Application of Fructooligosaccharides to Medical Foods as a Fermentable Dietary Fiber

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Fructooligosaccharides are an ideal source of fermentable fiber for medical foods. Typically, medical foods are liquid, many of which are fed to patients through a tube. Liquid medical foods that are fed through a tube must be low in viscosity. Fructooligosaccharides are soluble and will not clog feeding tubes and do not significantly increase the viscosity of the product. Rationale for the use of fructooligosaccharides in medical foods includes: normalization of bowel function, maintenance of large bowel integrity, restoration of colonization resistance, alteration in route of nitrogen excretion, and improvement in calcium absorption. Normalization of bowel function refers to the treatment or prevention of constipation or diarrhea in patients receiving a medical food. Fructooligosaccharides, through anaerobic fermentation by colonic bacteria and the production of short chain fatty acids, may be useful in preventing large bowel atrophy or treating distal ulcerative colitis. Fructooligosaccharides, by selectively supporting the growth of bifidobacteria or producing an environment in the colon (e.g., increased short chain fatty acid concentration or decreased pH) that is not conducive to the growth of certain pathogenic organisms, may help restore colonization resistance. Anaerobic fermentation of fructooligosaccharides, leading to the bacterial cell growth and a reduction is colonic pH, may shift nitrogen excretion from the urinary to the fecal route. Improvements in calcium absorption may occur through mechanisms involving short chain fatty acid absorption and a reduction in large bowel pH. Overall, compatibility with liquid products and numerous physiological benefits to the patient justify the use of fructooligosaccharides in medical foods.

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