Immunity Through Gut

Pioneering innovations in early life nutrition for immunity through gut

Human milk is the best nutrition for infants, and amongst others contains bioactive compounds. It is one of the first factors in life establishing a stable microbiota and supporting mucosal immune development. 1

An infant’s diet in the first weeks of life is crucial to ensuring the development of a healthy and resilient immune system, laying the foundation for lifelong good health. Central to healthy immune system development is the colonisation of the infant’s gut by a diverse array of microorganisms, known as the “microbiota”.

Human milk is perfectly tailored to support a well-balanced microbiota and promote optimum immune functioning and development. Extensive research has identified several bioactive compounds that contribute to these effects:,

 

Prebiotics

Prebiotics are substrates that are selectively utilized by host microorganisms conferring a health benefit

The International Scientific Association for Probiotics and Prebiotics (ISAPP) has published this definition for prebiotics in a consensus statement in June 20171. Prebiotics are non-digestible carbohydrates, primarily oligosaccharides, that pass through the small intestine and stimulate growth of beneficial microorganisms, such as bifidobacteria, in the lower intestine.

Human milk contains many specific oligosaccharides (HMOS) of which more than 200 have been identified. As a matter of fact, HMOS are the 3rd largest fraction in human milk (12-15 g/l). They are known to exert a beneficial impact on an infant’s immune system, primarily through promoting a balanced gut microbiota. Individual oligosaccharides have also been shown to have specific immune benefits, such as by binding to pathogens and encouraging the maturation of the immune system. Due to the diversity in HMOS structures, HMOS are not anticipated to be mimicked by one or a few oligosaccharide structures, rather by a combination of oligosaccharides with varying structures.

In order to mimic the prebiotic effect of breastfeeding, non-milk-derived oligosaccharides have been developed for use in infant formula. The most studied mixture is Nutricia’s “scGOS/lcFOS (9:1)”. This mixture of over 100 oligosaccharides contains short-chain galacto-oligosaccharides and long-chain fructo-oligosaccharides in a 9:1 ratio – a composition that closely mimics the complexity, diversity, amount and functionality of HMOS in human milk and has shown its clinical benefits.

Infant formulas enriched with this prebiotic mixture have demonstrated a wide range of gut and immune benefits, in comparison with formulas lacking prebiotics.

Taken together, the data show that prebiotics can mimic the prebiotic effects of human milk, demonstrated to beneficially impact the gut microbiota composition and activity as well as the immune system, showing reduced risk of allergies and infections2,3.

Postbiotics

There is increasing interest in postbiotics because of their wide-ranging potential benefits for human health. It is anticipated that the effects of postbiotics can be both local as well as systemic, affecting different organs and systems. For example, different postbiotic compounds have been shown to have anti-inflammatory, antimicrobial, and immunomodulatory properties4.

To harness these potential benefits for the developing infant, learning from the benefits of human milk seen in breastfed infants, infant formula may contain postbiotics. Postbiotics are produced during fermentation with specific strains of bacteria under carefully controlled conditions. During fermentation bacteria metabolise food and produce various bacterial compounds and metabolites. Each bacterial strain used during specific fermentation processes produce unique postbiotics and therefore postbiotics from other bacterial strains or produced with another fermentation process cannot be compared.

Postbiotics are bioactive compounds produced by food-grade micro-organisms in a fermentation process (based on 4)

Research shows that formulae fermented with two particular bacterial strains – Bifidobacterium breve C50 and Streptococcus thermophilus 065 using a specific fermentation process Lactofidus™ – has a range of advantages for infants, in comparison with formulas lacking postbiotics. The scientific evidence therefore supports infant formulae with specific postbiotics to confer immune benefits for the developing infant.

A postbiotic derived during the Lactofidus™ fermentation process is 3′-galactosyllactose (3′-GL). 3′-GL is structurally identical to the 3′-GL HMOS found in human milk. It is a HMO with confirmed immune effect.5

Combining pre- and postbiotics

To extend the benefits of human milk to bottle-fed babies, our dedication has led us to design the next generation of infant nutrition, bringing together our two pioneering innovations. It is the first and only infant formula with a unique combination of the prebiotic mixture scGOS/lcFOS (9:1) and postbiotics derived from our unique fermentation process Lactofidus™. In clinical trials, the new formula was shown to be safe and to have positive effects on many aspects of gut and immune system functioning compared with formulas lacking these compounds.

The new formula with prebiotics and postbiotics has been shown in clinical studies to:

  • be safe, well tolerated and result in adequate growth6
  • improve gut characteristics like lower pH, increased sIgA levels, decreased levels of Clostridium difficile7 and ensure an overall gut microbiota composition and fecal metabolite profile7,8 closer to human milk fed infants and relevant for the gut and immune system
  • Promote softer and more frequent stools, close to those of human milk fed infants6,9,10

Overall, the new infant formula with prebiotics and postbiotics ensures a pool of nutritional and bioactive compounds closely reflecting the complexity, diversity and functionality of breast milk. It has been shown to support optimal growth, promote a more favourable gut environment, thereby supporting the healthy development and functioning of a resilient immune system to be closer to human milk.

1.
1. Gibson GR, Hutkins R, Sanders ME, Prescott SL, Reimer RA, Salminen SJ, Scott K, Stanton C, Swanson KS, Cani PD, Verbeke K, Reid G. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol 2017;14:491-502.
2.
Oozeer R, van L, Ludwig T, et al. Intestinal microbiology in early life: specific prebiotics can have similar functionalities as human-milk oligosaccharides. Am J Clin Nutr. 2013;98(2):561S-71S.
3.
Jeurink P, van B, Jiménez E, et al. Human milk: a source of more life than we imagine. Benef Microbes. 2013;4(1):17-30.
4.
Aguilar-Toalá JE, Garcia-Varela R, Garcia HS, et al. Postbiotics: An evolving term within the functional foods field. T. 2018;75:105-114. doi:10.1016/j.tifs.2018.03.009
5.
Ayechu-Muruzabal V, van Stigt AH, Mank M, et al. Diversity of Human Milk Oligosaccharides and Effects on Early Life Immune Development. F. 2018;6. doi:10.3389/fped.2018.00239
6.
Rodriguez-Herrera A, Abrahamse-Berkeveld M M, Alles M, Bouritius H. A partly fermented infant formula containing scGOS/lcFOS supports adequate growth in healthy, term infants: the life study. JPGN. 2016;62:658-659.
7.
Tims S, et al . Tims S. et al. Gut microbiota composition modulation by partly fermented infant formulae supplemented with prebiotics scGOS/lcFOS. . JPGN. 2018;66(2):1-1177;
8.
Tim S, Rodriguez-Herrera A. A partly fermented infant formula with prebiotics scGOS/lcFOS modulates the gut microbiota functioning towards a more breastfed-like microbiota. . J Pediatr Gastroenterol Nutr. 2018;66(2):1-1177.
9.
9th Excellence in Pediatrics Conference – 2017 Book of Abstracts. C. 2017;4(1). doi:10.1080/2331205x.2017.1408251
10.
Herrerra AR. . J Pediatr Gastroenterol Nutr, . 2015;(61):516-517.