Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
권호 표지

The Effect of Inulin Supplementation on Blood Lipid Levels, and Fecal Excretion of Bile Acid and Neutral Sterol in Korean Postmenopausal Women

폐경 후 한국 여성에서 이눌린 보충이 혈중 지질 농도와 변 담즙산 및 중성 스테롤 배설에 미치는 영향

  • 이은영 (경희대학교 동서의학대학원 의학영양학과) ;
  • 김윤영 (경희대학교 동서의학대학원 의학영양학과) ;
  • 장기효 (삼척대학교 식품영양학과) ;
  • 강순아 (건국대학교 분자생물공학과) ;
  • 조여원 (경희대학교 동서의학대학원 의학영양학과, 임상영양연구소)
  • Published : 2004.06.01
Download PDF
⟨ Previous Next ⟩

Abstract

Lipid-lowering effects of the inulin have been demonstrated in animal, yet attempts to reproduce similar effects in humans have generated conflicting results. In this study, the lipid-lowering potential of inulin and especially its effect on bile acid and neutral sterol excretion were investigated in Korean postmenopausal women. Nineteen postmenopausal women were randomly divided into two groups in a double-blind parallel design and consumed one of two supplements for 12 weeks; placebo of 8g maltodextrins/sucrose mixture (placebo group) or 8g inulin (inulin group). There were no significant changes in body weight during the supplementation period in either inulin or placebo group. Dietary consumption of animal fat in both group tended to decrease after 12 weeks of experiment. Intake of cholesterol was lower in placebo group, whereas the decrease of cholesterol intake in inulin group did not reach statistical significance after 12 weeks. The levels of serum total cholesterol (TC) and LDL-cholesterol (LDL-C) were significantly decreased in both placebo (p＜0.05) and inulin group (p＜0.01) after supplementation for 12 weeks compared with the baseline. The levels of serum triglyceride (TG) and HDL-cholesterol (HDL-C) were not significantly affected by inulin supplements, but atherogenic index (AI) and LDL-C/HDL-C ratio (LHR) as a predictor for coronary heart disease were improved (p＜0.01) significantly after inulin supplementation. Therefore, inulin supplement may decrease the risk of cardiovascular disease via improving blood cholesterol level. Fecal weight and pH were not changed after 12 weeks of supplementation. There were no statistically significant changes for the fecal short-chain fatty acids (SCFAs). In inulin group, fecal deoxycholic acid (DCA) was significantly lowered compared with the baseline (p＜0.05) whereas other bile acids were not changed. During the 12 weeks of intervention, no differences were found in fecal excretion of neutral sterol in the two groups. In summary, dietary inulin decreases serum TC, LDL-C, AI, LHR and lowers excretion of fecal DCA in the Korean postmenopausal women. These results support the use of inulin for reducing risk factors for hyperlipidemic postmenopausal women. However, the exact mechanism (s) responsible for the blood lipid lowering action of inulin including altered fecal bile acid remain to be elucidated.

Keywords

References

  1. Kor J Nutr v.6 no.2 A retrospective one-year study of hormone replacement therapy on lipid profile in postmenopausal women Choue,R.W.;Hong,J.Y.;Song,Y.B.
  2. Korean J Obstetrics and Gynecology v.31 no.6 A study of symptomatology, lipid chagnes and hormonal changes in the menopausal women Hur,M.;Kim,B.c.;Kim,D.H.
  3. Circulation v.101 no.23 Hormone replacement and cardiac prevention Abramson,B.L. https://doi.org/10.1161/01.CIR.101.23.e223
  4. J Cardiovasc Risk v.9 no.6 Postmenopausal hormone replacement therapy and the prevention of cardiovascular disease : a review Abramson,B.L. https://doi.org/10.1097/00043798-200212000-00003
  5. AWHONN Lifelines v.6 no.4 NHLBI stops estrogen plus progestin trial Cockey,C.D. https://doi.org/10.1111/j.1552-6356.2002.tb00482.x
  6. Br J Gen Pract v.53 no.488 A case-control study on the effect of hormone replacement therapy on ischaemic heart disease Hippisley-Cox,J.;Pringle,M.;Crown,N.;Coupland,C.
  7. Cochrane Database Syst Rev no.3 Reduced dietary salt for prevention of cardiovascular disease Hooper,L.;Bartlett,C.;Davey Smith,G.;Ebrahim,S.
  8. J Korean Society Menopause v.9 no.2 Review: For Healthy Elderly Life Hrt: The Controversy Continues after Decades of Debate Yoor,V.Y.
  9. Kor J Nutr v.34 no.3 Dose response relationship of isoflavone supplementation on plasma lipid profiles and total antioxidant status in perimenpausal and postmenopausal women Choi,Y;Yoon,S.;Lee,M.J.;Lee,S.K.;Lee,B.S.
  10. J Nutr v.36 no.6 The effect of isoflavone supplement on plasma lipids & antioxidant status in hypersholemic postmenopausal women Kim,E.M.;Lee,Y.S.;Wander,R.C.
  11. J Nutr Biochem v.14 no.9 Dietary fish oil decreases C-reactive protein interleukin-6, and triacylglycerol to HDL-cholesterol ratio in postmenopausal women on HRT Ciubotaru,I.;Lee,Y.S.;Wander,R.C. https://doi.org/10.1016/S0955-2863(03)00101-3
  12. Cynecol Endocrinol v.7 no.2 Endocrine and metabolic effects of guar gum in menopausal women Makkonen,M.;Simpanen,A.L.;Saarikoski,S.;Uusitupa,M;Penttila,I.;Silvasti,M.;Korhonen,P. https://doi.org/10.3109/09513599309152493
  13. Eur J Clin Nutr v.49 no.3 an alternative fibre;Properties and quantitative analysis Dysseler,P.;Hoffem D. Inulin
  14. Lipids v.30 no.2 Dietary oligofructose lowers triglycerides, phospholipids and cholesterol in serum and very low density lipoproteins of rats Fiordaliso,M.;KoK,D.Desager,J.P.;Goethals,F.;Deboyser,D.;Roberfroid,M.;Delzenne,N. https://doi.org/10.1007/BF02538270
  15. J Nutr v.128 no.1 The bifidogenic nature of chicory inulin and its hydrolysis products Roberfroid,M.B.;van Loo J.A.;Gibson,G.R.
  16. J Nutr v.128 no.11 Dietary inulin lowers plasma cholesterol and triacylglycerol and alters biliary bile acid profile in hamsters Trautwein,E.A.;Rieckhoff,D.;Erbersdobler,H.F. https://doi.org/10.1093/jn/128.11.1937
  17. Nutr Res v.18 Effects fo dietary inulin on serum lipids in men and women with hypercholesterolemia Davidson,M.H.;Maki,K.c.;Synecki,C.;Torri,S.A.;Drennan,K.B. https://doi.org/10.1016/S0271-5317(98)00038-4
  18. Nutr Res v.4 Effect of fructooligosaccharides on blood glucose and serum lipids in diabetic subjects Yamashita,K.;Kawai,K.;Itakura,M. https://doi.org/10.1016/S0271-5317(84)80075-5
  19. Rev Med Chil v.131 no.6 Effect of oral inulin administration on lipid profile and insulin sensitivity in subjects with obesity and dyslipidemia Balcazar-Munoz B.R.;Martinez-Abundis E.;Gonzalez-Ortiz M.
  20. Am J Clin Nutr v.77 no.3 Addition of inulin to a moderaterly high-charbohydrate diet reduces hepatic lipogenesis and plasma triacylglycerol concentrations in humans Letexier,D.;Diraison,F.;Beylot,M.
  21. Recommended dietary allowances for Koreans(7th revision) The Korean Nutrition Society
  22. Kor J Nutr v.35 no.9 The effects of levan and inulin on the growth of lactic acid-producing bacteria and intestinal conditions in rats Jang,K.H.;Kang,S.A.;Cho,Y.H.;Kim,Y.Y.;Lee,Y.J.;Hong,K.H.;Jang,E.K.;Kim,C.H.;Cho,R.W.
  23. J lipid Res v.40 no.6 Highly simplified method for gas-liquid chromatographic quantitation of bile acids and sterols in human stool Batta,A.K.;Salen,G.;Rapole,K.R.;Batta,M.;Batta,P.;Alberts,D.;Earnst,D.
  24. N Engl J Med v.341 no.6 Guidelines for healty weight Willett,W.C.;Dietz,W.H.;Colditz,G.A. https://doi.org/10.1056/NEJM199908053410607
  25. J Intern Med v.241 no.5 Interrelationships between weight loss, body fat distribution and sex hormones in pre- and postmenopausal obese women Turcato,E.;Zamboni,M.;De Pergola G.;Armellini,F.;Zivelonghi,A.;Bergamo-Andreis,I.A.;Giorgino,R.;Bosello,O. https://doi.org/10.1046/j.1365-2796.1997.120129000.x
  26. J Korean Acad Fam Med v.17 no.9 Regional fat distribution as a cardivascular risk factors Lee,Y.M.;Choi,Y.S.;Hong,M.H.;Kim,S.D.
  27. J Korean Soc Study Obesity v.11 no.2 Reliability of measurement of waist circumference at 3 different site Lee,Y.M.;Park,H.S.;Chen,B.C.;Kim,H.S.
  28. J Korean Soc Study Obesity v.7 no.2 What is the best simple anthropometric indexes of abdominal visceral fat in obese patients? Kim,S.M.;Kim,S.S.;Yoon,S.J.;Shim,K.W.;Choi,H.J.;Kim,K.M.;Lee,D.J.
  29. J Korean Acad Fam Med v.19 no.9 The usefulness of wais/height ratio as a predictor for the risk factors of coronary artery desease Ko,J.Y.;Lee,H.L.;Park,S.A.;Park,W.M.;Lee,S.W.;Lee,H.S.
  30. Kor J Nutr v.35 no.1 The analysis of the factors related to diet quality in the postmenopausal women Jang,Y.K.;Choi,Y.J.;Kim,S.Y.;Jung,K.A.
  31. The asiapacific perspective; redefining obesity and its treatment World health organization western pacific region
  32. J Korean Soc Study Obesity v.9 no.1 Obesity treatment of postmenpausal women Kim,S.M.
  33. Guidelines of treatment for Korean hyperlipidemic patients Committee of Establishing Guidelines of Treatment for Korean Hyperlipidemic Patients
  34. Kor J Nutr v.32 no.5 The effects of lowering Dietary fat and cholesterol on hypercholesterolemic men Hwang,K.H.;Heo,Y.R.;Lim,H.S.
  35. Am J Epidemiol v.125 no.3 Characteristics of human hypo- and hyperresponders to dietary cholesterol Katan,M.B.;Beynen,A.C. https://doi.org/10.1093/oxfordjournals.aje.a114545
  36. Handbook of lipids in human nutrition Effects fo dietary fatty acids and cholesterol on cardiovascular disease risk factors in man McPherson,R.;Spiller,G.A.;Spiller,G.A.
  37. Third report of the natinoal cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel) Natinoal Istitutes of Health;National Heart, Lung, and Blood Istitute
  38. In-depth analysis on 1998 national health and nutrition survey; nutrtion survey Ministry of Health and Welfare
  39. Report on 2001 national health and nutrition survey; nutrition survey Ministry of Health and Welfare;Korea Health Industry Development Institute
  40. Kor J Nutr v.29 no.1 The relationship to dietary fiber intake and fecal bile acid profiles Hwang,E.H.
  41. Kor J Nutr v.24 no.6 Estimatino of dietary fiber intake of college students Lee,H.S.;Lee,Y.K.;Chen,S.C.
  42. Am J Clin Nutr v.39 no.5 Estimatino of per capita crude and dietary fiber supply in 38 countries Bright-See E.;McKeown-Eyssen G.E.
  43. Kor J Nutr v.27 no.1 Annual changes in the estimated dietary fiber intake of Kor during 1969-1990 Lee,H.S.;Lee,Y.K.;Seo,Y.J.
  44. Am J Gastroenterol v.81 no.10 Dietary fiber: Hyperlipidemia hypertension, and cornary heat disease Anderson,J.W.;Tietyen-Clark J.
  45. J Nutr v.126 no.5 Increased intestinal contents viscosity reduces cholesterol absorption efficiency in hamsters fed hydroxypropyl methylcellulose Carr,T.;Gallaher,D.;Yang,C.H.;Hassel,C.A. https://doi.org/10.1093/jn/126.5.1463
  46. Manual of medical nutrition therapy(2nd ed.) Korean Dietitian Association
  47. Kor J Nutr v.34 no.3 The nutritional status of antioxidant vitamins in relation to serum MDA level in postmenopausal women Jung,K.A.;Kim,S.Y.;Choi,Y.J.;Woo,J.I.;Chang,Y.K.
  48. Am J Clin Nutr v.38 no.4 The effects of diet and zinc treatment on the fatty acid composition of serum lipids and adipose tissue and on serum lipoproteins in two adolescent patients with acrodematitis enteropathica Walldius,G.;Michaelsson,G.;Hardell,L,I.;Aberg,H. https://doi.org/10.1093/ajcn/38.4.512
  49. Optimal calcium intake. NIH Consens Statement v.12 no.4
  50. Guidelines of treatment for Korean hyperlipidemic patients(2nd ed.) Committee of Establishing Guidelines of Treatment for Korean Hyperlipidemic Patients
  51. Int J Epidemiol v.19 no.1 Menopause-related changes in lipoproteins and some other cardiovascular risk factors Bonithon-Kopp C.;Scarabin,P.Y.;Darne,B.;Malmejac,A.;Guize,L. https://doi.org/10.1093/ije/19.1.42
  52. J Korean Society Menopause v.9 no.2 Review: Recent Trend in Hormone Replacement Therapy Yoon,B.K.
  53. Br J Nutr v.82 no.1 The effect of the daily intake of inulin on fasting lipid, insulin and glucose concentrations in middle-aged men and women Jackson,K.G.;Taylor,G.R.;Clohessy,A.M.;Williams,C.M. https://doi.org/10.1017/S0007114599001087
  54. Br J Nutr v.78 no.2 The effect of ingestion of inulin on blood lipids and gastrointestinal symptoms in healty females Pedersen,A.;Sandstrom,B.;Van Amelsvoort J.M. https://doi.org/10.1079/BJN19970141
  55. Biochem Soc Trans v.26 no.2 Effect of non-digestible fermentable carbohydrates on hepatic fatty metabolism Delzenne,N.;Kok,N. https://doi.org/10.1042/bst0260228
  56. Br J Nutr v.76 no.6 Involvement of lipogenesis in the lower VLDL secretion induced by oligofructose in rats Kok,N.;Roberfroid,M.;Rober,A.;elzenne,N. https://doi.org/10.1079/BJN19960094
  57. J Nutr v.121 no.11 High propionic acid fermentations and mineral accumulation in the cecum of rats adapted to different levels of inulin Levrat,M.A.;Remesy,C.;Demigne,C.
  58. Nutr v.36 no.4 Effects of fructooligosaccharide and fructooligosaccharide containing sponge cake on blood lipids, intestinal function and short chain fatty acid production in rats Lee,S.Y.;Lee,K.A.;Cho,J.H.
  59. Crit Rev Food Sic Nutr v.33 no.2 Dietary fiber; inulin, and oligofructose: a review comparing their physiological effects Roberfroid,M. https://doi.org/10.1080/10408399309527616
  60. J Nutr v.129 no.SUP. 7 Inulin, oligofructose and intestinal function Jenkins,D.J.;Kendall,C.W.;Vuksan,V. https://doi.org/10.1093/jn/129.7.1431S
  61. Am J Gastroenterol v.84 no.9 Effect of rectal infusion of short chain fatty acids in human subjects Wolever,TMS;Brighenti,F.;Royall,D.;Jenkins,A.L.;Jenkins,D.J.A.
  62. J Nutr v.127 no.1 Selected indigestible oligosaccharides affect large bowel mass, cecal and fecal short-chain fatty acids, pH and microflora in rats Campbell,J.M.;Fahey,G.C.;Wolf,B.W.
  63. Br J Nutr v.76 no.2 Fate of fructo-oligosaccharides in the human intestine Alles,M.S.;Hautvast,J.G.;Nagengast,F.M.;Hartemink,R.;Van Laere K.M.;Jansen,J.B. https://doi.org/10.1079/BJN19960026
  64. Gastroenterology v.103 no.6 Fecal weight, colon cancer risk, and dietary intake of non-starch polysaccharides(dietary fiber) Cummings,J.H.;Bigham,S.A.;Heaton,K.W.;Eastwood,M.A.
  65. Eur J Clin Nutr v.53 no.9 Effect of consumption of a ready-to-eat breakfast cereal containing inulin on the intestinal milieu and blood Iipids in healthy male volunteers Brighenti,F.;Casiraghi,M.C.;Canzi,E.;Ferrari,A. https://doi.org/10.1038/sj.ejcn.1600841
  66. Br J Nutr v.74 no.1 Recovery of inulin from Jerusalem artichoke (Helianthus tuberosus L.) in the small intestine of man Bach Knudsen K.E.;Hessov,I.B. https://doi.org/10.1079/BJN19950110
  67. Dis Colon Rectum v.45 no.5 Effect of dietary inulin supplementation on inflammation of pouch mucosa in patients with an ileal pouchanal anastomosis Welters,C.F.;Heineman,E.;Thunnissen,F.B.;van den Bogaard A.E.;Soeters,P.B.;Baeten,C.G. https://doi.org/10.1007/s10350-004-6257-2