Long-term supplementation of isomalto-oligosaccharides improved colonic microflora profile, bowel function, and blood cholesterol levels in constipated elderly people—A placebo-controlled, diet-controlled trial

Yen, Chi-Hua; Tseng, Yun-Hua; Kuo, Yi-Wen; Lee, Meng-Chih; Chen, Hsiao-Ling

doi:10.1016/j.nut.2010.05.012

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Volume 27, Issue 4 , Pages 445-450, April 2011

Long-term supplementation of isomalto-oligosaccharides improved colonic microflora profile, bowel function, and blood cholesterol levels in constipated elderly people—A placebo-controlled, diet-controlled trial

Chi-Hua Yen, M.D., Ph.D.
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Center for Education and Research on Geriatrics and Gerontology, Chung Shan Medical University, Taichung, Taiwan
Yun-Hua Tseng, M.S., R.D.
- School of Nutrition, Chung Shan Medical University, Taichung, Taiwan
Yi-Wen Kuo, M.S.
- School of Nutrition, Chung Shan Medical University, Taichung, Taiwan
Meng-Chih Lee, M.D., Ph.D.
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Center for Education and Research on Geriatrics and Gerontology, Chung Shan Medical University, Taichung, Taiwan
Hsiao-Ling Chen, Ph.D., R.D.
- Center for Education and Research on Geriatrics and Gerontology, Chung Shan Medical University, Taichung, Taiwan
- School of Nutrition, Chung Shan Medical University, Taichung, Taiwan
- Department of Nutrition, Chung Shan Medical University Hospital, Taichung, Taiwan
- Corresponding author. Tel.: +886-4-24730022, ext. 11745; fax: +886-4-23248175.

Received 13 March 2010; accepted 24 May 2010. published online 12 July 2010.

Abstract

Objectives

The main purpose of this study was to determine the long-term (8 wk) effects of isomalto-oligosaccharide (IO) supplementation on fecal microflora, bowel function, and biochemical indicators of nutritional status in constipated elderly subjects. We also assessed whether the effect of IO was sustained after its withdrawal.

Methods

Thirteen (five male) constipated subjects (age 82.5 ± 1.9 y) participated in this diet-controlled study that consisted of a 4-wk placebo period, two 4-wk IO (10 g/d) -supplementation periods (IO1 and IO2), and a 4-wk post period. Fasting blood was collected on the last day of each period. Stools were collected during the last week of each period. The bowel function was monitored throughout the study.

Results

The fecal bifidobacteria, lactobacilli, and bacteroides counts (log counts/g wet feces) significantly increased and clostridia count decreased at the end of the IO1 period. The effects were more pronounced in the IO2 period and then returned to the levels of the IO1 period at the end of the post period. Daily fecal excretion of acetate and propionate increased along with IO supplementation. The frequency of spontaneous defecation increased in the IO2 period, and wet fecal mass increased by 24% in both the IO1 and the IO2 periods. The effects of IO on bowel function diminished in the post period. Plasma total and low-density lipoprotein cholesterol levels were lower with 4- or 8-wk IO supplementation as compared with the placebo and post period, respectively.

Conclusions

IO supplementation into a low-fiber diet improved colonic microflora profile and bowel movement in a time-dependent fashion in constipated elderly subjects. These beneficial effects decreased after discontinuation of the supplements.

Keywords: Isomalto-oligosaccharide, Bifidobacteria, Clostridium perfringens, Cholesterol, Bowel function, Elderly