Fructo-oligosaccharides and fibre in enteral nutrition has a beneficial influence on microbiota and gastrointestinal quality of life.
OBJECTIVE
Intestinal microbiota is important in health and disease. The aim of this study was to evaluate the effect of fructo-oligosaccharides (FOS) and fibre-enriched tube feeding on quality of life and intestinal microbiota (faecal Bifidobacteria).


METHODS
Nineteen out of 59 home-living, tube-feeding-dependent, adult patients and matched healthy controls were included in this randomized, double-blind study. After a washout period, patients received either no residue tube feeding (non-FOS group) or FOS and fibre-enriched tube feeding (FOS group). Quality of life as defined by the Gastrointestinal Quality of Life Index (GIQLI) and quantification of faecal Bifidobacteria were determined.


RESULTS
At baseline, GIQLI scores in controls and patients were 88+/-12 and 67+/-14, respectively (p=0.001). Following 6 weeks' intervention, GIQLI scores remained stable (65+/-14 versus 67+/-17) in the FOS group, whereas the non-FOS group values decreased (68+/-17 versus 64+/-19). Baseline faecal samples contained 2. 1x 10(7)+/-3.5 x 10(7) and 2.1 x 10(6)+/-5.6 x10(6)Bifidobacteria (p=0.002) in controls and patients, respectively, with no differences between patient groups. During the intervention, this number remained stable in the FOS group (0.7 x 10(6)+/-1.3 x 10(6) versus 1.0 x 10(6)+/-1.3 x 10(6) baseline versus end-point), but decreased in the non-FOS group (3.6 x1 0(6)+/-8.0 x 10(6) versus 2.5 x 10(4)+/-4.0 x 10(4)). GIQLI scores were correlated with the number of faecal Bifidobacteria (r=0.41, p=0.007).


CONCLUSIONS
The GIQL score for the tube-fed patients increased with the number of faecal Bifidobacteria, although in a non-linear way, and addition of FOS increased the number of Bifidobacteria. This suggests that prebiotic tube feeding may lead to a change in intestinal microbiota that could induce an increased quality of life in these patients.
Department of Nutrition and Dietetics, VU University Medical Centre, Amsterdam, The Netherlands. N.Wierdsma@vumc.nl
Nicolette J
NJ
Wierdsma
Adriaan A
AA
van Bodegraven
Bernhard M J
BM
Uitdehaag
Willy
W
Arjaans
Paul H M
PH
Savelkoul
Hinke M
HM
Kruizenga
Marian A E
MA
van Bokhorst-de van der Schueren
D000368:Aged; D000369:Aged, 80 and over; D001644:Bifidobacterium / Q000302:isolation & purification*; D016022:Case-Control Studies; D004043:Dietary Fiber / Q000008:administration & dosage / Q000494:pharmacology*; D004750:Enteral Nutrition; D005243:Feces / Q000382:microbiology; D006801:Humans; D007422:Intestines / Q000382:microbiology*; D008875:Middle Aged; D009844:Oligosaccharides / Q000008:administration & dosage / Q000494:pharmacology*; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
D004043:Dietary Fiber; D009844:Oligosaccharides