Plant-based Enteral Nutrition Modifies the Gut Microbiota and Improves Outcomes in Murine Models of Colitis

Yeh, Andrew; Conners, Eric M.; Ramos-Jimenez, Rafael G.; Firek, Brian; Novak, Elizabeth; Rogers, Matthew B.; Cheek, Richard C.; Ozolek, John A.; Mollen, Kevin P.; Morowitz, Michael J.

doi:10.1016/j.jcmgh.2019.01.007

Cited by 5 publications

(6 citation statements)

References 15 publications

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“…Numerous studies, including our own, have now shown the negative impact of high sugar diet in murine models of colitis, suggesting that we may improve these therapies by reducing sugar content (11–13). Indeed, both murine studies and clinical trials in pediatric cohorts have found that diets lower in sugar lead to better outcomes in patients that exhibited intestinal inflammation (Obih et al, 2016; Yeh et al, 2019). Therefore, in order to better treat patients exhibiting high levels of intestinal damage, whether it be from infection, auto-inflammation, or radiation, it is imperative that we better understand how different dietary components may impact the regenerative capacity of the intestinal epithelium.…”

Section: Discussionmentioning

confidence: 99%

“…Diet is an important contributor to the development of IBD as epidemiological studies have found a positive association of IBD and high consumption of dietary sugar and sweetened beverages (Hou, Abraham, & El-Serag, 2011; Racine et al, 2016; Thornton, Emmett, & Heaton, 1979). Mice that consume a diet high in sugar have worse disease in models of colitis and clinical trials that significantly reduce dietary sugar have already shown promise in reducing disease burden in IBD patients in the pediatric intensive care unit (Laffin et al, 2019; Obih et al, 2016; Yeh et al, 2019). However, the mechanism behind this correlation remains unknown.…”

Section: Introductionmentioning

confidence: 99%

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Excess dietary sugar impairs colonic epithelial regeneration in response to damage

Burr

Ozler

et al. 2021

Preprint

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The colonic epithelium requires continuous renewal by intestinal stem cells (ISCs) to restore the barrier after damage and proliferation of epithelial cells is modulated by dietary metabolites. We demonstrate that mice fed a high sugar diet failed to repair colonic barrier damage, resulting in increased intestinal pathology. Culturing ISCs in excess sugar limited murine and human colonoid development, indicating that dietary sugar can directly affect colonic epithelial proliferation. Similarly, in vivo lineage tracing experiments and transcriptomic analysis indicated that dietary sugar impeded the proliferative potential of ISCs. ISCs and their immediate daughter cells predominantly rely on mitochondrial respiration for energy; however, metabolic analysis of colonic crypts revealed that a high sugar diet primed the epithelium for glycolysis without a commensurate increase in aerobic respiration. Colonoids cultured in high-glucose conditions accumulated glycolytic metabolites but not TCA cycle intermediates, indicating that the two metabolic pathways may not be coupled in proliferating intestinal epithelium. Accordingly, biochemically inducing pyruvate flux through the TCA cycle by inhibiting pyruvate dehydrogenase kinase rescued sugar-impaired colonoid development. Our results indicate that excess dietary sugar can directly inhibit epithelial proliferation in response to damage and may inform diets that better support the treatment of acute intestinal injury.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Excess dietary sugar impairs colonic epithelial regeneration in response to damage

Burr

Ozler

et al. 2021

Preprint

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“…For most ICU patients, if it is safe to initiate EN, both soluble and insoluble fiber should be provided in the feeding regimen. Consideration should be given to advancing early to a blenderized whole food formula, which is more likely than a refined formula to reach the site of greatest microbial burden in the distal GI tract 27 …”

Section: Implications and Conclusionmentioning

confidence: 99%

Can feeding strategies alter immune signaling and gut sepsis in critical illness?

McClave

2021

J Parenter Enteral Nutr

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The insult necessitating admission to the intensive care unit propels the patient along a course involving increasing oxidative stress, immune dysregulation, and adverse outcomes. As the largest immune organ with the greatest microbial burden, the gastrointestinal (GI) tract may change the speed and direction the patient follows along this pathway. The gut's influence is mediated by a complex process of cross‐talk immune signaling between the intestinal epithelium, the liver, and the microbiome. Agents that invoke this response vary from mitochondrial DNA, inflammatory cytokines, and bacterial organisms to short‐chain fatty acids and bile salts. The site of action of these agents again varies widely from pattern‐recognition receptors, G protein receptors, and farnesoid X receptors in the gut and liver to transcriptional factors in epithelial cells, hepatocytes, macrophages, and neutrophils. Whereas the initial focus of response may be local within the GI tract and liver, the process extends in a systemic manner to affect immune tissue and various organs at distant sites. The gut can modulate this cross‐talk signaling through numerous strategies in the design of nutrition therapy. The physiologic response to luminal nutrients and short‐chain fatty acids, and more novel approaches like using phosphorylated polyethylene glycol, bovine serum–derived immunoglobulin, and specialized proresolving molecules, may help slow disease progression and even reverse the patient's course toward one of health and recovery. The optimal benefit to be derived from nutrition therapy may have more to do with the degree to which immune cross‐talk signaling can be modified by such innovative strategies.

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“…Most formulas are water-based with a source of protein and added additives to ensure needed caloric requirements as well as macro and micro nutrients (See Information on tube feeding, and formula options…). Yeh et al (2019) also points out that this type of nutrition generally contains less fibre and is high in content of sugar and emulsifiers, which in tests with animal models has shown worsening of colitis. In addition, changes in gut microbiology have been observed, especially when dealing with chronic diseases.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, changes in gut microbiology have been observed, especially when dealing with chronic diseases. A loss of protective anaerobes and the growth of pathogens have been noticed (Yeh et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Concentration of Bioactive and Mineral Compounds in Enteral Tube Feed Products Made of Plant-Based Ingredients

Ozola

Kampuse

2022

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

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Nowadays available products for enteral nutrition are supplemented with synthetic ingredients. The effectiveness of these products is undeniable in the medical industry, but there is concern about bioavailability of synthetic vitamin and mineral compounds in comparison to naturally occurring ones. The aim of this study was to create plant-based formulations for enteral tube feed and to determine their bioactive compound and mineral compound concentration in comparison with the values recommended by the European regulations for special medical purpose food that is not meant to satisfy the nutritional requirements of infants. For this study, five enteral tube feed formulas were made from fruit, berry, and vegetable semi-finished products with added whey protein isolate, canola oil, cod liver oil, iodised salt, and ascorbic acid. The samples were thermally processed and concentration of vitamin C, total carotenes, total phenols and mineral compounds: P, K, Na, Ca, Mg, Fe, Mn, Zn, Cu and Se was determined. All samples showed < 20 mg·kg−1 per sample of Se, and also concentration of Zn was under the (EU) 2016/128 requirements. However, concentration of Mg (345.2 to 420 mg·100 kcal−1 of product) and K (29.2 to 39.2 mg·100 kcal−1 of product) exceeded the maximum levels. Also, the concentration of vitamin C exceeded the maximum, by average two times per sample, as L-ascorbic acid was added in response to previous experiments showing unsatisfying levels.

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Plant-based Enteral Nutrition Modifies the Gut Microbiota and Improves Outcomes in Murine Models of Colitis

Cited by 5 publications

References 15 publications

Excess dietary sugar impairs colonic epithelial regeneration in response to damage

Excess dietary sugar impairs colonic epithelial regeneration in response to damage

Can feeding strategies alter immune signaling and gut sepsis in critical illness?

Concentration of Bioactive and Mineral Compounds in Enteral Tube Feed Products Made of Plant-Based Ingredients

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