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Improvement of functional constipation with kiwifruit intake in a Mediterranean patient population: An open, non-randomized pilot study.
... 24,29,44,45 ), and six uncontrolled trials. [26][27][28]34,35,42 Of the uncontrolled trials, five were single-arm, and one trial (constipation vs. ...
... healthy group) was treated as single-arm as data were extracted for constipation only. 26 Studies administered kiwifruit (n = 7), [25][26][27][28][29]44,45 prunes (n = 2), 24,25 mango (n = 1), 30 fig paste (n = 1), 31 rye bread (n = 2), 32,33 cereal (n = 1), 34 oat bran biscuits (n = 1), 35 pasteurised yoghurt (n = 1), 36 high-mineral water (n = 4), 37-40 water supplementation (n = 1), 41 prune juice (n = 1), 46 a high-fibre diet (n = 1), 43 and a 'no-fibre' diet (n = 1). 42 There were no eligible studies of herbs or spices in chronic constipation. ...
... 27 There were 22 full text articles and one commercial report. 27 Twenty-one authors were contacted to provide additional information 24,25,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][43][44][45][46] ; nine replied, [25][26][27]38,39,[43][44][45][46] and five provided additional data. 39,[43][44][45][46] The outcomes of the meta-analyses are reported in Table 3. ...
Background
Dietary approaches are recommended for the management of chronic constipation. Until now, there has been no systematic review and meta‐analysis on foods, drinks and diets in constipation.
Aims
To investigate the effect of foods, drinks and diets on response to treatment, stool output, gut transit time, symptoms, quality of life, adverse events and compliance in adults with chronic constipation via a systematic review and meta‐analysis.
Methods
Studies were identified using electronic databases (12th July 2023). Intervention trials (randomised controlled trials [RCTs], non‐randomised, uncontrolled) were included. Risk of bias was assessed using Cochrane 2.0 (RCTs) or JBI Critical Appraisal (uncontrolled trials). Data from RCTs only were synthesised using risk ratios (RRs), mean differences (MDs), standardised mean differences (95% CI) using random‐effects.
Results
We included 23 studies (17 RCTs, 6 uncontrolled; 1714 participants): kiwifruit ( n = 7), high‐mineral water ( n = 4), prunes ( n = 2), rye bread ( n = 2), mango, fig, cereal, oat bran, yoghurt, water supplementation, prune juice, high‐fibre diet, no‐fibre diet ( n = 1). Fruits resulted in higher stool frequency than psyllium (MD: +0.36 bowel movements [BM]/week, [0.25–0.48], n = 232), kiwifruits in particular (MD: +0.36 BM/week, [0.24–0.48], n = 192); there was no difference for prunes compared with psyllium. Rye bread resulted in higher stool frequency than white bread (MD: +0.43 BM/week, [0.03–0.83], n = 48). High‐mineral water resulted in higher response to treatment than low‐mineral water (RR: 1.47, [1.20–1.81], n = 539).
Conclusions
Fruits and rye bread may improve certain constipation‐related outcomes. There is a scarcity of evidence on foods, drinks and diets in constipation and further RCTs are needed.
... 2023;49(4):e3926Esta obra está bajo una licencia https://creativecom m ons.org/licenses/b y -nc/4.0/deed.es_E S de tiempo, aumentaron el número de deposiciones significativamente, cabe mencionar que para dicho efecto es necesario consumir tres porciones al día.( 26,27,28) La última categoría es acerca de las preferencias y rechazos al tratamiento nutricional en el adulto mayor. En los grupos focales en los que participaron, los adultos mayores manifestaron poca aceptación frente a la presentación de la fibra en agua y en jugo, por ende, reportaron escasa adherencia frente a su consumo. ...
Introducción:
Los adultos mayores son la población más propensa a presentar desórdenes gastrointestinales, específicamente y en mayor proporción el estreñimiento idiopático. La alimentación es un factor clave, pero poco estudiado a la hora de tratar el estreñimiento.
Objetivo:
Comprender las diferentes percepciones por parte de los profesionales de la salud, los cuidadores y el adulto mayor acerca del manejo del estreñimiento idiopático, desde un enfoque alimentario, teniendo en cuenta las preferencias y gustos en el adulto mayor institucionalizado de Medellín.
Métodos:
La técnica de generación de la información se realizó a través de grupos focales, efectuando seis grupos: uno conformado por los profesionales del área de la salud, tres por los adultos mayores y dos por los cuidadores.
Resultados:
Se identificó que una de las recomendaciones que más se repite es el incremento del aporte de fibra y líquidos. En general, los adultos mayores tienen poca adherencia a las estrategias nutricionales para el manejo del estreñimiento, ya que los alimentos que se les ofrecen no se adecuan a sus preferencias.
Conclusiones:
No existe una percepción unánime en el personal de salud y los cuidadores con respecto a la efectividad del tratamiento nutricional para el manejo del estreñimiento en el adulto mayor; sin embargo, se identificaron testimonios exitosos sobre el uso de algunas frutas, la inclusión de fibra en la dieta y el aumento en el consumo de líquidos.
... A growing body of evidence suggests regular consumption of fresh green kiwifruit (Actinidia chinensis var. deliciosa "Hayward") may be of benefit (8)(9)(10)(11)(12). However, these studies have typically been single-centered, with relatively small cohorts, and have used nonstandardized end points. ...
Introduction:
Consumption of green kiwifruit is known to relieve constipation. Previous studies have also reported improvements in gastrointestinal (GI) comfort. We investigated the effect of consuming green kiwifruit on GI function and comfort.
Methods:
Participants included healthy controls (HC, n = 63), patients with functional constipation (FC, n = 60) and constipation-predominant irritable bowel syndrome (IBS-C, n = 61) randomly assigned to consume two green kiwifruit or psyllium (7.5 g) per day for 4 weeks, followed by a 4-week wash-out, then the other treatment for 4 weeks. The primary outcome was the number of complete spontaneous bowel movements (CSBM) per week. Secondary outcomes of GI comfort, including the gastrointestinal symptom rating scale (GSRS), a validated instrument. Data (intent-to-treat (ITT)) were analysed as difference from baseline using repeated measures analysis of variance suitable for AB/BA cross-over design.
Results:
Consumption of green kiwifruit was associated with a clinically relevant increase of ≥ 1.5 CSBM per week (FC; 1.53, p<0.0001, IBS-C; 1.73, p=0.0003), and significantly improved measures of GI comfort (GSRS total score) in constipated participants (FC, p<0.0001; IBS-C, p<0.0001). No significant adverse events were observed.
Discussion:
This study provides original evidence that the consumption of a fresh, whole fruit has demonstrated clinically relevant increases in CSBM and improved measures of GI comfort constipated populations. Green kiwifruit are a suitable dietary treatment for relief of constipation and associated GI comfort.
... The soluble fibre may be the cause of the increase in faecal water seen in this study. Results from several clinical trials also show that kiwifruit promotes laxation [47][48][49][50]. ...
Kiwifruit are a nutrient dense food and an excellent source of vitamin C. Supplementation of the diet with kiwifruit enhances plasma vitamin C status and epidemiological studies have shown an association between vitamin C status and reduced insulin resistance and improved blood glucose control. In vitro experiments suggest that eating kiwifruit might induce changes to microbiota composition and function; however, human studies to confirm these findings are lacking. The aim of this study was to investigate the effect of consuming two SunGold kiwifruit per day over 12 weeks on vitamin C status, clinical and anthropometric measures and faecal microbiota composition in people with prediabetes. This pilot intervention trial compared baseline measurements with those following the intervention. Participants completed a physical activity questionnaire and a three-day estimated food diary at baseline and on completion of the trial. Venous blood samples were collected at each study visit (baseline, 6, 12 weeks) for determination of glycaemic indices, plasma vitamin C concentrations, hormones, lipid profiles and high-sensitivity C-reactive protein. Participants provided a faecal sample at each study visit. DNA was extracted from the faecal samples and a region of the 16S ribosomal RNA gene was amplified and sequenced to determine faecal microbiota composition. When week 12 measures were compared to baseline, results showed a significant increase in plasma vitamin C (14 µmol/L, p < 0.001). There was a significant reduction in both diastolic (4 mmHg, p = 0.029) and systolic (6 mmHg, p = 0.003) blood pressure and a significant reduction in waist circumference (3.1 cm, p = 0.001) and waist-to-hip ratio (0.01, p = 0.032). Results also showed a decrease in HbA1c (1 mmol/mol, p = 0.005) and an increase in fasting glucose (0.1 mmol/L, p = 0.046), however, these changes were small and were not clinically significant. Analysis of faecal microbiota composition showed an increase in the relative abundance of as yet uncultivated and therefore uncharacterised members of the bacterial family Coriobacteriaceae. Novel bacteriological investigations of Coriobacteriaceae are required to explain their functional relationship to kiwifruit polysaccharides and polyphenols.
... A growing body of evidence suggests regular consumption of fresh green kiwifruit (Actinidia chinensis var. deliciosa "Hayward") may be of benefit (8)(9)(10)(11)(12). However, these studies have typically been single-centered, with relatively small cohorts, and have used nonstandardized end points. ...
... The daily consumption of two kiwifruit was found to increase stool frequency, including the number of complete spontaneous bowel motions per week, reduce gastrointestinal transit time and improve measures of intestinal comfort. These early human studies [50,114,130,[140][141][142] were carried out in different countries and included different study populations (e.g., differing in age, health status), and the lack of a common protocol may have led to results that were not applicable to the larger normal healthy population. Most studies consider the effects of prolonged kiwifruit consumption, however recently Wallace et al. [143] investigated the acute effects of green kiwifruit on gastric emptying following consumption of a steak meal, using a computerised SmartPill™, and measures of digestive comfort. ...
Purpose:
To describe the nutritional and health attributes of kiwifruit and the benefits relating to improved nutritional status, digestive, immune and metabolic health. The review includes a brief history of green and gold varieties of kiwifruit from an ornamental curiosity from China in the 19th century to a crop of international economic importance in the 21st century; comparative data on their nutritional composition, particularly the high and distinctive amount of vitamin C; and an update on the latest available scientific evidence from well-designed and executed human studies on the multiple beneficial physiological effects. Of particular interest are the digestive benefits for healthy individuals as well as for those with constipation and other gastrointestinal disorders, including symptoms of irritable bowel syndrome. The mechanisms of action behind the gastrointestinal effects, such as changes in faecal (stool) consistency, decrease in transit time and reduction of abdominal discomfort, relate to the water retention capacity of kiwifruit fibre, favourable changes in the human colonic microbial community and primary metabolites, as well as the naturally present proteolytic enzyme actinidin, which aids protein digestion both in the stomach and the small intestine. The effects of kiwifruit on metabolic markers of cardiovascular disease and diabetes are also investigated, including studies on glucose and insulin balance, bodyweight maintenance and energy homeostasis.
Conclusions:
The increased research data and growing consumer awareness of the health benefits of kiwifruit provide logical motivation for their regular consumption as part of a balanced diet. Kiwifruit should be considered as part of a natural and effective dietary strategy to tackle some of the major health and wellness concerns around the world.
... Tradicionalmente se han reconocido los efectos beneficiosos del kiwi sobre la digestión y el tránsito intestinal. Se han demostrado los efectos positivos y significativos en el tratamiento del estreñimiento de ancianos sanos en Nueva Zelanda (18), China (19) y en población española (20), así como en pacientes con colon irritable (21). Estos beneficios se deben al contenido en fibra tanto soluble como insoluble, que retiene gran cantidad de agua, aumenta la masa fecal y suaviza el tránsito. ...
Both the Green® kiwifruit (Actinidia deliciosa)and the Sungold® one (A. chinensis)stand out among other commonly consumed fruits for their nutritional composition. They are fruits exceptionally rich in vitamin C, since green kiwi fruit have twice and Sungold® have three times the same amount of the vitamin of strawberries or oranges. Kiwifruit is very rich in vitamins E, K, folates, carotenoids, potassium, fiber and other phytochemicals. Regular consumption of kiwifruit, in the context of a balanced diet, has proven to have beneficial effects on immune function and antioxidant defense; also in the gastrointestinal function, improving protein digestion and constipation; and in the upper respiratory tract, preventing infections and improving their symptoms. Finally, regular consumption of kiwifruit has been associated with improvements in mood. Most of these benefits may be due not only to the high content of vitamin C of the kiwifruit, but also to other nutrients and phytochemicals that work synergistically in the food matrix. The results of the studies suggest that the daily consumption of kiwifruit can be an effective strategy for health promotion and prevention of numerous diseases.
Background
Over‐the‐counter supplements are commonly used to manage chronic constipation; however, their efficacy remains unclear. We aimed to investigate the effect of food, vitamin or mineral supplements on stool output, gut transit time, symptoms, and quality of life in adults with chronic constipation via a systematic review and meta‐analysis of randomized controlled trials (RCTs).
Methods
Studies were identified using electronic databases, backward citation, and hand‐searching abstracts. RCTs reporting administration of food supplements (e.g., fruit extract supplements), vitamin or mineral supplements in adults with chronic constipation were included. Studies administering whole foods (e.g., fruits) were excluded. Risk of bias (RoB) was assessed with Cochrane RoB 2.0. Relative risks (RR), mean differences (MD), or standardized mean differences (95% confidence intervals [CI]) were calculated using a random‐effects model.
Key Results
Eight RCTs (787 participants) were included, investigating kiwifruit (n = 3 RCTs), senna (n = 2), magnesium oxide (n = 2), Ziziphus jujuba (n = 1), and Malva Sylvestris (n = 1) supplements. Kiwifruit supplements did not impact stool frequency (MD 0.24 bowel movements/week [−0.32, 0.80]; p = 0.40) or consistency (MD −0.11 Bristol points [−0.31, 0.09], p = 0.29). Overall, 61% responded to senna and 28% to control; however, this did not reach statistical significance (RR 2.78, [0.93, 8.27]; p = 0.07). Overall, 68% responded to magnesium oxide and 19% to control (RR 3.32 [1.59, 6.92]; p = 0.001). Magnesium oxide improved stool frequency (MD 3.72 bowel movements/week [1.41, 6.03]; p = 0.002) and consistency (MD 1.14 Bristol points [0.48, 1.79]; p = 0.0007).
Conclusions and Inferences
Magnesium oxide supplements are effective at improving cardinal symptoms of chronic constipation. Senna and kiwifruit supplements did not impact symptoms; however, findings were based on a small number of studies. Further research is required to investigate the effect of food supplements (e.g., kiwifruit supplements), as well as their whole food equivalents (e.g., whole kiwifruits) in chronic constipation.
Abstract Following an application from Zespri International Limited, submitted for authorisation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of Belgium, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on the scientific substantiation of a health claim related to green kiwifruit (lat. Actinidia deliciosa var. Hayward) and maintenance of normal defecation. The scope of the application was proposed to fall under a health claim based on newly developed scientific evidence. The food proposed by the applicant as the subject of the health claim is green kiwifruit. The Panel considers that green kiwifruit (Actinidia deliciosa var. Hayward) is sufficiently characterised. The claimed effect proposed by the applicant is ‘maintenance of normal defecation’. Maintenance of normal defecation is a beneficial physiological effect provided that it does not result in diarrhoea. All human intervention studies submitted had different limitations and could not be used on their own for the scientific substantiation of the claim. However, the results of six pertinent human intervention studies are consistent with respect to an effect of consuming daily between two and four green kiwifruits var. Hayward on an increase in stool frequency. Two out of four studies in which a validated instrument was used to assess stool consistency showed an effect also on stool consistency. There is evidence for a plausible mechanism by which kiwifruit could exert an effect on normal defecation. The consumption of kiwifruit in the studies did not result in diarrhoea. A cause and effect relationship has been established between the consumption of green kiwifruit (Actinidia deliciosa var. Hayward) and maintenance of normal defecation. The following wordings reflect the scientific evidence: ‘consumption of kiwifruit contributes to the maintenance of normal defecation’. In order to obtain the claimed effect, two large green kiwifruits (i.e. around 200 g of kiwi flesh) should be consumed.
Constipation is a very common disorder that adversely affects well-being and quality of life. Evidence-based clinical practice guidelines are an essential element for proper patient management and safe, effective treatment.
The aim of these guidelines is to provide health care professionals who care for patients with chronic constipation with a tool that allows them to make the best decisions about the prevention, diagnosis and treatment of constipation.
The methodology used to draw up these guidelines is described in the Part 1. In this article we will discuss the recommendations for the diagnostic and therapeutic management of constipation.
ResearchGate has not been able to resolve any references for this publication.