Perspective: Physiologic Importance of Short-Chain Fatty Acids from Nondigestible Carbohydrate Fermentation

In recent years, it has become increasingly obvious that dietary fiber or nondigestible carbohydrate (NDC) consumption is critical for maintaining optimal health and managing symptoms of metabolic disease. In accordance with this, the US FDA released its first official definition of dietary fiber in 2016 for regulation of Nutrition and Supplement Facts labels. Included in this definition is the requirement of an isolated or synthetic NDC to produce an accepted physiologic health benefit, such as improved laxation or reduced fasting cholesterol concentrations, upon consumption. Even though NDC fermentation and production of short-chain fatty acids elicit many physiologic effects, including serving as a source of energy for colonocytes, curbing glycemic response and satiety, promoting weight loss, enhancing mineral absorption, reducing systemic inflammation, and improving intestinal health, the process of fermentation is not considered a physiologic endpoint. Instead, expensive and laborious clinical trials must be conducted and an accepted physiologic benefit observed. In this review, we discuss the physiologic importance of NDC fermentation through extensive examination of clinical evidence and propose that the degree of fermentability of an NDC, rather than the endpoints of a clinical trial, may be appropriate for classifying it as a dietary fiber.