Review articleRole of guar fiber in improving digestive health and function
Graphical abstract
Introduction
Digestive health plays a direct role in one's quality of life and daily performance. Digestive problems, such as irregular bowel movements, gas, bloating, and abdominal pain, may impair daily life. Irregular bowel movements such as constipation (less than 3 bowel movements per week), diarrhea (more than three bowel movements per day), irritable bowel syndrome (IBS; either constipation, diarrhea, or both associated with abdominal pain/spam), and inflammatory bowel disease (IBD) are the common morbidities associated with digestive health. Globally, >12% of the population suffers with constipation, whereas 11% suffer with IBS [1]. The World Health Organization (WHO) reported nearly 1.7 billion cases of diarrhea, of which 760 000 were in children who died annually worldwide [2]. Another report stated that IBD causes 50 000 deaths annually [3].
Although medications are sometimes indispensable for the cure of these morbidities, particularly if chronic, medical experts and dietitians often urge the use of dietary fibers for prevention and maintenance of proper digestive health [4]. Dietary fibers are available in both soluble and insoluble forms, but none are the same or equal in exhibiting their benefits due to differences in structure and function [5], [6]. Insoluble fibers have mostly viscous and bulking properties that are effective in easing constipation, but they are limited in their effectiveness against other bowel morbidities [7]. Additionally, their bulking effects may cause discomfort and aggravate complications associated with bowel diseases [8], [9], [10], [11]. Soluble fibers are fermentable to exhibit prebiotic effects by which they synthesize various amounts of short-chain fatty acids (SCFA), which are closely associated with gut health and many other physiological health benefits [12]. However, the chemical structure of the dietary fiber, their transit time in gut, the degree of fermentation, and corresponding influence on the growth of probiotics and release of SCFA greatly affects the performance of different soluble fibers [13], [14].
Previous systematic reviews suggest that dietary fibers may be effective for constipation [15] and IBS [16], but they lack explanations on the efficacy of any specific dietary fiber. Most soluble fibers are helpful in the prevention or reduction of constipation but seem to have little effect on diarrhea and IBS. In this context, guar fiber, popularly known as partially hydrolyzed guar gum (PHGG; Sunfiber, Taiyo Kagaku Co Ltd, Yokkaichi, Japan), emerged as a potential soluble fiber offering prevention and cure against all bowel morbidities, including constipation, diarrhea, IBS, and IBD. Previously, guar fiber earned Grade A recommendations from a fiber consensus group for having “Level 1 evidence” (randomized trial, meta-analysis with low risk for error) in clinical use against diarrhea and IBS and in enteral nutrition (EN) [17]. Recently, Health Canada approved guar fiber for use in childhood constipation and IBS. Also, it was approved for the alleviation of constipation and diarrhea in Japan. Therefore, the aim of this review was to summarize the clinical evidence regarding the physiological effects of soluble fibers on digestive health, with specific reference to guar fiber.
Section snippets
Guar gum versus guar fiber
Guar fiber is one form of guar gum having 100% guar galactomannans derived from the endosperm of Cyamopsis tetragonolobus L. (guar plant) seeds. The guar galactomannans are composed of mannose and galactose approximately in a 2:1 ratio. Guar gum is typically composed of very long chain galactomannans (50–8000 × 103 units) and have high molecular weight (200–300 kDa). It forms very high viscous gel (>2000 cps with 1% of guar gum) when dissolved in liquids. Therefore, it is mostly used as a
Reduction of constipation
Constipation varies by definition but essentially occurs when there is no fecal output for 3 to 4 d. Constipation has symptoms of hard feces causing difficulty in output and delayed transit time [47]. Other symptoms associated with it are painful defecation, hard or dry stool, abnormally small stool, or a feeling of incomplete rectal evacuation. Chronic constipation can lead to more serious complications, such as bowel perforations, fecal impaction, and other bowel diseases. It is important to
Reduction of diarrhea
In humans, dietary fibers are mainly fermented in the large intestine by intestinal microflora, and in this process SCFAs are produced. SCFAs are absorbed in the colon, stimulating sodium transport in several species, including humans [61], [62]. This effect may be particularly important in acute diarrheal diseases in the colon and may cause colonic dysfunction [63]. SCFA levels in the colon, therefore, may influence the clinical course of acute diarrheal conditions. Fiber added to tube-feeding
Effects on IBS
IBS is the most common disease diagnosed by gastroenterologists, with a prevalence rate of 3% to 25% in various countries. IBS is not a disease, but a functional disorder characterized by the symptoms of abdominal pain, bloating, flatulence, and bowel dysfunction. IBS could be varying with type: diarrhea-predominant (IBS-D), constipation-predominant (IBS-D), and alternating diarrhea–constipation (IBS-A). IBS-D is more common in men (48%) and IBS-C and IBS-A in women (39% and 48%, respectively)
Prebiotic effect of guar fiber and digestive health
The gut microbiome has emerged as a crucial regulator of digestive health [98], [99]. It has been found that the composition of microbiota differs between healthy and diseased individuals, wherein the ratio of good bacteria often is compromised in diseased cases [100], [101], [102]. The good microbiome consist mainly of Lactobacillus and Bifidobacterium spp and are effective against digestive disorders such as constipation [103], [104], [105], diarrhea [106], [107], [108], [109], and IBS [110].
Conclusions
Guar fiber, commonly known as partially hydrolyzed guar gum, is a non-viscous soluble dietary fiber that is effective for the treatment of constipation, diarrhea, and IBS. Fourteen clinical studies with 631 participants suggest improvement of constipation with guar fiber. Eight of 14 studies evaluated a dose <10 g/d (3.5–10 g). Therefore, the effective dose of guar fiber for constipation could be considered <10 g/d. In the case of diarrhea, seven clinical studies with a total of 465
References (119)
- et al.
Position of the American dietetic association: health implications of dietary fiber
J Am Dietetic Assoc
(2002) - et al.
Effect of oligosaccharides and fiber substitutes on short-chain fatty acid production by human fecal microflora
Anaerobe
(2000) - et al.
Developing a quantitative approach for determining the in vitro prebiotic potential of dietary oligosaccharides
FEMS Micobiol Letters
(2004) - et al.
Consensus recommendations on the effects and benefits of fibre in clinical practice
Clin Nut
(2004) - et al.
Effects of guar gum in male subjects with hypercholesterolemia
Am Soc Clin Nutr
(1984) - et al.
Guar gum improves insulin sensitivity, blood lipids, blood pressure, and fibrinolysis in healthy men
Am J Clin Nutr
(1992) - et al.
Effects of solid and liquid guar gum on plasma cholesterol and triglyceride concentrations in moderate hypercholesterolemia
Am J Cardiol
(1988) - et al.
Metabolic studies on the hypolipidaemic effects of guar gum
Atherosclerosis
(1990) - et al.
Long-term effects of guar gum in subjects with non-insulin-dependent diabetes mellitus
Am J Clin Nutr
(1993) - et al.
Dietary guar gum effects on postprandial blood glucose, insulin and hydroxyproline in humans
J Nutr
(1989)
Partially hydrolyzed guar gum: clinical nutrition uses
Nutrition
Effect of partially hydrolyzed guar gum on fecal output in human volunteers
Nutr Res
Partially hydrolyzed guar gum-regulates colonic inflammatory response in dextran sulfate sodium-induced colitis in mice
J Nut Biochem
Dietary fiber
J Lipid Res
Effects of a partially hydrolyzed guar gum on intestinal absorption of carbohydrate, protein and fat: a double-blind controlled study in volunteers
Clin Nutr
Partially hydrolysed guar gum intake ameliorates constipation, improves nutritional status and reduces indoxylsulfuric acid in dialysis patients
Kidney Res Clin Practice
Effect of supplements of partially hydrolyzed guar gum on the occurrence of constipation and use of laxative agents
Res Prof Briefs
Absorption of short-chain fatty acids by the colon
Gastroenterology
Faecal fermentation of partially hydrolyzed guar gum
J Funct Foods
Soluble fiber reduces the incidence of diarrhea in septic patients receiving total enteral nutrition: a prospective, double-blind, randomized and controlled trial
Clin Nutr
Control of diarrhea by fiber-enriched diet in ICU patients on enteral nutrition: a prospective randomized controlled trial
Clin Nutr
The beneficial effects of PHGG in enteral nutrition in medical and surgical patients
Clin Nutr
Usefulness of soluble dietary fiber for the treatment of diarrhea during enteral nutrition in elderly patients
Nutrition
Effect of liquid diets with or without partially hydrolysed guar gum on intestinal microflora and functions of rats
Nut Res
Role of partially hydrolyzed guar gum in the treatment of irritable bowel syndrome
Nutrition
The mycobiome: role in health and disease, and as a potential probiotic target in gastrointestinal disease
Dig Liver Dis
The epidemiology of irritable bowel syndrome
Clin Epidemiol
Global, regional and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the global burden of disease study 2013
Lance
Structural and physical properties of dietary fibres and consequences of processing on human physiology
Food Res Int
Dietary fiber, inulin and oligofructose: a review comparing their physiological effects
Crit Rev Food Sci Nut
Systemic review: the role of different types of fibre in the treatment of irritable bowel syndrome
Aliment Pharamacol Ther
Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine and American Society For Patental and Enteral Nutrition
Crit Care Med
Intestinal obstruction from cecal bezoar; a complication of fiber-containing tube feedings
Nutrition
Mechanism, prevention and management of diarrhea in enteral nutrition
Cur Opi Gastroenterol
The role of fiber in the treatment of irritable bowel syndrome: therapeutic recommendations
J Clin Gastroenterol
Colonic health: fermentation and short chain fatty acids
J Clin Gastroenterol
Effect of dietary fiber on constipation: a meta-analysis
World J Gastroenterol
The effect of fiber supplementation on the irritable bowel syndrome: a systematic review and meta-analysis
Am J Gastroenterol
Cholesterol-lowering effects of guar gum: changes in bile acid and intestinal reabsorption
Lipids
Long term effects of guar gum on metabolic control, serum cholesterol and blood pressure levels in type 2 (non-insulin dependent) diabetic patients with high blood pressure
Ann Clin Res
The mechanism of action of guar gum in improving glucose tolerance in man
Clin Sci
Comparisons of viscous properties of oat and guar gum and the effects of these and oat bran on glycemic index
J Aric Food Chem
Chemical and physical properties, safety and application of partially hydrolyzed guar gum as dietary fiber
J Clin Biochem Nutr
Partially hydrolyzed guar gum as source of fiber
Cereal Foods World
Evaluation of the health aspects of using partially hydrolysed guar gum as a food ingredient
Determination of the GRAS status of partially hydrolyzed guar gum for addition to enteral feeding products and conventional foods
Safety assessment and caloric value of partially hydrolysed guar gum
J Agr Food Chem
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TPR is employed by the company that produces guar fiber. However, this scientific review is written based on the scientific studies done elsewhere. The authors have no conflicts of interest to declare.