Digestible and Non-Digestible Carbohydrates 49
1
no possibility of formulating any clear recom-
mendation; only few studies showed an associa-
tion of dietary intake with fasting blood glucose
concentrations and weight gain [13 , 15]. Current
recommendations for fibre intake in children
vary among organisations; the EFSA concluded
that a fibre intake of 2 g per 1 MJ of energy is ad-
equate for normal laxation in children from the
age of 1 year [4].
P r e b i o t i c s
Prebiotics are a non-digestible food ingredients
that selectively stimulate the growth and/or activ-
ity of intestinal bacteria associated with health
and wellbeing [16]. Those beneficial bacteria are
mostly bifidobacteria and lactobacilli. Prebiotics
typically consist of ≤ 10 sugar molecules, and the
most widely used types are fructooligosaccha-
rides, inulin and galactooligosaccharides. The
beneficial prebiotic effect proposed can be seen
via improved gut barrier function and host im-
munity, reduction in potentially pathogenic bac-
terial subpopulations and enhancement of SCFA
production. The most important prebiotics for
infants are human milk oligosaccharides, which
are very complex carbohydrates that significantly
stimulate the growth of specific commensal bac-
teria in a breastfed infant. Although many studies
demonstrated a bifidogenic effect of prebiotics
and their addition to infant formulae seems rea-
sonable, there is a lack of strong evidence that
their addition could improve growth or clinical
outcomes in term infants [17]. Prebiotics have
been shown to increase calcium absorption and
bone mineral density in adolescents by lowering
stool pH and increasing the amount of soluble
calcium available for absorption, but this effect
has not been confirmed in infants [18].Conclusions- Carbohydrates may be classified into carbohy-
drates that provide the body with monosac-
charides and are called ‘digestible’ (available
or glycaemic) and carbohydrates that resist
digestion in the small intestine and are called
‘resistant’ (unavailable or non-glycaemic) - Dietary recommendations for infants and
children should propose the intake of slowly
absorbed carbohydrates and avoidance of add-
ed sugars and sweet drinks - Fibres have a positive effect on laxation by in-
creasing the amount of stool and influencing
stool consistency - Prebiotics promote the growth of beneficial
bacteria, mostly bifidobacteria and lactobacilli - For infants, the most important carbohydrates
with a prebiotic effect are human milk oligo-
saccharides
and nutrient intake and indices of
body fatness in British children and
adolescents. Br J Nutr 2013; 110: 1512–
1523.
7 Te Morenga L, Mallard S, Mann J: Di-
etary sugars and body weight: system-
atic review and meta-analyses of ran-
domised controlled trials and cohort
studies. BMJ 2013; 346:e7492.
8 Cañete R, Gil-Campos M, Aguilera CM,
et al: Development of insulin resistance
and its relation to diet in the obese child.
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2 Cummings JH, Stephen AM: Carbohy-
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3 Englyst KN, Liu S, Englyst HN: Nutri-
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tion and Allergies: Scientific opinion on
dietary reference values for carbohy-
drates and dietary fibre. EFSA J 2010; 8:
1462.
5 FAO/WHO: Carbohydrates in human
nutrition. Report of a Joint FAO/WHO
expert consultation. FAO Food and Nu-
trition Paper, vol 66. Rome, FAO/WHO,
1998.
6 Murakami K, McCaffrey TA, Living-
stone MB: Dietary glycaemic index
and glycaemic load in relation to foodKoletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 46–50
DOI: 10.1159/000360316