Prebiotics and synbiotics in clinical medicine

Stig Bengmark, Robert Martindale

Research output: Contribution to journalReview articlepeer-review

59 Scopus citations


Pharmaceutical medicine has thus far been unable to stop the increasing global morbidity and mortality both in acute and chronic diseases. Typically, medical practice has focused on reducing the aggressor with treatments such as antibiotics; little interest has been given to efforts to increase the individual's resistance to disease. The increased morbidity has occurred in parallel to a deviation from a large consumption of fresh fruits, vegetables, and tubers rich in live lactic acid bacteria (LAB), plant fibers, and natural antioxidants to an industry-produced diet rich in fat and refined sugar but containing little fiber, antioxidants, and LAB. Plant fiber/prebiotics, plant-derived antioxidants, and LAB/probiotics are known to have the potential to reinforce the immune system of the body and increase resistance to disease. However, this depends on the type of fiber, antioxidant, and strain or combination of strain used. At this stage, only about 10% of the LAB studied have proven strong immunosupportive effects. Similarly, only a few plants contain what has been called superantioxidants, antioxidants 10 or more times stronger than vitamin C and E. Increasing evidence suggests that combining several probiotic bacteria into multistrain probiotics will achieve stronger effects than single-strain probiotics. And combining probiotics and prebiotics into "synbiotics" will further enhance the immunosupportive effects. There is little evidence that a single-strain-based "superprobiotic"/ magic LAB will ever be found. Instead, combining several specific and defined probiotics and several key plant fibers into multistrain/multifiber synbiotics appears to be the most promising alternative. Some edge-cutting effects from using multistrain and multifiber compositions are reported both from animal and controlled clinical studies.

Original languageEnglish (US)
Pages (from-to)244-261
Number of pages18
JournalNutrition in Clinical Practice
Issue number2
StatePublished - 2005
Externally publishedYes

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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