Sixty healthy Japanese women with a defaecation frequency of 2-4 times/week participated in this randomised, double-blind crossover trial. Participants received 2 g/day lactulose for 2 weeks and placebo in a random order, separated by a washout period of 3 weeks. Eight participants were excluded who did not satisfy the conditions, and therefore data from 52 were analysed. The primary outcome was defaecation frequency and the secondary outcomes were the number of defaecation days, faecal consistency, faecal volume, and the number and percentage of Bifidobacterium in faeces. The defaecation frequency (times/week) was significantly higher during lactulose (4.28±0.23) than placebo (3.83±0.23) treatment (delta (Δ) 0.45 [95% confidence interval (CI) 0.10-0.80], P=0.013). The defaecation days (days/week) was significantly higher during lactulose (3.77±0.17) than placebo (3.47±0.17) treatment (Δ0.30 [95% CI 0.04-0.56], P=0.024). Faecal consistency using the Bristol Stool Scale (/defaecation) was significantly higher during lactulose (3.84±0.10) than placebo (3.68±0.10) treatment (Δ0.16 [95% CI 0.00-0.31], P=0.044). Faecal volume (/week) was significantly higher during lactulose (21.73±3.07) than placebo (17.65±3.07) treatment (Δ4.08 [95% CI 0.57-7.60], P=0.024). The number of Bifidobacterium in faeces (log colony forming units/g faeces) was significantly higher during lactulose (9.53±0.06) than placebo (9.16±0.06) treatment (Δ0.37 [95% CI 0.23-0.49], P<0.0001). The percentage of Bifidobacterium in faeces was also significantly higher during lactulose (25.3±1.4) than placebo (18.2±1.4) treatment (Δ7.1 [95% CI 2.9-11.4], P=0.0014). Finally, straining at defaecation (/defaecation) during lactulose (3.62±0.24) treatment was significantly lower than during placebo (3.97±0.24) treatment (Δ0.35 [95% CI -0.69 – -0.02], P=0.037). No significant difference was observed between lactulose and placebo with regard to flatulence. Severe adverse effects did not occur. Thus, oral ingestion of 2 g/day lactulose had a prebiotic effect, increasing the number and percentage of bifidobacteria in faeces, softening the faeces, and increasing defaecation frequency, but without increasing flatulence.
Aït-Aissa, A. and Mohammed, A., 2014. Lactulose: production and use in functional food, medical and pharmaceutical applications. Practical and critical review. International Journal of Food Science and Technology 49: 1245-1253. DOI: https://doi.org/10.1111/ijfs.12465
Bharucha, A.E., John, H.P. and Locke 3rd, G.R., 2013. American Gastroenterological Association technical review on constipation. Gastroenterology 144: 218-238. DOI: https://doi.org/10.1053/j.gastro.2012.10.028
Blake, M.R., Raker, J.M. and Whelan, K., 2016. Validity and reliability of the Bristol Stool Form Scale in healthy adults and patients with diarrhoea-predominant irritable bowel syndrome. Alimentary Pharmacology and Therapeutics 44: 693-703. DOI: https://doi.org/10.1111/apt.13746
Bolyen, E., Rideout, J.R., Dillon, M.R., Bokulich, N.A., Abnet, C., Al-Ghalith, G.A., Alexander, H., Alm, E.J., Arumugam, M., Asnicar, F., Bai, Y., Bisanz, J.E., Bittinger, K., Brejnrod, A., Brislawn, C.J., Brown, C.T., Callahan, B.J., Caraballo-Rodríguez, A.M., Chase, J., Cope, E., Da, Silva, R., Dorrestein, P.C., Douglas, G.M., Durall, D.M., Duvallet, C., Edwardson, C.F., Ernst, M., Estaki, M., Fouquier, J., Gauglitz, J.M., Gibson, D.L., Gonzalez, A., Gorlick, K., Guo, J., Hillmann, B., Holmes, S., Holste, H., Huttenhower, C., Huttley, G., Janssen, S., Jarmusch, A.K., Jiang, L., Kaehler, B., Kang, K.B., Keefe, C.R., Keim, P., Kelley, S.T., Knights, D., Koester, I., Kosciolek, T., Kreps, J., Langille, M.G., Lee, J., Ley, R., Liu, Y., Loftfield, E., Lozupone, C., Maher, M., Marotz, C., Martin, B.D., McDonald, D., McIver, L.J., Melnik, A.V., Metcalf, J.L., Morgan, S.C., Morton, J., Naimey, A.T., Navas-Molina, J.A., Nothias, L.F., Orchanian, S.B., Pearson, T., Peoples, S.L., Petras, D., Preuss, M.L., Pruesse, E., Rasmussen, L.B., Rivers, A., Robeson II, M.S., Rosenthal, P., Segata, N., Shaffer, M., Shiffer, A., Sinha, R., Song, S.J., Spear, J.R., Swafford, A.D., Thompson, L.R., Torres, P.J., Trinh, P., Tripathi, A., Turnbaugh, P.J., Ul-Hasan, S., Van der Hooft, J.J., Vargas, F., Vázquez-Baeza, Y., Vogtmann, E., Von Hippel, M., Walters, W., Wan, Y., Wang, M., Warren, J., Weber, K.C., Williamson, C.H., Willis, A.D., Xu, Z.Z., Zaneveld, J.R., Zhang, Y., Zhu, Q., Knight, R. and Caporaso, J.G., 2018. QIIME 2: Reproducible, interactive, scalable, and extensible microbiome data science. PeerJ Preprints 6: e27295v2. https://doi.org/10.7287/peerj.preprints.27295v2
Callahan, B.J., McMurdie, P.J., Rosen, M.J., Han, A.W., Johnson, A.J.A. and Holmes, S.P., 2016. DADA2: high-resolution sample inference from Illumina amplicon data. Nature Methods 13: 581-583. DOI: https://doi.org/10.1038/nmeth.3869
Degen, L.P. and Phillips, S.F., 1996. How well does stool form reflect colonic transit? Gut 39: 109-113. DOI: https://doi.org/10.1136/gut.39.1.109
Gibson, G.R., Hutkins, R., Sanders, M.E., Prescott, S.L., Reimer, R.A., Salminen, S.J., Scott, K., Stanton, C., Swanson, K.S., Cani, P.D., Verbeke, K. and Reid, G., 2017. Expert consensus document: the International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nature Reviews Gastroenterology & Hepatology 14: 491-502. DOI: https://doi.org/10.1038/nrgastro.2017.75
Kato, K., Ishida, S., Tanaka, M., Mitsuyama, E., Xiao, J.Z. and Odamaki, T., 2018. Association between functional lactase variants and a high abundance of Bifidobacterium in the gut of healthy Japanese people. PLoS ONE 13: e0206189. DOI: https://doi.org/10.1371/journal.pone.0206189
Kiyosawa, I., Takase, M., Yamauchi, K., Ono, J., Yaeshima, T. and Okonogi, S., 1986. Lactulose and intestinal microflora in infant nutrition. Bifidobacteria and Microflora 5: 27-35. DOI: https://doi.org/10.12938/bifidus1982.5.1_27
Kurbel, S., Kurbel, B. and Včev, A., 2006. Intestinal gases and flatulence: possible causes of occurrence. Medical Hypotheses 67: 235-239. DOI: https://doi.org/10.1016/j.mehy.2006.01.057
Lewis, S.J. and Heaton, K.W., 1997. Stool form scale as a useful guide to intestinal transit time. Scandinavian Journal of Gastroenterology 32: 920-924. DOI: https://doi.org/10.3109/00365529709011203
Matsuki, T., Watanabe, K., Fujimoto, J., Kado, Y., Takada, T., Matsumoto, K. and Tanaka, R., 2004. Quantitative PCR with 16S rRNA-gene-targeted species-specific primers for analysis of human intestinal bifidobacteria. Applied and Environmental Microbiology 70: 167-173. DOI: https://doi.org/10.1128/AEM.70.1.167-173.2004
Ministry of Health, Labour and Welfare of Japan, 2018. 2016 Comprehensive survey of living conditions. Available at: https://www.e-stat.go.jp/stat-search/ [in Japanese]
Mitsuoka, T., 1990. Bifidobacteria and their role in human health. Journal of Industrial Microbiology 6: 263-267. DOI: https://doi.org/10.1007/BF01575871
Mizota, T., Mori, T., Yaeshima, T., Yanagida, T., Iwatsuki, K., Ichibashi, N., Tamura, Y. and Fukuwatari, Y., 2002. Effects of low dosages of lactulose on the intestinal function of healthy adults. Milchwissenschaft 57: 312-315.
'Effects of low dosages of lactulose on the intestinal function of healthy adults ' () 57 Milchwissenschaft : 312 -315.
Morii, H., Oda, K., Suenaga, Y. and Nakamura, T., 2003. Low methane concentration in the breath of Japanese. Journal of the University of Occupational and Environmental Health 25: 397-407. DOI: https://doi.org/10.7888/juoeh.25.397 [in Japanese]
Nishijima, S., Suda, W., Oshima, K., Kim, S.W., Hirose, Y., Morita, H. and Hattori, M., 2016. The gut microbiome of healthy Japanese and its microbial and functional uniqueness. DNA Research 23: 125-133. DOI: https://doi.org/10.1093/dnares/dsw002
Nishimura, N., 2014. Study on prevention of lifestyle diseases by regulating fermentation in the large intestine using luminacoids. Journal of Japanese Association for Dietary Fiber Research 18: 79-87. [in Japanese]
'Study on prevention of lifestyle diseases by regulating fermentation in the large intestine using luminacoids ' () 18 Journal of Japanese Association for Dietary Fiber Research : 79 -87.
Oku, T. and Okazaki, M., 1998. Transitory laxative threshold of trehalose and lactulose in healthy women. Journal of Nutritional Science and Vitaminology 44: 787-798. DOI: https://doi.org/10.3177/jnsv.44.787
Petuely, F., 1957. Bifidusflora bei Flaschenkindern durch bifidogene Substanzen (Bifidusfaktor). Zeit Kinderheilk 79: 174-179. DOI: https://doi.org/10.1007/BF00440162 (in German)
Sakai, Y., Seki, N., Hamano, H., Ochi, H., Abe, F., Shimizu, F, Masuda, K. and Iino, H., 2019. A study of the prebiotic effect of lactulose with low dosages on healthy Japanese women. Bioscience of Microbiota, Food and Health 38: 69-72. DOI: https://doi.org/10.12938/bmfh.18-013
Schiller, L.R., 2001. Review article: the therapy of constipation. Alimentary Pharmacology & Therapeutics 15: 749-763. DOI: https://doi.org/10.1046/j.1365-2036.2001.00982.x
Seki, N. and Saito, H., 2012. Lactose as a source for lactulose and other functional lactose derivatives. International Dairy Journal 22: 110-115. DOI: https://doi.org/10.1016/j.idairyj.2011.09.016
Sugahara, H., Odamaki, T., Hashikura, N., Abe, F. and Xiao, J.Z., 2015. Differences in folate production by bifidobacteria of different origins. Bioscience of Microbiota, Food and Health 34: 87-93. DOI: https://doi.org/10.12938/bmfh.2015-003
Terada, A., Hara, H., Kataoka, M. and Mitsuoka, T., 1992. Effect of lactulose on the composition and metabolic activity of the human faecal flora. Microbial Ecology in Health and Disease 5: 43-50. DOI: https://doi.org/10.3109/08910609209141303
Tomoda, T., Yasuo, N. and Takashi, K., 1991. Effect of yogurt and yogurt supplemented with Bifidobacterium and/or lactulose in healthy persons: a comparative study. Bifidobacteria and Microflora 10: 123-130. DOI: https://doi.org/10.12938/bifidus1982.10.2_123
Yaeshima, T., 1996. Benefits of bifidobacteria to human health: oligosaccharides and probiotic bacteria. Bulletin of the International Dairy Federation 313: 36-42.
'Benefits of bifidobacteria to human health: oligosaccharides and probiotic bacteria ' () 313 Bulletin of the International Dairy Federation : 36 -42.
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Sixty healthy Japanese women with a defaecation frequency of 2-4 times/week participated in this randomised, double-blind crossover trial. Participants received 2 g/day lactulose for 2 weeks and placebo in a random order, separated by a washout period of 3 weeks. Eight participants were excluded who did not satisfy the conditions, and therefore data from 52 were analysed. The primary outcome was defaecation frequency and the secondary outcomes were the number of defaecation days, faecal consistency, faecal volume, and the number and percentage of Bifidobacterium in faeces. The defaecation frequency (times/week) was significantly higher during lactulose (4.28±0.23) than placebo (3.83±0.23) treatment (delta (Δ) 0.45 [95% confidence interval (CI) 0.10-0.80], P=0.013). The defaecation days (days/week) was significantly higher during lactulose (3.77±0.17) than placebo (3.47±0.17) treatment (Δ0.30 [95% CI 0.04-0.56], P=0.024). Faecal consistency using the Bristol Stool Scale (/defaecation) was significantly higher during lactulose (3.84±0.10) than placebo (3.68±0.10) treatment (Δ0.16 [95% CI 0.00-0.31], P=0.044). Faecal volume (/week) was significantly higher during lactulose (21.73±3.07) than placebo (17.65±3.07) treatment (Δ4.08 [95% CI 0.57-7.60], P=0.024). The number of Bifidobacterium in faeces (log colony forming units/g faeces) was significantly higher during lactulose (9.53±0.06) than placebo (9.16±0.06) treatment (Δ0.37 [95% CI 0.23-0.49], P<0.0001). The percentage of Bifidobacterium in faeces was also significantly higher during lactulose (25.3±1.4) than placebo (18.2±1.4) treatment (Δ7.1 [95% CI 2.9-11.4], P=0.0014). Finally, straining at defaecation (/defaecation) during lactulose (3.62±0.24) treatment was significantly lower than during placebo (3.97±0.24) treatment (Δ0.35 [95% CI -0.69 – -0.02], P=0.037). No significant difference was observed between lactulose and placebo with regard to flatulence. Severe adverse effects did not occur. Thus, oral ingestion of 2 g/day lactulose had a prebiotic effect, increasing the number and percentage of bifidobacteria in faeces, softening the faeces, and increasing defaecation frequency, but without increasing flatulence.
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