*4.4.11 Anxiolytic effect of prebiotics*

*Oral Health by Using Probiotic Products*

*4.4.9 Prebiotics and renal profile*

*4.4.10 Prebiotics in controlling cancer*

*4.4.8 Prebiotics in diabetes and cardiovascular diseases*

protons and increase level of calbindin and butyrate. Colon surface area also enlarged that is a good source to increase the minerals and trace elements absorption [125].

Prediabetes is linked with the long term inflammation that is associated with greater risk of developing type 2 diabetes and cardiovascular diseases. Increased concentration of lipopolysaccharides is linked with dysbiosis of the natural microbiota that is involved in the development of type 2 diabetes and cardiovascular diseases. Prebiotics involved in the selective functioning of natural micro biota such as inulin decreases the concentration of endotoxin, reduces permeability of the intestines and limit the metabolic dysfunction in rodents. The impact of prebiotics on the cardiovascular functions in patients at the risk of type 2 diabetes is still unknown. The prebiotic supplementation along with inulin could be used as preventive strategy for limiting the risk of cardiovascular diseases in the patients at risk of type 2 diabetes. This strategy can affect the clinical practices by setting and accepting dietary recom-

It is well documented that prebiotics, probiotics and the symbiotic supplementation had resulted in the improvement of renal function. Firouzi and Haghighatdoost [127] studied renal profile of a meta-analysis of a clinical trial. They pointed out that level of glomerular filtration rate was reduced whereas the concentration of creatinine was increased in the intervention group in comparison to the placebo group and the results were non-significant. The combined effect on the blood urea nitrogen demonstrated that the level declined as compared to the placebo group. Whereas the levels of uric acid increased in intervention group in comparison with the placebo group. The supplementation of prebiotics, probiotics and symbiotic should be limited among those in which renal function is compromised until well designed and large scale randomized controlled trials prove the efficiency and safety of prebiotics, probiotics and symbiotic supplementation for having improved effects on the renal function.

A study was conducted to check the impact of prebiotics intake consisting of xylo-oligosaccharides, fructo-oligosaccharides, resistant dextrin and polydextrose on immunity and the structure of gut microbiota in perioperative colorectal cancer

A double blind, randomized clinical trial was conducted that consisted of 140 perioperative colorectal cancer patients involving 50 females and 90 males having age between 40 and 75 years. Patients were divided on random basis into two groups consisting of intervention group that received 30 g/day of prebiotic supplementation for the period of 7 days and control group that did not receive supplementation. The immunological and nutritional indices of both groups were evaluated before and after operation and were compared with their baseline levels. Also the fecal samples of random 40 patients from the both groups were taken to examine the gut microbiota. There was significant reduction in the abundance of intestinal microbiata from pre to post operation in the control group. Intake of prebiotics is recommended to improve immunological indices in patient having colorectal cancer for 7 days before operation. Prebiotics enhanced the concentration of four commensal microorganism containing opportunistic pathogens in patients having colorectal cancer. Surgical stress decreased the population of intestinal microbiota

mendation of prebiotics by medical and scientific community [126].

**20**

patients.

Long term treatment of prebiotics particularly combination of fructooligosaccharides and galactooligosaccharides have antidepressant effects and also involved in combating the issues related to anxiety. The effect of Galactooligosaccharide (GOS) and the combination of fructooligosaccharides and galactooligosaccharides is involved in reducing the level of corticosterone level in the body by mainly limiting its release. Prebiotics are involved in modifying the expression of specific genes related to the concentration of short chain fatty acids in the hypothalamus and hippocampus. Administration of Prebiotics resulted in the increased level of acetate and propionate and reduction in the concentration of isobutyrate that have significant correlation with the positive effects on behavior. Moreover, the administration fructooligosaccharides and galactooligosaccharides reduced the level of corticosterone and proinflammatory cytokines resulted from the chronic stress as well as normalizing the anxiety and depression like behavior along with mitigating the impact of stress on the microbiota [129].
