Famularo Giuseppe, De Simone Claudio, Pandey Vandana, Sahu Adita Ranjan, Minisola Giovanni
Department of Internal Medicine, San Camillo Hospital, Circonvallazione Gianicolense, 00152 Rome, Italy.
Med Hypotheses. 2005;65(6):1132-5. doi: 10.1016/j.mehy.2004.09.030. Epub 2005 Aug 10.
Vegetarians may have subtle nutritional deficiencies which have been related to the occurrence of an unrecognized malabsorption syndrome. The excess phytate content in cereals, nuts, legumes and oilseeds which represent the mainstay of their food intake, seems to play a central role in the pathogenesis of this malabsorption syndrome as an inverse relationship has been shown to link the phytate content of the diet with the intestinal absorption of trace minerals and proteins. We postulate that manipulating the endogenous digestive microflora of subjects on a vegetarian diet through administering probiotic lactic bacteria would represent an innovative tool to counteract the occurrence of the malabsorption syndrome dependent on the high phytate content of their diet. Even though there are no data about the composition of endogenous digestive microflora in subjects on a vegetarian diet, we expect that probiotic lactobacilli can interact with or affect distinct yet interrelated components within the intestinal milieu, such as epithelial cells, enteric flora, and/or mucosal immune cells. This would ultimately translate into the correction of the unregulated mechanisms implicated in the altered intestinal absorption of trace metals and proteins commonly seen in vegetarians. Clinical experience with probiotic therapy of patients with inflammatory bowel disease fully agrees with this view. One additional point of interest is that probiotic lactobacilli, and other species of the endogenous digestive microflora as well, are an important source of the enzyme phytase which catalyses the release of phosphate from phytate and hydrolyses the complexes formed by phytate and metal ions or other cations, rendering them more soluble ultimately improving and facilitating their intestinal absorption. The regular intake of probiotic preparation, may represent a cheap and safe tool in order to convert a diet with a low potential for bioavailability of trace minerals and proteins, such as the vegetarian diet, into a diet with a high bioavailability potential. The benefit of such an approach would not be restricted to vegetarians.
素食者可能存在细微的营养缺乏,这与一种未被识别的吸收不良综合征的发生有关。谷物、坚果、豆类和油籽是他们食物摄入的主要组成部分,其中过量的植酸盐含量似乎在这种吸收不良综合征的发病机制中起核心作用,因为已表明饮食中的植酸盐含量与微量矿物质和蛋白质的肠道吸收呈负相关。我们推测,通过施用益生菌乳酸菌来调控素食者体内的内源性消化微生物群,将是一种创新手段,可对抗因饮食中植酸盐含量高而导致的吸收不良综合征的发生。尽管目前尚无关于素食者内源性消化微生物群组成的数据,但我们预计益生菌乳酸菌可与肠道环境中的不同但相互关联的成分相互作用或产生影响,如上皮细胞、肠道菌群和/或黏膜免疫细胞。这最终将转化为对素食者中常见的微量金属和蛋白质肠道吸收改变所涉及的失调机制的纠正。对炎症性肠病患者进行益生菌治疗的临床经验完全支持这一观点。另一个有趣的点是,益生菌乳酸菌以及内源性消化微生物群的其他种类,是植酸酶的重要来源,植酸酶可催化植酸盐释放磷酸盐,并水解植酸盐与金属离子或其他阳离子形成的复合物,使其最终更易溶解,从而改善并促进其肠道吸收。定期摄入益生菌制剂,可能是一种廉价且安全的手段,可将微量矿物质和蛋白质生物利用度低的饮食(如素食)转变为具有高生物利用度潜力的饮食。这种方法的益处并不局限于素食者。