**5. Applications of fractionated carbohydrates**

Lactose is used as an agglomerating agent, a flavor enhancer, and a diluent in many foods, beverages, and bakery and confectionery products. In the pharmaceutical industry, it is employed as a diluent in tablets and a carrier in medicines [119, 120]. In the last year, the interest in lactulose has increased to a high extent due to its application in the pharmaceutical and food industry. Lactulose is considered as a prebiotic because it promotes the proliferation of *Bifidobacteria* in the human intestine. Therefore, this disaccharide is used as a food supplement in pediatric and geriatric diets [121] as well as for prevention and treatment of chronic constipation, portal systemic encephalopathy, and other intestinal or hepatical disorders [122]. It has been suggested that lactulose has anti-inflammatory properties, which make it an appropriate and useful adjunctive treatment to inflammatory bowel diseases in humans [123]. Most recently, lactulose has been proposed as a treatment for the *Salmonella* carrier state, a preventative and treatment for high cholesterol, a preventative for gall stones, and an adjunctive treatment for colorectal cancers [124]. Moreover, lactulose is used in pharmaceuticals as a mild laxative and to treat hyperammonemia.

The main characteristics of lactobionic acid include moisturizing, antioxidant, stabilizing, and acidifying capacities. Lactobionic acid appears to be a less commonly used prebiotic for both *Lactobacilli* and *Bifidobacteria*. However, lactobionic acid has been suggested to improve gut health [125]. Other applications of lactobionic acid include as a calcium supplement (calcium lactobionate) in pharmaceutical solutions for stabilizing the organs during transplant [126] and in the cosmetic industry [127]. Lactitol is widely used in chocolates, biscuits, sweets, ice cream, and confectionary manufacture as an alternative to other sugar alcohols, such as mannitol, sorbitol, and xylitol. It is used in low-energy, low-fat, and glycemic foods for diabetics and is also recognized as not causing dental caries [128].

It is widely accepted that milk oligosaccharides play several important protective, physiological, and biological roles including selective growth stimulation for beneficial gut microbiota, inhibition of pathogen adhesion, and immunoregulation [88, 129]. The use of free oligosaccharides and their conjugated derivatives in anti-adhesion therapy may provide an effective therapeutic approach to prevent diseases [21]. GOSs are widely used in infant milk formula, infant foods, follow-on formula, beverages, and fermented milks and in confectionary and bread making, of their functional properties as well as health-enhancing properties. The use of GOS in the livestock feed and a pet food industry is also increasing, especially in the poultry, pig, and aqua-culture [130].
