scholarly journals 3185 A Randomized Controlled Trial Comparing the Nonabsorbable Antibiotic Rifaximin vs. Dietary Intervention Low in Fermentable Sugars (FODMAP) in Irritable Bowel Syndrome

2019 ◽  
Vol 3 (s1) ◽  
pp. 31-31
Author(s):  
Allen Lee ◽  
Krishna Rao ◽  
Emily Haller ◽  
Lauren Van Dam ◽  
Jason Baker ◽  
...  
Keyword(s):  
Dietary Intervention ◽  
Controlled Trial ◽  
Gastrointestinal Surgery ◽  
Fecal Microbiota ◽  
Longitudinal Analyses ◽  
Dietary Interventions ◽  
Microbial Composition ◽  
Hydrogen Breath Test ◽  
Fodmap Diet ◽  
Hydrogen Breath Tests

OBJECTIVES/SPECIFIC AIMS: Objectives and goals of this study are to (i) determine whether IBS-D patients randomized to either rifaximin or low FODMAP diet show improvement in IBS-related symptoms; and (2) identify using longitudinal analyses how SIBO status and fecal microbiota features associate with response to either rifaximin or low FODMAP dietary intervention. METHODS/STUDY POPULATION: 42 patients ≥ 18 years of age who meet Rome IV criteria for IBS-D will be randomized to receive either rifaximin or low FODMAP diet intervention. The primary outcome will be the proportion of responders to intervention which is defined as ≥ 30% reduction in mean daily abdominal pain or bloating by visual analog scale compared with baseline. Exclusion criteria will include: (a) history of microscopic colitis, inflammatory bowel disease, celiac disease, or other organic disease that could explain symptoms, (b) prior gastrointestinal surgery, other than appendectomy or cholecystectomy > 6 months prior to study initiation, (c) prior use of rifaximin or formal dietary interventions for IBS-D, (d) use of antibiotics within the past 3 months, or (e) use of probiotics within 1 month of study entry. Glucose hydrogen breath tests will be performed at the beginning and end of the trial to evaluate for SIBO. Fecal samples will be collected at 0, 2, and 6 weeks to determine changes in fecal microbial composition and structure. RESULTS/ANTICIPATED RESULTS: This study seeks to examine whether longitudinal analyses of small intestinal and colonic microbiota can subtype IBS-D subjects into clinically relevant phenotypes. A total of 18 subjects have been enrolled into the study. Clinical variables, hydrogen breath test results, and fecal microbiota data are being collected for ongoing analysis. DISCUSSION/SIGNIFICANCE OF IMPACT: Results from this study may help move treatment of IBS from a purely symptom based approach to a more individualized approach by stratifying IBS-D patients into distinct clinical phenotypes which are amenable to targeted therapeutic approaches.

scholarly journals Fecal microbiota dynamics during disease activity and remission in newly diagnosed and established ulcerative colitis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lena Öhman ◽  
Anders Lasson ◽  
Anna Strömbeck ◽  
Stefan Isaksson ◽  
Marcus Hesselmar ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Gut Microbiota ◽  
Disease Activity ◽  
Temporal Dynamics ◽  
Fecal Microbiota ◽  
Disease Stage ◽  
Dietary Interventions ◽  
Microbial Composition ◽  
Fecal Samples ◽  
Specific Species

AbstractPatients with ulcerative colitis (UC) have an altered gut microbiota composition, but the microbial relationship to disease activity needs to be further elucidated. Therefore, temporal dynamics of the fecal microbial community during remission and flare was determined. Fecal samples were collected at 2–6 time-points from UC patients during established disease (cohort EST) and at diagnosis (cohort NEW). Sampling range for cohort EST was 3–10 months and for cohort NEW 36 months. Relapses were monitored for an additional three years for cohort EST. Microbial composition was assessed by Genetic Analysis GA-map Dysbiosis Test, targeting ≥ 300 bacteria. Eighteen patients in cohort EST (8 with maintained remission and 10 experiencing a flare), provided 71 fecal samples. In cohort NEW, 13 patients provided 49 fecal samples. The microbial composition showed no clustering related to disease activity in any cohort. Microbial dissimilarity was higher between than within patients for both cohorts, irrespective of presence of a flare. Microbial stability within patients was constant over time with no major shift in overall composition nor modification in the abundance of any specific species. Microbial composition was not affected by intensified medical treatment or linked to future disease course. Thus in UC, the gut microbiota is highly stable irrespective of disease stage, disease activity or treatment escalation. This suggests that prolonged dietary interventions or repeated fecal transplantations are needed to be able to induce permanent alterations of the gut microbiota.

scholarly journals Effect of dietary interventions in mild cognitive impairment: a systematic review

2018 ◽  
Vol 120 (12) ◽  
pp. 1388-1405 ◽  
Author(s):  
Andrea M. McGrattan ◽  
Claire T. McEvoy ◽  
Bernadette McGuinness ◽  
Michelle C. McKinley ◽  
Jayne V. Woodside
Keyword(s):  
Cognitive Impairment ◽  
Folic Acid ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Dietary Intervention ◽  
Controlled Trial ◽  
Cognitive Status ◽  
Dietary Factors ◽  
Cognitive Outcomes ◽  
Dietary Interventions

AbstractDiet has been investigated in relation to its ability to promote cognitive function. However, evidence is currently limited and has rarely been systematically reviewed, particularly in a mild cognitive impairment (MCI) population. This review examined the effect of diet on cognitive outcomes in MCI patients. A total of five databases were searched to find randomised controlled trial (RCT) studies, with diet as the main focus, in MCI participants. The primary outcome was incident dementia and/or Alzheimer's disease (AD) and secondary outcomes included cognitive function across different domains using validated neuropsychological tests. Sixteen studies met the inclusion criteria. There was a high degree of heterogeneity relating to the nature of the dietary intervention and cognitive outcomes measured, thus making study comparisons difficult. Supplementation with vitamin E (one study, n 516), ginkgo biloba (one study, n 482) or Fortasyn Connect (one study, n 311) had no significant effect on progression from MCI to dementia and/or AD. For cognitive function, the findings showed some improvements in performance, particularly in memory, with the most consistent results shown by B vitamins, including folic acid (one study, n 266), folic acid alone (one study, n 180), DHA and EPA (two studies, n 36 and n 86), DHA (one study, n 240) and flavonol supplementation (one study, n 90). The findings indicate that dietary factors may have a potential benefit for cognitive function in MCI patients. Further well-designed trials are needed, with standardised and robust measures of cognition to investigate the influence of diet on cognitive status.

scholarly journals A Molecular-Level Landscape of Diet-Gut Microbiome Interactions: Toward Dietary Interventions Targeting Bacterial Genes

mBio ◽  
2015 ◽  
Vol 6 (6) ◽  
Author(s):  
Yueqiong Ni ◽  
Jun Li ◽  
Gianni Panagiotou
Keyword(s):  
Gene Expression ◽  
Human Health ◽  
Gut Microbiome ◽  
Dietary Intervention ◽  
Methodological Approach ◽  
Bacterial Species ◽  
Detailed Knowledge ◽  
Dietary Interventions ◽  
Microbial Composition ◽  
Bacterial Proteins

ABSTRACT As diet is considered the major regulator of the gut ecosystem, the overall objective of this work was to demonstrate that a detailed knowledge of the phytochemical composition of food could add to our understanding of observed changes in functionality and activity of the gut microbiota. We used metatranscriptomic data from a human dietary intervention study to develop a network that consists of >400 compounds present in the administered plant-based diet linked to 609 microbial targets in the gut. Approximately 20% of the targeted bacterial proteins showed significant changes in their gene expression levels, while functional and topology analyses revealed that proteins in metabolic networks with high centrality are the most “vulnerable” targets. This global view and the mechanistic understanding of the associations between microbial gene expression and dietary molecules could be regarded as a promising methodological approach for targeting specific bacterial proteins that impact human health. IMPORTANCE It is a general belief that microbiome-derived drugs and therapies will come to the market in coming years, either in the form of molecules that mimic a beneficial interaction between bacteria and host or molecules that disturb a harmful interaction or proteins that can modify the microbiome or bacterial species to change the balance of “good” and “bad” bacteria in the gut microbiome. However, among the numerous factors, what has proven the most influential for modulating the microbial composition of the gut is diet. In line with this, we demonstrate here that a systematic analysis of the interactions between the small molecules present in our diet and the gut bacterial proteome holds great potential for designing dietary interventions to improve human health.

scholarly journals Fecal Microbiota Dynamics During Disease Activity and Remission in Newly Diagnosed and Established Ulcerative Colitis

2021 ◽  
Author(s):  
Lena Öhman ◽  
Anders Lasson ◽  
Anna Strömbeck ◽  
Stefan Isaksson ◽  
Marcus Hesselmar ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Gut Microbiota ◽  
Disease Activity ◽  
Temporal Dynamics ◽  
Fecal Microbiota ◽  
Disease Stage ◽  
Dietary Interventions ◽  
Microbial Composition ◽  
Fecal Samples ◽  
Specific Species

Abstract Patients with ulcerative colitis (UC) have an altered gut microbiota composition, but the microbial relationship to disease activity needs to be further elucidated. Therefore, temporal dynamics of the fecal microbial community during remission and flare was determined. Fecal samples were collected at 2–6 time-points from UC patients during established disease (cohort EST) and at diagnosis (cohort NEW). Sampling range for cohort EST was 3–10 months and for cohort NEW 36 months. Relapses were monitored for an additional three years for cohort EST. Microbial composition was assessed by Genetic Analysis GA-map™ Dysbiosis test, targeting ≥ 300 bacteria. Eighteen patients in cohort EST (8 with maintained remission and 10 experiencing a flare), provided 71 fecal samples. In cohort NEW, 13 patients provided 49 fecal samples. The microbial composition showed no clustering related to disease activity in any cohort. Microbial dissimilarity was higher between than within patients for both cohorts, irrespective of presence of a flare. Microbial stability within patients was constant over time with no major shift in overall composition nor modification in the abundance of any specific species. Microbial composition was not affected by intensified medical treatment or linked to future disease course. Thus in UC, the gut microbiota is highly stable irrespective of disease stage, disease activity or treatment escalation. This suggests that prolonged dietary interventions or repeated fecal transplantations are needed to be able to induce permanent alterations of the gut microbiota.

Abstract P150: Weight-Loss Diets and 2-Year Change of Circulating Amino Acids in Two Randomized Intervention Trials

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Yan Zheng ◽  
Uta Ceglarek ◽  
Tao Huang ◽  
Lerong Li ◽  
Jennifer Rood ◽  
...  
Keyword(s):  
Amino Acids ◽  
Weight Loss ◽  
Amino Acid ◽  
Weight Change ◽  
Plasma Levels ◽  
Dietary Intervention ◽  
Controlled Trial ◽  
Dietary Interventions ◽  
Amino Acid Profiles ◽  
Intervention Trials

Background: Emerging evidence has related circulating amino acids to diabetes and cardiovascular risk. Little is known about how diet modifications affect circulating amino acids. The present study aimed to examine the effects of weight-loss diets on long-term changes in plasma amino acids, and their relations with weight loss and metabolic outcomes. Methods and Results: We repeatedly measured plasma amino acid profiles over 2 years among overweight or obese participants from two randomized dietary interventional weight-loss trials: 774 from the Preventing Overweight Using Novel Dietary Strategies trial (POUNDS LOST) and 318 from Dietary Intervention Randomized Controlled Trial (DIRECT). The plasma levels of most amino acids decreased from baseline during follow-up in both trials. In the POUNDS LOST trial, compared to the high-protein diets, the average-protein weight-loss diets showed a greater effect on decreasing plasma levels of a diabetes-associated branched-chain amino acid (BCAA) valine and another amino acid methyl-histidine at 6 months, independent of weight change (p<0.002). Furthermore, the changes of plasma BCAA leucine/isoleucine, aromatic amino acid tyrosine and phenylalanine, and four other amino acids (alanine, sarcosine, hydroxyproline, and methionine) were positively related to concurrent weight loss, consistently in both trials (5-13g weight loss per 1 unit decease in log[amino acid in μmol/L], p<0.002). Moreover, the changes in tyrosine and alanine were positively related to changes in insulin resistance, independent of weight change, in both trials (p<0.05). Conclusion: Our findings underscore the potential importance of weight-loss dietary interventions in improvement of amino acid profiles and related cardiometabolic risk.

Low FODMAP Diet Is Not Effective in Children with Functional Abdominal Pain: A Randomized Controlled Trial

2020 ◽  
Vol 76 (5) ◽  
pp. 334-344
Author(s):  
Katarzyna Mirosława Boradyn ◽  
Katarzyna Eufemia Przybyłowicz ◽  
Elżbieta Jarocka-Cyrta
Keyword(s):  
Abdominal Pain ◽  
Dietary Intervention ◽  
Rating Scale ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Gastrointestinal Symptoms ◽  
Stool Consistency ◽  
Functional Abdominal Pain ◽  
Abdominal Symptoms ◽  
Fodmap Diet

<b><i>Introduction:</i></b> A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) has been shown to reduce symptoms among adult patients and children with irritable bowel syndrome. There are no studies investigating the effectiveness of the low FODMAP diet in pediatric patients with functional abdominal pain (FAP). <b><i>Objective:</i></b> The study aimed to evaluate the effectiveness of the low FODMAP diet in reducing gastrointestinal symptoms in children with FAP in comparison to the control diet based on the National Institute for Health and Care Excellence (NICE) guidelines<b>.</b> <b><i>Methods:</i></b> Twenty-seven children with diagnosed FAP were randomized to 2 groups. Each group received an intervention: the low FODMAP diet or the diet based on NICE. All food was prepared and delivered by a catering company. Data regarding gastrointestinal symptoms were recorded by participants during the 2-week baseline assessment and 4-week dietary intervention. The frequencies of abdominal pain and stools were reported as a number of events per day. The severity of abdominal pain was assessed using the Wong-Baker FACES Pain Rating Scale. The assessment of stool consistency was based on the Bristol Stool Form Scale. <b><i>Results:</i></b> The tendency toward the improvement in abdominal symptoms was noted in the low FODMAP group but without statistical significance. No significant differences in stool consistency were observed in this group. The NICE group experienced significant reduction in abdominal pain intensity and frequency (<i>p</i> &#x3c; 0.01) and improvement in stool consistency (93% reporting normal stool, <i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> The results of this pilot study suggest that the low FODMAP diet is not effective in the reduction of symptoms in children with FAP.

Multivariate modelling of faecal bacterial profiles of patients with IBS predicts responsiveness to a diet low in FODMAPs

Gut ◽  
2017 ◽  
Vol 67 (5) ◽  
pp. 872-881 ◽  
Author(s):  
Sean M P Bennet ◽  
Lena Böhn ◽  
Stine Störsrud ◽  
Therese Liljebo ◽  
Lena Collin ◽  
...  
Keyword(s):  
Dietary Intervention ◽  
Gut Bacteria ◽  
Dietary Interventions ◽  
Before And After ◽  
Multivariate Modelling ◽  
Symptom Severity Score ◽  
Registration Number ◽  
Faecal Bacteria ◽  
Fodmap Diet ◽  
Microbiome Data

ObjectiveThe effects of dietary interventions on gut bacteria are ambiguous. Following a previous intervention study, we aimed to determine how differing diets impact gut bacteria and if bacterial profiles predict intervention response.DesignSixty-seven patients with IBS were randomised to traditional IBS (n=34) or low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) (n=33) diets for 4 weeks. Food intake was recorded for 4 days during screening and intervention. Faecal samples and IBS Symptom Severity Score (IBS-SSS) reports were collected before (baseline) and after intervention. A faecal microbiota dysbiosis test (GA-map Dysbiosis Test) evaluated bacterial composition. Per protocol analysis was performed on 61 patients from whom microbiome data were available.ResultsResponders (reduced IBS-SSS by ≥50) to low FODMAP, but not traditional, dietary intervention were discriminated from non-responders before and after intervention based on faecal bacterial profiles. Bacterial abundance tended to be higher in non-responders to a low FODMAP diet compared with responders before and after intervention. A low FODMAP intervention was associated with an increase in Dysbiosis Index (DI) scores in 42% of patients; while decreased DI scores were recorded in 33% of patients following a traditional IBS diet. Non-responders to a low FODMAP diet, but not a traditional IBS diet had higher DI scores than responders at baseline. Finally, while a traditional IBS diet was not associated with significant reduction of investigated bacteria, a low FODMAP diet was associated with reduced Bifidobacterium and Actinobacteria in patients, correlating with lactose consumption.ConclusionsA low FODMAP, but not a traditional IBS diet may have significant impact on faecal bacteria. Responsiveness to a low FODMAP diet intervention may be predicted by faecal bacterial profiles.Trial registration numberNCT02107625.

scholarly journals Hydrogen Breath Tests: Are They Really Useful in the Nutritional Management of Digestive Disease?

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 974
Author(s):  
Paolo Usai-Satta ◽  
Francesco Oppia ◽  
Mariantonia Lai ◽  
Francesco Cabras
Keyword(s):  
Clinical Practice ◽  
Dietary Intervention ◽  
Diagnostic Technique ◽  
Sufficient Evidence ◽  
Nutritional Management ◽  
Noninvasive Technique ◽  
Lactose Malabsorption ◽  
Carbohydrate Malabsorption ◽  
Fodmap Diet ◽  
Hydrogen Breath Tests

Background: Carbohydrate malabsorption is a frequent digestive problem associated with abdominal pain, bloating and diarrhea. Hydrogen breath testing (BT) represents the most reliable and validated diagnostic technique. The aim of this manuscript was to clarify the usefulness of BTs in the nutritional management of these disorders. Methods: A literature search for BT related to carbohydrate malabsorption was carried out using the online databases of Pubmed, Medline and Cochrane. Results: Lactose BT showed good sensitivity and optimal specificity for lactose malabsorption. However, an accurate diagnosis of lactose intolerance should require blind lactose challenge although this method is difficult to utilize in clinical practice. Regarding dose-depending fructose and sorbitol malabsorption, BTs could not add diagnostic advantage compared with a direct dietary intervention. In addition, carbohydrates are fundamental components of fermentable oligo-, di- and monosaccharides and polyols (FODMAPs). Before starting a low FODMAP diet, lactose BT should be suggested in a population with low prevalence of hypolactasia. Conclusions: BTs represent a valid and noninvasive technique in many digestive conditions. Regarding the management of carbohydrate intolerance, lactose BT can be recommended with some limitations. No sufficient evidence is available about the usefulness of BTs for other sugars in clinical practice.

Dietary interventions in mild cognitive impairment and dementia

2019 ◽  
Vol 21 (1) ◽  
pp. 69-82 ◽  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Functional Outcomes ◽  
Clinical Utility ◽  
Randomized Clinical Trials ◽  
Dietary Intervention ◽  
Nutritional Supplements ◽  
Dietary Interventions ◽  
Dietary Counseling ◽  
Nutritional Elements

Dietary intervention is an enticing approach in the fight against cognitive impairment. Nutritional supplements and dietetic counseling are relatively easy and benign interventions, but research has not yet yielded irrefutable evidence as to their clinical utility. Heterogeneity in the results of available clinical studies, as well as methodological and practical issues, does not allow replication and generalization of findings. The paper at hand reviews only randomized clinical trials of single nutrients, multi-nutrient formulations and dietary counseling in mild cognitive impairment and dementia of the Alzheimer's type focusing on both cognitive and functional outcomes. Thus far, folate, vitamin E, Ω-3 fatty acids, and certain multi-nutrient formulations have shown some preliminary promising results; larger, well-designed trials are needed to confirm these findings before nutritional elements can be incorporated in recommended clinical guidelines.

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