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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Fiber and prebiotic supplementation in enteral nutrition: A systematic review and meta-analysis</title>
<author><name sortKey="Kamarul Zaman, Mazuin" sort="Kamarul Zaman, Mazuin" uniqKey="Kamarul Zaman M" first="Mazuin" last="Kamarul Zaman">Mazuin Kamarul Zaman</name>
</author>
<author><name sortKey="Chin, Kin Fah" sort="Chin, Kin Fah" uniqKey="Chin K" first="Kin-Fah" last="Chin">Kin-Fah Chin</name>
</author>
<author><name sortKey="Rai, Vineya" sort="Rai, Vineya" uniqKey="Rai V" first="Vineya" last="Rai">Vineya Rai</name>
</author>
<author><name sortKey="Majid, Hazreen Abdul" sort="Majid, Hazreen Abdul" uniqKey="Majid H" first="Hazreen Abdul" last="Majid">Hazreen Abdul Majid</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">25954112</idno>
<idno type="pmc">4419079</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4419079</idno>
<idno type="RBID">PMC:4419079</idno>
<idno type="doi">10.3748/wjg.v21.i17.5372</idno>
<date when="2015">2015</date>
<idno type="wicri:Area/Pmc/Corpus">000018</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Fiber and prebiotic supplementation in enteral nutrition: A systematic review and meta-analysis</title>
<author><name sortKey="Kamarul Zaman, Mazuin" sort="Kamarul Zaman, Mazuin" uniqKey="Kamarul Zaman M" first="Mazuin" last="Kamarul Zaman">Mazuin Kamarul Zaman</name>
</author>
<author><name sortKey="Chin, Kin Fah" sort="Chin, Kin Fah" uniqKey="Chin K" first="Kin-Fah" last="Chin">Kin-Fah Chin</name>
</author>
<author><name sortKey="Rai, Vineya" sort="Rai, Vineya" uniqKey="Rai V" first="Vineya" last="Rai">Vineya Rai</name>
</author>
<author><name sortKey="Majid, Hazreen Abdul" sort="Majid, Hazreen Abdul" uniqKey="Majid H" first="Hazreen Abdul" last="Majid">Hazreen Abdul Majid</name>
</author>
</analytic>
<series><title level="j">World Journal of Gastroenterology : WJG</title>
<idno type="ISSN">1007-9327</idno>
<idno type="eISSN">2219-2840</idno>
<imprint><date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p>AIM: To investigate fiber and prebiotic supplementation of enteral nutrition (EN) for diarrhea, fecal microbiota and short-chain fatty acids (SCFAs).</p>
<p>METHODS: MEDLINE, EMBASE, Cochrane Library, CINAHL, Academic Search Premier, and Web of Science databases were searched for human experimental and observational cohort studies conducted between January 1990 and June 2014. The keywords used for the literature search were fiber, prebiotics and enteral nutrition. English language studies with adult patient populations on exclusive EN were selected. Abstracts and/or full texts of selected studies were reviewed and agreed upon by two independent researchers for inclusion in the meta-analysis. Tools used for the quality assessment were Jadad Scale and the Scottish Intercollegiate Guidelines Network Critical Appraisal of the Medical Literature.</p>
<p>RESULTS: A total of 456 possible articles were retrieved, and 430 were excluded due to lack of appropriate data. Of the 26 remaining studies, only eight investigated the effects of prebiotics. Results of the meta-analysis indicated that overall, fiber reduces diarrhea in patients receiving EN (OR = 0.47; 95%CI: 0.29-0.77; <italic>P</italic>
= 0.02). Subgroup analysis revealed a positive effect of fiber supplementation in EN towards diarrhea in stable patients (OR = 0.31; 95%CI: 0.19-0.51; <italic>P</italic>
< 0.01), but not in critically ill patients (OR = 0.89; 95%CI: 0.41-1.92; <italic>P</italic>
= 0.77). Prebiotic supplementation in EN does not improve the incidence of diarrhea despite its manipulative effect on bifidobacteria concentrations and SCFA in healthy humans. In addition, the effect of fiber and/or prebiotic supplementation towards fecal microbiota and SCFA remain disputable.</p>
<p>CONCLUSION: Fiber helps minimize diarrhea in patients receiving EN, particularly in non-critically ill patients. However, the effect of prebiotics in moderating diarrhea is inconclusive.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">World J Gastroenterol</journal-id>
<journal-id journal-id-type="iso-abbrev">World J. Gastroenterol</journal-id>
<journal-id journal-id-type="publisher-id">WJG</journal-id>
<journal-title-group><journal-title>World Journal of Gastroenterology : WJG</journal-title>
</journal-title-group>
<issn pub-type="ppub">1007-9327</issn>
<issn pub-type="epub">2219-2840</issn>
<publisher><publisher-name>Baishideng Publishing Group Inc</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25954112</article-id>
<article-id pub-id-type="pmc">4419079</article-id>
<article-id pub-id-type="other">jWJG.v21.i17.pg5372</article-id>
<article-id pub-id-type="doi">10.3748/wjg.v21.i17.5372</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Systematic Reviews</subject>
</subj-group>
</article-categories>
<title-group><article-title>Fiber and prebiotic supplementation in enteral nutrition: A systematic review and meta-analysis</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Kamarul Zaman</surname>
<given-names>Mazuin</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Chin</surname>
<given-names>Kin-Fah</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Rai</surname>
<given-names>Vineya</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Majid</surname>
<given-names>Hazreen Abdul</given-names>
</name>
</contrib>
<aff>Mazuin Kamarul Zaman, Hazreen Abdul Majid, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia</aff>
<aff>Kin-Fah Chin, Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia</aff>
<aff>Vineya Rai, Department of Anaesthesiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia</aff>
</contrib-group>
<author-notes><fn><p>Author contributions: Kamarul Zaman M and Majid HA analyzed the data, and drafted and wrote the paper; Chin KF, Rai V and Majid HA designed the study and revised the manuscript; all authors approved the final version submitted for publication.</p>
<p>Correspondence to: Hazreen Abdul Majid, PhD, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia. <email>hazreen.abdulmajid@gmail.com</email>
</p>
<p>Telephone: +60-37-9674757 Fax: +60-37-9674975</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><day>7</day>
<month>5</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>7</day>
<month>5</month>
<year>2015</year>
</pub-date>
<volume>21</volume>
<issue>17</issue>
<fpage>5372</fpage>
<lpage>5381</lpage>
<history><date date-type="received"><day>24</day>
<month>10</month>
<year>2014</year>
</date>
<date date-type="rev-recd"><day>7</day>
<month>12</month>
<year>2014</year>
</date>
<date date-type="accepted"><day>30</day>
<month>1</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.</copyright-statement>
<copyright-year>2015</copyright-year>
</permissions>
<abstract><p>AIM: To investigate fiber and prebiotic supplementation of enteral nutrition (EN) for diarrhea, fecal microbiota and short-chain fatty acids (SCFAs).</p>
<p>METHODS: MEDLINE, EMBASE, Cochrane Library, CINAHL, Academic Search Premier, and Web of Science databases were searched for human experimental and observational cohort studies conducted between January 1990 and June 2014. The keywords used for the literature search were fiber, prebiotics and enteral nutrition. English language studies with adult patient populations on exclusive EN were selected. Abstracts and/or full texts of selected studies were reviewed and agreed upon by two independent researchers for inclusion in the meta-analysis. Tools used for the quality assessment were Jadad Scale and the Scottish Intercollegiate Guidelines Network Critical Appraisal of the Medical Literature.</p>
<p>RESULTS: A total of 456 possible articles were retrieved, and 430 were excluded due to lack of appropriate data. Of the 26 remaining studies, only eight investigated the effects of prebiotics. Results of the meta-analysis indicated that overall, fiber reduces diarrhea in patients receiving EN (OR = 0.47; 95%CI: 0.29-0.77; <italic>P</italic>
= 0.02). Subgroup analysis revealed a positive effect of fiber supplementation in EN towards diarrhea in stable patients (OR = 0.31; 95%CI: 0.19-0.51; <italic>P</italic>
< 0.01), but not in critically ill patients (OR = 0.89; 95%CI: 0.41-1.92; <italic>P</italic>
= 0.77). Prebiotic supplementation in EN does not improve the incidence of diarrhea despite its manipulative effect on bifidobacteria concentrations and SCFA in healthy humans. In addition, the effect of fiber and/or prebiotic supplementation towards fecal microbiota and SCFA remain disputable.</p>
<p>CONCLUSION: Fiber helps minimize diarrhea in patients receiving EN, particularly in non-critically ill patients. However, the effect of prebiotics in moderating diarrhea is inconclusive.</p>
</abstract>
<kwd-group><kwd>Bifidobacteria</kwd>
<kwd>Diarrhea</kwd>
<kwd>Enteral nutrition</kwd>
<kwd>Fiber</kwd>
<kwd>Prebiotics</kwd>
<kwd>Short-chain fatty acids</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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