Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics

Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics Glenn R. Gibson Robert W. Hutkins Mary Ellen Sanders Susan L. Prescott Raylene A. Reimer Seppo Salminen Karen P. Scott Catherine Stanton Kelly S. Swanson Patrice D. Cani Kristin Verbeke Gregor Reid

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Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics 2017 Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2017.75 gibson2017-expert-consensus-document-the-inte gibson2017-expert-consensus-document-the-inte.txt, the project's staged copy fe5f5ac508fce8a569995c8e6473dbc7c3a054c5 cc-by biology

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0 spans located by searching the stored text for the quote's exact words, allowing any whitespace between them the word 'prebiotic' - what it has meant since 1995, what it should mean now, and which substances fall inside and outside the category Quotation withheld because this record is not cleared for redistribution. whether the 1995 definition still fits the evidence, and specifically whether selectivity, the colon and the food category should remain part of what the term requires Quotation withheld because this record is not cleared for redistribution. a consensus definition - a substrate that is selectively utilized by host microorganisms conferring a health benefit - which restores the selectivity requirement a 2010 definition had removed, drops the restriction to the gut and to food, and names what is excluded Quotation withheld because this record is not cleared for redistribution. method Quotation withheld because this record is not cleared for redistribution. a scientific category being fixed by deliberation rather than discovered - twelve named experts, one day, a printed history of the previous definitions and a figure with a NOT PREBIOTIC column Quotation withheld because this record is not cleared for redistribution. expert-consensus expert-consensus Quotation withheld because this record is not cleared for redistribution. the panel prints the 1995 wording, the three criteria it implied, the 2010 revision that removed selective fermentation and confined prebiotics to the gut, and then its own. A reader can see which requirement was dropped and put back, which is the record most redefinitions do not leave a definition with a history attached Quotation withheld because this record is not cleared for redistribution. antibiotics, minerals, vitamins and bacteriophages are named as NOT prebiotics even though they alter the microbiota. Defining by exclusion tests the criterion where it is hardest - on things that produce the same observable effect by a different mechanism a boundary drawn from outside Quotation withheld because this record is not cleared for redistribution. butyrate generated by pathogens with a bad outcome for the host is not a prebiotic effect. So membership depends jointly on the substrate, on which organisms used it and on what happened to the host - and none of that is measurable from the substance alone the category is a property of the event, not the substance Quotation withheld because this record is not cleared for redistribution. the panel requires assessment of the full microbial diversity in vivo and calls inference from pure or co-culture inadequate. Widening a category while raising its evidence bar is what stops a broader definition from admitting more claims the evidence standard raised at the same time as the definition Quotation withheld because this record is not cleared for redistribution. ISAPP raises funds through an Industry Advisory Committee, and the statement records that no input into this consensus process came from its members. The disclosure is placed in the methods, next to the procedure it could have influenced the conflict declared where it would operate Quotation withheld because this record is not cleared for redistribution. A DEFINITION FAILED BY ITS EXTENSION AND THE PAPER SAYS SO: the 2008 FAO/UN wording dropped selective fermentation, and `IN DOING SO THE DEFINITION WAS CRITICIZED FOR NOT EXCLUDING ANTIBIOTICS`. An intergovernmental panel widened a category until it admitted the one class of substance the category exists to be distinguished from - and the corpus already carries `antibiotics` on this record as the named excluded case. Quotation withheld because this record is not cleared for redistribution. THE REPAIR WAS A NEW NAME, NOT AN AMENDMENT: two years after the 2008 wording failed, `Gibson et al.20 ... defined the narrower category of ‘dietary prebiotics’ as “a selectively fermented ingredient”`. Rather than revise the term that had gone wrong, the field minted a second term carrying the criterion the first had lost - and then in 2015 the unqualified term moved AGAIN, the other way. Quotation withheld because this record is not cleared for redistribution. AND THE PANEL RECORDS WHY IT PICKED ONE WORD: `Quotation withheld`. A consensus body justifying a single lexical choice in print, in a box headed as justification for the new definition. Quotation withheld because this record is not cleared for redistribution. THE STATED TRIGGER FOR A CONSENSUS IS THE PLURALITY OF DEFINITIONS ITSELF: `Given the proposed definitions already described, as well as others, the need for A CONSENSUS DEFINITION WAS EVIDENT`. The paper treats the count of competing definitions as sufficient grounds to convene a panel - and says `as well as others`, so the five it prints are not the whole set. Quotation withheld because this record is not cleared for redistribution. THE STATED TRIGGER FOR A CONSENSUS IS THE PLURALITY OF DEFINITIONS ITSELF: `Given the proposed definitions already described, as well as others, the need for A CONSENSUS DEFINITION WAS EVIDENT`. The paper treats the count of competing definitions as sufficient grounds to convene a panel - and says `as well as others`, so the five it prints are not the whole set. Quotation withheld because this record is not cleared for redistribution. currently established prebiotics are carbohydrate-based, and non-carbohydrate candidates only might fit the updated definition pending convincing evidence Quotation withheld because this record is not cleared for redistribution. the health benefit must be documented for a substance to be considered a prebiotic, so the category cannot be assigned from chemistry alone Quotation withheld because this record is not cleared for redistribution. inference about prebiotic effects from pure or co-culture experiments is inadequate; conclusions require the full microbiota in vivo Quotation withheld because this record is not cleared for redistribution. a 2010 definition had removed the selective-fermentation requirement and confined prebiotics to the gut, so the term has carried incompatible meanings in the literature the panel is summarising Quotation withheld because this record is not cleared for redistribution. the definition is produced by consensus among a panel rather than by a test, so its authority rests on the procedure and the panel composition Quotation withheld because this record is not cleared for redistribution. the consensus-panel procedure itself, carried from clinical guideline development into terminology - a category settled by documented deliberation rather than by experiment Quotation withheld because this record is not cleared for redistribution. the statement records that ISAPP raises funds through an Industry Advisory Committee and that no input into this consensus panel came from its members eliminates: industry influence on a definition that governs product marketing and regulatory oversight - the one place a funded body's category would be worth buying · outcome: held Quotation withheld because this record is not cleared for redistribution. the previous definitions reproduced verbatim alongside the new one, with the requirement each version added or removed named eliminates: a silent redefinition - a reader can see that selectivity was removed in 2010 and restored here, rather than having to reconstruct it · outcome: held Quotation withheld because this record is not cleared for redistribution. substances that alter the microbiota by other mechanisms - antibiotics, minerals, vitamins, bacteriophages - tested against the criterion and named as excluded eliminates: a criterion that admits anything with an effect on the microbiota, which is what a definition without selective utilization would do · outcome: held Quotation withheld because this record is not cleared for redistribution. the requirement that prebiotic activity be assessed across the full microbial diversity in vivo rather than by abundance of bifidobacteria or lactobacilli eliminates: a positive result manufactured by measuring only the two genera the substrate was already known to feed · outcome: held Quotation withheld because this record is not cleared for redistribution. the panel procedure - discussion per issue until consensus, sections written by individual panellists, compiled, then edited and agreed by all members and the board eliminates: a consensus document that records the view of a single panellist - every section was written individually, then compiled, edited and agreed by all members · outcome (stated by the tagger, no quotation): held Quotation withheld because this record is not cleared for redistribution. prebiotic prebiotic Quotation withheld because this record is not cleared for redistribution. probiotics probiotics Quotation withheld because this record is not cleared for redistribution. dietary fibres dietary fibres Quotation withheld because this record is not cleared for redistribution. selective utilization selective utilization Quotation withheld because this record is not cleared for redistribution. antibiotics antibiotics Quotation withheld because this record is not cleared for redistribution. butyrate butyrate Quotation withheld because this record is not cleared for redistribution. consensus consensus Quotation withheld because this record is not cleared for redistribution. Industry Advisory Committee Industry Advisory Committee Quotation withheld because this record is not cleared for redistribution. full microbial diversity full microbial diversity Quotation withheld because this record is not cleared for redistribution. bifido bacteria bifido bacteria Quotation withheld because this record is not cleared for redistribution. prebiotic - AS DEFINED IN 1995: a non-digestible FOOD ingredient that selectively stimulates one or a limited number of bacteria ALREADY RESIDENT IN THE COLON Quotation withheld because this record is not cleared for redistribution. prebiotic - AS DEFINED IN 2015 by Bindels et al.: limited to the gut microbiota, excluding extraintestinal sites such as vagina and skin, and with the requirement for selective fermentation REMOVED - the definition this panel was convened to replace Quotation withheld because this record is not cleared for redistribution. prebiotic - AS DEFINED IN 2017: a substrate that is selectively utilized by host microorganisms conferring a health benefit - selectivity restored, no food requirement, no site requirement Quotation withheld because this record is not cleared for redistribution. prebiotic - BY WHAT IT EXCLUDES: not antibiotics, minerals, vitamins or bacteriophages, which alter the microbiota without being growth substrates Quotation withheld because this record is not cleared for redistribution. a prebiotic effect - AS A PROPERTY OF THE SUBSTANCE: what the category name suggests, and what the panel rejects Quotation withheld because this record is not cleared for redistribution. a prebiotic effect - AS A PROPERTY OF THE WHOLE EVENT: if pathogens generate the butyrate and the host is harmed, the same molecule is not a prebiotic effect Quotation withheld because this record is not cleared for redistribution. evidence of prebiotic activity - AS PRACTISED: increased abundance of bifidobacteria or lactobacilli Quotation withheld because this record is not cleared for redistribution. evidence of prebiotic activity - AS REQUIRED HERE: an assessment of the full microbial diversity in vivo, with pure and co-culture inference called inadequate Quotation withheld because this record is not cleared for redistribution. prebiotic - AS DEFINED IN 2004: `selectively fermented ingredients that allow specific changes ... in the gastrointestinal microflora that confers benefits upon host well-being and health`, carrying THREE explicit criteria - resist host digestion, be fermented by intestinal microorganisms, and selectively stimulate health-associated intestinal bacteria. Quotation withheld because this record is not cleared for redistribution. prebiotic - AS DEFINED IN 2008 BY AN FAO/UN TECHNICAL MEETING: `a non-viable food component that confers a health benefit on the host associated with modulation of the microbiota`. SELECTIVE FERMENTATION WAS REMOVED, AND THE DEFINITION WAS THEN CRITICISED FOR NOT EXCLUDING ANTIBIOTICS - a definition whose extension was wrong in a way anyone could check. Quotation withheld because this record is not cleared for redistribution. dietary prebiotics - A NARROWER SIBLING TERM COINED IN 2010 TO REPAIR THE 2008 DEFINITION: `a selectively fermented ingredient that results in specific changes in the composition and/or activity of the gastrointestinal microbiota`. The repair was made by NAMING A NEW TERM rather than by amending the old one, and it RESTORED the criterion 2008 had dropped. Quotation withheld because this record is not cleared for redistribution. critiques → the 2010 definition, which confined prebiotics to the gut and removed the requirement for selective fermentation Quotation withheld because this record is not cleared for redistribution. extends → the 1995 definition, by dropping the food, colon and non-digestibility restrictions while keeping selectivity Quotation withheld because this record is not cleared for redistribution. critiques → the field's practice of evidencing prebiotic activity by increased abundance of bifidobacteria and lactobacilli Quotation withheld because this record is not cleared for redistribution. distinguishes-from → probiotics and dietary fibres, as neighbouring categories the term must not absorb Quotation withheld because this record is not cleared for redistribution. prebiotic —distinct-from→ probiotics prebiotic probiotics differs in: whether the thing administered is alive or is food for something alive · the relation itself is separately evidenced · strength of the relation: 0.95 · differs in (stated by the tagger, no quotation): whether the thing administered is alive or is food for something alive · the relation stated: probiotics are live microorganisms; prebiotics are non-viable substrates that feed them, including administered probiotic strains Quotation withheld because this record is not cleared for redistribution. prebiotic —distinct-from→ dietary fibres prebiotic dietary fibres differs in: whether the substrate is used selectively or by the whole community · the relation itself is separately evidenced · strength of the relation: 0.95 · differs in (stated by the tagger, no quotation): whether the substrate is used selectively or by the whole community · the relation stated: most dietary fibres encourage a wide variety of gut microorganisms; a prebiotic must not be broadly metabolized but bias metabolism towards health-promoting members Quotation withheld because this record is not cleared for redistribution. full microbial diversity —distinct-from→ bifido bacteria full microbial diversity bifido bacteria differs in: whether the evidence covers the community or two convenient genera · the relation itself is separately evidenced · strength of the relation: 0.95 · differs in (stated by the tagger, no quotation): whether the evidence covers the community or two convenient genera · the relation stated: a prebiotic claim must rest on an assessment of the whole community, not on increased abundance of two genera Audit 2026-09-28: DOUBTFUL - read against its full span and kept, but prebiotic effects must be judged on full diversity 'not simply' bifidobacteria; distinct-from is loose. Quotation withheld because this record is not cleared for redistribution. the panel redefined a prebiotic as a substrate that is selectively utilized by host microorganisms conferring a health benefit the panel redefined a prebiotic as a substrate that is selectively utilized by host microorganisms conferring a health benefit Quotation withheld because this record is not cleared for redistribution. a 2010 definition had removed the requirement for selective fermentation and confined prebiotics to the gut; this panel restores selectivity and removes the site restriction a 2010 definition had removed the requirement for selective fermentation and confined prebiotics to the gut; this panel restores selectivity and removes the site restriction Quotation withheld because this record is not cleared for redistribution. antibiotics, minerals, vitamins and bacteriophages are named as not prebiotics even though their intake might alter the microbiota antibiotics, minerals, vitamins and bacteriophages are named as not prebiotics even though their intake might alter the microbiota Quotation withheld because this record is not cleared for redistribution. butyrate generated by pathogenic microorganisms with a negative consequence for the host cannot be termed a prebiotic effect butyrate generated by pathogenic microorganisms with a negative consequence for the host cannot be termed a prebiotic effect Quotation withheld because this record is not cleared for redistribution. prebiotic activity must be assessed across the full microbial diversity in vivo, not by increased abundance of bifidobacteria or lactobacilli prebiotic activity must be assessed across the full microbial diversity in vivo, not by increased abundance of bifidobacteria or lactobacilli Quotation withheld because this record is not cleared for redistribution. no input into the consensus panel process was provided by members of the ISAPP Industry Advisory Committee no input into the consensus panel process was provided by members of the ISAPP Industry Advisory Committee Quotation withheld because this record is not cleared for redistribution. the stated goal is to engender appropriate use of the term by stakeholders in research reports, product marketing and regulatory oversight the stated goal is to engender appropriate use of the term by stakeholders in research reports, product marketing and regulatory oversight Quotation withheld because this record is not cleared for redistribution. 2017 ISAPP: a substrate that is selectively utilized by host microorganisms conferring a health benefit - expanded to non-carbohydrates, to sites beyond the gut and to categories beyond food, with the selectivity requirement retained prebiotic Quotation withheld because this record is not cleared for redistribution. 1995: a non-digestible food ingredient that beneficially affects the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria already resident in the colon prebiotic Quotation withheld because this record is not cleared for redistribution. selective utilization selective utilization Quotation withheld because this record is not cleared for redistribution.

The full text of this article is not redistributable, so it is not included here. The evidence sentences are withheld with it; the tag layer and its grounding status remain. The article itself is at https://doi.org/10.1038/nrgastro.2017.75.