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Microbial degradation of complex carbohydrates in the gut

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Abstract
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Bacteria that colonize the mammalian intestine collectively possess a far larger repertoire of degradative enzymes and metabolic capabilities than their hosts. Microbial fermentation of complex non-digestible dietary carbohydrates and host–derived glycans in the human intestine has important consequences for health. Certain dominant species, notably among the Bacteroidetes, are known to possess very large numbers of genes that encode carbohydrate active enzymes and can switch readily between different energy sources in the gut depending on availability. Nevertheless, more nutritionally specialized bacteria appear to play critical roles in the community by initiating the degradation of complex substrates such as plant cell walls, starch particles and mucin. Examples are emerging from the Firmicutes, Actinobacteria and Verrucomicrobium phyla, but more information is needed on these little studied groups. The impact of dietary carbohydrates, including prebiotics, on human health requires understanding of the complex relationship between diet composition, the gut microbiota and metabolic outputs.

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Introduction Glucose is an important, if not the sole, source of energy metabolism in the fed state for brain and other nervous tissue, red blood cells, renal medulla, and retina. Assimilation of diet-derived glucose is necessary to provide glucose per se for these tissues, to serve as a source of nonprotein energy, and to stimulate normal rates of insulin secretion required to adequately suppress protein degradation and excessive lipolysis, and to stimulate protein synthesis. Carbohydrate contributes approximately 40% of the energy intake in infants ingesting human milk or cow milk-based formulas, and lactose provides perhaps the sole source of diet-derived glucose in human milk and about 50% of the diet-derived glucose in preterm formulas. Dietary carbohydrate is assimilated via the intestine and colon in humans of all ages, but in the preterm newborn or young infant with defective function of the small intestine, bacterial fermentation of dietary carbohydrate is an especially quantitatively important metabolic pathway for enteral carbohydrate assimilation. This process may have both beneficial and adverse effects on the infant. Figure 22.1 summarizes carbohydrate assimilation by the gut. Lactose, like other dietary sugars fed to newborn infants (such as glucose polymer), is digested in the small intestine but also may undergo some fermentation in the colon. Glucose and galactose, derived from lactose digestion, are absorbed in the small intestine, enter the portal vein, and then undergo uptake by the liver, where galactose is almost quantitatively removed by the combined processes of conversion to glucose or incorporation into glycogen.

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