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ABSTRACT Background and objectives: Recent nutrition research emphasizes the importance of prebiotics in health and disease. Several non-digestible but fermentable dietary carbohydrates may have the potential to regulate body weight and atherogenic profile in humans; however, the mechanisms for these changes are not fully understood. Methods: Using the double blind placebo control trial design 72 obese adults aged 25-35 y were randomly selected from banks of urban Vadodara and further divided into control (n=32) and experimental group (n=40) who were supplemented with 20 g fructooligosaccharide and dextrose/day for 90 days respectively. Anthropometric profile, dietary intakes, hunger and satiety scores and atherogenic profile were determined using standard methods. Gut profile with respect to Bifidobacteria, Lactobacilli, Clostridium, and Bacteroides was determined using selective medium. Results: Post intervention results revealed that body weight, and percent body fat reduced significantly by 1.71% and 4.30% (p<0.001) respectively. The total mean satiety scores decreased by 7.74%. Improvement in atherogenic profile was observed in terms of reduced serum triglyceride levels by 22.82% followed by LDL cholesterol (16.55%) and TC (15.41%). FOS supplementation increased colonization of beneficial microflora in terms of bifidobacteria and lactobacilli significantly by 9.62% and 28.47% respectively whereas clostridium and bacteroides significantly reduced by 2.37% and 12.04% respectively. Conclusions: 20 g Fructooligosaccharide supplementation for 3 months reduced weight and improvised atherogenic profile of obese young adults which may have resulted due to altered gut microflora and improved satiety.
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Nidhi et al. World Journal of Pharmaceutical Research
FOS INTAKE IMPROVES ATHEROGENIC PROFILE AND BODY
WEIGHT IN YOUNG OBESE ADULTS OF URBAN VADODARA
Nidhi Jain*1 and Mini Sheth2
1Research Scholar, 2Associate Professor, Department of Foods and Nutrition,
The M. S. University of Baroda, Vadodara, Gujarat (INDIA), 390002.
ABSTRACT
Background and objectives: Recent nutrition research emphasizes the
importance of prebiotics in health and disease. Several non-digestible
but fermentable dietary carbohydrates may have the potential to
regulate body weight and atherogenic profile in humans; however, the
mechanisms for these changes are not fully understood. Methods:
Using the double blind placebo control trial design 72 obese adults
aged 25-35 y were randomly selected from banks of urban Vadodara
and further divided into control (n=32) and experimental group (n=40)
who were supplemented with 20 g fructooligosaccharide and
dextrose/day for 90 days respectively. Anthropometric profile, dietary
intakes, hunger and satiety scores and atherogenic profile were
determined using standard methods. Gut profile with respect to
Bifidobacteria, Lactobacilli, Clostridium, and Bacteroides was determined using selective
medium. Results: Post intervention results revealed that body weight, and percent body fat
reduced significantly by 1.71% and 4.30% (p<0.001) respectively. The total mean satiety
scores decreased by 7.74%. Improvement in atherogenic profile was observed in terms of
reduced serum triglyceride levels by 22.82% followed by LDL cholesterol (16.55%) and TC
(15.41%). FOS supplementation increased colonization of beneficial microflora in terms of
bifidobacteria and lactobacilli significantly by 9.62% and 28.47% respectively whereas
clostridium and bacteroides significantly reduced by 2.37% and 12.04% respectively.
Conclusions: 20 g Fructooligosaccharide supplementation for 3 months reduced weight and
improvised atherogenic profile of obese young adults which may have resulted due to altered
gut microflora and improved satiety.
World Journal of Pharmaceutical Research
SJIF Impact Factor 5.045
Volume 4, Issue 01, 1094-1109. Research Article ISSN 2277 7105
Article Received on
29 October 2014,
Revised on 20 Nov 2014,
Accepted on 11 Dec 2014
*Correspondence for
Author
Nidhi Jain
Research Scholar,
Department of Foods and
Nutrition, The M. S.
University of Baroda,
Vadodara, Gujarat
(INDIA).
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KEYWORDS: Fructooligosaccharide, cholesterol, triglycerides, obesity, prebiotics and gut
flora.
INTRODUCTION
Obesity is considered as cluster of non-communicable diseases called ‗New World
Syndrome‘ creating an enormous socio economic and public health burden in developing
countries particularly like India where a significant proportion of the population belongs to
younger age group. [1, 11, 19, and 23] According to WHO (2009) [27] by 2015, approximately 2.3
billion adults will be overweight and more than 700 million will be obese and by 2030 and
cardiovascular diseases will remain the leading causes of death, affecting approximately 23.6
million people around the world.
There is an abundant market and public attention in the ability of functional foods in
benefiting health and lowering the risk of allied diseases which are caused by diet and
lifestyle. Possible effects of prebiotics and probiotics including FOS outfitting such health
benefits has been a focus of research in the recent years.
Animal and human data have suggested that the composition of the gut microflora may be an
important mediator of the risk of obesity. [7] Inulin type fructans are well studied and clearly
effective in humans and animal models to stimulate growth of health promoting species
belonging to bifidobacteria and lactobacillus [10, 20] however its effect on lipid profile and
obesity has not been studied sufficiently.
Many studies have shown lipid lowering effects of fructooligosaccharide (FOS). Because
FOS is not hydrolyzed by enzymes in the small intestine of humans, they reach the colon
intact where they are fermented by the colonic microflora. End products of this fermentation
are some gases and short chain fatty acids such as acetate, propionate and butyrate. These
SCFA‘s are readily absorbed by the colonic mucosa. It is known that butyrate act as an
energy substrate for the mucosa and, whereas acetate and propionate enter the portal blood
and may influence systemic carbohydrate and lipid metabolism. [14, 21] Furthermore, a study
demonstrated that in healthy humans, feeding of 16g/day FOS promoted satiety followed
breakfast and dinner and reduced hunger after dinner. This was accompanied by a significant
10% lower total energy intake.[3]
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However, these studies need to be validated in humans in Indian context and it was felt
important to understand the mechanisms involved in weight loss and alteration in the
atherogenic profile in obese individuals residing in urban Vadodara.
METHODS AND MATERIALS
Study Design and subject enrollment
The study was a double blind placebo control trial design which involved 72 obese grade-I
(BMI-25-30 kg/m2) male and female adults aged between 25-35 years. Six banks (A total of
20 different branches) in different areas of Vadodara city were conveniently selected based
on the permission obtained from the administration department to organize the health
screening camp. Purposive sampling method was used to enroll subjects. Written and verbal
information was provided to these subjects about the study. The subjects who willingly
signed the written informed consent form were enrolled for the study. Obese adults (n=72)
further randomly divided into placebo group (PG) (n=32) and experimental groups (EG)
(n=40).
Subjects with confirmed disorders like hypertension, diabetes mellitus, cardiovascular
disorder, thyroid hormone disorder, valve replacement surgery, gastric surgery or perforation,
renal disorder, locomotor disorder, cancer / AIDS, and with psychological disorder were
excluded from the study.
Study Methodology
Baseline Information regarding age, gender, religion of subjects was obtained using a pre-
tested semi-structured questionnaire and the socio economic status was collected from the
subjects using the Kuppuswamy‘s Socioeconomic Status Scale 2010. [2] Sitting blood
pressure of subjects was measured using the standard electric sphygmomanometer on the
right arm. All anthropometric measurements were made using the guidelines adopted at the
NIH sponsored Arlie Conference (Lohman et al 1988).
Enzymatic colorimetric method (GPO/PAP) was used to measure serum total cholesterol
(TC) and triglyceride (TG) procured from City Lab, Vadodara. Serum HDL, LDL and VLDL
fraction of cholesterol was determined using enzymatic, colorimetric method (CHOD/PAP)
without sample pretreatment (City Lab, Vadodara).
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Gut microbial counts levels was determined in terms of lactobacilli, bifidobacteria,
bacteroides and clostridium. The subjects were randomly assigned using computer generated
random tables to either control or experimental group by a person who was not related to the
study. Subjects were required to provide fecal samples and blood samples before and at the
end of intervention. Fecal samples were collected for determining microbial counts in terms
of lactobacilli, bifidobacteria, bacteroides and clostridium and blood samples were collected
in the fasted state for biochemical estimation. Subjects were advised not to alter their usual
calorie intakes and physical activity pattern and were asked to document any unusual
symptoms or side effects.
Study food and mode of Intervention
The Fructooligosaccharide (FOS) used for the intervention was food grade
fructooligosaccharide was procured from Mitushi Pharma, Ahmedabad. (Make: Meiji Japan;
20 kg bag; Lot no.MMS 182-270). The experimental and placebo groups were supplemented
with 20 g FOS and dextrose/day for 90 days respectively in powder form packed in 10g
sachets. The subjects were asked to consume FOS or dextrose in to water along with the
lunch. According to FAO-WHO (2001), FOS is regarded as safe when consumed upto 20 g.
Test Methods
Measurements of Blood pressure: measurements were taken after the subject was made to sit
down quietly for at least 5 minutes. The bare arm of the subject was supported and positioned
at heart level. A cuff of suitable size was evenly applied to the exposed upper arm, with the
bladder of the cuff positioned over the brachial artery. The bladder length was at least 80%
and width at least 40% of the circumference of the arm. The cuff was snugly wrapped around
the upper arm and inflated to 30 mmHg above the pressure at which the radial pulse
disappeared. The cuff was deflated at rate greater than 2 mmHg/beat. If initial readings were
high, several further readings were taken after 5 min. of rest. On each occasion two or more
readings were averaged. For diastolic reading, the disappearance of sound was used; muffing
of sound was used if sound continued towards zero (Thomas. G. et al, 2005).
Measurements of Hunger and satiety: A score card was used to rate the degree of hunger and
satiety, before and after meals developed by Lisa Burgoon MS, RD, LD, Sports Nutritionist,
Sportwell Center, McKinley Health Center, University of Illinois at Urbana Champain,
1998.
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Table 1: Hunger and Satiety Score Card
Scale
Score
Famished, starving
1
Headache, weak, cranky, low energy
2
Want to eat now, stomach growls and feels empty
3
Hungry - but could wait to eat, starting to feel empty but not there yet
4
Not hungry, not full
5
Feeling satisfied, stomach feels full and comfortable
6
Feeling full, definitely don‘t need more food
7
Uncomfortably full
8
Stuffed, very uncomfortable
9
Bursting, painfully full
10
Atherogenic Profile
After the overnight fast, venous blood sample was collected in clean, sterilized vacuum
containers and allowed to stand at room temperature for 15 minutes and serum was separated
from total blood. Total cholesterol (TC) was estimated using end point enzymatic
colorimetric technique (Richmand.W., 1973). Enzymatic colorimetric method (GPO/PAP)
with glycerol phosphate oxidase and 4- aminophenazone was used to assess triglycerides
(Fossati.P., and Prencipe.L., 1982). HDL, LDL and VLDL fraction of cholesterol was
determined using enzymatic, colorimetric method (CHOD/PAP) without sample pretreatment
(Sughichi H., 1995).
Gut bacteria enumeration
Fecal samples were collected in an air tight sterile container kept with cold packs. The serial
dilutions of 1 gram of fecal samples were made up from 10-2 to 10-8 dilutions (Ramona R et
al 2000). The media for bifidobacteria was prepared in laboratory using the dehydrated
bifidobacterium agar procured from Hi Media and was autoclaved at 1210 C for 15 minutes
(Nystrom T et al 2004). The prepared media were poured into sterile petri plates and were
allowed to set. The enumeration of lactic acid bacteria was done using Hi Media MRS Agar
M 641 (67.15 g in 1000 ml distilled water). The media for clostridium was prepared in
laboratory using the Hi Media Anaerobic Agar M 228 (58 g in 1000 ml distilled water) and
for bacteriodes Hi Media Anaerobic Basal Agar M 1635 (45.9 g in 1000 ml distilled water)
was used.
The samples were plated on the respective media as per the methods for the selective
enumeration of lactobacilli, bifidobacteria bacteroides and clostridium (Ramona R et al 2000;
Nystrom. T. et al, 2004 and De. Man. J. et al, 1960). The plates of bifidobacteria, bacteroides
and clostridium were incubated at 37ºC placed in the anaerobic jar with gas packs in the
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incubator and read after 48 hours. Plates of lactic acid bacteria were placed in desiccators as
it is a facultative anaerobe After 48 hours of incubation the colonies were counted using a
colony counter and were converted in to log counts after multiplying with their dilution
factors (FAO/WHO 2001).
Statistical methods: Data analysis was performed using Microsoft Office Excel 2007 and the
Statistical Package for the Social Sciences (SPSS 16.0 version). Paired t test was performed
to observe the effect of FOS supplementation. Student t test was performed for the
comparison between control and experimental group. The significance levels were set at 5%
by two sided tests.
Ethical clearances: The Medical Ethics committee of the Foods and Nutrition Department,
The M.S. University of Baroda approved the study proposal and provided the Medical ethics
approval number (IECHR/2012/13).
RESULTS
As seen in Table 2, the general information of subjects revealed that mean age for all the
subjects was 30.81 wherein most subjects (52.77%) were in the age group of 30-35 y, 87.5%
were males and belonged to upper middle class income group (91.66%).
Table 2: Background information of obese placebo and experimental groups
Placebo Group (n=32)
Experiment Group (n=40)
10(31.25)
16(50)
21(52.5)
16(40)
1(3.12)
5(15.62)
2(5)
1(2.5)
26(81.25)
6(18.75)
37(92.5)
3(7.5)
4(12.5)
28(87.5)
----
1(2.5)
38(95)
1(2.5)
NOTE: Figures in parenthesis represent percent of subjects.
FOS supplementation and anthropometry
Results on anthropometric profile of the obese subjects after FOS supplementation for 90
days revealed a significant (p<0.001) reduction in total body weight (1.17%) and BMI
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(1.57%) with improvement in abdominal obesity (p<0.001) and central obesity (p<0.01) by
1.91% and 1.07% respectively. A significant reduction (p<0.001) was seen in percent body
fat by 4.30% in EG after intervention (Table 3).
FOS supplementation and biophysical profile
As seen in Table 3, FOS intervention significantly reduced the systolic blood pressure by
2.15% (p<0.001) where diastolic blood pressure remained unchanged.
Table 3: Mean anthropometric values of obese subjects before and after intervention
Parameters
Placebo Group
(n=32)
Experiment Group
(n=40)
Student
‘t’ Test
Height (cms)
Mean ±SD
Pre intervention
167.54±10.14
169.44±7.26
0.92NS
Post intervention
167.54±10.14
169.44±7.26
0.92NS
----
-----
----
Weight (kg)
Mean ±SD
Pre intervention
76.91±11.73
80.33±9.01
1.39NS
Post intervention
76.70±11.39
78.95±9.13
0.92NS
Paired ‘t’ Test
0.71NS
4.23***
% decrease
0.27%↓
1.71%↓
BMI (kg/m2)
Mean ±SD
Pre intervention
27.23±1.55
27.85±1.47
1.75NS
Post intervention
27.17±1.53
27.41±1.58
0.64NS
Paired ‘t’ Test
0.55NS
3.74***
% decrease
0.22%↓
1.57%↓
WC(cm)
Mean ±SD
Pre intervention
95.37±7.45
97.77±7.72
1.33NS
Post intervention
94.30±6.81
95.90±7.64
0.92NS
Paired ‘t’ Test
2.23*
4.87***
% decrease
1.12%↓
1.91%↓
HC (cm)
Mean ±SD
Pre intervention
102.40±7.28
104.37±5.61
1.29NS
Post intervention
101.64±7.58
104.02±5.57
1.53NS
Paired ‘t’ Test
2.25*
1.59NS
% decrease
0.74%↓
0.33%↓
WHR
Mean ±SD
Pre intervention
0.92±0.04
0.93±0.05
0.43NS
Post intervention
0.92±0.04
0.92±0.05
0.63NS
Paired ‘t’ Test
0.19NS
3.18**
% decrease
------
1.07%↓
Body Fat (%)
Mean ±SD
Pre intervention
31.46±5.06
32.03±3.79
0.55NS
Post intervention
31.62±5.04
30.65±3.75
0.93NS
Paired ‘t’ Test
0.40NS
3.86***
%
increase/decrease
0.50%↑
4.30%↓
Systolic blood
pressure
(mmHg)
Mean ±SD
Pre intervention
125.53±8.76
127.82±8.09
1.15NS
Post intervention
124.96±8.25
125.07±5.48
0.06NS
Paired ‘t’ Test
0.69NS
4.45***
% decrease
0.45%↓
2.15%↓
Diastolic blood
pressure
Pre intervention
79.06±7.35
79.70±6.17
0.39NS
Post intervention
79.53±5.73
79.82±5.56
0.21NS
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(mmHg)
Mean ±SD
Paired ‘t’ Test
0.72NS
0.29NS
% increase
0.59%↑
0.15%↑
Note: Level of significance:* p- value <0.05;**p-value<0.01 ***p-value<0.001; NS = Not
Significant;
FOS supplementation and hunger and satiety scores
As shown in Table 4, the subjects felt less hungry post intervention with FOS and their
Satiety scores improved post lunch and dinner by 10.46% and 11.05% respectively and total
satiety scores decreased by 7.74% (p<0.001).
Table 4: Hunger and satiety scores of obese subjects before and after intervention
Parameters
Placebo
Group (n=32)
Mean±SD
Experiment Group
(n=40)
Mean±SD
Student
‘t’ Test
Hunger
Scores
(Breakfast)
Pre intervention
4.00±0.67
3.75±1.08
1.14NS
Post intervention
3.90±0.81
4.12±0.75
1.17NS
Paired ‘t’ Test
0.90NS
2.36*
% increase/decrease
2.5%↓
9.86%↑
Hunger
Scores
(Lunch)
Pre intervention
3.71±0.77
3.17±0.93
2.65**
Post intervention
3.68±0.59
3.72±0.75
0.23NS
Paired ‘t’ Test
0.19NS
3.27**
%increase/decrease
0.80%↓
17.35%↑
Hunger
Scores
(Evening)
Pre intervention
4.00±1.04
4.20±0.85
0.89NS
Post intervention
4.15±1.08
4.30±0.82
0.64NS
Paired ‘t’ Test
1.22NS
0.68NS
% decrease
3.75%↑
2.38%↑
Hunger
Scores
(Dinner)
Pre intervention
3.50±1.07
3.05±1.08
1.75NS
Post intervention
3.78±0.94
3.70±0.75
0.40NS
Paired ‘t’ Test
1.55NS
3.66***
% decrease
8.00%↑
21.31%↑
Total
Hunger
Mean Scores
Pre intervention
3.77±0.55
3.58±0.73
1.19NS
Post intervention
3.88±0.47
3.90±0.58
0.62NS
Paired ‘t’ Test
1.21NS
2.85**
% decrease
2.91%↑
8.93%↑
Satiety
Scores
(Breakfast)
Pre intervention
6.40±0.75
6.47±0.87
0.35NS
Post intervention
6.40±0.87
6.22±0.69
0.97NS
Paired ‘t’ Test
0.00 NS
1.46NS
% increase
---
3.86%↓
Satiety
Scores
(Lunch)
Pre intervention
6.84±0.76
7.17±0.93
1.62NS
Post intervention
6.78±0.75
6.42±0.74
2.00*
Paired ‘t’ Test
0.49NS
5.11***
% increase
0.87%↓
10.46%↓
Satiety
Scores
(Evening)
Pre intervention
6.09±0.64
6.15±0.62
0.37NS
Post intervention
6.09±0.64
6.00±0.81
0.53NS
Paired ‘t’ Test
0.00NS
1.18NS
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% increase
----
2.43%↓
Satiety
Scores
(Dinner)
Pre intervention
7.37±1.00
7.42±1.05
0.20NS
Post intervention
7.31±0.89
6.60±0.84
3.46***
Paired ‘t’ Test
0.37NS
4.08***
% increase
0.81%↓
11.05%↓
Total Satiety
Mean Scores
Pre intervention
6.70±0.53
6.84±0.58
1.05NS
Post intervention
6.64±0.47
6.31±0.57
2.65**
Paired ‘t’ Test
0.64NS
4.63***
% increase
0.89%↓
7.74%↓
Note: Level of significance:* p- value <0.05;**p-value<0.01 ***p-value<0.001; NS = Not
Significant;
FOS supplementation and dietary intakes
Intake of all the macronutrients along with total dietary fiber and soluble dietary fiber intakes
significantly reduced with maximum reduction in the fat intake (12.53%) in EG post
intervention (Table 5).
Table 5: Mean dietary intakes of obese subjects before and after intervention
Parameters
Placebo Group
(n=32)
Experiment
Group (n=40)
Student
‘t’ Test
Energy (Kcals)
Mean ±SD
Pre intervention
2710.56±568.52
2832.95±520.16
0.95NS
Post intervention
2632.89±561.40
2530.82±479.67
0.83NS
Paired ‘t’ Test
3.76***
5.40***
% decrease
2.86%↓
10.66%↓
Protein (gms)
Mean ±SD
Pre intervention
77.90±16.14
83.28±24.53
1.06NS
Post intervention
75.29±15.98
74.80±20.45
0.11NS
Paired ‘t’ Test
6.17***
5.66***
% decrease
3.35%↓
10.18%↓
Fat (gms)
Mean ±SD
Pre intervention
101.75±37.32
107.74±41.87
0.63NS
Post intervention
99.22±36.85
94.24±36.79
0.57NS
Paired ‘t’ Test
2.83***
5.51***
% decrease
2.48%↓
12.53%↓
Carbohydrates
(gms)
Mean ±SD
Pre intervention
359.95±81.47
373.22±71.16
0.73NS
Post intervention
350.58±79.07
334.74±81.11
0.83NS
Paired ‘t’ Test
2.97**
5.35***
% decrease
2.60%↓
10.31%↓
Total dietary
fiber (gms)
Mean ±SD
Pre intervention
20.92±7.59
21.90±8.32
0.51NS
Post intervention
20.10±7.57
19.75±8.13
0.18NS
Paired ‘t’ Test
5.43***
8.84***
% decrease
3.91%↓
9.81%↓
Crude fibre
[gms]
Mean ±SD
Pre intervention
9.48±3.49
9.28±2.28
0.28NS
Post intervention
9.76±3.73
9.25±2.34
0.72NS
Paired ‘t’ Test
2.23*
0.27NS
%
increase/decrease
2.95%↑
0.32%↓
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Insoluble Dietary
fibre [gms]
Mean ±SD
Pre intervention
15.18±5.78
15.52±6.23
0.24NS
Post intervention
14.50±5.76
15.20±5.69
0.51NS
Paired ‘t’ Test
6.74***
1.51NS
% decrease
4.47%↓
2.06%↓
Soluble Dietary
fibre [gms]
Mean ±SD
Pre intervention
5.28±1.67
5.58±1.76
0.73NS
Post intervention
5.20±1.62
5.07±1.85
0.30NS
Paired ‘t’ Test
2.23*
7.79***
% decrease
1.51%↓
9.13%↓
Total
Monounsaturates
[gms ]
Mean ±SD
Pre intervention
14.01±14.31
14.88±11.73
0.28NS
Post intervention
13.51±14.25
12.06±9.28
0.51NS
Paired ‘t’ Test
2.19*
3.85***
% decrease
3.56%↓
18.95%↓
Total
Polyunsaturates
[gms]
Mean ±SD
Pre intervention
14.61±15.57
19.41±15.27
1.31NS
Post intervention
14.40±15.56
18.78±14.89
1.21NS
Paired ‘t’ Test
1.59NS
3.51**
% decrease
1.43%↓
3.24%↓
Total Saturates
[gms]
Mean ±SD
Pre intervention
13.49±13.19
20.50±15.30
2.05*
Post intervention
12.75±12.82
16.34±12.08
1.21NS
Paired ‘t’ Test
2.27*
4.32***
% decrease
5.48%↓
20.29%↓
Note: Level of significance:* p- value <0.05;**p-value<0.01 ***p-value<0.001; NS = Not
Significant;
FOS supplementation and atherogenic profile
Total cholesterol and serum triglycerides decreased significantly in EG after supplementation
by 15.41% and 22.82% respectively. Low density lipoproteins and very low density
lipoproteins were also reduced significantly by 16.55% and 22.70%. HDL remained
unaffected in both the groups‘ (Table 6).
Table 6: Mean atherogenic profile of obese subjects before and after intervention
Parameters
Placebo Group
(n=32)
Experiment Group
(n=40)
Student ‘t’
Test
Total
Cholesterol
(mg/dl)
Mean ±SD
Pre Intervention
184.47±27.41
181.06±32.98
0.46NS
Post intervention
161.67±41.55
153.15±44.75
0.82NS
Paired ‘t’ Test
2.33*
3.25**
% decrease
12.35%↓
15.41%↓
Triglycerides
(mg/dl)
Mean ±SD
Pre Intervention
189.25±60.94
198.89±72.85
0.59NS
Post intervention
158.77±40.08
153.50±44.62
0.52NS
Paired ‘t’ Test
2.52*
4.02***
% decrease
16.10%↓
22.82%↓
HDL
(mg/dl)
Mean ±SD
Pre Intervention
36.59±7.75
36.57±7.56
0.01NS
Post intervention
36.43±7.82
34.80±6.49
0.96NS
Paired ‘t’ Test
0.07NS
1.12NS
% decrease
0.43%↓
4.84%↓
LDL
Pre Intervention
110.20±30.41
104.71±33.41
0.72NS
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Nidhi et al. World Journal of Pharmaceutical Research
(mg/dl)
Mean ±SD
Post intervention
92.91±38.15
87.38±41.53
0.72NS
Paired ‘t’ Test
1.85NS
2.13*
% decrease
15.68%↓
16.55%↓
VLDL
(mg/dl)
Mean ±SD
Pre Intervention
37.66±12.30
39.77±14.57
0.65NS
Post intervention
31.75±8.01
30.74±8.86
0.50NS
Paired ‘t’ Test
2.42*
4.00***
% decrease
15.69%↓
22.70%↓
TC/HDL
Ratio
Mean ±SD
Pre Intervention
5.23±1.32
5.18±1.51
0.15NS
Post intervention
4.57±1.47
4.54±1.56
0.08NS
Paired ‘t’ Test
1.70NS
1.84NS
% decrease
12.61%↓
12.35%↓
LDL/HDL
Ratio
Mean ±SD
Pre Intervention
3.17±1.27
3.06±1.38
0.35NS
Post intervention
2.67±1.30
2.63±1.41
0.13NS
Paired ‘t’ Test
1.39NS
1.42NS
% decrease
15.77%↓
14.05%↓
Note: Level of significance:* p- value <0.05;**p-value<0.01 ***p-value<0.001; NS = Not
Significant;
FOS supplementation and gut profile
FOS supplementation for 3 months significantly improved the gut health of EG with
significant increase (p<0.001) in the colonization of Bifidobacteria and lactobacillus by
9.62% and 28.47% respectively. A significant reduction (p< 0.001) was seen in clostridium
and bacteroides counts by 2.37% and 12.04% respectively (Table 7).
Table 7: Gut profile of obese subjects before and after intervention
Parameters
Placebo Group
(n=32)
log 10 Values
(CFU /g)
Mean±SD
Experiment Group
(n=40)
log 10 Values (CFU
/g)
Mean±SD
Student
‘t’ Test
Bifidobacteria
Pre Intervention
12.26±1.06
12.05±1.14
0.78NS
Post intervention
12.01±1.03
13.21±1.20
4.41***
Paired ‘t’ Test
0.81 NS
3.89***
%
decrease/increase
2.03%↓
9.62%↑
Lactobacillus
Pre Intervention
11.00±1.08
10.92±1.10
0.30NS
Post intervention
11.09±1.36
14.03±1.11
9.93***
Paired ‘t’ Test
0.25NS
12.93***
% increase
0.81%↑
28.47%↑
Clostridium
Pre Intervention
11.74±0.47
11.77±0.31
0.36NS
Post intervention
11.54±0.48
11.49±0.33
0.56NS
Paired ‘t’ Test
1.60NS
3.62***
% decrease
1.70%↓
2.37%↓
Bacteriodes
Pre Intervention
13.75±0.78
13.87±0.85
0.61NS
Post intervention
13.38±0.36
12.20±0.23
16.40***
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Nidhi et al. World Journal of Pharmaceutical Research
Paired ‘t’ Test
2.29***
11.71***
% decrease
2.69%↓
12.04%↓
NOTE: p < 0.001: ***; p<0.01:**; NS=Non-significant
DISCUSSION
The present study demonstrated significant reduction in systolic blood pressure by 2.15% in
EG. Various mechanisms have been hypothesized to explain the ability of prebiotics to
reduce the risk of hypertension. One of the possible mechanisms is via lowering of blood
lipid and cholesterol. The cholesterol lowering effect could reduce the stiffness of large
arteries and thus could potentially reduced blood pressure. [15] In another study, Lairon et al
(2005) [8] suggested that the reduction of obesity upon consumption of prebiotics such as
soluble fiber could prevent the elevation of blood pressure. Similar results was found in
present study where total cholesterol and serum triglycerides decreased significantly by
15.41% and 22.82% respectively and reduction in body weight (1.17%) and BMI (1.57%)
was also observed in EG after supplementation.
In present study total mean hunger scores increased by 8.93%, satiety scores for lunch
(10.46%) and dinner (11.05%) decreased significantly whereas total satiety scores decreased
by 7.74% (p<0.001) which indicates the reduced appetite and improved satiety signaling from
hypothalamus, resulting in their decreased food intake. Parallel to these results several studies
have shown that supplementation of FOS lead to increase in SCFA formation in the gut and
related beneficial effects on the host metabolism like increased GLP-1 incretin and resultant
improved satiety and reduced hunger. [3, 4]
Total cholesterol and serum triglycerides decreased significantly in EG after supplementation
by 15.41% and 22.82% respectively. Low density lipoproteins and very low density
lipoproteins were also reduced significantly by 16.55% and 22.70% after intervention in EG.
Similar results were found in a study conducted by causey et al (2000) [13], who observed a
significant reduction in serum TG in subjects with moderate hyperlipidemia given 18 g/d
inulin for 3 weeks. In a study conducted on fifty-eight middle aged subjects with moderately
raised blood lipid concentrations, subjects consumed 10 g/d of inulin in a powdered form
found no significant changes in total LDL or HDL cholesterol either of the groups over the 8
weeks intervention with reduced serum TG levels by 19% after intervention in the inulin
treated group [16], indicating that a higher dose of FOS supplementation for at least 3 months
period is required to bring about desirable changes in the LDL cholesterol whereas, lower
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levels of supplementation for a shorter duration may bring about improvements in serum TG
levels which is consistent with the findings of the present study. Although evidence suggests
that TG lowering effect of prebiotic occurs via a reduction in VLDL TG secretion from the
liver due to reduction in the activity of all lipogenic enzymes and in the fatty acid synthase,
via modification of lipogenic gene expression [6, 26], One of the proposed mechanisms is also
through the type of beneficial gut microbiota which gets colonized in the gut. A study
conducted on 40 institutionalized elderly subjects (>60 years) revealed significant 7.4%
reduction in mean total cholesterol values and increased counts of Bifidobacteria and
lactobacillus after supplementing probiotic curd for 6 weeks [24] was again analogous to
present study in which bifidobacteria and lactobacillus increased significantly (p<0.001)
increased by 9.62% and 28.47% respectively. Although, reduction in total cholesterol and
serum TG was also observed in PG an increased reduction by almost 3% and 7% was seen in
FOS supplementation group respectively.
The present study also confirms the fact that colonization of beneficial microflora such as
bifidobacteria and lactobacillus increased upon intake of FOS. A study conducted in mice
showed that FOS intake increased the counts of bifidobacteria. [17] Human trials also elicited
that oligosaccharides that are fermented by colonic bacteria enhanced the growth of
beneficial commensal organism like bifidobacteria and lactobacillus. [12] A study conducted
on 8 human subjects revealed that after eating a diet supplemented with 8 g/d chicory
oligofructose for 2 weeks, the number of bifidobacteria in feces had increased significantly
(p<0.01) [9]. Similarly in present study bifidobacteria and lactobacillus increased significantly
(p<0.001 by 9.62% and 28.47% respectively.
A significant reduction was seen in clostridium and bacteroides counts (at p-value < 0.001)
by 2.37% and 12.04% respectively. Similar to this finding Ley et al (2006) [18] observed that
fecal gut microbiota in 12 obese subjects participating in a weight-loss program by
consuming restricted diets for a year. Following weight loss, the proportion of Bacteroidetes
increased while the number of Firmicutes reciprocally decreased.
Very few data are available on effect of FOS on weight reduction and other anthropometric
indices till date. Findings of a study conducted by Sheth and Gupta (2014) [22] observed
significant weight loss and BMI reduction (1.06%) in Sixty five obese subjects working in an
industrial setting (BMI 25-31kg/m2, aged 25-55 yrs) supplemented with 12 g FOS for 12
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Nidhi et al. World Journal of Pharmaceutical Research
weeks were similar to the findings of present study where a significant (p<0.001) reduction in
weight (1.17%) and BMI (1.57%) was observed.
CONCLUSIONS
Twenty gram FOS supplementation for 3 months in obese individuals reduces atherogenic
parameters, anthropometric indices through the mechanism of improving the colonization of
beneficial gut microflora and hunger and satiety. Hence Fructooligosaccharide can be
recommended to obese individuals to improve the overall health and thereby reduce the risk
of cardiovascular diseases.
ACKNOWLEDGMENT
We acknowledge the financial support extended by the Department of Biotechnology (DBT),
Ministry of Science and Technology, New Delhi.
REFRENCES
1. Adlakha A, (1996), Population Trends: India. International Brief U.S. Department of
Commerce Economics and Statistics Administration, Bureau of Census. Available:
http://www.census.gov/ipc/prod/ib-9701.pdf.
2. Binod Kumar Patro & Kathiresan Jeyashree & Pramod Kumar Gupta, (2012),
Kuppuswamy‘s Socioeconomic Status Scale 2010—The Need for Periodic Revision
Indian J Pediatr, 2012; 79(3):395396.
3. Cani PD, Joly E, Horsmans Y and Delzenne NM. (2006). Oligofructose promotes satiety
in healthy human: a pilot study. European Journal of Clinical Nutrition, 2006; 60: 567
572.
4. Cani PD, Knauf C, Iglesias MA, Drucker DJ, Delzenne NM, Burcelin R. (2006).
Improvement of glucose tolerance and hepatic insulin sensitivity by oligofructose requires
a functional GLP-1 receptor. Diabetes, 2006; 55: 14841490.
5. Cani PD, Lecourt E, Dewulf EM, Sohet FM, Pachikian BD, Naslain D, Fabienne DB,
Neyrinck AM and Delzenne NM. (2009). Gut microbiota fermentation appetite and gut
peptide. Am.J.Clin Nutr. 1-8.
6. Delzenne NM and Kok N. (1998). Effect of non-digestible fermented carbohydrates on
hepatic fatty acid metabolism. Biochemical Society Transactions, 1998; 26:228-230.
7. Delzenne NM, Cani PD, (2011) ―Interaction between obesity and the gut microbiota:
relevance in nutrition‖, Annu Rev Nutr,2011; 31: 1531
www.wjpr.net Vol 4, Issue 1, 2015.
1108
Nidhi et al. World Journal of Pharmaceutical Research
8. Denis Lairon, Nathalie Arnault, Sandrine Bertrais, Richard Planells, Enora Clero, Serge
Hercberg, and Marie-Christine Boutron-Ruault, (2005), Dietary fiber intake and risk
factors for cardiovascular disease in French adults, Am J Clin Nutr, 2005; 82:118594.
9. Evelyne Menne, Nicolas Guggenbuhl and Marcel Roberfroid, (2000) Fn-type Chicory
Inulin Hydrolysate Has a Prebiotic Effect in Humans J. Nutr.2000; 130: 11971199.
10. Flamm G, Glinsmann W, Kritchevsky D, Prosky L and Roberfroid M, (2001). Inulin and
Oligofructose as Dietary Fiber: A Review of Evidence. Critical Reviews in Food Science
and Nutrition. 2001; 41(5): 353-362
11. Flegal KM, Carroll MD, Ogden CL and Curtin LR, (2010), Prevalence and Trends in
Obesity among US Adults, JAMA, 2010; 303(3):235-41
12. Giovanni M, Roberto G and Maurizio C. (2010). Obesity, Diabetes and gut microflora:
the hygiene hypothesis expanded. Diabetes Care. 2010; 33:2277-2284
13. Jennifer L. Causey, B.S. Joellen M. Feirtag, Daniel D. Gallaher, Bryan C. Tungland, B.S.
Joanne L. Slavin, (2000), February Effects of dietary inulin on serum lipids, blood
glucose and the gastrointestinal environment in hypercholesterolemic men, Nutrition
Research, 2000;20(2): 191201.
14. John H Cummings, MD, and Hans N Englyst, (1987) Fermentation in the human large
intestine and the available substrates Am I Clin Nuir, 1987; 45:1243-55.
15. Kathryn E. Ferrier, Michael H. Muhlmann, Jean-Philippe Baguet, James D. Cameron,
Garry L. Jennings, Anthony M. Dart, Bronwyn A. Kingwell, (2002) Intensive Cholesterol
Reduction Lowers Blood Pressure and Large Artery Stiffness in Isolated Systolic
Hypertension, journal of the American College of Cardiology, 2002;39: 6.
16. Kim G. Jackson, Gary R. J. Taylor, Anna M. Clohessy and Christine M. Williams,
(1999), The effect of the daily intake of inulin on fasting lipid, insulin and glucose
concentrations in middle-aged men and women, , UK British Journal of Nutrition, 1999;
82: 2330p.
17. Kok NN, Morgan LM, Williams CM, Roberfroid MB, Thissen JP, Delzenne NM. (1998).
Insulin, GLP-1, GIP and IGF-I as putativemediators of the hypolipidemic effect of
oligofructose in rats. J Nutr, 1998; 128: 10991103
18. Ley RE, Turnbaugh PJ, Klein S and Gordon JI (2006). Microbial ecology: Human gut
microbes associated with obesity. Nature, 2006; 444: 1022-1023
19. Lissner L, Sohlström A, Sundblom E, Solberg A (2010), Trends in overweight and
obesity in Swedish schoolchildren; 1999-2005: has the epidemic reached a plateau? Obes
Rev. Aug; 2010; 11(8):553-9
www.wjpr.net Vol 4, Issue 1, 2015.
1109
Nidhi et al. World Journal of Pharmaceutical Research
20. Macfarlane S, Macfarlane GT and Cummings JH. (2006). Review article: prebiotics in
the gastrointestinal tract. Aliment Pharmacol Ther, 2006; 24: 701714
21. Martine S Alles, Nicole M de Roos, J Carel Bakx, Eloy van de Lisdonk, Peter L Zock,
and Joseph GAJ Hautvast, (1999) Consumption of fructooligosaccharides does not
favorably affect blood glucose and serum lipid concentrations in patients with type 2
diabetes13, Am J Clin Nutr, 1999; 69:649.
22. Mini K. Sheth and Neha Gupta, (2014), metabolic effect of FOS (fructooligosaccharide)
in terms of gut incretin (glp-1) gut microflora and weight reduction in obese adults,
IJABT, vol.5 issue 3, 256-254p.
23. Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. (2010), Prevalence of high
body mass index in US children and adolescents, 2007-2008 JAMA; 303(3):242-9
24. Parnami S and Sheth M. (2011). Indian Fermented Milk (Dahi) Fortified with Probiotic
Bacteria and Inulin Improves Serum Lipid, Blood Glucose Levels and Gut Microflora.
Journal of the Indian Academy of Geriatrics. 2011; 7:1-5.
25. Patrice D. Cani, Audrey M. Neyrinck, Nicole Maton, and Nathalie M. Delzenne, (2005),
Oligofructose Promotes Satiety in Rats Fed a High-Fat Diet: Involvement of Glucagon-
Like Peptide-1 OBESITY RESEARCH Vol. 13, No. 6, p1000-1007p
26. Rebecca Wall, Paul RR, Fergus S, Eamonn M Q, Timothy GD, John F, Cryan (2012).
Influence of gut microbiota and manipulation by probiotics and prebiotics on host tissue
fat: Potential clinical implications. Lipid Technology, 2012; 24(10): 227-229.
27. WHO, ―Cardiovascular Disease,‖ Fact sheet no. 317, WHO, Geneva, Switzerland, 2009,
http://www.who.int/mediacentre/ factsheets/fs317/en/print.html.
... 2 of 16 its phenolic compounds [14], immunity improvement in preschool children [15], diabetes management in the elderly [16,17], weight management, and obesity prevention in overweight adults [17][18][19][20], all of which have been reported to be associated with the content of fructooligosaccharides (FOS) and inulins. In addition, yacon has potential markets in the development of new food products and new dietotherapy applications [4,5,21]. ...
... Due to its non-digestible property, FOS have a low glycemic impact. A randomized, doubleblind trial in obese adults (body mass index (BMI) 25-30 kg m -2 ) reported that the daily intake of 20 g of FOS (n = 40) for three months resulted in a significant reduction of atherogenesis and body weight, compared with placebo control (n = 32) [18]. Due to its non-digestible property, FOS have a low glycemic impact. ...
... Due to its non-digestible property, FOS have a low glycemic impact. A randomized, double-blind trial in obese adults (body mass index (BMI) 25-30 kg m -2 ) reported that the daily intake of 20 g of FOS (n = 40) for three months resulted in a significant reduction of atherogenesis and body weight, compared with placebo control (n = 32) [18]. ...
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