively. The observed values for number of theoretical plates (N > or = 2000), tailing factor (T < or = 2), asymmetry factor (AF < or = 1), and relative standard deviation (RSD < or = 1%) of applied method showed the reliability for gliclazide estimation in Isabgol husk hydrogel beads.

In vitro release profile of anti-ulcer drug rabeprazole from biocompatible psyllium-PVA hydrogels

The present article discusses the synthesis, characterization and haemocompatibility behaviour of the psyllium-PVA hydrogels prepared by chemical method in the presence of N,N'-methylenebisacrylamide. These hydrogels have been characterized by Fourier Transform infrared spectroscopy, thermo gravimetric analysis, swelling and drug release studies. The release of model drug rabeprazole sodium from the drug loaded hydrogels occurred through non-Fickian diffusion mechanism. Psyllium itself acts as anti-ulcer agent and release of rabeprazole from the drug loaded hydrogels may enhance the curing potential of the drug delivery device. The haemocompatibility was evaluated by studying the blood interactions with hydrogels with reference to thrombogenicity and haemolytic potential. Thrombogenicity results indicate that hydrogels are non-thrombogenic as the weight of clot formed and thrombus percentage for hydrogels was less than the positive control. The haemolytic index has been observed <5%. These observations indicate that these hydrogels are haemo-compatible and hence could be used for oral administration of antiulcer drugs.

Plantago ovata consumption and colorectal mortality in Spain, 1995-2000

BACKGROUND

Consumption of Plantago ovata may protect against colorectal cancer. To test this hypothesis, an ecological study was performed to determine mortality rates and distribution of colorectal cancer, and the consumption and distribution of P ovata, in different provinces in Spain. The putative association between P ovata consumption and mortality from colorectal cancer was then evaluated.

METHODS

We conducted a comparative ecological study of Spanish provinces, with colorectal cancer mortality as the dependent variable and per capita consumption of P ovata by province and year as the independent variable. Associations were analyzed by calculating Spearman's correlation coefficients and a Poisson multiple regression model.

RESULTS

Consumption of P ovata tended to be inversely correlated with mortality from colorectal cancer. In the Poisson regression analysis this tendency remained and reached statistical significance for the top quintile of P ovata consumption in the adjusted analysis (P = 0.042).

CONCLUSIONS

Our results show an inverse trend between the consumption of P ovata and colorectal cancer mortality. We recommend additional observational studies of individuals, in order to better control confounding factors.

Effect of gelatinization on gastric emptying and absorption

BACKGROUND/AIMS

For gastrointestinal functional analysis such as gastric emptying tests, either a liquid or solid meal is used as a test meal. Only a few studies have compared meal characteristics, such as liquid and solid. No previous study has compared test meals that had the same composition but different properties. The aim of this study was to compare the gastric emptying and absorption obtained by 13C-breath test after ingestion of liquid or gelatinized liquid nutrients.

METHODOLOGY

Ten healthy volunteers were studied four times, with 2-week intervals. For the test meal, 200 mL of liquid meals (200 kcal) and gelatinized liquid meals were used. Gelatinized liquid nutrients were prepared by mixing 6 g, 12 g and 18 g of Natural psyllium husk with 200 mL of liquid meals. Breath samples were collected for four hours. Gastric emptying were expressed as the time of peak excretion, absorption were expressed as the area under the 13CO2 curve up to the time of peak excretion.

RESULTS

Gastric emptying times were 54.5, 54.5, 81.7 and 93.3 min. Absorption was 20.8, 20.9, 27.8 and 29.8% dose.

CONCLUSIONS

Gelatinization influences gastric emptying, but does not influence absorption. Gelatinized liquid meals may be useful for a substitute for solid meals on gastrointestinal functional analysis.

A regional evaluation of the effect of fiber type in gestation diets on sow reproductive performance

A cooperative regional research study using 194 sows, from which data were collected from 381 litters, was conducted at 3 research stations to determine the effects of added psyllium (a concentrated fiber source) or soybean hulls to gestation diets on reproductive performance of sows and preweaning performance of their pigs. Primiparous and multiparous sows were allotted to the 3 treatments of control (corn and soybean meal-based), 0.30% psyllium, or 20% soybean hulls. Sows fed the control and 0.30% psyllium diets were provided 1.82 kg/d, and sows fed the 20% soybean hulls diet were provided 2.0 kg/d to equalize ME, Lys, Ca, P, and vitamin and trace mineral intake. Treatments 1 to 3 had 130, 130, and 121 litters per treatment from 64, 64, and 63 sows, respectively. Gestating sows fed psyllium had a greater (P < 0.01 to 0.10) d 110 gestation, farrowing, weaning, and 17 d postpartum BW and gestation ADG compared with sows fed soybean hulls. Sows fed psyllium also had a greater (P < 0.10 and 0.08) d 110 gestation BW and gestation ADG than the control sows. Sows fed soybean hulls had a reduced (P < 0.06) farrowing BW compared with the control sows. Sows fed psyllium weaned lighter (P < 0.09) pigs than sows fed the control diet. Litter size was not affected (P > 0.10) by diet. Sows fed psyllium had a reduced (P < 0.03) feed intake compared with sows fed soybean hulls for d 5 to 7 postpartum, and sows fed the control diet were intermediate. Fecal scores (1 to 5 with 1 = dry and 5 = watery) were greater (P < 0.001) and DM content was less (P < 0.001 to 0.01) in the feces of sows fed soybean hulls compared with sows fed psyllium or the control diet on d 112 of gestation and d 4 postpartum. Fecal scores were greater (P < 0.10) and fecal DM content was less (P < 0.02) in sows fed psyllium compared with sows fed the control diet only on d 4 postpartum. In summary, sows fed soybean hulls during gestation had reduced BW compared with sows fed the control diets. In contrast, sows fed psyllium had an increased BW.

β-Sitosterol From Psyllium Seed Husk (Plantago ovata Forsk) Restores Gap Junctional Intercellular Communication in Ha-ras Transfected Rat Liver Cells

We purified compounds from the husks of psyllium seeds (Plantago ovata Forsk; desert Indian wheat), beginning with an ethanol extraction then followed by HP-20 and silica gel chromatography, which restored gap junctional intercellular communication (GJIC) in v-Ha-ras transfected rat liver epithelial WB-F344 cell line (WB-Ha-ras). GJIC was assessed by a scrape loading dye transfer assay. The active compound was identified as beta-sitosterol based on gas chromatography retention times and electron ionization mass spectroscopy (EI-MS) spectrum of authentic beta-sitosterol. Authentic beta-sitosterol restored GJIC in the tumorigenic WB-Ha-ras GJIC-deficient cells at a dose of 2.4 microM. In addition, a similar phytosterol, stigmasterol, also restored GJIC, albeit at a lower activity. beta-sitosterol and stigmasterol increased the level of connexin43 protein (Cx43) and restored phosphorylation of Cx43 to levels similar to the parental nontransfected cell line. We concluded that the restoration of intercellular communication in the GJIC-deficient, tumorigenic WB-Ha-ras cell line by the ethanol soluble fraction of psyllium seed husks is largely due to the presence of the phytosterol, beta-sitosterol. We discuss implications for dietary modulation of cancer by beta-sitosterol.

Intestinal anti-inflammatory activity of dietary fiber (Plantago ovata seeds) in HLA-B27 transgenic rats

BACKGROUND & AIMS

Dietary fiber has been proven to be beneficial in maintaining remission in human ulcerative colitis, an effect related with an increased luminal production of short-chain fatty acids (SCFA). The aim of the present study was to further investigate the mechanisms involved in the intestinal anti-inflammatory effects of dietary fiber in an experimental model of rat colitis.

METHODS

HLA-B27 transgenic rats (8-10 weeks old) were fed a fiber-supplemented diet (5% Plantago ovata seeds) for 13 weeks before evaluation of the colonic inflammatory status, both histologically and biochemically. The luminal colonic production of SCFA was quantified. In vitro studies were also performed to test the interaction between two SCFA (butyrate and propionate) as inhibitors of cytokine production in THP-1 cells.

RESULTS

Dietary fiber supplementation ameliorated the development of colonic inflammation in transgenic rats as evidenced by an improvement of intestinal cytoarchitecture. This effect was associated with a decrease in some of the pro-inflammatory mediators involved in the inflammatory process: nitric oxide, leukotriene B(4), tumor necrosis factor alpha (TNFalpha). The intestinal contents from fiber-treated colitic rats showed a significant higher production of SCFA, butyrate and propionate, than non-treated colitic animals. In vitro studies revealed a synergistic inhibitory effect of butyrate and propionate on TNFalpha production.

CONCLUSIONS

Dietary fiber supplementation ameliorated colonic damage in HLA-B27 transgenic rats. This effects was associated with an increased production of SCFA, which can act synergistically in inhibiting the production of pro-inflammatory mediators.

Helical CT of the small bowel with an alternative oral contrast material in patients with Crohn disease

BACKGROUND

We assessed the usefulness of helical computed tomography (CT) with a negative oral contrast material for detecting Crohn disease.

METHODS

Thirty-eight patients with proven Crohn disease were examined. We administered a large volume of a new negative oral contrast material (Mucofalk suspended in water) and then proceeded with helical CT scanning. This technique is an alternative to CT and conventional enteroclyses that use a nasojejunal tube. Two radiologists interpreted the scans, and patients were interviewed about their tolerance of the procedure. We created multiplanar reformatted images in all cases. Potential of small bowel distention by Mucofalk was evaluated by two observers on a three-point scale, and interobserver agreement was calculated with kappa statistics.

RESULTS

All patients who underwent enteroclysis stated that CT was the more comfortable method, the taste of the peroral contrast medium was considered good by 52.6% and acceptable by 47.4%. Small bowel distention was excellent in 55% of cases, moderate in 26%, and poor in 19%, with an interoberserver agreement of 78%. CT findings correlated with enteroclysis in 27 patients who underwent both methods. Analysis of CT versus enteroclysis showed a sensitivity of 89% for CT versus 78% for small bowel enteroclysis.

CONCLUSION

Mucofalk CT is a simple, rapid, noninvasive, and accurate method of evaluating extramucosal manifestations of Crohn disease. The tubeless procedure improved patients' comfort and decreased time, cost, and radiation exposure.

The presence of antiamoebic constituents in psyllium husk

The crude extract of psyllium husk (ispaghula) and its active constituent (petroleum fraction) caused varying degrees of growth inhibition in three different species of Entamoeba, i.e. Entamoeba histolytica, E. invadens and E. dispar. The inhibitory effect of the crude extract was in the dose range of 1-10 mg/mL, whereas a similar inhibitory effect was obtained with the petroleum fraction at a much lower dose (0.1-1.0 mg/mL), indicating that the active chemical(s) is/are concentrated in the petroleum fraction. These data support the traditional use of psyllium husk in amoebic dysentery.

Persistent specific bronchial reactivity to occupational agents in workers with normal nonspecific bronchial reactivity

Specific bronchial reactivity (SBR) to common inhalants is related to the degree of nonspecific bronchial reactivity (NSBR) and to specific allergen sensitivity. We investigated 16 workers with normal NSBR who had been previously diagnosed with occupational asthma caused by high-molecular-weight agents. The agents were flour in seven workers, psyllium in five, and guar gum in four. The subjects had been removed from exposure to these agents for a mean of 5.7 (+/- 4.0 SD) yr, no longer showed evidence of persisting asthma, and had a normal lung function. In the present study, the workers were reexposed to the sensitizing agent by specific inhalation challenges, in the same way they were as at the time of the diagnosis, to assess their current SBR to the sensitizer. SBR was estimated as the duration of exposure that induced a 20% decrease in FEV(1). Eleven of the 16 subjects had an asthmatic reaction at the time of the study; the duration of exposure necessary to induce the asthmatic reaction was the same as that needed at the time of diagnosis (3.55 +/- 0.5 min and 4.2 +/- 0.7 min, respectively, p = 0.8). The decrease in specific IgE levels between the two events was much greater in the subjects who failed to react to the second challenge test (from 24.2 +/- 37.5% to 3.0 +/- 16.9% binding) than in those who reacted on both occasions (from 31.2 +/- 27.0% to 21.6 +/- 36.7% binding); however, in both groups the change was significant (p = 0.05 and 0.04, respectively). We conclude that SBR to high-molecular-weight agents persists in most cases despite a normalization of NSBR, and that this persistence is associated with a persistence of specific immunization to the agent.

Cholesterol-lowering effects of psyllium seed associated with urea metabolism

Twenty-eight mild hypercholesterolemic male and female adults were orally administered psyllium seed for 3 months. After psyllium treatment, the serum total cholesterol, low-density-lipoprotein-cholesterol and atherogenic index significantly decreased, but levels of high-density-lipoprotein-cholesterol, triglyceride and urea nitrogen did not. To determine the parameters associated with the cholesterol-lowering effect in the subjects' backgrounds, both biochemical and hematological parameters, we statistically examined the correlation between pretreatment parameters and the absolute change of total cholesterol level. The absolute change of total cholesterol level showed a direct correlation with the triglyceride level at pretreatment (r=0.41, P=0.03) and had an inverse correlation with urea nitrogen level (r=-0.46, P=0.01) but not with the total cholesterol level (r=-0.18). The change in urea nitrogen level had an inverse correlation with the urea nitrogen level itself at pretreatment (r=-0.82, P=7 x 10[-8]) and had a direct correlation with the triglyceride level (r=0.43, P=0.02). The change in triglyceride level had an inverse correlation with the urea nitrogen level (r=-0.48, P=0.008). Furthermore, the change in total cholesterol level had direct correlations with changes in the triglyceride level (r=0.56, P=0.002) and the urea nitrogen level (r=0.51, P=0.006), but these changes in triglyceride and urea nitrogen level did not correlate significantly. These findings suggest the close association of urea nitrogen and lipid metabolism in hyperlipidemia and psyllium seed treatment.

A NOTE ON PLANTAGO MAJOR SEEDS: A SUBSTITUTE FOR ISPAGHULA

The pharmacognostical features of the seeds of Plantago major, a substitute of “Ispaghula” (P. ovata) are described and illustrated, and points of difference indicated.

Determination of soluble and insoluble dietary fiber in psyllium-containing cereal products

A method for soluble and insoluble dietary fiber determinations was developed for psyllium-containing food products, which are highly viscous in aqueous solutions. The assay is based on a modification of the AOAC soluble and insoluble dietary fiber method (991.43), which was recommended for nutrition labeling in the final U.S. food labeling regulations. We found that method 991.43 and other existing dietary fiber methods could not be applied to psyllium food products, which exhibit high viscosity in aqueous solutions, because highly viscous solutions could not be filtered easily. In this study, we modified AOAC method 991.43 to accommodate the filtration process of viscous sample solutions. Sonication followed by high-speed centrifugation was used before filtration. The principles of the method are similar to those for AOAC method 991.43, including the use of the same 3 enzymes (heat-stable alpha-amylase, protease, and amyloglucosidase) as well as similar enzyme incubation conditions. The modification using sonication and high-speed centrifugation did not alter the method performance for analytically normal products such as wheat bran, oat bran, and soy fiber. Yet, the modification allowed the separation of soluble dietary fiber fractions from insoluble fractions for psyllium products with satisfactory precision. This method for psyllium dietary fiber determinations may be applied to other food products that exhibit high viscosity in aqueous solutions.

Effect of dietary fiber on serum bile acids in patients with chronic cholestatic liver disease under ursodeoxycholic acid therapy

During ursodeoxycholic acid therapy for chronic cholestatic liver disease, the serum levels of lithocholic acid increase about twofold. Lithocholic acid has been shown to be hepatotoxic in some animal species. Administration of psyllium hydrophilic mucilloid (PHM), a dietary fiber, has been reported to increase the bile acid mass excreted by the feces. We, therefore, studied the effect of PHM (3 x 3.25 g/day) on serum bile acids including lithocholic acid in 12 patients with primary sclerosing cholangitis (n = 7) and primary biliary cirrhosis (n = 5) receiving ursodeoxycholic acid therapy. After 2 and 6 weeks of treatment with PHM, the serum levels of ursodeoxycholic acid increased by 52.4 +/- 72.8% (p < 0.05) and 40.5 +/- 69.6% (NS), respectively. The absolute serum levels of lithocholic acid were not significantly changed. This led to a decrease of the relative amount of lithocholic acid as referred to total bile acids and to ursodeoxycholic acid in serum by 27.4 +/- 34.5% (p < 0.05) and 25.5 +/- 32.8% (p < 0.05), respectively, after 6 weeks of PHM treatment.

[Effectiveness of plantago seed husks in comparison with wheat brain on stool frequency and manifestations of irritable colon syndrome with constipation]

BACKGROUND AND AIM

The importance of dietary fibres in treatment of irritable bowel syndrome increased during the last years. Yet the results of clinical studies on the different dietary fibres are not consistent. Therefore we decided to perform a controlled trial with a well defined group of patients to compare the effectiveness of wheat bran to psyllium seeds.

PATIENTS AND METHODS

Thirty patients each with irritable bowel syndrome group II to III were treated in an open, not controlled study design either with 3 times 3.25 g psyllium seeds or 3 times 7 g wheat bran daily. All patients entering the study had not been treated for at least 3 weeks before. The study comprised two treatment phases of two weeks each, separated by two weeks without any treatment, thus leading to a study duration of 6 weeks altogether. Parameters for evaluation were stool frequency and consistency and the symptoms pain and abdominal distention, measured by a score (1 to 4).

RESULTS

In both treatments groups stool frequency and consistency improved apparently compared to the starting point or the two weeks treatment free time in between. The improvement of stool frequency was statistically significant (p < 0.0001) for both substances. Furthermore the effect of psyllium seeds exceeded that of wheat bran statistically significant in week 1, 2, 3, 5 and 6 (p < 0.005). Other symptoms such as abdominal pain improved too by therapy, psyllium seeds again tending to show better results. A significant difference between both substances could be observed on the symptom abdominal distension. Whereas abdominal distension decreased under treatment with psyllium seeds it increased with wheat brain. This lead to discontinuation of the study in 5 cases, 3 of which could be changed successfully to psyllium seeds. The difference between psyllium seeds and wheat bran concerning the occurrence of abdominal distension was statistically significant (p < 0.01).

CONCLUSION

The results of this study demonstrate the effectiveness of psyllium seeds and wheat bran on stool frequency and consistency of patients with irritable bowel syndrome. Psyllium seeds showed to be superior to wheat brain with respect to stool frequency and abdominal distension so that it should be preferred in treatment of irritable bowel syndrome and constipation.

Digestibility and bulking effect of ispaghula husks in healthy humans

The digestibility of ispaghula, a mucilage from Plantago ovata composed mainly of arabinoxylans, and its faecal bulking effect were studied in seven healthy volunteers who ingested a low fibre controlled diet plus either placebo or 18 g/day of ispaghula for two 15 day periods. Whole gut transit time and gas excretion in breath and flatus were not different during the periods of ispaghula and placebo ingestion. Faecal wet and dry weights rose significantly, however, during ispaghula ingestion. Faecal short chain fatty acid concentrations and the molar proportions of propionic and acetic acids also increased. Most of the ispaghula had reached the caecum four hours after ingestion in an intact highly polymerised form. During ispaghula ingestion, the increase in the faecal output of neutral sugars was accounted for by the faecal excretion of arabinose and xylose in an intact highly polymerised form; the apparent digestibilities of these sugars were 24 (11) and 53% (6) respectively (mean (SEM)). In conclusion, ispaghula is more resistant to fermentation than previously reported in humans, and its bulking effect largely results from intact material.

Involvement of small intestinal motility in blood glucose response to dietary fibre in man

Three dietary fibres with different physicochemical properties were studied in healthy humans for their effects on small intestinal motility and postprandial hyperglycaemia. Duodeno-jejunal motor activity was evaluated electromyographically for 180 min in six subjects who had ingested a test meal composed of glucose alone or glucose with 15 g of wheat bran (WB), sugar beet (SB) or ispaghula (I) fibres. Glucose and insulin concentrations were determined during the same period. Each subject received each of the four test meals randomly during a 4 d period. Addition of SB or I to the glucose meal altered duodeno-jejunal motility. Both of these fibres inhibited stationary contractile activity and increased the propagation length and velocity of propagated activity, whereas addition of WB had no effect. These results could reflect the high water-holding capacity of SB and I. Blood glycaemic response to the glucose meal was reduced by SB and I but remained unchanged with WB. Postprandial blood glucose levels were significantly correlated with the total motility index (r 0.82) and stationary activity (r 0.79). Taken together, these observations suggest that the contractile activity induced by dietary fibre in the small intestine probably plays a major role in delayed glucose absorption.

Soluble fiber and serum lipids: a literature review

Although fiber has been increasingly recognized as an important dietary constituent, controversy and confusion still exist about the physiologic effects of fiber. Specifically, the independent ability of dietary fiber to lower serum lipid levels is controversial. The purpose of this article is to review available evidence regarding the impact of soluble fibers on serum lipid levels. Soluble fibers appear to have a greater potential to alter serum lipid levels than do insoluble fibers. Significant reduction in the level of serum total cholesterol by soluble fiber was found in 68 of the 77 (88%) human studies reviewed. Of the studies measuring low-density lipoprotein cholesterol, 41 of 49 (84%) reported significant reductions. No significant changes were reported in 43 of the 57 (75%) studies that reported high-density lipoprotein cholesterol and/or in 50 of the 58 (86%) studies that measured triglyceride levels.

Postprandial lipid response following a high fat meal in rats adapted to dietary fiber

Rats were adapted to diets containing 5 g/100 g cellulose (CL), 5 g/100 g oat bran fiber (OB) or 5 g/100 g psyllium husk (Psy) for 4 wk. Following a 12-h fast, animals were either killed at 0 h (baseline) or fed 4.5 g of a test meal that provided 50% energy from fat, then killed at 1, 4 or 6 h postprandially. Fasting plasma and HDL cholesterol concentrations were lower in Psy-fed animals than in rats fed either CL or OB. Plasma triglycerides increased significantly from baseline (0 h) in all groups but did not differ among diet treatments. Increases in triglyceride content of the treatments. Increases in triglyceride content of the chylomicron/VLDL fraction occurred in the CL- and OB-fed groups and in the HDL fraction of the Psy-fed group during the postprandial period. In unfed animals the hepatic and intestinal levels of apolipoprotein A-IV mRNA were higher in the CL-fed group than in the groups fed OB and Psy. Apolipoprotein B mRNA was higher in the intestine of the OB-fed group than in the groups fed CL and Psy and had a significant gradient along the small intestine, increasing in the distal third. The results suggest that chronic consumption of fiber is less likely to modify the acute plams triglyceride response to a fat-containing test meal than if a fiber supplement is incorporated into the meal.

Dietary soluble fiber and cholesterol affect serum cholesterol concentration, hepatic portal venous short-chain fatty acid concentrations and fecal sterol excretion in rats

Sprague-Dawley rats were fed diets containing 7.5% dietary fiber as cellulose (control), pectin, psyllium or oat bran with or without 0.3% added cholesterol for 3 wk. Among rats fed cholesterol, liver total lipid and cholesterol concentrations were significantly lower in groups fed pectin, psyllium and oat bran compared with cellulose-fed controls. Cholesterol feeding resulted in significantly greater liver cholesterol in rats fed cellulose, psyllium and oat bran but not in those fed pectin. Among rats fed cholesterol, total serum cholesterol levels were significantly lower in those fed pectin than in those fed psyllium, oat bran or cellulose. When cholesterol was fed, the oat bran-fed group had significantly higher butyrate and the pectin-fed group had significantly higher propionate concentrations in the hepatic portal vein than did cellulose-fed controls. The groups fed psyllium, oat bran and pectin all had significantly higher fecal neutral sterols than did the cellulose-fed group when cholesterol was fed. Without dietary cholesterol only pectin-fed rats had significantly higher fecal excretion of neutral sterols than those fed cellulose. Dietary fiber did not influence fecal acidic sterol excretion. However, the addition of cholesterol to these fiber diets was accompanied by a significantly higher bile acid excretion than that of animals fed cellulose without cholesterol. The results of this study indicate that soluble dietary fibers may exert their hypocholesterolemic effect by increasing excretion of fecal neutral sterols.

Sudan stain of fecal fat: new insight into an old test

The 72-h fecal fat determination is used as the gold standard to document the presence of steatorrhea. Although the Sudan stain for fecal fat is advocated as a sensitive screening test, a quantitative correlation between the 72-h fecal fat quantitation and the fecal Sudan stain is lacking. This study was designed to examine the staining properties of different classes of purified lipids in an experimentally defined artificial matrix, and to elucidate the reasons for the lack of quantitative correlation between these two tests. Our results indicate that the "neutral fat" stain without acidification or heating identifies triglyceride; and at an appropriate pH, the "neutral stain" also identifies fatty acid. The "split fat" stain with acidification and heating identifies both triglyceride and fatty acid. After acidification, fatty acid soaps are converted to the nonionized fatty acid. Thus, fatty acid soaps can be identified indirectly as fat droplets that are stained by the split fat stain. Although cholesterol is stained with Sudan stain after heating, upon cooling, cholesterol forms crystals of anhydrous cholesterol, making its staining pattern distinct. Neither the neutral fat nor the split fat stain can detect phospholipid or cholesteryl ester. The 72-h fecal fat determination is a measure of the total fatty acid content after a specimen is saponified. The resulting fatty acids are derived from a variety of endogenous and exogenous sources, including free fatty acids, soaps of fatty acids, triglycerides, cholesterol esters, and phospholipids. Therefore, the 72-h fecal fat quantitation does not differentiate between the primary sources of the measured fatty acid. It is concluded that the 72-h fecal fat determination is not specific for documenting triglyceride (fat) malabsorption. Until new methods are developed that specifically measure fecal triglyceride and fatty acid, the Sudan stain of fecal fat appears to be a more specific method for detecting the presence of triglyceride and fatty acid in a matrix.

Effect of cellulose and ispaghula husk on fasting blood glucose of developing rats

Fasting blood sugar was measured at the beginning and end of a 4-wk dietary period during which weanling rats were fed either a fibre-free diet, or a similar diet containing cellulose or ispaghula husk. The fibre-free group showed no significant change, but the groups fed cellulose or ispaghula showed a significant fall in fasting blood sugar.

Effect of psyllium gum and wheat bran on spontaneous energy intake

Energy intake, fecal energy output, and gastrointestinal symptoms were measured in 12 females who consumed either approximately 23 g/d supplementary fiber or a 4 g/d fiber control. Fiber supplements were crackers containing psyllium gum, wheat bran, or a combination of the two fiber sources. After 1 wk on the control cracker, subjects consumed the three high-fiber crackers and the control cracker for 2-wk periods in a balanced design. Gum and combination supplements gave increased bloating and flatulence. Increase in abdominal pain was reported with gum supplement. Mean daily fecal energy was 96 kcal/d with control crackers and was increased by 63 kcal with high-fiber crackers. Gum and combination supplements significantly decreased intake of digestible energy by 153 and 115 kcal/d, respectively. This suppression was not dependent upon fiber intolerance. Wheat bran supplement had no effect on energy intake.

Method for the quantitation of gastric emptying time of gel test meals

Isotopic markers were developed to allow measurement of the gastric emptying times of homogeneous and nonhomogeneous gel meals. Meals containing the dietary fibers psyllium and guar gum presented as homogeneous, viscous gels while meals containing the synthetic polymer polycarbophil presented as discrete gel particle-water mixtures. Fiber meals were labeled differently than polycarbophil meals. Fiber meals were labeled with 51Cr-CM-Sephadex. The marker was uniformly suspended in meals containing at least 1% guar or 2% psyllium. In contrast, polycarbophil particles were labeled by hydrating the dried granules with saline in which Na2(51)CrO4 had been dissolved. Use of the markers to measure gastric emptying was demonstrated in dogs fitted with duodenal cannulas. Half of the fiber meals emptied from the stomach in about 40 min without significant dilution by secretions. In contrast, only 8% of the polycarbophil particles emptied by 90 min. Particle-specific labeling of polycarbophil was important because the meal effluent was diluted extensively by secretions. We conclude that 51Cr-CM-Sephadex and soluble Cr-51 may be used as meal markers for estimation of the gastric emptying times of certain homogeneous and nonhomogeneous gel-type meals, respectively.