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Randomized Controlled Trial
. 2023 Jun 1;118(6):1058-1068.
doi: 10.14309/ajg.0000000000002124. Epub 2022 Dec 20.

Consumption of 2 Green Kiwifruits Daily Improves Constipation and Abdominal Comfort-Results of an International Multicenter Randomized Controlled Trial

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
Affiliations
Randomized Controlled Trial

Consumption of 2 Green Kiwifruits Daily Improves Constipation and Abdominal Comfort-Results of an International Multicenter Randomized Controlled Trial

Richard Gearry et al. Am J Gastroenterol. .

Abstract

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.

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Conflict of interest statement

Guarantor of the article: Richard Gearry, MD, PhD.

Specific author contributions: R.G., S.F., and G.B.: principal investigators who oversaw the trial in their respective countries and contributed to writing and review of the manuscript. B.K.S.: conducted the statistical analysis and reviewed the manuscript. J.A.: contributed to trial design and reviewed the manuscript. P.B.: conducted laboratory analysis and reviewed the manuscript. A.W.: and C.B.: involved in running the New Zealand clinical trial and reviewed the manuscript. C.C., M.R.B., and I.P.: involved in running the Italy clinical trial and reviewed the manuscript. Y.O., T.M., T.O., M.F., Y.E., Mi.K., Mo.K., N.K., and K.N.: involved in running the Japan clinical trial and reviewed the manuscript. L.D.: involved with trial design, contributed to writing, and review of the manuscript.

Financial support: Zespri International Ltd. was the principal sponsor and reviewed, approved, and funded the study design. The New Zealand study center trial was jointly funded by a grant from the New Zealand government (Contract C11X1312) and the sponsor company, Zespri International Ltd. In Italy and Japan, Zespri International Ltd. was the sole funder for each study center trial. The funder did not contribute to the study design or data analysis.

Potential competing interests: J.A. and P.B. are employed by Zespri International who part-funded the study. R.G. and L.D. sit on the Science Advisory Board, have received travel and research grants from Zespri International. SF and GB have received research travel grants from Zespri International.

Figures

Figure 1.
Figure 1.
Crossover study design.
Figure 2.
Figure 2.
Overview of study plan and test procedures.
Figure 3.
Figure 3.
Consolidated Standards of Reporting Trials.
Figure 4.
Figure 4.
Change from baseline in CSBM frequency during interventions.
Figure 5.
Figure 5.
Weekly CSBM frequencies in the combined constipated group during each intervention.
Figure 6.
Figure 6.
Change from baseline in GSRS total scores.
See this image and copyright information in PMC

Comment in

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