Chronic consumption of a blend of inulin and arabinoxylan reduces energy intake in an ad libitum meal but does not influence perceptions of appetite and satiety: a randomised control-controlled crossover trial

Prebiotics are non-digestible components that beneficially modify the activity and composition of the colonic microbiota, increase the production of short-chain fatty acids (SCFAs) in the gut, and lead to various health benefits in the host. This paper reports on the MIXSAT trial, a randomized, double-blinded, placebo-controlled crossover study investigating the effects of chronic consumption of a prebiotic blend with a 50:50 mix of inulin and arabinoxylan (I+AX) in twenty healthy adult men. The two study groups included an 8-g per day I+AX treatment and a weight-matched maltodextrin control for 21 days. Following a 14-day washout, the alternate drink was consumed for additional 21 days. The primary study outcomes were satiety and appetite measures during an acute study visit, while the secondary included energy intake in an ad libitum meal, faecal SCFA concentrations, and faecal microbiota composition. The results showed no effect on satiety and appetite but a reduction in energy intake in an ad libitum meal, increased faecal SCFA concentration, and an increase in cell counts of bifidobacteria, lactobacilli, and propionibacteria associated with health. Further studies are needed to confirm the mechanism of action and to determine the effects of chronic consumption of the prebiotic blend I+AX in weight management. 

Key takeaways:

• Prebiotic foods support SCFA production in the gut.
• Chronic consumption of an inulin and arabinoxylan prebiotic blend increased cell counts of bifidobacteria, lactobacilli, and propionibacteria associated with health, and reduced the energy intake in an ad libitum meal.
• Future studies may provide insights into the mechanisms of action and validate this study’s results concerning weight management.

Access to the study: https://pubmed.ncbi.nlm.nih.gov/37046122/ 

Reference: Collins, S. M., Gibson, G. R., Stainton, G. N., Bertocco, A., Kennedy, O. B., Walton, G. E., & Commane, D. M. (2023). Chronic consumption of a blend of inulin and arabinoxylan reduces energy intake in an ad libitum meal but does not influence perceptions of appetite and satiety: a randomised control-controlled crossover trial. European journal of nutrition, 62(5), 2205–2215. https://doi.org/10.1007/s00394-023-03136-6 

A Double-Blind, Randomized, Placebo-Controlled Trial of the Effect of 1-Kestose on Defecation Habits in Constipated Kindergarten Children: A Pilot Study

While constipation is a common condition in children and affects their quality of life, research is lacking to investigate the effects of dietary interventions such as prebiotics on constipation in this age group. Prebiotics in constipated adults have shown positive outcomes; however, only a few studies have examined their potential beneficial effects in constipated children. As such, this randomized, double-blinded, placebo-controlled pilot study investigated the effects of fructooligosaccharide 1-kestose on defecation habits in constipated kindergarten children who initially defecated on ≤ 4 days/week. The study compared the effects of consuming three g/day of 1-kestose for eight weeks to those of maltose, including frequency of defecation, defecation volume, fecal characteristics, and color of feces. The study showed that 1-kestose did not affect SCFA concentrations in stools or stool properties but significantly increased the number of bowel movements per week. Additionally, the ingestion of 1-kestose decreased the fecal relative abundance of Intestinibacter spp., but no correlation with defecation results was observed. Altogether, 1-kestose intake improved bowel movements and reduced Intestinibacter relative abundance among preschool children with constipation.

Key takeaways:

• Prebiotics have been widely used in adults to relieve constipation symptoms, with a noticeable lack in using this intervention in young children, who commonly experience the condition.
• 1-kestose intake significantly increased the frequency of bowel movements per week in constipated kindergarten children.
• 1-kestose may serve as a potential therapy to relieve constipation symptoms in children, with further research needed to confirm these findings.

Access to the study: https://pubmed.ncbi.nlm.nih.gov/37513693/ 

Reference: Takahashi, M., Kadota, Y., Shiko, Y., Kawasaki, Y., Sakurai, K., Mori, C., & Shimojo, N. (2023). A Double-Blind, Randomized, Placebo-Controlled Trial of the Effect of 1-Kestose on Defecation Habits in Constipated Kindergarten Children: A Pilot Study. Nutrients, 15(14), 3276. https://doi.org/10.3390/nu15143276  

Lactulose regulates gut microbiota dysbiosis and promotes short-chain fatty acids production in acute pancreatitis patients with intestinal dysfunction

Acute pancreatitis (AP) is an abdominal emergency causing multi-organ failure, including the gut. Intestinal dysfunction is a common complication of early-stage AP and is associated with poor prognosis, especially infectious complications. As such, this prospective, single-center, open-labeled, randomized, controlled trial investigated the efficacy of lactulose on intestinal function, infectious complications, and prognosis in patients with moderate-severe acute AP. Participants received either 50 mL lactulose oral solution twice daily or 50 g of the Chinese herb rhubarb twice daily for 1 week. The primary efficacy endpoint was intestinal function recovery, while other studied outcomes included serum levels of inflammatory cytokines and gut barrier indexes, intestinal functions, and clinical prognosis. The study results revealed a prominent improvement in intestinal dysfunction after seven days of either the lactulose or rhubarb treatments. Serum cytokine levels and gut permeability indexes decreased after treatments, particularly in the lactulose group. Additionally, lactulose showed greater effect in the modulation of gut microbiota, including the proliferation of Bifidobacterium, inhibition of Escherichia-Shigella as well as the increased production of SCFAs. As such, lactulose may serve as a promising therapeutic option for improving gut health in AP patients.

Key takeaways: 

• Intestinal dysfunction is a common complication in early-stage AP and is associated with detrimental outcomes.
• Lactulose is a widely used prebiotic for improving gut health, which makes it a promising candidate for improving gut health in AP patients.
• Lactulose showed some superior effects compared to rhubarb on gut health, including restoring intestinal function, regulating the gut microbiota, reducing the serum levels of inflammatory cytokines, and promoting the production of SCFAs.

Access to the study: https://pubmed.ncbi.nlm.nih.gov/37116350/ 

Reference: Wang, J., Jiang, M., Hu, Y., Lei, Y., Zhu, Y., Xiong, H., & He, C. (2023). Lactulose regulates gut microbiota dysbiosis and promotes short-chain fatty acids production in acute pancreatitis patients with intestinal dysfunction. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 163, 114769. https://doi.org/10.1016/j.biopha.2023.114769 

Faecal and urine metabolites, but not gut microbiota, may predict response to low FODMAP diet in irritable bowel syndrome

Irritable bowel syndrome (IBS) is a chronic and debilitating gastrointestinal disorder that affects 1.5%-4.1% of adults globally, causing abdominal pain and modified bowel habit. Altered microbiota and faecal metabolites are part of the pathophysiology of IBS. As such, the use of microbiota-modulating dietary components is a common approach in the management of IBS, including the restriction of fermentable oligo-, di-, mono-saccharides, and polyols (FODMAPs), commonly known as the low FODMAP diet (LFD). This study explored differences in faecal microbiota as well as faecal and urine metabolites between responders and non-responders to the LFD in IBS using data from a previously published 3-arm parallel, placebo-controlled trial (Wilson et al., 2020). IBS patients were recruited and randomized to one of three groups for four weeks: a sham diet with placebo (control), an LFD supplemented with placebo (LFD), or an LFD supplemented with 1.8 g/day B-galactooligosaccharide (LFD/B-GOS). The study defined clinical response as adequate symptom relief after the intervention. At the end of the 4-week intervention, clinical response differed across the three groups, with adequate symptom relief of 30% in controls, 50% in the LFD group, and 67% in the LFD/B-GOS group. In the LFD group, higher baseline faecal propionate, cyclohexanecarboxylic acid esters, and urine metabolite profile predicted a clinical response. Further studies adequately powered may help validate these results and lead to personalized nutrition for IBS patients. 

Key takeaways:

• Microbial dysbiosis and altered faecal metabolites are part of IBS pathophysiology, but whether they are causes or symptoms is unknown.
• The low FODMAP diet, as a dietary intervention approach in IBS, has shown clinical response in 50%-80% of patients, with an unknown reason as to why only some patients respond.
• Faecal and urine metabolites may predict individual responses to LFD and the diet’s efficacy in managing IBS.

Access the study: https://pubmed.ncbi.nlm.nih.gov/37313992/ 

Reference: Wilson, B., Kanno, T., Slater, R., Rossi, M., Irving, P. M., Lomer, M. C., Probert, C., Mason, A. J., & Whelan, K. (2023). Faecal and urine metabolites, but not gut microbiota, may predict response to low FODMAP diet in irritable bowel syndrome. Alimentary pharmacology & therapeutics, 58(4), 404–416. https://doi.org/10.1111/apt.17609