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Improvement of functional constipation with kiwifruit intake in a Mediterranean patient population: An open, non-randomized pilot study.

Authors:
  • Direcció d'Atenció Primària Costa de Ponent. Institut Català de la Salut (ICS)
  • Catalan Institute of Health, IDIAP Jordi Gol i Gurina
... 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]. ...
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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.
... 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. ...
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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. ...
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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.
... 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. ...
Article
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Los kiwis, tanto la variedad verde (Actinidia deliciosa) como la de color amarillo (Sungold®) (A. chinensis), destacan entre las frutas de consumo habitual por su composición nutricional. Son excepcionalmente ricos en vitamina C, ya que los kiwis verdes duplican la cantidad que tienen fresas o naranjas, y el kiwi de color amarillo incluso la triplica. Además, los kiwis tienen un elevado contenido en vitaminas E, K, folatos, carotenoides, potasio, fibra y otros fitoquímicos, que proporcionan no solo beneficios nutricionales, sino también sanitarios. El consumo regular de kiwi en el contexto de una dieta equilibrada tiene efectos beneficiosos sobre la función inmune y defensa antioxidante; en la función gastrointestinal, mejorando la digestión proteica y el estreñimiento; y en el tracto respiratorio superior, ayudando en la prevención de infecciones y mejorando su sintomatología. Por último, el consumo habitual de kiwi se ha asociado a mejoras del estado de ánimo. La mayoría de estos beneficios pueden deberse al elevado contenido de vitamina C del kiwi, pero también a los otros nutrientes y fitoquímicos que actúan de forma sinérgica en la matriz alimentaria. Los resultados de los estudios realizados hasta ahora sugieren que el consumo diario de kiwi puede ser una estrategia efectiva para la promoción de la salud y prevención de numerosas enfermedades.
Article
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.
Article
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.
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