Description
SIBO is an increasingly common condition where there is a microbial imbalance in the small intestine typically characterized by a high concentration of bacteria in the small intestine, which could be due to an overgrowth of naturally occurring bacteria in the small bowel or translocation of bacteria from the large intestine. Gas and bloating are common gastrointestinal symptoms for individuals with SIBO due to the imbalance and/or overabundance of bacteria in the small intestine, creating uncomfortable abdominal distress. Although providing essential fuel for the epithelial cells, traditional fiber-based prebiotics are not the ideal choice because of the gas they produce during the fermentation process, exacerbating the symptoms of individuals with SIBO. As a solution, polyphenolbased, non-fiber prebiotics can provide essential nutrients to the gut lining without producing bloating as a side effect, helping to reestablish a healthy mucosal barrier and to restore the gut terrain in individuals with SIBO.
Ingredients
Pomegranate Fruit Extract (Pomanox)
Pomegranate fruit extract contains the polyphenols, ellagic acid and punicalagins A and B which are not only known to have antioxidant properties and help maintain normal inflammatory balance, but have been shown in preclinical and clinical studies to promote the proliferation of beneficial gut microbes. These polyphenols are not absorbed intact in the small intestine and, consequently, the unabsorbed polyphenols can be metabolized by microbes in the small intestine to produce secondary metabolites such as urolithins.
Specifically, one in vitro study incubated pomegranate extract with fecal bacteria and found formation of urolithins, increased growth of total bacteria, increased Bifidobacterium spp. and Lactobacillus spp., and increased concentrations of short chain fatty acids (SCFA). Animal models confirm these in vitro findings showing that supplementation of mice with pomegranate extract for 20 days led to significant increases in the ratio of the percentage of Bifidobacterium spp. to total bacteria compared to control.
Human clinical studies have also show beneficial changes in the gut microbiota composition with pomegranate extract supplementation. In one small study, Bifidobacterium spp. increased in fecal samples of more than 50% of subjects in response to supplementation with 660 mg pomegranate extract/day (providing 200 mg punicalagins A and B) for thirty days. Similarly, 83.3% of subjects saw an increase in beneficial bacteria after 28 days of supplementation with 575 mg of pomegranate extract containing 20% punicalagins, while having healthy competition against unwanted microorganisms.
There were no adverse gastrointestinal effects and 83.3% of subjects reported achieving regularity in intestinal transit. Another small exploratory human clinical trial found positive changes to the fecal microbiota in the 70% of subjects that produced urolithins in response to four weeks of pomegranate fruit extract supplementation (1,000 mg containing 7% punicalagin A/B and 6.8% ellagic acid).
Citrus Fruit Extract Effects on Gut Microbiota & Health Parameters
The gut microbiota is known to interact with food components such as fiber and secondary plant compounds like polyphenols. The relationship between the gut microbiota and polyphenols is considered bidirectional — not only do the intestinal microbes possess the ability to metabolize polyphenols, but it is also now understood that polyphenols exerts changes to intestinal microbes. For example, in vitro evidence suggests that 500 mg of citrus fruit extract administered in between meals over a three-week period significantly increased butyrate and total SCFAs levels by influencing the growth of bacterial groups known to produce butyrate. In addition, a 12-week randomized, double-blind, placebo-controlled study demonstrated in vivo that 500 mg of a citrus fruit extract (MicrobiomeX) was able to lead to beneficial shifts in SCFA profiles. Additionally, it was reported that MicrobiomeX was able to lower calprotectin levels, suggesting it helps maintain normal inflammatory balance in the GI tract.
References
† These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
- Euromed Nature & Science. In vitro Studies on the Bifidogenic effect of Pomanox™.
- Bialonska D, Ramnani P, Kasimsetty SG, Muntha KR, Gibson GR, Ferreira D. The influence of pomegranate by-product and punicalagins on selected groups of human intestinal microbiota. Int J Food Microbiol. 2010;140(2-3):175-182.
- Euromed Nature & Science. Prebiotic effect of Pomanox™ in an animal model.
- Euromed Nature & Science. The Prebiotic Effect of Pomanox™: Clinical Study 2.
- Euromed Nature & Science. The Prebiotic Effect of Pomanox™: Clinical Study 1.
- Li Z, Henning SM, Lee RP, et al. Pomegranate extract induces ellagitannin metabolite formation and changes stool microbiota in healthy volunteers. Food Funct. 2015;6(8):2487-2495.
- Makki K, Deehan EC, Walter J, B ckhed F. The Impact of Dietary Fiber on Gut Microbiota in Host Health and Disease. Cell host & microbe. 2018;23(6):705-715.
- Duda-Chodak A, Tarko T, Satora P, Sroka P. Interaction of dietary compounds, especially polyphenols, with the intestinal microbiota: a review. European journal of nutrition. 2015;54(3):325-341.
- Vamanu E, Gatea F. Correlations between Microbiota Bioactivity and Bioavailability of Functional Compounds: A Mini-Review. Biomedicines. 2020;8(2).
- Stevens Y, Rymenant EV, Grootaert C, et al. The Intestinal Fate of Citrus Flavanones and Their Effects on Gastrointestinal Health. Nutrients. 2019;11(7).
- Van Rymenant E, Salden B, Voorspoels S, et al. A Critical Evaluation of In Vitro Hesperidin 2S Bioavailability in a Model Combining Luminal (Microbial) Digestion and Caco-2 Cell Absorption in Comparison to a Randomized Controlled Human Trial. Molecular nutrition & food research. 2018;62(8):e1700881.
- Salden BN, Troost, F.J., Possemiers, S., Stevens, Y., Masclee,A.A.,. In: Maastricht University; 2019.
Warnings
Always be sure to speak with your healthcare provider before starting any new nutritional supplement when pregnant or nursing. For children, we recommend speaking with your child's pediatrician regarding proper dosing. Store away from children.
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