TABLE 2.
ITF effects on gastrointestinal health in healthy adults1
| Ref. | Study design | Comparator | ITF type | DP, range (mean) | ITF dose, g/d | Intervention duration (wk) | Washout duration, wk | N (nin ITF group) | Study population characteristics | Results |
|---|---|---|---|---|---|---|---|---|---|---|
| (18) | MC, OLS | Glucose | FOS (Raftilose P95) | 2–7 | 0, 5, 15 | 1 | 1 | 24 | Healthy adult men age 19–28 y, BMI 21.7 ± 1.9 | ↑ Flatulence (15 g/d), breath H2 excretion (15 g/d)↔ Stool frequency, abdominal pain or cramps, stool forms or bloating |
| (20) | R, DB, SC, PC, P | Maltodextrin | Inulin (Beneo-Orafti HSI) | NA | 8 | 4 | NA | 36 (18) | Healthy adults with GI symptoms age 20–70 y | ↔ Transit time, stool frequency, stool consistency↓ Gas retention |
| (72) | R, DB, PC, CF, DR | Saccharose | Fibrulose 97 Fibruline instant (FI)Fibruline XL (FXL) | F97: 2–20FI: 2–60 (10)FXL: 2–60 (>20) | 0, 5, 10, 20 | 10 | 2 | 84 | Healthy adults age 30.1 ± 8.6 y, BMI 25.1 ± 3.1 | ↑ Flatulence, gas, bloating↔ Stool frequency, stool consistency, gastrointestinal rumbling |
| (27) | R, DB, PC, CF | No ITF | Inulin (Beneo HP, DKSH/Orafti) | ≥23 | 10 | 1 | 2 | 21 | Adults with overweight/obesity age 60 y, BMI 25–40 | ↑ Breath H2, stomach discomfort, nausea, flatulence, heartburn, and frequency↔ Bloating, belching |
| (29) | R, P | Low nonstarch polysaccharide diet | Chicory inulin (Agro-industries, Recherches et Developpements Society) | NA | 2 wk @ progressive intake, 12 d @ 50 | 3.7 | NA | 9 | Healthy adult men age 21.5 + 2.5 y, BMI <25 | ↑ Defecation, wet stool weight↔ Dry fecal weight |
| (32) | R, DB, PC, CF | Maltodextrin | Inulin–oligofructose (Synergy 1, Beneo-Orafti) | Oligofructose: 2–8 (4)Inulin: 10–60 (24) | 15 | 3 | 2 | 30 | Healthy adults age 28.1 ± 5.1 y, BMI 24.2 ± 3.0 | ↑ Gas, bloating, cramping, indigestion↔ Daily bowel movements |
| (33) | R, DB, PC, CF | Maltodextrin | VLCI, Bayer Cropscience AG) + Inulin (Beneo HP, Beneo-Orafti) | VLCI: 50–103HP: ≥23 | 10 | 3 | 3 | 31 | Healthy adults age 25 y, BMI 20–30 | ↑ Bloating, gas production↔ Daily bowel movements, stool consistency, abdominal pain, flatulence |
| (73) | R, DB, P, PC | Maltodextrin | scFOS | NA | 10 | 4 | NA | 244 | Healthy adults age 50 y | ↑ Flatulence, sense of “well-being,” stool frequency and regularity (in those with complaints of diarrhea), stool hardness (in those with constipation)↔ Post-study: bloating, flatulence, constipation, greater regularity, reduced IBS symptoms↓ Stool size (in those with constipation) |
| (34) | R, SB, PC, CF | No ITF | Inulin (Inulin HP, Beneo-Orafti) | ≥23 | 22.4 | 1 | 1 | 13 | Healthy adults age 23 ± 4 y, BMI 22.1 ± 1.6 | ↑ H2, flatulence |
| (35) | R, SB, PC, P | Cellulose+Maltodextrin | Oligofructose (Beneo P95, Beneo-Orafti) | 2–7 | 30 | 6 | NA | 22 (12) | Healthy adults with overweight and obesity, 20–49 y, BMI 30.33 | ↑ Breath H2, flatulence, bloating, abdominal pain↔ Symptoms of diarrhea, stomach discomfort |
| (74) | R, DB, CF | Sucrose | Inulin (Raftiline ST, Beneo-Orafti) | 2–65 (10) | 18 | 6 | 6 | 21 | Adults with mild-to-moderate hypercholesterolemia (LDL 3.36–5.17), age 60.4 y, BMI 27.99 | ↑ Flatulence, cramping, bloating, frequency, loose stool |
| (75) | R, PC, DB, CF | Molasses | Yacon (scFOS) | 2–10 | 20 | 2 | 2 | 16 | Healthy adults age 29.3 ± 4.9 y | ↑ Stool frequency and softer stool consistency (trending)↔ Left colon or sigmoid rectum transit time, mean number of days with bloating↓ Colonic transit time |
| (76) | R, DB, CF | Maltodextrin | scFOS (Raftilose P95, Orafti) | <10 | 10 | 5 | NA | 20 | Healthy adults age 28 y, BMI 22.5 | ↑ Belching, bloating (males), abdominal pain (males), urgency (rectal barostat)↔ Women only: bloating, frequency, borborygmi, pain, belching, nausea |
| (40) | SGD | Habitual diet | ITF-rich vegetables (artichoke, garlic, salsify, shallot, leek, scorzonera, onion, celery root) | NA | ∼15 | 2 | 3 | 26 | Healthy adults age 21.84 ± 0.39 y, BMI 22.29 ± 0.32 | ↑ Flatulence↔ Transit time, stool frequency, stool consistency, bloating, rumbling, cramp, and nausea↓ Intestinal discomfort, bloating (during fasting after intervention) |
| (77) | R, DB, PC, CF | Placebo | Inulin (BIOAGAVE, Ingredion) | 25–34 | 0, 5, 7.5 | 3 | 1 | 29 | Healthy adults age 27 ± 4.1 y, BMI 24.4 ± 2.26 | ↑ Bloating, flatulence, rumbling, bowel movement, breath H2, softer stools, abdominal pain (daily only), rumbling (daily only)↔ Weekly abdominal, nausea, ease of stool passage↓ Stool dry matter |
| (42) | R, DB, PC, CF | Maltodextrin | scFOS | NA | 16 | 1.4 | 3 | 20 | Adults with IBS (diarrhea-predominant or mixed), age 34.6 y, BMI 26.9 | ↑ Severity and frequency of abdominal pain, severity of abdominal distention, VAS IBS severity, nausea/vomiting, headache, belching, flatulence |
| (43) | R, DB, PC, P | Cereal mixture | Artichoke inulin (Liven GmbH)Chicory inulin (Fibruline Instant, Cosucra) | 5–12 | 1 wk @ 7.72 wk @ 15.4 | 3 | NA | 45 (15) | Healthy adults age 23.5 ± 2.3 y, BMI 22.4 ± 2.7 (F) 23.4 ± 1.4 (M) | ↑ Stool frequency, flatulence, stool consistency |
| (45) | CF | No inulin | Inulin (Fibruline, Cosucra) | 2–50 (9) | 22–34 (25% of energy from CHO) | 9.14 | 4.9 | 8 | Healthy adults age 26–53 y, BMI 22.8 ± 4.4 (F) 25.8 ± 1.6 (M) | ↑ Flatulence, bloating↔ Diarrhea, nausea, stool consistency |
| (46) | P | No ITF | Inulin–oligofructose (Raftiline HP + Raftilose P95, Beneo-Orafti) | HP: 5–60 (10)P95: 2–7 | 15 | 2 | NA | 29 (14) | Adults undergoing colonoscopy age 35–72 y | ↑ Flatulence, bloating, laxation |
| (47) | R, DB, PC, P | Maltodextrin | Inulin–oligofructose (Synergy 1, Beneo-Orafti) | Oligofructose: 2–8 (4)Inulin: 10–60 (24) | 8 | 4 | NA | 43 (22) | Healthy adults age 45–63 y, BMI 25.36 | ↑ Flatulence, bowel movements↔ Constipation, stool consistency |
| (78) | R, DB, PC,P, MC | Glucose | scFOS (Idolax, Orafti) | NA | 2 wk @ 10, 10 wk @ 20 | 12 | NA | 96 (50) | Adults with IBS age 45.1 ± 13.1 y | ↑ Flatulence, defecation frequency↔ Weekly defecation frequency, IBS symptoms |
| (79) | R, DB, PC, P | Maltodextrin | Oligofructose (Raftilose P95) | 2–7 | 21 | 12 | NA | 39 (21) | Adults with overweight/obesity age 40.4 y, BMI 30.1 | ↑ Flatulence↔ Diarrhea, nausea |
| (80) | R, DB, CF | No ITF | Inulin (Raftilin LS, Orafti) | 11–12 | 14 | 4 | 0 | 72 | Healthy women age 20–36 y, BMI 21.9 ± 2.6 | ↑ Flatulence, rumbling, cramps, bloating |
| (81) | R, TB, PC, P | Maltodextrin | Oligofructose (Fructalose L92, Sensus) | 2–10 | 1 wk @ 8, 11 wk @ 16 | 12 | NA | 55 (29) | Adults with overweight/obesity age 41 ± 12 y, BMI 29.4 ± 2.6 | ↑ Flatulence (compared with control) and perceived bloating↔ Looser stools, regurgitation, nausea |
| (50) | R, DB, DR, PC, CF | Placebo | ITF | NA | 0, 3, 7 | 4 | 4 | 48 | Healthy adults age 30.85 y, BMI 23.98 | ↑ Bloating, abdominal distention |
| (51) | R, DB, PC, P | Placebo | Inulin (4 g) + oligofructose (12 g) | NA | 2 wk @ 8, 10 wk @ 16 | 12 | NA | 96 (26) | Adults with overweight/obesity, 39.8 y, BMI 31.5 | ↑ Bloating, flatulence, rumbling↔ Looser stools, regurgitation and nausea |
| (82) | DB, CF | Sucrose | Inulin-rich soluble chicory extract | 3–60 | 5, 7.8 | 4 | NA | 53 | Healthy adults age 18–67 y, BMI 22.05 | ↑ Abdominal discomfort (7.8 g/d dosage)↔ Flatulence, abdominal pain, stool consistency and frequency |
| (83) | R, DB, PC, CF | No ITF | Inulin (Raftiline HP-Gel, Orafti) | >23 | 11 | 5 | 8 | 20 | Healthy adult men, 18.8 ± 0.7 y, BMI 22.8 ± 2.3 | ↑ Gastric emptying rate↔ Flatulence, meteorism, bowel habit |
| (84) | R, DB, PC, CF | No ITF | Inulin (Raftiline HP-Gel, Orafti) | >23 | 11 | 5 | 8 | 20 | Healthy adult men age 18.8 ± 0.7 y, BMI 22.8 ± 2.3 | ↓ Lactulose, zonulin |
| (53) | R, DB, PC, CF | Maltodextrin | scFOS (Raftilose P95) | 2–7 | 25–30 | 2 | 2 | 12 | Healthy adults age 21.4 ± 2 y, BMI 20.75 | ↑ Stool frequency, flatulence↓ Fecal water cytotoxicity |
| (54) | R, DB, PC, CF | Corn syrup | Inulin (Frutafit, Sensus) | 9 (2–60) | 20 | 3 | 0 | 12 | Healthy adult men age 27–49 y, BMI <32 | ↑ Flatulence↔ Stool weight, transit time, stool frequency, and stool consistency |
| (55) | SC, R, DB, PC, P | Maltodextrin | Oligofructose (Orafti P95, Beneo-Orafti) | 2–8 | 14 | 1 | NA | 37 (19) | Healthy adults age 25 y, BMI 23 | ↑ Breath H2, total colonic volume (ascending, transverse, distal)↔ Transit scores |
| (56) | R, DB, PC, P | Sucrose | scFOS (NutraFlora, GTC Nutrition) | 3–5 | 3 | 4 | NA | 62 (15) | Healthy adults age 25.3 y | ↔ Stools, fecal scores |
| (59) | R, DB, PC, CF | Sucrose | scFOS (Raftilose P95) | 2–7 | 20 | 2 | 2 | 34 | Healthy adult men age 27.7 ± 1.7 y, BMI 23.2 ± 0.5 | ↑ Flatulence, bloating, fecal wet weight, fecal lactic acid excretion, fecal mucin excretion↔ Fecal water cytotoxicity |
| (61) | R, DB, CF, LS | Basal diet | InulinscFOS | NA | 15 | 3 | 0 | 12 | Healthy adult men age 23 ± 3 y, BMI 23 | ↑ Breath H2 excretion (scFOS) |
| (62) | R, DB, DR, PC, CF | Sucrose | Oligofructose (Fructalose L92, Sensus) | 2–10 | 1 wk @ 15, 1 wk @ 30 | 2 | 2 | 19 | Healthy adults age 46.9 y, BMI 24.4 | ↓ Fecal water cytotoxicity |
1
CF, crossover feeding; CHO, carbohydrate; DB, double-blinded; DP, degree of polymerization; DR, dose ranging; FI, Fibruline Instant; FOS, fructooligosaccharide; FXL, Fibruline XL; GI, gastrointestinal; H2, hydrogen; IBS, irritable bowel syndrome; ITF, inulin-type fructans; LS, Latin square; MC, multiple crossover; MCF, multiple crossover feeding; NA, not applicable; OLS, orthogonal Latin-square; P, parallel; PC, placebo-controlled; Pr, prospective; R, randomized; Ref, reference; SB, single-blinded; SC, single-center; scFOS, short-chain fructooligosaccharides; SGD, single-group design; TB, triple blind; VAS, visual analogue scale; VLCI, very long chain inulin.