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A weblog on the sciences and practices of living healthily very long – perhaps hundreds of years. There is strong and widespread current interest in gut microbiota and I have found thousands of relevant research publications related to gut microbiota.  My purpose here it to introduce the topic in this blog, to establish its relevance, and to identify some recent key research findings.
Aging of a human happens in a meta-organism consisting not only of that person’s body and cells but also of the 100 trillion organisms that exist in that persons gut.
The 2009 publication Acquisition, evolution and maintenance of the normal gut microbiota reports: “The gut is sterile at birth, but is rapidly colonised by faecal and vaginal bacteria of maternal origin. From Genomic Insights into Bifidobacteria: “The human large intestine is a very complex ecosystem that is still not fully understood, and while its microbial composition consists primarily of just four bacterial phyla, Bacteroidetes, Firmicutes, Actinobacteria, and Proteobacteria (as well as some Archaea, Eukarya, and viruses), it is highly variable at the genus level between individuals, likely due to factors such as age, health, diet, etc. The 2007 publication Intestinal bacteria and ageing reported: “Advancements in science and medicine, as well as improved living standards, have led to a steady increase in life expectancy, and subsequently a rise in the elderly population.
The 2010 publication Role of the gut microbiota in defining human health reported: “The human superorganism is a conglomerate of mammalian and microbial cells, with the latter estimated to outnumber the former by ten to one and the microbial genetic repertoire (microbiome) to be approximately 100-times greater than that of the human host.
While the study of gut bacteria has been going on for more than 100 years, many new insights are now flowing from massive genomic sequencing techniques. Bifidobacteria appear to be an important set of species of gut bacteria from a health viewpoint. Gut microflora may play an even more important role in maintaining human health than previously thought.  Specifically it appears they are involved in the control of energy and metabolic homeostasis. This theme has been repeated in a substantial number of publications for over five years now. The August 2011 publication Programming of host metabolism by the gut microbiota reports: “The human gut harbors a vast ensemble of bacteria that has co-evolved with the human host and performs several important functions that affect our physiology and metabolism. The mixture of kinds of bacteria in the gut may contribute to metabolic disorders such as obesity, diabetes, and cardiovascular diseases or can contribute strongly to maintenance of health homeostasis. The November 2010 publication Ecology and Physiology of the Intestinal Tract reports: “The number of microorganisms inhabiting the human digestive tract exceeds the number of body cells by a factor of ten.
The January 2012 publication Is the gut microbiota a new factor contributing to obesity and its metabolic disorders? A discussion of the role of gut flora in autism and inflammatory bowel disease can be found on this webpage of science-autism.org which is about published scientific data concerning autism. Image from Gut Flora in Autism:  “A well considered pathway for the effect of bacterial flora on the inflammatory response of the gut wall in IBD. With advanced aging, changes typically happen in the ecology of the gut microorganism, system resulting in increased susceptibility to infectious diseases and related infirmities. On the other hand, the 2010 e-publication Human intestinal microbiota and healthy ageing review publication reports: “Earlier studies have indicated a decrease in anaerobes and bifidobacteria and a concomitant increase in enterobacteria in the intestinal microbiota with ageing. TLR and NLR signaling in intestinal epithelial cells triggered by gut microbiota contribute to a range of homeostatic mechanisms including proliferation, wound healing, epithelial integrity, and regulation of mucosal immune functions. The 2010 publication The role of innate signaling in the homeostasis of tolerance and immunity in the intestine reports: “In the intestine innate recognition of microbes is achieved through pattern recognition receptor (PRR) families expressed in immune cells and different cell lineages of the intestinal epithelium. Our old friend NF-kappaB can be activated by TLR and NOD signaling by gut microbiota, resulting in possible positive or detrimental effects. The 2010 publication Role of NF-kappaB activation in intestinal immune homeostasis reports: “Inflammatory bowel diseases (IBD) are characterised by a disturbance of intestinal immune homeostasis, either caused by or followed by inappropriate responses to the resident commensal bacteria. The May 2011 publication Influence of gastrointestinal commensal bacteria on the immune responses that mediate allergy and asthma reports: “The human intestine contains more than 100 trillion microorganisms that maintain a symbiotic relationship with the host. Raising bifidobacteria levels by the use of probiotics and prebiotics appears to be the most-established strategy for modifying microbial balance in human colons to promote health.  However, much remains to be learned. The December 2009 publication Food-based strategies to modulate the composition of the intestinal microbiota and their associated health effects reports: “The most well known food-based strategies to modulate the composition of the intestinal microbiota are the dietary use of prebiotics, probiotics and their combination, synbiotics. Prebiotics may be useful for the prevention or treatment of insulin resistance, diabetes and obesity. The 2011 publication Gut microbiota and the pathogenesis of insulin resistance reports: “Several reviews recently explored how the gut microbiota was able to control host energy metabolism, and thereby the development of adiposity. The LKM512 strain of yogurt bacteria has attracted particular attention as a probiotic for increasing polyamines levels and inhibiting inflammation. The 2009 publication Polyamine-rich food decreases age-associated pathology and mortality in aged micerelates polyamine consumption to senescence markers in mice: “The purpose of this study was to test whether oral intake of foods rich in polyamines (spermine and spermidine) suppresses age-associated pathology in aged mice.
The 2009 publication Dynamics of fecal microbiota in hospitalized elderly fed probiotic LKM512 yogurt reports: “The comprehensive dynamics of intestinal microbiota including uncultured bacteria in response to probiotic consumption have not been well studied. Some researchers think targeting the gut microbiota may be an avenue for human life extension.
While this discussion is theoretical, it does appear that life extension in mice is possible by feeding them probiotics. I was motivated to research and generate this blog entry by coming across the August 2011 publication Longevity in mice is promoted by probiotic-induced suppression of colonic senescence dependent on upregulation of gut bacterial polyamine production. This post was originally published on this siteA British woman with type 1 diabetes has undergone a pancreas transplant because of a serious needle phobia, the first case of its kind. For people with type 1 diabetes, and those with type 2 diabetes who inject insulin, a fear of needles can be exhausting to live with.
A significant moment occurred in 2012, when the DVLA changed its regulations for people with diabetes, insisting that drivers check their blood glucose levels before driving and once every two hours on long journeys. There are several reasons that a needle phobia can develop, such as an upsetting childhood experience. Genes may explain higher death of type 2 #diabetes patients with intense glycemic control in ACCORD trial.
This assumption imposes a more holistic view of the ageing process where dynamics of the interaction between environment, intestinal microbiota and host must be taken into consideration. Over the succeeding weeks, months and years, a complex microbiota develops that plays a major role in host physiology.
The intestinal microbiota is important for maintenance of host health, providing energy, nutrients and protection against invading organisms. Given the ability of the immune response to rapidly counter infectious agents, it is striking that such a large density of microbes can exist in a state of synergy within the human host. Identification of Bifidobacteria goes back to 1900.  Also from the September 2010 publication Genomic Insights into Bifidobacteria “Tissier (315) suggested that the large number of bifidobacteria in the feces of healthy breast-fed infants was likely the reason for their lower incidence of infantile diarrhea. The 2007 reviewpublication Gut microflora as a target for energy and metabolic homeostasis reported “Purpose of review: Gut microbiota plays an important role in health and disease, but this ecosystem remains incompletely characterized and shows a wide diversity. The human gut is sterile at birth and is subsequently colonized with bacteria from the mother and the environment.
Relates: “The gut microbiota refers to the trillions of microorganisms residing in the intestine and is integral in multiple physiological processes of the host. We observed that the microbial composition and diversity of the gut ecosystem of young adults and seventy-years old people is highly similar but differs significantly from that of the centenarians. However, new data obtained with molecular techniques suggests decreased stability and increased diversity of the gut microbiota with advancing age. Toll-like receptor (TLR) and nucleotide-binding and oligomerization domain-like receptor (NLR) families are emerging as key mediators of immunity through their role as maturation factors of immune cells and triggers for the production of cytokines and chemokines and antimicrobial factors. Under normal conditions, these bacteria are not pathogenic and in fact confer health benefits to the host. By far the most important predominant populations are in the colon where a true symbiosis with the host exists that is a key for well-being and health.
Currently established prebiotic compounds are mainly targeting the bifidobacteria population of the colon microbiota.
In this review, we focused on the state of the art that supports a link between the gut microbiota composition and activity, and the management of glycemia associated with overweight and diabetes. Synthetic polyamines were mixed into experimental chows, and 24-week-old Jc1:ICR male mice were fed one of three chows containing differing polyamine concentrations.
The aims of this study were twofold: firstly to analyze the impact on intestinal microbiota of yogurt fermented by Bifidobacterium animalis subsp.
During evolution, an integrative circuitry fundamental for survival has been established between commensal gut microbiota and host.
She told the BBC’s Victoria Derbyshire programme that she would shake violently and even vomit when injecting herself with insulin.
York had spent two years trying to get onto a waiting list for a transplant, and appeared in front of a panel three times to discuss her suitability for the procedure. York had previously tried hypnotherapy and cognitive behavioural therapy to cure her phobia, but this was unsuccessful.


Relaxation exercises can be helpful in building confidence, but the fear of needles may always exist. York’s case is an exceptional one due to the severe nature of her needle phobia, and possibly unlikely to be repeated for a very long time. The website provides an overview of the available medications and the pharmaceutical players in the field. While the digestive tract is colonised to varying degrees by micro-organisms throughout its length, due to acid pH and the short retention time of gastric contents, bacterial numbers in the stomach are usually low. Although the colonic microbiota is relatively stable throughout adult life, age-related changes in the gastrointestinal (GI) tract, as well as changes in diet and host immune system reactivity, inevitably affect population composition. This is particularly true of the distal gastrointestinal (GI) tract, which houses up to 1000 distinct bacterial species and an estimated excess of 1 x 10(14) microorganisms. In his pediatric work, he used bifidobacteria for the treatment of this intestinal diarrhea, and this likely represents the first example of the oral administration of a live microorganism for the treatment of a disease (316).
The complexity of the gut microbiota is increased during childhood, and adult humans contain 150-fold more bacterial genes than human genes. The metabolic potential of the gut microbiota is immense affording the extraction of energy from otherwise indigestible carbohydrates (dietary fiber) and the conversion of host-derived substances, non-nutritive dietary components and drugs. Recent research has shown that gut bacteria play a role in metabolic disorders such as obesity, diabetes, and cardiovascular diseases. After 100 years of symbiotic association with the human host, the microbiota is characterized by a rearrangement in the Firmicutes population and an enrichment in facultative anaerobes, notably pathobionts. At the mucosal surface chronic activation of the immune system is avoided through the epithelial production of a glycocalyx, steady-state production of antimicrobial factors as well as the selective expression and localization of PRRs. The enormous amount of commensal bacteria in the intestine might play a role in the distinct functions of NF-kappaB in the intestine, as they can initiate signalling to NF-kappaB through both Toll-like receptors and NOD-like receptors in intestinal epithelial cells as well as mucosal immune cells. The microbiota interacts with the innate and adaptive arms of the host’s intestinal mucosal immune system and through these mechanisms drives regulatory cell differentiation in the gut that is critically involved in maintaining immune tolerance. Several microbial-derived compounds are related to disturbances of glucose homeostasis including the gram-negative-derived lipopolysaccharides.
On the basis of recent knowledge in worms, flies, and humans, an important role of the gut microbiota in aging and longevity is emerging. In mammals, levels of polyamines (PAs) decrease during the ageing process; PAs are known to decrease systemic inflammation by inhibiting inflammatory cytokine synthesis in macrophages. There were questions over her eligibility: she did not have any kidney complications and she had to prove that her phobia was a strong enough reason to justify major surgery. However, her story is inspirational in that someone with type 1 diabetes is now free from a crippling phobia and much healthier as a result. Here we review the current knowledge of the changes occurring in the gut microbiota of old people, especially in the light of the most recent applications of the modern molecular characterisation techniques. The rapid passage of digestive materials through the upper gut does not provide time for significant bacterial growth to occur, but cell numbers increase considerably in the distal ileum. Recent studies indicate shifts in the composition of the intestinal microbiota, which may lead to detrimental effects for the elderly host. An ever-increasing body of evidence implicates the GI microbiota in defining states of health and disease.
The abundance of bifidobacteria in the feces of breast-fed infants was thought to be due to the Bifidobacterium-stimulating properties of human breast milk (38, 46, 60, 96, 196, 321). Recent advances in next-generation sequencing technology and mechanistic testing in gnotobiotic mice have identified the gut microbiota as an environmental factor that contributes to obesity. Recognized functions of the gut microbiota include provision of colonization resistance against pathogens and priming of both the innate and the acquired immune systems.
The presence of such a compromised microbiota in the centenarians is associated with an increased inflammatory status, also known as inflammageing, as determined by a range of peripheral blood inflammatory markers. Except for the reduced immune function, ageing itself may have relatively little effect on overall gastrointestinal function.
Additionally, the polarization of epithelial TLR signaling and suppression of NF-kappaB activation by luminal commensals appears to contribute to the homeostasis of tolerance and immunity.
However, the exact individual contributions of different NF-kappaB-activating stimuli as well as the target cells that mediate the detrimental or beneficial functions of NF-kappaB in the intestine are still elusive. Specifically, the microbiota can activate distinct tolerogenic dendritic cells in the gut and through this interaction can drive regulatory T-cell differentiation.
The present document has been written by a group of both academic and industry experts (in the ILSI Europe Prebiotic Expert Group and Prebiotic Task Force, respectively). Some nutrients with prebiotic properties, which escape the digestion in the upper part of the gut, modify the composition of the gut microbiota in favor of bacteria that could play a beneficial role on glucose homeostasis, namely by modulating the endocrine function of the gut, and by reinforcing the gut barrier. An increase in concentration of polyamine in the blood was found only in mice fed the high polyamine chow at 50 weeks of age. The complex bacterial community that populates the gut and that represents an evolutionary adapted ecosystem correlated with nutrition appears to limit the accumulation of pathobionts and infections in all taxa, being able of affecting the efficiency of the host immune system and exerting systemic metabolic effects. Reductions in intestinal luminal PAs levels have been associated with intestinal barrier dysfunction. She decided to give up driving, but as she struggled to walk long distances, she was at risk of becoming housebound. Diabetes health care professionals can draw on resources for professional development and support. The hypothetical involvement of the age-related gut microbiota unbalances in the inflamm-aging, and immunosenescence processes will also be discussed. The rate of movement of intestinal contents slows in the colon, which facilitates the development of complex bacterial communities. Increased numbers of facultative anaerobes, in conjunction with a decrease in beneficial organisms such as the anaerobic lactobacilli and bifidobacteria, amongst other anaerobes, have been reported.
Recent data suggest that the modulation of gut microbiota affects host metabolism and has an impact on energy storage.
Germ-free mice are protected against developing diet-induced obesity and the underlying mechanisms whereby the gut microbiota contributes to host metabolism are beginning to be clarified. However, the intestinal microbiota may also contribute to the development of diseases such as ulcerative colitis and colorectal cancer. Gut microbiota has evolved with humans as a mutualistic partner, but dysbiosis in a form of altered gut metagenome and collected microbial activities, in combination with classic genetic and environmental factors, may promote the development of metabolic disorders. Concomitant changes in nutrition, increased incidence of disease and corresponding use of medication with advancing age modify the composition of the microbial community of the gastrointestinal tract. Several studies have demonstrated that TLR signaling in epithelial cells contributes to a range of homeostatic mechanisms including proliferation, wound healing, epithelial integrity, and regulation of mucosal immune functions. In addition, the microbiota is important in driving T(H)1 cell differentiation, which corrects the T(H)2 immune skewing that is thought to occur at birth.
Interestingly, the changes in the gut microbes can be reversed by dieting and related weight loss. While the body weights of mice in all three groups were similar, the survival rate of mice fed high polyamine chow was significantly higher than those in the other two groups (p=0.011). There is an urgent need to disentangle the underpinning molecular mechanisms, which could shed light on the basic mechanisms of aging in an ecological perspective.
The large intestine is an intricate ecosystem that contains a complex microbiota composed of several hundred different types of bacteria. These changes, along with a general reduction in species diversity in most bacterial groups, and changes to diet and digestive physiology such as intestinal transit time, may result in increased putrefaction in the colon and a greater susceptibility to disease. The obese phenotype is associated with increased microbial fermentation and energy extraction; however, other microbially modulated mechanisms contribute to disease progression as well.
Culture-dependent studies provided basic knowledge on the gut microbiota, but only the advent of culture-independent molecular methods led to a better understanding of host-microbe interactions. If appropriate immune tolerance is not established in early life and maintained throughout life, this represents a risk factor for the development of inflammatory, autoimmune, and allergic diseases. A large number of human intervention studies have been performed that have demonstrated that dietary consumption of certain food products can result in statistically significant changes in the composition of the gut microbiota in line with the prebiotic concept. The intestinal microbiota can be considered as a metabolically adaptable and rapidly renewable organ of the body.
The qualitative and quantitative changes in the intake of specific food components (fatty acids, carbohydrates, micronutrients, prebiotics, probiotics), have not only consequences on the gut microbiota composition, but may modulate the expression of genes in host tissues such as the liver, adipose tissue, intestine, muscle.
Mice fed the high polyamine chow analyzed at 88 weeks of age, corresponding to the end of the study, demonstrated lower incidence of glomerulosclerosis and increased expression of senescence marker protein-30 in both kidney and liver compared to those fed the low polyamine chow.


The growth and metabolism of microbial communities in the large intestine are determined by many factors, such as diet, environment and host physiological processes, as well as the anatomic structure of the digestive tract, disease, immunity, host genetics, drugs and ageing.
An understanding of their full interactions with intestinal microbes and the host is needed to scientifically validate any health benefits they may afford.
The literature provides new evidence that the increased prevalence of obesity and type 2 diabetes cannot be attributed solely to changes in the human genome, nutritional habits, or reduction of physical activity in our daily lives.
The gut microbiota has profound effects on host gene expression in the enterohepatic system, including genes involved in immunity and metabolism. The application of metagenomics to the gut microbial ecosystem revealed truly remarkable correlations between certain diseases and the gut microbiome. Early-life events are instrumental in establishing the microbiota, the composition of which throughout life is influenced by various environmental and lifestyle pressures. Among the numerous purported health benefits attributed to probiotic bacteria, the (transient) modulation of the intestinal microflora of the host and the capacity to interact with the immune system directly or mediated by the autochthonous microflora, are basic mechanisms. However, unbalances in its microbial community and activities are found to be implicated in disease initiation and progression, such as chronic inflammatory bowel diseases and colonic cancers. This in turn may drive or lessen the development of fat mass and metabolic disturbances associated with the gut barrier function and the systemic immunity. Modifications in diet and host immune system activity, as well as physiological changes in the digestive tract affect microbiota composition in older people. These include dietary supplements containing prebiotics, probiotics and a combination of both of these, synbiotics.
Recently, the genome sequences of nine strains representing four species of Bifidobacterium became available. For example, the gut microbiota affects expression of secreted proteins in the gut, which modulate lipid metabolism in peripheral organs. They are supported by an increasing number of in vitro and in vivo experiments using conventional and molecular biologic methods. The more data are accumulating, the more it will be recognised that such changes in the microbiota’s composition, especially increase in bifidobacteria, can be regarded as a marker of intestinal health.
Restoration of this balance by increasing bifidobacteria levels has demonstrated to reduce disease severity of patients and to improve well-being in healtly volunteers. The relevance of the prebiotic or probiotic approaches in the management of obesity in humans is supported by few intervention studies in humans up to now, but the experimental data obtained with those compounds help to elucidate novel potential molecular targets relating diet with gut microbes.
The T-RFLP patterns in five of the six volunteers were changed in a similar fashion by LKM512 yogurt consumption, although these patterns were individually changed following consumption of placebo. The elderly have fewer bifidobacteria and higher numbers of enterobacteria and clostridia than young adults. A comparative genome analysis of these genomes reveals a likely efficient capacity to adapt to their habitats, with B.
Scientists may take into consideration a key question: could we manipulate the microbiotic environment to treat or prevent obesity and type 2 diabetes? In addition, the gut microbiota is also a source of proinflammatory molecules that augment adipose inflammation and macrophage recruitment by signaling through the innate immune system. In addition to these, a limited number of randomized, well-controlled human intervention trials have been reported. The review is divided in chapters that cover the major areas of nutrition research where a prebiotic effect has tentatively been investigated for potential health benefits. New emerging evidence on the difference in the composition of the colonic microbiota between obese and lean volunteers has opened new areas for pre-, pro- and synbiotic research. TLRs (Toll-like receptors) are integral parts of the innate immune system and are expressed by both macrophages and epithelial cells.
The prebiotic effect has been shown to associate with modulation of biomarkers and activity(ies) of the immune system. Nutrients with prebiotic properties allows, by changing the gut microbiota, to promote the endocrine function of the gut (increase in GLP-1, and GLP-2 producing cells), and to modulate the activation of the endocannabinoid system in the intestine and in the adipose tissue.
We then analyzed inflammatory and intestinal conditions by measuring several markers using HPLC, ELISA, reverse transcription-quantitative PCR, and histological slices. Activation of TLRs in macrophages dramatically impairs glucose homeostasis, whereas TLRs in the gut may alter the gut microbial composition that may have profound effects on host metabolism.
All those effects contribute to lessen gut permeability (improved distribution of the tight junction proteins ZO-1 and Occludin), thereby decreasing endotoxemia, and systemic inflammation.
LKM512 mice showed altered 16S rRNA gene expression of several predominant intestinal bacterial groups. This concomitantly improves stool quality (pH, SCFA, frequency and consistency), reduces the risk of gastroenteritis and infections, improves general well-being and reduces the incidence of allergic symptoms such as atopic eczema.
Changes in GLP-1 contribute to decrease food intake, fat mass, glycemia and insulin resistance. Changes in the gut microbiota composition are classically considered as one of the many factors involved in the pathogenesis of either inflammatory bowel disease or irritable bowel syndrome.
Colonic mucosal function was also better in LKM512 mice, with increased mucus secretion and better maintenance of tight junctions. The similar changes in the intestinal microbiota of the elderly caused by consumption of the LKM512 yogurt were found to be influenced by the LKM512 strain itself, and not by the lactic acid bacteria in the yogurt.
An intriguing observation is the loss of much of this genome potential when strains are adapted to pure culture environments, as highlighted by the genomes of B. Prevention and alleviation of unspecific and irregular complaints of the gastrointestinal tracts in healthy people. Promising beneficial effects have been demonstrated in some preliminary studies, including changes in gut microbiota composition (especially increase in bifidobacteria concentration). This indicates that ingestion of specific probiotics may be an easy approach for improving intestinal health and increasing lifespan.
Beneficial effects on microbial aberrancies, inflammation and other complaints in connection with: inflammatory diseases of the gastrointestinal tract, Helicobacter pylori infection or bacterial overgrowth.
Some of these studies (including one human trial) have also reported that, in such conditions, gut microbiota composition was modified (especially due to increased concentration of bifidobacteria). Normalization of passing stool and stool consistency in subjects suffering from obstipation or an irritable colon. Dietary intake of particular food products with a prebiotic effect has been shown, especially in adolescents, but also tentatively in postmenopausal women, to increase Ca absorption as well as bone Ca accretion and bone mineral density.
Recent data, both from experimental models and from human studies, support the beneficial effects of particular food products with prebiotic properties on energy homaeostasis, satiety regulation and body weight gain. Pathways that were downregulated by ageing were upregulated by LKM512 administration and vice versa.
Together, with data in obese animals and patients, these studies support the hypothesis that gut microbiota composition (especially the number of bifidobacteria) may contribute to modulate metabolic processes associated with syndrome X, especially obesity and diabetes type 2. In other words, LKM512 administration suppressed ageing-associated change in gene pathways. It is plausible, even though not exclusive, that these effects are linked to the microbiota-induced changes and it is feasible to conclude that their mechanisms fit into the prebiotic effect. Prevention of respiratory tract infections (common cold, influenza) and other infectious diseases as well as treatment of urogenital infections. However, the role of such changes in these health benefits remains to be definitively proven.
Insufficient or at most preliminary evidence exists with respect to cancer prevention, a so-called hypocholesterolemic effect, improvement of the mouth flora and caries prevention or prevention or therapy of ischemic heart diseases or amelioration of autoimmune diseases (e.g. In other words, LKM512 administration suppressed ageing-associated change in gene pathways.” – “The anti-inflammatory effects of LKM512 administration were also revealed by a DNA microarray. Today, only bifidogenic, non-digestible oligosaccharides (particularly inulin, its hydrolysis product oligofructose, and (trans)galactooligosaccharides), fulfill all the criteria for prebiotic classification. Expression levels of genes in the TNF-NF?B, IL-1, IL-2, and IL-6 pathways were higher in the control group than in LKM512 and younger mice; additionally, gene expression levels in LKM512 mice were similar to those in younger mice (Fig.
They are dietary fibers with a well-established positive impact on the intestinal microflora. Other health effects of prebiotics (prevention of diarrhoea or obstipation, modulation of the metabolism of the intestinal flora, cancer prevention, positive effects on lipid metabolism, stimulation of mineral adsorption and immunomodulatory properties) are indirect, i.e.



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