Prebiotics: what you need to know
With just one different letter separating prebiotics and probiotics, no wonder they get confused! To muddy the waters even further, they both have the same “purpose”, namely, to balance our microbiota and improve our health. But they are really quite different, both in terms of their nature and how they work. As relative newcomers, prebiotics are still not well understood by consumers. What are they? Where can you get them? Why are they good for you? It’s time to take stock and set matters straight!
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Table of contents
Table of contents
What is a prebiotic?
The first “official” definition of prebiotics was suggested back in 1995. Since then, it has evolved based on breakthroughs in our understanding of the role and inner workings of the human microbiota.1,2
A potted history
Prebiotics were defined for the first time in 1995 by two scientists, Glenn Gibson and Marcel Roberfoid.3 They described them as “a nondigestible food ingredient that beneficially affects the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon, and thus improves host health”. This definition underwent various iterations until 2016, when an international panel of experts came to a consensus on “a substrate selectively used by host microorganisms that confers health benefits”.4 In layman's terms, prebiotics are substances that target specific microorganisms in our microbiota, the beneficial ones, and “feed” them. In doing so, they improve our health. This means that these substrates (foods) are out-of-bounds to the majority of microorganisms in our microbiota,5 especially to bacteria that can make us ill, such as certain species of clostridia and E. coli!6
Some things change, some things stay the same: prebiotics today and tomorrow
According to the 1995 definition, only certain compounds from the carbohydrate family would be classed as prebiotics.7 The word “substrate”, which has recently been preferred by experts, extends the concept of prebiotics beyond carbohydrates to anything that specifically feeds bacteria in the microbiota and thus improves our health.8,9 In addition, prebiotics can work in other areas of the body with a microbiota, not just the intestines. They can support the skin, mouth, and vagina.10
Neither the first nor the most recent definition specifies which microorganisms are targeted by prebiotics. Historically, these have been bifidobacteria and lactobacilli, known to be beneficial for our health and also used as probiotics.11 They are still the most commonly tested and used as a target for prebiotics. However, we now know that other microorganisms can metabolize prebiotics and contribute to our good health.12 Researchers are turning their attention to prebiotics able to stimulate species such as Propionibacterium, Faecalibacterium, Eubacterium, Akkermansia, and Roseburia.13,14
Requirements for a “prebiotic”
The definition may have been extended,15 but this doesn’t mean any old product can call itself a prebiotic!
Before a product can be classified as prebiotic, its chemical structure must first be clearly described. Preclinical laboratory studies must then be conducted, followed by clinical trials in humans, to confirm:
- Its resistance to digestive enzymes (e.g., stomach acid and bile) allowing it to reach the target microbiota (e.g., gut microbiota) intact;
- its selectivity and action on the target microorganisms;
- how it affects the microbiota and its measurable health benefits;
- the effective dose with no side effects.16,17,18
Sources, functions, mechanism of action... Prebiotics
Find out what prebiotics look like, where to find them, and how they target our beneficial microbes.
Time for some chemistry: what are prebiotics?
Nowadays, most compounds classified as prebiotics belong to the family of complex carbohydrates: oligosaccharides and polysaccharides.25,26 Oligosaccharides are chains, or polymers, of several simple sugars or monosaccharides (usually between 3 and 10), such as glucose, fructose, and galactose. Polysaccharides contain more than 20;27 However, some of the rarer prebiotics contain only two sugars; these are known as disaccharides.
The main prebiotics are
which contain one molecule of glucose and several molecules of galactose, a sugar found in milk.
GOS belongs to the “galactan” family.31
which contain one molecule of glucose and some molecules of fructose. Their main natural sources are fruits and honey.
FOS belongs to the “fructan” family31
a type of FOS containing several molecules of fructose, found mainly in chicory root.
Inulin belongs to the “fructan” family.31
a galactose-fructose disaccharide used medicinally for relieving constipation.28,29,30
FOS (including inulin) and GOS are the prebiotics whose effects on the beneficial microbes in our intestinal microbiota and on our health are most scientifically recognized. They are therefore currently the “stars” of the prebiotic world;32,33 The recommended dose for a prebiotic effect in adults is 5-8 g FOS or GOS per day.34
However, other substances are being tested for their prebiotic potential, such as:
- Other complex carbohydrates (fibers): xylo-oligosaccharides (XOS), isomalto-oligosaccharides (IMO), polydextrose, soybean oligosaccharides (SBOS), beta-glucans, and pectin;
- Starch derivatives, such as polyols: sorbitol, maltitol, etc.;
- Polyunsaturated fatty acids; o Polyphenols: such as cocoa and tea.35,36,37,38
Where exactly can you find them?
Prebiotics are found naturally in many fruits and vegetables and in breastmilk. They are also added to foods, such as cookies, cereals, drinks, and dairy products, as well as to baby food.41 Finally, they are available as dietary supplements,42 alone or combined with probiotics, vitamins, minerals, or plant extracts, etc.
Natural sources of prebiotics
Many fruits, vegetables, cereals, and other natural foodstuffs contain prebiotics. For example:
- Artichokes, chicory root, leeks, asparagus (which contain inulin);
- Bananas, garlic, onions, honey, wheat (which contain FOS);
- Soy and oat milk, cashew nuts, lupins, chickpeas, and pistachios (which contain GOS).43,44
These foods contain small quantities of prebiotics and eating them only occasionally will not have any significant effect on your health.45
Our hunter-gatherer ancestors ate lots of foods containing natural prebiotics, consuming up to about 135 g per day. However, this is quite uncommon with our modern Western diets, which usually only provide us with 1-4 g a day in the US, and 3-11 g a day in Europe.46
Prebiotics are now manufactured industrially, either isolated from foods rich in prebiotic substances or made synthetically from sugars, such as fructose, lactose, or sucrose.47,48,49
What are prebiotics for?
Imagine your microbiota like a garden, where prebiotics are the “fertilizer” that help beautiful plants grow taller, but not the pesky weeds! So, the whole body benefits.
Just like fertilizer, prebiotics aren't “essential” for feeding the microbes in our microbiota. But they do stimulate the growth and activity of microorganisms that are beneficial for our health. This means they help rebalance our microbiota, especially by increasing the ratio of beneficial bacteria to pathogenic bacteria, allowing the microbiota to correctly perform its role of digestion, absorption of nutrients, supporting our natural defenses, etc.50,51
During fermentation, prebiotics also help bacteria to produce other substances that help the body and our health.52 For example, they increase the production of lactate and the short-chain fatty acids (SCFAs) acetate, propionate, and butyrate, which act in the intestine and travel around the rest of the body in the bloodstream.53 They are a source of energy for the body and play important roles for our health, such as maintaining the integrity of the intestinal barrier, and regulating the metabolism of sugars and fats.54
Finally, these SCFAs lower the pH in our colon (making it more acidic), which also has health benefits, such as better absorption of nutrients, and more effective protection against microbes.55,56
How can prebiotics improve our health?
Prebiotics are a relatively new field of science, and there are fewer clinical studies on their health effects than for probiotics.59 However, results suggest that by supporting the growth and metabolism of beneficial bacteria in the microbiota,60 prebiotics contribute to several main essential bodily functions, making it better equipped to combat various situations.61
When the proportion of microorganisms, such as lactobacilli and bifidobacteria, in our gut increases thanks to the work of prebiotics, the proportion of pathogens falls. Moreover, they monopolize the nutrients that would otherwise feed the pathogenic microbes, preventing them from forming colonies.62 In addition, during the fermentation of prebiotics, these bacteria produce compounds that lower the pH in the colon, further inhibiting the growth of harmful germs.63,64
Prebiotics boost our immune defenses, not only in the intestinal microbiota, but thanks to interactions around the whole body.65 Their fermentation produces metabolites (SCFA, peptidoglycans, etc.) that stimulate the immune system and regulate the production of anti- and pro-inflammatory molecules.66,67 Studies show that taking prebiotics, such as GOS, boosts the performance of circulating immune cells in the elderly,68 and that a combination of FOS and inulin can improve our immune response to the flu vaccine.69
Prebiotics may inhibit the activity of certain immune cells, known as helper cells, involved in allergic reactions. The modulatory effect of prebiotics on allergies has been particularly observed in studies on infants: babies fed milk enriched with GOS and FOS were less likely to suffer from atopic dermatitis, asthma, and urticaria than those fed on non-enriched milk.70 However, the effect of prebiotics on allergies has yet to be confirmed.71
Thanks to their ability to bind to water, prebiotics taken orally may soften stools and ease their evacuation.72 In addition, the SCFA they produce may also regulate the hormones involved in intestinal transit.73 Lactulose is already used medicinally to treat constipation, and encouraging results have been obtained with low-dose prebiotics to relieve certain symptoms of irritable bowel syndrome.74 The European Union has officially authorized the health claim “improves intestinal health” for chicory inulin 12 g/day, due to robust scientific evidence of its effects in humans.75
Prebiotics may help the absorption of mineral salts, such as calcium and magnesium, which have potential benefits for bone growth in teenagers and bone density in menopausal women.76 In fact, by stimulating the production of SCFA, they increase the absorption surface of intestinal cells and the solubility of minerals, making them easier to assimilate.77,78
Studies show that some prebiotics have a positive effect on blood sugar (glycemia) and levels of fat (such as triglycerides),79 as well as on the regulation of insulin in both healthy people and those with diabetes.80 The SCFA produced by these beneficial bacteria contributes to this effect, but the prebiotics also have a direct effect on maintaining the “barrier” function of the intestinal microbiota. In fact, they make it harder for certain molecules such as bacterial lipopolysaccharides, which can cause chronic inflammation associated with diabetes and obesity, to enter the bloodstream.81
The SCFA produced from the fermentation of prebiotics in the gut may help regulate appetite and satiety. In fact, these feelings are regulated by the release of various mediators into a complex circuit dependent on the nature of our diet (sugars, proteins, fats, etc.), the volume contained in our stomach, our digestive nervous system, and our brains.82 These mediators include hormones, the appetite-stimulant ghrelin, as well as peptide YY and glucagon-like peptide-1, which trigger satiety. SCFAs may interact with certain fatty acid receptors, thereby helping reduce the production of ghrelin and stimulate the production of peptide YY and glucagon-like peptide1.83
By feeding the lactobacilli in the vaginal flora, GOS may reduce the risk of infection.84
Dynamic research for uncovering new benefits
Studies are currently under way into other potential health benefits of prebiotics, mainly involving animal models, with promising initial results. For example, prebiotics may help combat the malignant transformation of cells. In fact, their fermentation products, such as butyrate, could provide protection from colorectal cancer. Some prebiotics could also help improve memory and concentration in the elderly, or even slow down cognitive decline in diseases such as Alzheimer’s. Finally, they could lower triglyceride levels in the blood, which would help improve the health of the cardiovascular system. Although there is mounting evidence as to the benefits of prebiotics, much more scientific work is needed before learned societies can release further recommendations as to their use.85,86
Different effects for you and me!
Just like probiotics, prebiotics can affect each person differently. First, their effects depend on the presence of their particular target microorganisms in the person’s microbiota. The effects may also vary in people with microbiota-altering genes or a genetic predisposition to certain diseases. Finally, they may be influenced by individual lifestyle: diet, general health, or even medicine use, etc.87,88 Researchers hope to still further their understanding of how prebiotics affect the microbiota, and of techniques for analyzing the microbiota in individuals in order to develop more accurate and personalized recommendations.89
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1 Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14(8):491-502
2 Bedu-Ferrari C, Biscarrat P, Langella P, Cherbuy C. Prebiotics and the Human Gut Microbiota: From Breakdown Mechanisms to the Impact on Metabolic Health. Nutrients. 2022;14(10):2096
3 Roberfroid, M. Health benefits of non-digestible oligosaccharides. In Dietary Fiber in Health and Disease; Springer: New York, NY, USA, 1997; pp. 211–219
4 Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14(8):491-502
5 ISAPP : Understanding Prebiotics and Fiber, 2018
6 Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14(8):491-502
7 Davani-Davari D, Negahdaripour M, Karimzadeh I, et al. Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods. 2019;8(3):92
8 Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14(8):491-502
9 ISAPP : Prebiotics :https://isappscience.org/for-scientists/resources/prebiotics/
10 ISAPP : Prebiotics: A Consumer Guide for Making Smart Choices - Developed by the International Scientific Association for Probiotics and Prebiotics (04/11/21)
11 ISAPP : Understanding Prebiotics and Fiber, 2018
12 Bedu-Ferrari C, Biscarrat P, Langella P, Cherbuy C. Prebiotics and the Human Gut Microbiota: From Breakdown Mechanisms to the Impact on Metabolic Health. Nutrients. 2022;14(10):2096
13 Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14(8):491-502
14 Prebiotics: A Consumer Guide for Making Smart Choices - Developed by the International Scientific Association for Probiotics and Prebiotics (04/11/21)
15 Bedu-Ferrari C, Biscarrat P, Langella P, Cherbuy C. Prebiotics and the Human Gut Microbiota: From Breakdown Mechanisms to the Impact on Metabolic Health. Nutrients. 2022;14(10):2096
16 Quigley EMM. Prebiotics and Probiotics in Digestive Health. Clin Gastroenterol Hepatol. 2019;17(2):333-344
17 Bedu-Ferrari C, Biscarrat P, Langella P, Cherbuy C. Prebiotics and the Human Gut Microbiota: From Breakdown Mechanisms to the Impact on Metabolic Health. Nutrients. 2022;14(10):2096
18 Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14(8):491-502
19 Markowiak P, Slizewska K. Effects of Probiotics, Prebiotics, and Synbiotics on Human Health. Nutrients 2017, 9, 1021
20 ISAPP : Understanding Prebiotics and Fiber, 2018
21 Markowiak P, Slizewska K. Effects of Probiotics, Prebiotics, and Synbiotics on Human Health. Nutrients 2017, 9, 1021
22 ISAPP : Prebiotics, 2019
23 FAO/OMS. Report on drafting guidelines for the evaluation of probiotics in food, 2002.
24 Hill C, Guarner F, Reid G, et al. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014;11(8):506-514
25 Markowiak P, Slizewska K. Effects of Probiotics, Prebiotics, and Synbiotics on Human Health. Nutrients 2017, 9, 1021
26 Jenkins G, Mason P. The Role of Prebiotics and Probiotics in Human Health: A Systematic Review with a Focus on Gut and Immune Health. Food Nutr J 2022, 7: 245
27 Cours-médecine. Fr : Les polyosides https://www.cours-medecine.info/medecine/biochimie/polyosides.html
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29 WGO Review Team. Probiotiques et prébiotiques, World Gastroenterology Organisation Global guideline, février 2017
30 Whisner CM, Castillo LF. Prebiotics, Bone and Mineral Metabolism. Calcif Tissue Int. 2018;102(4):443-479
31 Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14(8):491-502
32 Whisner CM, Castillo LF. Prebiotics, Bone and Mineral Metabolism. Calcif Tissue Int. 2018;102(4):443-479
33 Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14(8):491-502
34 ISAPP : Prebiotics: A Consumer Guide for Making Smart Choices - Developed by the International Scientific Association for Probiotics and Prebiotics (04/11/21)
35 ISAPP : Prebiotics: A Consumer Guide for Making Smart Choices - Developed by the International Scientific Association for Probiotics and Prebiotics (04/11/21)
36 Bedu-Ferrari C, Biscarrat P, Langella P, Cherbuy C. Prebiotics and the Human Gut Microbiota: From Breakdown Mechanisms to the Impact on Metabolic Health. Nutrients. 2022;14(10):2096
37 Sanders ME, Merenstein DJ, Reid G, Gibson GR, Rastall RA. Probiotics and prebiotics in intestinal health and disease: from biology to the clinic [published correction appears in Nat Rev Gastroenterol Hepatol. 2019 Aug 9;:]. Nat Rev Gastroenterol Hepatol. 2019;16(10):605-616
38 Jenkins G, Mason P. The Role of Prebiotics and Probiotics in Human Health: A Systematic Review with a Focus on Gut and Immune Health. Food Nutr J 2022, 7: 245
39 Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14(8):491-502
40 Binns N : Probiotics, Prebiotics and the gut microbiota, ILSI Europe Concise monograph series, Belgium, ISBN: 9789078637394
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42 Jenkins G, Mason P. The Role of Prebiotics and Probiotics in Human Health: A Systematic Review with a Focus on Gut and Immune Health. Food Nutr J 2022, 7: 245
43 Jenkins G, Mason P. The Role of Prebiotics and Probiotics in Human Health: A Systematic Review with a Focus on Gut and Immune Health. Food Nutr J 2022, 7: 245
44 Scott KP, Grimaldi R, Cunningham M, et al. Developments in understanding and applying prebiotics in research and practice-an ISAPP conference paper. J Appl Microbiol. 2020;128(4):934-949
45 Jenkins G, Mason P. The Role of Prebiotics and Probiotics in Human Health: A Systematic Review with a Focus on Gut and Immune Health. Food Nutr J 2022, 7: 245
46 Whisner CM, Castillo LF. Prebiotics, Bone and Mineral Metabolism. Calcif Tissue Int. 2018;102(4):443-479
47 Whisner CM, Castillo LF. Prebiotics, Bone and Mineral Metabolism. Calcif Tissue Int. 2018;102(4):443-479
48 Bedu-Ferrari C, Biscarrat P, Langella P, Cherbuy C. Prebiotics and the Human Gut Microbiota: From Breakdown Mechanisms to the Impact on Metabolic Health. Nutrients. 2022;14(10):2096
49 Davani-Davari D, Negahdaripour M, Karimzadeh I, et al. Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods. 2019;8(3):92
50 Sanders ME, Merenstein DJ, Reid G, Gibson GR, Rastall RA. Probiotics and prebiotics in intestinal health and disease: from biology to the clinic [published correction appears in Nat Rev Gastroenterol Hepatol. 2019 Aug 9;:]. Nat Rev Gastroenterol Hepatol. 2019;16(10):605-616
51 Davani-Davari D, Negahdaripour M, Karimzadeh I, et al. Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods. 2019;8(3):92
52 Markowiak P, Slizewska K. Effects of Probiotics, Prebiotics, and Synbiotics on Human Health. Nutrients 2017, 9, 1021
53 Davani-Davari D, Negahdaripour M, Karimzadeh I, et al. Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods. 2019;8(3):92
54 Markowiak P, Slizewska K. Effects of Probiotics, Prebiotics, and Synbiotics on Human Health. Nutrients 2017, 9, 1021
55 Markowiak P, Slizewska K. Effects of Probiotics, Prebiotics, and Synbiotics on Human Health. Nutrients 2017, 9, 1021
56 Sanders ME, Merenstein DJ, Reid G, Gibson GR, Rastall RA. Probiotics and prebiotics in intestinal health and disease: from biology to the clinic [published correction appears in Nat Rev Gastroenterol Hepatol. 2019 Aug 9;:]. Nat Rev Gastroenterol Hepatol. 2019;16(10):605-616
57 Bedu-Ferrari C, Biscarrat P, Langella P, Cherbuy C. Prebiotics and the Human Gut Microbiota: From Breakdown Mechanisms to the Impact on Metabolic Health. Nutrients. 2022;14(10):2096
58 Sanders ME, Merenstein DJ, Reid G, Gibson GR, Rastall RA. Probiotics and prebiotics in intestinal health and disease: from biology to the clinic [published correction appears in Nat Rev Gastroenterol Hepatol. 2019 Aug 9;:]. Nat Rev Gastroenterol Hepatol. 2019;16(10):605-616
59 ISAPP : Prebiotics: A Consumer Guide for Making Smart Choices - Developed by the International Scientific Association for Probiotics and Prebiotics (04/11/21)
60 Quigley EMM. Prebiotics and Probiotics in Digestive Health. Clin Gastroenterol Hepatol. 2019;17(2):333-344
61 Jenkins G, Mason P. The Role of Prebiotics and Probiotics in Human Health: A Systematic Review with a Focus on Gut and Immune Health. Food Nutr J 2022, 7: 245
62 Jenkins G, Mason P. The Role of Prebiotics and Probiotics in Human Health: A Systematic Review with a Focus on Gut and Immune Health. Food Nutr J 2022, 7: 245
63 Markowiak P, Slizewska K. Effects of Probiotics, Prebiotics, and Synbiotics on Human Health. Nutrients 2017, 9, 1021
64 Sanders ME, Merenstein DJ, Reid G, Gibson GR, Rastall RA. Probiotics and prebiotics in intestinal health and disease: from biology to the clinic [published correction appears in Nat Rev Gastroenterol Hepatol. 2019 Aug 9;:]. Nat Rev Gastroenterol Hepatol. 2019;16(10):605-616
65 Jenkins G, Mason P. The Role of Prebiotics and Probiotics in Human Health: A Systematic Review with a Focus on Gut and Immune Health. Food Nutr J 2022, 7: 245
66 Davani-Davari D, Negahdaripour M, Karimzadeh I, et al. Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods. 2019;8(3):92
67 Jenkins G, Mason P. The Role of Prebiotics and Probiotics in Human Health: A Systematic Review with a Focus on Gut and Immune Health. Food Nutr J 2022, 7: 245
68 Sanders ME, Merenstein DJ, Reid G, Gibson GR, Rastall RA. Probiotics and prebiotics in intestinal health and disease: from biology to the clinic [published correction appears in Nat Rev Gastroenterol Hepatol. 2019 Aug 9;:]. Nat Rev Gastroenterol Hepatol. 2019;16(10):605-616
69 Davani-Davari D, Negahdaripour M, Karimzadeh I, et al. Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods. 2019;8(3):92
70 Sanders ME, Merenstein DJ, Reid G, Gibson GR, Rastall RA. Probiotics and prebiotics in intestinal health and disease: from biology to the clinic [published correction appears in Nat Rev Gastroenterol Hepatol. 2019 Aug 9;:]. Nat Rev Gastroenterol Hepatol. 2019;16(10):605-616
71 Jenkins G, Mason P. The Role of Prebiotics and Probiotics in Human Health: A Systematic Review with a Focus on Gut and Immune Health. Food Nutr J 2022, 7: 245
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73 Sanders ME, Merenstein DJ, Reid G, Gibson GR, Rastall RA. Probiotics and prebiotics in intestinal health and disease: from biology to the clinic [published correction appears in Nat Rev Gastroenterol Hepatol. 2019 Aug 9;:]. Nat Rev Gastroenterol Hepatol. 2019;16(10):605-616
74 Simon E, Călinoiu LF, Mitrea L, Vodnar DC. Probiotics, Prebiotics, and Synbiotics: Implications and Beneficial Effects against Irritable Bowel Syndrome. Nutrients. 2021;13(6):2112
75 EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies). Scientific Opinion on the substantiation of a health claim related to “native chicory inulin” and maintenance of normal defecation by increasing stool frequency pursuant to Article 13.5 of Regulation (EC) No 1924/2006. EFSA https://www.efsa.europa.eu/en/efsajournal/pub/3951 (2015).
76 Whisner CM, Castillo LF. Prebiotics, Bone and Mineral Metabolism. Calcif Tissue Int. 2018;102(4):443-479
77 Sanders ME, Merenstein DJ, Reid G, Gibson GR, Rastall RA. Probiotics and prebiotics in intestinal health and disease: from biology to the clinic [published correction appears in Nat Rev Gastroenterol Hepatol. 2019 Aug 9;:]. Nat Rev Gastroenterol Hepatol. 2019;16(10):605-616
78 Collins S, Reid G. Distant Site Effects of Ingested Prebiotics. Nutrients. 2016;8(9):523
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80 Bedu-Ferrari C, Biscarrat P, Langella P, Cherbuy C. Prebiotics and the Human Gut Microbiota: From Breakdown Mechanisms to the Impact on Metabolic Health. Nutrients. 2022;14(10):2096
81 Sanders ME, Merenstein DJ, Reid G, Gibson GR, Rastall RA. Probiotics and prebiotics in intestinal health and disease: from biology to the clinic [published correction appears in Nat Rev Gastroenterol Hepatol. 2019 Aug 9;:]. Nat Rev Gastroenterol Hepatol. 2019;16(10):605-616
82 Gananopoulo L . Comment le cerveau gère notre appétit, Le Journal du CNRS, publié le 22/06/2020, mis à jour le 13/09/21 : https://lejournal.cnrs.fr/articles/comment-le-cerveau-gere-notre-appetit
83 Sanders ME, Merenstein DJ, Reid G, Gibson GR, Rastall RA. Probiotics and prebiotics in intestinal health and disease: from biology to the clinic [published correction appears in Nat Rev Gastroenterol Hepatol. 2019 Aug 9;:]. Nat Rev Gastroenterol Hepatol. 2019;16(10):605-616
84 Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14(8):491-502
85 Davani-Davari D, Negahdaripour M, Karimzadeh I, et al. Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods. 2019;8(3):92
86 Bedu-Ferrari C, Biscarrat P, Langella P, Cherbuy C. Prebiotics and the Human Gut Microbiota: From Breakdown Mechanisms to the Impact on Metabolic Health. Nutrients. 2022;14(10):2096
87 Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14(8):491-502
88 Bedu-Ferrari C, Biscarrat P, Langella P, Cherbuy C. Prebiotics and the Human Gut Microbiota: From Breakdown Mechanisms to the Impact on Metabolic Health. Nutrients. 2022;14(10):2096
89 Bedu-Ferrari C, Biscarrat P, Langella P, Cherbuy C. Prebiotics and the Human Gut Microbiota: From Breakdown Mechanisms to the Impact on Metabolic Health. Nutrients. 2022;14(10):2096
