Effects of regularly consuming dietary fibre rich soluble cocoa products on bowel habits in healthy subjects: a free-living, two-stage, randomized, crossover, single-blind intervention

Abstract

BackgroundDietary fibre is both preventive and therapeutic for bowel functional diseases. Soluble cocoa products are good sources of dietary fibre that may be supplemented with this dietary component. This study assessed the effects of regularly consuming two soluble cocoa products (A and B) with different non-starch polysaccharides levels (NSP, 15.1 and 22.0% w/w, respectively) on bowel habits using subjective intestinal function and symptom questionnaires, a daily diary and a faecal marker in healthy individuals.MethodsA free-living, two-stage, randomized, crossover, single-blind intervention was carried out in 44 healthy men and women, between 18-55 y old, who had not taken dietary supplements,laxatives, or antibiotics six months before the start of the study. In the four-week-long intervention stages, separated by a three-week-wash-out stage, two servings of A and B, that provided 2.26 vs. 6.60 g/day of NSP respectively, were taken. In each stage, volunteers' diet was recorded using a 72-h food intake report.ResultsRegularly consuming cocoa A and B increased fibre intake, although only cocoa B significantly increased fibre intake (p < 0.001) with respect to the non-cocoa stage. No changes in body weight were observed in either of the 4 week interventions. With cocoa product B, the number of daily bowel movements increased (p = 0.002), the frequency of having a bowel movement once a day increased (p = 0.009), the time to have a bowel movement was lower (p = 0.016) as well as the feeling of constipation (p = 0.046) without inducing adverse gastrointestinal symptoms, only flatulence increased (p = 0.019).ConclusionsRegular consumption of the cocoa products increases dietary fibre intake to recommended levels and product B improves bowel habits. The use of both objective and subjective assessments to evaluate the effects of food on bowel habits is recommended.

Nonpharmacological Clinical Effective Interventions in Constipation: A Systematic Review

“…All the studies complied with ethical criteria, obtaining the informed consent of the participants for their participation and ensuring the absence of conflicts of interest. Importantly, regarding the different studies’ contexts, participants with chronic constipation were recruited from nursing homes (a total of 189 nursing home participants) in the studies of Bub et al (2006), Lamas et al (2009), and Huang et al (2015); or from the community as volunteers (a total of 464 participants) recruited according to a list of patients with this diagnose (Attaluri et al, 2011; López Román et al, 2008; Magro et al, 2014; Mazlyn et al, 2013; Rao et al, 2010; Sairanen, Piirainen, Nevala, & Korpela, 2007; Sarriá et al, 2012; Simón & Bueno, 2009; Waitzberg et al, 2013).…”

“…Soluble cocoa is a good source of dietary fiber and a good supplemented dietary component. The regular consumption of cocoa increased fiber intake and bowel movements (Sarriá et al, 2012). Some infusions, namely herbal tea, also promote bowel movements.…”

“…A cup each afternoon of Smooth Move herbal tea (Traditional Medicinals, Sebastopol, CA, USA), when added to the standard treatment regimen for nursing home residents with chronic constipation, increased the average number of bowel movements (Bub et al, 2006). Adequate fluid intake increases the number of stools, decreases stool consistency, increases bowel movements, and decreases the consumption of laxatives (Lamas et al, 2009; Sarriá et al, 2012). The daily intake of a dairy preparation enriched with 20 g of soluble fiber increases the number of weekly bowel movements, decreases stool consistency, and increases the sensation of complete intestinal emptying and absence of impaction (López Román et al, 2008).…”

“…Unfortunately, many of the participants continued medication for constipation during treatment with nonpharmacological interventions. Studies included in this review referred to interventions such as educational measures in lifestyle and dietary modification, through behavior modification with biofeedback (Rao et al, 2011; Simon & Bueno, 2009); diets rich in fiber, through fiber supplementation, probiotics, and dietary supplementation with a symbiotic compound (Attaluri et al, 2011; Bub et al, 2006; López Román et al, 2008; Magro et al, 2014; Mazlyn et al, 2013; Sairanen et al, 2007; Sarriá et al, 2012; Waitzberg et al, 2013); individualized interventions based on the capacity of participants to acknowledge modifiable risk factors of constipation (Huang et al, 2015); and abdominal massage techniques (Lamas et al, 2009). These interventions revealed some positive results regarding the level of symptoms and severity of constipation.…”

“…Risk factors for constipation include medication intake, the use of certain drugs (e.g., anticholinergics, antidepressants, opioids, analgesics, nonsteroidal drugs, and anti‐inflammatory drugs, including aspirin), whose continuous use will very likely lead to stool dehydration and hardening. Other associated risk factors include medical conditions, toileting facilities, reduced mobility, and prolonged bed rest (Huang et al, 2015), as well as changes in diet, such as insufficient nutritional, fluid, or fiber intake (Huang et al, 2015; Sarriá et al, 2012). Ignoring the urge to defecate or potential delay can result in progressive loss of the fundamental nervous stimulus to defecate.…”