Abstract
In recent years, research has focused on the use of dietary fibers and prebiotics, since many of these polysaccharides can be metabolized by intestinal microbiota, leading to the production of short-chain fatty acids. The metabolites of prebiotic fermentation also show anti-inflammatory and immunomodulatory capabilities, suggesting an interesting role in the treatment of several pathological conditions. Galacto-oligosaccharide and short- and long-chain fructans (Fructo-oligosaccharides and inulin) are the most studied prebiotics, even if other dietary compounds seem to show the same features. There is an increasing interest in dietary strategies to modulate microbiota. The aim of this review is to explore the mechanisms of action of prebiotics and their effects on the principal gastro-intestinal disorders in adults, with a special focus on Galacto-oligosaccharides, Fructo-oligosaccharides, lactulose and new emerging substances which currently have evidence of prebiotics effects, such as xilooligosaccharides, soybean oligosaccharides, isomaltooligosaccharides, lactobionic acid, resistant starch and polyphenols.
Highlights
In recent years, research has focused on the use of dietary fibers and prebiotics, since many of these polysaccharides can be metabolized by intestinal microbiota, leading to the production of short-chain fatty acids
They agreed that undigestible carbohydrates with a degree of polymerization (DP) 3-9 have to be included among dietary fibers, and they listed the beneficial effects of fiber on human health: (1) A reduction in blood lipid levels; (2) A reduction in post prandial blood glucose and insulin level; (3) An increased stool mass and reduced intestinal transit; (4) Fermentability by microbiota [18]
Dietary intake of prebiotics seems to positively affect the intestinal microbiota promoting the growth of beneficial intestinal bacteria, and producing metabolites that are potentially protective of gut functionality
Summary
Gibson and Roberfroid elaborated the first definition of prebiotics in 1995 as “selectively fermented ingredients that allow for specific changes, both in the composition of and/or activity in the gastrointestinal microflora that confer benefits upon hosts’ well-being and health” [1]. In 2017, during an important meeting of the International Scientific Association of Probiotics and Prebiotics (ISAPP) [8], prebiotics were identified as “a substrate that is selectively utilized by host microorganisms, conferring a health benefit” These substances have to show specific features, which are to be tested by in vitro and in vivo experiments in different targets (i.e., animals or humans): (1) resistance to gastric acidity, hydrolysis by digestive enzymes and gastro-intestinal (GI) absorption; (2) fermentation by intestinal microflora, which can be evaluated in vitro through the addition of the respective carbohydrates to colon content suspensions, or pure or mixed bacteria cultures in an anaerobic batch or continuous culture fermentation system [9]; and (3) growth promotion of intestinal bacteria beneficially related to health and well-being [10]. According to the ISAPP consensus statement [8], other substances, such as polyphenols and polyunsaturated fatty acids, which are converted to respective conjugated fatty acids, could be included in the most recent definition, acquiring a convincing weight of evidence in the target host [14,15]
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