The Effect of Oligofructose-Enriched Inulin on Faecal Bacterial Counts and Microbiota-Associated Characteristics in Celiac Disease Children Following a Gluten-Free Diet: Results of a Randomized, Placebo-Controlled Trial.

Nutrients. 2018;10(2)
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Plain language summary

Coeliac disease (CD) is associated with changes in the gut microbiome. Prebiotics, that feed beneficial bacteria, are a promising method of restoring normal gut function in those with CD. The aim of this study was to evaluate the effect of prebiotics on the intestinal microbiota in children with CD. The researchers looked at a group of 34 children of average age 10 years. The children had all been diagnosed with CD and were following a gluten-free diet. The children were given either a supplement of oligofructose-enriched inulin or a placebo (maltodextrin) daily for 3 months. At the end of the study, Bifidobacterium count increased significantly in the group of children given the prebiotic. Faecal acetate and butyrate levels also increased in the prebiotic group, with total short-chain fatty acid levels increasing by 31% compared to the start of the study. Constipation or diarrhoea was reported by only 5% of the prebiotic group, compared to 31% of the placebo group. The authors concluded that the prebiotic supplement used in this trial had a beneficial effect on the characteristics of faecal microbiota in children with CD on a gluten-free diet.

Abstract

Celiac disease (CD) is associated with intestinal microbiota alterations. The administration of prebiotics could be a promising method of restoring gut homeostasis in CD. The aim of this study was to evaluate the effect of prolonged oligofructose-enriched inulin (Synergy 1) administration on the characteristics and metabolism of intestinal microbiota in CD children following a gluten-free diet (GFD). Thirty-four paediatric CD patients (mean age 10 years; 62% females) on a GFD were randomized into two experimental groups receiving Synergy 1 (10 g/day) or placebo (maltodextrin; 7 g/day) for 3 months. The quantitative gut microbiota characteristics and short-chain fatty acids (SCFAs) concentration were analysed. In addition, side effects were monitored. Generally, the administration of Synergy 1 in a GFD did not cause any side effects. After the intervention period, Bifidobacterium count increased significantly (p < 0.05) in the Synergy 1 group. Moreover, an increase in faecal acetate and butyrate levels was observed in the prebiotic group. Consequently, total SCFA levels were 31% higher than at the baseline. The presented trial shows that Synergy 1 applied as a supplement of a GFD had a moderate effect on the qualitative characteristics of faecal microbiota, whereas it stimulated the bacterial metabolite production in CD children.

Lifestyle medicine

Fundamental Clinical Imbalances : Digestive, absorptive and microbiological
Patient Centred Factors : Mediators/Microbiome
Environmental Inputs : Nutrients
Personal Lifestyle Factors : Nutrition
Functional Laboratory Testing : Stool
Bioactive Substances : Inulin ; Prebiotics

Methodological quality

Allocation concealment : No

Metadata

Nutrition Evidence keywords : Coeliac disease ; Oligosaccharides ; Microbiome