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Short-Chain Fatty Acids: Ready for Prime Time?
Claude C. Roy, MD*,||
C. Lawrence Kien, MD, PhD
Lise Bouthillier, RD, MSc
Emile Levy, MD, PhD*,
* Pediatric GI Unit and
Department of Dietetics, Hôpital
Sainte-Justine; Department of Pediatrics and
Medicine, College of Medicine, University of Vermont; and the
Department of Nutrition,||
Université de Montréal
Correspondence: Correspondence: Claude C. Roy, MD, Ste Justine Hospital, 3175 Ste-Catherine
Road, Montreal, Quebec H3T 1C5, Canada. Electronic mail may be sent to
claude.roy{at}recherche-ste-justine.qc.ca.
The concept of colonic health has become a major target for the development
of functional foods such as probiotics, prebiotics, and synbiotics. These
bioactive agents have a profound effect on the composition of the microflora,
as well as on the physiology of the colon, and display distinct health
benefits. Dietary carbohydrates escaping digestion/absorption in the small
bowel and prebiotics undergo fermentation in the colon and give rise to
short-chain fatty acids (SCFA). As the main anions of the colon and the major
source of energy for colonocytes, SCFA are rapidly absorbed by nonionic
diffusion mostly but also by active transport mediated by a sodium-coupled
transporter, thereby fostering the absorption of sodium and water. SCFA in
general and butyrate in particular enhance the growth of lactobacilli and
bifidobacteria and play a central role on the physiology and metabolism of the
colon. The effect of prebiotics on cell proliferation, differentiation,
apoptosis, mucin production, immune function, mineral absorption, lipid
metabolism, and gastrointestinal (GI) peptides has been well documented
experimentally. These effects seem to be largely mediated by SCFA, but
evidence from human studies remains inconsistent. The food industry is making
a leap of faith in their efforts to commercialize prebiotics and exploit
potential health benefits. The future lies with the design of studies to
further explore basic mechanisms, and gene expression in particular, but
emphasis should be placed on human intervention trials.
Nutrition in Clinical Practice, Vol. 21, No. 4,
351-366 (2006)
DOI: 10.1177/0115426506021004351
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