Eczema, Digestion, Infant and Children | December 5, 2014 | Author: The Super Pharmacist
Saccharides are sugars, or simple carbohydrates, that are often linked to a sweet taste. The most familiar saccharide types may be glucose or fructose, which are commercially refined in great quantities and used to flavour many processed and/or packaged foods. Saccharides are also found naturally in foods, though often in smaller concentrations. These molecules may link together to form slightly more complex carbohydrates, called oligosaccharides.
Oligosaccharides, translating literally to 'a small number of sugars' then form larger carbohydrates called polysaccharides ('many sugars'), which are the basis for complex carbohydrates, such as dietary fibre. Dietary oligosaccharides have functions and roles in human biology, the most prominent of these may be their ability to promote 'beneficial' bacteria in the gastrointestinal tract. These bacteria, which include species such as Bifidobacteria, Lactobacillus and Eubacteria, inhibit the growth of 'foreign' bacteria which can result in gastric infection or other illness. They also break down or metabolise oligosaccharides into other simple molecules such as short-chain fatty acids, required as fuel by some cells of the gastrointestinal tract.
Oligosaccharides found in the human body include:
These molecules are found in a wide variety of foodstuffs such as:
Most foods only contain a very small amount of oligosaccharide per piece or portion, therefore, considerable amount has to be eaten per day to gain an appreciable concentration of the molecules. An alternative to this is supplementation. Currently, there are many refined oligosaccharide products available for those wishing to increase their intake. On the other hand, some researchers argue that these are structurally different from the oligosaccharides found in the body, thus reducing any potential effect of this strategy.
Oligosaccharides may have many benefits for human health and have been linked to positive effects in many disorders and conditions, some of which include:
Inflammatory bowel disease is a condition in which disruptions to the normal gut microflora (made up of 'beneficial' bacteria) and the immune responses to these bacteria are thought to play important roles. Bifidobacteria has been shown to be significantly reduced in studies of this condition. Therefore, oligosaccharide supplementation may be of use in this condition. However, there is an unfortunate lack of research into this.
There have been some studies into the use of probiotics as a therapeutic application in IBD, although many of these are small-scale.
A meta-analysis of 23 trials of probiotics in childhood ulcerative colitis (one sub-type of IBD) concluded that this treatment may contribute to remission and the maintenance of remission in this condition. However, there is no evidence for any effect of oligosaccharides or probiotics in Crohn's disease, the other major subtype of IBD.
Some studies indicate that oligosaccharides may play a role in the absorption of calcium from the gut and into the rest of the body, where it may be integrated into the structure of bones, to help maintain bone structure and prevent osteoporosis, or bone density loss in old age. However, many clinical trials on this that include human subjects have small numbers, thus affecting the validity of their outcomes.
For example, a crossover trial allocated 12 postmenopausal women to drink 200ml yogurt with 20g/day transgalacto-oligosaccharides twice daily for nine days, then repeat this process with yogurt containing a placebo. This resulted in a moderately significant increase in calcium absorption after the 'treatment' phase compared to the 'placebo' phase.
Another crossover trial included 59 adolescent (pre-menarche) girls who were allocated 8 g/d oligofructose, an inulin/oligofructose mixture and then a sucrose (placebo) in 3-week phases. Approximately 1500 mg/day supplementary calcium was also administered for the duration of the trial. Calcium absorption was significantly higher after the inulin/oligofructose phase, but not the oligofructose phase, compared to placebo.
Another trial randomised 100 adolescents to 8g/day inulin derivatives or a placebo, and measured calcium absorption after eight weeks and one year of this supplementation. Absorption was significantly increased in the 'inulin' group at both end-points compared to the placebo group. This indicates potential for bone density improvements mediated by oligosaccharides in both the short and long term.
This is a broad term describing excessive concentrations of an immune-system protein known as immunoglobulin type E, or IgE. Increased IgE is linked to disorders including food allergies - or, more accurately, hyper-sensitive immune responses to molecules found in certain foods. Bacteria that contribute to gastrointestinal health, may also increase immunoglobulin type A, which may be associated with reductions in IgE and IgE-related disorders.
There is some evidence that oligosaccharide intake, and thus the promotion of 'beneficial' bacteria, may reduce the symptoms or incidence of these conditions, including atopic dermatitis (eczema).
Small-scale clinical trial data indicates that the administration of oligosaccharide reduced the incidence of atopic dermatitis by 58% compared to placebo. A double-blind trial randomised 206 infants to a prebiotic mixture or placebo. The results showed that 10 infants in the prebiotic group developed eczema, in comparison to 24 in the control group, and that the faecal samples of the treatment group showed significant increases in Bifidobacteria counts.
However, a meta-analysis of 18 human trials on the effects of oligosaccharide supplementation, bacterial supplementation (in the form of products known as 'probiotics') or both ('synbiotics') on eczema in infants concluded that only probiotic intake was associated with the reduced incidence, but not symptom severity, of the condition.
It should be noted that the ingestion of extra oligosaccharides may have some risks and side-effects. Bacteria ferment these molecules to use them as fuel, which means the by-products of this include gases such as carbon dioxide. These by-products may increase the risk of flatulence or even diarrhoea. The ingestion of prebiotics may also have a mild laxative effect. However, many safety studies indicate that these oligosaccharides are associated with acceptable levels of side-effects.
Macfarlane GT, Steed H, Macfarlane S. Bacterial metabolism and health-related effects of galacto-oligosaccharides and other prebiotics. J Appl Microbiol. 2008;104(2):305-344.
Roberfroid M, Gibson GR, Hoyles L, et al. Prebiotic effects: metabolic and health benefits. Br J Nutr. 2010;104 Suppl 2:S1-63.
Cherbut C. Inulin and oligofructose in the dietary fibre concept. Br J Nutr. 2002;87 Suppl 2:S159-162.
Jantscher-Krenn E, Bode L. Human milk oligosaccharides and their potential benefits for the breast-fed neonate. Minerva Pediatr. 2012;64(1):83-99.
Rijkers GT, de Vos WM, Brummer R-J, Morelli L, Corthier G, Marteau P. Health benefits and health claims of probiotics: bridging science and marketing. Br J Nutr. 2011;106(9):1291-1296.
Kukkonen K, Kuitunen M, Haahtela T, Korpela R, Poussa T, Savilahti E. High intestinal IgA associates with reduced risk of IgE-associated allergic diseases. Pediatr Allergy Immunol. 2010;21(1 Pt 1):67-73.
Moro G, Arslanoglu S, Stahl B, Jelinek J, Wahn U, Boehm G. A mixture of prebiotic oligosaccharides reduces the incidence of atopic dermatitis during the first six months of age. Arch Dis Child. 2006;91(10):814-819.
Foisy M, Boyle RJ, Chalmers JR, Simpson EL, Williams HC. Overview of Reviews The prevention of eczema in infants and children: an overview of Cochrane and non-Cochrane reviews. Evid Based Child Health. 2011;6(5):1322-1339.
Dang D, Zhou W, Lun ZJ, Mu X, Wang DX, Wu H. Meta-analysis of probiotics and/or prebiotics for the prevention of eczema. J Int Med Res. 2013;41(5):1426-1436.
Macfarlane S, Furrie E, Cummings JH, Macfarlane GT. Chemotaxonomic analysis of bacterial populations colonizing the rectal mucosa in patients with ulcerative colitis. Clin Infect Dis. 2004;38(12):1690-1699.
Guandalini S, Cernat E, Moscoso D. Prebiotics and probiotics in irritable bowel syndrome and inflammatory bowel disease in children. Benef Microbes. 2014:1-9.
van den Heuvel EG, Schoterman MH, Muijs T. Transgalactooligosaccharides stimulate calcium absorption in postmenopausal women. J Nutr. 2000;130(12):2938-2942.
Griffin IJ, Davila PM, Abrams SA. Non-digestible oligosaccharides and calcium absorption in girls with adequate calcium intakes. Br J Nutr. 2002;87 Suppl 2:S187-191.
Abrams SA, Griffin IJ, Hawthorne KM, et al. A combination of prebiotic short- and long-chain inulin-type fructans enhances calcium absorption and bone mineralization in young adolescents. Am J Clin Nutr. 2005;82(2):471-476.
Coussement PA. Inulin and oligofructose: safe intakes and legal status. J Nutr. 1999;129(7 Suppl):1412S-1417S.