Modulation of the human gut microbiome is an emerging approach to support gastrointestinal, metabolic, and immune health. One way to modulate the gut microbiome is by consuming prebiotics. Prebiotics act as fermentation substrates for intestinal microbes, leading to a greater abundance of Bifidobacterium, production of short-chain fatty acids (SCFAs), and lower intestinal pH. These effects support the developing immune system and are the reason that prebiotics are added to infant formulas. Although the immune benefits of prebiotics for infants are well recognized, their immune effects in children beyond the infant years are less researched.

A randomized controlled trial, published in the Journal of Nutrition in 2018, explored whether prebiotic supplementation in young children would reduce the frequency of infectious disease episodes through the winter months. The study was conducted in 219 Hungarian kindergarten children, aged 3-6 years old. Healthy children were randomized to take a placebo or 6 grams per day of an an Orfati inulin-type product with shorter and longer chains for 24 weeks. The primary outcome was the frequency of infectious disease episodes reported by the parents. Stool samples were also analyzed, and physicians recorded any diagnoses or prescribed treatments during the period.

Results showed no significant difference between groups in the primary outcome measure: parents in both groups reported a similar number of infectious episodes during the 24-week intervention period. Parents reported no significant differences in the total number of infectious days, duration of infections, febrile days, days of antibiotic treatment, or days of absence from school.

In contrast to these null results, significant differences were detected in several secondary outcome measures. The number of febrile episodes requiring medical attention and the incidence of sinusitis were both significantly lower in the prebiotic group than in the placebo group. Also, relative abundances of Bifidobacterium and Lactobacillus were significantly higher in the prebiotic group than in the placebo group at the end of the study. These changes were accompanied by softer stool (still within the normal range) in children taking prebiotics.

Despite no significant differences in parental reports of infectious disease episodes, supplementation for 24 weeks with 6 grams per day of a prebiotic inulin-type fructan product had beneficial effects on the composition of the gut microbiome, improved stool consistency, and reduced sinusitis and febrile episodes requiring medical attention in kindergarten-aged children.

By TAP Integrative


Lohner S, Jakobik V, Mihályi K et al. Inulin-Type Fructan Supplementation of 3 to 6 Year-Old Children Is Associated with Higher Fecal Bifidobacterium Concentrations and Fewer Febrile Episodes Requiring Medical Attention. J Nutr. 2018.

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