Food matters: how the microbiome and gut–brain interaction might impact the development and course of anorexia nervosa

Simopoulos AP (2001) The Hippocratic concept of positive health in the fifth century BC and in the new millennium. World Rev Nutr Diet 89:1–4 American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Press Minuchin S, Baker L, Rosman BL, Liebman R, Milman L, Todd TC (1975) A conceptual model of psychosomatic illness in children. Family organization and family therapy. Arch Gen Psychiatry 32:1031–1038 Herpertz-Dahlmann B, Seitz J, Konrad K (2011) Aetiology of anorexia nervosa: from a “psychosomatic family model” to a neuropsychiatric disorder? Eur Arch Psychiatry Clin Neurosci 261(Suppl 2):S177–S181. doi:10.1007/s00406-011-0246-y Kaplan AS, Walsh BT, Olmsted M, Attia E, Carter JC, Devlin MJ, Pike KM, Woodside B, Rockert W, Roberto CA, Parides M (2009) The slippery slope: prediction of successful weight maintenance in anorexia nervosa. Psychol Med 39:1037–1045. doi:10.1017/s003329170800442x Misra M, Golden NH, Katzman DK (2016) State of the art systematic review of bone disease in anorexia nervosa. Int J Eat Disord 49:276–292. doi:10.1002/eat.22451 Misra M, Klibanski A (2016) Anorexia nervosa and its associated endocrinopathy in young people. Horm Res Paediatr 85:147–157. doi:10.1159/000443735 Pollice C, Kaye WH, Greeno CG, Weltzin TE (1997) Relationship of depression, anxiety, and obsessionality to state of illness in anorexia nervosa. Int J Eat Disord 21:367–376 Meehan KG, Loeb KL, Roberto CA, Attia E (2006) Mood change during weight restoration in patients with anorexia nervosa. Int J Eat Disord 39:587–589. doi:10.1002/eat.20337 Chen J, Papies EK, Barsalou LW (2016) A core eating network and its modulations underlie diverse eating phenomena. Brain Cogn. doi:10.1016/j.bandc.2016.04.004 Sherwin E, Rea K, Dinan TG, Cryan JF (2016) A gut (microbiome) feeling about the brain. Curr Opin Gastroenterol 32:96–102. doi:10.1097/mog.0000000000000244 Kelly JR, Kennedy PJ, Cryan JF, Dinan TG, Clarke G, Hyland NP (2015) Breaking down the barriers: the gut microbiome, intestinal permeability and stress-related psychiatric disorders. Front Cell Neurosci 9:392. doi:10.3389/fncel.2015.00392 Backhed F, Ley RE, Sonnenburg JL, Peterson DA, Gordon JI (2005) Host-bacterial mutualism in the human intestine. Science 307:1915–1920. doi:10.1126/science.1104816 Derrien M, van Hylckama Vlieg JE (2015) Fate, activity, and impact of ingested bacteria within the human gut microbiota. Trends Microbiol 23:354–366. doi:10.1016/j.tim.2015.03.002 Petra AI, Panagiotidou S, Hatziagelaki E, Stewart JM, Conti P, Theoharides TC (2015) Gut-microbiota-brain axis and its effect on neuropsychiatric disorders with suspected immune dysregulation. Clin Ther 37:984–995. doi:10.1016/j.clinthera.2015.04.002 Carr J, Kleiman SC, Bulik CM, Bulik-Sullivan EC, Carroll IM (2016) Can attention to the intestinal microbiota improve understanding and treatment of anorexia nervosa? Expert Rev Gastroenterol Hepatol 10:565–569. doi:10.1586/17474124.2016.1166953 Steinhausen HC (2002) The outcome of anorexia nervosa in the 20th century. Am J Psychiatry 159:1284–1293 Arcelus J, Mitchell AJ, Wales J, Nielsen S (2011) Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Arch Gen Psychiatry 68:724–731. doi:10.1001/archgenpsychiatry.2011.74 Herpertz-Dahlmann B, van Elburg A, Castro-Fornieles J, Schmidt U (2015) ESCAP Expert Paper: new developments in the diagnosis and treatment of adolescent anorexia nervosa–a European perspective. Eur Child Adolesc Psychiatry 24:1153–1167. doi:10.1007/s00787-015-0748-7 Schmidt U, Campbell IC (2013) Treatment of eating disorders can not remain ‘brainless’: the case for brain-directed treatments. Eur Eat Disord Rev 21:425–427. doi:10.1002/erv.2257 Staubach F, Kunzel S, Baines AC, Yee A, McGee BM, Backhed F, Baines JF, Johnsen JM (2012) Expression of the blood-group-related glycosyltransferase B4galnt2 influences the intestinal microbiota in mice. ISME J 6:1345–1355. doi:10.1038/ismej.2011.204 Kelly JR, Clarke G, Cryan JF, Dinan TG (2016) Brain-gut-microbiota axis: challenges for translation in psychiatry. Ann Epidemiol 26:366–372. doi:10.1016/j.annepidem.2016.02.008 Vanuytsel T, van Wanrooy S, Vanheel H, Vanormelingen C, Verschueren S, Houben E, Salim Rasoel S, Tomicronth J, Holvoet L, Farre R, Van Oudenhove L, Boeckxstaens G, Verbeke K, Tack J (2014) Psychological stress and corticotropin-releasing hormone increase intestinal permeability in humans by a mast cell-dependent mechanism. Gut 63:1293–1299. doi:10.1136/gutjnl-2013-305690 Monteleone AM, Monteleone P, Serino I, Amodio R, Monaco F, Maj M (2016) Underweight subjects with anorexia nervosa have an enhanced salivary cortisol response not seen in weight restored subjects with anorexia nervosa. Psychoneuroendocrinology 70:118–121. doi:10.1016/j.psyneuen.2016.05.004 Schorr M, Lawson EA, Dichtel LE, Klibanski A, Miller KK (2015) Cortisol measures across the weight spectrum. J Clin Endocrinol Metab 100:3313–3321. doi:10.1210/jc.2015-2078 Jesus P, Ouelaa W, Francois M, Riachy L, Guerin C, Aziz M, Do Rego JC, Dechelotte P, Fetissov SO, Coeffier M (2014) Alteration of intestinal barrier function during activity-based anorexia in mice. Clin Nutr 33:1046–1053. doi:10.1016/j.clnu.2013.11.006 Yano JM, Yu K, Donaldson GP, Shastri GG, Ann P, Ma L, Nagler CR, Ismagilov RF, Mazmanian SK, Hsiao EY (2015) Indigenous bacteria from the gut microbiota regulate host serotonin biosynthesis. Cell 161:264–276. doi:10.1016/j.cell.2015.02.047 Wikoff WR, Anfora AT, Liu J, Schultz PG, Lesley SA, Peters EC, Siuzdak G (2009) Metabolomics analysis reveals large effects of gut microflora on mammalian blood metabolites. Proc Natl Acad Sci 106:3698–3703. doi:10.1073/pnas.0812874106 Ridaura V, Belkaid Y (2015) Gut microbiota: the link to your second brain. Cell 161:193–194. doi:10.1016/j.cell.2015.03.033 Jenkins TA, Nguyen JC, Polglaze KE, Bertrand PP (2016) Influence of tryptophan and serotonin on mood and cognition with a possible role of the gut–brain axis. Nutrients. doi:10.3390/nu8010056 Neufeld KM, Kang N, Bienenstock J, Foster JA (2011) Reduced anxiety-like behavior and central neurochemical change in germ-free mice. Neurogastroenterol Motil 23(255–264):e119. doi:10.1111/j.1365-2982.2010.01620.x Duman RS (2011) Neurochemical theories of depression: preclinical studies. In: Charney DS, Nestler EJ (eds) Neurobiology of mental illness. Oxford Press, pp 414–444 Clarke G, Grenham S, Scully P, Fitzgerald P, Moloney RD, Shanahan F, Dinan TG, Cryan JF (2013) The microbiome–gut–brain axis during early life regulates the hippocampal serotonergic system in a sex-dependent manner. Mol Psychiatry 18:666–673. doi:10.1038/mp.2012.77 Jiang H, Ling Z, Zhang Y, Mao H, Ma Z, Yin Y, Wang W, Tang W, Tan Z, Shi J, Li L, Ruan B (2015) Altered fecal microbiota composition in patients with major depressive disorder. Brain Behav Immun 48:186–194. doi:10.1016/j.bbi.2015.03.016 Lurie I, Yang YX, Haynes K, Mamtani R, Boursi B (2015) Antibiotic exposure and the risk for depression, anxiety, or psychosis: a nested case-control study. J Clin Psychiatry 76:1522–1528. doi:10.4088/JCP.15m09961 Kaye WH, Fudge JL, Paulus M (2009) New insights into symptoms and neurocircuit function of anorexia nervosa. Nat Rev Neurosci 10:573–584. doi:10.1038/nrn2682 Kaye WH, Wierenga CE, Bailer UF, Simmons AN, Bischoff-Grethe A (2013) Nothing tastes as good as skinny feels: the neurobiology of anorexia nervosa. Trends Neurosci 36:110–120. doi:10.1016/j.tins.2013.01.003 Herpertz-Dahlmann B, Wewetzer C (2014) Eating disorders. In: Gerlach M, Warnke A, Greenhill L (eds) Psychiatric drugs in children and adolescents. Springer, Heidelberg, pp 429–437 Harrisberger F, Smieskova R, Schmidt A, Lenz C, Walter A, Wittfeld K, Grabe HJ, Lang UE, Fusar-Poli P, Borgwardt S (2015) BDNF Val66Met polymorphism and hippocampal volume in neuropsychiatric disorders: a systematic review and meta-analysis. Neurosci Biobehav Rev 55:107–118. doi:10.1016/j.neubiorev.2015.04.017 Desbonnet L, Clarke G, Traplin A, O’Sullivan O, Crispie F, Moloney RD, Cotter PD, Dinan TG, Cryan JF (2015) Gut microbiota depletion from early adolescence in mice: implications for brain and behaviour. Brain Behav Immun 48:165–173. doi:10.1016/j.bbi.2015.04.004 Savignac HM, Corona G, Mills H, Chen L, Spencer JP, Tzortzis G, Burnet PW (2013) Prebiotic feeding elevates central brain derived neurotrophic factor, N-methyl-d-aspartate receptor subunits and d-serine. Neurochem Int 63:756–764. doi:10.1016/j.neuint.2013.10.006 Liang S, Wang T, Hu X, Luo J, Li W, Wu X, Duan Y, Jin F (2015) Administration of Lactobacillus helveticus NS8 improves behavioral, cognitive, and biochemical aberrations caused by chronic restraint stress. Neuroscience 310:561–577. doi:10.1016/j.neuroscience.2015.09.033 Savignac HM, Tramullas M, Kiely B, Dinan TG, Cryan JF (2015) Bifidobacteria modulate cognitive processes in an anxious mouse strain. Behav Brain Res 287:59–72. doi:10.1016/j.bbr.2015.02.044 Monteleone P, Fabrazzo M, Martiadis V, Serritella C, Pannuto M, Maj M (2005) Circulating brain-derived neurotrophic factor is decreased in women with anorexia and bulimia nervosa but not in women with binge-eating disorder: relationships to co-morbid depression, psychopathology and hormonal variables. Psychol Med 35:897–905 Zwipp J, Hass J, Schober I, Geisler D, Ritschel F, Seidel M, Weiss J, Roessner V, Hellweg R, Ehrlich S (2014) Serum brain-derived neurotrophic factor and cognitive functioning in underweight, weight-recovered and partially weight-recovered females with anorexia nervosa. Prog Neuropsychopharmacol Biol Psychiatry 54:163–169. doi:10.1016/j.pnpbp.2014.05.006 Mohle L, Mattei D, Heimesaat MM, Bereswill S, Fischer A, Alutis M, French T, Hambardzumyan D, Matzinger P, Dunay IR, Wolf SA (2016) Ly6C(hi) monocytes provide a link between antibiotic-induced changes in gut microbiota and adult hippocampal neurogenesis. Cell Rep 15:1945–1956. doi:10.1016/j.celrep.2016.04.074 Martin-Subero M, Anderson G, Kanchanatawan B, Berk M, Maes M (2016) Comorbidity between depression and inflammatory bowel disease explained by immune-inflammatory, oxidative, and nitrosative stress; tryptophan catabolite; and gut–brain pathways. CNS Spectr 21:184–198. doi:10.1017/s1092852915000449 Bailey MT, Dowd SE, Galley JD, Hufnagle AR, Allen RG, Lyte M (2011) Exposure to a social stressor alters the structure of the intestinal microbiota: implications for stressor-induced immunomodulation. Brain Behav Immun 25:397–407. doi:10.1016/j.bbi.2010.10.023 Maes M, Kubera M, Leunis JC, Berk M (2012) Increased IgA and IgM responses against gut commensals in chronic depression: further evidence for increased bacterial translocation or leaky gut. J Affect Disord 141:55–62. doi:10.1016/j.jad.2012.02.023 Raevuori A, Haukka J, Vaarala O, Suvisaari JM, Gissler M, Grainger M, Linna MS, Suokas JT (2014) The increased risk for autoimmune diseases in patients with eating disorders. PLoS One 9:e104845. doi:10.1371/journal.pone.0104845 Frost GS, Walton GE, Swann JR, Psichas A, Costabile A, Johnson LP, Sponheimer M, Gibson GR, Barraclough TG (2014) Impacts of plant-based foods in ancestral hominin diets on the metabolism and function of gut microbiota in vitro. MBio 5:e00853–e00814. doi:10.1128/mBio.00853-14 den Besten G, van Eunen K, Groen AK, Venema K, Reijngoud DJ, Bakker BM (2013) The role of short-chain fatty acids in the interplay between diet, gut microbiota, and host energy metabolism. J Lipid Res 54:2325–2340. doi:10.1194/jlr.R036012 Stilling RM, Bordenstein SR, Dinan TG, Cryan JF (2014) Friends with social benefits: host-microbe interactions as a driver of brain evolution and development? Front Cell Infect Microbiol 4:147. doi:10.3389/fcimb.2014.00147 Stilling RM, Dinan TG, Cryan JF (2014) Microbial genes, brain & behaviour—epigenetic regulation of the gut–brain axis. Genes Brain Behav 13:69–86. doi:10.1111/gbb.12109 De Vadder F, Kovatcheva-Datchary P, Goncalves D, Vinera J, Zitoun C, Duchampt A, Backhed F, Mithieux G (2014) Microbiota-generated metabolites promote metabolic benefits via gut–brain neural circuits. Cell 156:84–96. doi:10.1016/j.cell.2013.12.016 Byrne CS, Chambers ES, Morrison DJ, Frost G (2015) The role of short chain fatty acids in appetite regulation and energy homeostasis. Int J Obes (Lond) 39:1331–1338. doi:10.1038/ijo.2015.84 Turnbaugh PJ, Ley RE, Mahowald MA, Magrini V, Mardis ER, Gordon JI (2006) An obesity-associated gut microbiome with increased capacity for energy harvest. Nature 444:1027–1031. doi:10.1038/nature05414 Ridaura VK, Faith JJ, Rey FE, Cheng J, Duncan AE, Kau AL, Griffin NW, Lombard V, Henrissat B, Bain JR, Muehlbauer MJ, Ilkayeva O, Semenkovich CF, Funai K, Hayashi DK, Lyle BJ, Martini MC, Ursell LK, Clemente JC, Van Treuren W, Walters WA, Knight R, Newgard CB, Heath AC, Gordon JI (2013) Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science 341:1241214. doi:10.1126/science.1241214 Smith MI, Yatsunenko T, Manary MJ, Trehan I, Mkakosya R, Cheng J, Kau AL, Rich SS, Concannon P, Mychaleckyj JC, Liu J, Houpt E, Li JV, Holmes E, Nicholson J, Knights D, Ursell LK, Knight R, Gordon JI (2013) Gut microbiomes of Malawian twin pairs discordant for kwashiorkor. Science 339:548–554. doi:10.1126/science.1229000 Adan RA, Hillebrand JJ, De Rijke C, Nijenhuis W, Vink T, Garner KM, Kas MJ (2003) Melanocortin system and eating disorders. Ann N Y Acad Sci 994:267–274 Monteleone P, Carratu R, Carteni M, Generoso M, Lamberti M, Magistris LD, Brambilla F, Colurcio B, Secondulfo M, Maj M (2004) Intestinal permeability is decreased in anorexia nervosa. Mol Psychiatry 9:76–80. doi:10.1038/sj.mp.4001374 Uil JJ, van Elburg RM, van Overbeek FM, Mulder CJ, VanBerge-Henegouwen GP, Heymans HS (1997) Clinical implications of the sugar absorption test: intestinal permeability test to assess mucosal barrier function. Scand J Gastroenterol Suppl 223:70–78 Pals KL, Chang RT, Ryan AJ, Gisolfi CV (1997) Effect of running intensity on intestinal permeability. J Appl Physiol (1985) 82:571–576 Elia M, Behrens R, Northrop C, Wraight P, Neale G (1987) Evaluation of mannitol, lactulose and 51Cr-labelled ethylenediaminetetra-acetate as markers of intestinal permeability in man. Clin Sci (Lond) 73:197–204 Welsh FK, Farmery SM, MacLennan K, Sheridan MB, Barclay GR, Guillou PJ, Reynolds JV (1998) Gut barrier function in malnourished patients. Gut 42:396–401 Pfleiderer A, Lagier JC, Armougom F, Robert C, Vialettes B, Raoult D (2013) Culturomics identified 11 new bacterial species from a single anorexia nervosa stool sample. Eur J Clin Microbiol Infect Dis 32:1471–1481. doi:10.1007/s10096-013-1900-2 Morita H, Obata K, Abe C, Shiba D, Shirakawa M, Kudo T, Takahashi S (2015) Feasibility of a short-arm centrifuge for mouse hypergravity experiments. PLoS One 10:e0133981. doi:10.1371/journal.pone.0133981 Armougom F, Henry M, Vialettes B, Raccah D, Raoult D (2009) Monitoring bacterial community of human gut microbiota reveals an increase in Lactobacillus in obese patients and methanogens in anorexic patients. PLoS One 4:e7125. doi:10.1371/journal.pone.0007125 Kleiman SC, Watson HJ, Bulik-Sullivan EC, Huh EY, Tarantino LM, Bulik CM, Carroll IM (2015) The intestinal microbiota in acute anorexia nervosa and during renourishment: relationship to depression, anxiety, and eating disorder psychopathology. Psychosom Med 77:969–981. doi:10.1097/psy.0000000000000247 Mack I, Cuntz U, Gramer C, Niedermaier S, Pohl C, Schwiertz A, Zimmermann K, Zipfel S, Enck P, Penders J (2016) Weight gain in anorexia nervosa does not ameliorate the faecal microbiota, branched chain fatty acid profiles, and gastrointestinal complaints. Sci Rep 6:26752. doi:10.1038/srep26752 Holzer P, Farzi A (2014) Neuropeptides and the microbiota-gut–brain axis. Adv Exp Med Biol 817:195–219. doi:10.1007/978-1-4939-0897-4_9 Smink FR, van Hoeken D, Hoek HW (2013) Epidemiology, course, and outcome of eating disorders. Curr Opin Psychiatry 26:543–548. doi:10.1097/YCO.0b013e328365a24f Neuman H, Debelius JW, Knight R, Koren O (2015) Microbial endocrinology: the interplay between the microbiota and the endocrine system. FEMS Microbiol Rev 39:509–521. doi:10.1093/femsre/fuu010 Terashi M, Asakawa A, Harada T, Ushikai M, Coquerel Q, Sinno MH, Dechelotte P, Inui A, Fetissov SO (2011) Ghrelin reactive autoantibodies in restrictive anorexia nervosa. Nutrition 27:407–413. doi:10.1016/j.nut.2011.01.002 Fetissov SO, Crook MA (2011) What increased consumption of licorice may reveal in anorexia nervosa. Nutrition 27:853–854. doi:10.1016/j.nut.2011.05.004 Corcos M, Guilbaud O, Paterniti S, Moussa M, Chambry J, Chaouat G, Consoli SM, Jeammet P (2003) Involvement of cytokines in eating disorders: a critical review of the human literature. Psychoneuroendocrinology 28:229–249 Solmi M, Veronese N, Favaro A, Santonastaso P, Manzato E, Sergi G, Correll CU (2015) Inflammatory cytokines and anorexia nervosa: a meta-analysis of cross-sectional and longitudinal studies. Psychoneuroendocrinology 51:237–252. doi:10.1016/j.psyneuen.2014.09.031 Solmi M, Santonastaso P, Caccaro R, Favaro A (2013) A case of anorexia nervosa with comorbid Crohn’s disease: beneficial effects of anti-TNF-alpha therapy? Int J Eat Disord 46:639–641. doi:10.1002/eat.22153 Lee KN, Lee OY (2014) Intestinal microbiota in pathophysiology and management of irritable bowel syndrome. World J Gastroenterol 20:8886–8897. doi:10.3748/wjg.v20.i27.8886 Rajilic-Stojanovic M, Jonkers DM, Salonen A, Hanevik K, Raes J, Jalanka J, de Vos WM, Manichanh C, Golic N, Enck P, Philippou E, Iraqi FA, Clarke G, Spiller RC, Penders J (2015) Intestinal microbiota and diet in IBS: causes, consequences, or epiphenomena? Am J Gastroenterol 110:278–287. doi:10.1038/ajg.2014.427 Herpertz-Dahlmann B (2015) Adolescent eating disorders: update on definitions, symptomatology, epidemiology, and comorbidity. Child Adolesc Psychiatr Clin N Am 24:177–196. doi:10.1016/j.chc.2014.08.003 Million M, Angelakis E, Maraninchi M, Henry M, Giorgi R, Valero R, Vialettes B, Raoult D (2013) Correlation between body mass index and gut concentrations of Lactobacillus reuteri, Bifidobacterium animalis, Methanobrevibacter smithii and Escherichia coli. Int J Obes (Lond) 37:1460–1466. doi:10.1038/ijo.2013.20 Marzola E, Panepinto C, Delsedime N, Amianto F, Fassino S, Abbate-Daga G (2016) A factor analysis of the meanings of anorexia nervosa: intrapsychic, relational, and avoidant dimensions and their clinical correlates. BMC Psychiatry 16:190. doi:10.1186/s12888-016-0894-6 Kleiman SC, Carroll IM, Tarantino LM, Bulik CM (2015) Gut feelings: a role for the intestinal microbiota in anorexia nervosa? Int J Eat Disord 48:449–451. doi:10.1002/eat.22394 Goffredo M, Mass K, Parks EJ, Wagner DA, McClure EA, Graf J, Savoye M, Pierpont B, Cline G, Santoro N (2016) Role of gut microbiota and short chain fatty acids in modulating energy harvest and fat partitioning in youth. J Clin Endocrinol Metab 101:4367–4376. doi:10.1210/jc.2016-1797 Jumpertz R, Le DS, Turnbaugh PJ, Trinidad C, Bogardus C, Gordon JI, Krakoff J (2011) Energy-balance studies reveal associations between gut microbes, caloric load, and nutrient absorption in humans. Am J Clin Nutr 94:58–65. doi:10.3945/ajcn.110.010132 Martinez KB, Pierre JF, Chang EB (2016) The gut microbiota: the gateway to improved metabolism. Gastroenterol Clin N Am 45:601–614. doi:10.1016/j.gtc.2016.07.001 Salonen A, de Vos WM (2014) Impact of diet on human intestinal microbiota and health. Annu Rev Food Sci Technol 5:239–262. doi:10.1146/annurev-food-030212-182554 Walker AW, Ince J, Duncan SH, Webster LM, Holtrop G, Ze X, Brown D, Stares MD, Scott P, Bergerat A, Louis P, McIntosh F, Johnstone AM, Lobley GE, Parkhill J, Flint HJ (2011) Dominant and diet-responsive groups of bacteria within the human colonic microbiota. ISME J 5:220–230. doi:10.1038/ismej.2010.118 David LA, Maurice CF, Carmody RN, Gootenberg DB, Button JE, Wolfe BE, Ling AV, Devlin AS, Varma Y, Fischbach MA, Biddinger SB, Dutton RJ, Turnbaugh PJ (2014) Diet rapidly and reproducibly alters the human gut microbiome. Nature 505:559–563. doi:10.1038/nature12820 Devkota S, Wang Y, Musch MW, Leone V, Fehlner-Peach H, Nadimpalli A, Antonopoulos DA, Jabri B, Chang EB (2012) Dietary-fat-induced taurocholic acid promotes pathobiont expansion and colitis in Il10−/− mice. Nature 487:104–108. doi:10.1038/nature11225 Misra M, Tsai P, Anderson EJ, Hubbard JL, Gallagher K, Soyka LA, Miller KK, Herzog DB, Klibanski A (2006) Nutrient intake in community-dwelling adolescent girls with anorexia nervosa and in healthy adolescents. Am J Clin Nutr 84:698–706 Gibson GR, Roberfroid MB (1995) Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr 125:1401–1412 https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Wikipedia/Assessment Hutkins RW, Krumbeck JA, Bindels LB, Cani PD, Fahey G Jr, Goh YJ, Hamaker B, Martens EC, Mills DA, Rastal RA, Vaughan E, Sanders ME (2016) Prebiotics: why definitions matter. Curr Opin Biotechnol 37:1–7. doi:10.1016/j.copbio.2015.09.001 Zhong Y, Cai D, Cai W, Geng S, Chen L, Han T (2009) Protective effect of galactooligosaccharide-supplemented enteral nutrition on intestinal barrier function in rats with severe acute pancreatitis. Clin Nutr 28:575–580. doi:10.1016/j.clnu.2009.04.026 Mika A, Greenwood B N, Chichlowski M, Borchert D, Hulen K A, Berg B et al (2014) Dietary prebiotics increase Bifidobacterium spp. and Lactobacillus spp. in the gut and promote stress resistance. Brain Behav Immun 40(Supplement). doi:10.1016/j.bbi.2014.06.175 Schmidt K, Cowen PJ, Harmer CJ, Tzortzis G, Errington S, Burnet PW (2015) Prebiotic intake reduces the waking cortisol response and alters emotional bias in healthy volunteers. Psychopharmacology 232:1793–1801. doi:10.1007/s00213-014-3810-0 Savignac HM, Kiely B, Dinan TG, Cryan JF (2014) Bifidobacteria exert strain-specific effects on stress-related behavior and physiology in BALB/c mice. Neurogastroenterol Motil 26:1615–1627. doi:10.1111/nmo.12427 Mazurak N, Broelz E, Storr M, Enck P (2015) Probiotic therapy of the irritable bowel syndrome: why is the evidence still poor and what can be done about It? J Neurogastroenterol Motil 21:471–485. doi:10.5056/jnm15071 Kristensen NB, Bryrup T, Allin KH, Nielsen T, Hansen TH, Pedersen O (2016) Alterations in fecal microbiota composition by probiotic supplementation in healthy adults: a systematic review of randomized controlled trials. Genome Med 8:52. doi:10.1186/s13073-016-0300-5 Sheridan PO, Bindels LB, Saulnier DM, Reid G, Nova E, Holmgren K, O’Toole PW, Bunn J, Delzenne N, Scott KP (2014) Can prebiotics and probiotics improve therapeutic outcomes for undernourished individuals? Gut Microbes 5:74–82. doi:10.4161/gmic.27252