Strengthening Immunity Using the Biotic Family In Early Life
Lifestyle factors such as diet, antibiotics and exposure to the environment can modulate the composition of the gut microbiome. Gut microbiota has a profound effect on the host’s immunity and may produce a transgenerational impact on the health of the progeny.1 This article discusses the gut microbiota dysbiosis and the effect of prebiotics and probiotics on host health through microbiota modulation.
What is Gut microbiota dysbiosis?
Gut Dysbiosis can be defined as the altered composition or activity, or both of gut microbiota. Gut microbiota dysbiosis during early life due to prenatal exposure, use of antibiotics, and mode of delivery may contribute to the development and progression of diseases like necrotizing enterocolitis, obesity, allergy, irritable bowel syndrome, asthma and type 1 diabetes in later part of the life.2 Particular foods and dietary habits also profoundly influence the abundance of the gut microbiota in adults and infants (Table 1).3
Figure 1: Diagrammatic representation of the role of gut microbiota in immune development during early life (Adapted from Wopereis et al., 2014)5
|Diet||Effect on gut microbiota||Health outcomes|
|Low FODMAP diet3||
|Dietary Polyphenols3(from coffee, tea, berries and vegetables such as olives and asparagus)||
|Fiber and prebiotics (GOS & FOS)3,4||
FODMAP-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; FOS-Fructooligosaccharides; GOS-Galacto-oligosaccharides; SCFA-Short-chain fatty acids; TMAO-trimethylamine N-oxide
Addressing gut microbiota in early life is the right choice
The infant's gut is immediately exposed to a plethora of microbes of maternal and environmental origins during the delivery process. The gut microbiota of infants significantly transforms and reaches maturation (as that of adults) in the first two years of life. However, certain conditions such as preterm birth, cesarean section and extensive antibiotic use significantly affect the infant's gut microbiota and may delay its maturation.5 Delayed maturation of gut microbiota has been linked with the development of health issues later in life.6 The adult human gut contains highly individualized microbiota. Once established, they remain relatively stable over time. Interestingly, the microbiota introduced to the neonatal gastrointestinal (GI) tract has a better prospect of getting established compared to establishing the same microbiota in the adult GI tract.5 Therefore, it seems a viable approach to address gut microbiota dysbiosis in infants using probiotics or prebiotics in the early stages of life.4,7,8
Prebiotics and probiotics are not the same
Prebiotics and probiotics are completely different from one another but often confused to be the same or are frequently used interchangeably. Several studies highlight the pros and cons of these two nutrients. Table 2 illustrates the difference between characteristics of prebiotics and probiotics.
Table 2. Difference between prebiotics and probiotics.9-17 (Adapted from Pandey et al., 2015; Dwivedi et al., 2016; Gourbeyre et al., 2011; Monteagudoet al., 2019; Shoaf et al., 2006; Schley et al., 2002; Quin et al., 2018; Maldonado J, 2019; Soto et al., 2014)
Live microorganisms, which when administered in adequate amounts confer a health benefitto the host.
Non-viable food components that confer health benefit(s) on the host through the modulation of the microbiota, such as lactobacilli and bifidobacterial.
|Safety in infants||
|The resemblance with human milk||
As evident from Table 2 and review of clinical studies, beneficial health effects of probiotics in infants is conflicting.13 Therefore, strengthening immunity using prebiotics in infants would be of significant interest to achieve health benefits (Figure 1). The addition of prebiotics, especially GOS:FOS (9:1)4, and probiotics8 to infant feed, may have health benefits.
Figure 1. Health benefits of prebiotic supplementation at an early stage of life. HBM-Human breast milk; NEC-Necrotizing enterocolitis. (Adapted from Azagra-Boronat et al., 2019; Armanian et al., 2014; Pandey et al., 2015)
In conclusion, complex interplay between prebiotics, gut microbiota and host’s immune system determines the ultimate health outcome. If not addressed, gut microbiota dysbiosis may lead to the development of diseases such as obesity, allergy, irritable bowel syndrome, etc. later in life.2 Dietary fibers have a profound modulatory effect on the gut microbiota.4 Therefore, prebiotics such as GOS and FOS, that resemble human milk oligosaccharides may be useful in restoring the gut microbiota imbalance in infants.4-6
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