Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-20T14:36:20.078Z Has data issue: false hasContentIssue false
  • English
  • Français

Gastrointestinal effects of prebiotics

Published online by Cambridge University Press:  09 March 2007

J. H. Cummings  and
G. T. Macfarlane
J. H. Cummings*
Affiliation:
Department of Molecular and Cellular Pathology, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
G. T. Macfarlane
Affiliation:
Department of Molecular and Cellular Pathology, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
*
*Corresponding author: Professor J. H. Cummings, fax +44 (0) 1382 633952, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The defining effect of prebiotics is to stimulate selectively the growth of bifidobacteria and lactobacilli in the gut and, thereby, increase the body's natural resistance to invading pathogens. Prebiotic carbohydrates may also have additional, less specific, benefits because they are fermented in the large intestine. The prebiotic carbohydrates that have been evaluated in humans at the present time largely consist of fructans or galactans. There is consistent evidence from in vitro and in vivo studies that these are not digested by normal human enzymes, but are readily fermented by anaerobic bacteria in the large intestine. There are no reports of faecal recovery of measurable quantities of prebiotic carbohydrates. Through fermentation in the large intestine, prebiotic carbohydrates yield short-chain fatty acids, stimulate the growth of many bacterial species in addition to the selective effects on lactobacilli and bifidobacteria, they can also produce gas. Along with other fermented carbohydrates, prebiotics have mild laxative effects, although this has proved difficult to demonstrate in human studies because the magnitude of laxation is small. Potentially, the most important effect of prebiotic carbohydrates is to strengthen the body's resistance to invading pathogens and, thereby, prevent episodes of diarrhoea. At the present time, this effect has not been convincingly demonstrated in either adults or children, although there have been attempts to ameliorate the diarrhoea associated with antibiotics and travel, but without success. However, prebiotic carbohydrates clearly have significant and distinctive physiological effects in the human large intestine, and on the basis of this it is likely that they will ultimately be shown to be beneficial to health.

Keywords

PrebioticsFermentationBiofilmTravellers' diarrhoea
Type
Research Article
Information
British Journal of Nutrition , Volume 87 , Issue S2 , May 2002 , pp. S145 - S151
Copyright
Copyright © The Nutrition Society 2002

References

Alles, MS, Hautvast, JGAJ, Nagengast, FM, Hartemink, R, Van Laere, KMJ & Jansen, JBM (1996) Fate of fructo-oligosaccharides in the human intestine. British Journal of Nutrition 76, 211–221.CrossRefGoogle ScholarPubMed
Bach Knudsen, KE & Hessov, I (1995) Recovery of inulin from Jerusalem artichoke (Helianthus tuberosus L) in the small intestine of man. British Journal of Nutrition 74, 101–103.CrossRefGoogle ScholarPubMed
Bouhnik, Y, Flourie, B & D'Agay-Abensour, L et al. , (1997) Administration of transgalacto-oligosaccharides increases fecal bifidobacteria and modifies colonic fermentation metabolism in healthy humans. Journal of Nutrition 127, 444–448.CrossRefGoogle ScholarPubMed
Brighenti, F, Casiraghi, MC, Pellingrini, N, Riso, P, Simonetti, P & Testolin, G (1995) Comparison of lactulose and inulin as reference standard for the study of resistant starch fermentation using hydrogen breath test. Italian Journal of Gastroenterology 27, 122–128.Google Scholar
Christl, SU, Murgatroyd, PR, Gibson, GR & Cummings, JH (1992) Production, metabolism and excretion of hydrogen in the large intestine. Gastroenterology 102, 1269–1277.CrossRefGoogle ScholarPubMed
Cummings, JH, Christie, S & Cole, TJ (2001 a) A study of fructo oligosaccharides (FOS) in the prevention of travellers’ diarrhoea. Alimentary Pharmacology and Therapeutics 15, 1139–1145.CrossRefGoogle Scholar
Cummings, JH, Macfarlane, GT & Englyst, HN (2001 b) Prebiotic digestion and fermentation. American Journal of Clinical Nutrition 73, 415S–420S.CrossRefGoogle ScholarPubMed
Cummings, JH, Rombeau, JL & Sakata, T (1995) Physiological and Clinical Aspects of Short Chain Fatty Acids. Cambridge: Cambridge University Press.Google Scholar
de Roos, NM & Katan, MB (2000) Effects of probiotic bacteria on diarrhea, lipid metabolism, and carcinogenesis: a review of papers published between 1988 and 1998. American Journal of Clinical Nutrition 71, 405–411.CrossRefGoogle ScholarPubMed
Ellegard, L, Andersson, H & Bosaeus, I (1997) Inulin and oligofructose do not influence the absorption of cholesterol, or the excretion of cholesterol, Ca, Mg, Zn, Fe, or bile acids but increases energy excretion in ileostomy subjects. European Journal of Clinical Nutrition 51, 1–5.CrossRefGoogle ScholarPubMed
Gibson, GR, Beatty, ER, Wang, X & Cummings, JH (1995) Selective stimulation of bifidobacteria in the human colon by oligofructose and inulin. Gastroenterology 108, 975–982.CrossRefGoogle ScholarPubMed
Gibson, GR & Wang, X (1994) Regulatory effects of bifidobacteria on the growth of other colonic bacteria. Journal of Applied Bacteriology 77, 412–420.Google Scholar
Gismondo, MR, Drago, L & Lombardi, A (1999) Review of probiotics available to modify gastrointestinal flora. International Journal of Antimicrobial Agents 12, 287–292.CrossRefGoogle ScholarPubMed
Hidaka, H, Eida, T, Takizawa, T, Tokunaga, T & Tashiro, Y (1986) Effects of fructooligosaccharides on intestinal flora and human health. Bifidobacteria Microflora 5, 37–50.CrossRefGoogle Scholar
Hidaka, H & Hirayama, M (1991) Useful characteristics and commercial applications of fructooligosaccharides. Biochemical Society Transactions 19, 561–565.CrossRefGoogle ScholarPubMed
Horan, SJ & Cummings, JH (1999) Inulin and oligofructose modify surface associated human colonic bacteria in vitro. Gut 45, A37.Google Scholar
Ito, M, Deguchi, Y & Miyamori, A et al. , (1990) Effects of administration of galactooligosaccharides on the human faecal microflora, stool weight and abdominal sensation. Microbial Ecology Health Disease 3, 285–292.CrossRefGoogle Scholar
Kawaguchi, M, Tashiro, Y, Adachi, T & Tamura, Z (1993) Changes on intestinal condition, fecal microflora and composition of rectal gas after administration of fructooligosaccharide and lactulose at different doses. Bifidobacteria Microflora 13, 57–68.CrossRefGoogle Scholar
Kleessen, B, Sykura, B, Zunft, H-J & Blaut, M (1997) Effects of inulin and lactose on fecal microflora, microbial activity, and bowel habit in elderly constipated persons. American Journal of Clinical Nutrition 65, 1397–1402.CrossRefGoogle ScholarPubMed
Külz, (1874) Beiträge zur Pathologie und Therapie des Diabetes Mellitus. Marburg Jahresbuch Tierchemie Iv, 448.Google Scholar
Langlands, SJ, Hopkins, MJ & Cummings, JH (2000) Inulin and FOS feeding modify colonic mucosal bacteria in vivo. Gastroenterology 118, A772, Suppl 2 part of 1.CrossRefGoogle Scholar
Lewis, HB (1912) The value of inulin as a foodstuff. Journal of the American Medical Association 58, 1176–1177.CrossRefGoogle Scholar
Lewis, S & Freedman, AR (1998) Review article: the use of biotherapeutic agents in the prevention and treatment of gastrointestinal disease. Alimentary Pharmacology and Therapeutics 12, 807–822.CrossRefGoogle ScholarPubMed
Lewis, SJ & Cohen, S (2000) Prevention of antibiotic associated diarrhoea with oligofructose. Gut 465, A70.Google Scholar
Livesey, G, Johnson, IT & Gee, JM et al. , (1993) Determination of sugar alcohol and polydextrose absorption in humans by the breath hydrogen (H2) technique: the stoichiometry of hydrogen production and the interaction between carbohydrates assessed in vivo and in vitro. European Journal of Clinical Nutrition 47, 419–430.Google ScholarPubMed
Luo, J, Rizkalla, SW & Alamowitch, C et al. , (1996) Chronic consumption of short-chain fructooligosaccharides by healthy subjects decreased basal hepatic glucose production but had no effect on insulin-stimulated glucose metabolism. American Journal of Clinical Nutrition 63, 939–945.CrossRefGoogle ScholarPubMed
Macfarlane, S, Cummings, JH & Macfarlane, GT (1999) Bacterial colonisation of surfaces in the large intestine. In Colonic Microbiota, Nutrition and Health, pp. 71–87. [Gibson, GR and Roberfroid, MB, editors]. Netherlands: Kluwer Academic Publishers.CrossRefGoogle Scholar
McCance, RA & Lawrence, RD (1929) The Carbohydrate Content of Foods. HMSO: London.Google Scholar
Mitsuoka, T, Hidaka, H & Eida, T (1987) Effect of fructooligosaccharides on intestinal microflora. Nahrung 31, 5–6.CrossRefGoogle ScholarPubMed
Molis, C, Flourie, B & Ouarne, F et al. , (1996) Digestion, excretion, and energy value of fructooligosaccharides in healthy humans. American Journal of Clinical Nutrition 64, 324–328.Google Scholar
Neubauer (1905), München Medizine Wochenschrift p. 1525.Google Scholar
Nilsson, U, Oste, R, Jagerstad, M & Birkhed, D (1988) Cereal fructans: in vitro and in vivo studies on availability in rats and humans. Journal of Nutrition 118, 1325–1330.CrossRefGoogle ScholarPubMed
Pedersen, A, Sandstrom, B & Van Amelsvoort, JMM (1997) The effect of ingestion of inulin on blood lipids and gastrointestinal symptoms in healthy females. British Journal of Nutrition 78, 215–222.Google Scholar
Persia, (1905) Nuova Revista Clinica Therapeutica. Jahresbuch Tierchemie XXV, 822.Google Scholar
Rumessen, JJ, Bode, S, Hamberg, O & Gudmand-Hoyer, E (1990) Fructans of Jerusalem artichokes: intestinal transport, absorption, fermentation and influence on blood glucose, insulin and C-peptide responses in healthy subjects. American Journal of Clinical Nutrition 52, 675–681.Google Scholar
Sanno, T (1987) Effects of Neosugar on constipation, intestinal microflora, and gall bladder contraction in diabetics. Proceedings of the Third Neosugar Research Conference, Tokyo, 1986. Tokyo: Meiji-Seika Publications, 109–117.Google Scholar
Stone-Dorshow, T & Levitt, MD (1987) Gaseous response to ingestion of a poorly absorbed fructooligosaccharide sweetener. American Journal of Clinical Nutrition 46, 61–65.Google Scholar
Van Laere, KMJ, Bosveld, M, Schols, HA, Beldman, G & Voragen, AGJ (1997) Fermentative degradation of plant cell wall derived oligosaccharides by intestinal bacteria. In Non-digestible Oligosaccharides: Healthy Food for the Colon? [Hartemink, R, editor] Proceedings of the International Symposium, Wageningen Graduate School VLAG. Wageningen, Netherlands: Wageningen Graduate School VLAG, 37–46.Google Scholar
Wang, X & Gibson, GR (1993) Effects of the in vitro fermentation of oligofructose and inulin by bacteria growing in the human large intestine. Journal of Applied Bacteriology 75, 373–380.Google Scholar
Wolf, BW, Meulbroek, JA, Jarvis, KP, Wheeler, KP & Garleb, KA (1997) Dietary supplementation with fructooligosaccharides increase survival time in a hamster model of Clostridium difficile – colitis. Bioscience Microflora 16, 59–64.Google Scholar