Browsing by Subject "FODMAP"

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  • Holma, Reetta; Laatikainen, Reijo; Orell, Helena; Joensuu, Heikki; Peuhkuri, Katri; Poussa, Tuija; Korpela, Riitta; Österlund, Pia (2020)
    Chemotherapy-induced mucosal injury of the small intestine may interfere with the enzymes and transporters responsible for the hydrolysis and absorption of dietary carbohydrates causing diarrhoea, abdominal discomfort and pain. The aim of this study was to investigate the association between the consumption of foods rich in FODMAPs (fermentable oligo-, di- and monosaccharides and polyols) and gastrointestinal symptoms in patients receiving adjuvant therapy for colorectal cancer. The patients (n = 52) filled in a 4-day food diary at baseline and during therapy and kept a symptom diary. The intakes of FODMAP-rich foods were calculated as portions and the intakes were divided into two consumption categories. Patients with high consumption of FODMAP-rich foods had diarrhoea more frequently than those with low consumption (for lactose-rich foods the odds ratio (OR) was 2.63, P = 0.03; and for other FODMAP-rich foods 1.82, P = 0.20). Patients with high consumption of both lactose-rich and other FODMAP-rich foods had an over 4-fold risk of developing diarrhoea as compared to those with low consumption of both (OR, 4.18; P = 0.02). These results were confirmed in multivariate models. Conclusion: Consumption of lactose-rich foods results in an increased risk of diarrhoea during adjuvant therapy for colorectal cancer, especially when the consumption of other FODMAP-rich foods is also high.
  • Simpura, Lyyra (Helsingin yliopisto, 2021)
    Background: Functional gastrointestinal disorders (FGIDs) are common diseases characterized by disturbing gastrointestinal (GI) symptoms in the absence of structural or biochemical changes in GI tract. Well identified group of compounds responsible for GI symptoms are FODMAPs (fermentable oligo-, di- and monosaccharides and polyols). Legumes contain α-galacto-oligosaccharides (α-GOS), unabsorbed, osmotically active and rapidly fermented fibres, known for colonic gas formation. The role of phytic acid (PA) and its effects on GI symptoms as complex-forming agent is not fully understood. These antinutrients can be removed by enzymatic treatments. However, usefulness of these treatments on reducing GI symptoms is not known. Aims: The aim of this research was to investigate whether two different enzymatic treatments of pea-based products have an impact on experienced GI symptoms. α-GOS and PA content was reduced in the test products. Material and methods: This was a 3–week randomized, double-blinded, placebo-controlled cross-over-designed study. Participants (n=26) were healthy males and females aged 21–70 who claimed to experience GI symptoms after consuming legumes. Each participant received weekly two portions of either α-galactosidase-treated, double-enzyme-treated or control, spoonable pea-based product. They reported severity of nine GI symptoms within 72–hour time period via web-based survey using visual analog scale (VAS). Maximum values, the time for experiencing the maximum values, maximum values in 8 time points and symptom sum scores were analyzed. To study differencies in GI symptoms caused by the study products, data was analyzed statistically using mainly non-parametric Friedman’s test. Dependence of baseline symptoms and symptom scores were examined using crosstabulation and analyzed statistically with Fisher’s exact test. Results: Participants’ median symptom scores were rather low throughout the intervention, indicating that the participants were after all not very sensitive for legume GOS. Maximum pain score was significantly higher with the double-enzyme-treated product compared to the control product (p=0,038). At time point 5 bloating score was significantly higher with the α-galactosidase-treated product than with the double-enzyme-treated product (p=0,051), and flatulence score was significantly higher with the α-galactosidase-treated product than with the control product (p=0,021). There were no statistically significant differencies in any other examined variables between the study products. Although there was a slight trend towards more severe symptoms with the enzyme-treated products compared to the control product. Conclusions: The enzyme-treated pea-based products were not better tolerated than the control product, but that may be due to the fact that the experienced GI symptoms were rather mild in general. There are some evidence on the use of α-galactosidase supplement to alleviate GOS-induced GI symptoms. In future, the products should be tested in specifically α-GOS- and/or PA sensitive population.
  • Kaltiokallio, Maija-Leena (Helsingfors universitet, 2017)
    Pulled Oats preparations are a new plant protein source that contain oats, pea and faba bean. People have been hyping this high-quality protein product but there may be a concern about possible naturally occurring compounds, which can deteriorate the health of sensitive individuals. The literature review deals with the chemical properties, analytics, health effects of FODMAPs (fermented oligo-, di- and monosaccharides and polyols), vicine and convicine but also different treatment methods to reduce their concentrations. In the experimental work the concentrations of antinutrients were analysed and the bases of enzyme treatments were investigated to aid future research in reducing antinutrients in Pulled Oats. Three different samples from the Pulled Oats and four samples from the company X´s processes were analysed. The FODMAPs were analysed using water extraction and HPAEC-PAD (high performance anion exchange chromatography connected to a pulsed amperometric detector). The vicine and convicine were analysed using perchloric acid extraction and HPLC (high performance liquid chromatography). For the enzyme treatments, the samples were extracted and the supernatant was used for incubation. Two different kinds of α-galactosidase were used to decrease the amounts of FODMAPs and β-galactosidase was used to reduce vicine and convicine amounts. Pulled Oats contained FODMAPs and this can cause problems in the digestive system especially for people who suffer from IBS (irritable bowel syndrome). Pulled Oats also contained some vicine and convicine, which can be harmful for individuals lacking G6FD (glucose-6-fosfate dehydrogenase). The amounts of antinutrients did not decrease during the Pulled Oats´ process whereas in the company X´s process they did. The enzyme treatments in laboratory conditions were effective for reducing the amounts but in the Pulled Oats´ processing conditions the result was not significant. The best way to eliminate the antinutrients could be enzyme treatments in the company X´s process. This study gave valuable knowledge for future investigations.
  • Laatikainen, Reijo; Jalanka, Jonna; Loponen, Jussi; Hongisto, Sanna-Maria; Hillilä, Markku; Koskenpato, Jari; Korpela, Riitta; Salonen, Anne (BioMed Central, 2019)
    Abstract Background A low intake of Fermentable, Oligo-, Di-, Mono-saccharides and Polyols (FODMAPs) is effective in the symptom control of irritable bowel syndrome (IBS) patients but may exert negative effects on the intestinal microbiota. The microbial effects of increasing regular or non-FODMAP fibre sources are largely unknown. Furthermore, it is not known if the baseline microbiota composition is associated with individual symptom control during the consumption of different rye products in IBS patients. Our objective was to evaluate whether increased consumption of low-FODMAP rye bread or regular rye bread for 4 weeks would alter the intestinal microbiota composition of IBS patients following their habitual diet, and whether these changes associate to symptoms and/or the baseline microbiota. Methods The study was conducted as a randomized double blind controlled cross-over study (n = 50). Microbiota was analysed by 16S rRNA gene sequencing and associated with gastrointestinal symptoms. Both microbial changes and their associations to symptoms were secondary outcomes. Results The consumption of the test breads did not alter microbiota diversity. Compared to baseline, consumption of the low FODMAP rye bread decreased the abundance of Bacteroides, Flavonifractor, Holdemania, Parasutterella and Klebsiella and showed a trend towards increased bifidobacteria, whereas the regular rye bread decreased the abundance of Flavonifractor. When comparing between the two test breads, Klebsiella was decreased after low-FODMAP rye bread intake. Patients whose symptoms decreased during the low-FODMAP rye bread displayed more Blautia and less Barnesiella at baseline. Conclusions Consumption of low-FODMAP rye bread had modest, potentially beneficial effects on patients’ microbiota while increasing their intake of fibre substantially. The baseline microbiota composition was associated with the variable degrees of symptom relief experienced by the patients. Consumption of a low-FODMAP rye bread might be one way to increase dietary fibre intake and improve the mild dysbiosis often observed among patients with IBS. Trial registration ClinicalTrials.gov: NCT02161120 . Retrospectively registered 11 June 2014.
  • Pirkola, Laura (Helsingfors universitet, 2016)
    Johdanto: Ärtyvän suolen oireyhtymä on toiminnallinen vatsavaiva, johon liittyy kipu tai epämiellyttävä tunne vatsassa ja muuttunut ulostustiheys tai ulosteen koostumus. Viime aikoina on saatu tutkimusnäyttöä paksusuolessa herkästi fermentoituvia FODMAP-hiilihydraatteja (fermentable oligo , di- and monosaccharides and polyols) rajoittavan ruokavalion tehosta ärtyvän suolen oireyhtymän hoidossa. Ruisleipä on keskeinen kuidun ja folaatin lähde suomalaisille, mutta se sisältää runsaasti FODMAP-hiilihydraatteja ja voi sen vuoksi aiheuttaa oireita herkkävatsaisille. Ruisleivän valmistusprosessia muuttamalla voidaan tehdä vähemmän FODMAP-hiilihydraatteja sisältävää ruisleipää. Tavoitteet: Tutkimuksen päätavoitteena oli verrata kahden, FODMAP-hiilihydraattien määrän suhteen toisistaan eroavan ruisleivän vaikutuksia IBS-potilaiden aterianjälkeisiin vatsaoireisiin, uloshengitysilman vetypitoisuuteen ja mahasuolikanavan läpikulkuaikoihin, happamuuteen ja paineeseen. Muina tavoitteina oli saada tietoa SmartPill®-laitteen toimivuudesta vatsaoireiden mittausmenetelmänä ja tutkia vatsaoireiden voimakkuuden ja uloshengitysilman vetypitoisuuden välistä yhteyttä. Aineisto ja menetelmät: Tutkittavana olivat normaalipainoiset ja ylipainoiset naiset, joilla oli IBS (n=7). Tutkimus oli kaksoissokkoutettu, satunnaistettu, vaihtovuoroinen ateriakoe kahdella eri ruisleivällä. Tutkittavat söivät satunnaisessa järjestyksessä kumpaakin leipää erillisillä koejaksoilla, minkä jälkeen heiltä mitattiin vatsaoireita, uloshengitysilman vetypitoisuutta ja suoliston sisäisiä olosuhteita. Suoliston lämpötilaa, painetta ja pH:ta mitattiin SmartPill®-laitteella, joka on pienikokoinen nieltävä kapseli. Kapselin mittaamista tiedoista saadaan läpikulkuajat, pH:n mediaanit, keskipaine ja supistuksien määrät mahasuolikanavan eri osille. Tutkimuksen tulokset esitettiin mm. käyrän alaisina pinta-aloina ja maksimiarvoina. Mittausjaksojen välisiä eroja analysoitiin tilastollisesti Wilcoxonin merkittyjen sijalukujen testillä. Vatsaoireiden voimakkuuden yhteyttä suoliston paineeseen ja uloshengitysilman vetypitoisuuteen analysoitiin Spearmanin järjestyskorrelaatiokertoimen avulla. Tulokset: Uloshengitysilman vetypitoisuuden käyrän alainen pinta-ala (AUC0-630min) erosi koejaksojen välillä (p=0,028). Uloshengitysilman vetypitoisuus oli matalampi tutkittavien syödessä vähemmän FODMAP-hiilihydraatteja sisältävää ruisleipää verrattuna tavalliseen ruisleipään. Ilmavaivojen voimakkuuden maksimiarvo oli suurempi tavallisella ruisleivällä (p=0,034). SmartPill®-kapselilla mitatut läpikulkuajat, pH, paine ja supistuksien määrä eivät eronneet koejaksojen välillä. Vatsaoireiden yhteenlaskettu voimakkuus oli positiivisesti yhteydessä paksusuolen keskipaineeseen toisella koejaksolla (ρ=0,786, p=0,036). Vatsaoireiden voimakkuuden ja uloshengitysilman vetypitoisuuden välillä ei havaittu yhteyttä. Johtopäätökset: Ruisleivän FODMAP-hiilihydraattien määrä saattaa vaikuttaa paksusuolessa tapahtuvaan mikrobifermentaatioon, joka lisää vetykaasun muodostumista suolistossa. Lisääntynyt kaasun määrä suolessa voi aiheuttaa ilmavaivoja ja nostaa paksusuolen painetta, mikä saattaa aiheuttaa myös muita vatsaoireita. Vähemmän fermentoituvia hiilihydraatteja sisältävä ruisleipä voi auttaa hillitsemään kaasun tuotantoa ja siihen liittyviä oireita IBS-potilailla, jotka saavat vatsaoireita tavallisesta ruisleivästä. SmartPill®-kapselin soveltuvuudesta vatsaoireiden mittausmenetelmäksi tarvitaan huomattavasti enemmän tutkimustietoa.