i3.1 mitigates the effects of fructose intolerance
Readily available, affordable to produce and considered to be the ‘sweetest’ sugar, fructose is an incredibly popular ingredient in processed food and drink products in Europe and the US. Indeed, according to one estimate, fructose consumption in the US grew by more than 1000% between 1970 and 1990,[i] and is still widely used despite the concerns surrounding its links to type II diabetes and obesity.[ii] In this context, estimates placing the prevalence of fructose malabsorption at 34% of the healthy adult population present a serious challenge. [iii],[iv]
Fructose malabsorption, and its more serious counterpart fructose intolerance (FI), are broadly defined as the inability of intestines to properly absorb the monosaccharide fructose, resulting in gastrointestinal symptoms such as bloating, diarrhea and abdominal pain.[v],[vi] Fructose intolerant people tend to experience a diminished quality of life, because they cannot enjoy a wide variety of foods and beverages without pain or discomfort. With over a third of the population thought to suffer from fructose sensitivity, the scientific community has been investigating treatments that could mitigate the effects of FI, including novel probiotic blends.
To build on this existing evidence, authors Piero Portincasa et al. devised a new study with the dual aim of investigating the prevalence of fructose intolerance in individuals with FGIDs and the effectiveness of a 30-day treatment with a novel probiotic formulation (L. plantarum—KABP 022 and 023 strains—and P. acidilactici KABP 021, commercialized under the brand i3.1) in improving symptoms in people with fructose intolerance on a fructose-free diet regimen and persistent symptomatology.[vii]
The study by Portincasa et al. started with an initial cohort of 69 Romanian adult subjects (mean age 53 ± 15 SD years, 26 males and 43 females) who had been referred to the outpatient unit of the 2nd Medical Clinic of the University Hospital of Cluj-Napoca with suspected FGIDs. After a breath test, all subjects who tested positive to fructose intolerance underwent a fructose- and sorbitol-free diet for 30 days. During this time participants were not permitted to consume fibers or probiotics, alcoholic beverages or any treatments acting on intestinal motility – a requirement which continued throughout the study’s duration. All subjects who did not report an improvement of symptoms after the 30 fructose-free diet were enrolled in the trial and started the treatment with 1 capsule per day of i3.1. To act as a control, 14 sex- and age-matched healthy subjects were also recruited and underwent the same treatment with the probiotic blend.
Evaluation of GI symptoms and a fecal sample collection from both groups was performed at two separate time points, before (T0) and after treatment (T30), yielding a set of results with great promise for FI suffers and supplement producers alike.
i3.1 improved bloating and abdominal pain
The effects of the i3.1 probiotic blend on both groups produced fascinating results in regard to GI symptom improvement and metabolomic profile changes.
Following the 30-day daily probiotic treatment, all the study participants reported a significant improvement in bloating and abdominal pain, while the marked differences in VOC profile observed between the FI and HC groups prior to the study were greatly reduced. These effects suggest that the i3.1 probiotic strain was not only effective in reliving the symptoms of FI, but also potentially brought FI people closer to the healthy control group in terms of fructose absorption and general GI function.
The results of the Portincasa et al. study are extremely promising. Demonstrating a credible correlation between the L. plantarum and P. acidilactici probiotic blend and an improvement in GI symptoms linked to fructose intolerance.
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[i] Johlin, F.C., Jr.; Panther, M.; Kraft, N. Dietary fructose intolerance: Diet modification can impact self-rated health and symptom control. Nutr. Clin. Care Off. Publ. Tufts Univ. 2004, 7, 92–97.
[ii] Bernadette P. Marriott, Nancy Cole, Ellen Lee, National Estimates of Dietary Fructose Intake Increased from 1977 to 2004 in the United States, The Journal of Nutrition, Volume 139, Issue 6, June 2009, Pages 1228S–1235S, https://doi.org/10.3945/jn.108.098277
[iii] Barrett, J.S.; Irving, P.M.; Shepherd, S.J.; Muir, J.G.; Gibson, P.R. Comparison of the prevalence of fructose and lactose malabsorption across chronic intestinal disorders. Aliment. Pharmacol. Ther. 2009, 30, 165–174. [CrossRef]
[iv] Wilder-Smith, C.H.; Materna, A.; Wermelinger, C.; Schuler, J. Fructose and lactose intolerance and malabsorption testing: The relationship with symptoms in functional gastrointestinal disorders. Aliment. Pharmacol. Ther. 2013, 37, 1074–1083. [CrossRef]
[v] Bonfrate, L.; Krawczyk, M.; Lembo, A.; Grattagliano, I.; Lammert, F.; Portincasa, P. Effects of dietary education, followed by a tailored fructose-restricted diet in adults with fructose malabsorption. Eur. J. Gastroenterol. Hepatol. 2015, 27, 785–796. [CrossRef] [PubMed]
[vi] Latulippe, M.E.; Skoog, S.M. Fructose malabsorption and intolerance: Effects of fructose with and without simultaneous glucose ingestion. Crit. Rev. Food Sci. Nutr. 2011, 51, 583–592. [CrossRef]
[vii] Portincasa, P.; Celano, G.; Serale, N.; Vitellio, P.; Calabrese, F.M.; Chira, A.; David, L.; Dumitrascu, D.L.; De Angelis, M. Clinical and Metabolomic Effects of Lactiplantibacillus plantarum and Pediococcus acidilactici in Fructose Intolerant Patients. Nutrients 2022, 14, 2488. https://doi.org/10.3390/ nu14122488