Lecture 2- Prebiotics, Probiotics and fermented Foods

Sauerkraut

- German for "sour cabbage"- sit for about a week - Shredded cabbage fermented by lactic acid producing bacteria (started by Weissella, Klebsiella and Enterobacter; continued by Leuconostoc, and finished by Lactobacillus and Pediococcus) with a sour taste and a long shelf life (keeps well at or below 15C in airtight containers) - Low in fats and calories, rich in vitamins, minerals and Lactobacillus - High acidic (may cause upset stomach) and salty; it contains tyramine; may protect vs. certain types of cancer and vs. scurvy. **high Na+ content

Natto

- Traditional Japanese food, eaten over rice or added to soups, sandwiches, toast, omelet, pasta or sushi. - Pungent smell, strong, nutty, salty, blue cheese-like flavor - Fermentation of natto soybeans with B. subtilis or B. natto. Beans washed and soaked in water for 12-24 hr, steamed for 6 hr, mixed with B. subtilis or B. natto, and allowed to stand at 40C x 20 hr for it to become gooey (sticky and stringy). - Rich source of protein, vitamin K2 and beneficial bacteria. - Also available in an odorless form that can be eaten as a snack , or as an ice cream. - Shown to have antibiotic and fibrinolytic action (nattokinase), to lower blood cholesterol, to promote amyloid degradation, and to prevent osteoporosis (due to activation of osteocalcin by K2).

CFU

- colony forming units- a measure of number of good bacteria and yeasts in the product - a CFU is a bacteria or yeast that is capable of living and reproducing to form a group of the same bacteria or yeasts - microbiologists use CFU to describe the number of active, live organism instead of the number of all bacteria in a laboratory sample. - only the viable organisms are considered to be probiotics

Kombucha

-Concept: probiotic-rich fermented drink made with tea (green or black), sugar, bacteria, and yeast. The yeast component usually includes Saccharomyces and other species; the bacterial component almost always includes Gluconacetobacter xylinus. Using little sugar makes the product unappealing. - Characteristics - A fermented slightly effervescent, sweetened, drink used as a functional beverage to provide health benefits. - Background - It has been traditionally used primarily in Manchuria, Russia, eastern Europe and Japan. The work "kombucha" originated in Japan in 415 AD, and represents a combination of the name of a Korean physician called Kombu who treated the Emperor Inyko with the tea (in Japanese "cha"). - Benefits - Claimed to asthma, cataracts, diabetes, diarrhea, gout, herpes, insomnia and rheumatism; to shrink the prostate, raise the libido, reverse grey hair, remove wrinkles, relieve haemorrhoids, lower hypertension, prevent cancer, to promote general well-being, and to stimulate the immune system. - Precautions - Due to its microbial sourcing and possible non-sterile packaging, it is not recommended for people with poor immune function, women who are pregnant or nursing, and children under 4 years old. SCOBY = Symbiotic Culture Of Bacteria and Yeast The scoby bacteria and yeast eat most of the sugar in the tea, transforming the tea into a refreshingly fizzy, slightly sour fermented (but mostly non-alcoholic) beverage that is relatively low in calories and sugar.

Immunobiotics

Concept - Certain bacterial probiotics that promote health by stimulating the mucosal immune system (dendritic cells, TH cells cells) to generate an immune response at local and systemic sites to prevent infection by bacteria or virus or to protect vs. allergic disease (locally, in lung, in skin) by modulating microbiota-mediated intestinal immune responses through attenuation of IgE responses, inhibition of pro-inflammatory cytokines production and signaling pathways, and increase in anti-inflammatory cytokines. Composition - They can be viable or dead microbes (incapable of proliferating or secreting metabolites/other beneficial products). Use - New tool to alleviate intestinal inflammation, normalize gut mucosa dysfunction, and downregulate hypersensitivity reactions (e.g., to reduce incidence/severity/duration of upper respiratory tract infec-tion (e.g., common cold, flu) and severity of atopic eczema in infants, prevent asthma or food-related allergy, alleviate lactose intolerance, reduce frequency/duration of infant acute diarrhea).

Paraprobiotics

Concept - Nonviable bacterial cells (killed or inactivated, intact or broken) or crude microbial fractions (extracts) capable of conferring health-related benefits in humans and animals when administered in adequate amounts (orally or topically) . Meaning - The prefix para implies "alongside of" or "atypical", which can simultaneously indicate similarity to and difference from a traditional probiotic . Advantages - May be advantageous in those for which probiotics may not be safe because of weak immune system, enhanced inflammatory responses and/or compromised mucosal barrier functions Potential uses - Management of allergy and asthma by influencing Th1 and Th2 cell activities and by inhibiting IgE production; treat IBS through antiinflammatory action and Treg cells activation.

Examples of commercial Probiotic products

Flora Five® pearls = 5 bacteria, 2 billion/pearl: Lactobacillus acidophilus, L. casei, and L. rhamnosus, Bifidobacterium lactis and B. longum Jarro-Dophilus EPS® capsules = 8 bacteria, 5 billion/ capsule: Lactobacillus acidophilus, L. plantarum, L. rhamnosus, L. casei, Bifidobacterium breve, B. longum, Lactococcus lactis and Pediococcus acidilactic Pro-Biotic Plus® capsules = 12 bacteria, FOS, 40 billion CFU/ capsule: Bacillus coagulans, B. infantis, Lactobacillus rhamnosus, L. salivarius, L. acidophilus, L. casei, L. plantarum, L. lactis, Enterococcus faecium, Streptococcus thermophilus, Bifido-bacterium longum and B. bifidum.

Background on probiotics

- "good bacteria", "friendly bacteria" providing health benefits - essential to overall health including digestive balance and supporting immune health Gut - large intestine-microflora (microbiota)- ~10^14 microbes- mostly strict anaerobes and mostly facultative anaerobes in the colon - mainly localized in the GI tract but can extend to the liver, brain and adipose tissue- connected to obesity, Type II diabetes, atherosclerosis, and mental stress - probiotics are transient guests- take probiotics on daily basis to maintain digestive balance and support immune health. - acidic environment can be detrimental- take a dosage form offering protection against acid - make sure label says live culture, live bacteria or probiotic

new evidence

- Americans with allergies have low microbiota diversity - gut microbiota of American adults with allergies is markedly diff and lower richness from people without, esp for nut and seasonal pollen allergies - NIH - probiotics maybe helpful for people susceptible to allergies - supplementing the diet with nulin-type fructans may improve the function of the endoothelium in blood vessels and reduce the risk of metabolic disorders related to CV diseases - Recent study conducted in rats showed that providing the prebiotic led to an increase in bacterial production of nitric oxide (NO), a potent vasodilator that improves blood flow, along with an increase in the abundance of Akkermansia, a bacterium that has been reported to have anti-obesity effects - These findings pave the way for innovative therapeutic approaches to the prevention of human vascular dysfunction and for which no treatment has been proven successful.

Types of products

- In a dosage form = capsule, caplet, tablet, powder, suspension In a food form = fermented solid or semisolid product (kimchi, natto, sauerkraut, tempeh, yogurt, soy sauce) - In a drink form = fermented soy drinks, kefir, yakult Milk fortified with probiotics Buttermilk - Fermented cheese = blue, Gouda, cottage, cheddar, edam, feta, Emental, provolone. - Sourdough bread, soda bread Pickled food: sour pickles, radish, beets (sea salt/water, but no vinegar)

Legal status of probiotics

- In the USA, they are examples of functional foods/dietary supplements that are regulated as foods by US FDA - available OTC - do not undergo the testing and approval process required for drugs - MFR responsible for making sure that they are safe and that any claims on the label are true - no guarantee on the contents and effects - US FDA has not verified any health claims on these products.

Kimchi (kimchee)

- Korean for "soaked vegetable" Eaten as a side dish or added to dishes (40 lb/yr) - Fermented cabbage, radish, green onion or cucumber Keep well under refrigeration for up to 1 month - Available in different varieties depending on vegetable and seasoning used - Kimchi Field Museum , Seoul, Korea; Kimchi Festival, Kwangju, Korea (mid October) - Rich in proteins, fiber, carotene, vitamins (A, B-1, B-2, niacin, C), minerals (Ca, Fe, P) and Lactobacillus kimchii - Aids digestion, increases immunity, prevents yeast infection, may prevent gastric cancer.

Synbiotics may control excess weight in obese kids

- May be the first study showing the effects of synbiotics on oxidative stress in obese children with an additional effect on weight loss regarding to previous studies - The researchers used the commercial NBL Probiotic Gold product from Nobel Ilac, Turkey, containing Lactobacillus acidophilus, L. rhamnosus, Bifidobacterium bifidum, B. longum, andEnterococcus faecium with fructooligosaccharides and lactulose prebiotics - This formulation can be used as an ADD-ON therapy to diet and physical exercise.

Eubiotics

- Term used in the feed industry (i.e., providing food for animal consumption) where it refers to a healthy balance of the microflora in the gastrointestinal tract. From two Greek words: eu = well/good and bios = life Scientific discipline whose subject is healthy (hygienic) living. It also designates bacterial preparations that are used to bring balance (normalize) the gastrointestinal microflora. Hence, it includes probiotics, prebiotics and certain organic acids

Miso

- Traditional Japanese seasoning. Made by fermentation of grains (wheat, barley, rice), corn or soybeans with fungus kojikin (Aspergillus oryzae). Most often from soybeans. Koji is fermented steamed rice with mold in it. Available in different colors (white, red, light brown, dark brown) and flavors (salty, sweet, earthy, fruity or savory taste). - Soak soybeans in water x at least 18 hr to allow beans to expand; transfer to pressure cooker and cook x 20-40 min till soft; cool, drain liquid and puree beans with potato masher or by hand; mix koji rice with salt and some water and add mixture to soybeans paste; mix till smooth and shape into balls; place balls into cylindrical ceramic container; press down firmly to make surface flat and spread salt on it; cover with a flat lid followed by a heavy weight on top; allow to ferment in a cool (60F) area for 4-12 months. - Product is a thick paste or thin and drippy. - High in proteins, vitamins (B complex), minerals, salt and Lactobacillus acidophilus, low in calories. - Added to sauces, soups, spreads, pickles, vegetables or meats. May protect against or attenuate radiation sickness. - contains Na+

Tempeh

- Type of traditional food popular in Indonesia (Java) - Made by controlled fermentation of soybeans, which are soaked in water, peeled, partially cooked, mixed with vinegar and fungus Rhizopus oligosporus, and spread in thin layers to ferment for 24-36 hr at 30C. - A good tempeh is surrounded by a mat of white mycelia and releases a mild ammonia-like odor. At lower temperatures or in a high ventilation, gray or black patches develop in the surface without affecting the flavor or texture. It has a nutty- smoky and mushroom-like ("earthy") taste. - Sold shaped as blocks (cakes), which are a rich source of protein, fiber, and vitamins (including B12). Can be eaten as such, dried, boiled, fried, or added to dishes. If grated, it can be used as a ground-meat substitute. - doesn't contain as much fat as other products - has less water

Kefir

- Word kefir from Persian kef = foam and shir = milk - Fermented, milk-derived drink. - Popular in Eastern/Central Europe (Russia, Lithuania, Estonia, Hungary, Poland, Romania, Serbia), Scandinavia. - Milk (oat, cow or sheep) is mixed with kefir grains (bacteria, yeast, protein, lipid, carbohydrate), and allowed to ferment overnight. - A thick, creamy, sour, carbonated, slightly alcoholic (1-2% alcohol), yogurt-like liquid. Contains lactic acid bacteria, yeasts, protein, polysaccharide, vitamins (A, B1, B2, B6, D, K2, folate), minerals (Ca, Fe, I), lactic and propionic acid, water - May be antioxidant, antimutagenic, and digestive. Can lower BP and cholesterol.

Synbiotics

- combo of probiotics and prebiotics - term implies synergism ( a prebiotic favors the survival, proliferation and growth of probiotics) - ex yogurt and kefir - skimmed milk with added probiotics is an enhanced food - IMMUNOBIOTICS- commercial mixture of the two- probiotics, inulin and immunoglobulins formulated as capsules, taken to boost immunity and promote intestinal health

Yogurt (yoghurt)

- from the Turkish for "to be curdled" or "to be coagulated" - dairy product produced by bacterial fermentation of milk. during the process lactic acid is produced which in turn contributes to the tangy taste and texture of the product. - made from different types of milk throughout Europe and Asia. - Milk is heated to 86C to kill undesirable bacteria and to denaturate (coagulated) the milk proteins; then it is cooled to 45C, and mixed with bacterial culture (containing Lactobacillus delbrueckii subsp. bulgaricus and Streptococuccus salivarius subsp. thermophilus ± L. acidophilus , L. casei. L. bifidus and/or Bifidobacteria). - In addition to probiotics, it is nutritionally rich in protein, Ca++, K+, and vitamins D, B2, B6 and B12. Lactose is minimal since it became lactic acid. - There are different types based on the fat content: non-fat (0% fat), low-fat (usually 2% fat) and plain or whole milk yogurt (~4% fat). - The National Yogurt Association (NYA) has established a standard for a healthy yogurt (at least 100 million cultures/g at time of manufacture). Frozen yogurt must contain 10 million cultures/g. Such products get a seal from NYA.

Human gut bacteria in health and disease

- gut bacteria play a role in obesity and in certain pathological conditions - mice receiving bacteria from obese people gained weight - mice with Alzheimer's disease had diff bacteria composition - mice born from antibiotic-free mothers had less bacteria count in the lungs and bronchial fluid - probiotics with antibiotics reduced diarrhea and C.diff - encouraging the growth of Fusobacterium nucleatum with whole grain and fiber rich diet may decrease the risk of certain types of colorectal cancer in humans

Prebiotics

- means "before life" - category of functional foods represented by nondigestible food ingredients which selectively stimulate the growth and or activity of desirable (beneficial or friendly) colonic bacteria already present in the gut - sources: fruits (bananas, kiwi), onion, garlic, honey, whole grains, brown rice, etc. Yogurt has both bacteria and prebiotics - Examples: mostly oligosaccharides 2-10 monosaccharides): fructooligosaccharides, galactooligosaccharides, inulin, Ca phosphate and chicory root - some maybe sensitive to cooking Importance- improve health by allowing growth of bacteria that facilitate the absorption of nutrients (minerals), helping food digestion (like lactose), maintaining intestinal pH and promoting intestinal peristalsis. - help to maintain normal balance btn good and bad bacteria in the gut, to control blood glucose, A1c, LDL, improve symptoms of IBS. used along with probiotics

Yakault

- probiotic, fermented, milk-like drink originating in Japan - made by fermentation of skimmed milk with Lactobacillus casei Shirota - sold in bottles containing 10^18 CFU/mL or 6.5 billion/65 mL or 8 billion/80mL. there is an original and a light formula. - In addition to probiotics, it also contains sugars (glucose, sucrose), milk protein, Na+, Ca2+ and artificial/natural flavors. calories per serving= 48 kcal or 28 kcal - keep in the refrigerator at 4 C; otherwise it becomes sour. - drinking 1 or 2 bottles/day will balance the intestinal bacteria count - can be added to cereals, smoothies, milkshakes, cheesecakes or any other cold food.

Current areas of interest for probiotics

- to reduce severity/prevent infections (ear, strep throat, cold and flu in children) by stimulating host innate and adaptive intestinal immune systems - reduce adipose tissue mass, adipocyte size, glucose levels, blood and liver lipids and activity of the sympathetic nervous ystem as a way to promote body weight loss - maybe due to effects on fatty acid and carb metabolism, leptin levels, fat intestinal absorption, appetite centers in CNS, and activity of SNS controlling lipolysis (antiobesity effect) - to overcome intestinal microbial imbalance - to prevent/lower severity of eczema in children - based on neural connection btn intestine and brain- to control stress-related disorder (depression, anxiety, schizophrenia) - reduce or delay allergic symptoms, especially in children - to prevent occurrence/recurrence of bladder and colon cancer

Trends of probiotic products

Florastor capsules with Sacharomyces boulardii to maintain balance of the intestinal flora and to promote intestinal health and normal function Yakult with GABA - BP, hence an antianxiety - Milk (reduced fat or fat free) + Bacillus coagulans Ganeden BC30 strain = probiotic milk Milk + Lactobacillus acidophilus = acidophilus milk ProbioticGum with BLIS K12 (strain of Streptococcus salivarius, a known friendly bacteria of the mouth) Cysbiotic - Women's health dietary supplement (Lactobacillus rhamnosus Rosell-11 + standardized cranberry powder)

Prebiotics vs Probiotics

Prebiotics - special form of dietary carb (oligosaccharides, polysaccharides) - powders are not affected by health, cold, acid or time - provide a wide range of heath benefits to the otherwise healthy person. most of these have been clinically proven - nourish the good bacteria already present in the gut - maybe helpful or preventative for irritable bowel (IBS) or inflammatory bowel disease, colon polyps and cancer Probiotics: - live bacteria in yogurt, dairy products and pills. hundreds of species available- which of them are best is still unknown - must be kept alive. may be killed by heat, stomach acid or simply die with time - not clearly known to provide health benefits to otherwise healthy individuals. - probiotics must compete with over 1000 bacteria species already in the gut - certain probiotic species have been shown to be helpful for irritable bowel disease and for recurrence of certain bowel infections such as C. diff

Selecting a probiotic

Probiotic component: Genus, species and strain Proof (evidence) of effect in the literature Labeling declaration on number of strains present and of CFU of each species of live (living) bacteria/serving Statement on servings/day Statement on expiration date Statement on stability Statement on storage conditions Product type (caplet, tablet, capsule, pearls, powder) According to the International Scientific Association for Probiotics and Prebiotics (ISAPP), there are five criteria that consumers should consider when selecting a probiotic product: - probiotic strain - proof - packaging - Quality - Quantity

Probiotics

meaning- greek origin- means "for life" - according to the Food and Agriculture Organization (FAO) of UN it is "live friendly bacteria which, when administered in adequate amounts, confer a health benefit on the host". - Lactobacillus, acidophilus, bifididobacterium source: fermented foods: yogurt, sauerkaut, kefir, sour milk, yakult action on foods- Microbes convert food carbohydrates to more digestible and nutritious products (small acids = acetate, butyrate, lactat; CO2 ; ethanol) - facilitate absorption of nutrients (ca, mg, Fe, Zn, glucose, amino acids), H2O and Na+ - restore normal intestinal pH and intestinal bacterial balance in dysbiosis - accelerate recovery from infectious diarrhea - maintain urogenital health disturbed by antibiotics, spermicides and birth control pills - relief of GI symptoms-gastric pain, epigastric fullness (bloating) and flatulence - also some research to show they help with - skin conditions, like eczema, vaginal health, preventing allergies and colds, oral health