The RAMP Study - Rejuvenation of the Aging Microbiota With Prebiotics

Inclusion Criteria:

- 60 years old and older

- Otherwise, healthy subjects willing and able to provide blood as well as stool specimens

- Must be able to provide signed and dated informed consent and be willing to follow protocol

Exclusion Criteria:

- Body Mass Index >= 40

- LDL-C > 190 mg/dL

- Systolic Blood Pressure >160 mmHg OR Diastolic Blood Pressure > 90 mmHg

- Use of any of the following drugs/supplements within the last 2 months:

- systemic antibiotics, antifungals, antivirals or antiparasitics (intravenous, intramuscular, or oral);

- corticosteroids (intravenous, intramuscular, oral, nasal or inhaled)

- cytokines

- methotrexate or immunosuppressive cytotoxic agents

- metformin

- proton pump inhibitors (PPIs)

- Regular use of any of the following medications:

- regular dose aspirin (>81mg/day)

- opiate pain medication

- Use of large doses of commercial probiotics consumed (greater than or equal to 10-8 cfu or organisms per day) - includes tablets, capsules, lozenges, chewing gum or powders in which probiotic is a primary component. Ordinary dietary components such as fermented beverages/milks, yogurts, foods do not apply.

- Acute disease at the time of enrollment. Acute disease is defined as the presence of a moderate or severe illness with or without fever. Examples include flu or gastroenteritis. Defer sampling until subject recover.

- Chronic, clinically significant, unstable (unresolved, requiring on-going changes to medical management or medication) pulmonary, cardiovascular, gastrointestinal, hepatic or renal functional abnormality, as determined by medical history. Type 2 diabetes, type 1 diabetes, and dialysis will be excluded.

- History of active uncontrolled gastrointestinal disorders or diseases including:

- inflammatory bowel disease (IBD) including ulcerative colitis (mild-moderate-severe), Crohn's disease (mild-moderate-severe), or indeterminate colitis;

- irritable bowel syndrome (IBS) (moderate-severe);

- persistent, infectious gastroenteritis, colitis or gastritis, persistent or chronic diarrhea of unknown etiology, Clostridium difficile infection (recurrent) or Helicobacter pylori infection (untreated).

- History of active cancer in the past 3 years except for squamous or basal cell carcinomas of the skin that have been medically managed by local excision.

- Unstable dietary history as defined by major changes in diet during the previous month, where the subject has eliminated or significantly increased a major food group in the diet.

- Recent history of chronic excessive alcohol consumption defined as more than five 1.5-ounce servings of 80 proof distilled spirits, five 12-ounce servings of beer or five 5-ounce servings of wine per day; or > 14 drinks/week.

- Positive test for HIV, HBV or HCV.

- Any confirmed or suspected condition/state of immunosuppression or immunodeficiency (primary or acquired) including HIV infection.

- Surgery of the GI tract, with the exception of cholecystectomy and appendectomy, in the past five years. Any major bowel resection at any time.

- Regular/frequent use of smoking or chewing tobacco, e-cigarettes, cigars or other nicotine-containing products.

- Any confirmed or suspected autoimmune disease. Examples include multiple sclerosis and Graves disease.

- Veganism.

- Dairy allergies.