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Low-Dose Lactulose as a Prebiotic for Improved Gut Health and Enhanced Mineral Absorption

Although medium and high doses of lactulose are used routinely for the treatment of constipation and hepatic encephalopathy, respectively, a wealth of evidence demonstrates that, at low doses, lactulose can also be used as a prebiotic to stimulate the growth of health-promoting bacteria in the gastr...

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Autores principales: Karakan, Tarkan, Tuohy, Kieran Michael, Janssen-van Solingen, Gwendolyn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8353095/
https://www.ncbi.nlm.nih.gov/pubmed/34386514
http://dx.doi.org/10.3389/fnut.2021.672925
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author Karakan, Tarkan
Tuohy, Kieran Michael
Janssen-van Solingen, Gwendolyn
author_facet Karakan, Tarkan
Tuohy, Kieran Michael
Janssen-van Solingen, Gwendolyn
author_sort Karakan, Tarkan
collection PubMed
description Although medium and high doses of lactulose are used routinely for the treatment of constipation and hepatic encephalopathy, respectively, a wealth of evidence demonstrates that, at low doses, lactulose can also be used as a prebiotic to stimulate the growth of health-promoting bacteria in the gastrointestinal tract. Indeed, multiple preclinical and clinical studies have shown that low doses of lactulose enhance the proliferation of health-promoting gut bacteria (e.g., Bifidobacterium and Lactobacillus spp.) and increase the production of beneficial metabolites [e.g., short-chain fatty acids (SCFAs)], while inhibiting the growth of potentially pathogenic bacteria (e.g., certain clostridia). SCFAs produced upon microbial fermentation of lactulose, the most abundant of which is acetate, are likely to contribute to immune regulation, which is important not only within the gut itself, but also systemically and for bone health. Low-dose lactulose has also been shown to enhance the absorption of minerals such as calcium and magnesium from the gut, an effect which may have important implications for bone health. This review provides an overview of the preclinical and clinical evidence published to date showing that low-dose lactulose stimulates the growth of health-promoting gut bacteria, inhibits the growth of pathogenic bacteria, increases the production of beneficial metabolites, improves mineral absorption, and has good overall tolerability. Implications of these data for the use of lactulose as a prebiotic are also discussed.
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spelling pubmed-83530952021-08-11 Low-Dose Lactulose as a Prebiotic for Improved Gut Health and Enhanced Mineral Absorption Karakan, Tarkan Tuohy, Kieran Michael Janssen-van Solingen, Gwendolyn Front Nutr Nutrition Although medium and high doses of lactulose are used routinely for the treatment of constipation and hepatic encephalopathy, respectively, a wealth of evidence demonstrates that, at low doses, lactulose can also be used as a prebiotic to stimulate the growth of health-promoting bacteria in the gastrointestinal tract. Indeed, multiple preclinical and clinical studies have shown that low doses of lactulose enhance the proliferation of health-promoting gut bacteria (e.g., Bifidobacterium and Lactobacillus spp.) and increase the production of beneficial metabolites [e.g., short-chain fatty acids (SCFAs)], while inhibiting the growth of potentially pathogenic bacteria (e.g., certain clostridia). SCFAs produced upon microbial fermentation of lactulose, the most abundant of which is acetate, are likely to contribute to immune regulation, which is important not only within the gut itself, but also systemically and for bone health. Low-dose lactulose has also been shown to enhance the absorption of minerals such as calcium and magnesium from the gut, an effect which may have important implications for bone health. This review provides an overview of the preclinical and clinical evidence published to date showing that low-dose lactulose stimulates the growth of health-promoting gut bacteria, inhibits the growth of pathogenic bacteria, increases the production of beneficial metabolites, improves mineral absorption, and has good overall tolerability. Implications of these data for the use of lactulose as a prebiotic are also discussed. Frontiers Media S.A. 2021-07-27 /pmc/articles/PMC8353095/ /pubmed/34386514 http://dx.doi.org/10.3389/fnut.2021.672925 Text en Copyright © 2021 Karakan, Tuohy and Janssen-van Solingen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Nutrition
Karakan, Tarkan
Tuohy, Kieran Michael
Janssen-van Solingen, Gwendolyn
Low-Dose Lactulose as a Prebiotic for Improved Gut Health and Enhanced Mineral Absorption
title Low-Dose Lactulose as a Prebiotic for Improved Gut Health and Enhanced Mineral Absorption
title_full Low-Dose Lactulose as a Prebiotic for Improved Gut Health and Enhanced Mineral Absorption
title_fullStr Low-Dose Lactulose as a Prebiotic for Improved Gut Health and Enhanced Mineral Absorption
title_full_unstemmed Low-Dose Lactulose as a Prebiotic for Improved Gut Health and Enhanced Mineral Absorption
title_short Low-Dose Lactulose as a Prebiotic for Improved Gut Health and Enhanced Mineral Absorption
title_sort low-dose lactulose as a prebiotic for improved gut health and enhanced mineral absorption
topic Nutrition
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8353095/
https://www.ncbi.nlm.nih.gov/pubmed/34386514
http://dx.doi.org/10.3389/fnut.2021.672925
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