Effects of dietary fibers or probiotics on functional constipation symptoms and roles of gut microbiota: a double-blinded randomized placebo trial
Hao Lai,
Yunfeng Li,
Yafang He,
Fangyao Chen,
Baibing Mi,
Junqi Li,
Jiawen Xie,
Guoqing Ma,
Jinzhao Yang,
Kun Xu,
Xia Liao,
Yan Yin,
Junrong Liang,
Liyun Kong,
Xinyan Wang,
Zhongxia Li,
Yuan Shen,
Shaonong Dang,
Lei Zhang,
Qian Wu,
Lingxia Zeng,
Lin Shi,
Xuguang Zhang,
Tian Tian,
Xin Liu
Affiliations
Hao Lai
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
Yunfeng Li
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
Yafang He
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
Fangyao Chen
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
Baibing Mi
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
Junqi Li
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
Jiawen Xie
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
Guoqing Ma
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
Jinzhao Yang
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
Kun Xu
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
Xia Liao
Department of Nutrition, The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
Yan Yin
Department of Gastroenterology, The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
Junrong Liang
Department of Gastroenterology, Tangdu Hospital, Fourth Military Medical University, Xi’an, China
Liyun Kong
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
Xinyan Wang
BYHEALTH Institute of Nutrition & Health, Guangzhou, China
Zhongxia Li
BYHEALTH Institute of Nutrition & Health, Guangzhou, China
Yuan Shen
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
Shaonong Dang
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
Lei Zhang
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
Qian Wu
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
Lingxia Zeng
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
Lin Shi
School of Food Engineering and Nutritional Science, Shaanxi Normal University, Xi’an, China
Xuguang Zhang
BYHEALTH Institute of Nutrition & Health, Guangzhou, China
Tian Tian
Department of Nutrition, Xi’an Daxing Hospital, Xi’an, China
Xin Liu
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Global Health Institute, Health Science Center, Xi’an Jiaotong University, Xi’an, China
ABSTRACTDietary fibers/probiotics may relieve constipation via optimizing gut microbiome, yet with limited trial-based evidences. We aimed to evaluate the effects of formulas with dietary fibers or probiotics on functional constipation symptoms, and to identify modulations of gut microbiota of relevance. We conducted a 4-week double-blinded randomized placebo-controlled trial in 250 adults with functional constipation. Intervention: A: polydextrose; B: psyllium husk; C: wheat bran + psyllium husk; D: Bifidobacterium animalis subsp. lactis HN019 + Lacticaseibacillus rhamnosus HN001; Placebo: maltodextrin. Oligosaccharides were also included in group A to D. 16S rRNA sequencing was used to assess the gut microbiota at weeks 0, 2, and 4. A total of 242 participants completed the study. No time-by-group effect was observed for bowel movement frequency (BMF), Bristol stool scale score (BSS), and degree of defecation straining (DDS), while BSS showed mean increases of 0.95–1.05 in group A to D (all P < 0.05), but not significantly changed in placebo (P = 0.170), and 4-week change of BSS showed similarly superior effects of the interventions as compared placebo. Group D showed a marginal reduction in plasma 5-hydroxytryptamine. Group A resulted in a higher Bifidobacterium abundance than placebo at week 2 and 4. Fourteen genera showed intervention-specific increasing or decreasing trends continuously, among which Anaerostipes showed increasing trends in groups B and C, associated with BMF increase. Random forest models identified specific baseline microbial genera panels predicting intervention responders. In conclusion, we found that the dietary fibers or probiotics may relieve hard stool, with intervention-specific changes in gut microbiota relevant to constipation relief. Baseline gut microbiota may predispose the intervention responsiveness. ClincialTrials.gov number, NCT04667884.
