Fiber-rich Foods Research Articles

Postprandial Glycemic, Insulinemic, and Short-Chain Fatty Acids Responses Following the Consumption of Okara and Biovalorized Okara Incorporated Biscuits

Abstract Objectives Okara is a fiber-rich food processing by-product. However, it is underutilized as food due to its rapid putrefaction and poor sensorial properties. Valorization via fermentation (biovalorization) can alleviate its undesirable qualities while augmenting its soluble fiber content. The increase in soluble fiber may improve postprandial glycemic and insulinemic responses, potentially via generation of short-chain fatty acids (SCFAs) from colonic bacteria fermentation. This study aimed to assess the effect of consuming okara and biovalorized okara-containing biscuits on postprandial glucose, insulin and SCFAs responses in older Singaporeans. Methods Fifteen healthy middle-aged and older Singaporeans participated in a randomized controlled crossover trial. Subjects underwent a 4-hour mixed meal tolerance test with 100 g ingestion of 3 types of biscuits – control (C, no okara), biovalorised okara (RO) and autoclaved okara (AOK). RO and AOK biscuits were produced by 20% substitution of wheat flour with okara powder that was fermented with Rhizopus oligosporus (7% w/w) or autoclaved. The 4-hour incremental area under the curve (iAUC) of glucose, insulin and SCFAs (acetate, propionate and butyrate) were assessed. β-cell function was evaluated based on glucose stimulated insulin secretion, using a ratio of 4-hour AUC of insulin to glucose. Estimated insulin sensitivity (ISI) and metabolic clearance rate (MCR) were assessed with Stumvoll Index. Results Although no difference in glucose response was noted, RO showed significantly lower insulin iAUC (RO: 8931 ± 1058 mU/L × min, mean ± SE; C: 10271 ± 866 mU/L × min, p = 0.021) and improved β-cell function (p = 0.028) compared to C. AOK yielded significantly greater ISI and MCR compared to C (pISI = 0.016, pMCR = 0.009) while RO showed no difference against AOK or C. Significantly higher acetate and total SCFAs iAUC were evident for both RO and AOK relative to C (C vs RO: pacetate = 0.012, ptotal SCFA = 0.001; C vs AOK: pacetate = 0.015, ptotal SCFA = 0.001). AOK also had significantly greater propionate and butyrate iAUC compared to C (C vs AOK: pacetate = 0.002, pbutyrate = 0.001). Conclusions Consumption of okara and biovalorized okara-containing biscuits offers the benefit of attenuating postprandial insulinemic response possibly via SCFAs modulation. Funding Sources Singapore Ministry of Education

Facilitators and barriers to preparing and offering whole grains to children diagnosed with prediabetes: qualitative interviews with low-income caregivers

BackgroundThe prevalence of U.S. youth with prediabetes and type 2 diabetes (T2D) is increasing, with those from racial/ethnic minority and low socioeconomic status (SES) backgrounds at greater risk. Dietary fiber (e.g., whole grains and vegetables) is shown to be inversely associated with T2D risk, yet dietary recommendations are not being met. Caregivers play an important role in home food availability, but low SES neighborhoods are shown to have limited access to fiber-rich foods such as whole grains. The overall aim of this qualitative study was to assess caregiver perceptions about facilitators and barriers to preparing and offering whole grains that they received as part of the 16-week Food Overcoming Our Diabetes Risk (FoodRx) pilot study.MethodsA convenience sample of 60 youth (8–17 years) with obesity and prediabetes were recruited from an urban pediatric weight management clinic to participate in the FoodRx pilot study. Caregivers accompanied youth to a baseline clinic visit and completed a survey that asked about individual and household characteristics. Exit interviews were conducted at the follow-up clinic visit with caregivers of all youth who completed the study (n = 48) in order to assess facilitators and barriers experienced when preparing and offering whole grains. Interview transcripts were coded using the constant comparative method and grounded theory approaches.ResultsCaregivers (n = 48) had a mean age of 43 years and were primarily female (n = 46) and Hispanic (71%). Main facilitators to preparing and offering whole grains in the home were caregivers’ improved knowledge of whole grain health benefits and the development of strategies to encourage their children to consume whole grains (i.e., pairing whole grains with another liked food). A main barrier for caregivers was the lack of resources available to identify and prepare the novel whole grains that they received.ConclusionFindings suggest that caregivers are receptive to incorporating more whole grains into home-prepared meals, but they may need additional nutrition and cooking education to improve their self-efficacy.

Prevalence of constipation in adults with obesity class II and III and associated factors

BackgroundConstipation and obesity have common risk factors. However, little is known about the occurrence of constipation in individuals with severe obesity and the associated factors.ObjectiveTo evaluate the prevalence of intestinal constipation and its associated factors in adults with obesity class II and III.MethodThis study analyzed baseline data from a randomized clinical trial with adults aged 18–64 with a Body Mass Index (BMI) ≥ 35 kg/m2, living in the metropolitan region of Goiânia, Brazil. Data were collected using a questionnaire containing sociodemographic, lifestyle, level of obesity, presence of comorbidities, water intake and food consumption variables. The outcome variable was constipation assessed by the Rome III criteria and the Bristol Stool Form Scale. Multiple Poisson regression analysis was used to assess the association between explanatory variables and the outcome.ResultsAmong the 150 participants, the prevalence of constipation was 24.67% (95% CI: 17.69–31.64). After multiple regression analyses constipation was associated with polypharmacy (adjusted PR: 2.99, 95% CI: 1.18–7.57, p = 0.021), younger age group i.e. 18–29 years (adjusted PR: 3.12, 95% CI: 1.21–8.06, p = 0.019) and former smoking (adjusted PR: 3.24, 95% CI: 1.28–9.14, p = 0.014). There was no statistically significant association between constipation and daily consumption of fiber-rich foods, however, the non-consumption of whole grains was borderline significant (adjusted PR: 2.92, 95% CI: 1.00 to 8.49, p = 0.050).ConclusionA high prevalence of constipation was found in adults with obesity class II and III. Constipation was significantly associated with the simultaneous use of five or more medications, younger age group and being a former smoker.

Association of Dietary Fiber, Fruit, and Vegetable Consumption with Risk of Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

No previous investigation has summarized findings from prospective cohort studies on the association between dietary intake of fiber, fruit, and vegetables and risk of inflammatory bowel disease (IBD). Dietary fiber and its major sources can influence the risk of IBD by modulation of the gut microbiota. This study summarizes findings from published cohort studies on the association between dietary fiber, fruit, and vegetable consumption and risk of IBD. Relevant articles published up to January 2019 were searched via PubMed, MEDLINE, Scopus, Embase, Cochrane Library, and Google Scholar. All prospective cohort studies investigating the association between dietary fiber, fruit, and vegetable intake and risk of IBD were included. Combining 7 effect sizes from 6 studies, no significant association was found between dietary intake of fiber and risk of ulcerative colitis (UC) (RR: 1.09; 95% CI: 0.88, 1.34). However, a significant inverse association was found between dietary fiber intake and risk of Crohn disease (CD) (RR: 0.59; 95% CI: 0.46, 0.74), based on 5 studies with 6 effect sizes. Pooling information from 4 studies, we found a significant protective association between dietary intake of fruit and risk of UC (RR: 0.69; 95% CI: 0.55, 0.86) and CD (RR: 0.47; 95% CI: 0.38, 0.58). We also found a significant inverse association between vegetable consumption and risk of UC (RR: 0.56; 95% CI: 0.48, 0.66) and CD (RR: 0.52; 95% CI: 0.46, 0.59). In conclusion, dietary intake of fruit and vegetables was inversely associated with risk of IBD and its subtypes. Dietary fiber intake was also inversely associated with incidence of IBD and CD, but not with UC. Further studies are warranted to examine the association of other fiber-rich foods with IBD.

Effect of Coarse and Superfine-ground Wheat Brans on the Microstructure and Quality Attributes of Dried White Noodle

Wheat bran is widely used in the food industry to produce fibre-rich food products with enhanced health benefits. The present study explored the effect of bran size reduction by superfine grinding on the microstructure and quality of bran-enriched dried white noodle (DWN). Coarse (D50 = 330.7 μm) and superfine-ground (D50 = 50.7 and 27.9 μm) wheat brans were fortified into DWN at levels of 10, 20 and 30%. The physical modifications by bran addition on the microstructure, cooking performance, and textural properties of DWN were determined. Then, the sensory quality of the products was evaluated by the human panel using both the hedonic and “difference-from-control” tests. With the increasing amount of bran added, noodle quality deteriorated in all aspects. DWN fortified with 30% of bran presented a highly obstructed or disrupted microstructure, and their appearance and taste were least favoured by the consumers. Superfine grinding effectively pulverized wheat bran into micro-scale, and DWN fortified with the finest bran (D50 = 27.9 μm) possessed the darkest colour and a compromised cooking yield rate. However, they maintained superior taste and texture that were comparable to the control, with up to 20% of bran addition. The present study demonstrated that superfine grinding not necessarily improves all aspects of noodle processing and cooking but would promote an overall improvement on the sensory quality of bran-fortified noodle. Besides, it was possible to produce fibre-rich DWN with relatively high (10–20%) bran addition levels with acceptable quality. The results may guide future development of bran-enriched products to stimulate consumer’s fibre intake.

榎茸による食餌性腸閉塞の1例(Dietary small bowel obstruction by enokitake mashrooms)

要旨症例は生来健康な67歳の男性。主訴は腹痛，嘔気。患者は榎茸をほとんど毎日摂取し，1日で最大500g（通常量の50倍）の榎茸を食べることもあった。受診10日前から間欠的な心窩部痛，腹部膨満感，嘔気がみられ，症状が持続するため救急外来を受診した。来院時バイタルはGCS E4V5M6，血圧96/55mmHg，心拍数95/分，SpO2 98%，体温36.2℃。腹部は膨満しており，圧痛は明らかではなかった。受診時の腹部エコーでは腸管拡張がみられ，腸閉塞の可能性を疑い，CT撮影した。CTでは小腸閉塞がみられ，閉塞部位に内部が不均一な高吸収の腫瘤様陰影がみられた。摂食歴と併せ，榎茸による食餌性腸閉塞と診断し入院加療とした。入院後イレウス管を留置したところ，症状改善がみられ，再度撮影したCTでは腫瘤様陰影は消失していた。榎茸の過剰摂取で，上記のような画像所見がみられる小腸閉塞では，榎茸による食餌性腸閉塞を鑑別にあげる必要がある。また治療後は，食餌性腸閉塞の再発予防のために食事指導を行うことが重要である。

Influence of Durum Wheat Bran Particle Size on Phytochemical Content and on Leavened Bread Baking Quality.

Wheat bran is a conventional by-product of the wheat milling industry mainly used for animal feed. It is a rich and inexpensive source of phytonutrients, so is in demand for fibre-rich food products but creates quality issues when incorporated into bread. The purpose of this study was to characterize the physicochemical properties and phytochemical composition of different size durum bran fractions and show how they impact bread quality. Durum wheat (Triticum durum Desf.) was milled to create a coarse bran fraction (CB), which was further ground into a finer fraction (FB) which was sieved using four screens with apertures 425, 315, 250, 180, and <180 µm to create a particle size range of 1497 to 115 µm. All fractions contained phytosterol with highest in the 180 and FB, while total phenolic acids and antioxidant capacity was highest in CB and 425. Use of the fractions in a leavened common wheat (T. aestivum L.) bread formula at 10% incorporation negatively impacted bread loaf volume, colour, and texture compared to standard loaves, with CB having the least impact. Results suggest that to combine the highest phytochemical content with minimal impact on bread quality, bran particle size should be considered, with CB being the best choice.

Effect of Fenugreek fiber on Rheological and chapati making quality of whole wheat flour.

Increase in awareness of consumers and demand has led to the development of various fibre rich food products from different fiber source. In the present work novel roller milled fenugreek fiber rich fraction (FFRF) rich in galactomannans was used for the development of high fiber chapati. Farinograph water absorption and dough stability increased with increase in the addition of FFRF in blends. The creep measurement results showed reduction in the maximum creep compliance and viscoelastic compliance while the zero shear viscosity showed the increasing trend with the increase in the addition of FFRF. The pliability of chapatis significantly decreased on addition of FFRF. The sensory evaluation concluded that the chapati with 10% FFRF is acceptable. The shear force value of chapatis prepared from the control and WWF-FFRF blends were decreased as the storage time increased showing brittleness in the chapatis. The micrographs of an outer layer of chapati (crust) showed partially gelatinized starch. The crumb micrographs of the WWF-FFRF blends chapatis showed large and small starch granules coated with galactomannans gums, and this coating increased with increased addition of FFRF. The composition of 10% fenugreek fiber chapati contained higher amount of minerals, insoluble and soluble dietary fiber compared to that of control sample. The in vitro starch digestibility of formulated chapati showed significant decrease in the values.

Individual fate and gut microbiome composition in the European wild rabbit (Oryctolagus cuniculus)

Studies connecting microbiome composition and functional performance in wildlife have received little attention and understanding their connections with wildlife physical condition are sorely needed. We studied the variation in gut microbiota (hard fecal pellets) between allopatric subspecies of the European wild rabbit in wild populations and in captured individuals studied under captivity. We evaluated the influence of environmental and host-specific factors. The microbiome of wild rabbit populations reduced its heterogeneity under controlled conditions. None of the host-specific factors tested correlated with the microbiota composition. We only observed significant intra-group dispersion for the age factor. The most diverse microbiomes were rich in Ruminococcaceae potentially holding an enriched functional profile with dominance of cellulases and xylanases, and suggesting higher efficiency in the digestion of fiber-rich food. Conversely, low diversity gut microbiomes showed dominance of Enterobacteriaceae potentially rich in amylases. We preliminary noticed geographical variations in field populations with higher dominance of Ruminococcaceae in south-western than in north-eastern Spain. Spatial differences appeared not to be subspecies driven, since they were lost in captivity, but environmentally driven, although differences in social structure and behavior may also play a role that deserve further investigations. A marginally significant relationship between the Ruminococcaceae/Enterobacteriaceae ratio and potential life expectancy was observed in captive rabbits. We hypothesize that the gut microbiome may determine the efficiency of feeding resource exploitation, and can also be a potential proxy for life expectancy, with potential applications for the management of declining wild herbivorous populations. Such hypotheses remain to be explored in the future.

Modification of Dietary Habits for Prevention of Gout in Japanese People: Gout and Food Intake

In Japan, most of gout patients are adults, and the prevalence of gout has increased markedly since the 1960s. This phenomenon is thought to be attributed to the westernization of the Japanese diet since 1955. Monitoring the intake of nutrients and foods in Japanese people is essential in the prevention of gout. The objective of this article is to propose a preventive method for gout through the evaluation of recent dietary habits in Japanese people. In this article, the author shows the relationship between the number of gout patients and food intake in Japanese people and suggests modification of food intake for the prevention of gout in Japanese people referencing the results of clinical research reported. The author used the data of the Comprehensive Survey of Living Conditions in Japan for the number of gout patients (1986-2016) and the data of the National Health and Nutrition Survey in Japan (1946-2017) for the intake of foods. The relationship between the number of gout patients and food intake in Japanese people was examined. Modification of food intake for the prevention of gout is suggested as follows: limiting the intake of meat, organ meats high in purine content (e.g., liver, kidney), confectioneries (sugary foods including desserts and sweets), and sugar-sweetened beverages; limiting alcohol beverage consumption; limiting or decreasing intake of oils and fats, and seasonings and condiments (soy paste, soy sauce, and sauce); encourage intake of fiber-rich foods (e.g., cereals, whole grains, high-fiber bread), eggs, milk and dairy products (especially low-fat dairy products), legumes, seeds and nuts, fruit, vegetables, and coffee. The above dietary habits for the prevention of gout with proper choices of foods may also play a helpful role in the prevention of gout.

Prospects for the correction of intestinal microbiota in the prevention and treatment of asthma in children

The issues of therapy and prevention of asthma in children do not lose their relevance. The increase in the prevalence of allergic diseases and asthma is associated, among other things, with a relative deficit in the microbial load and changes in the microbiota due to improved hygiene and living conditions. The microbiota plays an important role in the formation and functioning of the immune system. Contact with microorganisms contributes to the normal maturation of T-regulatory cells, preventing an inadequate immune response in both the Th1- and Th2-pathways. Aim - literature review on the possibilities of gut microbiota correction for prevention and treatment of asthma in children. Results. In children with an increased risk of asthma, abnormalities in the intestinal microbiota are observed in the first year of life: there is a relative deficiency of Lachnospira, Veillonella, Faecalibacterium and Rothia. The imbalance of the intestinal microbiota is accompanied by a decrease in the synthesis of short-chain fatty acids (butyrate, acetate, propionate), which, among other things, play the role of signaling molecules. Gut microbiota maturation is delayed in children at risk of asthma. It is not clear whether the diversity of the gut microbiota is associated with the risk of developing asthma. Maintenance of normal gut microbiota or correction of its disturbances in early life is a possible approach to the prevention and treatment of asthma. Breastfeeding, vaginal delivery, constant contact with farm animals or dogs since an early age, limiting antibiotic use in the first year of life, a varied diet with the inclusion of fiber-rich foods, and the use of pre- and probiotics can help. However, the implementation of these recommendations in practice is difficult. Further research is required to identify specific prophylactic stimuli reproducible in the urban environment. The conflicting results of studies in this area, in particular, the effectiveness of probiotics in the prevention of asthma, require large-scale prospective cohort studies with a long follow-up period and careful selection of probiotic strains and their combinations. Now, there are no definitive recommendations on the use of probiotics for the prevention of allergic diseases. Conclusion. The possibilities of correcting the gut microbiota for the prevention and treatment of asthma are actively studied, but at present, there are many contradictions and unresolved issues.

The legitimacy of using dietary supplement diglycoside secoisolariciresinol (SDG) from flaxseed in cancer.

Linseed, commonly known as flaxseed, is a fibre-rich food product. According to the recent study prepared by the American Institute for Cancer Research (AICR), an adequate intake of dietary fiber contributes to reducing the risk of colorectal cancer. In addition, the flaxseed and the oil extracted from it are considered to be food products with a high content of anti-inflammatory, unsaturated α-linolenic acid (ALA). However, the authors of the most recent scientific research have assigned the anticancer significance of flax seeds to plant lignan - secoisolariciresinol diglycoside (SDG), of which flaxseed is the main food source. This article provides a review of the world scientific literature together with an assessment of the validity of dietary supplementation with SDG from flaxseeds in cancer and during chemotherapeutic treatment. The paper also presents the European Food Safety Authority (EFSA) and the US Food and Drug Administration (FDA) view on dietary supplementation with flax seeds and its lignans. Additionally, selected dietary supplements available on the Polish market containing SDGs, linseed oil or linseed were analysed, together with a description of their intended use suggested by the manufacturers.

Effects of superfine grinding on asparagus pomace. Part II: Changes on intestinal function and health

This study aims to evaluate the effects of asparagus pomace with different particle size (~10 μm, ~30 μm, and ~80 μm) on intestinal function and health. One hundred and forty male Kunming mice were divided into fourteen groups and were used for small intestine movement experiment, defecation experiment, and intestinal function and health experiment, respectively. Results showed that, asparagus pomace samples treatment could markedly alleviate the constipation caused by loperamide with improved intestinal propulsion rate, reduced initial time of the first black stool, and increased the total mass of faeces within 6 h (P < 0.05), and finer samples worked better. All asparagus pomace-treated groups could significantly reduce the cecum ammonia concentration, increase the faeces dry weight and moisture content, and lower the β-d-glucosidase and β-d-glucuronidase activities. However, the difference in aforementioned properties between ~10 μm and ~30 μm groups were not significant (P > 0.05), and the respective maximal efficiency were observed when the sample was ranged within the size in ~30 μm, which indicated that a rational granularity can meet its objectives. This paper is expected to provide new insights of pulverization on functional properties of fiber-rich food materials.

Yuck, This Biscuit Looks Lumpy! Neophobic Levels and Cultural Differences Drive Children’s Check-All-That-Apply (CATA) Descriptions and Preferences for High-Fibre Biscuits

Food neophobia influences food choice in school-aged children. However, little is known about how children with different degrees of food neophobia perceive food and to what extent different sensory attributes drive their liking. This paper explores liking and sensory perception of fibre-rich biscuits in school-aged children (n = 509, age 9–12 years) with different degrees of food neophobia and from five different European countries (Finland, Italy, Spain, Sweden and United Kingdom). Children tasted and rated their liking of eight commercial biscuits and performed a Check-All-That-Apply task to describe the samples and further completed a Food Neophobia Scale. Children with a higher degree of neophobia displayed a lower liking for all tasted biscuits (p < 0.001). Cross-cultural differences in liking also appeared (p < 0.001). A negative correlation was found between degree of neophobia and the number of CATA-terms used to describe the samples (r = −0.116, p = 0.009). Penalty analysis showed that degree of food neophobia also affected drivers of biscuit liking, where particularly appearance terms were drivers of disliking for neophobic children. Cross-cultural differences in drivers of liking and disliking were particularly salient for texture attributes. Further research should explore if optimizing appearance attributes could be a way to increase liking of fibre-rich foods in neophobic children.

Aspects of dietary fibre in health and diseases

Dietary fibre is the name collectively given to the indigestible carbohydrates present in foods. These carbohydrates consist of cellulose, gum, pectin and mucilage. Enzymes of gastro-intestinal tracts in humans do not digest these fibres. Plants are the only source of dietary fibre. It is found in grains, vegetables and fruits. Dietary fibre helps to keep the digestive system healthy, and it is vital in reducing the risk of diseases such as coronary heart disease, diabetes, diverticulosis, haemorrhoids and intestinal cancer. Undigested fibres enter the large intestine where bacteria ferments them. Carbon dioxide, nitrogen, hydrogen and short-chain fatty acids are the by-products of the fermentation. Soluble fibre and resistant starch also serve as prebiotic and supports the necessary probiotic for digestive health. In grapes, peas, beans and barley, much of the soluble fibre is extracted. When dissolved in the water, a gel-like substance is formed. Soluble fibre helps to support the growth of friendly bacteria needed to maintain a healthy intestinal system. They also help in slowing down the time taken by the food to pass through the stomach into the small intestine, which helps to slow down the absorption of glucose and controls the blood sugar levels and helps in managing diabetes mellitus and keeps you feeling fuller for a longer time. The diets with high fibre intakes are known to have beneficial health effects as they have water holding capacity, helps in adsorption of organic molecules and facilitates its excretion, hypoglycemic effects and hypercholesterolemic effect. The inclusion of fibre rich food in weight-reducing diets is found to helpful since it provides a feeling of fullness without consumption of excess calories. The present review discusses the definition, nutritional properties of dietary fibre and therapeutic functions of dietary fibres in health and diseases.

The concentration of several perfluoroalkyl acids in serum appears to be reduced by dietary fiber

Fiber-rich food intake has been associated with lower serum concentrations of perfluoroalkyl substances (PFAS) in some studies and dietary fiber was related to lower serum PFAS in a recent study. Given the previous epidemiologic data suggesting that fiber might decrease serum PFAS concentrations, we examined the relation of serum PFAS concentrations to intake of dietary fiber in National Health and Nutrition Examination Survey (NHANES) data. We examined the PFAS-fiber association among 6482 adults who participated in the NHANES, 2005–2016. Fiber intake was estimated based on two 24-hour diet recalls. We adjusted the models for determinants of PFAS and potentially confounding factors such as intake of foods reported to increase PFAS exposure. Results were expressed as the percent difference in PFAS concentration per interquartile range (IQR) increase in fiber (and 95 percent confidence interval), and the NHANES sampling parameters were used to make the results generalizable to the U.S. The adjusted percent difference in perfluorooctanoic acid (PFOA) per IQR increase in fiber was −3.64 (−6.15, −1.07); for perfluorooctane sulfonic acid (PFOS) was −6.69 (−9.57, −3.73), and for perfluorononanoic acid (PFNA) was −8.36 (−11.33, −5.29). These results suggest that dietary fiber increases the gastrointestinal excretion of PFOA, PFOS, and PFNA. Because fiber also lowers serum cholesterol, in some studies of the serum cholesterol-PFAS relationship confounding by fiber may be worth evaluating.

Partial restoration of normal intestinal microbiota in morbidly obese women six months after bariatric surgery.

We studied the impact of bariatric surgery on the intestinal microbiota of morbidly obese study subjects. A total of 13 morbidly obese women (five of which had type 2 diabetes) and 14 healthy age- and gender-matched controls were recruited and the microbiota composition of fecal samples were determined by using a phylogenetic microarray. Sampling of the patients took place just one month before and 6 months after the operation. Within six months after bariatric surgery, the obese subjects had lost on average a quarter of their weight whereas four of the five of the diabetic subjects were in remission. Bariatric surgery was associated with an increased microbial community richness and Bacteroidetes/Firmicutes ratio. In addition, we observed an increased relative abundance of facultative anaerobes, such as Streptococcus spp., and a reduction in specific butyrate-producing Firmicutes. The observed postoperative alterations in intestinal microbiota reflect adaptation to the changing conditions in the gastrointestinal tract, such as energy restriction and the inability to process fiber-rich foods after bariatric surgery.

Chronic Kidney Disease, Gut Dysbiosis, and Constipation: A Burdensome Triplet.

Gut dysbiosis has been implicated in the progression of chronic kidney disease (CKD). Alterations in the gut environment induced by uremic toxins, the dietary restriction of fiber-rich foods, and multiple drugs may be involved in CKD-related gut dysbiosis. CKD-related gut dysbiosis is considered to be characterized by the expansion of bacterial species producing precursors of harmful uremic toxins, such as indoxyl sulfate and p-cresyl sulfate, and the contraction of species generating beneficial short-chain fatty acids, such as butyrate. Gut-derived uremic toxins cause oxidative stress and pro-inflammatory responses, whereas butyrate exerts anti-inflammatory effects and contributes to gut epithelial integrity. Gut dysbiosis is associated with the disruption of the gut epithelial barrier, which leads to the translocation of endotoxins. Research on CKD-related gut dysbiosis has mainly focused on chronic inflammation and consequent cardiovascular and renal damage. The pathogenic relationship between CKD-related gut dysbiosis and constipation has not yet been investigated in detail. Constipation is highly prevalent in CKD and affects the quality of life of these patients. Under the pathophysiological state of gut dysbiosis, altered bacterial fermentation products may play a prominent role in intestinal dysmotility. In this review, we outline the factors contributing to constipation, such as the gut microbiota and bacterial fermentation; introduce recent findings on the pathogenic link between CKD-related gut dysbiosis and constipation; and discuss potential interventions. This pathogenic link needs to be elucidated in more detail and may contribute to the development of novel treatment options not only for constipation, but also cardiovascular disease in CKD.

Relationship between Dietary Fiber Intake and the Prognosis of Amytrophic Lateral Sclerosis in Korea.

The gut microbiota has been suggested as an important factor in the pathogenic mechanisms of amyotrophic lateral sclerosis (ALS). This study aimed to investigate whether the intake of different kinds of dietary fiber was related to the disease progression rate (∆FS) and survival time. In total, 272 Korean sporadic ALS patients diagnosed according to the revised EI Escorial criteria were recruited starting in March 2011 and were followed until the occurrence of events or the end of September 2020. The events included percutaneous endoscopic gastrostomy, tracheostomy, and death. Dietary fiber intake was calculated based on a 24-h dietary recall and classified according to five major fiber-rich foods: vegetables, fruits, grains, legumes, and nuts/seeds. Among the total participants, the group with ∆FS values lower than the mean ∆FS (0.75) was noted in the highest tertiles of total and vegetable fiber intake. Participants in the highest tertile for vegetable fiber intake showed longer survival in the Kaplan–Meier analysis (p = 0.033). Notably, vegetable fiber intake was negatively correlated with pro-inflammatory cytokine (interleukin (IL)-1β, IL-6, and monocyte chemoattractant protein-1) levels in the cerebrospinal fluid. This study showed that vegetable fiber intake could influence the disease progression rate and survival time. Further clinical trials are needed to confirm whether dietary fiber supplementation improves the prognosis of ALS.

Anemia and Its Determinants among Male and Female Adolescents in Southern Ethiopia: A Comparative Cross-Sectional Study.

Background Adolescent anemia is a major public health problem worldwide. Adolescents (10–19 years) are at an increased risk of developing anemia due to increased iron demand during puberty, menstrual losses, limited dietary iron intake, and faulty dietary habits. Objective To assess the prevalence of anemia and associated factors among male and female adolescent students in Dilla Town, Gedeo Zone, Southern Ethiopia, May 2018. Methods A school-based comparative cross-sectional study was employed among 742 school adolescents. Basic characteristics, anthropometric measurements, haemoglobin measurement, and others were collected. Data were analyzed using SPSS version 20 software, and descriptive statistics were computed for all variables. Bivariate and multivariable logistic regression analyses using binary logistic regression were done, the results were interpreted by using AOR with their corresponding 95% CI, and statistically significant difference was declared at p < 0.05Result Out of the total 742 respondents, 377 (50.8%) were males and 365 (49.2%) were females. The overall prevalence of anemia was 21.1%, and the prevalence of anemia was 22.5% among male adolescents and 19.7% among females. Male adolescent students within the early adolescence age group (10–13 yrs) (AOR 0.27, 95% CI, 0.08–0.87), those consuming fibre-rich foods daily (AOR 0.11, 95% CI, 0.02–0.61), and those having no intestinal parasites (AOR 0.04, 95% CI, 0.02–0.09) were less likely to be anemic. Similarly, female adolescent students not having intestinal parasites (AOR 0.05, 95% CI, 0.01–0.11) were less likely to develop anemia while those from malaria endemic area (AOR 2.57, 95% CI, 1.13–5.83) were identified to be more anemic. Conclusion This study identified that anemia was a moderate public health significance in the study area, and the prevalence of anemia was slightly higher among male than female adolescents. Age category, frequency of eating fibre-rich foods, and positive intestinal parasite tests were factors contributing for anemia among male adolescents while presence of intestinal parasite and malaria endemicity were the determinants of anemia among female adolescents.