Dietary patterns, digestive symptoms, and health-related quality of life in women reporting minor digestive symptoms.

OBJECTIVE: Digestive symptoms are reported to result from a wide range of dietary components. Dietary pattern analysis is a useful method when considering the entire diet, rather than individual foods or nutrients, providing an opportunity to take interactions into account. The aim of the present study was to investigate, using a dietary pattern approach, the relationship between diet, digestive symptoms, and health-related quality of life (HRQoL) in women reporting minor digestive symptoms. METHODS: Analysis was performed on dietary and digestive symptoms data collected in France. Women (N = 308, ages 18-60 y) reporting a bowel movement frequency within the normal range (3-21 stools/wk) but with minor digestive symptoms in the previous month were studied. Dietary data was collected using three 24-h recalls. K-means was used to divide the dietary data into clusters. The frequency of digestive symptoms (abdominal discomfort or pain, bloating, flatulence, borborygmi) and bowel movements were evaluated over a 2-wk period. HRQoL was also assessed. RESULTS: Four dietary clusters were identified and characterized as unhealthy, balance, healthy, and convenience. No differences were found in the frequency of digestive symptoms according to dietary cluster, except for flatulence (P = 0.030), which was more prevalent in the unhealthy and convenience clusters. No significant differences were observed in HRQoL according to dietary clusters. CONCLUSIONS: Results from the present study demonstrated that even within a relatively homogeneous sample of French women, distinct dietary patterns can be identified but without significant differences in digestive symptoms (except for flatulence) or HRQoL.

Effects of short-chain fructooligosaccharides on faecal bifidobacteria and specific immune response in formula-fed term infants: a randomized, double-blind, placebo-controlled trial.

The aim of this study was to evaluate the effect of an infant formula supplemented with short-chain fructooligosaccharides (scFOS) on faecal concentration of bifidobacteria. Sixty-one healthy formula-fed infants participated in this double-blind controlled trial and were randomized to receive either the scFOS-supplemented formula (4 g/L scFOS) or the placebo-supplemented formula (4 g/L maltodextrins) until the age of 4 mo. Stool samples were analyzed for bifidobacteria at enrolment and at the age of 2 and 3 mo and for antipoliovirus IgA at the age of 4 mo. Parents completed a questionnaire to assess digestive tolerance. Change in faecal bifidobacteria after 2 mo were higher with scFOS compared to the placebo. At 4 mo, specific IgA tended to be higher with the scFOS group than with the placebo. Somatic growth and digestive tolerance were similar between groups. This study confirms that scFOS-supplemented formula can increase the concentration of faecal bifidobacteria while being well tolerated.

Evaluation of a diet quality index based on the probability of adequate nutrient intake (PANDiet) using national French and US dietary surveys.

BACKGROUND: Existing diet quality indices often show theoretical and methodological limitations, especially with regard to validation. OBJECTIVE: To develop a diet quality index based on the probability of adequate nutrient intake (PANDiet) and evaluate its validity using data from French and US populations. MATERIAL AND METHODS: The PANDiet is composed of adequacy probabilities for 24 nutrients grouped into two sub-scores. The relationship between the PANDiet score and energy intake were investigated. We evaluated the construct validity of the index by comparing scores for population sub-groups with 'a priori' differences in diet quality, according to smoking status, energy density, food intakes, plasma folate and carotenoid concentrations. French and US implementations of the PANDiet were developed and evaluated using national nutritional recommendations and dietary surveys. RESULTS: The PANDiet was not correlated with energy for the French implementation (r = -0.02, P>0.05) and correlated at a low level for the US implementation (r = -0.11, P<0.0001). In both implementations, a higher PANDiet score (i.e. a better diet quality) was associated with not smoking, having a lower-energy-dense diet, consuming higher amounts of fruits, vegetables, fish, milk and other dairy products and lower amounts of cheese, pizza, eggs, meat and processed meat, and having higher plasma folate and carotenoid concentrations after controlling for appropriate factors (all P<0.05, carotenoid data for US not available). CONCLUSIONS: The PANDiet provides a single score that measures the adequacy of nutrient intake and reflects diet quality. This index is adaptable for use in different countries and relevant at the individual and population levels.

Incidence of infectious diseases in infants fed follow-on formula containing synbiotics: an observational study.

AIM: Infectious diseases in infants are a major public health issue. Synbiotic-enriched formulas (EF) are intended to mimic the beneficial effects of human milk on infectious diseases. We performed an observational study in infants switching to follow-on formula to determine the effects of synbiotic-enriched formula compared to standard formula (SF). METHODS: We recorded family characteristics, medical history and growth data, as well as the symptoms, severity and treatment of infectious diseases. Main outcome measures were compared after adjustments for baseline characteristics. RESULTS: Between January and June 2007, 771 healthy infants were included in the study; 35.4% experienced at least one infectious disease during the 3-month study period. The most common were upper respiratory tract (24.1%), otitis (6.6%) and gastrointestinal infectious diseases (5.0%). Infants fed synbiotic-enriched formula had fewer infectious diseases overall (EF: 31.0%; SF: 40.6%; p = 0.005) and significantly fewer gastrointestinal infectious diseases (EF: 3.5%; SF: 6.8%; p = 0.03). During follow-up, weight gain was significantly higher (p = 0.0467) in infants fed synbiotic-enriched formula (18.3 ± 8.7 g/day) versus SF (16.9 ± 7.5 g/day). CONCLUSIONS: Supplementation with synbiotics may have beneficial effects on the incidence of infectious disease and growth in infants. Further studies are needed determine optimal doses and composition of synbiotics in infant formula.

Effects of seven potential probiotic strains on specific immune responses in healthy adults: a double-blind, randomized, controlled trial.

This pilot study investigated the immunomodulatory properties of seven probiotic strains. Eighty-three healthy volunteers aged 18-62 years consumed 2 x 10(10) CFU of bacteria or a placebo (maltodextrin) over 3 weeks (D0-D21). Subjects received an oral cholera vaccine at D7 and at D14; blood and saliva samples were collected at D0, D21 and D28. Serum samples were analyzed for specific IgA, IgG and IgM, and saliva samples were analyzed for specific IgA only, by ELISA. Statistical analyses were based on Wilcoxon's signed-rank test (intragroup analyses) and exact median t-test (intergroup analyses). Salivary analysis showed no difference in specific IgA concentrations between groups. Serum analysis indicated an effect of some of the tested strains on specific humoral responses. Between D0 and D21, IgG increased in two probiotic groups, for example, Bifidobacterium lactis Bl-04 and Lactobacillus acidophilus La-14, compared with controls (P=0.01). Trends toward significant changes in immunoglobulin serum concentrations compared with controls (P<0.1) were found for six out of the seven probiotic strains. In conclusion, some strains of probiotics demonstrated a faster immune response measured with serum immunoglobulin indicators, especially IgG, although overall vaccination was not influenced. Specific strains of probiotics may thus act as adjuvants to the humoral immune response following oral vaccination.

Comparison of field methods to estimate fat mass in children.

BACKGROUND: Reliable field methods to measure fat mass (FM) in children may contribute to primary prevention of childhood obesity. AIM: The objective was to compare the accuracy of existing field methods (skinfold thickness (SF), leg-to-leg bioelectrical impedance analysis (BIA), anthropometrics for FM measurement in prepubertal European children. SUBJECTS AND METHODS: Reference FM was measured in 55 French children (30 boys, 25 girls; mean age 8.7 years) using a three-compartment model: body volume (BV) was assessed by air displacement plethysmography (ADP) and total body water (TBW) was assessed by deuterium dilution. Agreement between field methods and the reference method was assessed using Bland-Altman analyses. Since field methods for FM measurement are reported to be population-dependent, adjustment to the study population was performed using stepwise multiple linear regressions modelling. RESULTS: Even after adjustment, field methods exhibited a high correlation (R(2) = 0.71-0.84) but a moderate agreement (+/-3.32 to +/-4.47 kg for fat mass) with the reference model. Methods based on BIA or SF performed slightly better than those based on anthropometry. CONCLUSIONS: Field methods for FM measurement may be recommended for epidemiological applications, but not for individual follow-up. New field equipment is required to improve accuracy of FM measurement in children and make individual follow-up possible.

Family dietary coaching to improve nutritional intakes and body weight control: a randomized controlled trial.

OBJECTIVE: To test the hypothesis that family dietary coaching would improve nutritional intakes and weight control in free-living (noninstitutionalized) children and parents. DESIGN: Randomized controlled trial. SETTING: Fifty-four elementary schools in Paris, France. PARTICIPANTS: One thousand thirteen children (mean age, 7.7 years) and 1013 parents (mean age, 40.5 years). INTERVENTION: Families were randomly assigned to group A (advised to reduce fat and to increase complex carbohydrate intake), group B (advised to reduce both fat and sugar and to increase complex carbohydrate intake), or a control group (given no advice). Groups A and B received monthly phone counseling and Internet-based monitoring for 8 months. OUTCOME MEASURES: Changes in nutritional intake, body mass index (calculated as weight in kilograms divided by height in meters squared), fat mass, physical activity, blood indicators, and quality of life. RESULTS: Compared with controls, participants in the intervention groups achieved their nutritional targets for fat intake and to a smaller extent for sugar and complex carbohydrate intake, leading to a decrease in energy intake (children, P < .001; parents, P = .02). Mean changes in body mass index were similar among children (group A, + 0.05, 95% confidence interval [CI], - 0.06 to 0.16; group B, + 0.10, 95% CI, - 0.03 to 0.23; control group, + 0.13, 95% CI, 0.04-0.22; P = .45), but differed in parents (group A, + 0.13, 95% CI, - 0.01 to 0.27; group B, - 0.02, 95% CI, - 0.14 to 0.11; control group, + 0.24, 95% CI, 0.13-0.34; P = .001), with a significant difference between group B and the control group (P = .01). CONCLUSIONS: Family dietary coaching improves nutritional intake in free-living children and parents, with beneficial effects on weight control in parents. Trial Registration clinicaltrials.gov Identifier: NCT00456911.

The effects of regular consumption of short-chain fructo-oligosaccharides on digestive comfort of subjects with minor functional bowel disorders.

A comparative, randomised, double-blind trial was performed in the medical departments of five hospitals to study the effects of regular consumption of short-chain fructo-oligosaccharides (sc-FOS) on the digestive comfort of subjects with minor functional bowel disorders (FBD). In step 1, 2235 subjects were questioned to assess the incidence and intensity of digestive disorders. In step 2, 105 of these patients diagnosed with minor FBD were randomised into two groups to receive either 5 g sc-FOS or 5 g placebo (sucrose and maltodextrins) per d over a 6-week period. The incidence and intensity of digestive disorders were assessed at the end of the treatment period (day 43) using the step 1 questionnaires. A quality-of-life questionnaire was also completed at the start and end of the treatment period to assess potential effects on well-being and social performance. In step 1, 44 % of the subjects questioned presented FBD, of whom 57.1 % suffered from minor FBD. In step 2, on day 43, the intensity of digestive disorders decreased by 43.6 % in the sc-FOS group v. a 13.8 % increase in the placebo group (P = 0.026). Symptoms were experienced less frequently by 75.0 % of subjects in the sc-FOS group, while 53.8 % of controls experienced no change (P = 0.064). Using the functional digestive disorders quality of life questionnaire, the discomfort item scores increased in the sc-FOS group (P = 0.031). However, expressed as change in quality of life (improvement, worsening or unchanged), daily activities were significantly improved in the sc-FOS group (P = 0.022). Regular consumption of sc-FOS may improve digestive comfort in a working population not undergoing medical treatment.

Four-week short chain fructo-oligosaccharides ingestion leads to increasing fecal bifidobacteria and cholesterol excretion in healthy elderly volunteers.

BACKGROUND: Short-chain fructo-oligosaccharides (scFOS) are increasingly used in human diet for their prebiotic properties. We aimed at investigating the effects of scFOS ingestion on the colonic microflora and oro-fecal transit time in elderly healthy humans. METHODS: Stools composition, oro-fecal transit time, and clinical tolerance were evaluated in 12 healthy volunteers, aged 69 +/- 2 yrs, in three consecutive periods: basal period (2 weeks), scFOS (Actilight) ingestion period (8 g/d for 4 weeks) and follow-up period (4 weeks). Two-way ANOVA, with time and treatment as factors, was used to compare the main outcome measures between the three periods. RESULTS: Fecal bifidobacteria counts were significantly increased during the scFOS period (9.17 +/- 0.17 log cfu/g vs 8.52 +/- 0.26 log cfu/g during the basal period) and returned to their initial values at the end of follow-up (8.37 +/- 0.21 log cfu/g; P < 0.05). Fecal cholesterol concentration increased during the scFOS period (8.18 +/- 2.37 mg/g dry matter vs 2.81 +/- 0.94 mg/g dry matter during the basal period) and returned to the baseline value at the end of follow-up (2.87 +/- 0.44 mg/g dry matter; P < 0.05). Fecal pH tended to decrease during scFOS ingestion and follow-up periods compared to the basal period (P = 0.06). Fecal bile acids, stool weight, water percentage, and oro-fecal transit time did not change throughout the study. Excess flatus and bloating were significantly more frequent during scFOS ingestion when compared to the basal period (P < 0.05), but the intensity of these symptoms was very mild. CONCLUSION: Four-week 8 g/d scFOS ingestion is well tolerated and leads to a significant increase in fecal bifidobacteria in healthy elderly subjects. Whether the change in cholesterol metabolism found in our study could exert a beneficial action warrants further studies.

The capacity of short-chain fructo-oligosaccharides to stimulate faecal bifidobacteria: a dose-response relationship study in healthy humans.

BACKGROUND: Short-chain fructo-oligosaccharides (scFOS) are well-known for their bifidogenicity. In a large study comprising 200 healthy volunteers, we determined the bifidogenic properties of 7 non-digestible carbohydrates administered at a dose of 10 g/d in the diet; we analysed dose-response relationships of the bifidogenic substrates at doses ranging from 2.5 to 10 g/d in comparison with a placebo. The aim of this presentation is to give more details about the dose-response effects of short-chain fructo-oligosaccharides (scFOS). METHODS: Forty healthy volunteers (18 males, 22 females) eating their usual diets were randomly divided into 5 groups of 8 subjects and received scFOS at a dose of 2.5, 5.0, 7.5 and 10 g/d or a placebo for 7 d. Stools were collected before (day (d) 8) and at the end (day (d) 15) of sugar consumption, and tolerance was evaluated using a daily chart. RESULTS (M +/- SEM): Bifidobacteria counts increase was higher in scFOS than in placebo group for all doses tested [2.5 g/d (from 9.15 +/- 0.59 to 9.39 +/- 0.70; P = 0.02); 5 g/d (from 10.21 +/- 0.21 to 10.67 +/- 0.22; P = 0.03); 7.5 g/d (from 9.28 +/- 0.49 to 9.85 +/- 0.35;P = 0.01); 10 g/d (from 9.00 +/- 0.81 to 10.18 +/- 0.60; P = 0.003)]. A significant correlation between the ingested dose of scFOS and faecal bifidobacteria counts was observed at d15 (r2 = 0.307, P < 0.001). Total anaerobes increased at the dose of 10 g/d. No significant differences were found for Bacteroides, Lactobacillus, enterobacteria or pH in any group. The frequency of digestive symptoms was not different between scFOS at any of the doses tested and placebo. Bloating was significantly more intense during scFOS ingestion at doses of 2.5 and 5 g/d, but not at doses of 7.5 and 10 g/d. Excess flatus, borborygmi and abdominal pain did not differ from the placebo at any of the doses tested. CONCLUSION: This study showed that scFOS is bifidogenic and well tolerated at doses ranging from 2.5 to 10 g/d, and that there is a dose-response relationship in healthy volunteers.