- Fecal Incontinence
|Consumption of 2 Green Kiwifruits Daily Improves Constipation and Abdominal Comfort-Results of an International Multicenter Randomized Controlled Trial
Am J Gastroenterol. 2023 Jun 1;118(6):1058-1068.doi: 10.14309/ajg.0000000000002124. Epub 2022 Dec 20.
Richard Gearry 1, Shin Fukudo 2 3, Giovanni Barbara 4, Barbara Kuhn-Sherlock 5, Juliet Ansell 6, Paul Blatchford 6, Sarah Eady 7, Alison Wallace 7, Christine Butts 7, Cesare Cremon 4, Maria Raffaella Barbaro 4, Isabella Pagano 4, Yohei Okawa 2, Tomohiko Muratubaki 2, Tomoko Okamoto 8, Mikiko Fuda 9, Yuka Endo 3, Michiko Kano 2, Motoyori Kanazawa 2 3, Naoki Nakaya 10, Kumi Nakaya 10, Lynley Drummond 11
1Department of Medicine, University of Otago, Christchurch, New Zealand.
2Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
3Department of Psychosomatic Medicine, Tohoku University Hospital, Sendai, Japan.
4Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
5BKS Consulting Limited, Hamilton, Waikato, New Zealand.
6Zespri International Limited, Tauranga, New Zealand.
7The New Zealand Institute for Plant and Food Research Limited, Palmerston North and Christchurch, New Zealand.
8Department of Nutrition, Sapporo University of Health Sciences, Sapporo, Japan.
9Department of Clinical Nutrition, Tohoku University Hospital, Sendai, Japan.
10Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
11Drummond Food Science Advisory Limited, Killinchy, Canterbury, New Zealand.
Introduction: Consumption of green kiwifruit is known to relieve constipation. Previous studies have also reported improvements in gastrointestinal (GI) comfort. We investigated the effect of consuming green kiwifruit on GI function and comfort.
Methods: 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.
Results: 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.
Discussion: This study provides original evidence that the consumption of a fresh whole fruit has demonstrated clinically relevant increases in CSBM and improved measures of GI comfort in constipated populations. Green kiwifruits are a suitable dietary treatment for relief of constipation and associated GI comfort.
Trial registration: ClinicalTrials.gov NCT02888392