Constipation is an ailment encountered often in elderly people. A study was initiated to test the effects of lactose or inulin on the bowel habits of constipated elderly patients and to correlate these effects with several variables measured in feces such as microflora composition, concentration of lactate and short-chain fatty acids (SCFAs), pH, and the activities of beta-glucosidase and beta-glucuronidase, Groups of 15 and 10 patients received lactose and inulin, respectively, for a period of 19 d. The dose, 20 g/d from days 1 to 8, was gradually increased to 40 g/d from days 9 to 11 and was kept at this dose from days 12 to 19. There was considerable interindividual variations with this kind of dietary intervention. Inulin increased bifidobacteria significantly from 7.9 to 9.2 log10/g dry feces, but decreased enterococci in number and enterobacteria in frequency. In individuals consuming lactose, a noticeable increase in fecal counts of enterococci and a decrease in lactobacilli and clostridia was detected. Total bacterial counts remained unchanged. No changes in the concentrations of fecal SCFAs and lactate were observed. SCFAs showed a slight trend toward higher molar ratios of acetate to butyrate in response to the intake of lactose or inulin. The fecal pH and the beta-glucosidase and beta-glucuronidase activities were not influenced by sugar intake. Inulin showed a better laxative effect than lactose and reduced functional constipation with only mild discomfort.

OBJECTIVE: To investigate the long-term effects of changes in dietary carbohydrateafat ratio and simple vs complex carbohydrates. DESIGN: Randomized controlled multicentre trial (CARMEN), in which subjects were allocated for 6 months either to a seasonal control group (no intervention) or to one of three experimental groups: a control diet group (dietary intervention typical of the average national intake); a low-fat high simple carbohydrate group; or a low-fat high complex carbohydrate group. SUBJECTS: Three hundred and ninety eight moderately obese adults. MEASUREMENTS: The change in body weight was the primary outcome; changes in body composition and blood lipids were secondary outcomes. RESULTS: Body weight loss in the low-fat high simple carbohydrate and low-fat high complex carbohydrate groups was 0.9 kg (P`0.05) and 1.8 kg (P`0.001), while the control diet and seasonal control groups gained weight (0.8 and 0.1 kg, NS). Fat mass changed by 7 1.3 kg (P`0.01), 7 1.8 kg (P`0.001) and 0.6 kg (NS) in the low-fat high simple carbohydrate, low-fat high complex carbohydrate and control diet groups, respectively. Changes in blood lipids did not differ signi®cantly between the dietary treatment groups. CONCLUSION: Our ®ndings suggest that reduction of fat intake results in a modest but signi®cant reduction in body weight and body fatness. The concomitant increase in either simple or complex carbohydrates did not indicate signi®cant differences in weight change. No adverse effects on blood lipids were observed. These ®ndings underline the importance of this dietary change and its potential impact on the public health implications of obesity.

The results indicate a beneficial effect on gastrointestinal symptoms of patients with chronic constipation. The administration of probiotic foodstuffs may be recommended as an adjunctive therapy of chronic constipation.

Objective: Arabinoxylan (AX) consumption is associated with metabolic improvement during diabetes and with modulation of ghrelin, an orexigenic gut hormone. The effect of AX consumption on ghrelin secretion in disturbed metabolic states is unknown. Therefore, we investigated the postprandial responses to AX consumption of serum glucose, insulin and triglycerides and plasma total and acylated ghrelin in subjects with impaired glucose tolerance (IGT). Design: Randomized, single-blind, controlled, crossover intervention trial. Subjects: Seven female and four male adults with IGT, aged 55.5 years, and body mass index (BMI) 30.1 kg/m 2 . Intervention: Subjects received either placebo or 15 g AX supplement for 6 weeks with a 6-week washout period in-between. Main outcome measurements: Postprandial responses of serum glucose, insulin and triglycerides, and plasma total and acylated ghrelin after a liquid meal challenge test (LMCT) measured at the beginning and at the end of the dietary intervention at À20, À5, 0, 15, 30, 45, 60, 90, 120, 150, 180, 210 and 240 min. Results: After LMCT, AX consumption resulted in lower postprandial responses in serum glucose, insulin and triglycerides (Po0.05). Compared to placebo, total plasma ghrelin was also reduced by 4278 pg/ml (Po0.001) after AX consumption with no difference in plasma acylated ghrelin. Conclusion: AX consumption improved postprandial metabolic responses after an LMCT in subjects with IGT and reduced total ghrelin response. However, acylated ghrelin responses were unchanged, suggesting that the acylated ghrelin-mediated orexigenic regulation is not improved as only total plasma ghrelin decreased. Sponsorship: Federal Ministry of Education and Research Germany (PTJ-BIO/0313042C).

Objectives: To assess body image perception and satisfaction with current body image across the EU and to explore the influence of sociodemographic variables, body-weight change and strategies for losing weight on body image perception. Design: A cross-sectional study in which quota-controlled, nationally representative samples of approximately 1000 adults from each country completed a face-to-face interview-assisted questionnaire. Setting: The survey was conducted in the 15 member states of the EU between March and April 1997. Subjects: The questionnaire was completed by 15 239 subjects (aged 15 years and upwards). Data were weighted by population size for each country and by sex, age and regional distribution within each member state. Results: Just 39% of respondents in the EU were satisfied with their weight and these were more likely to be male (46%) rather than female (31%). Across the EU 29% of Finnish subjects were content with their weight compared with 47% in Belgium and 48% in Luxembourg. The highest percentage of subjects who were content with their body weight was among females who were underweight (58%) and males who were normal weight (66%). A further 20% of underweight females wished to be lighter compared to only 5% of males. Diet was the most frequently selected method for losing weight especially among females wishing to be considerably lighter (27%) while males were as likely to use exercise as diet as a strategy to lose weight. Conclusions: Geographical and sociodemographical influences on body image perception are evident across the EU. There were clear gender differences in the desire to be thinner with a high proportion of females who were underweight being content to be so.