[Physiological effects, mechanisms of action and application of lactulose]

Vopr Pitan. 2020;89(2):5-20. doi: 10.24411/0042-8833-2020-10012. Epub 2020 Mar 16.
[Article in Russian]

Abstract

The discovery of lactulose as a bifidogenic factor became the background for the appearance of the prebiotics concept. Currently, lactulose is the most studied in terms of medical use oligosaccharide with a high prebiotic index. The exact mechanisms of action of lactulose remain largely unknown despite a number of new researches based on modern methods of molecular biology, genetics, and bioinformatics. The aim of this review to summarize and analyze the actual information about biological activity, probable mechanisms of action, and possible uses of lactulose in human nutrition. Results. The structure of lactulose, methods for its determination and preparation are briefly described. Promising methods for producing lactulose include enzymatic synthesis from lactose using β-galactosidase or epimerase. Information on the physiological effects of lactulose and the mechanisms of its action on the human organism is presented. The works confirming the ability of lactulose to stimulate the growth of bifidobacteria and to influence the metabolism of the intestinal microbiota are summarized. The results of studies of the ability of lactulose to have antitoxic and anticarcinogenic effects are presented. The mechanisms of the positive effect of the prebiotic on the absorption of minerals, increased absorption of Ca and Mg in the human organism are described. The effect of lactulose on immunity and the possibility of its use to reduce the glucose blood level in patients with type 2 diabetes mellitus are shown. The main directions of the use of lactulose in food production are systematized. The data confirming the possibility of using lactulose as a growth factor for probiotics, as well as a protective agent to increase the survival of some starter cultures, are presented. Brief information on the doses and forms of lactulose apply in medicine is presented. The dependence of the effects of lactulose on the dose, health condition and age of patients has been established. Conclusion. Perspective directions of lactulose using in combination with probiotics, other prebiotics, and as an encapsulating ingredient for vitamins and other functional nutrition ingredients are determined. In this regard, the study of lactulose interaction with the components of complex products is relevant.

Keywords: application; lactulose; mechanisms of action; physiological effects; prebiotic.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / metabolism
  • Diabetes Mellitus, Type 2* / microbiology
  • Diabetes Mellitus, Type 2* / pathology
  • Gastrointestinal Microbiome / drug effects*
  • Humans
  • Lactulose* / pharmacokinetics
  • Lactulose* / therapeutic use
  • Prebiotics*

Substances

  • Prebiotics
  • Lactulose