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◆ Clinical nutrition ESPEN2026-09-19

Rapidly Fermentable Prebiotic Substrates: Benefits, FODMAP Effects and Host Tolerance.

Fandi Ibrahim

原始摘要(英文原文)· Original abstract
Rapidly fermentable prebiotic substrates occupy a contradictory position in human nutrition. In microbiome and functional-food research, low molecular weight non-digestible carbohydrates such as inulin, fructo-oligosaccharides, galacto-oligosaccharides are added to foods and supplements to promote bifidogenic, metabolic and gastrointestinal benefits. In parallel, clinical nutrition often restricts the same substrates as FODMAPs to reduce symptoms in irritable bowel syndrome and related disorders of gut-brain interaction, while food-science research seeks to reduce raffinose-family oligosaccharides because of their flatulence-producing and antinutritional effects. This review examines these contradictory framings and asks whether the same rapidly fermentable substrates should be understood as beneficial prebiotics, symptom-provoking FODMAPs, or tolerance-limiting food components. It argues that the physiological effects of these substrates are not fixed properties of the compounds alone but also arise from interactions between intrinsic fermentability and host context. Rapidly fermentable substrates may support beneficial microbial and metabolic responses in tolerant individuals, but may contribute to gas production, osmotic effects, luminal distension, symptom generation or even immune activation in susceptible contexts. Future research should move beyond defining prebiotic efficacy primarily by enrichment of selected bacterial taxa. Instead, each substrate should be tested through dose-response studies that establish both beneficial and tolerance thresholds across healthy individuals and clinically relevant phenotypes. Future studies should also examine prebiotics within a host-ecology framework, testing whether benefit depends less on maximising microbial stimulation and more on maintaining a controlled, spatially contained and clinically tolerable microbiome.
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Rapidly Fermentable Prebiotic Substrates: Benefits, FODMAP Effects and Host Tolerance. — 科研速览 Science Skim