The investigators aim was to compare healthy young adults, senior orienteers (model of healthy ageing) and elderly with gastrointestinal symptoms on intestinal permeability, microbiota compositions and well-being. In addition, assess whether 3 weeks of oral intake of soluble or dispersible forms yeast-dervied beta-glucan could improve intestinal barrier function against drug-induced barrier disruption vs placebo for a cohort of elderly people with gastrointestinal symptoms, in a randomized double blinded placebo-controlled cross-over clinical trial.
Baseline samples for measurements of intestinal permeability (multisugar test), microbiota composition (faecal samples) and well-being (questionnaires) were collected during the first week for: Young healthy adults (healthy young controls) Senior orienteers (healthy elderly controls) Elderly with gastrointestinal (GI) symptoms Thereafter only the elderly with GI symptoms continued into the randomized cross-over trial where they were blindly and randomly distributed one of the following: Soluble yeast-derived beta-glucan, dispersible (whole) yeast-derived beta-glucan and placebo. Each supplement was taken for 3 weeks with a 1 week washout until all participants had taken all supplements. Towards the end of each supplement period, samples for measurement of intestinal permeability and microbiota were collected, in addition to questionnaires being filled out.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
43
Campus USÖ, Örebro University
Örebro, Sweden
Intestinal permeability at baseline (before indomethacin)
In vivo gastrointestinal permeability measured by oral intake of multi-sugar test before intake of indomethacin. Urine collected over 24 hours for measurement of excreted sugars.
Time frame: Day 1
Intestinal permeability at baseline (after indomethacin)
In vivo gastrointestinal (GI) permeability measured by oral intake of multi-sugar test after intake of indomethacin (GI barrier disruption challenge). Urine collected over 24 hours for measurement of excreted sugars.
Time frame: Day 1
Changes in Intestinal permeability 3 weeks after study supplementation 1 (before indomethacin).
Performed after study participants have orally taken study supplementation 1 for 3 weeks. In vivo gastrointestinal permeability measured by oral intake of multi-sugar test before intake of indomethacin. Urine collected over 24 hours for measurement of excreted sugars.
Time frame: 3 weeks
Changes in intestinal permeability 3 weeks after study supplementation 1 (after indomethacin).
Performed after study participants have orally taken study supplementation 1 for 3 weeks. In vivo gastrointestinal (GI) permeability measured by oral intake of multi-sugar test after intake of indomethacin (GI barrier disruption challenge). Urine collected over 24 hours for measurement of excreted sugars.
Time frame: 3 weeks
Changes in intestinal permeability 3 weeks after study supplementation 2 (before indomethacin)
Performed after study participants have orally taken study supplementation 2 for 3 weeks. In vivo gastrointestinal permeability measured by oral intake of multi-sugar test before intake of indomethacin. Urine collected over 24 hours for measurement of excreted sugars.
Time frame: 3 weeks
Changes in intestinal permeability 3 weeks after study supplementation 2 (after indomethacin)
Performed after study participants have orally taken study supplementation 2 for 3 weeks. In vivo gastrointestinal (GI) permeability measured by oral intake of multi-sugar test after intake of indomethacin (GI barrier disruption challenge). Urine collected over 24 hours for measurement of excreted sugars.
Time frame: 3 weeks
Changes in intestinal permeability 3 weeks after study supplementation 3 (before indomethacin)
Performed after study participants have orally taken study supplementation 3 for 3 weeks. In vivo gastrointestinal permeability measured by oral intake of multi-sugar test before intake of indomethacin. Urine collected over 24 hours for measurement of excreted sugars.
Time frame: 3 weeks
Changes in intestinal permeability 3 weeks after study supplementation 3 (after indomethacin)
Performed after study participants have orally taken study supplementation 3 for 3 weeks. In vivo gastrointestinal (GI) permeability measured by oral intake of multi-sugar test after intake of indomethacin (GI barrier disruption challenge). Urine collected over 24 hours for measurement of excreted sugars.
Time frame: 3 weeks
Microbiota diversity - at baseline
Faecal samples will be used for next-generation sequencing and analysed for diversity
Time frame: Day 1
Bacterial species - at baseline
Faecal samples will be used for next-generation sequencing and analysed for bacterial species
Time frame: Day 1
Changes in microbiota diversity 3 weeks after study supplementation 1
Faecal samples will be used for next-generation sequencing and analysed for changes in microbiota diversity
Time frame: 3 weeks
Changes in bacterial species 3 weeks after study supplementation 1
Faecal samples will be used for next-generation sequencing and analysed for changes in bacterial species levels
Time frame: 3 weeks
Changes in microbiota diversity 3 weeks after study supplementation 2
Faecal samples will be used for next-generation sequencing and analysed for changes in microbiota diversity
Time frame: 3 weeks
Changes in bacterial species 3 weeks after study supplementation 2
Faecal samples will be used for next-generation sequencing and analysed for changes in bacterial species levels
Time frame: 3 weeks
Changes in microbiota diversity 3 weeks after study supplementation 3
Faecal samples will be used for next-generation sequencing and analysed for changes in microbiota diversity
Time frame: 3 weeks
Changes in bacterial species 3 weeks after study supplementation 3
Faecal samples will be used for next-generation sequencing and analysed for changes in bacterial species levels
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Time frame: 3 weeks
Changes in microbiota diversity - Washout (1 week after ending supplementation 1, i.e. 4 weeks after baseline)
Faecal samples will be used for next-generation sequencing and analysed for changes in microbiota diversity from 1 weeks washout, after ending study supplementation 1 (4 weeks after baseline)
Time frame: 4 weeks
Changes in bacterial species - Washout (1 week after ending study supplementation 1, i.e. 4 weeks after baseline)
Faecal samples will be used for next-generation sequencing and analysed for changes in bacterial species from 1 weeks washout, after ending study supplementation 1 (4 weeks after baseline)
Time frame: 4 weeks
Changes in microbiota diversity - Washout (1 week after ending study supplementation 2, i.e. 4 weeks after baseline)
Faecal samples will be used for next-generation sequencing and analysed for changes in microbiota diversity from 1 weeks washout, after ending study supplementation 2 (4 weeks after baseline)
Time frame: 4 weeks
Changes in bacterial species - Washout (1 week after ending study supplementation 2, i.e. 4 weeks after baseline)
Faecal samples will be used for next-generation sequencing and analysed for changes in bacterial species from 1 weeks washout, after ending study supplementation 2 (4 weeks after baseline).
Time frame: 4 weeks
Changes in microbiota diversity - Washout (1 week after ending study supplementation 3, i.e. 4 weeks after baseline)
Faecal samples will be used for next-generation sequencing and analysed for changes in microbiota diversity from 1 weeks washout, after ending study supplementation 3 (4 weeks after baseline)
Time frame: 4 weeks
Changes in bacterial species - Washout (1 week after ending study supplementation 3, i.e. 4 weeks after baseline)
Faecal samples will be used for next-generation sequencing and analysed for changes in bacterial species from 1 weeks washout, after ending study supplementation 3 (4 weeks after baseline)
Time frame: 4 weeks
Changes in gastrointestinal symptom questionnaire scores
The Gastrointestinal Symptoms Rating Scale (GSRS) evaluates gastrointestinal (GI) symptoms based on the 5 domains diarrhoea, constipation, reflux, indigestion and abdominal pain. The symptoms are assessed with 15 items, ranging in scores 1 to 7 depending on their severity. A score of 1 represents "no problems" and score 7 represents "severe problems". The severity of symptoms may be defined as no problems (1 point), mild (1-2 points), moderate (2-4 points), and severe (4-7 points). The scores for each domain was calculated as the mean score of each corresponding item while the mean total GSRS score reflects the general severity of GI symptoms.
Time frame: up to 13 weeks
Changes in hospital and anxiety depression scores
The Hospital Anxiety and Depression Scale (HADS) was used to evaluate the psychological distress of study participants.This questionnaire consists of 14 items subdivided in two subscales for the assessment of anxiety or depression. The total score is used as a measure of general psychological distress. The minimum score is 0 and the maximum score is 21. A score \> 8 on respective subscales indicates a significant level of anxiety or depression.
Time frame: up to 13 weeks
Changes in perceived stress scale scores
The perceived stress scale (PSS) consists of 10 items, including a number of direct questions about current levels of experienced stress. The respondent answers how often a certain emotion has been present during the past month. PSS scores are obtained by reversing responses (e.g., 0 = 4, 1 = 3, 2 = 2, 3 = 1 \& 4 = 0) to the four positively stated items (items 4, 5, 7, \& 8) and then summing across all scale items. Each item is rated on a 5-point scale ranging from never (0) to almost always (4). The questions in this scale ask about the responders feelings and thoughts during the last month. In each case the questionnaire requires the respondent to indicate by circling how often they felt or thought a certain way.
Time frame: Up to 13 weeks
Changes in quality of life questionnaire scores
The EuroQol 5D-5L (EQ-5D-5L) tool consists of two parts; 5Q-5D, which includes 5 items related to wellbeing and function (mobility, self-care, usual activities, pain/discomfort and anxiety/ depression) and the visual analogue scale, 5Q-5D-VAS, ranging from 0 to 100.
Time frame: Up to 13 weeks