Effect of proteolytic enzyme and fiber of papaya fruit on human digestive health

The World Health Organization (WHO, 2005) recommends consumption of fruits and vegetables as part of a healthy diet with daily recommendation of 5 servings or at least 400 g per day. Fruits and vegetables are good sources of vitamins, minerals, antioxidants, and fiber. Papaya fruit is known for his high nutrient and fiber content, and with few exceptions, it is generally consumed ripe due to its characteristic flavor and aroma. Digestion improvement has been attributed to consumption of papaya; this we speculate is attributed to the fiber content and proteolytic enzymes associated with this highly nutritious fruit. However, research is lacking that evaluates the impact of papaya fruit on human digestion. Papain is a proteolytic enzyme generally extracted from the latex of unripe papaya. Previous research has focused on evaluating papain activity from the latex of different parts of the plant; however there are no reports about papain activity in papaya pulp through fruit maturation. The activity of papain through different stages of ripeness of papaya and its capacity of dislodging meat bolus in an in vitro model was addressed. The objective of this study was to investigate whether papain activity and fiber content are responsible for the digestive properties attributed to papaya and to find a processing method that preserves papaya health properties with minimal impact on flavor. Our results indicated that papain was active at all maturation stages of the fruit. Ripe papaya pulp displayed the highest enzyme activity and also presented the largest meat bolus displacement. The in vitro digestion study indicated that ripe papaya displayed the highest protein digestibility; this is associated with proteolytic enzymes still active at the acidity of the stomach. Results from the in vitro fermentation study indicated that ripe papaya produced the highest amount of Short Chain Fatty Acids SCFA of the three papaya substrates (unripe, ripe, and processed). SCFA are the most important product of fermentation and are used as indicators of the amount of substrate fermented by microorganisms in the colon. The combination of proteolytic enzymes and fiber content found in papaya make of this fruit not only a potential digestive aid, but also a good source of SCFA and their associated potential health benefits. Irradiation processing had minimal impact on flavor compounds of papaya nectar. However, processed papaya experienced the lowest protein digestibility and SCFA production among the papaya substrates. Future research needs to explore new processing methods for papaya that minimize the detrimental impact on enzyme activity and SCFA production.

Étude de l'impact de deux traitements, dont un sans antibiotiques, sur la santé digestive et les populations de Clostridium perfringens dans des élevages de poulets de chair.

Le problème grandissant de l’antibiorésistance remet en question plusieurs pratiques reliées à l’utilisation des antibiotiques, dont l’usage à grande échelle pour des fins de promotion de la croissance chez les animaux de consommation. Depuis 2006, le retrait des antibiotiques dans les élevages de poulets de chair en Europe a été associé à la résurgence d’entérite nécrotique, une maladie intestinale causée par la bactérie Clostridium perfringens. Alors que la pathogénie de la maladie semblait bien comprise, le retrait des antibiotiques a montré que peu de solutions de remplacement sont disponibles afin de prévenir cette maladie. Très peu d’études se sont intéressées à mieux caractériser la dynamique des populations de C. perfringens dans les élevages avicoles et l’effet que pouvait avoir le retrait des antibiotiques sur l’évolution de ces populations. La présente étude a évalué l’impact du remplacement des antibiotiques promoteurs de croissance et des anticoccidiens pendant une période de 14 mois, dans huit élevages commerciaux de poulets de chair au Québec. Un protocole d’élevage alternatif, combinant des stratégies telles que des produits à base d’huiles essentielles, des acides organiques et inorganique, une vaccination contre la coccidiose ainsi qu’une amélioration des conditions de démarrage des poussins, a été utilisé en remplacement des antimicrobiens. Les performances zootechniques, la santé digestive ainsi que l’occurrence d’entérite nécrotique pour les lots de poulets soumis au protocole d’élevage alternatif ont été comparées avec celles de lots de poulets de chair recevant une ration conventionnelle. Des analyses moléculaires basées sur la PCR et le PFGE ont été utilisées afin de documenter l’impact de la mise en place du protocole d’élevage alternatif sur les populations de C. perfringens. Les résultats obtenus montrent qu’aucune différence entre les groupes soumis aux deux types de protocoles n'est observée en ce qui a trait à la viabilité en élevage, à l'âge d'abattage et aux taux de condamnations à l'abattoir. Toutefois, les lots soumis au traitement alternatif ont eu des performances moindres pour le poids moyen à l'abattage, le gain moyen quotidien et la conversion alimentaire. Un peu plus de 27% des lots soumis au protocole alternatif ont connu un épisode d’entérite nécrotique clinique. Les analyses ont aussi montré que l’un ou l’autre des protocoles ne semble pas exercer d’influence particulière sur la dynamique temporelle des populations de C. perfringens. Pour les lots soumis au protocole d’élevage alternatif, une forte diversité génétique pour C. perfringens a été liée à un risque augmenté de vivre un épisode d’entérite nécrotique. À l’opposé, les lots alternatifs ayant vécu des épisodes récurrents de la maladie ont montré une diminution significative de la diversité génétique, ainsi qu’une augmentation marquée du nombre de souches de C. perfringens transportant plusieurs gènes de virulence. La présente étude a permis de mieux documenter, d’un point de vue économique et scientifique, la production de poulets de chair élevés sans antibiotiques ni anticoccidiens au Québec. Cette étude est la seule du genre s’étant intéressée à la caractérisation et à la comparaison dans le temps des flores de C. perfringens retrouvées dans les deux types d’élevages. Elle a révélé que la production à grande échelle de poulets de chair élevés sans antibiotiques ni anticoccidiens est possible au Québec, mais que celle-ci présente des impacts sur les performances zootechniques des oiseaux, sur leur santé digestive et sur la dynamique des populations de C. perfringens. Mots-clés : poulets de chair, antibiotiques, huiles essentielles, acides organiques, vaccination coccidiose, performances zootechniques, santé digestive, entérite nécrotique, Clostridium perfringens, dynamique populationnelle

Tolerance and nutritional therapy of dietary fibre from konjac glucomannan hydrolysates for patients with inflammatory bowel disease (IBD)

Carbohydrates may provide an alternative therapeutic approach for a number of digestive health disorders such as inflammatory bowel disease (IBD). The aim of this work was to characterise the tolerance and efficacy of low and high molecular weight konjac glucomannan hydrolysates within healthy volunteers and patients suffering from IBD and associated gut conditions. These conditions included constipation, Crohn's disease and ulcerative colitis. For general tolerance, fourteen patients participated whilst for the digestive disorder trial, there were twenty. Scores of taste/texture of the product, bowel movement, stool consistency, diarrhoea, existence/absence of blood in the faeces, abdominal pains, flatulence, vomiting, fever, improvement of life style after use, willingness to use in the future and clinician's statements about each patient's conditions before and after use were recorded. The results showed that the hydrolysates were tolerated well for patients with diarrhoea and had a significant improvement on bowel movement, stool consistency, abdominal pain and flatulence after ten days. With respect to effects on IBD, there was a significant health benefit after fourteen days of consumption for bowel movement, stool consistency, diarrhoea, existence/absence of blood in the faeces, abdominal pain, flatulence and vomiting. Most patients declared an improvement of their life style after consuming the hydrolysates. The use of konjac glucomannan hydrolysates as a therapeutic agent or adjunct to standard treatments could prove a successful tool for the treatment of a range of disorders; although large scale studies are required to characterise further the role of the carbohydrates.

Diagnosis and management of gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is probably one of the most prevalent diseases in the world that also compromises the quality of life of the affected significantly. Its incidence in Brazil is 12%, corresponding to 20 million individuals. OBJECTIVE: To update the GERD management and the new trends on diagnosis and treatment, reviewing the international and Brazilian experience on it. METHOD: The literature review was based on papers published on Medline/Pubmed, SciELO, Lilacs, Embase and Cochrane crossing the following headings: gastroesophageal reflux disease, diagnosis, clinical treatment, surgery, fundoplication. RESULTS: Various factors are involved on GERD physiopathology, the most important being the transient lower esophageal sphincter relaxation. Clinical manifestations are heartburn, regurgitation (typical symptoms), cough, chest pain, asthma, hoarseness and throat clearing (atypical symptoms), which may be followed or not by typical symptoms. GERD patients may present complications such as peptic stenosis, hemorrhage, and Barrett's esophagus, which is the most important predisposing factor to adenocarcinoma. The GERD diagnosis must be based on the anamnesis and the symptoms must be evaluated in terms of duration, intensity, frequency, triggering and relief factors, pattern of evolution and impact on the patient's quality of life. The diagnosis requires confirmation with different exams. The goal of the clinical treatment is to relieve the symptoms and surgical treatment is indicated for patients who require continued drug use, with intolerance to prolonged clinical treatment and with GERD complications. CONCLUSION: GERD is a major digestive health problem and affect 12% of Brazilian people. The anamnesis is fundamental for the diagnosis of GERD, with special analysis of the typical and atypical symptoms (duration, intensity, frequency, triggering and relief factors, evolution and impact on the life quality). High digestive endoscopy and esophageal pHmetry are the most sensitive diagnosctic methods. The clinical treatment is useful in controlling the symptoms; however, the great problem is keeping the patients asymptomatic over time. Surgical treatment is indicated for patients who required continued drug use, intolerant to the drugs and with complicated forms of GERD.

Role of fibre in broiler diets - Firend or foe?

The fibrous fraction of the feeds encompasses a group of heterogeneous compounds differing in chemical composition and physical properties (Graham and Aman, 1991, Bach Knudsen, 2001). Dietary fiber is the most used term to define the fiber fraction of ingredients and feeds, and includes cell walls, stored non-starch polysaccharides (NSP), and lignin (Bach Knudsen, 2001). Based on their physico-chemical properties, DF can be divided into soluble and insoluble fractions with distinct effects on digestive physiology and animal metabolism. Consequently, the benefits of fiber inclusion in poultry diets will vary depending on factors such as characteristics of the fiber source, type of bird, and digestive health status.

Identification of the method to quantify soluble fibre and the effect of the source of fibre on the ileal and faecal digestibility of soluble and insoluble fibre in rabbits = Identificación del método para cuantificar la fibra soluble y el efecto de la fuente de fibra en la digestibilidad ileal y fecal de la fibra soluble e insoluble en conejos

La presente tesis constituye un avance en el estudio de los métodos para cuantificar la fibra soluble y los efectos de las fracciones de fibra y las fuentes de fibra sobre la digestión de las diferentes fracciones de fibra (soluble e insoluble) en el conejo. Hay un efecto positivo de la fibra soluble sobre la salud intestinal de los conejos y, por ende, una reducción de la mortalidad en animales destetados. Pese a esto, no está claro si estos efectos se deben específicamente a la fracción soluble. Por lo que los objetivos generales de esta tesis fueron: 1) comparar diferentes metodologías químicas e in vitro para cuantificar la fibra soluble y estudiar las posibles interferencias en la cuantificación de la fibra soluble por las mucinas, y viceversa, 2) determinar los efectos de la fibra, el lugar de fermentación, el método para valorar la fibra soluble e insoluble, y la corrección de la fibra soluble por el contenido intestinal de mucinas sobre la digestibilidad de las distintas fracciones de la fibra y 3) evaluar los efectos individuales de las fracciones soluble e insoluble de la fibra de pulpa de remolacha y de manzana, sobre la digestibilidad de la fibra soluble e insoluble y los parámetros digestivos. Para ello se llevaron a cabo 4 estudios. En el primer estudio se compararon diferentes metodologías químicas e in vitro para valorar la fibra soluble de diferentes alimentos y se estudió la posible interferencia en la determinación de la fibra soluble y mucinas. Para ello se utilizaron seis ingredientes (pulpa de remolacha, pectinas de pulpa de remolacha, pulpa de remolacha lavada, paja de cereal, cascarilla de girasol y lignocelulosa) y siete piensos de conejos con diferentes niveles de fibra soluble. En un primer experimento se analizó la fibra dietética total (FDT), la fibra dietética insoluble (FDI), la fibra dietética soluble (FDS), la fibra neutro detergente corregida por cenizas y proteínas (aFNDmo-pb), y la digestibilidad in vitro 2 pasos pepsina/pancreatina (residuo corregido por cenizas y proteína, ivMSi2) de los ingredientes y piensos. Además la fibra soluble se calculó mediante la diferencia entre FDT-FDI (FDSFDI), FDT- ivMSi2 (FDSivMSi2), y FDT - aFNDmo-pb (FDSaFNDmo-pb). Cuando la fibra soluble se determinó directamente como FDS o se calculó como FDT-FDI no se observaron diferencias (109 g/kg MS, en promedio). Sin embargo, cuando la fibra soluble se calculó como FDT - aFNDmo-pb su valor fue un 40% menor (153 g/kg MS. P < 0,05), mientras que la FDSFDI (124 g/kg MS) no fue diferente a ninguna de las otras metodologías. La correlación entre los tres métodos fue elevada (r > 0,96. P < 0,001. n = 13), pero disminuyó o incluso desapareció cuando la pulpa o las pectinas de la remolacha fueron excluidas del análisis. En un segundo experimento, se comparó el método ivDMi2 usando crisoles (método de referencia) con una modificación del mismo usando bolsas ANKOM digeridas individualmente o en colectivo para simplificar la determinación de la FDSivMSi2. La FDSivMSi2 no difirió entre los métodos comparados. En un tercer experimento, se analizó la posible interferencia entre la determinación de la fibra soluble y las mucinas intestinales. Se observó un contenido de FDT y de mucinas elevado en las muestras de pectinas de remolacha (994 y 709 g/kg MS), así como en el moco intestinal de conejo (571 y 739 g/kg MS) cuando se aplicó el método de mucinas por precipitación con etanol. Sin embargo, después de aplicar una pectinasa en el material precipitado, la cantidad de mucinas recuperadas en las muestras de pectinas de remolacha fue cercana a cero, mientras que en el moco intestinal fue similar a los resultados previos al uso de la enzima. Con los resultados de este ensayo se estimaron los carbohidratos de mucinas retenidos en los contenidos digestivos y se propuso una corrección para la determinación de la digestibilidad de la FDT y fibra soluble. En conclusión, la contaminación de las mucinas de la digesta con fibra soluble se soluciona usando pectinasas. El segundo estudio se centró en estudiar: 1) el efecto del tipo de fibra, 2) el sitio de fermentación, 3) el método para cuantificar fibra y 4) la corrección por mucinas sobre la digestibilidad de la fibra. Para ello se formularon tres piensos con diferentes niveles de fibra soluble (FDT-aFNDmo-pb). Un pienso bajo en fibra soluble (LSF. 85 g/kg DM), un pienso medio en fibra soluble (MSF. 102 g/kg DM), y un pienso alto en fibra soluble (HSF. 145 g/kg DM). Estos piensos se obtuvieron reemplazando un 50% del heno del alfalfa en el pienso MSF por una mezcla de pulpa de manzana y remolacha (HSF) o por una mezcla de cascarilla de avena y proteína de soja (LSF). Se utilizaron 30 conejas canuladas para determinar la digestibilidad ileal y fecal. La digestibilidad cecal se calculó mediante diferencia entre la digestibilidad fecal e ileal. La fibra insoluble se determinó como aFNDmo-pb, IDF, e ivMSi2, mientras que la fibra soluble se calculó como FDSFDI, FDSaFNDmo-pb, y FDSivMSi2. La digestibilidad de la FDT y la fibra soluble se corrigieron por las mucinas. La concentración de mucinas en la digesta ileal y fecal, aumento desde el grupo LSF hasta el grupo con el pienso HSF (P < 0,01). La corrección por mucinas aumentó las digestibilidades de la FDT y la fibra soluble a nivel ileal, mientras que a nivel cecal las redujo. (P < 0.01). El coeficiente de digestibilidad ileal de FDT aumentó desde el grupo LSF al grupo HSF (0,12 vs. 0,281. P < 0,01), sin diferencias en el coeficiente de digestibilidad cecal (0,264), por lo que la tendencia a nivel fecal entre los grupos se mantuvo. El coeficiente de digestibilidad ileal de la fibra insoluble aumento desde el grupo con el pienso LSF al grupo con el pienso HSF (0,113 vs. 0,210. P < 0,01), sin diferencias a nivel cecal (0,139) y sin efecto del método usado, resultando en una digestibilidad elevada a nivel fecal, con tendencias similares a las observadas a nivel ileal. El coeficiente de digestibilidad de la FND fue elevada en comparación con la FDI o la ivMSi2 (P > 0.01). El coeficiente de la digestibilidad ileal de la fibra soluble fue mayor en el grupo LSF respecto al grupo LSF (0,436 vs. 0,145. P < 0,01) y el método no afectó a esta determinación. El coeficiente de la digestibilidad cecal de la fibra soluble se redujo desde el grupo LSF hasta el grupo HSF (0,721 vs. 0,492. P < 0,05). El valor más bajo de digestibilidad cecal y fecal de fibra soluble fue medido con el método FDSaFNDmo-pb (P < 0,01). Se observó una alta correlación entre las digestibilidades de la fibra soluble determinada como FDSFDI, FDSaFNDmo-pb, y FDSivMSi2, por lo tanto la información proporcionada por una u otra metodología fueron similares. Sin embargo, cuando se compararon con efectos fisiológicos (producción de mucinas y peso del ciego y pH del ciego de un trabajo previo), la FDSaFNDmo-pb globalmente mostró estar mejor correlacionado con estos parámetros fisiológicos. En conclusión, la corrección por mucinas es necesaria para determinar la digestibilidad ileal de la FDT y fibra soluble, mientras que la elección de uno u otro método es menos relevante. La inclusión de pulpa de manzana y remolacha incrementa la cantidad de FDT que desaparece antes de llegar al ciego. En el tercer estudio se estudió el efecto de la fracción fibrosa soluble e insoluble de la pulpa de remolacha y el método de cuantificación de la fibra soluble e insoluble sobre la digestibilidad de la fibra y algunos parámetros digestivos. Para ello se formularon cuatro piensos con niveles similares de fibra insoluble (315g aFNDmo-pb/kg MS) y proteína (167 g/kg MS). El pienso control contuvo el nivel más bajo de fibra soluble (30,3 g/kg, con cascarilla de girasol y paja como fuente de fibra). Un segundo pienso se obtuvo mediante la sustitución de 60 g de almidón/kg del pienso control por pectinas de remolacha (82,9 g fibra soluble/kg MS). Los otras dos piensos resultaron de la sustitución parcial de las fuentes de fibra del pienso control por la fracción insoluble de la pulpa de remolacha y la pulpa de remolacha entera (42.2 y 82.3 g fibra soluble/kg MS, respectivamente). Cincuenta y seis conejos en cebo (14/pienso), de 2,4  0.21 kg de peso, fueron usados para determinar la digestibilidad ileal y fecal de la FDT, FDI, aFNDmo-pb, FDSFDI, y FDSaFNDmo-pb. La concentración de mucinas en el íleon y heces se utilizaron para corregir la digestibilidad de la FDT y fibra soluble. También se midió el peso de diferentes segmentos del tracto digestivo y el pH del contenido digestivo. Los conejos alimentados con el pienso de fibra insoluble de pulpa de remolacha mostraron los consumos más bajos con respecto a los demás grupos (124 vs. 139 g/d, respectivamente. P < 0,05). El flujo de mucinas ileales fue más alto (P < 0.05) en el grupo alimentado con el pienso de pectinas de remolacha (9,0 g/d en promedio) que los del grupo control (4,79 g/d), mostrando los otros dos grupos valores intermedios, sin detectarse diferencias a nivel fecal. La digestibilidad ileal de la FDT (corregida por mucinas) y la fibra insoluble no se vieron afectadas por el tipo de pienso. El método usado para determinar la fibra insoluble afectó su digestibilidad ileal (0,123 para FDI vs. 0,108 para aFNDmo-pb. P < 0.01). De todas formas, los métodos no afectaron al cálculo de la fibra fermentada antes del ciego (4,9 g/d en promedio). Los conejos alimentados con el pienso de pulpa de remolacha y con el pienso con la fracción insoluble de la pulpa de remolacha mostraron las digestibilidades fecales más altas de la fibra insoluble (0,266 en promedio vs. 0,106 del grupo control), mientras que en los animales del pienso con pectinas esta digestibilidad fue un 47% mayor respecto al pienso control (P < 0,001). La digestibilidad fecal de la fibra insoluble fue un 20% más alta cuando se usó la FND en lugar de FDI para determinarla (P < 0.001). Esto hizo variar la cantidad de fibra insoluble fermentada a lo largo del tracto digestivo (9,5 ó 7,5 g/d cuando fue calculada como FDI o aFNDmo-pb, respectivamente. P < 0,001). Las digestibilidades ileales de la fibra soluble fueron positivas cuando los análisis de fibra soluble de los contenidos ileales fueron corregidos por mucinas, (P < 0,001) excepto para la digestibilidad ileal de la FDSIDF del grupo control. Una vez corregidas por mucinas, los conejos alimentados con los piensos que contuvieron la fracción soluble de la pulpa de remolacha (pienso de pectina y pulpa de remolacha) mostraron una mayor digestibilidad ileal de la fibra soluble, respecto al grupo control (0,483 vs. -0,010. P = 0.002), mientras que el grupo del pienso de fibra insoluble de pulpa de remolacha mostró un valor intermedio (0,274). La digestibilidad total de la fibra soluble fue similar entre todos los grupos (0.93). Los conejos alimentados con pulpa de remolacha y su fracción insoluble mostraron los pesos relativos más altos del estómago respecto a los del pienso control y de pectinas (11 y 56 % respectivamente; P < 0,05). Por otra parte, el peso relativo del ciego aumentó en los animales que consumieron tanto la fracción soluble como insoluble de la pulpa de remolacha, siendo un 16% más pesados (P < 0,001) que el grupo control. El pH del contenido cecal fue más bajo en los animales del grupo de pulpa de remolacha que en los del grupo control (5,64 vs. 6,03; P < 0,001), mientras que los del grupo de pectinas y de fibra insoluble de pulpa de remolacha mostraron valores intermedios. En conclusión, el efecto positivo de la pulpa de remolacha en el flujo de mucinas a nivel ileal se debe a la fracción soluble e insoluble de la pulpa de remolacha. La mitad de la fibra soluble de la pulpa de remolacha desaparece antes de llegar al ciego, independientemente si esta proviene de pectinas puras o de la pulpa de remolacha. El pH cecal esta mejor correlacionado con la cantidad de FDT que desaparece antes del ciego más que con la que se degrada en el ciego. En el último estudio se estudiaron los efectos de la fibra soluble e insoluble de la pulpa de manzana sobre la digestibilidad de la fibra y algunos parámetros digestivos. Cuatro dietas fueron formuladas con niveles similares de fibra insoluble (aFNDmo-pb 32,4%) y proteína (18,6% ambos en base seca). El pienso control contuvo el nivel más bajo de fibra soluble (46 g de fibra soluble/kg, con cascarilla de girasol y paja de cereales como la fuentes de fibra). Un segundo pienso fue obtenido mediante la sustitución de 60 g de almidón/kg del pienso control por pectinas de manzana (105 g fibra soluble/kg). Los otros dos piensos se obtuvieron por la substitución de parte de las fuentes de fibra del pienso control por pulpa de manzana o pulpa de manzana despectinizada (93 y 71 g de fibra soluble/kg, respectivamente). La digestibilidad fecal fue determinada en 23 conejos/pienso con 1.68 ± 0.23 kg de peso vivo, los cuales fueron sacrificados a los 60 d edad para recolectar su contenido digestivo para determinar digestibilidad ileal y otros parámetros digestivos. La fibra soluble de manzana (pectinas y pulpa entera) estimuló el flujo ileal de mucinas (P = 0,002), pero no asi la pulpa despectinizada. La corrección por mucinas incrementó la digestibilidad de la FDT y la fibra soluble a nivel fecal, y especialmente a nivel ileal. Cerca de la mitad de la fibra soluble proveniente de los piensos con cualquiera de las fracciones de la pulpa de manzana fue degradada a nivel ileal, sin mostrar diferencias entre los grupos (46 y 86% en promedio a nivel ileal y fecal respectivamente). La inclusión de pulpa despectinizada de manzana mejoró la digestibilidad de la FND a nivel fecal (P < 0,05) pero no a nivel ileal. El contenido cecal de los conejos alimentados con la pulpa de manzana tuvieron el pH cecal más ácido que los del pienso control (5,55 vs. 5,95. P < 0,001), mientras que los animales con el pienso de pectinas de manzana y de pulpa de manzana despectinizada mostraron valores intermedios. En conclusión los efectos positivo de la pulpa de manzana en el flujo de mucinas se debió principalmente a la fracción soluble de la pulpa de manzana. La mitad de la fibra soluble fue degradada antes del ciego independientemente de si esta provino de las pectinas o de la pulpa de manzana. El pH cecal estuvo mejor correlacionado con la cantidad de FDT fermentada en todo el tracto digestivo y antes de llegar al ciego que con la que se degradó en el ciego. Al integrar los resultados de los estudio 2, 3 y 4 se concluyó que la corrección de mucinas de los contenidos digestivos al determinar FDT y fibra soluble es necesaria para ajustar los cálculos de su digestibilidad. Esta corrección es mucho más importante a nivel ileal y en dietas bajas en fibra soluble. Por otra parte, la FDT desapareció en proporciones importantes antes de llegar al ciego, especialmente en piensos que contienen pulpa de remolacha o de manzana o alguna fracción soluble o insoluble de las mismas y estas diferencias observadas entre los piensos a nivel ileal se correlacionaron mejor con el pH cecal, lo que indicaría que la FDT se solubilizó antes de llegar al ciego y una vez en esté fermentó. Estos resultados implican que determinar la fibra soluble como FDSaFNDmo-pb es la mejor opción y que en la determinación de la digestibilidad de la FDT y fibra soluble se debe considerar la corrección por mucinas especialmente a nivel ileal y en piensos bajos en fibra soluble. ABSTRACT The present thesis constitutes a step forward in advancing the knowledge of the methods to quantify soluble fibre and the effects of the fibre fractions and source of fibre on the site the digestion of different fractions of fibre (soluble and insoluble) in the rabbit. There is a positive effect of soluble fibre on rabbit digestive health and therefore on the reduction of mortality in weaning rabbits. Nevertheless, it is no so clear that the effects of soluble fibre on rabbits are due particularly to this fraction. This thesis aims: 1) to compare the quantification of soluble fibre in feeds using different chemical and in vitro approaches, and to study the potential interference between soluble fibre and mucin determinations, 2) to identify the effects of type of fibre, site of fermentation, method to quantify insoluble and soluble fibre, and correction of the intestinal soluble fibre content for intestinal mucin on the digestibility of fibre fractions and 3) to evaluate the individual effect of soluble and insoluble fibre from sugar beet pulp and apple pulp on ileal and faecal soluble and insoluble digestibility and digestive traits. These objectives were developed in four studies: The first study compared the quantification of soluble fibre in feeds using different chemical and in vitro approaches, and studied the potential interference between soluble fibre and mucin determinations. Six ingredients, sugar beet pulp (SBP), SBP pectins, insoluble SBP, wheat straw, sunflower hulls and lignocellulose, and seven rabbit diets, differing in soluble fibre content, were evaluated. In experiment 1, ingredients and diets were analysed for total dietary fibre (TDF), insoluble dietary fibre (IDF), soluble dietary fibre (SDF), aNDFom (corrected for protein, aNDFom-cp) and 2-step pepsin/pancreatin in vitro DM indigestibility (corrected for ash and protein, ivDMi2). Soluble fibre was estimated by difference using three procedures: TDF - IDF (SDFIDF), TDF - ivDMi2 (SDFivDMi2), and TDF - aNDFom-cp (SDFaNDFom-cp). Soluble fibre determined directly (SDF) or by difference, as SDFivDMi2 were not different (109 g/kg DM, on average). However, when it was calculated as SDFaNDFom-cp the value was 40% higher (153 g/kg DM, P < 0.05), whereas SDFIDF (124 g/kg DM) did not differ from any of the other methods. The correlation between the four methods was high (r ≥ 0.96. P ≤ 0.001. n = 13), but it decreased or even disappeared when SBP pectins and SBP were excluded and a lower and more narrow range of variation of soluble fibre was used. In experiment 2, the ivDMi2 using crucibles (reference method) were compared to those made using individual or collective ankom bags in order to simplify the determination of SDFivDMi2. The ivDMi2 was not different when using crucibles or individual or collective ankom bags. In experiment 3, the potential interference between soluble fibre and intestinal mucin determinations was studied using rabbit intestinal raw mucus, digesta and SBP pectins, lignocelluloses and a rabbit diet. An interference was observed between the determinations of soluble fibre and crude mucin, as the content of TDF and apparent crude mucin were high in SBP pectins (994 and 709 g/kg DM) and rabbit intestinal raw mucus (571 and 739 g/kg DM). After a pectinase treatment, the coefficient of apparent mucin recovery of SBP pectins was close to zero, whereas that of rabbit mucus was not modified. An estimation of the crude mucin carbohydrates retained in digesta TDF is proposed to correct TDF and soluble fibre digestibility. In conclusion, the values of soluble fibre depend on the methodology used. The contamination of crude mucin with soluble fibre is avoided using pectinase. The second study focused on the effect of type of fibre, site of fermentation, method for quantifying insoluble and soluble dietary fibre, and their correction for intestinal mucin on fibre digestibility. Three diets differing in soluble fibre were formulated (85 g/kg DM soluble fibre, in the low soluble fibre [LSF] diet; 102 g/kg DM in the medium soluble fibre [MSF] diet; and 145 g/kg DM in the high soluble fibre [HSF] diet). They were obtained by replacing half of the dehydrated alfalfa in the MSF diet with a mixture of beet and apple pulp (HSF diet) or with a mix of oat hulls and soybean protein (LSF diet). Thirty rabbits with ileal T-cannulas were used to determine total tract apparent digestibility (CTTAD) and ileal apparent digestibility (CIAD). Caecal digestibility was determined by difference between CTTAD and CIAD. Insoluble fibre was measured as aNDFom-cp, IDF, and ivDMi2, whereas soluble fibre was calculated as SDFaNDFom-cp, SDFIDF, SDFivDMi2. The intestinal mucin content was used to correct the TDF and soluble fibre digestibility. Ileal and faecal concentration of mucin increased from the LSF to the HSF diet group (P < 0.01). Once corrected for intestinal mucin, The CTTAD and CIAD of TDF and soluble fibre increased whereas caecal digestibility decreased (P < 0.01). The CIAD of TDF increased from the LSF to the HSF diet group (0.12 vs. 0.281. P < 0.01), with no difference in the caecal digestibility (0.264), resulting in a higher CTTAD from the LSF to the HSF diet group (P < 0.01). The CIAD of insoluble fibre increased from the LSF to the HSF diet group (0.113 vs. 0.21. P < 0.01), with no difference in the caecal digestibility (0.139) and no effect of fibre method, resulting in a higher CTTAD for rabbits fed the HSF diet compared with the MSF and LSF diets groups (P < 0.01). The CTTAD of aNDFom-cp was higher compared with IDF or ivDMi2 (P < 0.01). The CIAD of soluble fibre was higher for the HSF than for the LSF diet group (0.436 vs. 0.145. P < 0.01) and fibre method did not affect it. Caecal soluble fibre digestibility decreased from the LSF to the HSF diet group (0.721 vs. 0.492. P < 0.05). The lowest caecal and faecal soluble fibre digestibility was measured using SDFaNDFom-cp (P < 0.01). There was a high correlation among the digestibilities of soluble fibre measured as SDFaNDFom-cp, SDFIDF, and SDFivDMi2. Therefore, these methodologies provide similar information. However, the method that seems to be globally better related to the physiological traits (ileal flow of mucins, and relative weight of the caecum and caecal pH from previous work) was the SDFaNDFom-cp. In conclusion, a correction for intestinal mucin is necessary for ileal TDF and soluble fibre digestibility whereas the selection of the fibre method has a minor relevance. The inclusion of sugar beet and apple pulp increased the amount of TDF fermented in the small intestine. The third study examined the effect of fibre fractions of sugar beet pulp (SBP) and the method for quantifying soluble and insoluble fibre on soluble and insoluble fibre digestibility and digestive traits. Four diets were formulated with similar level of insoluble fibre (aNDFom-cp: 315 g/kg DM) and protein (167 g/kg DM). Control diet contained the lowest level of soluble fibre (30.3 g/kg DM, including sunflower hulls and straw as sole sources of fibre). A second diet was obtained by replacing 60 g starch/kg of control diet with SBP pectins (82.9 g soluble fibre/kg DM). Two more diets were obtained by replacing part of the fibrous sources of the control diet with either insoluble SBP fibre or SBP (42.2 and 82.3 g soluble fibre/kg DM, respectively). Fifty six (14/diet) rabbits weighing 2.40  0.213 kg were used to determine faecal and ileal digestibility of total dietary fibre (TDF), insoluble dietary fibre (IDF), neutral detergent fibre corrected for ash and CP (aNDFom-cp) and soluble fibre estimated as SDFaNDFom-cp and SDFIDF. Faecal and ileal mucin content was used to correct TDF and soluble fibre digestibility. It was also recorded weight of digestive segments and digesta pH. Rabbits fed insoluble SBP showed the lowest feed intake with respect to the other 3 diets (124 vs. 139 g/d, respectively. P < 0.05). Ileal mucin flow was higher (P < 0.05) in animals fed pectin and SBP diets (9.0 g/d, as average) than those fed control diet (4.79 g/d), showing InsSBP group an intermediate value. No differences on mucin content were detected at faecal level. There was no diet effect on the CIAD of TDF (corrected for mucin) and insoluble fibre. Fibre methodology influenced the CIAD of insoluble fibre (0.123 for IDF vs. 0.108 for aNDFom-cp. P < 0.01). Anyway, the amount of insoluble fibre fermented before the caecum did not differ between both methods (4.9 g/d, on average). Rabbits fed insoluble SBP and SBP diets showed the highest CTTAD of insoluble fibre (0.266 on average vs. 0.106 for control group), whereas those fed pectin diet had an intermediate value (0.106. P < 0.001). The CTTAD of insoluble fibre measured with IDF was higher than that measured with aNDFom-cp (by 20%. P < 0.001). It led that the amount of insoluble fibre fermented along the digestive tract were different (9.5 or 7.5 g/d when calculated as IDF or aNDFom-cp, respectively; P < 0.001). When the CIAD of soluble fibre was corrected for mucin they became positive (P < 0.001) except for control group measured as SDFIDF. Once corrected for mucin content, rabbits fed soluble fibre from SBP (pectin and SBP groups) showed higher CIAD of soluble fibre than control group (0.483 vs. -0.019. respectively), whereas the value for insoluble SBP group was intermediate 0.274. The CTTAD of soluble fibre (mucin corrected) was similar among diets 0.93. Rabbits fed with SBP and insoluble SBP diets showed higher total digestive tract and stomach relative weight than those fed pectin and control diets (by 11 and 56 %. respectively, P < 0.05). The caecal relative weight did not differ in rabbits fed pectin, insoluble SBP, and SBP diets (62 g/kg BW, as average) and they were on average 16% higher (P < 0.001) than in control group. Caecal content of rabbits fed SBP diet was more acid than those fed control diet (5.64 vs. 6.03. P < 0.001), whereas those from pectin and insoluble SBP diets showed intermediate values. In conclusion, the positive effect of SBP fibre on ileal mucin flow was due to both its soluble and insoluble fibre fraction. Half of the soluble SBP fibre was degraded before the caecum independently it came from pectin or SBP. The caecal pH correlated better with the ileal amount of fermented TDF in the digestive tract rather than with that fermented in the caecum. The last study examined the effect of soluble and insoluble fibre of apple pulp on fibre digestibility and digestive traits. Four diets were formulated with similar level of insoluble fibre (aNDFom-cp: 324 g/kg DM) and protein (18.6 g/kg DM). Control diet contained the lowest level of soluble fibre (46 g soluble fibre/kg DM, including oat hulls and straw as sole sources of fibre). A second diet was obtained by replacing 60 g starch/kg of control diet with apple pectins (105 g soluble fibre/kg DM). Two more diets were obtained by substituting part of the fibrous sources of the control diet by either apple pulp or depectinized apple pulp (93 and 71 g soluble fibre/kg, respectively). The CTTAD was determined in 23 rabbits/diet weighing 1.68  0.23 kg BW, and 23 rabbits/diet were slaughtered at 60 d of age to collect ileal digesta to determine CIAD and record other digestive traits. Soluble fibre from apple stimulated ileal flow of mucin (P = 0.002), but depectinized apple pulp did not. The correction for mucin increased the digestibility of crude protein, total dietary fibre, and soluble fibre at faecal, but especially at ileal level, depending in this case on the diet. Around half of the soluble fibre in diets containing any fibre fraction from apple was degraded at ileal level, with no differences among these diets (0.46 vs. 0.066 for control group, P=0.046). Faecal soluble fibre digestibility was 0.86 on average for all groups). Inclusion of the apple insoluble fibre improved NDF digestibility at faecal (0.222 vs. 0.069. P < 0.05) but not at ileal level. Caecal content of rabbits fed apple pulp diet was more acid than those fed control diet (5.55 vs. 5.95. P < 0.001), whereas those from pectin and depectinised apple pulp diets showed intermediate values. In conclusion, the positive effect of apple fibre on ileal mucin flow was mainly due to its soluble fibre fraction. Half of the soluble apple fibre was degraded before the caecum independently it came from pectin or apple pulp. The caecal pH correlated better with the total and ileal amount of fermented TDF in the digestive tract rather than with that fermented in the caecum. The results obtained in the studies 2, 3 and 4 were considered together. These results showed that the mucin correction is necessary when the TDF and soluble fibre digestibility is determined, and it correction is more important at ileal level and in diets with low level of soluble fibre. On another hand, incrementing the soluble fibre using sugar beet and apple pulp increased the amount of TDF disappear before the caecum. Moreover, the caecal pH correlated better with the ileal amount of fermented TDF in the digestive tract rather than with that fermented in the caecum. This suggests that an ileal fibre solubilisation may occur rather than ileal fermentation. Therefore the implications of this work were that: the estimation of soluble fibre as SDFaNDFom-cp is an adequate method considering its correlation with the physiological effects; and the TDF and soluble fibre digestibility must be corrected with intestinal mucins, especially when the ileal digestibility is determined.

What health problems overcrowd hospital emergency departments in Queensland and has this changed over time? A case study of two hospitals in Queensland 2001 - 2009

Aim: to describe what health problems patients attending emergency department with and whether this changed over time. Methods: Electronic data was retrieved from EDIS (Emergency Department Information System) and HBCIS (Hospital Based Clinical Information System) in two hospitals in Queensland in the period 2001-2009. The ICD-10 code of patient's diagnosis was then extrapolated and then group into ICD-10 chapters, such that the health problem can be presented. Results: Among the specific health problems, Chapter XIX 'Injury and poisoning' ranked number one consistently (ranging from 22.1% to 31.2% of the total presentations) in both the urban and remote hospitals in Queensland. The top ten specific presenting health problems in both the urban and remote hospital include Chapter XI 'Digestive system', Chapter XIV 'Genitourinary system', Chapter IX 'Circulatory system', and Chapter XIII 'Musculoskeletal system and connective tissue'. Chapter X 'Respiratory system' made the top ten presenting Chapters in both hospitals, but ranked much higher (number four consistently for the eight years, ranging from 6.8% to 8.3%) in the remote hospital. Chapter XV 'Pregnancy childbirth and puerperium' made to the top ten in the urban hospital only while Chapter XII 'Skin and subcutaneous tissue', Chapter I 'Infectious and parasitic diseases' made the top ten in the remote hospital only. Conclusion: The number one health problem presenting to both the urban and remote hospitals in Queensland is Chapter XIX 'Injury and poisoning', and it did not change in the period 211 - 2009.

Effects of soluble dietary cellulose on specific growth rate, survival and digestive enzyme activities in three freshwater crayfish (Cherax) species

Three native freshwater crayfish Cherax species are farmed in Australia namely; Redclaw (Cherax quadricarinatus), Marron (C. tenuimanus), and Yabby (C. destructor). Lack of appropriate data on specific nutrient requirements for each of these species, however, has constrained development of specific formulated diets and hence current use of over-formulated feeds or expensive marine shrimp feeds, limit their profitability. A number of studies have investigated nutritional requirements in redclaw that have focused on replacing expensive fish meal in formulated feeds with non-protein, less expensive substitutes including plant based ingredients. Confirmation that freshwater crayfish possess endogenous cellulase genes, suggests their potential ability to utilize complex carbohydrates like cellulose as nutrient sources in their diet. To date, studies have been limited to only C. quadricarinatus and C. destructor and no studies have compared the relative ability of each species to utilize soluble cellulose in their diets. Individual feeding trials of late-juveniles of each species were conducted separately in an automated recirculating culture system over 12 week cycles. Animals were fed either a test diet (TD) that contained 20% soluble cellulose or a reference diet (RD) substituted with the same amount of corn starch. Water temperature, conductivity and pH were maintained at constant and optimum levels for each species. Animals were fed at 3% of their body weight twice daily and wet body weight was recorded bi-weekly. At the end of experiment, all animals were harvested, measured and midgut gland extracts assayed for alpha-amylase, total protease and cellulase activity levels. After the trial period, redclaw fed with RD showed significantly higher (p<0.05) specific growth rate (SGR) compare with animals fed the TD while SGR of marron and yabby fed the two diets were not significantly different (p<0.05). Cellulase expression levels in redclaw were not significantly different between diets. Marron and yabby showed significantly higher cellulase activity when fed the RD. Amylase and protease activity in all three species were significantly higher in the animals fed with RD (Table 1). These results indicate that test animals of all species can utilize starch better than dietary soluble cellulose in their diet and inclusion of 20% soluble cellulose in diets does not appear to have any significant negative effect on their growth rate but survival was impacted in C. quadricarinatus while not in C. tenuimanus or C. destructor.

Effects of soluble dietary cellulose on specific growth rate, survival and digestive enzyme activities in three freshwater crayfish (Cherax) species

The current study evaluated the effect of soluble dietary cellulose on growth, survival and digestive enzyme activity in three endemic, Australian freshwater crayfish species (redclaw: Cherax quadricarinatus, marron: C. tenuimanus, yabby: C. destructor). Separate individual feeding trials were conducted for late-stage juveniles from each species in an automated recirculating freshwater, culture system. Animals were fed either a test diet (TD) that contained 20% soluble cellulose or a reference diet (RD) substituted with the same amount of corn starch, over a 12 week period. Redclaw fed with RD showed significantly higher (p<0.05) specific growth rates (SGR) compared with animals fed the TD, while SGR of marron and yabby fed the two diets were not significantly different. Expressed cellulase activity levels in redclaw were not significantly different between diets. Marron and yabby showed significantly higher cellulase activity when fed the RD (p<0.05). Amylase and protease activity in all three species were significantly higher in the animals fed with RD (p<0.05). These results indicate that test animals of all three species appear to utilize starch more efficiently than soluble dietary cellulose in their diet. The inclusion of 20% soluble cellulose in diets did not appear, however, to have a significant negative effect on growth rates.

Berries:emerging impact on cardiovascular health

Berries are a good source of polyphenols, especially anthocyanins, micronutrients, and fiber. In epidemiological and clinical studies, these constituents have been associated with improved cardiovascular risk profiles. Human intervention studies using chokeberries, cranberries, blueberries, and strawberries (either fresh, or as juice, or freeze-dried), or purified anthocyanin extracts have demonstrated significant improvements in LDL oxidation, lipid peroxidation, total plasma antioxidant capacity, dyslipidemia, and glucose metabolism. Benefits were seen in healthy subjects and in those with existing metabolic risk factors. Underlying mechanisms for these beneficial effects are believed to include upregulation of endothelial nitric oxide synthase, decreased activities of carbohydrate digestive enzymes, decreased oxidative stress, and inhibition of inflammatory gene expression and foam cell formation. Though limited, these data support the recommendation of berries as an essential fruit group in a heart-healthy diet.

Health problems among detainees in Switzerland: a study using the ICPC-2 classification.

BACKGROUND: Little is known about the health status of prisoners in Switzerland. The aim of this study was to provide a detailed description of the health problems presented by detainees in Switzerland's largest remand prison. METHODS: In this retrospective cross-sectional study we reviewed the health records of all detainees leaving Switzerland's largest remand prison in 2007. The health problems were coded using the International Classification for Primary Care (ICPC-2). Analyses were descriptive, stratified by gender. RESULTS: A total of 2195 health records were reviewed. Mean age was 29.5 years (SD 9.5); 95% were male; 87.8% were migrants. Mean length of stay was 80 days (SD 160). Illicit drug use (40.2%) and mental health problems (32.6%) were frequent, but most of these detainees (57.6%) had more generic primary care problems, such as skin (27.0%), infectious diseases (23.5%), musculoskeletal (19.2%), injury related (18.3%), digestive (15.0%) or respiratory problems (14.0%). Furthermore, 7.9% reported exposure to violence during arrest by the police. CONCLUSION: Morbidity is high in this young, predominantly male population of detainees, in particular in relation to substance abuse. Other health problems more commonly seen in general practice are also frequent. These findings support the further development of coordinated primary care and mental health services within detention centers.

The potential therapeutic benefits of consuming 'health-promoting' fermented dairy products: a brief update

Despite the publication of a few contrary indications, the general consensus seems to be that the regular consumption of probiotic cultures, perhaps accompanied by 'prebiotic' compounds, improves the healthy operation of the digestive system of a typical consumer. Whether other benefits follow is a more contentious issue, especially for a given individual. Nevertheless, the dairy industry needs to be aware of the various ideas that are currently being explored, and this brief review seeks to summarize some recent findings.

From probiotics to prebiotics and a healthy digestive system

Ingestion of probiotics can be recommended as a preventative approach to maintaining intestinal microflora balance and thereby enhance 'well-being'. Undoubtedly, probiotic bacteria will vary in their efficacy. The literature indicates positive results in over 50 human trials with prevention/treatment of infections the most frequently reported. In theory increased levels of probiotics may induce a 'barrier' influence against common pathogens. Mechanisms of effect are likely to include the excretion of acids (lactate, acetate), competition for nutrients and gut receptor sites, immuno-modulation and the formation of specific antimicrobial agents. An alternative, or additional, approach is the prebiotic concept. This takes the view that probiotics are present indigenous to the gut and that a rational approach towards increasing their numbers would be to consume food ingredients (carbohydrates) that have a selective metabolism in the lower gut. A prebiotic is 'a nondigestible food ingredient that beneficially affects the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon that can improve the host health.' In particular, the ingestion of fructo-oligosaccharides, galacto-oligosaccharides, and lactulose has shown to stimulate bifidobacteria in the lower gut.