News & Perspective

Prebiotics and their benefits on human health

Gastroenterology
7 months ago, OP Editor

The health benefits of prebiotics have been the subject of extensive research in the recent years. Initially described in 1995 by Gibson and Roberfroid, prebiotics were defined as non-digested food components, which could stimulate the growth and activity of a single type or a limited amount of microorganisms residing in the gastrointestinal tract, thus improving the health condition of a host.1 Later in 2008, a group of international experts from the Food and Agriculture Organization evaluated the functional and health properties of prebiotics.2

A stressed and dysfunctional intestinal mucosa may have different origins, including infections or caused by different agents such as nonsteroidal anti-inflammatory drugs or high-dose chemotherapy treatment.3 The health and economic burden associated with a stressed intestinal mucosa has been estimated to be worth billions of dollars of direct health care costs, with related loss of productivity.4 Prebiotics and probiotics are known to be beneficial to human health by maintaining a healthy gut microflora and influencing the metabolic, trophic and protective mechanisms.5

As reported by Kuo et al., an ideal prebiotic should be resistant to the actions of acids in the stomach, bile salts and other hydrolysing enzymes in the intestine. Furthermore, it should not be absorbed in the upper gastrointestinal tract and can be easily fermented by the beneficial intestinal microflora.6 The prebiotics may be obtained from natural sources such as dairy products, raw vegetables and fruit or fermented pickles, or may have artificial origins such as lactulose, galactooligosaccharides and fructooligosaccharides.

There is an increasing evidence on the beneficial effects of prebiotics on human health. Several studies reported that the benefits include inhibition of the development of pathogens, increase of the absorption of minerals, mostly of magnesium and calcium, strengthening protective effects to prevent colon cancer and relief from inflammation and other symptoms associated with intestinal bowel disorders. Other findings seem to indicate that prebiotics could enhance the immune response, reduce serum cholesterol, and prevent colorectal cancer. Also, prebiotics have been shown to suppress the indigestion and diarrhea that were caused by pathogens.7

Prebiotics can also influence the composition of bacteria in human gut.8 Studies showed that when supplements of fructan and inulin were given, the number of bifidobacteria was increased.9 Other types of prebiotics that have been found to positively affect the gut microflora are arabinoxylan and inulin. These two have a modifying ability through affecting the function ability of gut microflora.10 Bifidobacteria and Lactobacilli selected fermentation of prebiotics have supported the symbiotic gut microbiota through improving the numbers of these commensals and decreasing the number of neutral or pathogenic organisms. While some of the health benefits are well documented, others require additional studies in order to be accepted by the medical community.11

It is important to recognize that there are no standard guidelines currently existing for oral administration of prebiotics, and its individual use should be carefully monitored in order to determine the potential adverse reaction.12

The current research focuses on evaluating new prebiotics and new strains of probiotics and their applicability in clinical research. Additional data from well-designed, randomized, and controlled clinical trials with adequate statistical power, are required to further strengthen the health benefits of prebiotics, paving a new direction for their exploitation.

1. Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr. 1995;125(6):1401-1412.

2. Pineiro M, Asp N-G, Reid G, et al. FAO Technical meeting on prebiotics. J Clin Gastroenterol. 2008;42 Suppl 3 Pt 2:S156-159.

3. Davidson G, Kritas S, Butler R. Stressed mucosa. Nestle Nutr Workshop Ser Paediatr Programme. 2007;59:133-142; discussion 143-146.

4. ACCA. The economic costs of Crohn’s disease and ulcerative colitis. Australia: Access Economics; 2007.

5. Stoidis CN, Misiakos EP, Patapis P, et al. Potential benefits of pro- and prebiotics on intestinal mucosal immunity and intestinal barrier in short bowel syndrome. Nutr Res Rev. 2011;24(1):21-30.

6. Kuo S-M. The Interplay Between Fiber and the Intestinal Microbiome in the Inflammatory Response. Adv Nutr. 2013;4(1):16-28.

7. Collins S, Reid G. Distant Site Effects of Ingested Prebiotics. Nutrients. 2016;8(9).

8. Thushara RM, Gangadaran S, Solati Z, et al. Cardiovascular benefits of probiotics: a review of experimental and clinical studies. Food Funct. 2016;7(2):632-642.

9. Scott KP, Antoine J-M, Midtvedt T, van Hemert S. Manipulating the gut microbiota to maintain health and treat disease. Microb Ecol Health Dis. 2015;26:25877.

10. Ryan PM, Ross RP, Fitzgerald GF, et al. Functional food addressing heart health: do we have to target the gut microbiota? Curr Opin Clin Nutr Metab Care. 2015;18(6):566-571.

11. Maftei NM. Probiotic, Prebiotic and Synbiotic Products in Human Health. IntechOpen. 2019.

12. Yoo JY, Kim SS. Probiotics and Prebiotics: Present Status and Future Perspectives on Metabolic Disorders. Nutrients. 2016;8(3):173.

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