Fecal Fat Content Research Articles

Unabsorbed Fecal Fat Content Correlates with a Reduction of Immunoglobulin a Coating of Gut Bacteria in High-Lard Diet-Fed Mice.

Immunoglobulin A (IgA) selectively coats gut bacteria and contributes to regulatory functions in gastrointestinal inflammation and glucose metabolism. Excess intake of lard leads to decrease in the IgA coating of gut bacteria, although the underlying mechanisms remain unknown. This study validates how unabsorbed fat derived from a high-lard diet in the gut affects the IgA coating of bacteria, as assessed in mouse models using three types of dietary fat (lard, medium-, and long-chain triglycerides [MLCTs], and medium-chain triglycerides [MCTs]) exhibiting different digestibilities. C57BL/6J mice are maintained on diets containing lard, MLCTs, or MCTs at 7% or 30% w/w for 10 weeks (n = 6 per group). The fecal fatty acid concentration is measured to quantify unabsorbed fat content. The ratio of IgA-coated bacteria to total bacteria (IgA coating ratio) in the feces is measured by flow cytometry. Compared to lard-fed mice, MLCT- and MCT-fed mice exhibit lower fecal concentrations of palmitic acid, stearic acid, and oleic acid and higher IgA coating ratios at both 7% and 30% dietary fat, and these parameters exhibit significant negative correlations. Unabsorbed fat content in the gut may result in attenuated IgA coating of bacteria in high-lard diet-fed mice.

Faecal Short-Chain, Long-Chain, and Branched-Chain Fatty Acids as Markers of Different Chronic Inflammatory Enteropathies in Dogs

Chronic inflammatory enteropathies (CIEs) are classified based on treatment trials, and new methods are being sought for earlier differentiation and characterization. Giardia infection (GIA) is one of the first differential diagnoses and may be present in CIE-affected dogs. The aim of this study was to evaluate the faecal characteristics and faecal fatty acid profile (short, medium, long, and branched-chain fatty acids) in dogs with food-responsive enteropathy (FRE), immunosuppressant-responsive enteropathy (IRE), and dogs infected with Giardia compared to healthy control (HC) animals as a potential non-invasive indicator of intestinal health that helps in the differentiation of CIEs. The C16:1n-7 percentage (p = 0.0001) and C16:1n-7/C16:0 ratio (p = 0.0001) served to differentiate between HC, FRE, and IRE. IRE dogs presented lower levels of short-chain fatty acids (∑SCFAs) (p = 0.0008) and acetic acid (C2) (p = 0.0007) compared to the other three groups and lower propionic acid (C3) (p = 0.0022) compared to HCs. IRE and GIA presented higher faecal fat content (p = 0.0080) and ratio of iso/anteiso branched-chain fatty acids (BCFAs) compared to HC and FRE. Correlations between some fatty acids and desaturation indices with the canine inflammatory bowel disease activity index and faecal characteristics were observed, suggesting that these compounds could play an important role in the pathogenesis of these diseases.

Effects of Banana (Musa spp.) Bract Flour on Rats Fed High-Calorie Diet.

The extensive cultivation of bananas (Musa sp.) is related to producing tons of residues, such as leaves, pseudostems and bracts (inflorescences). The banana bract is a commercially interesting residue due to its dietary fibre content and high antioxidant potential. With this in mind, this study evaluates the effects of administering banana bract flour in animal models fed a cafeteria diet. Thirty-two male rats were divided into 4 groups: (i) control diet, (ii) control diet with 10 % banana bract flour, (iii) hypercaloric diet, and (iv) hypercaloric diet with 10 % bract banana flour. The study was conducted for 12 weeks and included analysis of phenolic compounds, assessment of the antioxidant effect of banana bract flour, determination of serum biochemical parameters (glucose, total cholesterol, triglycerides, aspartate aminotransferase (AST), alanine transaminase (ALT), amylase, albumin, uric acid, creatine, total protein, and oral glucose), determination of faecal fat content, and histomorphological analysis of the liver, pancreas and adipose tissue. In addition, molecular parameters such as IL6, total and phosphorylated JNK, total and phosphorylated IKKβ, TNFα, TLR4 and HSP70 were determined. The banana bract flour showed a high content of phenolic compounds and an antioxidant effect. The in vivo results suggest that the supplementation of a hypercaloric diet with banana bract flour prevented pathological damage by reducing total cholesterol and glucose amounts, which may imply a hepatoprotective effect of this supplement. Thus, using banana bract flour as a supplement can increase the consumption of fibre, antioxidants and bioactive compounds. The development of flour from banana waste and its inclusion in the diet can prevent and/or help treat obesity. In addition, the use of banana bracts can help protect the environment, as they are considered a source of waste by the food industry.

Dairy Proteins Protect against Dimethylhydrazine-Induced Intestinal Cancers in Rats

The impact of different dietary protein sources (whey, casein, soybean, red meat) on the incidence, burden and mass index of intestinal tumors induced by dimethylhydrazine in male Sprague-Dawley rats was assessed. A purified diet (based on AIN-76A) with a fat concentration of 20 g/100 g and other proteins substituted for casein (20 g/100 g) was used. Whey and casein diets were more protective against the development of intestinal tumors than were the red meat or soybean diets, as evidenced by a reduced incidence of rats affected (P = 0.15), fewer tumors per treatment group (burden, P < 0.005), and a reduced pooled area of tumors (tumor mass index) that formed (P = 0.39). Intracellular concentration of glutathione, an antioxidant and anticarcinogenic tripeptide, measured in liver, was greatest in whey protein- and casein-fed rats and lowest in soybean-fed animals (P < 0.001). For other tissues (spleen, colon, tumor) the differences were not significant, although the whey-fed animals had the highest concentrations of glutathione (P = 0.8). Whey is a source of precursors (cysteine-rich proteins) for glutathione synthesis and may be important in providing protection to the host by stimulating glutathione synthesis. A positive correlation was observed between mean fecal fat concentrations for rats in each treatment group and large intestinal tumor burden (r2 = 0.898, P = 0.05). Fecal fat could be involved in aiding initiation and/or promotion of carcinogenesis. Whatever the mechanism(s), dairy proteins, and whey proteins in particular, offer considerable protection to the host against dimethylhydrazine-induced tumors relative to the other protein sources examined.

Short-Term Dietary Calcium Fortification Increases Fecal Saturated Fat Content and Reduces Serum Lipids in Men

The effect of dietary calcium on fecal fatty acid excretion and serum lipids was tested in a randomized, single-blind metabolic study in 13 healthy men with moderate hypercholesterolemia. A low calcium base diet containing 34% of energy from fat, 13% from saturated fatty acids, 240 mg cholesterol/d and 410 mg Ca/d was compared with a fortified version in which calcium citrate malate was added to orange juice, (550 mg) muffins (750 mg), and two tablets (500 mg) for a total calcium intake of 2200 mg/d. Fecal collections (72 h, d 8, 9, 10) and blood from fasting subjects for lipids and lipoproteins (d 9, 10, 11) were obtained. The percentage of dietary saturated fat excreted per day increased from 6 to 13% with calcium fortification. There was no change in fecal bile acid excretion. The high Ca diet significantly reduced total cholesterol 6% (5.99 to 5.66 mmol/L), LDL cholesterol 11% (4.13 to 3.67 mmol/L), and apolipoprotein B concentrations 7% when compared with the low Ca diet (P < 0.05). There was no change in HDL cholesterol or apolipoprotein A1 concentrations. Urinary calcium excretion increased from 146 to 230 mg/d when the high Ca diet was consumed. Calcium fortification was effective in lowering total and LDL cholesterol concentrations and may be an effective adjunct to cholesterol-lowering diet therapy.

Sweet potato extract alleviates high-fat-diet-induced obesity in C57BL/6J mice, but not by inhibiting pancreatic lipases.

Sweet potato is widely consumed as a healthy and nutritive vegetable containing bioactive constituents for health promotion. This study investigated the beneficial impact of white-fleshed sweet potato extract (SPE) on high fat diet (HFD)-induced obese mice. First, SPE, in which resin glycoside was found as the dominant constituent, was suggested as a potential anti-obesity agent, because 20-70% pancreatic lipase (PL) inhibition was measured with SPE by in vitro turbidity assay and pNPP assay. Hence, next, the effect of SPE on obese mice was detected by oral administration of HFD supplemented with 6% SPE on C57BL/6J mice for 9 weeks. Surprisingly, being the opposite of what was typically observed from a lipase inhibitor such as orlistat, the fecal fat content in SPE-fed obese mice was decreased (p < 0.01). Meanwhile, 6% SPE supplement indeed significantly ameliorated HFD-induced obesity in mice, including body weight gain, fat accumulation, adipocyte enlargement, insulin resistance, and hepatic steatosis (p < 0.05). The improved liver steatosis was found associated with a down-regulating action of SPE on nuclear factor kappa B activation in HFD-fed mice. The anti-obesity influence of SPE was also confirmed on the HepG2 cell model for non-alcoholic fatty liver disease (NAFLD). These results indicate that SPE, as a dietary supplement, has the great potential for weight control and treating hepatic steatosis, possibly through a different action mechanism from that of orlistat.

The proximal intestinal Fatty Acid-Binding Proteins liver FABP (LFABP) and intestinal FABP (IFABP) differentially modulate whole body energy homeostasis but are not centrally involved in net dietary lipid absorption: Studies of the LFABP/IFABP double knockout mouse

Proximal intestinal enterocytes expresses both intestinal-fatty acid binding protein (IFABP; FABP2) and liver-FABP (LFABP; FABP1). These FABPs are thought to be important in the net uptake of dietary lipid from the intestinal lumen, however their specific and potentially unique functions in the enterocyte remain incompletely understood. We previously showed markedly divergent phenotypes in LFABP−/− vs. IFABP−/− mice fed high-fat diets, with the former becoming obese and the latter remaining lean relative to wild-type (WT) mice, supporting different functional roles for each protein. Interestingly, neither mouse model displayed increased fecal lipid concentration, raising the question of whether the presence of one FABP was sufficient to compensate for absence of the other. Here, we generated an LFABP and IFABP double knockout mouse (DKO) to determine whether simultaneous ablation would lead to fat malabsorption, and to further interrogate the individual vs. overlapping functions of these proteins. Male WT, IFABP−/−, LFABP−/−, and DKO mice were fed a low-fat (10 % kcal) or high-fat (45 % kcal) diet for 12 weeks. The body weights and fat mass of the DKO mice integrated those of the LFABP−/− and IFABP−/− single knockouts, supporting the notion that IFABP and LFABP have distinct functions in intestinal lipid assimilation that result in downstream alterations in systemic energy metabolism. Remarkably, no differences in fecal fat concentrations were found in the DKO compared to WT, revealing that the FABPs are not required for net intestinal uptake of dietary lipid.

Lipid absorption and overall intestinal lymphatic transport are impaired following partial small bowel resection in mice

Short bowel syndrome (SBS) is associated with diminished levels of serum fats caused by unknown mechanisms. We have shown that mesenteric lymphatics remodel to a more primitive state one week after small bowel resection (SBR); therefore, this study focuses on the effect of chronic lymphatic remodeling and magnitude of resection on intestinal lipid uptake and transport. C57BL6 and Prox1 creER-Rosa26LSLTdTomato (lymphatic reporter) mice underwent 50% or 75% proximal SBR or sham operations. Functional transport of lipids and fecal fat content was measured and lymphatic vasculature was compared via imaging. There was a significant reduction in functional transport of cholesterol and triglyceride after SBR with increasing loss of bowel, mirrored by a progressive increase in fecal fat content. We also describe significant morphological changes in the lymphatic vasculature in both the lamina propria and mesentery. Intestinal lymphatic drainage assay in vivo demonstrated a marked reduction of systemic absorption after resection. Intestinal lymphatic vessels significantly remodel in the setting of chronic SBS. This remodeling may account at least in part for impaired intestinal uptake and transport of fat via the compromised lymphatic architecture. We believe that these changes may contribute to the development of intestinal failure associated liver disease (IFALD), a major morbidity in patients with SBS.

The effects of brewers’ spent grain on high-fat diet-induced fatty liver

Obesity drives nonalcoholic fatty liver disease (NAFLD). This study investigated the effects of dietary brewers’ spent grain (BSG) supplementation on obesity-induced NAFLD. Mice fed a high-fat diet supplemented with 30% BSG (HFD30) had reduced body weight and decreased plasma total cholesterol (TC) concentrations compared with HFD-fed mice. Retroperitoneal white adipose tissue (RWAT) and liver weights were reduced. Consistent with reduced hepatic triacylglycerol, TC, and non-esterified fatty acid concentrations, HFD30-fed mice showed reduced hepatic steatosis. 3-hydroxy-3-methylglutaryl-CoA reductase and low-density lipoprotein receptor genes were increased, whereas carnitine palmitoyltransferase 1 alpha, ATP-binding cassette subfamily A member 1 (Abca1), and cholesterol 7 alpha-hydroxylase genes were upregulated in the liver of HFD30-fed mice. Abca1 gene expression was also increased in epididymal WAT and RWAT of HFD30-fed mice. BSG supplementation increased and decreased fecal fat and bile acid concentrations, respectively. Taken together, BSG supplementation reduced HFD-induced hepatic lipid accumulation by increasing fatty acid oxidation and bile acid synthesis in the liver as well as decreasing lipid absorption in the intestine.

Changes in fecal microbiota with CFTR modulator therapy: A pilot study

Studies have demonstrated that people with CF with pancreatic insufficiency (PI) have fecal dysbioses. Evidence suggests the causes of these dysbioses are multifactorial, and that important drivers include antibiotic exposure, dietary intake, and CF gastrointestinal tract dysfunction, including nutrient malabsorption. In this pilot study, we tested whether initiation of the CFTR modulator treatments ivacaftor (in a cohort of pancreatic sufficient (PS) people with CF and an R117H CFTR variant) or lumacaftor/ivacaftor (in a cohort of PI people with CF and an F508del variant) changed fecal measures of malabsorption or fecal microbiomes. While we identified no statistically significant fecal changes with either treatment, we detected trends in the PI cohort when initiating lumacaftor/ivacaftor towards decreased fecal fat content and towards fecal microbiomes that more closely resembled the fecal microbiota of people without PI. While these findings support a model in which nutrient malabsorption resulting from CF-induced PI drives fecal dysbiosis, they must be validated in future, larger studies of fecal microbiome and malabsorption outcomes with highly effective CFTR modulator therapies.

Estimation of faecal fat content of jungle cat (Felis chaus), fishing cat (Prionailurus viverrinus) and gray langur (Semnopithecus sp.), and its comparative variations with respect to their captive and wild habitat

Estimation of faecal fat content of jungle cat (Felis chaus), fishing cat (Prionailurus viverrinus) and gray langur (Semnopithecus sp.), and its comparative variations with respect to their captive and wild habitat

Long term follow-up of a simplified and less burdened pancreatic duct ligation model of exocrine pancreatic insufficiency in Goettingen Minipigs

BackgroundPancreatic duct ligation in a minipig model leads to exocrine pancreatic insufficiency (EPI). This allows the study of digestive processes and pancreatic enzyme replacement therapies. However, detailed descriptions of the surgical procedure, perioperative management, a determination of exocrine pancreatic insufficiency are scarce in the literature. Data of the long-term health status of minipigs upon EPI induction are still not available. Therefore, the present study describes in detail an experimental approach to the induction of exocrine pancreatic insufficiency via pancreatic duct ligation in minipigs and the long term follow up of the animal’s health state.Methods14 Goettingen minipigs underwent pancreatic duct ligation via midline laparotomy for the induction of exocrine pancreatic insufficiency. Fecal fat content, fat absorption, chymotrypsin levels, body weight and blood vitamin and glucose levels were determined.ResultsExocrine pancreatic insufficiency was successfully induced in 12 Goettingen minipigs. Two minipigs failed to develop exocrine insufficiency most likely due to undetected accessory pancreatic ducts. All animals tolerated the procedure very well and gained weight within 8 weeks after surgery without requiring pancreatic enzyme replacement therapy. The follow up for approx. 180 weeks showed a stable body weight and health state of the animals with normal blood glucose levels (Table 1). From approx. 130 weeks post pancreatic duct ligation, all animals were supplemented with pancreatic enzymes and vitamins resulting in blood concentrations almost within the reference range.ConclusionsPancreatic duct ligation in minipigs is an excellent method of inducing exocrine pancreatic insufficiency. It is important to identify and ligate accessory pancreatic ducts since persistence of accessory ducts will lead to maintenance of exocrine pancreatic function. The EPI model caused no persistent side effects in the animals and has the potential to be used in long-term EPI studies with up to 100 weeks post-OP without supplementation with enzymes and vitamins.

Potato Fibers Have Positive Effects on Subjective Appetite Sensations in Healthy Men, but Not on Fecal Fat Excretion: A Randomized Controlled Single-Blind Crossover Trial.

Dietary fibers can affect appetite and gut metabolism, but the effect of the novel potato fibers FiberBind and rhamnogalacturonan I (RG-I) is unknown. We, therefore, aimed to investigate the effect of daily intake of FiberBind and RG-I on appetite sensations and fecal fat excretion. In a single-blinded, randomized, three-way crossover trial, wheat buns with FiberBind, RG-I, or low fiber (control) were consumed by 18 healthy men during a 21-day period. Appetite sensation and blood samples during a 3 h meal test, fecal fat content, and ad libitum energy intake were assessed after each period. Compared to RG-I and control, FiberBind caused a higher composite satiety score (6% ± 2% and 5% ± 2%), lower prospective food consumption (5% ± 2% and 6% ± 2%), and lower desire to eat (7% ± 3% and 6% ± 3%) (all p < 0.05). FiberBind also caused higher satiety (6% ± 2%) and fullness (9% ± 3%) compared to RG-I (all p < 0.01). No effects on fecal fat excretion or energy intake were found. The RG-I fiber caused higher postprandial glucose concentration compared to FiberBind (p < 0.05) and higher insulin concentration at 180 min compared to control (p < 0.05). Compared to the control, RG-I and FiberBind lowered peak insulin concentration (both p < 0.05) and delayed time to peak for glucose (both p < 0.05). In conclusion, FiberBind intake could be beneficial for appetite regulation, but neither FiberBind nor RG-I affected fecal fat excretion or energy intake.

Protective Effects of Fagonia cretica L. Extract in Cafeteria Diet Induced Obesity in Wistar Rats

Obesity is one of the major life style disorders which may lead to undesirable effects on cholesterol, triglycerides, blood pressure and insulin resistance and eventually increases the risk of various adverse conditions like ischemic heart disease, stroke, coronary artery disease & type 2 diabetes. The present investigation was undertaken to explore protective effects of aerial parts of Fagonia cretica L. extract in cafeteria diet induced obesity in Wistar rats. Female Wistar rats were provided with cafeteria diet (CD) for the period of 10 weeks to induce obesity. Fagonia cretica L. methanolic extracts (200 & 400 mg/kg) & standard drug orlistat (30 mg/kg) were administered for last 6 weeks along with the continuation of CD. Various primary metabolic indicators of obesity like daily food consumption, body weight, lipid profile, fecal fat content & fat pads were studied. Administration of methanolic extract of Fagonia cretica L. significantly stopped increase in daily food consumption & body weight gain as compared to obese control group. Improvement in lipid profile was also observed in the all treatment groups rats as compared to obese control group rats. Obtained results validate that supplementation of Fagonia cretica L. methanolic extracts in obese rats resulted in significant protection against various indicators of obesity.

Fecal Fermentation Profile, Serum Fatty Acid Profile and Measures of Liver Health in Male HIV-infected Versus Non-infected Controls

Abstract Objectives Many persons with an HIV infection and undergoing treatment still experience weight loss, hyperglycemia, hyperlipidemia, gastrointestinal issues (diarrhea and malabsorption), and symptoms of lipodystrophy. Symptoms include NAFLD and liver fibrosis. The gut microbiota and short chain volatile fatty acids (SCVFA) interface with other body systems. Dysbiosis of the gut microbiota due to pharmaceuticals, malabsorption, and chronic diseases is associated with milieu of imbalances indicated by the modification of the SCVFA profile. This study aimed to further elucidate the relationship between gut microbiota fermentation profiles, serum and fecal long chain fatty acid profiles, NAFLD, liver fibrosis, and anthropometric measures in HIV infected males. Methods This research enrolled 14 HIV-infected and 14 non-infected males that were matched for age and body mass index (BMI). Anthropometric measurements BMI and hip to waist ratio were obtained, along with a liver scan for fatty liver and fibrosis using the ARFI ultrasound technique as well as a single blood draw via venipuncture. A full bowel movement was collected for each participant, a small aliquot was collected for future microbiome analysis, and the remainder was freeze-dried and stored at −80 C. Proximate analysis of fecal fat content was analyzed by soxhlet extraction. Fermentation profile of both fecal SCVFA and LCFA, and serum LCFA were analyzed via gas chromatography. Results Significant differences in levels of specific SCVFAs were found between groups, with male controls having significantly higher amounts of acetate (P &amp;lt; 0.046), butyrate (P &amp;lt; 0.033), and valerate (P &amp;lt; .006). Serum LCFA were similar between groups with a few exceptions. Anthropometric data approached statistical significance, with the HIV infected males exhibiting a greater value for liver damage (P = 0.060) and hip to waist ratio (P = 0.015). Conclusions In addition to identifying altered lipid circulation and liver damage, this research suggests differences in microbial communities between HIV-infected and non-infected individuals. Planned future microbiome analysis will help to correlate bacterial populations with altered fecal fermentation profiles. Funding Sources Seed Grant, Center of Excellence in Inflammation, Infectious Diseases and Immunity, ETSU.

Experimental Studies to Define the Role of Calcium (Ca2+) and Voltage-Gated Calcium Channel Blockers (vCa-CCB) against Neurosteroid Induced Obesity

Introduction: Obesity is closely associated with various types of illness, primarily caused by more calorie intake than body burn. In adipocytes, Calcium (Ca2+) is an important second messenger involved in the regulation of many physiological functions which are essential for survival. In the present research, we have investigated the role of Ca2+ ions in obesity by manipulating cytosolic Ca2+ ion concentration by selective blocking/advancing the Ca2+ ions through the voltage-gated calcium channels. Voltage-gated calcium channel (vCa) plays a key role in regulating intracellular and extracellular Ca2+ concentration. Cytoplasmic level of Ca2+ was manipulated by supplying calcium carbonate and by using vCa blockers i.e. nifedipine- (N-type- vCa-CCB) and ethosuximide (T-type, vCa-CCB).&#x0D; Methods: Obesity was induced by progesterone in female mice and test drugs were co-administered with progesterone whereas sibutramine was used as standard. The treatment was carried out for 28 days, during and after the treatment period various parameters were studied viz food consumption, change in body weight and temperature, the effect on WAT (white adipose tissue, adiposity index, histology of fat pad) and fecal lipid content.&#x0D; Results: Calcium carbonate treated group has shown promising effects in the decrease in body weight by increasing fecal lipid content and lipolysis which was reflected by an increase in body temperature. Ethosuximide also offered significant protection by decreasing the food intake but has not shown any notable effect on fecal fat content, whereas nifedipine has not offered any protection against the obesity induced by neurosteroid.&#x0D; Conclusion: Calcium carbonate has significant anti-obesity activity by including thermogenesis, and increasing fecal lipid content.

Acid steatocrit in the first 2 years of life: diagnostic accuracy and reference limits

Introduction. The measurement of acid steatocrit (AS) is an established method to assess faecal fat balance. However, data regarding AS in healthy infants and toddlers are sparse. Aim. This study aimed to determine the range of normal values for AS in the first two years of life and evaluate the correlations with other faecal fat balance tests.Material and Methods. AS (%) was assessed by 72-hour stool collection in 160 children aged 1–24 months (8 groups of 20: aged 1–3, 4–6 months, etc.).Results. AS was higher in infants &lt; 6 months than in those aged 7–12, 13–18 and 19–24 months (p &lt; 0.05, p &lt; 0.001 and p &lt; 0.001, respectively). The correlations between AS and age and faecal fat concentration (FFC) were statistically significant, but moderate or weak (r = -0.48, p &lt; 0.0001; r = 0.28, p &lt; 0.001, respectively). A 90th/95th percentile nomogram of AS was created based on these results, with values ranging from 23.6/23.9% at 1 month to 12.1/12.9% at 24 months. Conclusions. Healthy infants have a significantly higher AS than older children. For this reason, we propose an upper limits nomogram, providing detailed reference values for infants and children in their first two years of life. However, it should be noted that AS does not reflect adequately FFE and FFC in this population.

Fecal Fat Concentration and Excretion in the First 2 Years of Life: a Cross-Sectional Study.

Data on pancreatic exocrine secretion in the youngest children are scarce. The aim of the study was to determine the range of normal values for fecal fat concentration (FFC) and fecal fat excretion (FFE) in infants and toddlers up to 2 years of age. A total of 160 subjects aged 1 to 24 months (8 groups of 20: aged 1-3, 4-6 months, etc) were included in the study. In all children, FFC (%) and FFE (g/day) were assessed in 3-day stool collection. FFC correlated with age (r = -0.50, P < 0.0001). Of infants aged 1 to 3 months 65% had FFC higher than the <5% norm proposed for older children. The values of 90th/95th FFC percentile ranged from 9.7/13.0% at 1 month to 3.1/3.2% at 24 months. FFE did not differ between age groups. It was, however, higher than 4 and 3 g/day in 7.5% and 15.0% infants, respectively. The first detailed nomogram for the assessment of FFC and FFE in children aged 1 to 24 months was created. Healthy infants may have higher FFC and FFE than older children. We provide reference values, which should allow for both precise and facile FFC and FFE interpretation in clinical practice.

The Soluble Fiber α-Cyclodextrin Does Not Increase the Fecal Losses of Dietary Fat in Adults—A Double-Blind, Randomized, Placebo-Controlled, Crossover Trial

α-Cyclodextrin (α-CD), a soluble dietary fiber, may improve abnormal plasma lipids and promote weight loss. Preliminary evidence suggests that it may exert these effects by binding dietary fat and reducing absorption; this has not been tested in humans. The primary objective was to test whether supplemental α-CD increases fecal content of dietary lipid in humans. This was a randomized, double-blind, placebo-controlled, crossover study completed at the Mayo Clinic. Eight healthy volunteers, 5 premenopausal women and 3 men ages 23-54 y with body mass index (BMI; kg/m2) 18-27, underwent 2 separate study visits with a ≥2-wk washout period. The first morning of each visit volunteers consumed a standardized breakfast (14.5% protein, 27.5% fat, 60% carbohydrate, and 1.5 kcal/mL) containing [14C]tripalmitin and [3H]triolein with 2 g of α-CD or placebo, followed by 2 g of α-CD or placebo per meal for 2 more days. Volunteers consumed 100 g/d of dietary fat. Feces were collected for 72 h after the labeled breakfast to measure radiotracer content and total fecal fat. Radiotracer appearance in plasma TGs was measured at intervals after the labeled meal as a secondary outcome. Virtually no 3H radiotracer, but an average of ∼20% of the 14C radiotracer was recovered in fecal lipids, with no difference between α-CD and placebo. Total fecal fat content and radiotracer appearance in postprandial plasma TGs did not differ between the α-CD and placebo treatments. Plasma appearance of 14C-TG was 37%±14% less (P<0.0001) than 3H-TG. α-CD supplementation did not increase loss of dietary lipid in stool or total fecal fat compared with placebo in healthy adults. Greater stool loss and lesser appearance in plasma TGs of tripalmitin-derived [14C] compared with triolein-derived [3H] TGs imply different metabolic handling of these 2 dietary fat tracers. This trial was registered at www.clinicaltrials.gov as NCT03002168.

Clinical, endoscopic, and histological differentiation between celiac disease and tropical sprue: A systematic review.

While the prevalence of celiac disease (CD) is increasing globally, the prevalence of tropical sprue (TS) is declining. Still, there are certain regions in the world where both patients with CD and TS exist and differentiation between them is a challenging task. We conducted a systematic review of the literature to find out differentiating clinical, endoscopic, and histological characteristics between CD and TS. Medline, PubMed, and EMBASE databases were searched for keywords: celiac disease, coeliac, celiac, tropical sprue, sprue, clinical presentation, endoscopy, and histology. Studies published between August 1960 and January 2018 were reviewed. Out of 1063 articles available, 12 articles were included in the final analysis. Between the patients with CD and TS, there was no difference in the prevalence and duration of chronic diarrhea, abdominal distension, weight loss, extent of abnormal fecal fat content, and density of intestinal inflammation. The following features were more common in CD: short stature, vomiting/dyspepsia, endoscopic scalloping/attenuation of duodenal folds, histological high modified Marsh changes, crescendo type of IELosis, surface epithelial denudation, surface mucosal flattening, thickening of subepithelial basement membrane and celiac seropositivity; while those in TS include anemia, abnormal urinary D-xylose test, endoscopic either normal duodenal folds or mild attenuation, histologically decrescendo type of IELosis, low modified Marsh changes, patchy mucosal changes, and mucosal eosinophilia. Both patients with CD and TS have overlapping clinical, endoscopic, and histological characteristics, and there is no single diagnostic feature for differentiating CD from TS except for celiac specific serological tests.