title: Effects of thickened beverages fortified with inulin on beverage acceptance, gastrointestinal function, and bone resorption in institutionalized adults.
abstract: OBJECTIVE
  We wanted to develop thickened beverages that contain soluble fiber (inulin) with acceptable consistency, taste, and texture and to determine the effects of these beverages on bone resorption markers (to determine calcium retention), bowel frequency, and indicators of gastrointestinal function in institutionalized adults bound to wheelchairs.
  
  
  METHODS
  A double-blind, 3-wk, cross-over study testing 13-g/d inulin-fortified versus isocaloric standard modified starch-thickened beverages was conducted in institutionalized adults who were bound to wheelchairs and had dysphagia or did not have dysphagia. Beverage acceptability, as assessed by discriminative and descriptive sensory testing, bowel frequency, fecal output, and laxative use, were determined by direct testing or by nursing charts. Bone resorption was measured by using the urinary excretion of fasting calcium and of cross-linked N-telopeptides of collagen.
  
  
  RESULTS
  Sensory panelists were unable to detect a difference between beverages thickened with modified starch and those fortified with inulin. Few differences were found between the control and inulin-fortified beverages for sensory descriptors. No significant difference was found in frequency of bowel movements between treatments; however, weighted bowel movement frequency increased by 13% with inulin (P < 0.01), whereas enema and laxative administration decreased by 13% (P < 0.05). Bone resorption, as an indicator of calcium retention, remained unchanged.
  
  
  CONCLUSIONS
  Inulin was incorporated into thickened beverages, with no decrease in acceptability; when consumed, perceived stool output increased in residents of long-term care facilities.
authors.affiliation: Food and Nutrition Services, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada. wendy.dahl@saskatoonhealthregion.ca
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Dahl
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Whiting
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Isaac
authors.forename: Shawna J
authors.initials: SJ
authors.lastname: Weeks
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Arnold
mesh_terms: D000328:Adult; D001628:Beverages; D001862:Bone Resorption / Q000517:prevention & control*; D002118:Calcium / Q000652:urine; D002400:Cathartics / Q000627:therapeutic use; D003094:Collagen / Q000652:urine; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005243:Feces; D005518:Food Preferences / Q000187:drug effects* / Q000502:physiology; D005527:Food, Fortified; D041981:Gastrointestinal Tract / Q000187:drug effects*; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data*; D007444:Inulin / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged
chemical_list: D002400:Cathartics; D007444:Inulin; D003094:Collagen; D002118:Calcium