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Biofilms are heterogeneous structures composed of microorganisms and the surrounding extracellular polymeric substances (EPS) that protect the microbial cells from harsh environments. Saccharomyces boulardii is the first yeast classified as a probiotic strain with unique properties. However, tolerance of S. boulardii biofilms to harsh environments especially during production and in the gastrointestine remains unknown. In this study, S. boulardii cells were encapsulated in alginate microcapsules and subsequently cultured to form biofilms, and their survival and tolerance were evaluated. Microencapsulation provided S. boulardii a confined space that enhanced biofilm formation. The thick alginate shell and the mature biofilm improved the ability of S. boulardii to survive under harsh conditions. The exogenous encapsulation and the endogenous biofilm structure together enhanced the gastrointestinal tolerance and thermotolerance of S. boulardii. Besides, as the alginate shell became thinner with an increase in the subsequent culture duration, the EPS of S. boulardii biofilms exerted an important protective effect in resisting high temperatures. The encapsulated biofilm of S. boulardii after 24-h culture exhibited 60 × higher thermotolerance at 60 °C (10 min), while those after 6-h and 24-h culture showed 1000 × to 550,000 × higher thermotolerance at 120 °C (1 min) compared with the planktonic cells without encapsulation. The present study's findings suggest that a combination of encapsulation and biofilm mode efficiently enhanced gastrointestinal tolerance and thermotolerance of S. boulardii. Key points: • Encapsulated S. boulardii in biofilm mode showed enhanced tolerance. • Exogenous shell and endogenous biofilm provided dual protection to S. boulardii. [ABSTRACT FROM AUTHOR]

The research aims to examine the effects of fructooligosaccharide (FOS) concentrations on the physicochemical properties of formulated sports drinks (FSDs) and the consumption of FSDs on the athletic gastrointestinal (GI) tolerance during intermittent high-intensity exercise. Three FSDs were developed from the diluted sugarcane juice (6.6% sugar content) with the addition of 2% calamansi juice, by varying FOS concentrations (0%, 1%, and 2% w/v). Thirty trained athletes performed four separate trials (1 week recovery period) using an exercise protocol consisting of sprint, lateral hopping, and sprint plus vertical jump in four quarters (Q). Each athlete received the samples in a randomized crossover counterbalance order and consumed 4.5 and 1.5 ml/kg of body weight before Q1 and Q3, and before Q2 and Q4, respectively. The GI problem questionnaire with 10-point scale was completed by the athletes after each quarter. The addition of 2% FOS significantly (p < 0.05) increased the total soluble solids and osmolality of the FSD. The intensity scores of GI problems (heartburn, reflux, bloating, flatulence, and right abdomen pain) and the cumulative GI problems index rating (Q2, Q3, and Q4) were significantly (p < 0.05) higher for the FSD trial with 2% FOS compared to mineral water (MW). Significant (p < 0.05) reduction on dizziness symptom was observed for all FSD trials (0%, 1%, and 2% FOS) as compared to MW. However, no significant (p > 0.05) differences were observed on athletic sweat rate, heart rate, and rate of perceived exertion among the trials. Conclusion, the FSD with 1% FOS addition is an athletic tolerable concentration without inducing GI problems. [ABSTRACT FROM AUTHOR]

Purpose of Review: Efforts to provide early enteral nutrition in critical illness are thwarted by gastrointestinal dysfunction and feeding intolerance. While many of the signs and symptoms of this dysfunction reflect gastroparesis and intestinal dysmotility, other symptoms which may or may not be related are often included such as diarrhea, bleeding, and intra-abdominal hypertension. This paper discusses the need to monitor tolerance of nutritional therapy in the critical care setting and reviews the results of those clinical trials which have helped establish objective measures, define feeding intolerance, and provide a tool to guide continued delivery of the enteral regimen. Recent Findings: While definitions vary, the presence of gastrointestinal dysfunction and feeding intolerance correlates with adverse clinical outcomes, including prolonged duration of mechanical ventilation, greater length of stay in the intensive care unit, and increased mortality. Summary: Despite their prognostic value, it is not clear to what extent these scoring systems should direct nutritional therapy. The clinician should be astute in the careful selection of monitors, in identifying and addressing signs and symptoms of intolerance, and by responding appropriately with feeding strategies that are effective and safe. Early enteral feeding in critical illness has been shown to be optimized by following protocols which allow monitoring patient tolerance while providing individualized care. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the probiotic potential of lactic acid bacteria (LAB) strains isolated from De'ang pickled tea, a traditional food consumed by the De'ang nationality of Yunnan, China. Twenty-six LAB strains isolated from De'ang pickled tea were subjected to identification based on 16S rRNA gene sequence analysis. Twenty-four belonged to Lactobacillus plantarum, one belonged to Enterococcus casseliflavus, and one belonged to Lactobacillus acidophilus. Eighteen out of 26 LAB strains which showed a higher capability to tolerate simulated gastrointestinal juices were chosen to further evaluate their probiotic properties. Varied adhesive abilities and auto-aggregative capacities of selected LAB strains were dependent on species and even strains. All tested LAB strains were resistant to kanamycin, streptomycin, gentamycin, and vancomycin and sensitive to tetracycline and chloramphenicol. Ten out of the 18 strains are resistant to ampicillin, and the remaining strains are sensitive to ampicillin; 4 out of the 18 strains showed resistance to erythromycin. Compared to reference strain Lactobacillus rhamnosus strain GG, these LAB strains had a greater or comparative antimicrobial activity against Salmonella typhimurium or Escherichia coli. In contrast, eight out of the 18 strains suppressed growth of Shigella flexneri. Two L. plantarum strains, ST and STDA10, not only exhibited good probiotic properties but also showed a good ability of scavenging DPPH and ABTS+. This study suggests that L. plantarum ST and STDA10 could be used as potential probiotics applied in functional foods. [ABSTRACT FROM AUTHOR]

Purpose: Recommendations to soak nuts prior to consumption to reduce phytate concentrations and improve gastrointestinal tolerance have received much attention in the popular press. This is despite no supporting scientific evidence for the practice. There is also a lack of information about how soaking nuts might affect consumer acceptability. This study primarily assessed the effects of soaking almonds on consumer acceptance and secondly assessed effects on gastrointestinal tolerance.Methods: In this 8-week randomised crossover trial, 76 participants were allocated in balanced order to receive 30 g/day of four different preparations of almonds for 12 days: whole unsoaked, whole soaked, sliced unsoaked, and sliced soaked. Ratings of overall liking, desire to consume, and likelihood of future consumption, and severity of gastrointestinal symptoms were measured daily on visual analogue scales. The phytate concentrations were measured in all four nut types using high-performance liquid chromatography.Results: Mean acceptance ratings of all nut types were above the neutral point indicating they were acceptable. However, sliced soaked almonds were rated significantly lower overall for all three acceptance scales compared to the other treatments (all P ≤ 0.003). The sliced unsoaked almonds were rated lower than both whole nut treatments (all P ≤ 0.006), while there were no significant differences between the two whole nut treatments (all P ≥ 0.511). Gastrointestinal symptoms were minimal, but flatulence was rated significantly higher for all time points combined for soaked whole nuts compared to unsoaked whole nuts (P = 0.005). Compared to the whole unsoaked nuts (mean [SD] 531 [9] mg/100 g), phytate concentration was higher for the whole soaked almonds (563 [38] mg/100 g, P = 0.016), with no evidence of a difference for the sliced soaked almonds (548 [27] mg/100 g, P = 0.197) and no difference between the soaked forms (P = 0.262).Conclusions: This research supports previous results suggesting nuts, including different forms, are an acceptable food. They are also well tolerated gastrointestinally, but soaking does not improve gastrointestinal tolerance or acceptance as claimed in the lay literature. [ABSTRACT FROM AUTHOR]

Purpose: Consuming 30 g of nuts/day is recommended to reduce chronic disease. However, nut consumption appears far from ideal among several populations. A potential strategy to increase consumption is to add nuts to a staple, for example, bread. Whether the health benefits and acceptability of nuts persist in this form is currently unknown. Thus, we examined the effects of consuming three nut-enriched breads on postprandial glycaemia, satiety, gastrointestinal tolerance, dietary intakes, and acceptance. Methods: In this controlled, crossover study, 32 participants were randomly allocated to receive one of four breads for 8 days each. Three breads contained either 30 g of finely sliced hazelnuts, 30 g semi-defatted hazelnut flour, or 15 g of each (amounts per 120 g bread) and were compared with a control nut-free bread. Blood glucose response was measured over 120 min, along with ratings of gastrointestinal discomfort. Appetite ratings and diet diaries were completed during each treatment period. Results: Area under the blood glucose curve was significantly lower for the nut breads compared to the control bread (all P < 0.001), with no significant differences between the nut breads (all P ≥ 0.130). There were no significant differences in satiety (all P ≥ 0.135) or gastrointestinal symptoms (all P ≥ 0.102) between the breads. Acceptance was highest for the finely sliced hazelnut bread. Furthermore, consuming hazelnut-enriched bread improved diet quality, increasing monounsaturated fat, vitamin E, and dietary fibre intakes. Conclusion: Bread appears to be an effective and acceptable vehicle for increasing nut consumption, resulting in improved postprandial glycaemia and diet profiles. Long-term studies are now required. [ABSTRACT FROM AUTHOR]

Background: Iron deficiency anaemia (IDA) is the last stage of iron deficiency, consecutive to an imbalance between iron supply through food intake and iron loss through physiological or pathological processes. As well as by haemoglobin levels, IDA is diagnosed by measuring biomarkers of iron stores. Women are most affected by IDA since their teenage years, as menstruation constitutes a chronic iron loss. Oral supplementation with ferrous sulphate is an effective therapy, but gastrointestinal side effects may impair treatment compliance. Methods: The present multicentric randomised controlled trial was designed to assess the non-inferiority of a ferrous sulphate prolonged release formulation called V0355 with the referential ferrous sulphate Ferrograd in a population of Italian women aged 18-50 years diagnosed for IDA. Three hundred and ninety-nine patients were randomised to receive V0355 (80 mg Fe/day) or Ferrograd (105 mg Fe/day). Results: After 12 weeks of treatment, the difference in the mean haemoglobin level between the two groups was 0.081 g/dL ([−2.986;1.361], p = 0.54), which confirmed the hypothesis of non-inferiority. All the other biochemical parameters (serum iron, serum ferritin, transferrin, and soluble transferrin receptor) and haematological parameters (erythrocytes count, reticulocytes count, haematocrit, and mean corpuscular volume), as well as patient's anaemia-related symptoms, were not different between treatment groups throughout the study. Furthermore, the incidence of gastrointestinal adverse events of moderate and severe intensity was significantly lower ( p = 0.007) in the V0355 group (5.6%) than in the Ferrograd group (13.9%). Conclusion: V0355 was as efficient as Ferrograd in the treatment of anaemia and exhibited a better gastrointestinal tolerance profile. [ABSTRACT FROM AUTHOR]

Lactobacillus plantarum (Lp) is a lactic acid bacterium that has many excellent traits that meet the needs of industrial production. Genetically modified (GM) Lp590 was obtained from Lp that was modified by the insertion of the gene nisI, which can confer resistance to nisin and play a role as a bio-preservative. Here, explorations were made to assess the safety of GM Lp590 and establish an in vitro evaluation model. The ability of Lp590 to tolerate both environmental stresses (such as temperatures ranging from 52 to 4°C, or exposure to ethanol, oxygen, and osmotic stresses) and gastrointestinal transit was assessed. Lp590 showed a tolerance to 4°C and ethanol (20%) within a period of 240 min that was similar to Lp. Notably, Lp590 can tolerate higher temperature (52°C) and higher levels of HO (2%) and NaCl (4.0 M) than Lp. In contrast, Lp590 has the same gastrointestinal transit tolerance as Lp. In addition, Lp590 can adhere to Caco-2 cells, and it has no adverse effect on the cell membrane in vitro. These results indicate that GM Lp590 has many desirable biological characteristics and has good prospects for industrial applications. A useful and comprehensive exploration has been undertaken to establish a new in vitro evaluation model for genetically modified microorganisms (GMMs). [ABSTRACT FROM AUTHOR]

Design:Study part 1 was executed as a randomized double-blind placebo-controlled crossover study and study part 2 as a longitudinal study.Subjects:Forty-one healthy adult volunteers aged 18–24 years were recruited from the student population of the University of Salford. All subjects enrolled and completed study part 1 and 39 subjects enrolled and completed study part 2.Interventions:In study part 1, individuals consumed, in random order 0, 20, 40, 60, 80, 100 or 120 g of a RRM containing starch product incorporated in pre-prepared foods on individual test days. Assuming a minimum content of 50% RRM in the starch product this delivered respectively 0, 10, 20, 30, 40, 50 or 60 g of RRM. All foods were prepared and coded by personnel not involved in carrying out the tests. Test days were separated by 7 day washout periods. In study part 2, consumption of RRM was increased from 3.6 g at day 1 in incremental doses up to each subject's MNED as determined in study 1, to be achieved at day 14. Subsequently, RRM intake was from day 15–21 in a way that the final intake at day 21 was at least 10 g above the individual MNED. In both parts of the study, subjects reported the prevalence and magnitude of GI symptoms.Results:No significant change was observed in either defecation frequency and faecal consistency or the number of subjects experiencing any GI symptoms, following consumption of foods containing 0–60 g RRM. The individual MNED at which an increase in symptoms did not occur was determined as 60 g RRM for 71% of the subjects who participated in study part 1. Regression analysis showed that consumption of gradually increasing doses of RRM in food products over 21 days was associated with a significant increase in the mean symptom score for flatulence (P=1.5 × 10−4), total bowel movement frequency (P=0.023) and bowel movement frequency to pass watery faeces (P=0.0157). Increasing the ingested dose of RRM by 10 g above the predetermined MNED, however, did not provoke significant increases in GI symptoms. In both studies, the majority of symptom responses were classified by the subjects as ‘little more than usual’.Conclusions:Consumption of up to 60 g RRM is tolerated well by most individuals with no evidence of any significant dose-dependent increase in the magnitude of symptoms or the occurrence of multiple GI symptoms. However, a mild laxative effect when consuming >60 g RRM is suggested. Although there was no change in GI responses following consumption of increasing doses of RRM over 21 days, generally a dose of 10 g RRM above the MNED level was tolerated well during medium term intake.Sponsorship:Cerestar-Cargill R&D Center, Vilvoorde, Belgium.The gastrointestinal (GI) responses to ingested digestion resistant retrograded maltodextrins, having a structural similarity to type 3 resistant starch (RS) but a lower molecular weight, were studied after acute single bolus ingestion as well as during a medium-term period of daily ingestion. The overall study was split into two parts: part 1 aimed (1) to determine the GI responses of young adults following consumption of 0–60 g resistant maltodextrin; (2) to define the maximum non-effective dose (MNED) at which a considerable increase in symptoms did not occur. Part 2 aimed to determine whether a gradual increase in the daily dose of retrograded resistant maltodextrin (RRM) to a level finally exceeding by at least 10 g the individually determined MNED to acute ingestion in part 1 of the study, modified tolerance over time.European Journal of Clinical Nutrition (2007) 61, 1262–1270; doi:10.1038/sj.ejcn.1602642; published online 7 February 2007 [ABSTRACT FROM AUTHOR]

Objectives:To determine and compare the gastrointestinal (GI) responses of young adults following consumption of 45 g sucrose, 20, 35 and 50 g xylitol or erythritol given as a single oral, bolus dose in a liquid.Design:The study was a randomized, double-blind, placebo-controlled study.Subjects:Seventy healthy adult volunteers aged 18–24 years were recruited from the student population of the University of Salford. Sixty-four subjects completed the study.Interventions:Subjects consumed at home without supervision and in random order, either 45 g sucrose or 20, 35 and 50 g erythritol or xylitol in water on individual test days, while maintaining their normal diet. Test days were separated by 7-day washout periods. Subjects reported the prevalence and magnitude of flatulence, borborygmi, bloating, colic, bowel movements and the passage of faeces of an abnormally watery consistency.Results:Compared with 45 g sucrose, consumption of a single oral, bolus dose of 50 g xylitol in water significantly increased the number of subjects reporting nausea (P<0.01), bloating (P<0.05), borborygmi (P<0.005), colic (P<0.05), watery faeces (P<0.05) and total bowel movement frequency (P<0.01). Also 35 g of xylitol increased significantly bowel movement frequency to pass watery faeces (P<0.05). In contrast, 50 g erythritol only significantly increased the number of subjects reporting nausea (P<0.01) and borborygmi (P<0.05). Lower doses of 20 and 35 g erythritol did not provoke a significant increase in GI symptoms. At all levels of intake, xylitol produced significantly more watery faeces than erythritol: resp. 50 g xylitol vs 35 g erythritol (P<0.001), 50 g xylitol vs 20 g erythritol (P<0.001) and 35 g xylitol vs 20 g erythritol (P<0.05).Conclusions:When consumed in water, 35 and 50 g xylitol was associated with significant intestinal symptom scores and watery faeces, compared to the sucrose control, whereas at all levels studied erythritol scored significantly less symptoms. Consumption of 20 and 35 g erythritol by healthy volunteers, in a liquid, is tolerated well, without any symptoms. At the highest level of erythritol intake (50 g), only a significant increase in borborygmi and nausea was observed, whereas xylitol intake at this level induced a significant increase in watery faeces.Sponsorship:Cerestar R&D Center, Vilvoorde, Belgium.European Journal of Clinical Nutrition (2007) 61, 349–354. doi:10.1038/sj.ejcn.1602532; published online 20 September 2006 [ABSTRACT FROM AUTHOR]

Objective:To determine the gastrointestinal (GI) tolerance of NUTRIOSE®FB in men.Design:A randomized, placebo-controlled, parallel, double-blind study.Setting:The metabolic ward of TNO Quality of Life.Subjects:Forty-eight subjects started the study: 16 men participated in one of the three treatments. Subjects consumed either 22.5 g of pure maltodextrin (Glucidex®6), or 30 or 45 g of the dextrin NUTRIOSE®FB daily for 4–5 weeks. Forty-three subjects completed the study (age: 34.7±8.2 years; BMI 24.9±3.3 kg m2).Measurements:Tolerance of NUTRIOSE®FB was examined with a GI complaints questionnaire; effectiveness on colonic flora was examined by faecal analysis; fermentation by breath hydrogen excretion measurement. Furthermore, the effect on body weight (BW), energy intake and blood parameters were examined in the study.Results:Both doses of NUTRIOSE®FB were very well tolerated and GI complaints hardly differed from the placebo treatment. No diarrhoea was reported due to NUTRIOSE®FB supplementation. In the course of the study, some habituation and adaptation of GI symptoms were found. Fermentation and faecal characteristics (pH and enzyme activity) were significantly positively affected with NUTRIOSE®FB treatment. Body weight in both NUTRIOSE®FB groups remained stable over time, although the placebo-treated group showed a small increase in BW (Δday35−1 0.8±1.0 kg) (P=0.07). However, total food intake and macronutrient composition of the diet remained the same throughout the study. No significant differences were found between the three treatment groups in hunger and satiety scores and food preferences.Conclusions:Long-term supplementation of 30 or 45 g of the dextrin NUTRIOSE®FB per day was well tolerated, and may act as a pre-biotic supplement.Sponsorship:TNO Quality of Life was assigned by Roquette Frères to perform the study.European Journal of Clinical Nutrition (2006) 60, 1024–1034. doi:10.1038/sj.ejcn.1602418; published online 15 February 2006 [ABSTRACT FROM AUTHOR]

The anti-inflammatory, analgesic and antipyretic properties of the new non-steroidal anti-inflammatory agent, meloxicam, were investigated in a variety of animal models and compared with the properties of piroxicam, diclofenac, indomethacin and several other NSAIDs. With respect to the total effect of a single oral dose, the anti-exudative effect of meloxicam on carrageenaninduced oedema in the rat exceeded that of all the NSAIDs included in the comparison. Additionally, meloxicam showed the greatest potency of all the compounds examined with respect to adjuvant-induced arthritis in the rat, the granuloma pouch model and the cotton pellet test in the rat. Unlike indomethacin, in the carrageenan pleurisy model in the rat, meloxicam caused both a dose-dependent reduction in exudate volume and also inhibition of leucocyte migration. Meloxicam showed a strong and lasting effect on inflammatory pain in the rat. Like other NSAIDs, but unlike dipyrone, meloxicam had no effect in the hot plate and tail clamp tests, which are used to identify weak central analgesic effects. Unlike dipyrone and like indomethacin, meloxicam had no effect in a model of visceral distention pain. In common with other NSAIDs, meloxicam had no influence on the body temperature of normothermic rats in the anti-inflammatory dose range, but did reduce yeastinduced fever in the rat in a dose-dependent manner. Like piroxicam, meloxicam had a uricosuric effect on rats treated with oxonic acid. Low-dose meloxicam inhibited both bradykinin-induced and PAF-induced bronchospasm in the guinea-pig, but had no effect on acetylcholine-induced bronchospasm. Piroxicam had greater ulcerogenic effects in the rat stomach than meloxicam. The therapeutic range of meloxicam in the rat, with regard to inhibition of adjuvant arthritis, was several times greater than that of piroxicam, indomethacin, diclofenac and naproxen. [ABSTRACT FROM AUTHOR]