Prebiotics to fight diseases: reality or fiction?

Bacteria living in the gastrointestinal tract are crucial for human health and disease occurrence. Increasing the beneficial intestinal microflora by consumption of prebiotics, which are 'functional foods', could be an elegant way to limit the number and incidence of disorders and to recover from dysbiosis or antibiotic treatments. This review focuses on the short-chain low-digestible carbohydrates (LDCs) which are metabolized by gut microbiota serving as energy source, immune system enhancers or facilitators of mineral uptake. Intake of foods containing LDCs can improve the state of health and may prevent diseases as for example certain forms of cancer. Given the large number of different molecules belonging to LDCs, we focused our attention on fructans (inulin, fructo-oligosaccharides), galacto-oligosaccharides and resistant starches and their therapeutic and protective applications. Evidence is accumulating that LDCs can inhibit bacterial and viral infections by modulating host defense responses and by changing the interactions between pathogenic and beneficial bacteria. Animal studies and studies on small groups of human subjects suggest that LDCs might help to counteract colorectal cancer, diabetes and metabolic syndrome. The action mechanisms of LDCs in the human body might be broader than originally thought, perhaps also including reactive oxygen species scavenging and signaling events.