Chemistry Reference
In-Depth Information
15.4.4.2 Antibiotic Resistance and Gene Transfer........................... 323
15.4.4.3 Deleterious Metabolic Activities: D-Lactic Acid............... 323
15.4.5 Current Recommendations for Starter and Follow-On Formulae .... 324
15.5 Summary and Future Developments............................................................. 324
References .............................................................................................................. 325
15.1 INTroDuCTIoN
Human milk is the ideal nutrition for term infants because it provides all neces-
sary nutrients for rapid growth and postnatal development. The quantity and quality
of nutrients is adapted to the high nutritional requirement of rapid growth as well as
to the functional maturation of the gastrointestinal tract and the metabolism of the
infant. In addition, human milk contains components which are—partially or com-
pletely—resistant to intestinal digestion and provide functional capacity.
1,2
There is
broad consensus that breastfed infants develop differently compared to infants with
artificial feeding.
3
Breastfed infants, in comparison to formula-fed infants, have a
reduced incidence of allergic or atopic diseases,
4-8
a reduced incidence of infec-
tions,
9-13
and a reduced incidence of diabetes mellitus type I.
14
This indicates a major
impact of breastfeeding on the development of the immune system.
15 -17
Better cogni-
tive functions
18
and lower blood pressure
19
in later life have also been reported for
breastfed infants.
The positive effects of breastfeeding are multifactorial. One of the physiologic
aspects of the effects of breastfeeding is the establishment of a specific intestinal
microbiota. There are many functions attributed to the intestinal microbiota found in
breastfed infants. There is increasing evidence that the composition of the intestinal
microbiota plays a key role in the postnatal development of the immune system,
20-23
but effects of bacterial fermentation products on the maturation of the immune sys-
tem
24,25
are under investigation.
Because of the importance of the intestinal microbiota for the development of gut
physiology and the immune system,
23
many attempts have been made to mimic the
intestinal microbiota of breastfed infants also in bottle-fed infants.
The composition of the intestinal microbiota can be influenced either by admin-
istration of large amounts of living bacteria that survive the gastrointestinal tract to
be active in the colon
26
or by the use of dietary ingredients that are nondigestible
during the passage through the small intestine, reach the colon, and can selectively
be used by health-promoting colonic bacteria.
27,28
As a third opportunity, the combination of both principles as “synbiotics” is
under discussion.
29
This chapter summarizes the current knowledge of the influence of breastfeeding
on the postnatal development of intestinal microbiota. The possibilities to mimic this
function with prebiotics or probiotics are evaluated and the functional consequences
of dietary manipulation of the composition of intestinal microbiota on the physiol-
ogy of the host are discussed.
