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Aktuelle Ernährungsmedizin 2014; 39(S 01): S8-S12
DOI: 10.1055/s-0033-1360023
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© Georg Thieme Verlag KG Stuttgart · New York

Spezialisten in Aktion

Die unterschiedlichen physiologischen Wirkungen der verschiedenen FasertypenSpecialists in ActionThe Different Physiological Effects of Different Types of Fibre
R. Meier
Kantonsspital Baselland, Liestal, Medizinische Universitätsklinik
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Publication History

Publication Date:
20 February 2014 (online)

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Zusammenfassung

Die Effekte der verschiedenen Nahrungsfasern (lösliche und unlösliche) sind im Magen-Darm-Trakt unterschiedlich. Lösliche Nahrungsfasern werden im Kolon durch Bakterien zu kurzkettigen Fettsäuren fermentiert, die entscheidend für die Darmgesundheit sind. Sie liefern Energie für die Mukosazellen, stimulieren deren Proliferation und Differenzierung. Zum anderen regulieren sie den Wasserhaushalt im Dickdarm. Da kurzkettige Fettsäuren zusammen mit Wasser resorbiert werden, kommen einzelne lösliche Nahrungsfasern in der Therapie von Diarrhöen zum Einsatz. Studien zufolge bewirken sie eine rasche Reduktion der Stuhlfrequenz und -menge. Darüber hinaus zeigen kurzkettige Fettsäuren antientzündliche Effekte, was zur Rezidivprophylaxe bei Colitis ulcerosa genutzt wird. Die antiproliferativen Eigenschaften hemmen wahrscheinlich auch die Ausbildung von Polypen und Dickdarmkrebs. Die Daten der EPIC-Studie belegen eine inverse Korrelation zwischen der totalen Aufnahme von Nahrungsfasern und der Inzidenz kolorektaler Karzinome.

Gelbildende visköse Nahrungsfasern, insbesondere Beta-Glucan, haben günstige Effekte auf den Glukose- und Lipidstoffwechsel.

Unlösliche Nahrungsfasern erhöhen das Stuhlgewicht und beschleunigen den Darmtransit. Faserreiche Ernährung kann einer Obstipation vorbeugen, während die Effekte bei einer bestehenden Obstipation gering sind. Eine positive Wirkung ist auch beim Reizdarm vom Obstipationstyp bekannt.

Abstract

Different types of dietary fibres (soluble and insoluble fibres) have different effects in the gastrointestinal tract. Soluble dietary fibres are fermented by bacteria in the colon into short-chain fatty acids, which are crucial for a healthy bowel. They provide energy for the mucosal cells, and they stimulate their proliferation and differentiation. Furthermore they regulate the water balance in the large bowel. As short-chain fatty acids are absorbed together with water, individual soluble dietary fibres are used in the treatment of diarrhoea. Studies have shown that they result in rapid reduction of the frequency and volume of bowel movements. Furthermore, short-chain fatty acids have anti-inflammatory effects, which are useful in preventing recurrences in ulcerative colitis. The antiproliferative characteristics probably also prevent the development of polyps and cancer of the large bowel. Data from the EPIC study have shown an inverse correlation between total intake of dietary fibre and the incidence of colorectal cancers.

Gel-forming viscous dietary fibres, especially beta glucan, have beneficial effects on the glucose and lipid metabolisms.

Insoluble dietary fibres increase the faecal weight and accelerate transit through the bowel. A diet rich in fibres can help prevent constipation, whereas its effects will be negligible if constipation is already present. A positive effect has also been observed in people with irritable bowel syndrome of the constipation type.

Schlüsselwörter

Präbiotika - kurzkettige Fettsäuren - Wasserhaushalt - Diarrhö - antiinflammatorische Effekte - antiproliferative Effekte

Keywords

prebiotics - short-chain fatty acids - water balance - diarrhoea - anti-inflammatory effects - antiproliferative effects
 

  • Literatur

  • 1 Englyst KN, Liu S, Englyst HN. Nutritional characterization and measurement of dietary carbohydrates. Eur J Clin Nutr 2007; 61: S19-39
    CrossrefPubMedGoogle Scholar
  • 2 British Nutrition Foundation. Complex carbohydrates in Foods: Report of the British Nutrition Foundation’s Task Force. London: Chapman and Hall; 1990
    Google Scholar
  • 3 Asp NG, Björck I, Nyman M. Physiological effects of cereal dietary fibre. Carbohydr Polym 1993; 21: 183-187
    CrossrefPubMedGoogle Scholar
  • 4 Liljeberg H, Granfeldt Y, Björck I. Metabolic responses to starch in bread containing intact kernels versus milled flour. Eur J Clin Nutr 1992; 46: 561-575
    PubMedGoogle Scholar
  • 5 Granfeldt Y, Liljeberg H, Drews A et al. Glucose and insulin responses to barley products: influence of food structure and amylose-amylopectin ratio. Am J Clin Nutr 1994; 59: 1075-1082
    PubMedGoogle Scholar
  • 6 Cummings JH. Non-starch polysaccharides (dietary fibre) including bulk laxatives in constipation. In: Kamm MA, Lennard-Jones JE, eds. Constipation. Petersfield, UK: Wrightson Biomedical Publishing Ltd; 1994: 307-314
    Google Scholar
  • 7 Berger M, Venhaus A. Dietary fibre in the prevention and treatment of diabetes mellitus. In: Schweizer TF, Edwards CA, eds. Dietary Fibre – A Component of Food. London: Springer; 1992: 279-293
    CrossrefGoogle Scholar
  • 8 Wolever TMS, Jenkins DJA. Effect of dietary fibre and foods on carbohydrate metabolism. In: Spiller GA, ed. CRC handbook of dietary fibre in human nutrition. Florida: CRC Press; 1993: 111-152
    Google Scholar
  • 9 Bosaeus I. Fibre effects on intestinal functions (diarrhoea, constipation and irritable bowel syndrome). Clin Nutr 2004; (Suppl. 01) 33-38
    PubMedGoogle Scholar
  • 10 Meier R, Gassull MA. Effects and benefits of fibre in clinical practice. Clinical Nutrition Supplements 2004; 1 (Suppl. 02)
    PubMedGoogle Scholar
  • 11 Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr 1995; 125: 1401-1412
    PubMedGoogle Scholar
  • 12 Gibson GR, Fuller R. Aspects of in vitro and in vivo research approaches directed toward identifying probiotics and prebiotics for human use. J Nutr 2000; 130 (Suppl. 02) 391S-395S
    PubMedGoogle Scholar
  • 13 Gibson GR, Beatty ER, Wang X et al. Selective stimulation of bifidobacteria in the human colon by oligofructose and inulin. Gastroenterology 1995; 108: 975-982
    CrossrefPubMedGoogle Scholar
  • 14 Guarner F, Malagelada JR. Gut flora in health and disease. Lancet 2003; 361: 512-509
    CrossrefPubMedGoogle Scholar
  • 15 Bengmark S. Pre-, pro- and synbiotics. Curr Opin Clin Nutr Metab Care 2001; 4: 571-579
    CrossrefPubMedGoogle Scholar
  • 16 Scheppach WM, Bartram HP. Experimental evidence for and clinical implications of fiber and artificial enteral nutrition. Nutrition 1993; 9: 399-405
    PubMedGoogle Scholar
  • 17 Roediger WE, Moore A. Effect of short-chain fatty acid on sodium absorption in isolated human colon perfused through the vascular bed. Dig Dis Sci 1981; 26: 100-106
    CrossrefPubMedGoogle Scholar
  • 18 Cummings JH, Pomare EW, Branch WJ et al. Short chain fatty acids in human large intestine, portal, hepatic and venous blood. Gut 1987; 28: 1221-1227
    CrossrefPubMedGoogle Scholar
  • 19 Cummings JH, Englyst HN. Fermentation in the human large intestine and the available substrates. Am J Clin Nutr 1987; 45: 1243-1255
    PubMedGoogle Scholar
  • 20 Cummings JH. Short chain fatty acids. In: Gibson GR, McFarlane GT, eds. Human Colonic Bacteria: Role in Nutrition, Physiology and Pathology. Boca Raton, FL: CRC Press; 1995: 101-130
    Google Scholar
  • 21 Segain JP, Raingeard de la Blétière D, Bourreille A et al. Butyrate inhibits inflammatory responses through NFkappaB inhibition: implications for Crohn’s disease. Gut 2000; 47: 397-403
    CrossrefPubMedGoogle Scholar
  • 22 Alam NH, Meier R, Schneider H et al. Partially hydrolyzed guar gum-supplemented oral rehydration solution in the treatment of acute diarrhea in children. J Pediatr Gastroenterol Nutr 2000; 31: 503-507
    CrossrefPubMedGoogle Scholar
  • 23 Alam NH, Meier R, Sarker SA et al. Partially hydrolysed guar gum supplemented comminuted chicken diet in persistent diarrhoea: a randomised controlled trial. Arch Dis Child 2005; 90: 195-199
    CrossrefPubMedGoogle Scholar
  • 24 Alam NH, Ashraf H, Olesen M et al. Efficacy of partially hydrolysed guar gum supplemented modified oral rehydration solution in the treatment of severely malnourished children with watery diarrhoea. Gut 2009; 58 (Suppl. 02) A41
    CrossrefPubMedGoogle Scholar
  • 25 Ramakrishna BS, Venkataraman S, Srinivasan P et al. Amylase-resistant starch plus oral rehydration solution for cholera. N Engl J Med 2000; 342: 308-313
    CrossrefPubMedGoogle Scholar
  • 26 Alam NH, Ashraf H, Sarker SA et al. Efficacy of Partially Hydrolyzed Guar Gum-Added Oral Rehydration Solution in the Treatment of Severe Cholera in Adults. Digestion 2008; 78: 24-29
    PubMedGoogle Scholar
  • 27 Klampfer L, Huang J, Sasazuki T et al. Inhibition of interferon gamma signaling by the short chain fatty acid butyrate. Mol Cancer Res 2003; 1: 855-1862
    PubMedGoogle Scholar
  • 28 Forest V, Pierre F, Bassonga E et al. Apc+/Min colonic epithelial cells express TNF receptors and ICAM-1 when they are co-cultured with large intestine intra-epithelial lymphocytes. Cell Immunol 2003; 223: 70-76
    CrossrefPubMedGoogle Scholar
  • 29 Ogawa H, Rafiee P, Fisher PJ et al. Butyrate modulates gene and protein expression in human intestinal endothelial cells. Biochem Biophys Res Commun 2003; 309: 512-519
    CrossrefPubMedGoogle Scholar
  • 30 Umemoto Y, Tanimura H, Ishimoto K et al. Trial of a new fructo-oligosaccharide therapy against IBD (Abstr.). Gastroenterology 1998; 114: A1102
    PubMedGoogle Scholar
  • 31 Welters CF, Heineman E, Thunnissen FB et al. Effect of dietary inulin supplementation on inflammation of pouch mucosa in patients with an ileal pouch-anal anastomosis. Dis Colon Rectum 2002; 45: 621-627 Epub 2004 Apr 19
    CrossrefPubMedGoogle Scholar
  • 32 Venkatraman A, Ramakrishna BS, Shaji RV et al. Amelioration of dextran sulfate colitis by butyrate: role of heat shock protein 70 and NF-kappaB. Am J Physiol Gastrointest Liver Physiol 2003; 285: G177-184
    PubMedGoogle Scholar
  • 33 Moreau NM, Martin LJ, Toquet CS et al. Restoration of the integrity of rat caeco-colonic mucosa by resistant starch, but not by fructo-oligosaccharides, in dextran sulfate sodium-induced experimental colitis. Br J Nutr 2003; 90: 75-85
    CrossrefPubMedGoogle Scholar
  • 34 Kanauchi O, Serizawa I, Araki Y et al. Germinated barley foodstuff, a prebiotic product, ameliorates inflammation of colitis through modulation of the enteric environment. J Gastroenterol 2003; 38: 134-141
    CrossrefPubMedGoogle Scholar
  • 35 Hallert C, Bjorck I, Nyman M et al. Increasing fecal butyrate in ulcerative colitis patients by diet: controlled pilot study. Inflamm Bowel Dis 2003; 9: 116-121
    CrossrefPubMedGoogle Scholar
  • 36 Vernia P, Annese V, Bresci G et al. Topical butyrate improves efficacy of 5-ASA in refractory distal ulcerative colitis: results of a multicentre trial. Eur J Clin Invest 2003; 33: 244-248
    CrossrefPubMedGoogle Scholar
  • 37 Fernández-Bañares F, Hinojosa J, Sánchez-Lombraña JL et al. Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with mesalamine in maintaining remission in ulcerative colitis. Spanish Group for the Study of Crohn’s Disease and Ulcerative Colitis (GETECCU). Am J Gastroenterol 1999; 94: 427-433
    CrossrefPubMedGoogle Scholar
  • 38 Bourquin LD, Titgenmeyer EC, Fahey GC. Fermentation of various dietary fibre sources by human fecal bacteria. Nutr Res (New York) 1996; 16: 1119-1131
    CrossrefPubMedGoogle Scholar
  • 39 Hylla S, Gostner A, Dusel G et al. Effects of resistant starch on the colon in healthy volunteers: possible implications for cancer prevention. Am J Clin Nutr 1998; 67: 136-142
    PubMedGoogle Scholar
  • 40 Cummings JH. Constipation, dietary fibre and the control of large bowel function. Postgrad Med J 1984; 60: 811-819
    CrossrefPubMedGoogle Scholar
  • 41 Voderholzer WA, Schatke W, Mühldorfer BE et al. Clinical response to dietary fiber treatment of chronic constipation. Am J Gastroenterol 1997; 92: 95-98
    PubMedGoogle Scholar
  • 42 Tramonte SM, Brand MB, Mulrow CD et al. The treatment of chronic constipation in adults. A systematic review. J Gen Intern Med 1997; 12: 15-24
    CrossrefPubMedGoogle Scholar
  • 43 Ford AC, Talley NJ, Spiegel BM et al. Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ 2008; 337: a2313
    CrossrefPubMedGoogle Scholar
  • 44 Parisi G, Bottona E, Carrara M et al. Treatment effects of partially hydrolyzed guar gum on symptoms and quality of life of patients with irritable bowel syndrome. A multicenter randomized open trial. Dig Dis Sci 2005; 50: 1107-1112
    CrossrefPubMedGoogle Scholar
  • 45 Bijkerk CJ, de Wit NJ, Muris JW et al. Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial. BMJ 2009; 339: b3154
    CrossrefPubMedGoogle Scholar
  • 46 Tappy L, Gügolz E, Würsch P. Effects of breakfast cereals containing various amounts of beta-glucan fibers on plasma glucose and insulin responses in NIDDM subjects. Diabetes Care 1996; 8: 831-834
    PubMedGoogle Scholar
  • 47 Schulze MB, Schulz M, Heidemann C et al. Fiber and magnesium intake and incidence of type 2 diabetes: a prospective study and meta-analysis. Arch Intern Med 2007; 167: 956-965
    CrossrefPubMedGoogle Scholar
  • 48 de Munter JS, Hu FB, Spiegelman D et al. Whole grain, bran, and germ intake and risk of type 2 diabetes: a prospective cohort study and systematic review. PLoS Med 2007; 4: e261
    CrossrefPubMedGoogle Scholar
  • 49 Jensen CD, Haskell W, Whittam JH. Long-term effects of water-soluble dietary fiber in the management of hypercholesterolemia in healthy men and women. Am J Cardiol 1997; 79: 34-37
    CrossrefPubMedGoogle Scholar
  • 50 Brown L, Rosner B, Willett WW et al. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr 1999; 69: 30-42
    PubMedGoogle Scholar
  • 51 Trock B, Lanza E, Greenwald P. Dietary fiber, vegetables, and colon cancer: critical review and meta-analyses of the epidemiologic evidence. J Natl Cancer Inst 1990; 82: 650-661
    CrossrefPubMedGoogle Scholar
  • 52 Scheppach W, Luehrs H, Melcher R et al. Antiinflammatory and anticarcinogenic effects of dietary fibre. Clinical Nutrition Supplements 2004; 1: 51-58
    CrossrefPubMedGoogle Scholar
  • 53 Bingham SA, Day NE, Luben R et al. Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study. Lancet 2003; 361: 1496-1501
    CrossrefPubMedGoogle Scholar