Department of Food Science and Human Nutrition, University of Illinois, Urbana, IL, USA.
Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA; Children's Nutrition Research Center, United States Department of Agriculture, Houston, TX, USA.
Adv Nutr. 2022 Dec 22;13(6):2084-2097. doi: 10.1093/advances/nmac091.
Human intestinal enzymes do not hydrolyze nondigestible carbohydrates (NDCs), and thus, they are not digested and absorbed in the small intestine. Instead, NDCs are partially to completely fermented by the intestinal microbiota. Select NDCs are associated with health benefits such as laxation and lowering of blood cholesterol and glucose. NDCs provide functional attributes to processed foods, including sugar or fat replacers, thickening agents, and bulking agents. Additionally, NDCs are incorporated into processed foods to increase their fiber content. Although consumption of NDCs can benefit health and contribute functional characteristics to foods, they can cause gastrointestinal symptoms, such as flatulence and bloating. As gastrointestinal symptoms negatively affect consumer well-being and their acceptance of foods containing NDC ingredients, it is crucial to consider tolerance when designing food products and testing their physiological health benefits in clinical trials. This perspective provides recommendations for the approach to assess gastrointestinal tolerance to NDCs, with a focus on study design, population criteria, intervention, comparator, and outcome. Special issues related to studies in children and implications for stakeholders are also discussed. It is recommended that the evaluation of gastrointestinal tolerance to NDCs be conducted in randomized, blinded, controlled crossover studies using standard gastrointestinal questionnaires, with attention to study participant background diets, health status, lifestyle, and medications.
人体肠道酶不能水解不可消化的碳水化合物 (NDCs)，因此它们不会在小肠中被消化和吸收。相反，NDCs 被肠道微生物群部分或完全发酵。一些特定的 NDCs 与健康益处相关，例如通便、降低血液胆固醇和葡萄糖水平。NDCs 为加工食品提供了功能性特性，包括糖或脂肪替代品、增稠剂和膨松剂。此外，NDCs 被添加到加工食品中以增加其纤维含量。尽管 NDC 的消耗可以有益于健康，并为食物提供功能性特征，但它们也可能导致胃肠道症状，如胀气和腹胀。由于胃肠道症状会对消费者的健康和对含有 NDC 成分的食物的接受程度产生负面影响，因此在设计食品产品和在临床试验中测试其生理健康益处时，考虑耐受性至关重要。本观点提供了评估 NDC 胃肠道耐受性的方法建议，重点是研究设计、人群标准、干预措施、对照和结果。还讨论了与儿童研究相关的特殊问题以及对利益相关者的影响。建议使用标准胃肠道问卷，在随机、双盲、对照交叉研究中评估 NDC 对胃肠道的耐受性，并注意研究参与者的背景饮食、健康状况、生活方式和药物使用情况。
