Inulin-Type Fructan Supplementation of 3- to 6-Year-Old Children Is Associated with Higher Fecal Bifidobacterium Concentrations and Fewer Febrile Episodes Requiring Medical Attention

Abstract

BackgroundInulin-type fructans used in formula have been shown to promote microbiota composition and stool consistency closer to those of breastfed infants and to have beneficial effects on fever occurrence, diarrhea, and incidence of infections requiring antibiotic treatment in infants.ObjectivesThe primary study aim was to explore whether prophylactic supplementation with prebiotic fructans is able to influence the frequency of infectious diseases in kindergarten children during a winter period. A secondary objective was to ascertain the effect on the intestinal microbiota.Methods142 boys and 128 girls aged 3–6 y were randomly allocated to consume 6 g/d fructans or maltodextrin for 24 wk. At baseline, stool samples were collected for microbiota analysis and anthropometric measurements were made. During the intervention period diagnoses were recorded by physicians, whereas disease symptoms, kindergarten absenteeism, dietary habits, and stool consistency were recorded by parents. Baseline measurements were repeated at wk 24.ResultsIn total 219 children finished the study. Both the relative abundance of Bifidobacterium (P < 0.001) and that of Lactobacillus (P = 0.014) were 19.9% and 7.8% higher, respectively, post data normalization, in stool samples of children receiving fructans as compared with those of controls at wk 24. This was accompanied by significantly softer stools within the normal range in the prebiotic group from wk 12 onwards. The incidence of febrile episodes requiring medical attention [0.65 ± 1.09 compared with 0.9 ± 1.11 infections/(24 wk × child), P = 0.04] and that of sinusitis (0.01 ± 0.1 compared with 0.06 ± 0.25, P = 0.03) were significantly lower in the prebiotic group. The number of infectious episodes and their duration reported by parents did not differ significantly between the 2 intervention groups.ConclusionsPrebiotic supplementation modified the composition of the intestinal microbiota and resulted in softer stools in kindergarten-aged children. The reduction in febrile episodes requiring medical attention supports the concept of further studies on prebiotics in young children. This trial was registered at clinicaltrials.gov as NCT03241355.

Microbiome Composition in Pediatric Populations from Birth to Adolescence: Impact of Diet and Prebiotic and Probiotic Interventions

“…Only a few studies have studied DFs and prebiotics on the gut microbiota in healthy 3-6-year-old children [52] and adolescents (8-15 years) [53][54][55][56] (Table 2). As prebiotic fibers, both GOS and inulin-type fructans have been shown to increase abundance of Bifidobacterium [52][53][54].…”

“…Only a few studies have studied DFs and prebiotics on the gut microbiota in healthy 3-6-year-old children [52] and adolescents (8-15 years) [53][54][55][56] (Table 2). As prebiotic fibers, both GOS and inulin-type fructans have been shown to increase abundance of Bifidobacterium [52][53][54]. Several studies have demonstrated that the intake of DFs shape the gut microbes of children; however, their effects on microbiota composition depend on the type of fiber studied.…”

Long-Term Safety and Efficacy of Prebiotic Enriched Infant Formula—A Randomized Controlled Trial

“…Two previous studies in healthy term newborns have demonstrated that infant formula supplemented with Orafti ® Synergy1, a chicory-derived inulin which is enriched by shorter chain inulin (oligofructose), modulates the gut microbiota composition as well as stool characteristics closer and more comparable to those of breast-fed infants [ 11 , 12 ]. Prebiotics have also been found effective in decreasing the rate of infections and in reducing febrile episodes in infants and young children [ 13 , 14 , 15 , 16 , 17 , 18 ]. Furthermore, inulin and oligofructose can modulate certain functions of the immune system.…”

Dietary Fibres Differentially Impact on the Production of Phenolic Acids from Rutin in an In Vitro Fermentation Model of the Human Gut Microbiota

“…Moreover, in that study, these fibres decreased the relative abundance of the Lachnospiraceae family [48]. Inulin has a demonstrated effect on the growth of bifidobacteria both in vitro [49] and in vivo [50][51][52], highlighting the relevance of batch incubations for initial screening purposes. In another in vitro study, dietary fibres caused specific changes: resistant starch caused a 6-13-fold increase in abundance of Ruminococcus bromii and increased the abundance of several species of bifidobacteria.…”