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1. Inulin-type fructans are fermentable dietary fiber and help improve gut functions especially by improving regularity, increasing stool frequency, and fecal bulking

2. Inulin-type fructans are bifidogenic and prebiotic

3. Inulin-type fructans increase calcium and magnesium absorption

4. Inulin reduces triglyceridemia in hyperlipidemic individuals

13.2.2 Inulin-Type Fructans: Health and Well-Being

It is not surprising that these ingredients are attracting interest as potential "feelgood" factors, as shown by the title of the last research conference, "Inulin and Oligofructose as Feel-Good Factors for Health and Well-being" (Paris, France, Cité de Sciences, February 12-13, 2004).

Recently, the World Health Organization (WHO) has defined health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." Thus, to study the impact of nutrition on health cannot be done without due consideration of the concept of well-being. In the occidental-industrialized world the life expectancy is now over 72 years and it is expected that within the next 20 years, more than 50% of the population will be over the age of 65. As such, the well-being aspect of human health is getting more and more relevance. But the aging population is by no means the only target group. Often facing stress as well as increasingly demanding working conditions, the younger generations are also concerned about health and well-being, especially in a stressful society where there is strong economic competition. Moreover, even in infants, nutrition is a key element of well-being through harmonization of physiological developments to guarantee improved quality of life, e.g., the key role of early life nutrition in the balanced development of the immune system (TH/TH2 ratio).

In this context, gastrointestinal functions, especially colonic functions (e.g., control of the colonic environment, regulation of hormone-dependent metabolic processes, modulation of the brain-gut axis, systemic impact of gut fermentation products, and activities of the immune system) deserve special attention. Disturbances of the colon's functions may lead to dysfunction, not only in the gut but also in the whole body. The classical view that the human colon is an organ (or a tube) that absorbs salt and water and provides a mechanism for the orderly disposal of waste products of digestion is no longer appropriate. Obviously, the colon has a major role in digestion (as achieved by the microbial fermentation) through the salvage of energy; it also contributes to absorption of nutrients like minerals and vitamins; it plays a key role in protecting the body against translocation of bacteria; and lastly, it is active as an endocrine (via the gastrointestinal peptides) as well as an immune organ.17 It is also involved in miscellaneous diseases from acute infections and diarrhea or constipation to chronic diseases like inflammatory bowel diseases (IBD), irritable bowel syndrome (IBS), or cancer.17

The reason the colon plays such an important physiological role originates in its unique composition that associates pluricellular eukaryotic epithelial tissue and unicellular (mostly prokaryotic) microorganisms, which collaborate in maintaining health. The microflora that symbiotically colonizes the large bowel is a key player in maintaining the colon (and thus the whole body) healthy. But this population of unicellular microorganisms is complex and highly diverse. To better understand the microflora and its symbiosis with the intestine, we hypothesize that, "stimulated" by the complexity of its host's pluricellular tissue, the intestinal microflora has itself developed during the evolution, and continues to develop during the individual's life, as a population of myriads of unicellular microorganisms belonging to hundreds of genera, species, and strains that not only live close together but actively collaborate to reach a (sometimes precarious) balanced activity, which becomes essential not only for health and well-being but simply for life. It can even further be speculated that it is, in fact, two "pluricellular worlds" (one eukaryotic and one mostly prokaryotic) that live together and cooperate in the large bowel. Such a hypothesis would suggest that, like the different eukaryotic cells of a tissue (especially the immune system that is composed of mostly isolated specialized cells that interact and cooperate to neutralize and eliminate antigens), the various genera, species, and strains of microorganisms that colonize the digestive tract are specialized cells that form a complex tissue-like structure in which the different types of "specialized" (but we still have to identify most of these specializations!) cells interact to perform a series of physiological functions. Intestinal health and well-being would then result from interactions within and between these two pluricellular worlds, the interaction between the two worlds being referred to as "crosstalk."18 The multicellular prokaryotic tissue-like entity would benefit from and, at the same time, provide benefits to the intestinal mucosa (i.e., the whole and complex pluricellular tissue) and vice versa. A major determinant of these interactions would be the composition of these two worlds, especially that of the prokaryotic population that establishes very early in life immediately after birth. It can also be modulated later in life by diet and may become more complex or more fragile as the body ages. Through modulation of the composition of the colonic microbiota, it is possible not only to influence large bowel functions but also to act indirectly on systemic functions and host health and well-being. Inversely, it cannot be denied that systemic dysfunction elsewhere in the body's organs influences the composition of the colonic flora and, as a consequence, the activities and the colonic functions.

By their specific effects, inulin-type fructans have the capacity to improve the composition, activity, and functionality of both the colonic microflora (see Chapter 9) and the intestinal mucosa (see Chapter 12, Section 12.4.1.1 and Section 12.4.1.2), and to optimize the interactions between these two pluricellular tissues and tissuelike structures thus creating the conditions for better intestinal health and well-being (Figure 13.1).

Inulin-type fructans beneficially affect three essential processes in the colon:

1. Fueling — because of resistance to digestion and no effect on digestion of nutrients (see Chapter 4, Section 4.3 and Section 4.4 and Chapter 6,

SENSE of WELL BEING/REDUCTION of DISEASE RISK

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