HEALTH CLAIM RELATED TO ‘NON-DIGESTIBLE

OLIGO-AND POLYSACCHARIDES INCLUDING

GALACTO-OLIGOSACCHARIDES,

OLIGOFRUCTOSE, POLYFRUCTOSE AND

INULIN’ AND ‘INCERASE IN CALCIUM

ABSORPTION’.Mamata Bhattarai

Bobby Antan CaiquoMichael Amoafo Mensah

Health claim request• Food constituents- Non digestible oligosaccharides and

polysaccharides including galacto-oligosaccharides, oligofructose, polyfructose and inulin • Health claim- Increase in Ca absorption• Target population- infants (from birth onwards) and young

children (up to three years of age)• Food- infant and follow on formula and processed cereal based

food

Reasons for refusal of application• Food ingredients not sufficiently characterized• Cause and effect relationship could not be established

between consumption and beneficial health effect

Health claim • According to EU regulation, 1924/2006, a health claim is any

claim that suggests or implies that a relationship exists between food category, a food or one of its constituents and health.• Consumption of food category, a food or one of its constituents

would lead to• Improve heath and well being• Reduction of diseases• Child development and health

Claim requirements by EU directive• Possible to add other substances, which have particular

nutritional purpose in infant and follow-on formula and cereal based processed foods for younger children up to 3 years.

Directive 2006/141/EC

What are prebiotics?

Prebiotics (contd..)• Non-digestible oligosaccharides (NDOs)- low molecular weight

carbohydrates- immediate in nature between simple sugars and polysaccharides• Can be made of one, two or even three different types of

monosaccharide units• Most investigated substances compared to probiotics and

synbiotics

Non-digestible carbohydrates• Galactooligosaccharides (GOS), or Trans-

galactooligosaccharides (TOS)• Oligosaccharides composed of galactose units, • DP ≤10, an average DP of 2-6. • Preferably, GOS contains at least 2/3 galactose units

• ‘Fructooligosaccharide, or oligofructose’• Soluble dietary fiber comprising a chain of β linked fructose units• Degree of polymerisation ≤ 10 • Also used as alternative sweetner

• Inulin and polyfructose• Glucose-terminated fructose chains with at least 90%-95% having DP≥10• Industrially, it is mostly extracted from chicory

Factors affecting Ca absorption and bioavailability

• Effective calcium absorption- active and passive diffusion in intestine• Presence of SCFAs is prerequisite for stimulation of Ca absorption

in human (Trinidad et al., 1993) • Many minerals like Ca chelated by pectin from fiber components

are freed in colon• Cell membranes have lower permeability to high charged ions like

calcium• Organic acids like SCFAs form charged mineral complexes which

helps in passive diffusion of these complexes

In his study, addition of SCFA enhanced the Ca absorption in distal colon in 6 healthy males

Mechanisms of Ca absorption - enhanced by prebiotics

• Increased solubility of minerals due to bacterial production of SCFAs• Enlargement of absorption surface by promoting proliferation of

enterocytes mediated by bacterial fermentation products• Degradation of mineral complexing phytic acid• Increased expression of calcium-binding proteins• Release of bone-modulating factors such as phytoestrogens from

foods• Stabilization of intestinal flora and ecology• Stabilization of intestinal mucus and impact of growth modulating

factors such as polyamines

NDOs with variable DP• Synergistic effects - combination of inulin and

fructooligosaccharides (FOS) or FOS with various DP• Mixture of different chain lengths- assumed to be fermented

sequentially and thus over a wider range of large intestine and with improved efficacy (Scholz-Ahren et al., 2007).

Prebiotics in infant nutrition• Prebiotics carbohydrates have been added to infant formula in

Japan for over 20 years• 90% of infant formula in Japan are purported to contain

prebiotics.• Process of commercialization going on in Europe and US• Beneficial role of prebiotics in infants diets has been proven in

many studies.

Prebiotics role in infant nutrition• Human gut micro flora is very complex. • At birth, infants intestine are almost

sterile• Intestinal micro flora does not change

significantly after infancy. • Infants early diet and intestinal micro

flora pivotal factors in overall health and development

Prebiotics and SCFAs• Stools from breast fed infants

and formula fed infants were collected and HMOS or GOS/FOS were added and incubated for 24h.

• Short chain fatty acids were detected.

• Bifidobacteria, lactobacillus, acetic acid was stimulated in GOS (2.4g/l) formula fed 371 infants, fecal pH was decreased (Cai et al, 2008)

Production of different SCFA during in-vitro fermentation of 2 test substances, human milk oligosaccharides (HMOS) and mixture of GOS/FOS compared to control without oligosaccharides. Adapted from Boehmn et al., 2004

Prebiotics and infant health

Improved Ca absorption

Substances Amount g/d

Calcium absorption

Subject of study Comment Method References

Inulin 40 sig Young men Metabolic Balance Coudray et al, 1997

OF 15 sig12 Adolescents (14-16y)

36h urine coll. Stable isotope Van den Heuvel et al, 1999

TOS 20 sig POM (12) 36h urine coll. Stable isotope Van den Heuvel et al, 2000

OF 8 ns Girls (30) 48h urine coll. Stable isotope Griffin et al, 2002

OF+inulin 8 sig Griffin et al, 2002

Sc and lc FOS mix 8 sig Boys and girls (48) 48h urine coll. Stable isotope Abrams et al, 2005

GOS+FOS 8 sig Adolescents girls (61) 12hr fast Serum ionized Ca

Sanwalka et al, 2002

Oligofructose15

sig Adolescents male (12) 36h urine coll. Stable isotope

Ellen et al, 1999

TOS 20 sigPost

menopausal women

36h urine coll. Stable isotope Ellen et al, 2000

Results from human studies

OF-Oligofructose, TOS-Transgalacto-oligosaccharides, Sc/lc FOS- shortchain/longchain fructo-oligosaccharides

Possible reasons for inconsistent and inadequate results

• Habitual intake of NDO cannot be easily controlled in human studies• More studies have been performed in animal model,

experimental conditions difficult to control in human• Ethical reason- difficult to conduct studies in

infants/children/human• Experimental design, efficacy depends on dose, time of

administration, content of calcium in diet, age of subjects studied• Effect is specific for type of carbohydrate and calcium

absorption capacity

Conclusion• Adverse effect of NDOs and others has not been reported in

scientific literature.• Synergistic effects among different NDOs and NDOs with

different DP was observed• Literature suggesting enhancement of Ca absorption by NDOs

and polysaccharides cannot be ignored• Based on these facts, our health claim should be reconsidered

by EFSA