Targeting Cognitive Resilience through Prebiotics: A Focused Perspective

Abstract

This perspective article is a product of the work of an expert group within the Prebiotic Task Force convened by the International Life Sciences Institute Europe, a non-profit organization that brings together experts from academia, industry, and public service to catalyze nutrition science for public benefit. An expert group was conceived in October 2023 to discuss the evidence base on the use of prebiotics to promote cognitive functioning, with a focus on highlighting knowledge gaps and proposing a list of recommendations to guide this specific area of research forward. To address this, we evaluated existing systematic reviews and meta-analyses of human intervention studies that examine the effects of prebiotics on cognitive functioning. These are predominantly conducted in healthy participants under basal conditions and have, to date, revealed limited effects. In this perspective, we propose that prebiotics should be investigated as agents to promote cognitive resilience by testing their effects on cognitive performance under certain cognition-taxing factors that individuals encounter across their lifespan. These include stress, poor sleep outcomes, sedentary behavior, and unhealthy dietary patterns, all of which have been shown to be associated with altered microbiome and impact global cognition or specific cognitive domains. In addition, we recommend identifying vulnerable populations that are either subclinical or that struggle chronically or periodically with 1 or more cognition-taxing factors, to better uncover the boundary conditions for prebiotic effectiveness. By broadening the scope of research to include diverse populations and challenging conditions in daily life or experimental settings, we can expand our understanding of the role of prebiotics not only in cognitive health or impairment, but also as potential preventative agents that may promote cognitive resilience during aging and in response to various lifestyle-related challenges.

Keywords: cognition; cognitive resilience; gut microbiota; gut-brain axis; nutritional interventions; prebiotics; sedentary behavior; sleep; stress.

FIGURE 1

Potential effects of prebiotics on cognitive resilience. Prebiotic-rich foods and prebiotic compounds such as inulin, FOS, and GOS should be investigated in healthy individuals exposed to cognition-taxing factors or to target populations where cognition is acutely or chronically compromised. Cognition-taxing factors may occur across the lifespan and include exposure to stress, poor sleep outcomes, sedentary behavior, or unhealthy dietary patterns. These factors can be acutely present in daily life or evoked in experimental settings, or can be chronically present in specific samples such as individuals with habitual reduced intake of dietary fiber or low levels of physical exercise. The effects of prebiotics can be studied under exposure to one or more cognition-taxing factors, on one or more cognitive domains that are most impacted by such factors. In addition, the impact of these cognition-taxing factors and the potential rescuing effects of prebiotics may differ depending on the target developmental epoch, such as school start and puberty, or later in the lifespan due to menopause and retirement. Various mechanisms are shared between the effects of prebiotics on host physiology and the effects of cognition-taxing factors on cognitive performance, including modulation of neuroendocrine factors and host metabolism. By fostering the growth of beneficial bacteria and increasing the production of SCFAs, prebiotics may have the potential to promote cognitive resilience across various cognitive domains. 5-HTP, 5-hydroxytryptophan; CCK, cholecystokinin; FOS, fructooligosaccharides; GABA, gamma-aminobutyric acid; GLP-1, glucagon-like peptide 1; GOS, galactooligosaccharides; PYY, peptide tyrosine tyrosine; SCFA, short-chain fatty acid. Created in BioRender.com.

FIGURE 2

A roadmap to conduct randomized placebo-controlled trials targeting cognitive resilience.