Inulin-type fructans improve stool consistency in constipated kids: Pilot study

By Will Chu

- Last updated on GMT

Childhood constipation occurs in all paediatric age groups and its severity may vary from mild and short‐lived to severe and chronic, accompanied by faecal impaction. ©iStock/ilmoro100
Childhood constipation occurs in all paediatric age groups and its severity may vary from mild and short‐lived to severe and chronic, accompanied by faecal impaction. ©iStock/ilmoro100

Related tags Dietary fiber

Supplementing constipated children with prebiotic inulin‐type fructans could improve stool consistency, a pilot study of 2 to 5 year-olds' has concluded.

Results from the double‐blind, randomised, placebo‐controlled group trial showed a progressive stool softening in children receiving the prebiotic compared to those in a placebo group.

However, secondary outcomes found no significant difference in stool frequency and gastrointestinal symptoms over time.

The trial, which had the participation of ingredients giant Beneo in the study design, looked at prebiotic fibres, such as inulin-type fructans, and their ability to resist digestion and to reach the large intestine.

Current thinking suggests they are completely fermented by the gut microbiota, leading to a selective increase of beneficial bacteria (e.g. bifidobacteria ​and lactobacillus​).

The fermentation of prebiotics by the colonic microbiota is joined by an increase in a higher moisture content of digested content and faeces.

The supplement's efficacy could aid childhood constipation, one of the most common gastrointestinal disorder in children. The estimated prevalence ranges from 0.7 to 29.6%, with an average of 3% in the Western world.

Although the diets of western nations are still lacking in sufficient fibre, adult consumers are actively asking for convenient food and drinks that include dietary fibres.

Benro consumer research has found that three out of four people in the UK and Spain consume digestive health products to improve their overall health.

Fermentation can lead to the generation of fermentation end products such as short chain fatty acids (SCFA) which can influence intestinal motility. ©iStock

In addition, one in two people surveyed in these countries said that they ate digestive health products to lose weight.

Meanwhile, the same survey found Americans associated fibres with satiety and even bowel regularity.

Study parameters

The research team, from the University of Tarragona, obtained data from 17 children aged 2 to 5 years.

These children received either inulin‐type fructans or the same amount of maltodextrin as a placebo during the study’s 6-week duration.

A diary was used throughout the study to record the stool frequency and consistency as was a three‐day food diary for dietary intake.

Results showed that Beneo's Orafti inulin‐type fructan resulted in softer stools in supplemented children. 

The longitudinal analysis showed no significant changes in controls, whereas supplemented children increased their stool consistency from 2.2 to 2.6 on the modified Bristol scale for children (five items instead of seven).

“Supplementing the daily diet with a rather low dose of inulin-type fructans, seems to be promising for treating functional constipation in young children,”​ the researchers found.

“Hence, functional constipation seems to be a relevant target for larger and confirmative studies focussing on digestive health benefits of inulin-type fructans in children of this particular age group.”

The case for upping fibre

Although dietary fibre is associated with lower constipation, the study authors acknowledged the limited evidence available that confirmed additional fibre improved constipation compared with a placebo in children.

However, two notable pieces of research point to a reduction of the colonic transit time in children receiving a cocoa husk supplement​.

Similarly, an improvement in constipated children receiving glucomannan supplementation​ was recorded after 4 weeks.

Source:  International Journal of Food Sciences and Nutrition

Published online ahead of print:

“The use of inulin-type fructans improves stool consistency in constipated children. A randomised clinical trial: pilot study.”

Authors: Ricardo Closa-Monasterolo, Natalia Ferré, Gemma Castillejo-DeVillasante, Veronica Luque, Mariona Gispert-Llaurado, Marta Zaragoza-Jordana, Stephan Theis & Joaquin Escribano

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