All Fiber is Not Fiber

Rahman, Shahrose; Trone, Kristin; Kelly, Caleb; Stroud, Andrea; Martindale, Robert G.

doi:10.1007/s11894-022-00858-1

Cited by 6 publications

(10 citation statements)

References 134 publications

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“…The gases produced are hydrogen in all patients, and methane in a smaller percentage of the population. Butyrate is associated with the least amount of hydrogen and methane produced, whereas acetate correlates with the greatest concentration of gas production 23 . The rate of fermentation in the subsequent production of SCFAs is variable across different types of fiber provided.…”

Section: Tolerance To the Use Of Fiber In The Patient Who Is Critical...mentioning

confidence: 99%

“…Butyrate is associated with the least amount of hydrogen and methane produced, whereas acetate correlates with the greatest concentration of gas production. 23 The rate of fermentation in the subsequent production of SCFAs is variable across different types of fiber provided. Four fibers typically used in EN formulations include inulin, oligofructose, starch, and pectin.…”

Section: Tolerance To the Use Of Fiber In The Patient Who Is Critical...mentioning

confidence: 99%

“…Of these, the ingestion and fermentation of inulin and oligofructose results in enough gas production to qualify these agents as fermentable oligosaccharrides, disaccharrides, monosaccharrides, and polyols (FODMAP) carbohydrates. 23 Tolerance to the provision of dietary fiber relates to the type of fiber ingested, its fermentation rate, the dose, and the patient's individual response. 23 Oligosaccharide and inulin are only tolerated up to a dose of 10-15 g/day.…”

Section: Tolerance To the Use Of Fiber In The Patient Who Is Critical...mentioning

confidence: 99%

“…23 Tolerance to the provision of dietary fiber relates to the type of fiber ingested, its fermentation rate, the dose, and the patient's individual response. 23 Oligosaccharide and inulin are only tolerated up to a dose of 10-15 g/day. Partially hydrolyzed guar gum and acacia gum are tolerated at higher doses from 20-40 g/day.…”

Section: Tolerance To the Use Of Fiber In The Patient Who Is Critical...mentioning

confidence: 99%

“…Four fibers typically used in EN formulations include inulin, oligofructose, starch, and pectin. Of these, the ingestion and fermentation of inulin and oligofructose results in enough gas production to qualify these agents as fermentable oligosaccharrides, disaccharrides, monosaccharrides, and polyols (FODMAP) carbohydrates 23 …”

Section: Tolerance To the Use Of Fiber In The Patient Who Is Critical...mentioning

confidence: 99%

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The importance of providing dietary fiber in medical and surgical critical care

McClave,

Omer,

Eisa

et al. 2023

Nut in Clin Prac

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The early provision of soluble/insoluble fiber to the patient who is critically ill has been controversial in the past. Especially in the setting of hemodynamic instability, dysmotility, or impaired gastrointestinal transit, fear of inspissation of formula with precipitation of nonocclusive mesenteric ischemia (NOMI)/nonocclusive bowel necrosis (NOBN) limited its utilization by medical and surgical intensivists. The incidence of NOMI/NOBN has been estimated at 0.2%–0.3% for all intensive care unit (ICU) patients receiving enteral nutrition (EN), and the occurrence of inspissated formula is even less. The science supporting a benefit from providing fiber has recently increased exponentially. The fermentation of soluble fibers leading to the production of short chain fatty acids supports gut barrier function, modulates immune responses, and promotes refaunation of commensal organisms. The “butyrate effect” refers to local (gastrointestinal tract) and systemic anti‐inflammatory responses mediated by the M2 polarization of macrophages, inhibition of histone deacetylase, and stimulation of ubiquitous G protein receptors. Both soluble and insoluble fiber have been shown to promote intestinal motility, reduce feeding intolerance, and shorten hospital length of stay. The benefit of providing dietary fiber early upon admission to the ICU outweighs its minimal associated risk. The point at which the intensivist determines that is safe to initiate EN, both soluble and insoluble fiber should be included in the enteral formulation.

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Section: Tolerance To the Use Of Fiber In The Patient Who Is Critical...mentioning

confidence: 99%

Section: Tolerance To the Use Of Fiber In The Patient Who Is Critical...mentioning

confidence: 99%

Section: Tolerance To the Use Of Fiber In The Patient Who Is Critical...mentioning

confidence: 99%

Section: Tolerance To the Use Of Fiber In The Patient Who Is Critical...mentioning

confidence: 99%

Section: Tolerance To the Use Of Fiber In The Patient Who Is Critical...mentioning

confidence: 99%

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The importance of providing dietary fiber in medical and surgical critical care

McClave,

Omer,

Eisa

et al. 2023

Nut in Clin Prac

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Epigenetic effects of short-chain fatty acids from the large intestine on host cells

Stein

Riber

2023

microLife

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Adult humans harbor at least as many microbial cells as eukaryotic ones. The largest compartment of this diverse microbial population, the gut microbiota, encompasses the collection of bacteria, archaea, viruses, and eukaryotic organisms that populate the gastrointestinal tract, and represents a complex and dynamic ecosystem that has been increasingly implicated in health and disease. The gut microbiota carries ∼100-to-150-times more genes than the human genome and is intimately involved in development, homeostasis, and disease. Of the several microbial metabolites that have been studied, short-chain fatty acids emerge as a group of molecules that shape gene expression in several types of eukaryotic cells by multiple mechanisms, which include changing histone acetylation, inducing DNA methylation, or through microRNA-mediated signaling. Butyric acid, one of the most extensively studied short-chain fatty acids, reaches higher concentrations in the colonic lumen, where it can be used as fuel by healthy colonocytes, than in the colonic crypts, where stem cells reside. In colon cancer cells, which preferentially metabolize glucose by glycolysis, butyric acid induces epigenetic modifications, leading to cell cycle progression inhibition and apoptosis. The lower butyrate concentration in the colonic crypts epigenetically inhibits negative regulators of the cell cycle, pointing towards the importance of the crypts in providing a protective niche for stem cells. A better understanding of the interface between the gut microbiota metabolites and epigenetic changes in eukaryotic cells promises to unravel in more detail processes that occur physiologically and, as part of disease, help develop novel biomarkers, and identify new therapeutic modalities.

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Gut microbial metabolites and its impact on human health

Rahman¹

2023

aog

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All Fiber is Not Fiber

Cited by 6 publications

References 134 publications

The importance of providing dietary fiber in medical and surgical critical care

The importance of providing dietary fiber in medical and surgical critical care

Epigenetic effects of short-chain fatty acids from the large intestine on host cells

Gut microbial metabolites and its impact on human health

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