Potential roles and clinical utility of prebiotics in newborns, infants, and children: proceedings from a global prebiotic summit meeting, New York City, June 27-28, 2008.
Initial bacterial colonization, including colonization with health-positive bacteria, such as bifidobacteria and lactobacilli, is necessary for the normal development of intestinal innate and adaptive immune defenses. The predominance of beneficial bacteria in the gut microflora of breast-fed infants is thought to be, at least in part, supported by the metabolism of the complex mixture of oligosaccharides present in human breast milk, and a more adult-type intestinal microbiota is found in formula-fed infants. Inadequate gut colonization, dysbiosis, may lead to an increased risk of infectious, allergic, and autoimmune disorders later in life. The addition of appropriate amounts of selected prebiotics to infant formulas can enhance the growth of bifidobacteria or lactobacilli in the colonic microbiota and, thereby, might produce beneficial effects. Among the substrates considered as prebiotics are the oligosaccharides inulin, fructo-oligosaccharides, galacto-oligosaccharides, and lactulose. There are some reports that such prebiotics have beneficial effects on various markers of health. For example, primary prevention trials in infants have provided promising data on prevention of infections and atopic dermatitis. Additional well-designed prospective clinical trials and mechanistic studies are needed to advance knowledge further in this promising field.
Sherman
Philip M
PM
Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. philip.sherman@sickkids.ca
Cabana
Michael
M
Gibson
Glenn R
GR
Koletzko
Berthold V
BV
Neu
Josef
J
Veereman-Wauters
Gigi
G
Ziegler
Ekhard E
EE
Walker
W Allan
WA
D000367:Age Factors; D001644:Bifidobacterium / Q000276:immunology* / Q000502:physiology; D001942:Breast Feeding; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018928:Immunity, Mucosal / Q000502:physiology*; D007223:Infant; D007225:Infant Food / Q000382:microbiology; D007231:Infant, Newborn; D007234:Infant, Premature; D007408:Intestinal Absorption / Q000276:immunology / Q000502:physiology; D007413:Intestinal Mucosa / Q000276:immunology / Q000382:microbiology; D007422:Intestines / Q000187:drug effects* / Q000276:immunology* / Q000382:microbiology; D007778:Lactobacillus / Q000276:immunology; D008297:Male; D019936:Probiotics / Q000008:administration & dosage*; D012307:Risk Factors; D047929:Term Birth