What Are Prebiotics?
The current definition describes a prebiotic as “a nondigestible compound that, through its metabolization by microorganisms in the gut, modulates composition and/or activity of the gut microbiota, thus conferring a beneficial physiologic effect on the host”. (12)
Essentially, prebiotics are fibrous carbohydrates that possess unique characteristics and health effects. In order to be classified as a prebiotic, a dietary fiber must:
- Resist normal digestion and absorption in the gastrointestinal tract
- Undergo fermentation by intestinal microbiota
- Confer health benefits to the host through selective stimulation of growth and/or activity of intestinal microbes (38)(42)
While inulin, fructooligosaccharides (FOS), and galactooligosaccharide (GOS) have been well-established as prebiotics, (12) a number of other compounds have also demonstrated prebiotic effects and associated health benefits, such as:
- Arabino-oligosaccharides (12)
- Beta-glucans (12)
- Fructans (26)
- Galactomannan (12)
- Human milk oligosaccharides (5)
- Isomaltooligosaccharide (12)
- Lactulose (12)
- Mannan (45) and glucomannan (17)
- Pectin (13)
- Xylooligosaccharides (12)
Prebiotic Versus Probiotic
While prebiotics and probiotics are often described as “synbiotics” since they can work synergistically to support the health of intestinal microbiota, there is a difference between prebiotic and probiotic functions. Prebiotics are non-digestible fibrous carbohydrates fermented by microbes in the digestive tract, essentially acting as “food” and stimulating the growth of beneficial bacteria. Probiotics, on the other hand, are live microorganisms that confer beneficial effects to the host. (31) Probiotics can be obtained from dietary supplements or fermented foods, such as yogurt, cultured vegetables (e.g., kimchi, sauerkraut, pickles), miso, and kombucha. (36) It’s important to note that, unlike probiotics, prebiotics can only support the growth of bacteria already residing in the gut. (30)
Prebiotic Benefits
Prebiotics are fermented in the gastrointestinal tract, thus acting as a source of fuel for commensal (beneficial) microbes (20), promoting a healthy microbial profile, and providing a number of associated health benefits. (30)Promote Microbiota
Prebiotics have been shown to promote a favorable composition of intestinal , particularly by increasing Bifidobacteria and Lactobacilli counts, (12)(30) as well as by decreasing or inhibiting the growth of pathogenic bacteria, such as E. coli, Salmonella spp, and Campylobacter. (12)(42) Improvements in microbial diversity have been shown to support proper immune function and have been associated with a decreased risk of developing allergies. (12)Produce Beneficial Metabolites
Furthermore, through their fermentation, prebiotic fibers produce beneficial metabolites. The actions of metabolites, such as short-chain fatty acids (e.g., acetate, propionate, and butyrate), (12)(30) may improve intestinal permeability (12) and immune function. (12)(42) Prebiotics also reduce the fermentation of protein and amino acids and therefore, the subsequent production of potentially harmful metabolites, such as sulfides, ammonia, and amines. (12)(30) Additionally, prebiotics have been shown to improve bioavailability and absorption of certain minerals, such as calcium and magnesium. (12)(42)May Help with Digestive, Cardiometabolic, and Immune Health Conditions
The supplementation of various types of prebiotic fibers has also been explored in many health conditions, particularly those related to digestive, cardiometabolic, and immune health, such as:- Constipation (14)(47)
- Diarrhea, including Traveller’s diarrhea (15) and C.difficile-associated diarrhea (27)
- Irritable bowel syndrome (4)
- Lactose intolerance (40)
- Crohn’s colitis (29)
- Type 2 diabetes (28)(41)
- Obesity and being overweight (37)(48)
- Cardiovascular disease (22)(23)
- Atopic dermatitis
- Hyperthyroidism (3)
- Polycystic ovary syndrome (PCOS)
- Neonatal hyperbilirubinemia
Sources of Prebiotics
Like probiotics, prebiotics may be obtained through the diet or supplementation. The following table provides examples of dietary sources for several compounds that have demonstrated prebiotic effects.
Prebiotic Supplementation Can Help Individuals with Certain Health Conditions
Prebiotics are dietary fibers that possess unique characteristics and health effects. Currently, only a small number of fibers have been classified as prebiotics, while many others have demonstrated prebiotic actions. Supplementation with certain prebiotics has also been shown to benefit individuals with a number of digestive, cardiometabolic, immune, and other health conditions. To learn more about prebiotics and how they may benefit your overall wellness plan, consult an integrative healthcare practitioner who can help you incorporate the most appropriate type and amount of prebiotic fiber into your diet.If you’re looking to prescribe prebiotic fiber through Fullscript, sign up for an account online today.
References
- Aachary, A.A., & Prapulla, S.G. (2011). Xylooligosaccharides (XOS) as an emerging prebiotic: Microbial synthesis, utilization, structural characterization, bioactive properties, and applications. Comprehensive Reviews in Food Science and Food Safety, 10(1), 2-16.
- Anderson, J.W., Baird, P., Davis, R.H.Jr., Ferreri, S., Knudtson, M., Koraym, A., … Williams, C.L. (2009). Health benefits of dietary fiber. Nutrition Reviews, 67(4), 188-205.
- Azezli, A.D., Bayraktaroglu, T., & Orhan, Y. (2007). The use of konjac glucomannan to lower serum thyroid hormones in hyperthyroidism. Journal of the American College of Nutrition, 26(6), 663-8.
- Azpiroz, F., Dubray, C., Bernalier-Donadille, A., Cardot, J.M., Accarino, A., Serra, J., … Dapoigny, M. (2017). Effects of scFOS on the composition of fecal microbiota and anxiety in patients with irritable bowel syndrome: a randomized, double blind, placebo controlled study. Neurogastroenterology & Motility, 29(2).
- Barile, D., & Rastall, R.A. (2013). Human milk and related oligosaccharides as prebiotics. Current Opinion in Biotechnology, 24(2), 214-9.
- Bashir, K., & Choi, J. S. (2017). Clinical and physiological perspectives of β-Glucans: The past, present, and future. International Journal of Molecular Sciences, 18(9), 1906.
- Belorkar, S.A., & Gupta. A.K. (2016). Oligosaccharides: a boon from nature’s desk. AMB Express, 6, 82.
- Bisceglia, M., Indrio, F., Riezzo, G., Poerio, V., Corapi, U., & Raimondi, F. (2009). The effect of prebiotics in the management of neonatal hyperbilirubinaemia. Acta Paediatrica, 98(10), 1579-81.
- Bode, L. (2012). Human milk oligosaccharides: Every baby needs a sugar mama. Glycobiology, 22(9), 1147–1162.
- Brighenti, F. (2007). Dietary fructans and serum triacylglycerols: a meta-analysis of randomized controlled trials. Journal of Nutrition, 137(11 Suppl), 2552S-2556S.
- Campos, D., Betalleluz-Pallardel, I., Chirinos, R., Aguilar-Galvez, A. Noratto, G., & Pedreschi, R. (2012). Prebiotic effects of yacon (Smallanthus sonchifolius Poepp. & Endl), a source of fructooligosaccharides and phenolic compounds with antioxidant activity. Food Chemistry, 135(3), 1592-1599.
- Carlson, J. L., Erickson, J. M., Lloyd, B. B., & Slavin, J. L. (2018). Health effects and sources of prebiotic dietary fiber. Current Developments in Nutrition, 2(3), nzy005.
- Chung, W.S.F., Meijerink, M., Zeuner, B., Holck, J., Louis, P., Meyer, A.S., … Duncan, S.H. (2017). Prebiotic potential of pectin and pectic oligosaccharides to promote anti-inflammatory commensal bacteria in the human colon. FEMS Microbiology Ecology, 93(11).
- Collado Yurrita, L., San Mauro Martín, I., Ciudad-Cabañas, M.J., Calle-Purón, M.E., & Hernández Cabria, M. (2014). Effectiveness of inulin intake on indicators of chronic constipation; A meta-analysis of controlled randomized clinical trials. Nutricion Hospitalaria, 30(2), 244-52.
- Drakoularakou, A., Tzortzis, G., Rastall, R.A., & Gibson, G.R. (2010). A double-blind, placebo-controlled, randomized human study assessing the capacity of a novel galacto-oligosaccharide mixture in reducing travellers’ diarrhoea. European Journal of Clinical Nutrition, 64(2), 146-52.
- De Leo, V., Tosti, C., Cappelli, V., Morgante, G., & Cianci, E.A. (2014). Combination inositol and glucomannan in PCOS patients. Minerva Ginecologica, 66(6), 527-33.
- Devaraj, R.D., Reddy, C.K., & Xu, B. (2018). Health-promoting effects of konjac glucomannan and its practical applications: A critical review. International Journal of Biological Macromolecules, 126, 273-281.
- Fedewa, A., & Rao, S.S.C. (2014). Dietary fructose intolerance, fructan intolerance and FODMAPs. Current Gastroenterology Reports, 16(1), 370.
- Fernández, J., Redondo-Blanco, S., Miguélez, E.S., Villar, C.J., Clemente, A., & Lombó, F. (2015). Healthy effects of prebiotics and their metabolites against intestinal diseases and colorectal cancer. AIMS Microbiology, 1(1), 48-71.
- Gibson, G.R., & Roberfroid, M.B. (1995). Dietary modulation of the human colonic microbiota: Introducing the concept of prebiotics. The Journal of Nutrition, 125(6), 1401–1412.
- Gourineni, V., Stewart, M. L., Icoz, D., & Zimmer, J. P. (2018). Gastrointestinal tolerance and glycemic response of isomaltooligosaccharides in healthy adults. Nutrients, 10(3), 301.
- Ho, H.V., Sievenpiper, J.L., Zurbau, A., Blanco Mejia, S., Jovanovski, E., Au-Yeung, F., … Vuksan, V. (2016). A systematic review and meta-analysis of randomized controlled trials of the effect of barley β-glucan on LDL-C, non-HDL-C and apoB for cardiovascular disease risk reductioni-iv. European Journal of Clinical Nutrition, 70(11), 1239-1245.
- Ho, H.V., Sievenpiper, J.L., Zurbau, A., Blanco Mejia, S., Jovanovski, E., Au-Yeung, F., … Vuksan, V. (2016). The effect of oat β-glucan on LDL-cholesterol, non-HDL-cholesterol and apoB for CVD risk reduction: a systematic review and meta-analysis of randomised-controlled trials. British Journal of Nutrition, 116(8), 1369-1382.
- Holtzapple, M.T. (2003). Hemicelluloses. Encyclopedia of Food Sciences and Nutrition, 3060-3071.
- Keithley, J. K., Swanson, B., Mikolaitis, S. L., DeMeo, M., Zeller, J. M., Fogg, L., & Adamji, J. (2013). Safety and efficacy of glucomannan for weight loss in overweight and moderately obese adults. Journal of Obesity, 2013, 610908.
- Kolida, S., & Gibson, G.R. (2007). Prebiotic capacity of inulin-type fructans. The Journal of Nutrition, 137(11), 2503S–2506S.
- Lewis, S., Burmeister, S., & Brazier, J. (2005). Effect of the prebiotic oligofructose on relapse of Clostridium difficile-associated diarrhea: a randomized, controlled study. Clinical Gastroenterology and Hepatology, 3(5), 442-8.
- Liu, F., Prabhakar, M., Ju, J., Long, H., & Zhou, H.W. (2017). Effect of inulin-type fructans on blood lipid profile and glucose level: a systematic review and meta-analysis of randomized controlled trials. European Journal of Clinical Nutrition, 71(1), 9-20.
- Lindsay, J.O., Whelan, K., Stagg, A.J., Gobin, P., Al‐Hassi, H.O., Rayment, N., … Forbes, A. (2006). Clinical, microbiological, and immunological effects of fructo‐oligosaccharide in patients with Crohn’s disease. Gut, 55(3), 348–355.
- Macfarlane, S., Macfarlane, G.T., & Cummings, J.H. (2006). Review article: Prebiotics in the gastrointestinal tract. Alimentary Pharmacology and Therapeutics, 24(5), 701-714.
- Markowiak, P., & Śliżewska, K. (2017). Effects of probiotics, prebiotics, and synbiotics on human health. Nutrients, 9(9), 1021.
- Moro, G., Arslanoglu, S., Stahl, B., Jelinek, J., Wahn, U., & Boehm, G. (2006). A mixture of prebiotic oligosaccharides reduces the incidence of atopic dermatitis during the first six months of age. Archives of Disease in Childhood, 91(10), 814–819.
- Moshfegh, A.J., Friday, J.E., Goldman, J.P., & Chug Ahuja, J.K. (1999). Presence of inulin and oligofructose in the diets of Americans. The Journal of Nutrition, 129(7), 1407S–1411S.
- Mudgil, D. (2017). The interaction between insoluble and soluble fiber. In R.A. Samaan (Ed). Dietary fiber for the prevention of cardiovascular disease (pp. 35-59). Los Angeles, CA: Elsevier Inc.
- Nakashima, A., Yamada, K., Iwata, O., Sugimoto, R., Atsuji, K., Ogawa, T., … Suzuki, K. (2018). β-Glucan in foods and its physiological functions. Journal of Nutritional Science and Vitaminology, 64(1), 8-17
- National Institutes of Health. (2019). Probiotics. Retrieved from https://ods.od.nih.gov/factsheets/Probiotics-HealthProfessional/
- Rahmani, J., Miri, A., Černevičiūtė, R., Thompson, J., de Souza, N.N., Sultana, R., … Hekmatdoost, A. (2019). Effects of cereal beta-glucan consumption on body weight, body mass index, waist circumference and total energy intake: A meta-analysis of randomized controlled trials. Complementary Therapies in Medicine, 43, 131-139.
- Roberfroid, M. (2007). Prebiotics: The concept revisited. The Journal of Nutrition, 137(3), 830S–837S.
- Sabater-Molina, M., Larqué, E., Torrella, F., & Zamora, S. (2009). Dietary fructooligosaccharides and potential benefits on health. Journal of Physiology and Biochemistry, 65(3), 315-28.
- Savaiano, D.A., Ritter, A.J., Klaenhammer, T.R., James, G.M., Longcore, A.T., Chandler, J.R., … Foyt, H.L. (2013). Improving lactose digestion and symptoms of lactose intolerance with a novel galacto-oligosaccharide (RP-G28): a randomized, double-blind clinical trial. Nutrition Journal, 12, 160.
- Shen, X.L., Zhao, T., Zhou, Y., Shi, X., Zou, Y., & Zhao, G. (2016). Effect of oat β-glucan intake on glycaemic control and insulin sensitivity of diabetic patients: A meta-analysis of randomized controlled trials. Nutrients, 8(1).
- Slavin, J. (2013). Fiber and prebiotics: Mechanisms and health benefits. Nutrients, 5(4), 1417-1435.
- Sprenger, N., Odenwald, H., Kukkonen, A.K., Kuitunen, M., Savilahti, E., & Kunz, C. (2017). FUT2-dependent breast milk oligosaccharides and allergy at 2 and 5 years of age in infants with high hereditary allergy risk. European Journal of Nutrition, 56(3), 1293-1301.
- Srivastava, P., & Malviya, R. (2011). Sources of pectin, extraction and its applications in pharmaceutical industry: An overview. Indian Journal of Natural Products and Resources, 2(1), 10-18.
- Walton, G., Rastall, R.A., Martini, M.C., Williams, C.E., Jeffries, R.L., & Gibson, G.R. (2010). A double-blind, placebo controlled human study investigating the effects of coffee derived manno-oligosaccharides on the faecal microbiota of a healthy adult population. International Journal of Probiotics and Prebiotics, 5(2), 75-83.
- Wu, T., Yang, Y., Zhang, L., & Han, J. (201). Systematic review of the effects of inulin-type fructans on blood lipid profiles: a meta-analysis. Wei Sheng Yan Jiu, 39(2), 172-6.
- Xu, L., Yu, W., Jiang, J., & Li, N. (2014). Clinical benefits after soluble dietary fiber supplementation: a randomized clinical trial in adults with slow-transit constipation. Zhonghua Yi Xue Za Zhi, 94(48), 3813-6.
- Zalewski, B.M., Chmielewska, A., & Szajewska, H. The effect of glucomannan on body weight in overweight or obese children and adults: a systematic review of randomized controlled trials. Nutrition, 31(3), 437-42.e2.
