by The California Prune Board

Credit: Pixabay/CC0 Public Domain

New research published in the journal Food & Function indicates that daily prune consumption may improve the gut fecal microbiome of postmenopausal women. The fecal microbiome—the ecosystem of microorganisms found in one's fecal matter—reflects an individual's overall gut health. Results from the study showed notable enrichment in bacteria from the family Lachnospiraceae. This group of bacteria has been associated with an ability to decrease inflammatory markers in the body and help maintain the integrity of the gut barrier.

The goal of this study was to characterize the effect of prune supplementation on the gut microbiome of postmenopausal women. Menopause is marked by a decline in ovarian hormones, which may negatively impact the gut microbiome. In turn, these changes in the gut microbiome potentially contribute to health risks, including increased body fat, decreased metabolism, and insulin resistance.

"Previous research has shown that postmenopausal women experience health benefits from consuming prunes," says study author Mary Jane De Souza, Ph.D., FACSM, Distinguished Professor, Pennsylvania State University. "It is likely that the gut microbiome helps facilitate these benefits. With that, we wanted to look more closely at the specific effects that prune consumption has on populations of gut microorganisms in postmenopausal women."

The randomized controlled trial included 143 postmenopausal women between the ages of 55 and 75. Participants were assigned to one of three treatment groups: no prunes (n=52), 50g prunes per day (n=54), or 100g prunes day (n=37). Results collected at the 12-month mark indicated significant changes in the microbiomes for those in the prune treatment groups—most notably, the enrichment of the Lachnospiraceae family of bacteria. Researchers suggest that these results may have implications for the use of prunes as a non-pharmacological whole food intervention for gut health.

"Consumers are becoming more concerned with their gut health and this study supports prunes' long-standing reputation as a gut-healthy food. Prunes are a natural, whole food that is easy and convenient for consumers to incorporate into their daily meals or snacks," says Andrea N. Giancoli, MPH, RD, Nutrition Advisor to the California Prune Board.

This new study adds to the growing body of research that explores the relationship between prune consumption, gut health, and the potential favorable effects on other major body systems. For instance, a recently published scientific review from Pennsylvania State University suggests that the phenolic compounds and dietary fiber content in prunes may alter the gut microbiome in a manner that ultimately supports bone health.

The findings are published in the journal Food & Function.

More information: Abigayle M. R. Simpson et al, Prune supplementation for 12 months alters the gut microbiome in postmenopausal women, Food & Function (2022). DOI: 10.1039/D2FO02273G

Provided by The California Prune Board

by Rory Smoot

Credit: Pixabay/CC0 Public Domain

Question: My mother has been experiencing unusual and persistent fatigue, abdominal pain, and jaundice. After undergoing a CT scan, her doctor diagnosed her with cholangiocarcinoma. What is this type of cancer? And what treatment options are available?

Answer: Cholangiocarcinoma is a rare cancer that develops from the bile ducts, which are slender tubes that carry the digestive fluid bile and connect the liver to the gallbladder and small intestine.

The tumor can occur anywhere along the biliary "tree" and is divided into three subtypes based on where it starts. The intrahepatic subtype starts in the bile duct inside the liver and typically appears as a mass in the liver, which may affect the organ's function. The second subtype, called perihilar cholangiocarcinoma, occurs just outside of the liver, where the bile ducts come together and exit the liver. Patients diagnosed with this form of cholangiocarcinoma typically present with jaundice. Distal cholangiocarcinoma is the third subtype. It occurs in the portion of the bile duct that is outside of the liver and nearest to the intestine. This subtype also typically presents with jaundice.

An initial CT scan can be suggestive of cholangiocarcinoma, but additional testing, including a biopsy or brushings, is required to establish the diagnosis and the stage. For all three subtypes, a health care professional typically also will order a CT scan of the chest to look for any signs of metastasis, or spread, to the lungs.

If there is blockage of the bile ducts and jaundice, symptoms most commonly occurring with the perihilar or distal subtypes, then a health care professional may perform an endoscopic evaluation with an endoscopic retrograde cholangiopancreatography. This allows for collection of a sample of the area of concern and placement of an internal stent to open the bile ducts so the liver can drain appropriately. Biliary drainage helps relieve signs and symptoms of biliary blockage, which can include jaundice, poor appetite and itching.

For intrahepatic tumors that present as a liver mass, it is common to have an ultrasound-guided biopsy performed by a radiologist to establish the diagnosis and obtain tissue for further testing, such as sequencing studies.

There are several options for treating these rare tumors, but determining the optimal approach for your mother will depend on the stage, location and subtype of her tumor. For example, most patients with localized disease, meaning the cancer has not spread to any other organs, are candidates for surgery to remove the tumors.

If your mother is diagnosed with intrahepatic or perihilar cholangiocarcinoma, removing part of the liver may be required. However, standard surgical approaches to remove the tumor may not be possible for some patients diagnosed with perihilar cholangiocarcinoma. In certain situations, a liver transplant may be an option instead.

Finally, the most common surgery to treat distal cholangiocarcinoma is called the Whipple procedure, which is a complex operation that involves removing a portion of the pancreas.

Surgery is the only curative treatment option for these tumors, but for those patients who are not candidates for surgery, other treatment options should be considered. These include chemotherapy, targeted therapy, immunotherapy, radiation and radioembolization. These treatments often are given in combination, and the combination and order of the treatments is dependent on the specific tumor subtype and extent of the disease.

As part of the testing for patients diagnosed with cholangiocarcinoma, it is now common to perform an analysis for mutations, called next-generation sequencing. These tests can identify certain mutations in tumors for which we have targeted therapy options, and these mutations occur more frequently in intrahepatic cholangiocarcinoma.

Finally, for patients who have not responded to standard treatments or have tumors that have progressed on standard treatments, we recommend considering enrollment in clinical trials evaluating new treatment strategies.

Ultimately, if your mother has been diagnosed with cholangiocarcinoma, it is important that she be seen at a cancer center with experience treating these tumor types because the treatment options, and determining which patients are candidates, is complex.

2023 Mayo Clinic News Network.

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