Health benefits of fibre, prebiotics and probiotics: a review of intestinal health and related health claims

Main Article Content

J. Carlson
J. Slavin


fibre, gut health, prebiotic, probiotic


Gastrointestinal health in regard to the gut microbiome is a rapidly emerging field and has many key components driving its emergence. Fibre, prebiotics and probiotics are all dietary components that can play a critical role in maintaining a healthy gut microflora. Fibre has long been appreciated for its influential role in cardiovascular disease, glycaemic control and weight management through various physiological mechanisms. Prebiotics have been shown to play an influential role in irritable bowel symptoms/disease, colon cancer, cardiovascular disease and overall digestive health. Together, various types of fibres and prebiotics have been targeted and synthesised to influence the gut microbiome, specifically Lactobacillus and Bifidobacterium populations. Lactobacillus spp. and Bifidobacterium spp. are common markers for gut health because they have been shown to down-regulate inflammation in the gastrointestinal tract, alleviate irritable bowel syndrome symptoms, stimulate immune functions, aid in mineral absorption and produce little, if any, gas or known carcinogenic substances. Probiotics have also been shown to display many of these pro-health components, and include many species of bacteria outside of the commonly utilised Lactobacillus and Bifidobacterium populations. How these dietary components are defined in the scientific and political arenas will play a critical role in the success of the gut health field moving forward. Key changes in administrative definitions and requirements of these dietary components will influence consumption, awareness and understanding of these key influential components. The purpose of this review is to provide current accepted definitions for fibre, prebiotics and probiotics, as well as introduce key scientific studies describing the health benefits of these components, as well as current health claims.

Abstract 294 | PDF Downloads 215


Ajani, U.A., Ford, E.S. and Mokdad, A.H., 2004. Dietary fibre and c-reactive protein findings from national health and nutrition examination survey data. The Journal of Nutrition 134: 1181-1185.
Alfieri, M.A.H. and Pomerleau, J., 1995. Fibre intake of normal weight, moderately obese and severely obese subjects. Obesity3: 541-547.
Anderson, J.W. and Siesel, A.E., 1990. Hypocholesterolemic effects of oat products. New developments in dietary fibre. Springer, New York, NY, USA, pp. 17-36.
AOAC International, 2016. Official methods of analysis (20th Ed.). AOAC International, Rockville, MD, USA.
Appleby, P.N. and Thorogood M., 1998. Low body mass index in non-meat eaters: the possible roles of animal fat, dietary fibre and alcohol. International Journal of Obesity 22: 454-450.
Bazzano, L.A., He, J., Ogden, L.G., Loria, C.M. and Whealton, P.K., 2003. Dietary fibre intake and reduced risk of coronary heart disease in us men and women: the national health and nutrition examination survey i epidemiologic follow-up study. Archives of Internal Medicine 163: 1897-1904.
Benjamin, J.L., Hedin, C.R., Koutsoumpas, S.C., Siew, N.G., McCarthy N.E., Hart, A.L., Kamm, M.A., Sanderson, J.D., Knight, S.C., Forbes, A., Stagg, A.J., Welan, K. and Lindsay, J.O., 2011. Randomised, double-blind, placebo-controlled trial of fructo-oligosaccharides in active crohn’s disease. Gut 60: 923-929.
Bennel, R. and Nord, C.E., 1987. Development of the faecal anaerobic microflora after caesarean section and treatment with antibiotics in newborn infants. Infection 15: 332-336.
Betz, M., Uzueta, A., Rasmussen, H., Gregoire, M., Vanderwall, C. and Witowich, G., 2015. Knowledge, use and perceptions of probiotics and prebiotics in hospitalised patients. Nutrition and Dietetics 72: 261-266.
Borruel, N., 2002. Increased mucosal tumour necrosis factor alpha production in crohn’s disease can be downregulated ex vivo by probiotic bacteria. Gut 51: 659-664.
Bourdon, I., Olson, B., Backus, R., Richter, D.B., Davis, P.A. and Schneeman, B.O., 2001. Beans, as a source of dietary fibre, increase cholecystokinin and apolipoprotein B48 response to test meals in men. The Journal of Nutrition 131: 1485-1490.
Bourdon, I., Yokoyama, W., Yokoyama, W., Davis, P., Hudson, C., Backus, R., Richter, D., Knuckles, B. and Schneeman, B.O., 1999. Postprandial lipid, glucose, insulin, and cholecystokinin responses in men fed barley pasta enriched with ?-glucan. The American Journal of Clinical Nutrition 69: 55-63.
Brighenti, F., Casiraghi M.C., Canzi, E. and Ferrari, A., 1999. Effect of consumption of a ready-to-eat breakfast cereal containing inulin on the intestinal milieu and blood lipids in healthy male volunteers. European Journal of Clinical Nutrition 53: 726-733.
Brownawell, A.M., Caers, W., Gibson, G.R., Kendall, C.W., Lewis, K.D., Ringel, Y. and Slavin, J.L., 2012. Prebiotics and the health benefits of fibre: current regulatory status, future research, and goals. Journal of Nutrition 142: 962-974.
Buchanan, R.E and Gibbons, N.E., 1974. Bergey’s manual of determinative bacteriology (8th Ed.). The Williams and Wilkens Company, Baltimore, MD, USA.
Burn, J., Gerdes, A.M., Macrae, F., Mecklin, J.P., Moeslein, G., Olschwant, S., Eccles, D., Evans, D.G., Maher, E.R., Bertario, L., Bisgaard, M.L., Dunlop, M.G., Ho, J.W.C., Hodgson, S.V., Lindblom, A., Lubinski, J., Morrison, P.J., Murday, V., Ramesar, R., Side, L. and Scott, R.J., 2011. Long-term effect of aspirin on cancer risk in carriers of hereditary colorectal cancer: an analysis from the CAPP2 randomised controlled trial. Lancet 378: 2081-2087.
Burton-Freeman, B., Davis, P.A. and Schneeman, B.O., 2002. Plasma cholecystokinin is associated with subjective measures of satiety in women. The American Journal Clinical Nutrition 76: 659-667.
Causey, J.L., Feirtag, J.M., Gallaher, D.D., Tungland, B.C. and Slavin, J.L., 2000. Effects of dietary inulin on serum lipids, blood glucose and the gastrointestinal environment in hypercholesterolemic men. Nutrition Research 20: 191-201.
Claesson, M.J., Cusack, S., O’Sullivan, O., Greene-Diniz, R., Weerd, H.D., Flannery, E., Marchesi, J.R., Falush, D., Dinan, T., Fitzgerald, G., Stanton, C., Sinderen, D.V., O’Connor, M., Harnedy, N., O’Connor, K., Henry, C., O’Mahony, D., Fitzgerald, A.P., Shannahan, F., Twomey, C., Hill, C., Ross., P.R. and O’Toole, P.W., 2011. Composition, variability, and temporal stability of the intestinal microbiota of the elderly. Proceedings of the National Academy of Sciences of the United States of America 108: 4586-4591.
Clark, M.J., Robien, K. and Slavin, J.L., 2012. Effect of prebiotics on biomarkers of colorectal cancer in humans: a systematic review. Nutrition Reviews 70: 436-443.
Collado, M.C., Isolauri, E., Laitinen, K. and Salminen, S., 2008. Distinct composition of gut microbiota during pregnancy in overweight and normal-weight women. The America Journal of Clinical Nutrition 88: 894-899.
Costello, E.K., Carlisle, E.M., Bik, E.M., Morowitz, M.J. and Relman, D.A., 2013. Microbiome assembly across multiple body sites in low-birthweight infants. mBio 4: e00782-13.
Degnan, F.H., 2008. The US food and drug administration and probiotics: regulatory categorization. Clinical Infectious Diseases 46: S133-S136.
Dronamraju, S.S., Coxhead, J.M., Kelly, S.B., Burn, J. and Mathers, J.C., 2009. Cell kinetics and gene expression changes in colorectal cancer patients given resistant starch: a randomised controlled trial. Gut 58: 413-420.
EUR-Lex, 2012. Commission Regulation (EU) No. 432/2012 of 16 May 2012 establishing a list of permitted health claims made on foods, other than those referring to the reduction of disease risk and to children’s development and health text with EEA relevance. Official Journal of the European Union L136: 1-40.
EUR-Lex, 2014. Sugar beet EU Commission Regulation. Official Journal of the European Union L14: 8-10.
European Food Safety Authority (EFSA), 2015. Scientific opinion on the substantiation of a health claim related to ‘native chicory inulin’ and maintenance of normal defecation by increasing stool frequency pursuant to Article 13.5 of Regulation (EC) No 1924/2006. EFSA, Parma, Italy. Available at:
Evans, C.E.L., Greenwood, D.C., Threapleton, D.E., Cleghorn, C.L., Nykjaer, C., Woodhead, C.E., Gale, C.P. and Burley, V., 2015. Effects of dietary fibre type on blood pressure: a systematic review and meta-analysis of randomized controlled trials of healthy individuals. Journal of Hypertension 33: 897-911.
Favier, C.F., Vaughan, E.E., Vos, W.M.D. and Akkermans, A.D.L., 2002. Molecular monitoring of succession of bacterial communities in human neonates. Applied and Environmental Microbiology 68: 219-226.
Finegold, S.M., Attebery, H.R., Sutter, V.L., 1974. Effect of diet on human fecal flora: comparison of Japanese and American diets. The American Journal of Clinical Nutrition 27: 1456-1469.
Finegold, S.M., Flora, D.J., Attebery, H.R. and Sutter, V.L., 1975. Fecal bacteriology of colonic polyp patients and control patients. Cancer Research 35: 3407-3417.
Food and Drug Administration (FDA), 2002. Food labeling: health claims; soluble dietary fibre from certain foods and coronary heart disease. Interim final rule, Federal Register. FDA, Silver Spring, MD, USA. Available at:
Food and Drug Administration (FDA), 2003. Food labeling: health claims; soluble dietary fibre from certain foods and coronary heart disease. Final rule. Federal Register. FDA, Silver Spring, MD, USA. Available at:
Food and Drug Administration (FDA), 2013. Guidance for industry: a food labeling guide. FDA, Silver Spring, MD, USA. Available at:
Food and Drug Administration (FDA), 2014. Food labeling: revision of the nutrition and supplements facts labels; proposed rule. Federal Register 79(41): 11880-11987. Available at:
Gades, M.D. and Stern, J.S., 2003. Chitosan supplementation and fecal fat excretion in men. Obesity 11: 683-688.
Gendron, R., Grenier, D. and Maheu-Robert, L.F., 2000. The oral cavity as a reservoir of bacterial pathogens for focal infections. Microbes and Infection 2: 897-906.
Ghouri, Y.A., Richards, D.M., Rahimi, E.F., Krill, J.T., Jelinek, K.A. and DuPont, A.W., 2014. Systematic review of randomized controlled trials of probiotics, prebiotics, and synbiotics in inflammatory bowel disease. Clinical and Experimental Gastroenterology 7: 473-487.
Gibson, G.R. and Roberfroid, M.B., 1995. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. The Journal of Nutrition 125: 1401-1412.
Gibson, G.R., Probert, H.M., Loo, J.V., Rastall, R.A. and Roberfroid, M.B., 2004. Dietary modulation of the human colonic microbiota: updating the concept of prebiotics. Nutrition Research Reviews 17: 259-275.
Gibson, G.R., Scott, K.P., Rastall, R.A., Tuohy, K.M., Hotchkiss, A., Dubert-Ferrandon, A., Gareau, M., Murphy, E.F., Saulnier, D., Loh, G., Macfarlane, S., Delzenne, N., Ringel, Y., Kozianowski, G., Dickmann, R., Lenoir-Wijnkoop, I., Walker, C. and Buddington, R., 2010. Dietary prebiotics: current status and new definition. Food Science and TechnologyBulletin: Functional Foods 7: 1-19.
Gill, H. and Prasad, J., 2008. Bioactive components of milk. Advances in experimental medicine and biology 606: 423-454.
Goldin, B.R., 1998. Health benefits of probiotics. The British Journal of Nutrition 80: S203-S207.
Gorkon, B.A.P., Karrenbeld, A., Sluis, T.V.D., Zwart, N., Meer, R.V.D., Vries, E.G.E. and Kleibeuker, J.H., 2002. Calcium or resistant starch does not affect colonic epithelial cell proliferation throughout the colon in adenoma patients: a randomized controlled trial. Nutrition and Cancer 41: 31-38.
Grubben, M.J.A.L., Braak, C.C.M., Essenberg, M., Olthof, M., Tangerman, A., Katan, M.B. and Nagengast, F.M., 2001. Effect of resistant starch on potential biomarkers for colonic cancer risk in patients with colonic adenomas. Digestive Diseases and Sciences 46: 750-756.
Guo, Z., Liu, X.M., Zhang, Q.X., Shen, Z., Tian, F.W., Zhang, H., Sun, Z.H., Zhang, H.P. and Chen, W., 2011. Influence of consumption of probiotics on the plasma lipid profile: a meta-analysis of randomised controlled trials. Nutrition, Metabolism, and Cardiovascular Diseases21: 844-850.
Hall, M.A., Cole, C.B., Smith, S.L., Fuller, R. and Rolles, C.J., 1990. Factors influencing the presence of faecal lactobacilli in early infancy. Archives of Disease in Childhood 65: 185-188.
Hällström, M., Eerola, E., Vuento, R., Janas., M. and Tammela, O., 2004. Effects of mode of delivery and necrotising enterocolitis on the intestinal microflora in preterm infants. European Journal of Clinical Microbiology and Infectious Diseases 23: 463-470.
Hansen, J., Gulati, A. and Sartor, R.B., 2010. The role of mucosal immunity and host genetics in defining intestinal commensal bacteria. Current Opinion in Gastroenterology 26: 564-571.
Hauner, H., Bechthold, A., Boeing, H., Bronstrup, A., Buyken, A., Leschik-Bonnet, E., Linseisen, J., Schulze, M., Strohm, D. and Wolfram, G., 2012. Evidence-based guideline of the German nutrition society: carbohydrate intake and prevention of nutrition-related diseases. Annals of Nutrition and Metabolism 60: 1-58.
Health Canada, 2009a. Accepted claims about the nature of probiotic microorganisms in food – food labelling. Health Canada, Ottawa, Ontario, Canada. Available at:
Health Canada, 2009b. Guidance document: the use of probiotic microorganisms in food. Health Canada, Ottawa, Ontario, Canada. Available at:
Heaton, K.W., 1973. Food fibre as an obstacle to energy intake. Lancet 302: 1418-1421.
Hempel, S., Newberry, S.J., Maher, A.R., Wang, Z., Miles, J.N.V., Shamman, R., Johnsen B. and Shekelle, P.G., 2012. Probiotics for the prevention and treatment of antibiotic-associated diarrhea: a systematic review and meta-analysis. Journal of the American Medical Association 307: 1959-1969.
Hentges, D.J., 2012. Human intestinal microflora in health and disease. Academic Press, New York, NY, USA.
Hill, C., Guarner, F., Reid, G., Gibson, G.R., Merenstein, D.J., Pot, B., Morelli, L., Canani, R.B., Flint, H.J., Salminen, S., Calder, P.C. and Sanders., M.E., 2014. Expert consensus document: the international scientific association for probiotics and prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature reviews. Gastroenterology and Hepatology 11: 506-514.
Holdeman, L.V., Good, I.J. and Moore, W.E., 1976. Human fecal flora: variation in bacterial composition within individuals and a possible effect of emotional stress. Applied and Environmental Microbiology 31: 359-375.
Holscher, H.D., Caporaso, J.G., Hooda, S., Brulc, J.M., Fahey Jr., G.C. and Swanson, K.S., 2015. Fibre supplementation influences phylogenetic structure and functional capacity of the human intestinal microbiome: follow-up of a randomized controlled trial. American Journal of Clinical Nutrition 101: 55-64.
Holt, S.H.A., Brand-Miller, J.C. and Stitt, P.A., 2001. The effects of equal-energy portions of different breads on blood glucose levels, feelings of fullness and subsequent food intake. Journal of the American Dietetic Association 101: 767-773.
Holzapfel, W.H., Haberer, P., Snel, J., Schillinger, U. and Veld, J.H.S.H., 1998. Overview of gut flora and probiotics. International Journal of Food Microbiology 41: 85-101.
Hopkins, M.J., Macfarlane, S, Furrie, E. and Fite, A., 2005. Characterisation of intestinal bacteria in infant stools using real-time PCR and northern hybridisation analyses. FEMS Microbiology Ecology 54: 77-85.
Hopping, B.N., Erber, E., Grandinetti, A., Verheus, M., Kolonel, L.N. and Maskarinec, G., 2010. Dietary fibre, magnesium, and glycemic load alter risk of type 2 diabetes in a multiethnic cohort in Hawaii. Journal of Nutrition 140: 68-74.
Hoveyda, N., Heneghan C., Mahtani, K.R., Perera, R., Roberts, N. and Glasziou, P., 2009. A systematic review and meta-analysis: probiotics in the treatment of irritable bowel syndrome. BMC Gastroenterology 9: 1-11.
Hutkins, R.W., Krumbeck, J.A., Bindels, L.B., Cani, P.D., Fahey Jr., G.F., Goh, Y.G., Hamaker, B., Martens, E.C., Mills, D.A., Rastal, R.A., Vaughan, E. and Sanders, M.E., 2016. Prebiotics: why definitions matter. Current Opinion in Biotechnology 37: 1-7.
Institute of Medicine (IOM), 2005. Dietary reference intakes for energy, carbohydrate, fibre, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients). The National Academies Press, Washington, DC, USA. Available at:
Institute of Medicine (IOM), 2006a. Ending the war metaphor: the changing agenda for unraveling the host-microbe relationship: workshop summary. National Academies Press, Washington, DC, USA. Available at:
Institute of Medicine (IOM), 2006b. Manipulating host-microbe interactions: probiotic research and regulations. The National Academies Press, Washington, DC, USA. Available at:
Iso, H., Date, C., Noda, H., Yoshimura, T. and Tamakoshi, A., 2005. Frequency of food intake and estimated nutrient intake among men and women: the JACC study. Journal of Epidemiology 15: 24-42.
Jones, J.M., 2014. CODEX-aligned dietary fibre definitions help to bridge the ‘fibre gap’. Nutrition Journal 13: 1-10.
Joossens, M., Huys, G., Cnockaert, M., Preter, V.D., Verbeke, K., Rutgeerts, P., Vandamme, P. and Vermeire, S., 2011. Dysbiosis of the faecal microbiota in patients with crohn’s disease and their unaffected relatives. Gut 60: 631-637.
Kalliomäki, M., Collado, M.C., Salminen, S., Isolauri, E., 2008. Early differences in fecal microbiota composition in children may predict overweight. American Journal of Clinical Nutrition 87: 534-538.
Kalliomäki, M., Kirjavainen, P., Eerola, E., Kero, P., Salminen, S. and Isolauri, E., 2001. Distinct patterns of neonatal gut microflora in infants in whom atopy was and was not developing. Journal of Allergy and Clinical Immunology 107: 129-134.
King, D.E., Egan, B.M., Woolson, R.F., Mainous, A.G., Al-Solaiman, Y. and Jesri, A., 2007. Effect of a high-fibre diet vs a fibre-supplemented diet on C-reactive protein level. Archives of Internal Medicine 167: 502-506.
King, D.E., Mainous, A.G. and Lambourne, C.A., 2012. Trends in dietary fibre intake in the United States, 1999-2008. Journal of the Academy of Nutrition and Dietetics 112: 642-648.
Kinross, J.M., Darzi, A.W. and Nicholson, J.K., 2011. Gut microbiome-host interactions in health and disease. Genome Medicine 3: 1-12.
Kumar, H., Salminen, S., Verhagen, H., Rowland, I., Heimbach, J., Banares, S., Young, T., Nomoto, K. and Lalonde, M., 2015. Novel probiotics and prebiotics: road to the market. Current Opinion in Biotechnology 32: 99-103.
Lahti-Koski, M., Pietinen, P., Heliövaara, M. and Vartiainen, E., 2002. Associations of body mass index and obesity with physical activity, food choices, alcohol intake, and smoking in the 1982-1997 FINRISK Studies. The American journal of clinical nutrition 75: 809-817.
Langlands, S. J., Hopkins, M.J., Coleman, N. and Cummings, J.H., 2004. ‘Prebiotic Carbohydrates modify the mucosa associated microflora of the human large bowel.’ Gut 53: 1610-1616.
Limburg, P.J., Mahoney, M.R., Ziegler, K.L.A., Sontag, S.J., Schoen, R.E., Benya, R., Lawson, M.J., Weinberg, D.S., Stoffel, E., Chiorean, M., Heigh, R., Levine, J., DellaZanna, G., Rodriguez, L., Richmond, E., Gostout, C., Mandrekar, S.J. and Smyrk, T.C., 2011. Randomized phase II trial of sulindac, atorvastatin, and prebiotic dietary fibre for colorectal cancer chemoprevention. Cancer Prevention Research4: 259-269.
Loo, J.V., Coussement, P., Leenheer, L.D., Hoebregs, H. and Smits, G., 1995. On the presence of inulin and oligofructose as natural ingredients in the western diet. Critical Reviews in Food Science and Nutrition 35: 525-552.
Loveren, H.V., Sanz, Y. and Salminen, S., 2012. Health claims in Europe: probiotics and prebiotics as case examples. Annual Review of Food Science and Technology 3: 247-261.
Ludwig, D.S., Pereira, M.A., Kroenke, C.H., Hilner, J.E., Horn, L.V., Slattery, M.L. and Jacobs, D.R., 1999. Dietary fibre, weight gain, and cardiovascular disease risk factors in young adults. Journal of the American Medical Association 282: 1539-1546.
Ma, Y., Griffith, J.A., Chasan-Taber, L., Olendzki, B.C., Jackson, E., Stanek, E.J., Li, W., Pagoto, S.L., Hafner, A.R. and Ockene, I.S., 2006. Association between dietary fibre and serum C-reactive protein. American Journal of Clinical Nutrition 83: 760-766.
Maslowski, K.M. and Mackay, C.R., 2011. Diet, gut microbiota and immune responses. Nature Immunology 12: 5-9.
Maslowski, K.M., Vieira, A.T., Ng, A., Kranich, J., Sierro, F., Yu, D., Schilter, H.C., Rolph, M.S., Fabienne, M., Artis, D., Xavier, R.J., Teixeira, M.M. and Mackay, C.R., 2009. Regulation of inflammatory responses by gut microbiota and chemoattractant receptor GPR43. Nature 461: 1282-1286.
Mathern, J.R., Raatz, S.K., Thomas, W. and Slavin, J.L., 2009. Effect of fenugreek fibre on satiety, blood glucose and insulin response and energy intake in obese subjects. Phytotherapy Research 23: 1543-1548.
McFarland, L.V., 2006. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. American Journal of Gastroenterology 101: 812-822.
McFarland, L.V., 2007. Meta-analysis of probiotics for the prevention of traveler’s diarrhea. Travel Medicine and Infectious Disease 5: 97-105.
Meyer, K.A., Kushi, L.H., Jacobs, D.R., Slavin, J., Sellers, T.A. and Folsom, A.R., 2000. Carbohydrates, dietary fibre, and incident type 2 diabetes in older women. American Journal of Clinical Nutrition 71: 921-930.
Miller, W.C., Niederpruem, M.G., Wallace, J.P. and Lendeman, A.K., 1994. Dietary fat, sugar, and fibre predict body fat content. Journal of the American Dietetic Association 94: 612-615.
Moayyedi, P., Ford, A.C., Talley, N.J., Cremonini, F., Foxx-Orenstein, A.E., Brandt, L.J. and Quigley, E.M.M., 2010. The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut 59: 325-332.
Moore, W.E.C. and Moore, L.V.H., 1994. The bacteria of periodontal diseases. Periodontology2000(5): 66-77.
Moshfegh, A.J., Friday, J.E., Goldman, J.P., Ahuja, J.K.C., 1999. Presence of Inulin and Oligofructose in the diets of Americans. Journal of Nutrition 129: S1407-S1411.
Mullie, P., Guelinckx, I., Clarys, P., Degrave, E., Hulens, M. and Vansant, G., 2009. Cultural, socioeconomic and nutritional determinants of functional food consumption patterns. European Journal of Clinical Nutrition 63: 1290-1296.
Nelson, L.H. and Tucker, L.A., 1996. Diet composition related to body fat in a multivariate study of 203 men. Journal of the American Dietetic Association 96: 771-777.
Neut, C., Bezirtzoglou, E., Romond, C., Beerens, H., Delcroix, M. and Noel, A.M., 1987. Bacterial colonization of the large intestine in newborns delivered by cesarean section. Zentralblatt für Bakteriologie, Mikrobiologie und Hygiene. Series A: Medical Microbiology, Infectious Diseases, Virology, Parasitology 266: 330-337.
Nicholson, J.K., Elaine, H., Kinross, J., Burcelin, R., Gibson, G., Jia, W. and Pettersson, S., 2012. Host-gut microbiota metabolic interactions. Science 336: 1262-1267.
Nikfar, S, Rahimi, R., Rahimi, F., Derakhshani, S. and Abdollahi, M., 2008. Efficacy of probiotics in irritable bowel syndrome: a meta-analysis of randomized, controlled trials. Diseases of the Colon and Rectum 51: 1775-1780.
Nilsson, A.C., Johansson-Boll, E.V. and Bjorck, M,E., 2015. Increased gut hormones and insulin sensitivity index following a 3-D intervention with a Barley Kernel-Based product: a randomised cross-over study in healthy middle-aged subjects. British Journal of Nutrition 114: 899-907.
Ning, H., Horn, L.V., Shay, C.M. and Lloyd-Jones, D.M., 2014. Associations of dietary fibre intake with long-term predicted cardiovascular disease risk and C-reactive protein levels (from the national health and nutrition examination survey data (2005-2010)). American Journal of Cardiology 113: 287-291.
Oliver, L., Rasmussen, H., Gregoire, M.B. and Chen, Y., 2014. Health care provider’s knowledge, perceptions, and use of probiotics and prebiotics. Topics in Clinical Nutrition 29: 139-149.
Olsen, G.J., Lane, D.J., Giovannoni, S.J. and Pace, N.R., 2003. Microbial ecology and evolution: a ribosomal RNA approach. Annual Reviews in Microbiology 40: 337-365.
Ooi, L.G. and Liong, M.T., 2010. Cholesterol-lowering effects of probiotics and prebiotics: a review of in vivo and in vitro findings. International Journal of Molecular Sciences 11: 2499-2522.
Orrhage, K. and Nord, C.E., 2007. Factors controlling the bacterial colonization of the intestine in breastfed infants. Acta Paediatrica 88: 47-57.
Ozen, A.E., Pons, A. and Tur, J.A., 2012. Worldwide consumption of functional foods: a systematic review. Nutrition Reviews 70: 472-481.
Palmer, C., Bik, E.M., DiGiulio, D.B., Relman, D.A. and Brown, P.O., 2007. Development of the human infant intestinal microbiota. PLoS Biology 5: 1556-1573.
Penders, J., Thijs, C., Vink, C., Stelma, F.F., Snijders, B., Kummeling, I., Brandt, P.A. and Stobberingh, E.E., 2006. Factors influencing the composition of the intestinal microbiota in early infancy. Pediatrics 118: 511-521.
Pereira, M.A. and Ludwig, D.S., 2001. Dietary fibre and body-weight regulation: observations and mechanisms. Pediatric Clinics of North America 48: 969-980.
Picard, C., Fioramonti, J., Francois, A., Robinson, T., Neant, F. and Matuchansky, C., 2005. Bifidobacteria as probiotic agents – physiological effects and clinical benefits. Alimentary Pharmacology and Therapeutics 22: 495-512.
Pineiro, M., Asp, G.N., Reid, G., Macfarlane, S., Morelli, L., Brunser, O. and Tuohy, K., 2008. FAO technical meeting on prebiotics. Journal of Clinical Gastroenterology 42: 156-159.
Roncucci, L., Donato, P.D., Carati, L., Ferrari, A., Perini, M., Bertoni, G., Bedogni, G., Paris, B., Svanoni, F., Girola, M. and Lean, M.P., 1993. Antioxidant vitamins or lactulose for the prevention of the recurrence of colorectal adenomas. Diseases of the Colon and Rectum 36: 227-234.
Salminen, S., Bouley, C., Boutron, M.C., Cummings, J.H., Franck, A., Gibson, G.R., Isolari, E., Moreau, M.C., Roberfroid, M. and Rowland, I., 2007. Functional food science and gastrointestinal physiology and function. British Journal of Nutrition 80: S147-S171.
Salminen, S., Ramos, P., Fonden, R. and Wright, A.V., 1993. Substrates and lactic acid bacteria. Lactic Acid Bacteria 1: 295-306.
Salyers, A.A., 1979. Energy sources of major intestinal fermentative anaerobes. American Journal of Clinical Nutrition 32: 158-163.
Sanders, M.E., Wijnkoop, I.L., Salminen, S., Merenstein, D.J., Gibson, G.R., Petschow, B.W., Nieuwdrop, M., Tancredi, D.J., Cifelli, C.J., Jacques, P. and Pot, B., 2014. Probiotics and prebiotics: prospects for public health and nutritional recommendations. Annals of the New York Academy of Sciences 1309: 19-29.
Sankar, S.A., Lagier, J.-C., Pontarotti, P., Raoult, D. and Fournier, P.-E., 2015. The human gut microbiome, a taxonomic conundrum. Systematic and applied microbiology 38: 276-286.
Santacruz, A., Collado, M.C., Valdes, L.G., Segura, M.T., Lagos, J.A.M., Anjos, T., Romero, M.M., Lopez, R.M., Florido, J., Campoy, C. and Sanz, Y., 2010. Gut microbiota composition is associated with body weight, weight gain and biochemical parameters in pregnant women. British Journal of Nutrition 104: 83-92.
Schulze, M.B., Liu, S., Rimm, E.B., Manson, J.E., Willett, W.C. and Hu, F,B., 2004. Glycemic index, glycemic load, and dietary fibre intake and incidence of type 2 diabetes in younger and middle-aged women. American Journal of Clinical Nutrition 80: 348-356.
Schwiertz, A., Taras, D., Schafer, K., Beijer, S., Bos, N.A., Donus, C. and Hardt, P.D., 2010. Microbiota and SCFA in lean and overweight healthy subjects. Obesity 18: 190-195.
.Sjögren, Y.M., Jenmalm, M.C., Bottcher, M.F., Bjorksten, B. and Ekstrom, E.S., 2009. Altered early infant gut microbiota in children developing allergy up to 5 years of age. Clinical and Experimental Allergy 39: 518-526.
Slavin, J.L., 2008 Position of the American Dietetic Association: health implications of dietary fiber. Journal of the American Dietetic Association108: 1716-1731.
Slavin, J., 2013. Fibre and prebiotics: mechanisms and health benefits. Nutrients 5: 1417-1435.
Slavin, J.L., 2005. Dietary fibre and body weight. Nutrition 21: 411-418.
Smug, L.N., Salminen, S., Sanders, M.E. and Ebner, S., 2014. Yoghurt and probiotic bacteria in dietary guidelines of the member states of the European Union. Beneficial Microbes 5: 61-66.
Stark, P.L. and Lee, A., 1982. The microbial ecology of the large bowel of breast-fed and formula-fed infants during the first year of life. Journal of Medical Microbiology 15: 189-203.
Streppel, M.T., Arends, L.R., Veer, P.V. and Grobbee, D.E., 2005. Dietary fibre and blood pressure: a meta-analysis of randomized placebo-controlled trials. Archives of Internal Medicine 165: 150-156.
Sunkata, R., Herring, J., Walkter, L.T. and Verghese, M., 2014. Chemopreventive potential of probiotics and prebiotics. 5: 1800-1809.
Tap, J., Mondot, S., Levenez, F., Pelletier, E., Caron, C., Furet, J.P., Ugarte, E., Tamayo, R.M., Paslier, D.L.E., Nalin, R., Dore, J. and Leclerc, M., 2009. Towards the human intestinal microbiota phylogenetic core. Environmental Microbiology 11: 2574-2584.
Threapleton, D.E., Greenwood, D.C., Evans, C.E.L., Cleghorn, C.L., Nykjaer, C., Woodhead, C., Cade, J.E., Gale, C.P. and Burley, V.J., 2013. Dietary fibre intake and risk of first stroke: a systematic review and meta-analysis. Stroke 44: 1360-1368.
Tosh, S.M., 2013. Review of human studies investigating the post-prandial blood-glucose lowering ability of oat and barley food products. European Journal of Clinical Nutrition 67: 310-317.
Tseng, C.C., Kieffer, T.J., Jarboe, L.A., Usdin, T.B., Wolfe, M.M., 1996. Postprandial stimulation of insulin release by glucose-dependent insulinotropic polypeptide (gip). effect of a specific glucose-dependent insulinotropic polypeptide. Journal of Clinical Investigation 99: 2440-2445.
United States Department of Agriculture (USDA), 2015. Scientific report of the 2015 dietary guidelines advisory committee. USDA, Washinton, DC, USA. Available at:
Van Dijk, G. and Thiele, T.E., 1999. Glucagon-like peptide-1 (7-36) amide: a central regulator of satiety and interoceptive stress. Neuropeptides 33: 406-414.
Wacker, M., Wanek, P., Eder, E., Hylla, S., Gostner, A. and Scheppach, W., 2002. Effect of enzyme-resistant starch on formation of 1,N(2)-propanodeoxyguanosine adducts of trans-4-hydroxy-2-nonenal and cell proliferation in the colonic mucosa of healthy volunteers. Cancer Epidemiology, Biomarkers and Prevention11: 915-920.
Welters, C.F.M., Heineman, E., Thunnissen, F.B.J.M., Boogard, A.E.J.M., Soeters, P.B. and Baeten, C.G.M.I., 2002. Effect of dietary inulin supplementation on inflammation of pouch mucosa in patients with an ileal pouch-anal anastomosis. Diseases of the Colon and Rectum 45: 621-627.
Whelton, S.P., Hyre, A.D., Pedersen, B., Yi, Y., Weaton, P.K. and He, J., 2005. Effect of dietary fibre intake on blood pressure: a meta-analysis of randomized, controlled clinical trials. Journal of Hypertension 23: 475-481.
Worthley, D.L., Keu, R.K.L., Whitehall, V.L., Conlon, M., Christophersen, C., Belobrajdic, D., Mallitt, K.A., Hu, Y., Irahara, N., Ogino, S., Leggett, B.A. and Young, G.P., 2009. A human, double-blind, placebo-controlled, crossover trial of prebiotic, probiotic, and synbiotic supplementation: effects on luminal, inflammatory, epigenetic, and epithelial biomarkers of colorectal cancer. American Journal of Clinical Nutrition 90: 578-586.
Wu, G.D., Chen, J., Hoffmann, C., Bittinger, K., Chen, Y.Y., Keilbaugh, S.A., Bewtra, M., Knights, D., Walters, W., Knight, R., Sinha, R., Gilroy, E., Gupta, K., Baldassano, R., Nessel, L., Li, H., Bushman, F.D. and Lewis, J.D., 2011. Linking long-term dietary patterns with gut microbial enterotypes. Science334: 105-108.
Yatsunenko, T., Rey, F.E., Manary, M.J., Trehan, I., Dominguez-Bello, M.G., Contreras, M., Magris, M., Hidalgo, G., Baldassano, R.N., Anokhin, A.P., Heath., A.C., Warner, B, Reeder, J., Kuczynski, J., Caporaso, J.G., Lozupone, C.A., Lauber, C., Clementa, J.C., Knights, D., Knight, R. and Gordon, J.I., 2012. Human gut microbiome viewed across age and geography. Nature 486: 222-227.
Yin, Y.N., Yu, Q.F., Fu, N., Liu, X.W. and Lu, F.G., 2010. Effects of four bifidobacteria on obesity in high-fat diet induced rats. World Journal of Gastroenterology16: 3394-3401.