The findings showed the potential of fermented soybean as an adjuvant to managing GERD, the researchers from Kuala Lumpur’s UCSI University and Pakistan’s Isra University wrote in Nutrients.
A total of 110 individuals who had experienced GERD symptoms in the three months prior to the study were recruited. These symptoms include heartburn, acid reflux, regurgitation, or non-cardiac chest pain.
They were randomised to take either the placebo or the intervention daily for 12 weeks.
The intervention material is a product known as Stomach Food by Malaysian firm Nattome Sdn Bhd.
It is a mixed oat powder powder containing isolated soy protein as well as soybean fermented with Lactobacillus delbrueckii, inulin, digestive enzyme blend, galacto-oligosaccharides (GOS), and Bifidobacterium longum Rosell-175.
Fermented soybean was of special interest for this study as existing studies have shown that soy-based foods could enhance gastrointestinal health, with fermented ones showing more consistent benefits, the researchers explained.
Participants took the intervention or the placebo by mixing the powder with lukewarm water and drank them once daily before meals.
Changes in their GERD symptoms were evaluated using the Reflux Disease Questionnaire (RDQ), while inflammatory markers, including interleukin-4 (IL-4), interleukin-6 (IL-6), and interleukin-8 (IL-8) were measured to assess inflammation.
The Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire was also used to evaluate their quality of life.
Findings showed that the intervention group had significant improvements in their GERD symptoms, especially in heartburn and regurgitation symptoms.
By the end of the study, heartburn scores based on the RDQ was significantly reduced by 47.6 per cent to a score of 0.220 ± 0.007 in the intervention group.
This amount of reduction was also significantly higher than that seen in the placebo group.
“Our research has demonstrated that FSB supplementation for three months can effectively alleviate heartburn symptoms by a notable 47.6 per cent.
“This significant improvement aligns with previous studies showing fermented soy supplementation can enhance the quality of life among adults suffering from heartburn.
“The process of fermenting soy flour leads to the production of bioactive peptides, which are believed to possess modulatory effects on inflammation and could play a crucial role in reducing heartburn symptoms,” said the researchers.
Additionally, the intervention group had a more significant reduction in their regurgitation symptoms, with regurgitation scores down 62.9 per cent to 0.335 ± 0.056.
In particular, individuals with higher BMI responded better to supplementation.
As for the quality of life, significant improvements were observed in the intervention group. particularly in vitality, emotional distress, and social functioning.
The overall scoring for quality of life went up from 5.268 ± 1.955 to 5.971 ± 1.999 in the intervention group, indicating a 13.3 per cent improvement.
The improvement was significantly higher than that of the placebo group.
Inflammatory markers
There were also significant reductions in the levels of IL-4, IL-6, and IL-8, indicating a notable anti-inflammatory effect.
In the intervention group, IL-4 levels decreased from 129.97 ± 37.73 pg/mL at baseline to 94.80 ± 24.32 pg/mL by the end of the trial, indicating a 27.1 per cent reduction.
However, IL-4 had increased from 137.29 ± 22.55 pg/mL to 149.45 ± 33.68 pg/mL by the end of the trial.
Similar trends were seen for IL-6 and IL-8, where reductions were seen in the intervention group, but the levels had gone up for the placebo group.
For instance, IL-6 levels had gone down by 43.5 per cent to 2.494 ± 0.483 pg/mL in the intervention group.
The placebo group, however, had increased from 4.747 ± 1.246 pg/mL to 4.982 ± 0.943 pg/mL.
In this case, the researchers said the reduction could be due to high concentration of isoflavone and fibrinolytic enzymes in fermented soybean.
“This effect is likely due to the high concentration of isoflavone and fibrinolytic enzymes in FSB that were found to possess anti-inflammatory properties, which can reduce the expression of IL-6 mRNA.
“Similarly, IL-4, a pro-inflammatory cytokine, has been strongly correlated with GERD severity and frequency of acid reflux episodes. Evidence indicates that FSB (fermented soybean) can alter the activities and expressions of various pro-inflammatory cytokines, including IL-4, as corroborated by our study,” said the researchers.
“These findings support using FSB as an adjuvant approach in managing GERD, with notable improvements in patients’ quality of life,” they concluded.
Source: Nutrients
Effect of Fermented Soybean (FSB) Supplementation on Gastroesophageal Reflux Disease (GERD)
https://doi.org/10.3390/nu16162779
Authors: Tan, E.S.S.; Zaman, R.; Memon, M.A.; Tan, C.K.