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Background Functional gastrointestinal symptoms such as abdominal pain, bloating, distension, constipation, diarrhea and flatulence have been noted in patients with irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). The diversity of symptoms has meant that finding an effective treatment has been challenging with most treatments alleviating only the primary symptom. A novel treatment option for IBS and IBD currently generating much excitement is the low fermentable, oligo-, di-, mono-saccharides and polyol (FODMAP) diet. The aim of this meta-analysis was to determine the evidence of the efficacy of such a diet in the treatment of functional gastrointestinal symptoms. Methods Electronic databases were searched through to March 2015 to identify relevant studies. Pooled odds ratios (ORs) and 95 % confidence intervals were calculated for the effect of a low FODMAP diet on the reduction in IBS [Symptoms Severity Score (SSS)] score and increase in IBS quality of life (QOL) score for both randomized clinical trials (RCTs) and non-randomized interventions using a random-effects model. Results Six RCTs and 16 non-randomized interventions were included in the analysis. There was a significant decrease in IBS SSS scores for those individuals on a low FODMAP diet in both the RCTs (OR 0.44, 95 % CI 0.25–0.76; I 2  = 35.52, p  = 0.00) and non-randomized interventions (OR 0.03, 95 % CI 0.01–0.2; I 2  = 69.1, p  = 0.02). In addition, there was a significant improvement in the IBS-QOL score for RCTs (OR 1.84, 95 % CI 1.12–3.03; I 2  = 0.00, p  = 0.39) and for non-randomized interventions (OR 3.18, 95 % CI 1.60–6.31; I 2  = 0.00, p  = 0.89). Further, following a low FODMAP diet was found to significantly reduce symptom severity for abdominal pain (OR 1.81, 95 % CI 1.13–2.88; I 2  = 0.00, p  = 0.56), bloating (OR 1.75, 95 % CI 1.07–2.87; I 2  = 0.00, p  = 0.45) and overall symptoms (OR 1.81, 95 % CI 1.11–2.95; I 2  = 0.00, p  = 0.4) in the RCTs. In the non-randomized interventions similar findings were observed. Conclusion The present meta-analysis supports the efficacy of a low FODMAP diet in the treatment of functional gastrointestinal symptoms. Further research should ensure studies include dietary adherence, and more studies looking at greater number of patients and long-term adherence to a low FODMAP diet need to be conducted.

Trigonella foenum-graecum (fenugreek) seeds have been documented as a traditional plant treatment for diabetes. In the present study, the antidiabetic properties of a soluble dietary fibre (SDF) fraction of T. foenum-graecum were evaluated. Administration of SDF fraction (0·5 g/kg body weight) to normal, type 1 or type 2 diabetic rats significantly improved oral glucose tolerance. Total remaining unabsorbed sucrose in the gastrointestinal tract of non-diabetic and type 2 diabetic rats, following oral sucrose loading (2·5 g/kg body weight) was significantly increased by T. foenum-graecum (0·5 g/kg body weight). The SDF fraction suppressed the elevation of blood glucose after oral sucrose ingestion in both non-diabetic and type 2 diabetic rats. Intestinal disaccharidase activity and glucose absorption were decreased and gastrointestinal motility increased by the SDF fraction. Daily oral administration of SDF to type 2 diabetic rats for 28 d decreased serum glucose, increased liver glycogen content and enhanced total antioxidant status. Serum insulin and insulin secretion were not affected by the SDF fraction. Glucose transport in 3T3-L1 adipocytes and insulin action were increased by T. foenum-graecum. The present findings indicate that the SDF fraction of T. foenum-graecum seeds exerts antidiabetic effects mediated through inhibition of carbohydrate digestion and absorption, and enhancement of peripheral insulin action.

The inhibition by 1,5-anhydro-d-glucitol (1,5-AG) was determined on disaccharidases of rats and humans. Then, the metabolism and fate of 1,5-AG was investigated in rats and humans. Although 1,5-AG inhibited about 50 % of sucrase activity in rat small intestine, the inhibition was less than half of d-sorbose. 1,5-AG strongly inhibited trehalase and lactase, whereas d-sorbose inhibited them very weakly. 1,5-AG noncompetitively inhibited sucrase. The inhibition of 1,5-AG on sucrase and maltase was similar between humans and rats. 1,5-AG in serum increased 30 min after oral administration of 1,5-AG (600 mg) in rats, and mostly 100 % of 1,5-AG was excreted into the urine 24 h after administration. 1,5-AG in serum showed a peak 30 min after ingestion of 1,5-AG (20 g) by healthy subjects, and decreased gradually over 180 min. About 60 % of 1,5-AG was excreted into the urine for 9 h following ingestion. Hydrogen was scarcely excreted in both rats and humans 24 h after administration of 1,5-AG. Furthermore, 1,5-AG significantly suppressed the blood glucose elevation, and hydrogen excretion was increased following the simultaneous ingestion of sucrose and 1,5-AG in healthy subjects. 1,5-AG also significantly suppressed the blood glucose elevation following the simultaneous ingestion of glucose and 1,5-AG; however, hydrogen excretion was negligible. The available energy of 1,5-AG, which is absorbed readily from the small intestine and excreted quickly into the urine, is 0 kJ/g (0 kcal/g). Furthermore, 1,5-AG might suppress the blood glucose elevation through the inhibition of sucrase, as well as intestinal glucose absorption.

The present study describes the in vivo modulatory potential of Lactobacillus rhamnosus GG (LGG), an effective probiotic, in Giardia intestinalis -infected BALB/c mice. Experimentally, it was observed that oral administration of lactobacilli prior or simultaneous with Giardia trophozoites to mice, efficiently ( p  < 0.05) reduced both the severity and duration of giardiasis. More specifically, probiotics fed, Giardia -infected mice, showed a significant increase in the levels of antioxidants [reduced glutathione (GSH) and superoxide dismutase (SOD)] and intestinal disaccharidases [sucrase and lactase] and decreased levels of oxidants in the small intestine, in comparison with Giardia -infected mice. Histopathological findings also revealed almost normal cellular morphology of the small intestine in probiotic-fed Giardia -infected mice compared with fused enterocytes, villous atrophy and increased infiltration of lymphocytes in Giardia -infected mice. The results of the present study has shed new light on the anti-oxidative properties of L GG in Giardia mediated tissue injury, thereby suggesting that the effects of probiotic L GG are biologically plausible and could be used as an alternative microbial interference therapy.

Human milk is rich in oligosaccharides that influence intestinal development and serve as prebiotics for the infant gut microbiota. Probiotics and 2’-fucosyllactose (2’-FL) added individually to infant formula have been shown to influence infant development, but less is known about the effects of their synbiotic administration. Herein, the impact of formula supplementation with 2’-fucosyllactose (2’-FL) and Bifidobacterium longum subsp. infantis Bi-26 (Bi-26), or 2’-FL + Bi-26 on weight gain, organ weights, and intestinal development in piglets was investigated. Two-day-old piglets (n = 53) were randomized in a 2 × 2 design to be fed a commercial milk replacer ad libitum without (CON) or with 1.0 g/L 2’-FL. Piglets in each diet were further randomized to receive either glycerol stock alone or Bi-26 (109 CFU) orally once daily. Body weights and food intake were monitored from postnatal day (PND) 2 to 33/34. On PND 34/35, animals were euthanized and intestine, liver and brain weights were assessed. Intestinal samples were collected for morphological analyses and measurement of disaccharidase activity. Dry matter of cecum and colon contents and Bifidobacterium longum subsp. infantis abundance by RT-PCR were also measured. All diets were well tolerated, and formula intake did not differ among the treatment groups. Daily body weights were affected by 2’-FL, Bi-26, and day, but no interaction was observed. There was a trend (p = 0.075) for greater total body weight gain in CON versus all other groups. Jejunal and ascending colon histomorphology were unaffected by treatment; however, there were main effects of 2’-FL to increase (p = 0.040) and Bi-26 to decrease (p = 0.001) ileal crypt depth. The addition of 2’-FL and/or Bi-26 to milk replacer supported piglet growth with no detrimental effects on body and organ weights, or intestinal structure and function.

During diabetes, structural and functional changes in the alimentary tract are known to take place resulting in an increased absorption of intestinal glucose and alterations in the activities of brush-border disaccharidases. To elucidate the effect of administrating polysaccharide from Gynura divaricata (PGD) on disaccharidase activities, the specific activities of intestinal disaccharidases, namely sucrase, maltase and lactase, were measured in streptozotocin-induced diabetic rats. Normal control and diabetic rats were treated by oral administration with PGD. Specific activities of intestinal disaccharidases were increased significantly during diabetes, and amelioration of the activities of sucrase and maltase during diabetes was clearly visible by the treatment with PGD. However, the increased activity of lactase during diabetes mellitus was remarkably alleviated by the administration of PGD only in the duodenum. Meanwhile, oral sucrose tolerance tests demonstrated that PGD alleviated the hyperglycaemia during diabetes mellitus, resulting from the amelioration in the activities of intestinal disaccharidases. The present investigation suggests that PGD exerted an anti-diabetic effect partly via inhibiting the increased intestinal disaccharidase activities of diabetic rats. This beneficial influence of administration of PGD on intestinal disaccharidases clearly indicates their helpful role in the management of diabetes.

An inhibitor of α-amylase was isolated and purified from an extract of white kidney beans (Phaseolus vulgaris). The acute oral administration of the inhibitor (50 mg/kg body weight) to adult Wistar rats together with a starch load (2 g/kg body weight suspended in NaCl (9 g/l)) reduced the increase in glycaemia over the basal value (NaCl, 222 (SEM 49); inhibitor, 145 (SEM 16) mmol/l×180 min; P<0.05) without modifying the insulin response. On administering the inhibitor orally (50 mg/kg body weight dissolved in NaCl (9 g/l)) for 21 d to rats fed on a standard diet, a decline was observed in the glycaemia values on day 0 (NaCl, 5.53 (SEM 0.12); inhibitor, 5.25 (SEM 0.16) mmol/l) relative to those obtained on days 10 (NaCl, 5.00 (SEM 0.14); inhibitor, 4.60 (SEM 0.08) mmol/l; P<0.05) and 21 (NaCl, 5.22 (SEM 0.22); inhibitor, 4.50 (SEM 0.12) mmol/l; P<0.01) of treatment, without modifying the plasma concentration of insulin. There was found to be a significant anorexigenic action of the inhibitor; there was reduced food intake (NaCl, 23.07 (SEM 0.31); inhibitor, 19.50 (SEM 0.49) g/d; P<0.01), a reduced weight gain (NaCl, 52 (SEM 3); inhibitor, −1.33 (SEM 8.9) g/21 d; P<0.01), as well as changes in the activity of some intestinal enzymes such as maltase (NaCl, 87 (SEM 7); inhibitor, 127 (SEM 11) U/g proteins; P<0.05). The present study has shown, for the first time, that the prolonged administration of an α-amylase inhibitor reduces blood glucose levels and body-weight gain in Wistar rats.

Plantago ovata has been reported to reduce postprandial glucose concentrations in diabetic patients. In the present study, the efficacy and possible modes of action of hot-water extracts of husk of P. ovata were evaluated. The administration of P. ovata (0·5g/kg body weight) significantly improved glucose tolerance in normal, type 1 and type 2 diabetic rat models. When the extract was administered orally with sucrose solution, it suppressed postprandial blood glucose and retarded small intestinal absorption without inducing the influx of sucrose into the large intestine. The extract significantly reduced glucose absorption in the gut during in situ perfusion of small intestine in non-diabetic rats. In 28d chronic feeding studies in type 2 diabetic rat models, the extract reduced serum atherogenic lipids and NEFA but had no effect on plasma insulin and total antioxidant status. No effect of the extract was evident on intestinal disaccharidase activity. Furthermore, the extract did not stimulate insulin secretion in perfused rat pancreas, isolated rat islets or clonal β cells. Neither did the extract affect glucose transport in 3T3 adipocytes. In conclusion, aqueous extracts of P. ovata reduce hyperglycaemia in diabetes via inhibition of intestinal glucose absorption and enhancement of motility. These attributes indicate that P. ovata may be a useful source of active components to provide new opportunities for diabetes therapy.

The aim of this study was to obtain information that could help to ease the weaning transition in commercial pig production. Before weaning, phytohemagglutinin (PHA) in the form of a crude preparation of red kidney bean lectin was fed by gavage to 24 crossbred [(Swedish Landrace x Yorkshire) x Hampshire] piglets, whereas 24 control piglets were fed α-lactalbumin by gavage, to study the effect on growth, occurrence of postweaning diarrhea, feeding behavior, and some anatomical and physiological traits of the gastrointestinal tract. Within the litter, piglets were randomly assigned to PHA treatment or control and remained in the same pen from the beginning (PHA exposure at 7 d before weaning) until the end of the experiment (14 d post-weaning). Weaning took place at the age of 31 to 34 d. Pigs treated with PHA grew faster (P = 0.013) during the first week postweaning and tended to have lower total diarrhea scores (P = 0.10) than did control pigs. On d 5 after weaning, piglets treated with PHA spent more time eating (P = 0.028) than control pigs. No immunostimulating effect of PHA, measured by plasma immunoglobulin G, could be detected. An increase in the intestinal barrier properties before weaning, as a response to PHA treatment, was demonstrated in intestinal absorption studies using Na-fluorescein and BSA as gavage-fed markers. Less uptake (measured as plasma concentrations) of the marker molecule Na-fluorescein occurred during a 24-h study period, and numerically lower levels of BSA were observed compared with studies in control pigs of the same age. A total of 12 pigs (6 control, 6 PHA-treated) were euthanized on the day of weaning for analyses of gastrointestinal properties. The PHA-treated pigs tended to have a longer total small intestinal length (P = 0.063) than that of the control pigs. The enzyme profile of the jejunal epithelium responded to PHA exposure with a decrease in lactase activity and an increase in maltase and sucrase activities, which is similar to changes normally observed after weaning. No differences were found in the size of the pancreas or in its contents of trypsin and amylase. In conclusion, exposing piglets to crude, red kidney bean lectin for 3 d during the week before weaning led to changes in performance and small intestinal functional properties that would be expected to contribute to a more successful weaning.

A purified pancreatic α-amylase inhibitor (α-AI) from white beans (Phaseolus vulgaris) was administered orally (100m/g body weight dissolved in 9g NaC/) for 22d to non-diabetic (ND) and type 2 diabetic (neonatal diabetes models n0-STZ and n5-STZ) male Wistar rats. Mean glycaemia (mmo/) declined from day 4 of the α-AI administration in ND rats (5·48 (sem 0·08) v. 4·39 (sem 0·13); P<0·05), n0-STZ diabetic rats (7·94 (sem 0·42) v. 5·56 (sem 0·32); P<0·01) and n5-STZ diabetic rats (17·34 (sem 2·58) v. 11·93 (sem 1·96)), until the end of treatment: ND (5·22 (sem 0·21) v. 3·97 (sem 0·06); P<0·01); n0-STZ (8·10 (sem 0·19) v. 5·21 (sem 0·30); P<0·01); and n5-STZ (16·36 (sem 2·14) v. 7·69 (sem 1·34); P<0·01). There was a decrease in water intake (m/) in the α-AI-treated diabetic rats: n0-STZ (30 (sem 0·10) v. 22 (sem 1·50); P<0·01) and n5-STZ (76 (sem 5·04) v. 57 (sem 4·85); P<0·01). Food intake (/) decreased in all three groups: ND (23 (sem 0·31) v. 20 (sem 0·03); P<0·05); n0-STZ (22 (sem 0·55) v. 16 (sem 0·98); P<0·01); and n5-STZ (31 (sem 0·58) v. 23 (sem 1·20); P<0·01). The enterocyte sucrase and maltase activities (/ proteins) were high (P<0·01) in the untreated diabetic rats, n0-STZ (45 (sem 4) and 152 (sem 10), respectively) and n5-STZ (67 (sem 12) and 151 (sem 10), respectively) with respect to the ND rats (24 (sem 2) and 74 (sem 10), respectively). After α-AI treatment, enzyme activities declined in both diabetic rats, n0-STZ (21 (sem 2) and 85 (sem 11); P<0·01) and n5-STZ (28 (sem 7) and 75 (sem 19); P<0·05), to values close to those in the ND rats. In conclusion, α-AI significantly reduced glycaemia in both the ND and diabetic animals and reduced the intake of food and water, and normalized the elevated disaccharidase levels of the diabetic rats.