Term Infant Formulas Influencing Gut Microbiota: An Overview
Abstract
:1. Introduction
2. Methods
2.1. Probiotics Supplemented IFs
2.1.1. Rational for the Use of Probiotics in Infant Formula
2.1.2. Microbiota and Gut Development
2.1.3. Probiotics Supplemented IFs Tolerability and Safety
2.1.4. Probiotics Supplemented IFs in Gastrointestinal Disorders
2.1.5. Conclusion on Probiotics Supplemented IFs
2.2. Prebiotics Supplemented IFs
2.2.1. Rational for the Use of Prebiotics in IFs
2.2.2. Prebiotics Supplemented IFs and Intestinal Parameters
2.2.3. Prebiotics Supplemented IFs and Growth
2.2.4. Prebiotics Supplemented IFs in Gastrointestinal Disorders
2.2.5. Conclusion on Probiotics Supplemented IF
2.3. HM Oligosaccharides (HMOs) Supplemented IFs
2.3.1. Rational for the Use of HMOs in Infant Formula
2.3.2. HMOs and Immune Modulation
2.3.3. HMOs Supplemented IFs, Growth and Gastrointestinal Disorders
2.3.4. Conclusion on HMOs Supplemented IFs
2.4. Synbiotics Supplemented IFs
2.4.1. Rational for the Use of Synbiotics in Infant Formula
2.4.2. Synbiotics Supplemented IFs and Growth
2.4.3. Synbiotics Supplemented IFs and Intestinal Parameters
2.4.4. Synbiotics Supplemented IFs in Gastrointestinal Disorders
2.4.5. Conclusion on Synbiotics Supplemented IFs
2.5. Postbiotics Supplemented IFs
2.5.1. Rational for the Use of Postbiotics in Infant Formula
2.5.2. Postbiotic, Microbiota and Metabolic Activity
2.5.3. Postbiotics Supplemented IFs in Gastrointestinal Disorders
2.5.4. Conclusion on Postbiotics Supplemented IFs
2.6. MIFs and Allergy
3. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Genus | Species | Subspecies | Strain Designation | Strain Abbreviation |
---|---|---|---|---|
Lactobacillus | rhamnosus | NA | GG | LGG |
Bifidobacterium | animalis | lactis | DN-173010 | Bifidus regularis |
Bifidobacterium | longum | longum | 36624 | Bifantis |
MIFs Enriched with Probiotics—Key Points |
---|
• The intestinal microbiota (IM) contributes to the early and healthy development of gut functions |
• Commensal microbes are essential for maturation of the immune system |
• IFs supplementation with probiotics has the purpose to modulate the activity of the intestinal microbiota of infants by modifying its balance |
• Probiotics enriched IFs have modest benefit in preventing acute gastrointestinal tract infections in healthy infants |
• Probiotics reduce the incidence of antibiotic-associated diarrhea |
• The effectiveness of probiotic supplemented IFs to reduce colic frequency, crying and irritability is debated |
• Major issues related to the use of probiotics: timing, duration of treatment |
MIFs Enriched with Prebiotics—Key Points |
---|
• Prebiotics stimulate the establishment and maintenance of a healthy gut environment |
• Commensal microbes are essential for maturation of the immune system |
• Prebiotics act through selective fermentation in the GI tract, which stimulates the growth of bifidobacteria and Lactobacilli |
• Different types of prebiotics substrates act differently on the growth of intestinal bacteria |
• Prebiotics enriched IFs are associated with lower intestinal pH, with a SCFAs pattern more similar to breastfed infants |
• Prebiotics enriched IFs are not associated with increased frequency of stool |
• Prebiotic supplemented formulas may be considered in infants with hard stool |
MIFs Enriched with HMOs—Key Points |
---|
• HMOs are non-digestible carbohydrates present in high concentrations in human milk |
• HMOs play a key role in promoting intestinal microbiome composition and diversity |
• HMOs prevent pathogen adhesion and could act as antiviral components |
• HMOs-enriched IFs result from the addition of industrially produced HMOs of two types 2o FL and LNnT |
• HMOs-enriched IFs are associated with normal infants’ growth |
• Incidence of GI symptoms, including flatulence, spitting up, and vomiting did not differ between HMOs-supplemented and unsupplemented IFs |
• IF enriched with 2 HMOs, 2o FL and LNnT, are considered as safe and approved for use as food |
• There is limited evidence regarding the potential preventive effects of supplemented IFs with one or both the above-mentioned HMOs |
MIFs Enriched with Synbiotics—Key Points |
---|
• The substrates do not need to be prebiotics but should be metabolized only by the co-administered microorganism with a synergistic beneficial effect on the host |
• Each component must fulfill the requirements for prebiotic or probiotic |
• Synbiotics might offer an added effect on the intestinal microbiota homeostasis |
• Infants’ growth parameters did not differ between synbotics-supplemented and unsupplemented IFs |
• Synbiotics enriched IFs seem to be associated with reduced incidence of GI infections |
• Frequency of flatulence, fussing, vomiting, crying and spitting up is not reduced in infants fed with synbiotics-enriched IFs |
• No specific therapeutic indications may be provided for synbiotics-enriched IFs |
MIFs Enriched with Postbiotics—Key Points |
---|
• Postbiotics are metabolites and fragments of microorganisms resulting from fermentation with live bacteria |
• Postbiotics may exert a beneficial effect in the host by pleiotropic properties |
• Postbiotics influence gut epithelium and microbiota, immune system, systemic metabolism, and the nervous system. Synbiotics might offer added beneficial effects on intestinal microbiota homeostasis |
• Infants’ growth parameters did not differ between postbiotics-supplemented and unsupplemented IFs |
• Postbiotics-enriched IFs are associated with softer stool |
• Contrasting results on the efficacy of postbiotics in reducing diarrhea episodes: there is limited evidence to recommend using postbiotics for prevention or treatment of acute gastroenteritis |
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Fabiano, V.; Indrio, F.; Verduci, E.; Calcaterra, V.; Pop, T.L.; Mari, A.; Zuccotti, G.V.; Cullu Cokugras, F.; Pettoello-Mantovani, M.; Goulet, O. Term Infant Formulas Influencing Gut Microbiota: An Overview. Nutrients 2021, 13, 4200. https://doi.org/10.3390/nu13124200
Fabiano V, Indrio F, Verduci E, Calcaterra V, Pop TL, Mari A, Zuccotti GV, Cullu Cokugras F, Pettoello-Mantovani M, Goulet O. Term Infant Formulas Influencing Gut Microbiota: An Overview. Nutrients. 2021; 13(12):4200. https://doi.org/10.3390/nu13124200
Chicago/Turabian StyleFabiano, Valentina, Flavia Indrio, Elvira Verduci, Valeria Calcaterra, Tudor Lucian Pop, Alessandra Mari, Gian Vincenzo Zuccotti, Fugen Cullu Cokugras, Massimo Pettoello-Mantovani, and Olivier Goulet. 2021. "Term Infant Formulas Influencing Gut Microbiota: An Overview" Nutrients 13, no. 12: 4200. https://doi.org/10.3390/nu13124200