Prebiotic effects: metabolic and health benefits

The different compartments of the gastrointestinal tract are inhabited by populations of micro-organisms. By far the most important predominant populations are in the colon where a true symbiosis with the host exists that is a key for well-being and health. For such a microbiota, 'normobiosis' characterises a composition of the gut 'ecosystem' in which micro-organisms with potential health benefits predominate in number over potentially harmful ones, in contrast to 'dysbiosis', in which one or a few potentially harmful micro-organisms are dominant, thus creating a disease-prone situation. The present document has been written by a group of both academic and industry experts (in the ILSI Europe Prebiotic Expert Group and Prebiotic Task Force, respectively). It does not aim to propose a new definition of a prebiotic nor to identify which food products are classified as prebiotic but rather to validate and expand the original idea of the prebiotic concept (that can be translated in 'prebiotic effects'), defined as: 'The selective stimulation of growth and/or activity(ies) of one or a limited number of microbial genus(era)/species in the gut microbiota that confer(s) health benefits to the host.' Thanks to the methodological and fundamental research of microbiologists, immense progress has very recently been made in our understanding of the gut microbiota. A large number of human intervention studies have been performed that have demonstrated that dietary consumption of certain food products can result in statistically significant changes in the composition of the gut microbiota in line with the prebiotic concept. Thus the prebiotic effect is now a well-established scientific fact. The more data are accumulating, the more it will be recognised that such changes in the microbiota's composition, especially increase in bifidobacteria, can be regarded as a marker of intestinal health. The review is divided in chapters that cover the major areas of nutrition research where a prebiotic effect has tentatively been investigated for potential health benefits. The prebiotic effect has been shown to associate with modulation of biomarkers and activity(ies) of the immune system. Confirming the studies in adults, it has been demonstrated that, in infant nutrition, the prebiotic effect includes a significant change of gut microbiota composition, especially an increase of faecal concentrations of bifidobacteria. This concomitantly improves stool quality (pH, SCFA, frequency and consistency), reduces the risk of gastroenteritis and infections, improves general well-being and reduces the incidence of allergic symptoms such as atopic eczema. Changes in the gut microbiota composition are classically considered as one of the many factors involved in the pathogenesis of either inflammatory bowel disease or irritable bowel syndrome. The use of particular food products with a prebiotic effect has thus been tested in clinical trials with the objective to improve the clinical activity and well-being of patients with such disorders. Promising beneficial effects have been demonstrated in some preliminary studies, including changes in gut microbiota composition (especially increase in bifidobacteria concentration). Often associated with toxic load and/or miscellaneous risk factors, colon cancer is another pathology for which a possible role of gut microbiota composition has been hypothesised. Numerous experimental studies have reported reduction in incidence of tumours and cancers after feeding specific food products with a prebiotic effect. Some of these studies (including one human trial) have also reported that, in such conditions, gut microbiota composition was modified (especially due to increased concentration of bifidobacteria). Dietary intake of particular food products with a prebiotic effect has been shown, especially in adolescents, but also tentatively in postmenopausal women, to increase Ca absorption as well as bone Ca accretion and bone mineral density. Recent data, both from experimental models and from human studies, support the beneficial effects of particular food products with prebiotic properties on energy homaeostasis, satiety regulation and body weight gain. Together, with data in obese animals and patients, these studies support the hypothesis that gut microbiota composition (especially the number of bifidobacteria) may contribute to modulate metabolic processes associated with syndrome X, especially obesity and diabetes type 2. It is plausible, even though not exclusive, that these effects are linked to the microbiota-induced changes and it is feasible to conclude that their mechanisms fit into the prebiotic effect. However, the role of such changes in these health benefits remains to be definitively proven. As a result of the research activity that followed the publication of the prebiotic concept 15 years ago, it has become clear that products that cause a selective modification in the gut microbiota's composition and/or activity(ies) and thus strengthens normobiosis could either induce beneficial physiological effects in the colon and also in extra-intestinal compartments or contribute towards reducing the risk of dysbiosis and associated intestinal and systemic pathologies.

The influence of age and gender on food choice: a focus group exploration

With 25% of the UK population predicted to be obese by 2010, the costs to individuals and society are set to rise. Due to the extra economic and social pressures obesity causes, there is an increasing need to understand what motivates and prevents consumers from eating a healthy diet so as to be able to tailor policy interventions to specific groups in society. In so doing, it is important to explore potential variations in attitudes, motivation and behaviour as a function of age and gender. Both demographic factors are easily distinguished within society and a future intervention study which targets either, or both, of these would likely be both feasible and cost-effective for policy makers. As part of a preliminary study, six focus groups (total n = 43) were conducted at the University of Reading in November 2006, with groups segmented on the basis of age and gender. In order to gather more sensitive information, participants were also asked to fill out a short anonymous questionnaire before each focus group began, relating to healthy eating, alcohol consumption and body dissatisfaction. Making use of thematic content analysis, results suggested that most participants were aware of the type of foods that contribute to a healthy diet and the importance of achieving a healthy balance within a diet. However, they believed that healthy eating messages were often conflicting, and were uncertain about where to find information on the topic. Participants believed that the family has an important role in educating children about eating habits. Despite these similarities, there were a number of key differences among the groups in terms of their reasons for making food choices. Older participants (60+ years old) were more likely to make food choices based on health considerations. Participants between the ages of 18–30 were less concerned with this link, and instead focused on issues of food preparation and knowledge, prices and time. Younger female participants said they had more energy when they ate healthier diets; however, very often their food choices related to concern with their appearance. Older female participants also expressed this concern within the questionnaire, rather than in the group discussions. Overall, these results suggest that consumer motivations for healthy eating are diverse and that this must be considered by government, retailers and food producers.

Consumer acceptance, valuation of and attitudes towards genetically modified food: Review and implications for food policy

An increasing set of evidence has been reported on how consumers could potentially react to the introduction of genetically modified food. Studies typically contain some empirical evidence and some theoretical explanations of the data, however, to date limited effort has been posed on systematically reviewing the existing evidence and its implications for policy. This paper contributes to the literature by bringing together the published evidence on the behavioural frameworks and evidence on the process leading to the public acceptance of genetically modified (GM) food and organisms (GMOs). In doing so, we employ a set of clearly defined search tools and a limited number of comprehensive key words. The study attempts to gather an understanding of the published findings on the determinants of the valuation of GM food - both in terms of willingness to accept and the willing-to-pay a premium for non-GM food, trust with information sources on the safety and public health and ultimate attitudes underpinning such evidence. Furthermore, in the light of such evidence, we formulate some policy strategies to deal with public uncertainly regarding to GMOs and, especially GM food. (c) 2007 Elsevier Ltd. All rights reserved.

Very long chain n-3 polyunsaturated fatty acids in the food chain in the UK and the potential of animal-derived foods to increase intake

The very long chain (VLC) n-3 polyunsaturated fatty acids (PUFA), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are widely recognised to have beneficial effects on human health. However, recommended intakes of VLC n-3 PUFA (450 mg/day) are not being met by the diet in the majority of the population mainly because of low consumption of oil-rich fish. Current mean intake of VLC n-3 PUFA by adults is estimated to be about 282 mg/day with EPA and DHA contributing about 244 mg/day. Furthermore, the fact that only about 27% of adults eat any oil-rich fish (excluding canned tuna) and knowledge of the poor conversion of α-linolenic acid to EPA and DHA in vivo, particularly in men, leads to the need to review current dietary sources of these fatty acids. Animal-derived foods are likely to have an important function in increasing intake and studies have shown that feeding fish oils to animals can increase the EPA and DHA content of the resulting food products. This paper highlights the importance of examining current and projected consumption trends of meat and other animal products when exploring the potential impact of enriched foods by means of altering animal diets. When related to current food consumption data, potential dietary intakes of EPA+DHA from foods derived from animals fed enriched diets are calculated to be about 231 mg/day. If widely consumed, such foods could have a significant impact on progression of conditions such as cardiovascular disease. Consideration is also given to the sources of VLC n-3 PUFA in animal diets, with the sustainability of fish oil being questioned and the need to investigate the use of alternative dietary sources such as those of algal origin.

Effect of Information about benefits of biotechnology on consumer acceptance of genetically modified food; evidence from experimental auctions in the United States, England, and France

This study investigates the effect of information about potential benefits of biotechnology on consumer acceptance of genetically modified (GM) foods. Consumer willingness to accept compensation to consume a GM food was elicited using an incentive compatible auction mechanism in three US states (California, Florida, and Texas) and in two European countries (England and France). Results indicate that information on environmental benefits, health benefits and benefits to the third world significantly decreased the amount of money consumers demanded to consume GM food; however, the effect of information varied by type of information and location. Consistent with prior research, we find that initial attitudes toward biotechnology have a significant effect on how individuals responded to new information.

Food scares and trust: A European study

The complex interactions between the determinants of food purchase under risk are explored using the SPARTA model, based on the theory of planned behaviour, and estimated through a combination of multivariate statistical techniques. The application investigates chicken consumption choices in two scenarios: ( a) a 'standard' purchasing situation; and (b) following a hypothetical Salmonella scare. The data are from a nationally representative survey of 2,725 respondents from five European countries: France, Germany, Italy, the Netherlands and the United Kingdom. Results show that the effects and interactions of behavioural determinants vary significantly within Europe. Only in the case of a food scare do risk perceptions and trust come into play. The policy priority should be on building and maintaining trust in food and health authorities and research institutions, while food chain actors could mitigate the consequences of a food scare through public trust. No relationship is found between socio-demographic variables and consumer trust in food safety information.

Unravelling the conundrum of tannins in animal nutrition and health

This paper examines the nutritional and veterinary effects of tannins on ruminants and makes some comparisons with non-ruminants. Tannin chemistry per se is not covered and readers are referred to several excellent reviews instead: (a) Okuda T et al. Heterocycles 30:1195-1218 (1990); (b) Ferreira D and Slade D. Nat Prod Rep 19:517-541 (2002); (c) Yoshida T et al. In Studies in Natural Product Chemistry. Elsevier Science, Amsterdam, pp. 395-453 (2000); (d) Khanbabaee K and van Ree T. Nat Prod Rep 18:641-649 (2001); (e) Okuda et al. Phytochemistvy 55:513-529 (2000). The effects of tannins on rumen micro-organisms are also not reviewed, as these have been addressed by others: (a) McSweeney CS et al. Anim Feed Sci Technol 91:83-93 (2001); (b) Smith AH and Mackie RI. Appl Environ Microbiol 70:1104-1115 (2004). This paper deals first with the nutritional effects of tannins in animal feeds, their qualitative and quantitative diversity, and the implications of tannin-protein complexation. It then summarises the known physiological and harmful effects and discusses the equivocal evidence of the bioavailability of tannins. Issues concerning tannin metabolism and systemic effects are also considered. Opportunities are presented on how to treat feeds with high tannin contents, and some lesser-known but successful feeding strategies are highlighted. Recent research has explored the use of tannins for preventing animal deaths from bloat, for reducing intestinal parasites and for lowering gaseous ammonia and methane emissions. Finally, several tannin assays and a hypothesis are discussed that merit further investigation in order to assess their suitability for predicting animal responses. The aim is to provoke discussion and spur readers into new approaches. An attempt is made to synthesise the emerging information for relating tannin structures with their activities. Although many plants with high levels of tannins produce negative effects and require treatments, others are very useful animal feeds. Our ability to predict whether tannin-containing feeds confer positive or negative effects will depend on interdisciplinary research between animal nutritionists and plant chemists. The elucidation of tannin structure-activity relationships presents exciting opportunities for future feeding strategies that will benefit ruminants and the environment within the contexts of extensive, semi-intensive and some intensive agricultural systems. (c) 2006 Society of Chemical Industry

Food consumption impacts of adherence to dietary norms in the United States: a quantitative assessment

Promotion of adherence to healthy-eating norms has become an important element of nutrition policy in the United States and other developed countries. We assess the potential consumption impacts of adherence to a set of recommended dietary norms in the United States using a mathematical programming approach. We find that adherence to recommended dietary norms would involve significant changes in diets, with large reductions in the consumption of fats and oils along with large increases in the consumption of fruits, vegetables, and cereals. Compliance with norms recommended by the World Health Organization for energy derived from sugar would involve sharp reductions in sugar intakes. We also analyze how dietary adjustments required vary across demographic groups. Most socio-demographic characteristics appear to have relatively little influence on the pattern of adjustment required to comply with norms, Income levels have little effect on required dietary adjustments. Education is the only characteristic to have a significant influence on the magnitude of adjustments required. The least educated rather than the poorest have to bear the highest burden of adjustment. Out- analysis suggests that fiscal measures like nutrient-based taxes may not be as regressive as commonly believed. Dissemination of healthy-eating norms to the less educated will be a key challenge for nutrition policy.

Food consumption impacts of adherence to dietary norms in the United States: a quantitative assessment

Promotion of adherence to healthy-eating norms has become an important element of nutrition policy in the United States and other developed countries. We assess the potential consumption impacts of adherence to a set of recommended dietary norms in the United States using a mathematical programming approach. We find that adherence to recommended dietary norms would involve significant changes in diets, with large reductions in the consumption of fats and oils along with large increases in the consumption of fruits, vegetables, and cereals. Compliance with norms recommended by the World Health Organization for energy derived from sugar would involve sharp reductions in sugar intakes. We also analyze how dietary adjustments required vary across demographic groups. Most socio-demographic characteristics appear to have relatively little influence on the pattern of adjustment required to comply with norms, Income levels have little effect on required dietary adjustments. Education is the only characteristic to have a significant influence on the magnitude of adjustments required. The least educated rather than the poorest have to bear the highest burden of adjustment. Out- analysis suggests that fiscal measures like nutrient-based taxes may not be as regressive as commonly believed. Dissemination of healthy-eating norms to the less educated will be a key challenge for nutrition policy.