For health promotion purposes (e.g. to reduce concentrations of carcinogens in the large bowel, improve digestion,
elimination and immune function) a daily dosage of 500-1,000 mg is often recommended.
Adverse Side Effects and Toxicity
Generally, oligosaccharides are well tolerated. Some individuals report increased flatulence initially. At very high
levels, (40 gm), FOS and other oligosaccharides may induce diarrhea.1
Drug-Nutrient Interactions
There are no well-known drug interactions with FOS or other Prebiotics.17
1. Tomomatsu H. Health effects of oligosaccharides. Prog Food Nutr Sci 1983;7:29-37.
2. Molis C, Flourie B, Ourne F, Gailing MF, Lartique S, Guibert A, et al. Digestion, excretion, and energy value of
fructooligosaccharides in healthy humans. Am J Clin Nutr 1996;64:324-8.
3. Alles MS, Hautvast JG, Nagengast FM, Hartemink R, Van Laere KM. Fate of fructo-oligosaccharides in the human intestine. Br J
Nutr 1996;76:211-21.
4. Duggan C, Gannon J, Walker WA. Protective nutrients and functional foods for the gastrointestinal tract. Am J Clin Nutr
2002:75(5):789-808.
5. Gibson GR, Beatty EH, Wang X, Cummings JH. Selective stimulation of bifidobacteria in the human colon by oligofructose and
mutin. Gastroenterology 1995;106:975-82.
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6. Bouhnik Y, Fluorié B, Dagay-Abensour L, Pochart P, Gramet G, Durand M, et al. Administration of transgalacto-oligosaccharides
increases faecal Bifidobacteria and modifies colonic fermentation metabolism in healthy humans. J Nutr 1997; 127: 444-8.
7. Bouhmik Y, et al. Short-chain fructo-oligosaccharide administration dose-dependently increases fecal bifodobacteria in healthy
humans. J Nutr 1999;129:113-6.
8. Roberfroid M. Dietary fibre, inulin and oligosaccharides. Crit Rev Good Sci Nutr 1993;33:103-48 [review].
9. Tomomatsu H. Health effects of oligosaccharides. Food Technology 1994;48(10):61-5.
10. Gibson GR, Beatty ER, Wang X, Cummings JH. Selective stimulation of bifidobacteria in the human colon by oligofructose and
inulin. Gastroenterology 1995;108:975-82.
11. Jackson KG, Taylor GRJ, Clohessy AM, Wlliams CM. The effect of the daily intake of inulin on fasting lipid, insulin and glucose
concentrations in middle-aged men and women. Br J Nutr 1999;82:23-30.
12. Yamashita, K, Kawai, K, and Itakura, M. Effects of fructo-oligosoccharides on blood glucose and serum lipids in diabetic subjects.
Nutr Res 1984;4:961-6.
13. Roberfroid M. Prebiotics: preferential substrates for specific germs. Am J Clin Nutr.2001;73(Suppl 2):406S-9S.
14. Isolauri E, Sutas Y, Kankaanpaa P, Arvilommi H, Salminen S. Probiotics; effects on immunity. Am J Clin Nutr 2001:73(Suppl
2):444S-50S.
15. Wollowski I, Rechkemmer G, Pool-Zobel BL. Protective role of probiotics and prebiotics in colon cancer. Am J Clin Nutr
2001;73(Suppl 2):451S-5S.
16. Roberfroid M. Dietary fibre, inulin and oligofructose. A review comparing their physiological effects. Crit Rev Food Sci Nutr
1993;33:103-48.
17. Healthnotes online. 2000 Healthnotes, Inc. (www.healthnotes.com):FOS.
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Probiotics
General Features
Probiotics is a term used to describe supplementation with the friendly bacteria of the large intestine; the most
important of which are lactobacillus acidophilus and bifidobacteria. The of icial definition of the term probiotic (as
defined by Havenaar and Huis In’t Veld) is described as “microorganisms in suf icient numbers, which alter the
microflora (by implantation or colonization) in a compartment of the host and by that exert beneficial health ef ects in
this host.”
The health ef ects at ributed to the use of Probiotics are numerous. Well documented ef ects include lower frequency
and duration of diarrhea associated with antibiotics, rotavirus infection, chemotherapy, and to a lesser degree
traveler’s diarrhea; stimulation of humoral and cellular immunity; and decrease in unfavourable metabolites in the
bowel that are linked to colon cancer development (ammonium and procarcinogenic enzymes). Other health benefits
are also related to the use of Probiotics as reviewed below.1,2
It has been shown that lactobacilli inhibit the growth of less desirable organisms in the large intestine through
competition for nutrients, alteration of pH and oxygen tension to levels less favourable to pathogens (disease-causing
organisms), prevention of attachment of pathogens by physically covering at achment sites, and production of limiting
factors such as antimicrobial factors.1,3,4
The gut microflora (normal bacterial population) is an important constituent in the intestine’s defense barrier, as
demonstrated by increased antigen transport across the gut mucosa in the absence of an intestinal microflora. The
gut microflora also elicits specific immune responses at a local and systemic level. A healthy composition of microflora
has also been shown to tone-down hypersensitivity reactions involving food allergies, infant atopic dermatitis,
autoimmune conditions (rheumatoid arthritis, juvenile arthritis), and inflammatory bowel conditions.
In general, evidence exists to show that probiotic supplementation reduces the entry of pathogens and antigens from
reaching the bloodstream. Supplementation with probiotics tends to stimulate and enhance systemic immune function
in healthy individuals, while toning-down (down-regulating) the exaggerated immune reactions that contribute to food
allergies and inteolerance, atopic dermatitis (eczema), certain autoimmune diseases and inflammatory bowel
conditions such as Chrohn’s disease and ulcerative colitis, as noted above.
In one placebo-controlled trial, patients with pouchitis (inflammation of the ileal pouch-anal anastamosis after
colectomy) had fewer episodes of clinical relapse when treated with Probiotics, and had clinical outcomes as good as
those treated with the anti-inflammatory agent mesalamine.
Probiotic supplementation has also been shown to reduce the secretion of pro-inflammatory cytokines (particularly,
tumor necrosis factor alpha) from white blood cells that promote inflammatory responses in conditions such as atopic
dermatitis. At the same time, Probiotics stimulate the release of interferon gamma which has positive ef ects on the
gut, preventing inflammation, and providing systemic benefits as well.5,6
One researcher states “these data point to the conclusion that Probiotics can be used as innovative tools for treating
dysfunction of the gut mucosal barrier, including acute gastroenteritis, food allergy, and inflammatory bowel disease.
Many of the probiotic ef ects are mediated via immune regulation, in particular by control of the balance of pro-
inflammatory and anti-inflammatory cytokines.5
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Clinical Application and Mechanism of Action