Prebiotics and Probiotics

May 1, 2009 Written by JP       [Font too small?]

I’ve discussed the importance of probiotics in the past. Probiotics are friendly bacteria that primarily inhabit the digestive system. They play a role in everything from helping to break down food to improving immune function, and even supporting healthy mood. Eating cultured and fermented foods and supplementing with probiotic supplements is one way to increase the number of these desirable microbes. But there’s another strategy that can support the growth and population of these intestinal helpers – by eating and supplementing with prebiotics.

Probiotic Effects in the Body
The Effects of Probiotics in the Body

Prebiotics are a special class of carbohydrates and soluble fibers that are not digested in the upper GI tract. Instead, they make their way down to the colon where they naturally ferment. This fermentation process selectively promotes the growth of beneficial bacteria which help support intestinal and overall good health.

An interesting development has recently emerged in prebiotic research. It appears that these unique carbohydrates may actually curb appetite and encourage weight loss. Let’s examine two studies that suggest a connection between a prebiotic called “oligofructose” and weight.

  1. A paper in the April 22nd issue of the American Journal of Clinical Nutrition studied the effects of oligofructose on 48 overweight volunteers. Half the group consumed 21 grams of oligofructose daily and the remainder were fed a placebo. The experiment lasted 12 weeks and included various measures of appetite, body composition and food intake. There was a modest reduction in body weight in the prebiotic group, but a small increase in weight in the placebo participants. Blood glucose and insulin levels decreased in the prebiotic volunteers, but again increased slightly in the placebo group. There was also a decline in ghrelin and an increase in peptide YY levels in the prebiotic group only. These two changes results in appetite suppression. (1)
  2. A 2008 study involving both obese adults and children found that adding 14 grams of oligofructose to a calorie-restricted diet helped to satisfy hunger, reduce body mass index and body fat percentage. The female participants also demonstrated a reduction in triglyceride levels, a risk factor for heart disease. The oligofructose used in this study was derived from Jerusalem artichoke concentrate. (2)

A 2007 scientific review confirms the triglyceride lowering effect of inulin and oligofructose, the two most popular prebiotics. (3) This effect is quite interesting because similar carbohydrates, such as common fructose, have the opposite/harmful effects in the body. (4) But what’s even more surprising is that prebiotics may actually help to mitigate some of the damaging effects of fructose in our diets. This was most recently exhibited in a study that found that prebiotics prevent a rise in blood pressure in rats that suffer from “fructose induced elevated blood pressure”. (5) Collectively, these findings present a hopeful role for prebiotics in the promotion of cardiovascular health.

Another intriguing use for prebiotics is to assist with the absorption of essential minerals. The assimilation of minerals such as calcium, copper, iron, magnesium and zinc are all positively affected by the presence of prebiotics. (6) One manifestation of this is in regard to improved calcium uptake that may lead to a strengthening of bone structure. (7)

Prebiotics Promote the Growth of Beneficial Bacteria

When I searched through the many studies on prebiotics, I was impressed by their potential application in a wide variety of conditions. For instance, there’s great interest in the role that inulin and oligofructose may play in the fight against colon cancer. (8,9) Many digestive conditions, such Irritable Bowel Syndrome (IBS), also appear to be responsive to prebiotic therapy. (10,11) Even the immune system of both young and old is stimulated can be stimulated by prebiotics. (12,13)

Evidence derived from human and animal toxicology studies point to a high degree of safety with regard to these special carbohydrates. (14) In fact, one study published in the December 2008 issue of the British Journal of Nutrition found that rats who consumed a prebiotic blend lived longer than those receiving a placebo. (15) We can’t necessarily count on that same effect in humans, but it’s reassuring to know that it’s at least present in an animal model.

As an added bonus, prebiotics have a naturally sweet taste. At the moment I’m using a stevia and luo han guo sweetener that both contain prebiotics in their base. Adding oligofructose and/or inulin to these non-caloric, natural sweeteners allows them to have a similar volume and weight as common table sugar. This makes it easier to measure and use them for everyday cooking and sweetening needs.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP

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18 Comments & Updates to “Prebiotics and Probiotics”

  1. Rod Dorman Says:

    Great article. There are a lot of misconceptions about prebiotics and your article does a very nice job of explaining what they are, how they work, and their benefits. If you haven’t seen it already, the International Scientific Association for Probiotics and Prebiotics has a great consumer guide at http://www.isapp.net/docs/Consumer_Guidelines-prebiotic.pdf . I must also admit to being biased. I produce Healthy 10 Kefir Beverage. Healthy 10 contains probiotics, omega-3 DHA, fiber and vitamins. The fiber is oligofructose-enriched inulin produced by Beneo-Orafti, the company that I identify as being the leader in the field.

  2. lowcarber Says:

    hmm very interesting.. here in Japan they sell oligofructose as a low calorie or no calorie sweetener.. and its not very expensive.. do you think that this can be used on a low carb diet? Here is a link for an example..
    http://item.rakuten.co.jp/kusuriya/c/0000000157/

    This Origo is derived from sugar beets. It shows that the total carbs per 100 grams are 85.3 grams.. if I was to use a product like this how many would I need to count??

    Thanks in advance and great article :)

  3. JP Says:

    Thanks for kind comment and the informative link about the prebiotics, Rod.

    Be well!

    JP

  4. JP Says:

    Low Carber,

    I’m currently using two natural (non-caloric) sweeteners as part of my low(er) carb diet. They provide a much smaller amount of prebiotics than what was used in the weight loss studies. But so far, they don’t appear to negatively impact my blood sugar or weight. I’m in the process of doing additional (personal) experimentation on that.

    Even though the preliminary results on prebiotics and blood sugar/insulin/weight are promising, I would still proceed with caution – while on a low carb diet. Start slowly and see how it affects you. That’s what I’m doing. For instance, there may be a difference in the effects of adding prebiotics to a standard diet as compared to a very low carb diet.

    Is the 85.3 grams of carboydrates (you mentioned) broken down into fiber and sugar amounts or just a generic carbohydrate quantity? The sweetener packets I use have 1 gram of carbohydrate (in each packet) but they’re classified mostly as fiber.

    You’ve given me an idea for another experiment down the line. :)

    Feel free to bounce any ideas off of me. I’ll continue to report my personal findings in the hope that they will apply to others too.

    Be well!

    JP

  5. Anna M Says:

    Great article JP! I work for a company that formulates and manufactures probiotic and enzyme products, and we are now in the process of adding scFOS (prebiotic) to most of our formulas to support probiotic growth. It’s great to hear of all the benefits in this creative carbohydrate! I’m especially interested in the link between prebiotic fiber and helping mitigate effects of fructose on the body. Good stuff to “chew on.”
    ~ Anna M.

  6. JP Says:

    Thank you, Anna!

    Be well!

    JP

  7. Lynne Says:

    chicory in chicory coffee has inulin. but.. I’m not sure if you get that benefit by brewing the coffee. I can always hope.

  8. JP Says:

    Lynne,

    I would imagine so. At least some of the soluble fiber (prebiotic) is likely to end up in the brewed cup.

    The sweeteners I use (luo han guo or stevia) often contain chicory in their base. When I add them to liquids, they dissolve very efficiently.

    Be well!

    JP

  9. Elizabeth Redmond, PhD, RD Says:

    I think we all agree on the benefits of probiotics, I have discussed them myself in my own blog, http://www.metametrixinstitute.org/post/2009/09/14/Little-Things-Can-Make-a-Big-Difference.aspx , but what I never hear mentioned is that people can, and should, test their level of predominate gut bacteria. People who need to lose weight should first check their levels of bacteria, and if they are low they should supplement or change thier diet accordingly. I work at Metametrix; a private clinical laboratory that has invested significant resources to offer clinicians the same DNA-PCR tests used by researchers. http://www.metametrix.com/content/DirectoryOfServices/DNA-Stool-Analysis-GI-Effects

  10. JP Says:

    Thank you, Elizabeth. Interesting information.

    Be well!

    JP

  11. Orna Izakson, ND, RH (AHG) Says:

    Great piece, JP! I’m reposting with wild abandon.

    It’s always great to have more evidence supporting the treatments I offer my patients, and pretty much everyone gets probiotics with FOS in them.

  12. JP Says:

    Many thanks, Orna!

    I’ll include some additional information about synbiotics in today’s column about the current E. coli outbreak.

    Be well!

    JP

  13. Martin Weaver Says:

    An interesting article, with superscripts indicating references – but the references are not listed, or am I blind?
    This is just the type of website my students would access, but without the references they cannot evaluate the comments, so cannot use it.

  14. JP Says:

    Martin,

    Thank you. The numerical footnotes link to the scientific abstracts and full text of the studies.

    Example: (14) links to: http://www.ncbi.nlm.nih.gov/pubmed/18644419

    Be well!

    JP

  15. JP Says:

    Update: Fascinating study finds that pre- and probiotics (synbiotics) increase breast milk mineral concentrations …

    http://www.sciencedirect.com/science/article/pii/S0946672X15000097

    J Trace Elem Med Biol. 2015 Apr;30:25-9.

    A pilot study of synbiotic supplementation on breast milk mineral concentrations and growth of exclusively breast fed infants.

    Despite the crucial role of breast milk mineral contents for health and growth of the infants, they decrease with the duration of lactation. So, this pilot study aimed to determine the effects of synbiotic supplementation on breast milk mineral composition and infants’ growth. In this pilot, randomized, double-blind, placebo-controlled trial, 57 lactating mothers were randomly divided into two groups to receive a daily supplement of synbiotic (n=30) or a placebo (n=27) for 30 days. Breast milk zinc, copper, Iron, magnesium and, calcium concentrations were determined by flame atomic absorption spectrometry. Weight for age Z-score (WAZ) and height for age Z-score (HAZ) were assessed for infants. Dietary intake was collected from lactating women using the 24-h recall method. Data analyses were carried out using nutritionist IV, Epi Info and SPSS soft wares. Synbiotic supplementation led to an insignificant increase of the mean breast milk levels of zinc (from 2.44±0.65 to 2.55±0.55mgL(-1)), copper (from 0.35±0.24 to 0.40±0.26mgL(-1)), iron (from 0.28±0.42 to 0.31±0.38mgL(-1)), magnesium (from 17.14±1.35 to 17.17±1.09mgL(-1)), and calcium (from 189±25.3 to 189.9±21.7mgL(-1)); whilst in the placebo group, these variables decreased significantly (P=0.001). The observed changes between two groups were statistically significant (P<0.05). Although WAZ and HAZ of infants increased slightly in the supplemented group (from 1.19±0.79 to 1.20±0.69 and 0.36±0.86 to 0.37±0.85 respectively), these two parameters decreased in the placebo group which was significant only for WAZ (P=0.01). Moreover, no significant association was found between mineral intake and breast milk mineral contents. It seems, synbiotic supplementation may have positive effects on breast milk mineral contents.

    Be well!

    JP

  16. JP Says:

    Update 05/11/15:

    April 2015 The FASEB Journal vol. 29 no. 1 Supplement 597.3

    Prebiotic Fiber Consumption Decreases Energy Intake in Overweight and Obese Children

    Excess energy intake is thought to be a major driver of the obesity epidemic and even small disturbances in energy balance may lead to the onset of pediatric obesity. Prebiotic fiber improves appetite regulation and decreases energy intake in obese adults; however, its’ therapeutic potential in the obese pediatric population has not been investigated. To determine the effect of prebiotic fiber intake on prospective food consumption and energy intake in the obese pediatric population, 39 male and female overweight and obese children (7-12y) consumed 1) 8 g/d of prebiotic fiber (1:1 oligofructose:inulin); or 2) equicaloric dose of maltodextrin for 16 wk. Subjective appetite ratings were obtained before and after an ad libitum breakfast buffet at 0 and 16 wk as well as Children’s Eating Behaviour Questionnaire (CEBQ) scores. Energy intake was measured at the breakfast buffet and in weighed 3-day food records. The first of 2 cohorts to complete the study showed a decreased desire to eat following fiber supplementation (p=0.02). There was also a trend for increased fullness and decreased prospective food consumption in the fiber group. CEBQ scores showed increased satiety responsiveness with fiber consumption (p=0.01). The change in energy intake at the final breakfast buffet was 84 kcal lower with fiber versus placebo. In conclusion, long term prebiotic fiber intake may lead to reductions in energy intake that positively impact body weight. Potential causes for decreased energy intake include heightened satiety responsiveness and fullness following fiber consumption.

    Be well!

    JP

  17. JP Says:

    Update 06/24/15:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463018/

    J Nutr Sci. 2015 May 4;4:e17.

    Oral administration of Bifidobacterium breve B-3 modifies metabolic functions in adults with obese tendencies in a randomised controlled trial.

    Accumulating evidence suggests an association between gut microbiota and the development of obesity, raising the possibility of probiotic administration as a therapeutic approach. Bifidobacterium breve B-3 was found to exhibit an anti-obesity effect on high-fat diet-induced obesity mice. In the present study, a randomised, double-blind, placebo-controlled trial was conducted to evaluate the effect of the consumption of B. breve B-3 on body compositions and blood parameters in adults with a tendency for obesity. After a 4-week run-in period, the participants were randomised to receive either placebo or a B-3 capsule (approximately 5 × 10(10) colony-forming units of B-3/d) daily for 12 weeks. A significantly lowered fat mass was observed in the B-3 group compared with the placebo group at week 12. Improvements were observed for some blood parameters related to liver functions and inflammation, such as γ-glutamyltranspeptidase and high-sensitivity C-reactive protein. Significant correlations were found between the changed values of some blood parameters and the changed fat mass in the B-3 group. These results suggest the beneficial potential of B. breve B-3 in improving metabolic disorders.

    Be well!

    JP

  18. JP Says:

    Updated 06/27/16:

    http://journals.lww.com/jcge/pages/articleviewer.aspx?year=9000&issue=00000&article=98270&type=abstract

    J Clin Gastroenterol. 2016 Jun 15.

    A Mixture of 3 Bifidobacteria Decreases Abdominal Pain and Improves the Quality of Life in Children With Irritable Bowel Syndrome: A Multicenter, Randomized, Double-Blind, Placebo-Controlled, Crossover Trial.

    GOALS: We assessed the efficacy of a probiotic mixture of Bifidobacterium infantis M-63, breve M-16V, and longum BB536 in improving abdominal pain (AP) and quality of life (QoL) in children with irritable bowel syndrome (IBS) and functional dyspepsia (FD).

    BACKGROUND: AP-associated functional gastrointestinal disorders, particularly IBS and FD, are common in pediatrics, and no well-established treatment is currently available. Although probiotics have shown promising results in adults, data in children are heterogeneous.

    STUDY: Forty-eight children with IBS (median age, 11.2 y; range, 8 to 17.9 y) and 25 with FD (age, 11.6 y; range, 8 to 16.6 y) were randomized to receive either a mixture of 3 Bifidobacteria or a placebo for 6 weeks. After a 2-week “washout” period, each patient was switched to the other group and followed up for further 6 weeks. At baseline and follow-up, patients completed a symptom diary and a QoL questionnaire. AP resolution represented the primary outcome parameter.

    RESULTS: In IBS, but not in FD, Bifidobacteria determined a complete resolution of AP in a significantly higher proportion of children, when compared with placebo (P=0.006), and significantly improved AP frequency (P=0.02). The proportion of IBS children with an improvement in QoL was significantly higher after probiotics than after placebo (48% vs. 17%, P=0.001), but this finding was not confirmed in FD.

    CONCLUSIONS: In children with IBS a mixture of Bifidobacterium infantis M-63, breve M-16V, and longum BB536 is associated with improvement in AP and QoL. These findings were not confirmed in FD subjects.

    Be well!

    JP

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