Insights & Discussion
Consuming kiwifruit, particularly the green variety, can effectively alleviate upper gastrointestinal symptoms like abdominal discomfort, pain, and indigestion.
The research undertook a systematic scoping review of three electronic databases from 1947 until January 2021. The team searched for clinical trials that investigated the effects of either green or gold kiwifruit or their compounds on upper gastrointestinal symptoms. They focused on the studies that had the symptom relief as secondary outcomes in healthy participants or those with functional constipation or irritable bowel syndrome with constipation. The outcomes were analyzed based on the type of measurement tools used; one being the Gastrointestinal Symptom Rating Scale (GSRS) and the others being non-GSRS methods.
The analysis unveiled that out of the identified 12 clinical trials, with a total of 661 participants, only five used the GSRS to assess symptom relief. Green kiwifruit showed notable results in reducing abdominal discomfort and pain. Kiwifruit consumption, in general, appeared to diminish indigestion. While the number of studies reporting on symptom relief using a comparable measurement was limited, the evidence for kiwifruit's positive efficacy on gastrointestinal symptom relief remained consistent.
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Consuming green kiwifruits is associated with a clinically relevant increase of ≥ 1.5 complete spontaneous bowel movements per week in those experiencing constipation.
2022 American Journal of Gastroenterology Consumption of 2 Green Kiwifruits Daily Improves Constipation and Abdominal Comfort—Results of an International Multicenter Randomized Controlled Trial Gearry R, Fukudo S, Barbara G, Kuhn-Sherlock B, Ansell J, Blatchford P, et al.
Randomised Controlled Trial Constipation Irritable Bowel Syndrome Kiwifruit
Participants included healthy controls (n = 63), patients with functional constipation (FC, n = 60), and patients with constipation-predominant irritable bowel syndrome (IBS-C, n = 61) randomly assigned to consume 2 green kiwifruits or psyllium (7.5 g) per day for 4 weeks, followed by a 4-week washout, and then the other treatment for 4 weeks. The primary outcome was the number of complete spontaneous bowel movements (CSBM) per week. Secondary outcomes included GI comfort which was measured using the GI symptom rating scale, a validated instrument. Data (intent-to-treat) were analyzed as difference from baseline using repeated measures analysis of variance suitable for AB/BA crossover design.
Consumption of green kiwifruit was associated with a clinically relevant increase of ≥ 1.5 CSBM per week (FC; 1.53, P < 0.0001, IBS-C; 1.73, P = 0.0003) and significantly improved measures of GI comfort (GI symptom rating scale total score) in constipated participants (FC, P < 0.0001; IBS-C, P < 0.0001). No significant adverse events were observed.
Xiao Yao San can improve symptoms and reduce recurrence rates in patients with disorders of gut-brain interaction.
2022 Frontiers in Pharmacology Efficacy and Safety of Chinese Herbal Medicine Xiao Yao San in Functional Gastrointestinal Disorders: A meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials Liu Q, Shi Z, Zhang T, Jiang T, Luo X, Su X, et al.
Systematic Review Constipation Functional gastrointestinal disorders Irritable Bowel Syndrome
The paper's methodology involved a meta-analysis of randomized controlled trials found in seven databases, up until November 22, 2021. The trials, which totaled 48 all together, were included to determine the efficacy of Xiao-Yao-San in treating disorders of gut-brain interaction (previously known as functional gastrointestinal disorders). A range of measures, including therapeutic efficacy, symptom score, Self-Rating Anxiety Scale score, Self-Rating Depression Scale score, and the recurrence rate, were analysed using both random-effects and fixed-effects models, as well as trial sequential analysis.
In terms of results, Xiao-Yao-San showed a marked improvement in the effective rate of managing disorders of gut-brain interaction compared to western drugs, both when used alone and in combination with western medicine. The paper also found the treatment notably reduced symptom scores, anxiety scores, and depression scores for patients with the disorder. Further, instances of recurrence were also reduced. Overall, Xiao-Yao-San was well tolerated and no serious adverse events were reported in any of the trials included in this analysis.
Eating whole SunGold kiwifruits, both with and without skin, can significantly decrease gut inflammation and alleviate constipation for both healthy people and those with irritable bowel syndrome.
2020 Nutrients The Effects on Immune Function and Digestive Health of Consuming the Skin and Flesh of Zespri® SunGold Kiwifruit (Actinidia Chinensis var. Chinensis ‘Zesy002’) in Healthy and IBS-Constipated Individuals Eady SL, Wallace AJ, Hedderley DI, Bentley-Hewitt KL, Butts CA
Randomised Controlled Trial Constipation Irritable Bowel Syndrome Kiwifruit
In the 16-week cross-over study, 38 participants (both healthy and those with Irritable Bowel Syndrome-Constipation) were randomly assigned to consume either three whole SunGold kiwifruits without the skin or three whole kiwifruits with the skin for periods of four weeks, with a length of four weeks between each intervention as a washout period.
Following the intervention, it was observed that there was a significant reduction in pro-inflammatory cytokines (specifically TNF-α) for both the healthy participants and those with Irritable Bowel Syndrome-Constipation when whole kiwifruits, including the skin, were consumed. Furthermore, similar results were witnessed for the healthy individuals upon consumption of whole kiwifruits without their skin. The consumption of kiwifruit – including its skin – also increased bowel frequency and led to significant reductions in the gastrointestinal symptom rating scale for constipation and Irritable Bowel Syndrome-related pain scores for both participant groups. Results indicate that the skin of the SunGold kiwifruit may have beneficial effects on gastrointestinal health that are not derived from merely consuming the fruit's flesh.
Kiwifruits can relieve constipation and irritable bowel syndrome, potentially through protease-activated signaling, modulation of microflora, changes in colonic methane, bile flux, or mediation of inflammatory processes.
2017 Critical Reviews in Food Science and Nutrition Putative mechanisms of kiwifruit on maintenance of normal gastrointestinal function Bayer SB, Gearry RB, Drummond LN
Review Article Digestive Health Gut Microbiota Irritable Bowel Syndrome
The review outlines the physiological processes underlying constipation and irritable bowel syndrome, and discusses the nutritional composition of kiwifruits. It delves into recent advances made in the study of kiwifruits and their impact on abdominal comfort, with the focus being given to the effect of kiwifruit fibers on gastrointestinal health. The study also identified and examined certain gaps in the existing research, using indications from studies on other foods known to affect the gastrointestinal tract to derive possible mechanisms of kiwifruits' beneficial actions.
In discussing the results, the review observed that while the effect of kiwifruit fibers on gastrointestinal health is well established, the supposed increase in gastrointestinal motility caused by kiwifruits is yet to be fully characterized. Numerous potential mechanisms were invoked that could be contributing to the physiological effects observed - these included the induction of motility through protease-activated signaling, the modulation of microflora in the gut, alterations in colonic methane status or bile flux, and the mediation of inflammation within the gut.
The consumption of kiwifruit with a meal can increase the rate and extent of the hydrolysis of protein.
2014 Nutrients Variation in Gastric pH May Determine Kiwifruit’s Effect on Functional GI Disorder: An in Vitro Study Donaldson B, Rush E, Young O, Winger R
Network Pharmacology Kiwifruit
This in vitro study has shown that in elevated gastric pH conditions, such as may present with compromised gastric function, the addition of kiwifruit protease more than doubled the rate of hydrolysis of meat protein. This novel finding supports the hypothesis that consumption of kiwifruit with a meal can increase the rate and extent of the hydrolysis of protein.
Evidence is also provided that when the added acid concentration decreased from 0.074 M to 0.022 M (HCl), pepsin activity reduced by 50% and kiwifruit activity increased by 300%.
This evidence indicates that kiwifruit may exert its influence on digestion by increasing the extent of protein digestion in the gastric medium when the secretion of pepsin and/or hydrochloric acid is less than optimal. It is reported [12] in a study of 365 healthy subjects, average fasting gastric pH was 2.16 ± 0.11 for men and 2.79 ± 0.18 for women, but in another study of 79 healthy elderly people [13], 11% of the participants recorded fasting gastric pH > 5.0 throughout the study.
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