Intestinal Warfare: The Role of Short‐Chain Fructooligosaccharides in Health and Disease

Abstract

Short‐chain fructooligosaccharides (FOS) are a long‐studied functional food made up of a glucose molecule linked to between 2 and 4 fructose molecules and not significantly digested in the small intestine. Short‐chain FOS provide an energy source that is relatively specific for beneficial bacteria in the large intestine, with even small amounts leading to dramatic increases in bifidobacteria, which have a variety of health benefits in and of themselves. In addition, a predicable fall in pathogenic bacteria, such as clostridia, occurs as bifidobacteria increase. This has implications for several disorders, ranging from liver disease to antibiotic‐associated diarrhea to colon cancer. Short‐chain FOS are metabolized to short‐chain fatty acids, lowering pH in the colon. This facilitates calcium absorption, which may be beneficial for individuals with renal and liver disease, and has implications for colon cancer protection as well. Short‐chain fatty acids are the preferred substrate for colonic epithelial cells, which are potentially beneficial for those with ulcerative colitis risk. Other effects of short‐chain FOS include an effect on cholesterol metabolism through interference with enterohepatic circulation of cholesterol. Short‐chain FOS allow for a favorable shift in the balance of healthful vs harmful organisms, lowering colonic pH while providing an energy source for the gut, with significant implications for disease prevention.

Fructo-oligosaccharide Reduces Inflammation in a Dextran Sodium Sulphate Mouse Model of Colitis

“…When FOS is fermented in the large intestine, short-chain fatty acid concentrations such as butyrate increase within the colonic lumen [32,33]. Butyrate is a major source of energy for colonocytes to grow and proliferate, and it has been suggested that a defective butyrate metabolism may be involved in the pathogenesis of human ulcerative colitis [24,34].…”

Nutritional management of gastrointestinal disease

“…18 In studies of humans with IBD or colitis, adding FOS to the diet highly improved the response to therapy, clinical disease was reduced, and relapses were fewer. 19 There have been only a few studies in dogs, and even fewer in cats, evaluating the role of FOS in the dietary therapy of GI disease. However, preliminary evidence supports the finding in humans that FOS increases the numbers of beneficial bacteria in the colon of dogs and cats, and may prove beneficial in controlling bacterial overgrowth, antibiotic responsive diarrhea, or other inflammatory diseases suspected to have a bacterial origin (eg, IBD).…”

Functional food in athletes

“…They proceed undigested and unresorbed through the upper part of the gastrointestinal tract. Once in the colon, FOS are rapidly fermented to short-chain fatty acids, especially by Bifidobacteria, whose growth is consequently promoted (100). The breakdown of FOS by bacterial fermentation is followed by a pronounced increase in hydrogen concentrations, which promotes peristalsis of the colon and can be responsible for side effects like bloating, flatus, abdominal rumbling, and an irregular defecation pattern (109).…”