Fiber-rich Foods Research Articles

Association between dietary fiber intake and suicidal ideation: a cross-sectional survey.

Dietary fiber is beneficial for improving mental health. However, few studies have evaluated the relationship between fiber-rich food and suicidal ideation. Thus, we aimed to assess whether dietary fiber consumption was associated with the risk of suicidal ideation. Data of 21,865 American adults were retrieved from the National Health and Nutrition Examination Survey (NHANES). Logistic and restricted cubic spline regression analyses were performed in order to evaluate the association of dietary fiber intake with suicidal ideation, as indicated by item nine of the nine-item Patient Health Questionnaire (PHQ-9). These analyses took into consideration several confounding factors that may potentially influence the results. Herein, we detected an L-shaped association between dietary fiber intake and the risk of suicidal ideation. For the most conclusive model, an increase of 1 g/1000 kcal/d in dietary fiber intake was accompanied by a 5% reduction in the risk of suicidal ideation. The inflection point of the L-shaped association was located at 7.8 g/1000 kcal/d. When dietary fiber intake exceeded the above level, the risk of suicidal ideation no longer decreased. Our findings of reduced risk of suicidal ideation in people with higher dietary fiber intake suggest the potential clinical and public health value of dietary fiber. Interventional investigations are warranted to prove whether adhering to a high-fiber diet prevents and reduces suicidality.

Exploring UK older adults' dietary fibre consumption habits and associated factors: a national diet and nutrition survey perspective.

The UK population is living longer; therefore, promoting healthy ageing via positive nutrition could have widespread public health implications. Moreover, dietary fibre intake is associated with health benefits; however, intake is below UK recommendations (30 g/d). Utilising national dietary survey data can provide up-to-date information on a large representative cohort of UK older adults, so that tailored solutions can be developed in the future. This study used cross-sectional data from the National Diet and Nutrition Survey (years 2008-2009 to 2018-2019) for older adults' (n 1863; 65-96 years) dietary fibre intake (three-to-four-day food diaries), top ten dietary fibre-rich foods, associated factors (demographics, dietary/lifestyle habits) and various health outcomes (anthropometric, blood and urine). Mean dietary fibre intake was 18·3 g/d (range: 2·9-55·1 g/d); therefore, below the UK dietary recommendations, with compliance at 5·7 %. In addition, there were five significant associations (P < 0·05) related to lower dietary fibre intake such as increasing age group, without own natural teeth, impaired chewing ability, lower education leaving age and poor general health. Older adults' key foods containing dietary fibre were mainly based on convenience such as baked beans, bread and potatoes. Positively, higher dietary fibre consumption was significantly associated (P = 0·007) with reduced diastolic blood pressure. In summary, the benefits of dietary fibre consumption were identified in terms of health outcomes and oral health were key modulators of intake. Future work should focus on a life course approach and the role of food reformulation to help increase dietary fibre intake.

Dietary Strategies to Reduce Atherosclerosis and Heart Attack Risk

The article delves into the significance of incorporating omega-3 fatty acids, antioxidants, and fiber-rich foods into one's diet, all of which have been associated with a lower risk of atherosclerosis and heart attacks.

An Empirical Dietary Pattern Associated With the Gut Microbial Features in Relation to Colorectal Cancer Risk

Background & AimsEpidemiologic evidence for dietary influence on colorectal cancer (CRC) risk through the gut microbiome remains limited. MethodsLeveraging 307 men and 212 women with stool metagenomes and dietary data, we characterized and validated a sex-specific dietary pattern associated with the CRC-related gut microbial signature (CRC Microbial Dietary Score [CMDS]). We evaluated the associations of CMDS with CRC risk according to Fusobacterium nucleatum, pks+Escherichia coli, and enterotoxigenic Bacteroides fragilis (ETBF) status in tumor tissue using Cox proportional hazards regression in the Health Professionals Follow-up Study (1986-2018), Nurses’ Health Study (NHS) (1984-2020), and NHS II (1991-2019). ResultsThe CMDS was characterized by high industrially processed foods and low unprocessed fiber-rich foods intakes. In 259,200 participants, we documented 3,854 incident CRC cases over 6,467,378 person-years of follow-up. CMDS was associated with a higher risk of CRC (Ptrend<0.001), with a multivariable hazard ratio (HRQ5vs.Q1) of 1.25 (95%CI, 1.13-1.39). The association remained after adjusting for previously established dietary patterns, e.g., the Western and prudent diets. Notably, the association was stronger for tumoral F. nucleatum-positive (HRQ5vs.Q1, 2.51; 95%CI, 1.68-3.75; Ptrend<0.001) (Pheterogeneity=0.03, positivity vs. negativity), pks+E. coli-positive (HRQ5vs.Q1, 1.68; 95%CI, 0.84-3.38; Ptrend=0.005) (Pheterogeneity=0.01, positivity vs. negativity), and ETBF-positive CRC (HRQ5vs.Q1, 2.06; 95%CI, 1.10-3.88; Ptrend=0.016) (Pheterogeneity=0.06, positivity vs. negativity), compared with their negative counterparts. ConclusionsCMDS was associated with increased CRC risk, especially for tumors with detectable F. nucleatum, pks+E. coli, and ETBF in tissue. Our findings support a potential role of the gut microbiome underlying the dietary effects on CRC.

Effects of Fermented and Fiber-Rich Foods on Maternal & Offspring Microbiome Study (FeFiFo-MOMS)

Effects of Fermented and Fiber-Rich Foods on Maternal & Offspring Microbiome Study (FeFiFo-MOMS)

Identification of Candidate Biomarkers of Fiber-Rich Foods Captured by Metabolomics Analyses

Identification of Candidate Biomarkers of Fiber-Rich Foods Captured by Metabolomics Analyses

Utilizing Sweet Corn “Milk” Residue to Develop Fiber-Rich Pasta: Effects of Replacement Ratio and Transglutaminase Treatment on Pasta Quality

The rising demand for fiber-rich food products has fuelled the exploration of innovative approaches to enhance their dietary fiber content. Although adding dietary fiber-rich materials into pasta formula can increase the dietary fiber content, this approach counters several technological problems as the cooking and textural properties of the resulting pastas are usually negatively affected. This study is aimed at utilizing sweet corn “milk” residue (SCMR), a food by-product, and transglutaminase to develop fiber-rich pasta. Durum wheat semolina was replaced by SCMR powder at the ratio of 0 (control), 5, 10, 15, and 20% to make SCMR-fortified pasta. The chemical compositions and cooking and textural properties of the fortified pasta were then quantified. As the replacement ratio increased, the dietary fiber content, total phenolic content (TPC), and antioxidant properties of pasta were considerably improved while the cooking and textural attributes were negatively impacted. At 20% SCMR fortification, the dietary fiber content and TPC of the pasta were increased by 3.2 and 1.2 times, respectively, while the cooking loss increased by 73% as compared to those of the control pasta. Meanwhile, the chewiness, cohesiveness, tensile strength, and elongation rate at break of the 20% SCMR-fortified pasta were reduced by 19%, 26%, 21%, and 65%, respectively, compared to those of the control pasta. To improve the cooking properties and the textural properties of the fortified pasta, transglutaminase was added to the pasta dough with 20% SCMR. The effect of transglutaminase was enzyme-dose dependent. The cooking and textural qualities of pasta were improved as enzyme concentration increased 0 to 0.75 U/g protein and declined as the enzyme concentration increased from 0.75 to 1.25 g/U protein. At the optimal concentration of transglutaminase (0.75 U/g protein), the cooking loss reduced by 16% while the chewiness, cohesiveness, tensile strength, and elongation rate increased by 18%, 11%, 31%, and 32% compared to those without transglutaminase. Novelty Impact Statement. This study focuses on developing the dietary fiber-enriched pasta using sweet corn “milk” residue and transglutaminase enzyme. The results showed that replacing 20% durum wheat semolina with SCMR powder significantly enhanced the dietary fiber and total phenolic content of the pasta but negatively affect the cooking and textural properties of the pasta. Adding transglutaminase at 0.75 U/g protein to the SCMR-semolina blended dough successfully restored the adverse effects of SCMR on the cooking and textural properties. This study showed that dietary fiber-enriched pasta with improved cooking and textural properties can be prepared using the combination of SCMR and transglutaminase.

Food Consumption and Sleep Disturbances in 9-year-old Children

Abstract Objective To assess the association of food consumption with sleep disturbances in 9-year-old children. Material and Methods The present study is part of a larger cohort study named Predictors of Maternal and Infant Excess Body Weight (PREDI) that was conducted in the homes of the participants during the fourth study follow-up. Anthropometric assessment and demographic, socioeconomic, food consumption, and sleep data were obtained. The children's food consumption was evaluated using the Brazilian Food and Nutrition Surveillance System (SISVAN, in the Portuguese acronym). Sleep habits were assessed using the Sleep Disturbance Scale for Children to evaluate sleep pattern-related behaviors in children/adolescents aged 3 to 18 years. Data were self-reported by the mother and her child on the day of the visit. Logistic regression analysis was used to estimate the association of food consumption with sleep disturbances in children at 9 years of age. Results Of the 142 children who participated in the study, 45.1% had sleep disturbances; most of them were boys (53.6%). The proportion of children with sleep disturbances was higher (55.6%) among children who did not consume fruits compared with those who ate fruits (p = 0.008). Logistic regression analysis revealed that the lack of fruit consumption was associated with sleep disturbances (OR = 2.26, p = 0.023), even after adjustment for other predictors. Conclusion We showed that the lack of fruit consumption is a predictor of sleep disturbances. Since fruit consumption had a protective effect on sleep disturbances at 9 years of age, encouraging the consumption of fiber-rich foods may contribute to preventing the establishment of sleep problems even in infants.

Fiber rich food suppressed airway inflammation, GATA3 + Th2 cells, and FcεRIα+ eosinophils in asthma.

Allergic Asthma is a disease presenting various endotypes and no current therapies act curative but alleviate disease symptoms. Dietary interventions are gaining increasing importance in regulating immune responses. Furthermore, short chain fatty acids (SFCA), as the main products of dietary fiber's fermentation by the gut bacteria, ameliorate the pathogenesis and disease burden of different illnesses including asthma. Nevertheless, the connection and crosstalk between the gut and lung is poorly understood. In this work, the role of high fiber diet on the development of allergic asthma at baseline and after exacerbation of disease induced by respiratory viruses was investigated. Hereby, SCFA in serum of asthmatic and non-asthmatic pre-school children before and after airway disease symptoms were analyzed. Moreover, the effect of high fiber diet in vivo in a murine model of house dust mite extract (HDM) induced allergic asthma and in the end in isolated lung and spleen cells infected ex vivo with Rhinovirus was analyzed. In this study, a decrease of the SCFA 3-Hydroxybutyric acid in serum of asthmatic children after symptomatic episodes at convalescent visit as compared to asthmatic and control children at baseline visit was observed. In experimental asthma, in mice fed with high fiber diet, a reduced lung GATA3 + Th2 type mediated inflammation, mucus production and collagen deposition and expression of Fc epsilon receptor Ia (FcεRIa) in eosinophils was observed. By contrast, the CD8+ memory effector T cells were induced in the lungs of asthmatic mice fed with high fiber diet. Then, total lung cells from these asthmatic mice fed with either standard food or with fiber rich food were infected with RV ex vivo. Here, RV1b mRNA was found significantly reduced in the lung cells derived from fiber rich food fed mice as compared to those derived from standard food fed asthmatic mice. Looking for the mechanism, an increase in CD8+ T cells in RV infected spleen cells derived from fiber rich fed asthmatic mice, was observed. Convalescent preschool asthmatic children after a symptomatic episode have less serum ß-Hydroxybutyric acid as compared to control and asthmatic children at baseline visit. Fiber rich diet associated with anti-inflammatory effects as well as anti-allergic effects by decreasing Type 2 and IgE mediated immune responses and inducing CD8+ memory effector T cells in a murine model of allergic asthma. Finally, ex vivo infection with Rhinovirus (RV) of total lung cells from asthmatic mice fed with fiber rich food led to a decreased RV load as compared to mice fed with standard food. Moreover, spleen cells derived from asthmatic mice fed with fiber rich food induced CD8+ T cells after ex vivo infection with RV. Dietary interventions with increased content in natural fibers like pectins would ameliorate asthma exacerbations. Moreover, respiratory infection in asthma downregulated SCFA in the gut contributing to asthma exacerbations.

Dietary Fiber in Inflammatory Bowel Disease: Are We Ready to Change the Paradigm?

Accumulating evidence from pre-clinical and clinical studies demonstrate the benefit of dietary fibers for inflammatory bowel disease (IBD). However, the majority of patients avoid or limit their consumption to manage their symptoms during the active and remission phases, although limited research supports these long-term dietary habits. Although recent evidence-based dietary guidelines highlight the importance of promoting an adequate intake of dietary fiber in IBD patients, intervention trials have not yet clearly clarified the quality and quantity of dietary fiber that should be consumed to be equally tolerated by and provide benefit for patients with IBD. This narrative review describes dietary fibers and their characteristics, analyzes the real-word studies on the impact of dietary fiber consumption in IBD in different clinical settings, and concludes with potential future directions in fiber research, focusing on the real-world needs of characterizing the consumption of fiber-rich foods and promoting their adequate intake.

Exploring the impact of lifestyle and environmental exposures on appetite hormone levels in children and adolescents: An observational study

BackgroundAppetite hormones are considered a promising target in fighting obesity as impaired appetite hormone levels have already been associated with obesity. However, further insights in the drivers of appetite hormone levels are needed. ObjectivesIn this study, we investigated the associations of fasting appetite hormone levels with lifestyle and environmental exposures in children and adolescents. MethodsA total of 534 fasting blood samples were collected from children and adolescents (4-16y,50% boys) and appetite hormone levels (glucagon-like peptide-1 (GLP-1), peptide YY (PYY), pancreatic polypeptide (PP), leptin and ghrelin) were measured. Exposures included dietary quality (fiber-rich food intake, sugar propensity, fat propensity), psychosocial stress (happiness, negative emotions, negative life events and emotional problems), sleep duration, physical activity and environmental quality (long term black carbon (BC), particulate matter <2.5 μM (PM2.5), nitrogen dioxide (NO2) exposure, and green space in a 100 m and 2000 m radius around the residence). A multi-exposure score was calculated to combine all the exposures at study in one measure. Associations of individual exposures and multi-exposure score with appetite hormone levels were evaluated using linear mixed regression models adjusting for sex, age, socioeconomic status, waist-to-height ratio and multiple testing. ResultsGLP-1 was associated with air pollution exposure (NO2 β* = -0.13, BC β* = -0.15, PM2.5 β* = -0.16, all p < 0.001). Leptin was associated with green space in a 100 m radius around the residence (β* = -0.11; p = 0.002). Ghrelin was associated with negative emotions (active ghrelin β* = -0.16; p = 0.04, total ghrelin β* = -0.23; p = 0.0051) and happiness (active ghrelin β* = 0.25; p < 0.001, total ghrelin β* = 0.26; p < 0.001). Furthermore, total ghrelin levels were associated with the multi-exposure score, reflecting unhealthy exposures and lifestyle (β* = -0.22; p = 0.036). DiscussionOur findings provide new insights into the associations of exposures with appetite hormone levels, which are of high interest for preventive obesity research. Further research is crucial to reveal the underlying mechanisms of the observed associations.

Abstract P489: Intake of Fiber-Rich Foods is Favorably Associated With Cardiac Structure and Function: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Background: Abnormal cardiac phenotypes, including left ventricular (LV) structure and function, are subclinical characteristics, detectable before experiencing heart failure (HF) symptoms. Identifying lifestyle risk factors of abnormal cardiac phenotypes can help to prevent or slow down the progression to HF and ultimately reduce the burden of the aging heart. Therefore, we aimed to identify the associations of carbohydrate (CHO) quality and fiber-rich foods with LV structure and function. Methods: We studied 3,171 Black and White adults in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Dietary intake was assessed via Diet History and averaged across years 0 (1985-86), 7, and 20. CHO:fiber ratio was created to define CHO quality (greater CHO:fiber ratio representing lower CHO quality). The fiber-rich food score was created based on the servings of whole grains, fruits, vegetables, nuts, and legumes. LV structure and function measures were assessed via echocardiography at years 25 and 30 and were the dependent variables in linear repeated measures models, including random intercepts for individuals. CHO:fiber ratio was treated as a fixed effect. Results: Study participants were 25.1 (range: 18-30, SD: 3.61) years old on average at baseline, 57% (1,807 of 3,171) female, and 53% (1,678 of 3,171) White. Higher CHO quality ratio was favorably associated with global longitudinal strain (GLS); while the fiber-rich food score was favorably associated with LV mass index, GLS, and E/e’ ratio after adjusting for demographic and lifestyle characteristics (see table). Conclusions: Our study finding suggests that higher CHO quality is associated with better systolic function and greater intake of fiber-rich foods is associated with better LV structure and function, which support the Dietary Guidelines for Americans and the Dietary Guidance to Improve Cardiovascular Health by the AHA that recommend intakes of high-quality CHO foods such as whole grains, fruit, and vegetables.

Weight Status (BMI) and Self-Reported Body Image of Saudis and Non - Saudis Female Staff at the University of Hail, (KSA)

Background: Body image and weight perceptions have a significant impact on nutritional practices and weight management. An inability to accurately assess body image and weight status may result in ineffective weight management measures and health risks. Objective: The aim of this study was to assess the weight status (BMI), self-perceived body image, and dietary habits of Saudi and non-Saudi women working at the University of Hail. Material and Methods: A well-designed and pre-tested questionnaire was used to collect data on 240 respondents' demographic characteristics, anthropometric measurements, self-perceived body image, medical histories, amount of time spent engaging in various activities, and frequency of consuming various food categories. Results: Sixty-one percent were 31–40 years old, and 33% were 41–50 years of age. Saudi subjects' mean height was 159 cm, their weight was 65 kg and their BMI was 25 kg/m2. Whereas in non-Saudi countries, the mean height was 160 ± 5.8, weight 66 ± 16.1, and BMI 26 ± 6.0. The prevalence of obesity or being overweight is shown for both categories. A comparison of BMI and self-perceived body image revealed that Saudi respondents accurately assessed their own body image, in contrast to pre-obese and obese non-Saudis. Hypertension and diabetes were common among pre-obese and obese subjects in both groups. Pre-obese (23%), obese (17%), Saudis, and pre-obese (18%) non-Saudis spend more than 6 hours on their cell phone. Walking and exercising at the gym were favourite activities among normal and pre-obese Saudi and non-Saudi subjects. Chi-square analysis revealed a statistically significant relationship between weight status and the amount of time spent doing sedentary activities (X2 (9, N = 240) =19.60, P =.0204). Dietary practices showed consumption of cereals, meat, and milk products was higher compared to fruits and vegetables. As a result, the diet was lacking in fiber-rich foods, which may be one of the causes of the high prevalence of overweight or obesity. Conclusion: For the promotion of a healthy lifestyle, good dietary practices with an emphasis on physical activity should be highlighted. Keywords: Weight status (BMI); Body Image; Weight perceptions; Dietary practices; Physical Activity

Fibre-rich Foods to Treat Obesity and Prevent Colon Cancer trial study protocol: a randomised clinical trial of fibre-rich legumes targeting the gut microbiome, metabolome and gut transit time of overweight and obese patients with a history of noncancerous adenomatous polyps

IntroductionRecently published studies support the beneficial effects of consuming fibre-rich legumes, such as cooked dry beans, to improve metabolic health and reduce cancer risk. In participants with overweight/obesity and a...

The Dairy and Cancer Controversy: Milking the Evidence.

Cancer risk reduction remains a significant concern for both individuals with a cancer diagnosis and those aiming to prevent it. Dairy products, a source of beneficial dietary nutrients, have sparked controversy regarding their impact on cancer risk. Evidence indicates that dairy consumption, particularly milk, can decrease colorectal cancer risk. However, cow's milk, a key dairy product, exposes individuals to growth hormones, notably insulin-like growth factor-1, potentially elevating cancer risk. Extensive research supports the link between dairy intake and heightened prostate cancer risk. Nonetheless, investigations into dairy's association with breast, ovarian, and other cancers yield mixed results. The overall data on dairy and cancer remains inconclusive. Available data suggests that a diet emphasizing fiber-rich foods such as whole grains, fruits, and vegetables, while restricting milk and dairy intake-similar to the Mediterranean dietary pattern-might mitigate cancer incidence. However, further research is crucial to elucidate the precise role of dairy products in overall cancer risk.

Functional Properties of Tannia Corms (Xanthosoma sagittifolium (L.) Schott) Flour As Affected By Cooking, Soaking, and Peeling Processes

The study aimed to characterize the functional properties of tannia (Xanthosoma sagittifolium (L.) Schott) flour to realize the crop’s immense potential as an alternative ingredient. Experiments were conducted using a 23 factorial design with cooking, soaking, and peeling as the independent variables. The predicted best treatment was subjected to proximate analysis. Results revealed that tannia flour had high water absorption capacity (71.6-75.9%), oil absorption capacity (52.3-58.3%), foaming stability (94.0-97.0%), and swelling power (53.1-75.0%). The flour obtained had a low gelling point (46.7°C-58.7°C), boiling point (52.0-64.0°C), and least gelation concentration (4-5.33%). Further, peeling significantly affected the water absorption capacity, foaming capacity and stability, and swelling power of tannia flour, while cooking and soaking significantly affected tannia flour’s foaming capacity and gelling point. The interaction of factors (peeling, cooking, and soaking) was also found to significantly affect the functional properties of tannia flour, except for the least gelation concentration. The predicted best treatment was the combination of steaming, cold water soaking, and peeled tannia (Treatment 7), which contains lower moisture (4.31%), ash (0.52%), crude protein (4.41%), crude fat (1.01%), but higher contents of carbohydrates (89.74%), and crude fiber (10.5%.). Overall, tannia flour has good functional properties with the best treatment containing comparable amounts of nutrients with wheat flour except for ash, crude protein, and crude fat. This provides an advantage in enhancing its applicability in various food products and in the production of energy and fiber-rich food products.

Enzymatic treatment of pineapple pomace and its application into fiber-rich biscuit making

Pineapple pomace is a by-product of the pineapple juice industry. With high dietary fiber content, it has become a potential source added to fiber-rich foods in recent years. However, the ratio of soluble dietary fiber (SDF) to total dietary fiber (TDF) in pineapple pomace is very low while both SDF and insoluble dietary fiber (IDF) have positive effects on human health. In this study, the enzymatic treatment conditions of fresh pineapple pomace with commercial cellulase on its dietary fiber profile were investigated. The addition of non-enzyme-treated pineapple pomace (NTPP) and enzyme-treated pineapple pomace (ETPP) into biscuit formulation was then examined. The appropriate cellulolytic treatment conditions were the water content of 86 %, the cellulase concentration of 7.5 U/g dry matter, and the treatment time of 3 h, under which the SDF content was enhanced from 1.26 to 4.43 % while the SDF/TDF ratio was improved from 2.2 to 9.5 % as compared to those of NTPP. The use of NTPP or ETPP in biscuit formula increased TDF content and antioxidative capacities as well as hardness of the product. At the ratio of 30 %, the biscuits made with ETPP were lower in hardness, greater in SDF content, SDF/TDF ratio, antioxidative capacities, and overall organoleptic acceptance compared to the biscuits made with NTPP.

Dietary pattern, physical activity and body composition of Children with and without Down Syndrome – A case control study

Background: Down syndrome (DS) is a known chromosomal disorder that results in changes in physical and clinical characteristics. Subjects with DS are more likely to be obese or overweight and have some recognized nutrition related problems. The objectives of this study are to compare body composition, food consumption pattern and physical activity level of children with and without DS. Methods: A case-control study of 82 participants (32 cases and 50 controls) was done. Anthropometric data related to weight, height, waist circumference, fat mass and fat free mass were obtained from the subjects. Food frequency questionnaire and survey were used to evaluate the dietary intake from 8 food groups and physical activity, respectively. Results: Children with DS exhibited significantly less intake of fruits and leafy vegetables (P &lt; 0.05) compared to controls. There was no significant difference in the average number of sport activities that both children with DS and NDS were involved in, male with DS preferred dancing (P = 0.028) while NDS preferred football (P = 0.008). Statistically significant difference between the cases and controls was found in female fat mass (P = 0.043), waist circumference (P = 0.024, 0.007), hip circumference (P = 0.05, 0.011) and waist to height ratio (P &lt; 0.001) of both male and female children with and without DS. Conclusion: Abdominal obesity is a major health concern among children with DS, indicating their increased risk of comorbidities associated with abdominal obesity such as insulin resistance. Their tendency to consume simple carbohydrate instead of fiber rich food, fruits and vegetables might further increase their risk of obesity. Perception of the dietary and physical activity preferences could help in the development of a life style program for higher quality of life.

Effect of Prebiotic Rich Diet on Gut Microbiome in Patients (Pts) Undergoing Stem Cell Transplants- Results of Phase I Study (NCT04629430)- Clinical Outcomes

Introduction An increase in gut microbial diversity during Stem cell transplant (HSCT) has been associated with improved treatment-related mortality (TRM) and gastro-intestinal graft versus host disease (GI GVHD). Prebiotics are indigestible carbohydrates rich in fructo-oligosaccharides such as inulin and Galacto- oligosaccharides. Prebiotics are metabolized by the gut bacteria to produce short-chain fatty acids which in turn nourish the gastrointestinal- epithelium. Hence, the implementation of a diet rich in pre-biotics could increase gut microbial diversity and improve outcomes such as GVHD and Overall survival (OS). We report clinical results from single-center Phase I study that investigates the feasibility of consuming a prebiotic rich diet in patients undergoing HSCT. Methods Both Allogeneic (Allo) and Autologous (Auto) HSCT Pts &amp;gt;18 yrs were included. Allo Pts undergoing second transplants and needing broad-spectrum antibiotics 1 week before starting the conditioning regimen were excluded. Pts were requested to have at least 2 servings of prebiotic-rich foods such as oats, artichokes an greens daily from the date of conditioning HSCT chemotherapy to Day +100. A list of vegetables and grains with serving size of approximately 5 grams of commercially available fructo-oligosaccharides per day was provided and consumption was recorded with a patient-reported diary. Stool samples were collected before the start of HSCT conditioning regimen, and once a month for 3 months post-transplant. Compliance was defined as consuming 2 servings of prebiotics &amp;gt;/= 80% days of the study period. Secondary endpoints included incidence of acute GVHD, Clostridium difficle infections (C.Diff), Neutrophil (ANC), and Platelet Engraftment. Exploratory endpoints included Meta- genomics sequencing of the stool samples and patient-reported quality of life (QoL) outcomes. Results 27 Pts, median age 60 yrs were enrolled in this phase 1 study. 5 patients withdrew prior to Day 100 of the intervention. Difficulty in following the diet and maintaining the diary were cited as the main reasons for the withdrawal. 14 were female; 14 pts had Allo HSCT, 5 of whom had Myeloablative conditioning. Only 8 pts were able to comply with the diet (29.6%), 19 were not compliant - of whom 11 (40.8%) pts were not able to comply with the diet and 8 patients were not able to provide a diary. Attempts were made to communicate with them to get an approximation of consumption, none reported &amp;gt; 80% of the study period. None of the patients had C diff infections, 3 of 14 Pts developed acute skin GVHD, grade 1-2; no GI GVHD was reported. Day 100 overall Survival was 100% for both Auto and Allo transplant pts. 1 yr OS 25 pts were evaluable and was 100% and 85.8% in the Auto and Allo Group respectively. 1 pt died of relapsed disease, and another of uncontrolled sepsis at Day +360, after cessation of the diet. Median days for ANC engraftment, and platelet engraftment in the Auto group were 10 days and 16 days; in the Allo group were 17 days and 18 days respectively. The mean percent of change in weight from pre-conditioning to day +100 was -10.26% in the Allo group and -2.5% in the Auto group. FACT-BMT QOL total score decreased by a mean percent of 10.7 % in the Allo pts and improved by 3.8% in the Auto group at Day 100 after transplant from baseline. Meta-genomic analysis of stool samples is currently ongoing. Conclusion Results from the Phase I study unfortunately show that a naturally occurring prebiotic-rich diet of green leafy vegetables, pulses, and fiber-rich food is very hard to consume daily in the first 100 days after HSCT. Regional dietary habits, mucositis, and chemotherapy-related change in taste could be contributory factors. However, most importantly implementation of this diet did not result in adverse events such as increased sepsis, GI GVHD, or C Diff infections and reported a remarkable 1 yr OS. Hence further studies to help improve compliance of diet with foods rich in pre-biotics may have a valuable impact on post-Transplant outcomes.

A Whole Food Plant-Based Approach to Ulcerative Colitis; A Case Series.

Inflammatory bowel disease (IBD) is a relapsing and remitting condition that requires continuous treatment to reduce the risk of relapse. Alongside genetic factors, diet and lifestyle factors are heavily implicated in the pathogenesis of the disease, with diets high in meat and ultra-processed foods and low in fibre-rich plant foods thought to be central to the disease process. There is considerable interest in using dietary interventions to prevent, treat and IBD, with the hope that this can limit and, in some cases, even eliminate the use of pharmaceutical interventions. A whole food plant-based diet (WFPBD) is an attractive option given its emphasis on foods that promote gut health and reduce inflammation and the avoidance of foods that are associated with dysbiosis and inflammation. Here we describe 3 case histories of patients with ulcerative colitis and the successful use of a WFPBD for remission induction and maintenance with over 2years of follow-up.