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Prebiotics play a pivotal role in fostering probiotics, essential contributors to the creation and maintenance of a conducive environment for beneficial microbiota within the human gut. To qualify as a prebiotic, a substance must demonstrate resilience to stomach enzymes, acidic pH levels, and intestinal bacteria, remaining unabsorbed in the digestive system while remaining accessible to gut microflora. The integration of prebiotics and probiotics into our daily diet establishes a cornerstone for optimal health, a priority for health-conscious consumers emphasizing nutrition that supports a balanced gut flora. Prebiotics offer diverse biological functions in humans, exhibiting antiobesity, antimicrobial, anticancer, anti-inflammatory, antidiabetic, and cholesterol-lowering properties, along with preventing digestive disorders. Numerous dietary fibers possessing prebiotic attributes are inadvertently present in our diets, emphasizing the broader significance of prebiotics. It is crucial to recognize that, while all dietary fibers are prebiotics, not all prebiotics fall under the category of dietary fibers. The versatile applications of prebiotics extend across various industries, such as dairy, bakery, beverages, cosmetics, pharmaceuticals, and other food products. This comprehensive review provides insights into different prebiotics, encompassing their sources, chemical compositions, and applications within the food industry.
RESUMO
CONTEXT: Coronavirus disease 2019 (COVID-19) predominantly involves the lungs, albeit many other organ systems, including the hypothalamic-pituitary-adrenal (HPA) axis, can be affected due to the expression of the angiotensin-converting enzyme 2 (ACE2) binding receptor. Few studies have reported the involvement of adrenal gland and the HPA axis during the acute phase of COVID-19; however, the data on the long-term effect of COVID-19 on the HPA axis after acute infection is scarce. OBJECTIVE: To assess and compare the changes in HPA axis in mild, moderate and severe COVID-19 categories at ≥ 3 months after acute infection. METHODS: A prospective, observational study was conducted to assess the HPA axis status among COVID-19 subjects at least 3 months after recovery from acute infection. The study was conducted from June 2021 to May 2022. Subjects visited the hospital in the fasting state (8.00-9.00am), serum cortisol levels were measured at baseline, 30 and 60 minutes after a 1-µg short Synacthen test (SST). RESULTS: A total of 66 subjects ≥ 18 years of age were included in the study. The mean age (SD) was 49.13 ± 11.9 years, 45(68.18%) were male and 21 (31.81%) were female subjects. The mean BMI in the study was 25.91 ± 4.26 kg/m2. Seventeen (25.8%) subjects had mild, twelve (18.2%) had moderate and thirty-seven (56.1%) subjects had severe COVID-19 infection. Out of the sixty-six subjects with COVID-19, nine subjects (9/66, 13.63%) had peak serum cortisol < 496.62 nmol/L suggestive of adrenal insufficiency (AI). SST peak serum cortisol levels did not differ significantly across the disease severity [Mild, (628.50 ± 214.65 nmol/L) vs moderate, [603.39 ± 161.95 nmol/L) vs severe, (597.59 ± 163.05 nmol/L), P = 0.617]. Six subjects with AI came for follow-up at 12 months, and all had normal HPA axis. CONCLUSION: HPA axis is affected in 13.63% (9/66) of subjects at least 3 months after recovery from COVID-19 infection. AI in COVID-19 might be transient and would recover spontaneously. These findings have important implications for the clinical care and long-term follow-up of subjects after COVID-19 infection.
