Abstract
The aim of this systematic review and meta-analysis was to assess the effects of β-fructan supplementation on bowel function in healthy volunteers and patients. The search process was based on the selection of publications listed in the Pubmed and EUPMC database until December 2017, plus two unpublished studies, to identify studies evaluating the impact of β-fructans on bowel movement and stool parameters. Forty-seven publications were selected for inclusion. Primary parameter was frequency of bowel movements, evaluated by the number of defecations per day during the study period. Secondary outcomes were stool consistency, stool dry and wet weights, and transit time. Short-chain (DP < 10) β-fructans contributed to increased stool frequency (0.36 defecation +/− 0.06 per day; p < 0.001), while no significant effect was reported with long-chain (DP ≥ 10) β-fructans (−0.03 +/− 0.11, p = 0.82). A minimal increase in stool wet weight was also statistically demonstrated with short-chain β-fructans. Moreover, the meta-analysis highlighted significant differences in stool consistency in contrast to fecal dry weight after β-fructan supplementation. This systematic review and meta-analysis indicates that short-chain β-fructan supplementation has a positive effect on bowel function by significantly increasing the frequency of bowel movements.
Highlights
Functional constipation is a gastrointestinal syndrome based on at least two of the following symptoms during the last three months in at least 25% of defecations: (a) straining; (b) lumpy or hard stools; (c) sensation of incomplete evacuation; (d) sensation of anorectal blockage; (e) manual maneuvers to facilitate; and, (f) as well as fewer than three bowel movements per week [1]
The primary question was “Does regular intake of β-fructans increase frequency of bowel movements and is there a different effect according to degree of polymerization (DP) of β-fructans?”
The results showed that the frequency of bowel movements is significantly dependent on out: the higher the body mass index (BMI) of the subject, the greater the impact of β-fructan on increasing the frequency
Summary
Functional constipation is a gastrointestinal syndrome based on at least two of the following symptoms during the last three months in at least 25% of defecations: (a) straining; (b) lumpy or hard stools; (c) sensation of incomplete evacuation; (d) sensation of anorectal blockage; (e) manual maneuvers to facilitate; and, (f) as well as fewer than three bowel movements per week [1]. The median prevalence of functional constipation in adults is around 16% globally and varies from 0.7 to 79%. Depending on the definition used in different regions [2,3,4] This disorder is more common in women than in men and found to increase with age [5,6]. Inadequate dietary fiber intake and inadequate fluid consumption are some of the multiple etiologies of constipation and gastrointestinal discomfort [8]. Treatment of functional constipation with dietary and lifestyle adjustments, including the higher consumption of dietary fibers, Nutrients 2019, 11, 91; doi:10.3390/nu11010091 www.mdpi.com/journal/nutrients
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