Effect of fruit intake on functional constipation: A systematic review and meta-analysis of randomized and crossover studies

Abstract

Functional constipation (FC) is commonly treated with fruits whose efficacy remains unclear. We conducted a meta-analysis of fruit intervention for FC and provided evidence-based recommendations. We searched seven databases from inception to July 2022. All randomized and crossover studies on the effectiveness of fruits on FC were included. We conducted sensitivity and subgroup analysis. A total of 11 studies were included in this review. Four trials showed that kiwifruits have significantly increased stool frequency (MD = 0.26, 95% CI (0.22, 0.30), P < 0.0001, I2 = 0%) than palm date or orange juice in the fixed-effect meta-analysis. Three high-quality studies suggested that kiwifruits have a better effect than ficus carica paste on the symptom of the FC assessed by the Bristol stool scale in the fixed-effect meta-analysis [MD = 0.39, 95% CI (0.11, 0.66), P < 0.05, I2 = 27%]. Besides, five trials showed that fruits can increase the amount of Lactobacillus acidophilus [MD = 0.82, 95% CI (0.25, 1.39), P < 0.05, I2 = 52%], analyzed with the random-effect model. Subgroup meta-analysis based on the types of fruits suggested that fruits including pome fruit, citrus fruit, and berries have increased the effect of Bifidobacterium t more than the stone fruits in the random effect meta-analysis [MD = 0.51, 95% CI (0.23, 0.79), P < 0.05, I2 = 84%]. Totally, fruit intake may have potential symptom alleviation on the FC as evidence shows that they can affect stool consistency, stool frequency, and gut microbiota. Further large-scale studies are needed to gain more confident conclusions concerning the association between fruit intake and FC in the future.

Constipation: A Pristine Universal Pediatric Health Delinquent

“…The lack of fiber is a forefront factor among the well-known risk factors of childhood constipation [57]. The association of fiber in food and constipation has been established by several studies [58][59][60][61][62]. Dietary fibers are a non-digestible form (resistant toward human intestinal enzyme) of composite saccharides, basically cellulose and noncellulosic polysaccharides, for example, hemicellulose, pectic constituents, mucilage, gums, and a noncarbohydrate ingredient lignin.…”

Dietary Fibers in Healthy Children and in Pediatric Gastrointestinal Disorders: A Practical Guide

“…Moreover, three high-quality studies found that kiwifruits have a better effect on stool symptoms and consistency (assessed by the Bristol stool scale) than Ficus carica paste [MD = 0.39, 95% CI (0.11, 0.66), p < 0.05, I 2 = 27%]. Analyzing the prebiotic effects, five trials showed that fruits increased the amount of Lactobacillus acidophilus [MD = 0.82, 95% CI (0.25, 1.39), p < 0.05, I 2 = 52%], and that pome fruits, citrus fruits, and berries increased bifidobacteria more than stone fruits [MD = 0.51, 95% CI (0.23, 0.79), p < 0.05, I 2 = 84%] [55]. No similar data are currently available for children.…”

El consumo de dos kiwis diarios podría mejorar el hábito intestinal en personas con estreñimiento crónico

“…2022 Oct 6;9:1018502 Objetivo. Evaluar el efecto del consumo de ciertas frutas en el tratamiento de la constipación funcional 10 .…”

“…Por último, la revisión de Huo et al 10 incluyó ensayos aleatorizados paralelos y cruzados, con la particularidad de evaluar no solo el efecto del kiwi, sino también el de otras frutas. Sin embargo, tiene numerosas limitaciones que dificultan la interpretación de sus resultados.…”

“…Otra limitación de la evidencia recolectada [9][10][11] fue el breve tiempo de seguimiento, que fluctuó entre tres días y ocho semanas, lo que no permite conocer los efectos a largo plazo del consumo de kiwi.…”