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3262-3265-The Prebiotic Inulin As a Functional Food – a Review

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3262-3265-The Prebiotic Inulin As a Functional Food – a Review Eur opean Rev iew for Med ical and Pharmacol ogical Sci ences 2016; 20: 3262-3265 The prebiotic inulin as a functional food – a review C.-H. FAN, J.-H. CAO, F.-C. ZHANG Xuzhou Children's Hospital, Xuzhou, Jiangsu, P.R. China Abstract. – The newborn digestive tract is Health Organization (WHO) have proposed the rapidly colonized right after birth. The type of deciding factors affecting the classification of feeding could significantly influence this colo - carbohydrates and are suggested to be based nization process. Infant formulas like inulin try to mimic the bifidogenic effects of human milk by on their molecular size, polymerization degree, 8 addition of prebiotics. Moreover, studies in the bond type and on monomers features . Based recent past have evidenced important effects of on above literature, carbohydrates are broadly inulin during early infant life. The present review divided into two 3 categories primarily based article will highlight recent updates about the on the degree of polymerization, but inulin is use of inulin in the pediatric clinical setting. found in multiple molecular forms. So, the ex - Key Words: istence of certainly confirmed line of differ - Functional foods, Inulin, Breast milk, Infants. ence amongst oligosaccharides and polysac - charides is not a recommended by IUB −IUPAC Joint Commission on Biochemical Nomencla - Introduction ture 9. Food supplement inulin falls in oligosaccha - Breast-feeding is considered as the gold stan - rides group. Furthermore, the main group of dard for the optimum nutrition and protection for oligosaccharides is further sub categorized into developing infants 1. There is compelling evi - two broad categories viz. digestible oligosac - dence that breast-feeding has positive effects on charides that included maltodextrins, which are health in the newborn and later life 2. The World widely used in food industry to substitute fat, to Health Organization has recommended exclu - modify the texture of the products and as sweet - sively breast-feeding for infants from birth to six eners. The other group is the non- α-glucan months, and is continued partially up to the age oligosaccharides, among which we highlight in - of 2 years 3,4 . Although the majority of the moth - ulin and fructo-oligosaccharides 10 . Maltodex - ers start breastfeeding their infant from the first trins are digestible carbohydrates, whereas in - day (50-75% of mothers), the percentage of ex - ulin and fructo-oligosaccharides pass through clusively breast-fed infants at 4 months is quite the upper gastrointestinal system without being different 5. hydrolyzed and then, reach the colon where In an attempt to maintain the breast milk bene - they stimulate the development of the bifidus- fits, the formula milk manufacturers try to offer predominant flora 11 . So they are called “non-di - products that could simulate the composition and gestible oligosaccharides” (NDO) 12 . NDOs also biological effects of human milk as closely as have the basic characteristic of being soluble possible 6,7 . A focus of research, driven by a com - and fermentable dietary fiber 13 . Inulin and mercial interest, is the development of some oligofructose are natural food ingredients wide - functional foods called prebiotics to confer bene - ly found in many plants, vegetables, fruits and fits for the host health. This review article is also cereals including leek, onion, wheat, garlic, ba - focused on the prebiotic called inulin and will nana and chicory 14 . It has been estimated that discuss all important aspects and updates about the average daily consumption of inulin and its pediatric use in the clinical setting as well. oligofructose in Europe is between 3-10 g/day and between 1-4 g/day in America 15 . The most Inulin And Oligofructose important source of inulin and oligofructose for The Joint Food and Agriculture Organiza - the food industry production is essentially the tion (FAO) in association with the World chicory, which is a biennal plant. 3262 Corresponding Author: Fengchao Zhang, MD; e-mail: [email protected] The prebiotic inulin as a functional food – a review Food Applications of Inulin Possible Reported Side Effects and Oligofructose There are reports that evidenced negative aspects The consumers demand foods with both great too and now we will discuss them one by one. taste as well as health benefits 16 . Inulin and oligofructose have many nutritional, technologi - Effects on weight cal and health-promoting properties and are Some researches reported the weight gain widely used in functional foods. Oligofructose is (g/day), length and head circumference gain used mixed with intensity sweeteners to replace (cm/week) of the infants in prebiotic and control sugars providing a great taste and masking the formula group 24-26 . No individual study reported after taste of aspartame. It is usually used in significant differences in weight; however, a dairy products, baked goods, frozen desserts, meta-analysis 27 of most of the previously men - low fat cookies and granola bars 17 . Because of tioned studies showed that the weight gain in - the gelling characteristics, inulin is also used in creased significantly in the prebiotic-supplement - dairy products, table spreads, baked goods, ed group (1 g/day) compared to control formula. cream cheeses, processed cheeses, frozen Also, a meta-analyses review 28 has evidenced desserts and dressings replacing the fat content. that prebiotic supplementation is associated with For example, in dairy products, inulin improves slightly greater weight gains. These results the flavor and provides the creamier mouth feel. showed that prebiotics have no negative effects Due to the non-digestibility by the intestinal mi - on weight gain and allow a proper growth of croflora, inulin and oligofructose are used as in - newborns. Furthermore, no significant effects of gredients in the diabetic’s food products. Fur - prebiotics were observed in length and head cir - thermore, both inulin and oligofructose are used cumference gain of infants in a meta-analysis 29 . as a fiber ingredient in food products. Moreover, both are also a good source of better viscosity Effects on Stool Consistency and taste. In addition to this, both products have and Frequency an effect on intestinal function, increasing stools Concerning the stools frequency and consis - frequency, stools weight and reducing the pH tency, Fanaro et al 30 concluded that prebiotics in level 16 . infant formulas increase significantly the stools frequency compared to control formula and also Effects ofI and/or Oligofructose in some studies 31,32 found that the stools from the Newborns prebiotic group were significantly softer com - Roberfroid 18 has confirmed the existence of pared to control group. Also, a prospective work, nomenclature for oligofructose and inulin terms not included in the previous meta-analyses, was as both terms are in use in different studies, and performed with 160 healthy term infants. Infants some authors have even used only oligofructose were randomly assigned to receive standard for - for the identification of both the compounds. Fur - mula with 0.4 g/dL GOS/FOS (90% galac - thermore, the term fructan is being utilized for tooligosaccharides and 10% long-chain inulin) or representing any compound constituting one or control formula (standard formula) during the more fructosyl fructose linkage including inulin first 12 weeks after birth. The results showed sig - and oligofructose as well. The investigations on nificantly higher frequency of soft stools and in the beneficial clinical outcomes of use of in - prebiotic formula group as compared to control ulin/oligofructose have been demonstrated well group 23 . Regarding the digestive tolerance, Rao in literature. Meyer and Stasse-Wolthuis 19 report - et al 28 showed no difference between prebiotic ed significant bifidogenic changes on the micro - and control formula group in the occurrence of biota composition upon consumption of inulin or colic, regurgitation, vomiting and reported cry - oligofructose at recommended doses. The eleva - ing. On the other hand, Ziegler et al 31 evidenced tion of Bifidobacterium has been demonstrated that infants fed by a prebiotic supplemented for - well as well as studied well in response to sup - mula (based on GOS and lactulose) had a higher plementation of prebiotic in adults 20,21 . Similarly, risk of irritability, eczema and diarrhea. The inulin and related compounds including long- above report justified its results by concluding chain fructan polysaccharides (i.e., long-chain in - that prebiotics could affect the infant’s immunity; ulin and fructooligosaccharides (FOS) have however, there were no consistent data and fur - shown promising effects in the studies on healthy ther researches would be necessary. So, certainty newborns 22,23 . about the negative aspects of prebiotics is still an 3263 C.-H. Fan, J.-H. Cao, F.-C. Zhang important research question. Moreover, lower oc - 6) DONOVAN SM, G IBSON G, N EWBURG DS (E DS ). Prebi - currences of gastrointestinal infections have been otics in infant nutrition. 2009. confirmed in a multicenter prospective study 33 in - 7) OOZEER R, O OZEER R, VAN LIMPT K, L UDWIG T, B EN volving 342 healthy full term infants apportioned AMOR K, M ARTIN R, W IND RD, B OEHM G, K NOL J. In - testinal microbiology in early life: specific prebi - to the GOS/FOS formula. Also, a statistically otics can have similar functionalities as human- non-significant effect of prebiotic supplementa - milk oligosaccharides. Am J Clin Nutr 2013; 98: tion on respiratory infections was observed in the 561S-571S. above work proving its beneficial effects on res - 8) FAO. Carbohydrates in human nutrition. Food and piratory systems of infants. However, besides this Agriculture Organization of the United Nations: beneficial aspects, one negative observation high - Rome. Report of a Joint FAO/WHO expert consul - lighted by the European Society for Pediatric tation, 1998. Gastroenterology, Hepatology and Nutrition 9) ROBERFROID M. Inulin-type fructans. Functional (ESPGHAN) showed induction of a state of de - Food Ingredients. CRC Press: Boca Raton ed, 2005.
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