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| Name | Class |
|---|---|
| WholeFiber BV | UNKNOWN |
| Wageningen University and Research, Laboratory of Microbiology | UNKNOWN |
| Wageningen University and Research, Division of Human Nutrition & Health | UNKNOWN |
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A randomized, placebo-controlled, parallel, double-blind trial with three intervention arms and a period of four intervention-weeks that assesses the intake of different dosages of a complex fiber product on bowel function via microbiota changes in subjects that are unsatisfied with their current bowel function.
Background: Bowel function issues can have a substantial effect on quality of life. Additional fiber intake might modulate bowel function and gut microbiota, thereby increasing stool frequency and consistency. This could improve defecation ease, feeling of incomplete bowel emptying and bowel function satisfaction. We hypothesize that a dried vegetable, that is naturally high in fiber within plant cells could improve bowel function in subjects with bowel function issues.
Objective: The main objective of the study is to assess whether a dried multifiber vegetable improves bowel function assessed by stool frequency, consistency, defecation ease, feeling of incomplete bowel emptying and satisfaction. Secondary objectives are to assess whether these effects are dose-dependent and associated with the modulation of the gut microbiota and activity. Furthermore, the adaption of bowel function and adaptation of the gut microbiota and activity over time will be analyzed.
Study design: A parallel, randomized, double-blind, placebo-controlled trial of four weeks with one placebo control and three intervention arms that differ in intervention product dose.
Study population: Healthy human volunteers, 20 - 80y old, with bowel function issues reflected in low stool frequency/consistency, difficulty to defecate, and dissatisfaction with their current bowel function.
Intervention: A vegetable product consisting of dried chicory root cubes containing 85% dietary fiber is added to the daily diet. The intervention product is consumed twice daily for four weeks with a maximum dose of 15 g/day. The control (placebo) consists of easily digestible rice puff particles and is consumed in the same manner as the intervention.
Main study parameters/endpoints: Main study outcome are endpoint (week 4) differences from baseline between the highest dose (15 g/day) of the treatment intervention and placebo in bowel function assessed by changes in stool frequency, stool consistency, ease of defecation, incomplete feeling of bowel emptying and bowel function satisfaction. Secondary endpoints are gut microbiota composition and differences in bowel function, quality of life and constipation symptoms assessment between all doses and placebo. Finally, changes over time in gut microbiota and bowel function will be assessed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Highest fiber dose | Experimental | This arm receives the highest dose of the intervention product, which is 15g dried vegetable per day divided into two portions of each 7.5g, which are consumed during the course of the day in the food of choice. |
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| Medium fiber dose | Experimental | This arm receives the highest dose of the intervention product, which is 10g dried vegetable per day divided into two portions of each 5.0g, which are consumed during the course of the day in the food of choice. |
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| Lowest fiber dose | Experimental | This arm receives the highest dose of the intervention product, which is 5g dried vegetable per day divided into two portions of each 2.5g, which are consumed during the course of the day in the food of choice. |
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| Control | Placebo Comparator | This arm is the control arm receiving as placebo rice puff particles each day, whose amount corresponds iso-calorically to the medium fiber dosage (~ 21 kcal/day). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dried chicory root particles | Dietary Supplement | The intervention product consists of chicory root that have been sliced and dried and are provided in the form of particles (~3mm). |
| Measure | Description | Time Frame |
|---|---|---|
| Bowel function (differences highest dose vs placebo) - bowel function satisfaction | Bowel function satisfaction is rated on a five-point scale (from "0-not at all" to "4-extremely"). | Change after the intervention of 4 weeks |
| Bowel function (differences highest dose vs placebo) - ease of defecation | Ease of defecation is rated on a five-point scale (from "0-not at all" to "4-extremely"). | Change after the intervention of 4 weeks |
| Bowel function (differences highest dose vs placebo) - feeling of incomplete bowel emptying | Feeling of incomplete bowel emptying is rated on a five-point scale (from "0-not at all" to "4-extremely"). | Change after the intervention of 4 weeks |
| Bowel function (differences highest dose vs placebo) - stool consistency | Stool consistency is measured using the Bristol Stool Form Scale (7-point scale from 1=hard to 7=diarrhea). | Change after the intervention of 4 weeks |
| Bowel function (differences highest dose vs placebo) - stool frequency | Stool frequency is measured by counting number of bowel movements per week. | Change after the intervention of 4 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Fecal gut microbiota (between dose differences) | Measured in fecal samples using DNA sequencing. Compared between different fiber dosages and placebo. | Change after the intervention of 4 weeks |
| Fecal gut microbiota activity (between dose differences) |
| Measure | Description | Time Frame |
|---|---|---|
| Bowel function (weekly changes) - bowel function satisfaction | Bowel function satisfaction is rated on a five-point scale (from "0-not at all" to "4-extremely"). Compared between different fiber dosages and placebo. | Weekly development for a period of 4 weeks |
| Bowel function (weekly changes) - ease of defecation |
Inclusion Criteria:
Exclusion Criteria:
Having a history of medical or surgical events that may significantly affect the study outcome: e.g., IBS or IBD patients and subjects with medically diagnosed constipation (i.e., constipation related to anatomic, medication-related, or readily identifiable physiological causes.)
Less than one bowel movement per week during the screening
Medical drug use:
Consumption of supplements containing fibres (other than laxatives), pro-/ post-/ synbiotics 1 month before the screening
Not willing to provide faecal samples
Unable to comply with proper study procedures
For women of childbearing age: current or planned pregnancy, lactation
Known allergic reactions to plants from the Asteraceae (Compositae) family (e.g., lettuce, daisies, sunflowers, artichokes, sage, tarragon, chamomile, chicory etc.)
Reported unexplained weight loss or weight gain of greater than 5 kg in the month prior to pre-study screening
Reported slimming or medically prescribed diet
Reported macrobiotic lifestyle
Personnel the Division of Human Nutrition & Health or the Laboratory of Microbiology
Current participation in other medical scientific research
Not having a general practitioner
Not willing to be informed about accidental discoveries in relation to the subjects health
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Edith JM Feskens, Prof. dr | Contact | +31317482567 | edith.feskens@wur.nl | |
| Sofie CC van der Zalm, MSc | Contact | +31618417162 | vezel@wur.nl |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Wageningen University & Research, Division of Human Nutrition & Health | Recruiting | Wageningen | Gelderland | 6708 WE | Netherlands |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32199025 | Background | Puhlmann ML, de Vos WM. Back to the Roots: Revisiting the Use of the Fiber-Rich Cichorium intybusL. Taproots. Adv Nutr. 2020 Jul 1;11(4):878-889. doi: 10.1093/advances/nmaa025. | |
| 39295776 | Background | Puhlmann ML, Jokela R, van Dongen KCW, Bui TPN, van Hangelbroek RWJ, Smidt H, de Vos WM, Feskens EJM. Dried chicory root improves bowel function, benefits intestinal microbial trophic chains and increases faecal and circulating short chain fatty acids in subjects at risk for type 2 diabetes. Gut Microbiome (Camb). 2022 Apr 28;3:e4. doi: 10.1017/gmb.2022.4. eCollection 2022. |
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As the data contains sensitive personal information researchers interested in the data can contact the principal investigator.
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| ID | Term |
|---|---|
| D003248 | Constipation |
| ID | Term |
|---|---|
| D012817 | Signs and Symptoms, Digestive |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Wageningen University and Research |
| OTHER |
A randomized, placebo-controlled, parallel, double-blind trial with three intervention arms and one control (placebo) arm.
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Subjects not receiving the intervention product will consume a placebo (rice puff particles). Neither the investigator, nor the participants, nor the outcome assessor will know who received what. No Care Provider is included in this trial.
|
| Placebo | Other | The control arm receives a placebo consisting of rice puff particles. |
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Fecal gut microbiota activity is determined by measuring microbial metabolites in fecal samples among which fermentation products (short-chain fatty acids) using HPLC. Compared between different fiber dosages and placebo.
| Change after the intervention of 4 weeks |
| Quality of Life (between dose differences) | Quality of life is measured using the questionnaire Patient Assessment of Constipation - Quality of Life. Compared between different fiber dosages and placebo. | Change after the intervention of 4 weeks |
| Constipation-related symptoms (between dose differences) | Constipation symptoms is measured using the questionnaire Patient Assessment of Constipation - Symptoms. Compared between different fiber dosages and placebo. | Change after the intervention of 4 weeks |
| Bowel function (between dose differences) - bowel function satisfaction | Bowel function satisfaction is rated on a five-point scale (from "0-not at all" to "4-extremely"). Compared between different fiber dosages and placebo. | Change after the intervention of 4 weeks |
| Bowel function (between dose differences) - ease of defecation | Ease of defecation is rated on a five-point scale (from "0-not at all" to "4-extremely"). Compared between different fiber dosages and placebo. | Change after the intervention of 4 weeks |
| Bowel function (between dose differences) - feeling of incomplete bowel emptying | Feeling of incomplete bowel emptying is rated on a five-point scale (from "0-not at all" to "4-extremely"). Compared between different fiber dosages and placebo. | Change after the intervention of 4 weeks |
| Bowel function (between dose differences) - stool consistency | Stool consistency is measured using the Bristol Stool Form Scale (7-point scale from 1=hard to 7=diarrhea). Compared between different fiber dosages and placebo. | Change after the intervention of 4 weeks |
| Bowel function (between dose differences) - stool frequency | Stool frequency is measured by counting number of bowel movements per week. Compared between different fiber dosages and placebo. | Change after the intervention of 4 weeks |
Ease of defecation is rated on a five-point scale (from "0-not at all" to "4-extremely"). |
| Weekly development for a period of 4 weeks |
| Bowel function (weekly changes) - feeling of incomplete bowel emptying | Feeling of incomplete bowel emptying is rated on a five-point scale (from "0-not at all" to "4-extremely"). | Weekly development for a period of 4 weeks |
| Bowel function (weekly changes) - stool consistency | Stool consistency is measured using the Bristol Stool Form Scale (7-point scale from 1=hard to 7=diarrhea). | Weekly development for a period of 4 weeks |
| Bowel function (weekly changes) - stool frequency | Stool frequency is measured by counting number of bowel movements per week. | Weekly development for a period of 4 weeks |
| Fecal gut microbiota (weekly changes) | Measured in fecal samples using DNA sequencing. | Weekly development for a period of 4 weeks |
| Fecal gut microbiota activity (weekly changes) | Fecal gut microbiota activity is determined by measuring microbial metabolites in fecal samples among which fermentation products (short-chain fatty acids) using HPLC. | Weekly development for a period of 4 weeks |