Abstract
Agavins are prebiotics and functional fiber that modulated the gut microbiota and metabolic status in obese mice. Here, we designed a placebo-controlled, double-blind, exploratory study to assess fluctuations in gastrointestinal (GI) tolerability-related symptoms to increasing doses of agavins in 38 lean and obese Mexican adults for five weeks and their impact on subjective appetite, satiety, metabolic markers, and body composition. All GI symptoms showed higher scores than placebo at almost every dose for both lean and obese groups. Flatulence caused an intense discomfort in the lean-agavins group at 7 g/day, while obese-agavins reported a mild-to-moderate effect for all five symptoms: no significant differences among 7, 10, and 12 g/day for flatulence, bloating, and diarrhea. Ratings for any GI symptom differed between 10 and 12 g/day in neither group. The inter-group comparison demonstrated a steady trend in GI symptoms scores in obese participants not seen for lean volunteers that could improve their adherence to larger trials. Only body weight after 10 g/day reduced from baseline conditions in obese-agavins, with changes in triglycerides and very-low-density lipoproteins compared to placebo at 5 g/day, and in total cholesterol for 10 g/day. Altogether, these results would help design future trials to evaluate agavins impact on obese adults.
Highlights
Overweight and obesity are defined as “abnormal or excessive fat accumulation that may impair health” [1]
Several studies of GI tolerance and adaptation to fiber intake considered symptoms like nausea, constipation, GI rumbling, bloating, flatulence, GI cramps, diarrhea, stomach noises, distension, stomach pain, among others, in response to different doses and a wide variety of fibers in a healthy population [19,20,22,30,31,32,33]. In this randomized placebo-controlled pilot trial, we present a dose-escalation intervention evaluating five daily doses, 2.5 g, 5 g, 7 g, 10 g, and 12 g that were determined from pilot data from our lab, and their impact on flatulence, bloating, borborygmi, abdominal pain, and diarrhea, in lean and obese participants
We found that every agavins dose induced a significant difference in daily ratings for the five GI symptoms evaluated in lean participants compared to placebo controls, except for abdominal pain at 7 g/day
Summary
Overweight and obesity are defined as “abnormal or excessive fat accumulation that may impair health” [1]. A recent international nutrition report showed the alarming growing prevalence of adult obesity, with an increase from 11.8% of the global population in 2012 to 13.1% in 2016 that is not on course to change this trend by 2025 [3]; in other words, more than one-third of the world’s population is classified as overweight or obese, a disease that affects almost all physiological functions of the body and represents a public health threat [4]. The gut microbiota is regarded as a contributing factor to the development of obesity and related metabolic disorders [6]; disturbance of the host-microbiome symbiosis leads to an increase in obesity and other immune-mediated pathologies; consumption of a diet different to the one under which the human-microbiome interrelationship evolved is considered to support this phenomenon [7]. One of the major changes to the ancestral diet is a drastic reduction in non-fermentable carbohydrate intake or microbiota-accessible carbohydrates, meaning that they are metabolically available to gut microbiota, such as dietary fiber [8]; while recommendations for dietary fiber intake in adults range from
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