Inulin fiber exacerbates inflammatory bowel disease, study finds

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kiny

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https://news.weill.cornell.edu/news/2024/05/common-type-of-fiber-may-trigger-bowel-inflammation

Institute for Research in Inflammatory Bowel Disease, Weill Cornell Medicine, Cornell University

Mohammad Arifuzzaman,Tae Hyung Won,Hiroshi Yano,Jazib Uddin,
Elizabeth R. Emanuel,Elin Hu,Wen Zhang,Ting-Ting Li,Wen-Bing Jin,Alex Grier,Sanchita Kashyap,Chun-Jun Guo,Frank C. Schroeder,David Artis

May, 2024

Inulin, a type of fiber found in certain plant-based foods and fiber supplements, causes inflammation in the gut and exacerbates inflammatory bowel disease in a preclinical model, according to a new study by Weill Cornell Medicine investigators.

The surprising findings could pave the way for therapeutic diets that may help ease symptoms and promote gut health.

He and his colleagues expected that inulin would also have protective effects in inflammatory bowel disease. But they found just the opposite.

Feeding inulin to mice in the context of a model of inflammatory bowel disease increased the production of certain bile acids by specific groups of gut bacteria. The increased bile acids boosted the production of an inflammatory protein called IL-5 by ILC2s. The ILC2s also failed to produce a tissue-protecting protein called amphiregulin. In response to these changes, the immune system promotes the production of immune cells called eosinophils, which further ramp up inflammation and tissue damage. Previously, a 2022 study by the same team of investigators showed that this flood of eosinophils may help protect against parasite infections. However, in the inflammatory bowel disease model, this chain reaction exacerbated intestinal inflammation, weight loss and other symptoms like diarrhea.
 
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This US study complements the Canadian study showing unfermented b-fructan fibers induces a proinflammatory immune response in certain people with crohn's disease.

"Unfermented b-fructan Fibers Fuel Inflammation in Select IBD patients"

https://www.gastrojournal.org/article/S0016-5085(22)01150-7/fulltext

A Dutch study showed oral delivery of B-glucan aggravate intestinal inflammation.

"β-glucans aggravate the course of dextran sulfate sodium (DSS)-induced intestinal inflammation at the level of the mucosa."

https://pubmed.ncbi.nlm.nih.gov/26500083/

A UK double blind study with 103 patients with active crohn's disease.
Patients were put on 15 g/day FOS prebiotic, this is usually made by Inulin degradation. Not only did the FOS prebiotic group not show any benefit, more people on FOS had to drop out of the study than those on placebo and more still in the FOS group had active inflammation than those in the placebo group, showing the potential harm of the prebiotic.

"More patients receiving FOS (14 (26%) vs 4 (8%); p=0.018) withdrew before the 4-week end point. There was no significant difference in the number of patients achieving a clinical response between the FOS and placebo groups in the ITT analysis (12 (22%) vs 19 (39%), p=0.067). An adequately powered placebo-controlled trial of FOS showed no clinical benefit in patients with active Crohn's disease, despite impacting on DC function."

https://gut.bmj.com/content/60/7/923.long
 
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The FDA recommendation for the "Guidance of the industry" regarding non-digestible carbohydrates, including Inulin, is so unbelievably ridiculous.

The FDA's "scientific evaluation" on the listing and benefits of these fibers, includes "citizen petitions" and "comments that we received".

These FDA recommendations have consequences, it allows anyone to just sell Inulin as prebiotics and claim it is "beneficial for gut health", whatever that means. While actual studies regarding crohn's disease, that show the potential for harm, can be flat out ignored.

https://www.fda.gov/media/113663/download
 
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I am typically sceptical of these fiber = inflammation studies, as it does not overlap with my personal experience, but there might be something in above ones. I checked and I am actually not able to tolerate most (perhaps all) foods having inulin and / or FOS and / or b-fructans. The fiber-containing products I have been doing remarkably well and that reduced my inflammation were papaya, squash, and peanut butter.
 

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