ProbioticsProbiotics & & Functional FoodsFunctional Foods

Friendly FloraFriendly FloraGabriela Pacheco, RD, LD, SNSGabriela Pacheco, RD, LD, SNS

MicrobesMicrobes

��Not all microbes are badNot all microbes are bad–– Pathogenic bacteriaPathogenic bacteria–– YeastYeast–– VirusesViruses

��Belief that all are associated Belief that all are associated with morbidity and mortalitywith morbidity and mortality

MicrobesMicrobes

��Growing amount of research, Growing amount of research, evidence and documentation evidence and documentation of of ““ otherother ”” microbes called microbes called ProbioticsProbiotics–– Contribute to human healthContribute to human health–– Live microorganismsLive microorganisms

““ The Dr. of the future will give The Dr. of the future will give no medicine, but will interest no medicine, but will interest the patient in the care of the the patient in the care of the human frame, in diet and in human frame, in diet and in the cause and prevention of the cause and prevention of diseasedisease ””

Thomas Thomas EdisonEdison

�� The human body holds a vast The human body holds a vast internalinternalecosystem consisting of millions of ecosystem consisting of millions of living micro organisms that coexist, living micro organisms that coexist, sometimes sometimes harmoniouslyharmoniously and and sometimes sometimes disruptivelydisruptively

�� This ecosystem, our human intestinal This ecosystem, our human intestinal flora, dramatically influences, and to a flora, dramatically influences, and to a certain degree even directs, every certain degree even directs, every individual's personal state of health individual's personal state of health and well beingand well being–– physical and mental healthphysical and mental health–– metabolismmetabolism–– our life span?our life span?

ObjectivesObjectives

��History History ��DefinitionsDefinitions

–– PrePre--bioticsbiotics–– ProPro --bioticsbiotics–– SynSyn --bioticsbiotics

��PhysiologyPhysiology��Health benefitsHealth benefits��Future directionsFuture directions

GuidelinesGuidelines

The science and practiceThe science and practice --based guidelines based guidelines presented will enhance presented will enhance understanding of understanding of probioticsprobiotics , , prebioticsprebiotics , and , and functional foodsfunctional foods

Sum of current knowledge & practiceSum of current knowledge & practice

GoalGoal

To improve appropriate To improve appropriate recommendationsrecommendations and and informedinformed use of these use of these emerging dietary emerging dietary ingredients and the ingredients and the products containing themproducts containing them

Recent HistoryRecent History

��Probiotic conceptProbiotic concept--Created the Created the probiotic revolutionprobiotic revolution

��Isolated lactobacillus Isolated lactobacillus culture from culture from Bulgarian yogurtBulgarian yogurt

��Lactic Acid bacteria Lactic Acid bacteria in fermented milk in fermented milk

Immunologist Elie Metchnikoff

(1845-1916)

DefinitionsDefinitions��ProPro --bioticsbiotics / / Antonym = AntibioticAntonym = Antibiotic

–– ProPro --Greek Greek ““ for lifefor life ””–– 19501950’’s s –– Live microorganismsLive microorganisms

Modify intestinal Modify intestinal microfloramicroflora

–– Provide benefit beyond nutritionProvide benefit beyond nutrition--Improves Improves VitVit K production, nutrient K production, nutrient

absorption, stimulate immune absorption, stimulate immune systemsystem

DefinitionsDefinitions��PrePre--bioticsbiotics --food for the probioticfood for the probiotic

–– Complex Complex CHOsCHOs –– not metabolizednot metabolized–– Energy source for Energy source for probioticsprobiotics–– InulinInulin is most commonis most common --soluble fibersoluble fiber

Artichokes, asparagus, onions, Artichokes, asparagus, onions, garlic,raisins,bananasgarlic,raisins,bananas

��SynSyn --bioticsbiotics–– Pairing of prePairing of pre -- and proand pro --bioticsbiotics–– SuitabilitySuitability --success in colonizing gut success in colonizing gut –– Allows manufacturers to design Allows manufacturers to design

products w/very specific functional products w/very specific functional claimsclaims

No No ““ LegalLegal ”” Definition for Definition for ““ probioticprobiotic ””

��There is an accepted scientific There is an accepted scientific definitiondefinition–– w/o legal definitionw/o legal definition --consumers are consumers are

at a disadvantageat a disadvantage

��Term often used commerciallyTerm often used commercially–– Minimum criteria for Minimum criteria for probioticsprobiotics–– Never associated with dead bacteriaNever associated with dead bacteria–– Must be viableMust be viable

Minimum CriteriaMinimum Criteria

��Purified strain of microbePurified strain of microbe��Identified to the strain level using Identified to the strain level using

biochemical and genetic biochemical and genetic techniquestechniques

��Shown in human studies to Shown in human studies to improve some parameter of improve some parameter of human healthhuman health

��Safe for target consumersSafe for target consumersJrnlJrnl of the American Dietetic Assoc.of the American Dietetic Assoc.

Recommending Recommending ProbioticsProbiotics

��Generally of interest to two Generally of interest to two groups of peoplegroups of people–– With specific health concernsWith specific health concerns

Can have measurable outcomeCan have measurable outcome--symptom symptom improvementimprovement

–– Generally healthy peopleGenerally healthy peopleEnhance immune functionEnhance immune functionReduction of risk of diseaseReduction of risk of disease

Current Emphasis is on Whole Current Emphasis is on Whole FoodsFoods

��Philosophy changed from what to Philosophy changed from what to avoidavoid to what to to what to include include –– Naturally occurring beneficial Naturally occurring beneficial

componentscomponents

–– Functional foodsFunctional foods

DistinctionDistinction-- drug or food? drug or food?

There is a major concern, among There is a major concern, among many, that functional foods blur many, that functional foods blur the distinction between foods and the distinction between foods and drugsdrugs

��Ongoing debate over labeling Ongoing debate over labeling ––health claims*health claims*

*relationship of dietary substance to reduction of risk *relationship of dietary substance to reduction of risk of disease or health related conditionof disease or health related condition

JrnlJrnl American Dietetic AssociationAmerican Dietetic Association

DistinctionDistinction --drug or food?drug or food?

��Add a functional ingredient that is Add a functional ingredient that is not normally present in foodnot normally present in food

��Replace a component (fat) with a Replace a component (fat) with a functional component (functional component ( fructanfructan ))

��Increase the bioavailability of a Increase the bioavailability of a functional componentfunctional component

Food or Drug?Food or Drug?

��Eliminate a component known Eliminate a component known to have an adverse effectto have an adverse effect

��Fortify a food with a Fortify a food with a functional ingredient to functional ingredient to promote healthpromote health

“The Smelliest Lab”

� Total human cells = 10 13

� Total microbial cells in human body = 10 14

� Diversity >400 microbial species

– > 5 million genes

� Directing similar metabolic functions

– Immunomodulation– Detoxification– Mucin secretion– Protection from enteric disease

Pincock, The Scientist, 2005

Human GI tractHuman GI tract

��Diverse microbial populationsDiverse microbial populations��Factors affectingFactors affecting

–– Age, nutrition, antibiotics, Age, nutrition, antibiotics, stress, stress, EtOHEtOH, pH, transit time , pH, transit time

��Balance is key Balance is key ––a symbiotic a symbiotic relationshiprelationship

StrainsStrains

��LactobacillusLactobacillus–– L. acidophilusL. acidophilus

–– L. L. caseicasei

–– L. L. fermentumfermentum

–– L. L. gasserigasseri

–– L. L. johnsoniijohnsonii

–– L. L. lactislactis

–– L. L. salivariussalivarius

��BifidobacteriumBifidobacterium–– B. B. bifidumbifidum–– B. B. brevebreve–– B. B. lactislactis

��StreptococcusStreptococcus–– S. S. thermophilusthermophilus

��Yeast/moldYeast/mold–– SaccharomycesSaccharomyces

bouldariibouldarii

Published Target PointsPublished Target PointsOral microbiology• Dental caries• S. mutans• Halitosis

Allergy• Atopic dermatitis• Asthma

Colorectal cancer

Vaginal infections

Systemic effects• Immune function • Growth parameters in undernourished children

Delivery of components active in gut

H. pylori

Colds, respiratory infections

• Reduced absences

GI effectsDiarrhea• AAD• Traveler’s diarrhea• RotavirusLactose digestionIBS symptoms•Food Allergies

MicrofloraMicroflora in in Allergic ChildrenAllergic Children

�� hypothesis that allergic conditions hypothesis that allergic conditions among children may be associated among children may be associated with differences in their gut bacteriawith differences in their gut bacteria

�� 2 2 y/oy/o ’’ss –– Northern EuropeNorthern Europe

Allergic childrenL. bacilli colonization

aerobic bacteria

- Coliform

- S. aureus

Non-Allergic childrenL. bacilli colonization

aerobic bacteria

- Coliform

- S. aureus

Bjorksten 1999. Clin Experim Allergy, 29:342–6

WIIFM?WIIFM?(What(What ’’s in it for me?)s in it for me?)

��Probiotic optionsProbiotic options–– FoodFood–– SupplementSupplement–– Medical foodMedical food–– Pharmaceutical (pending)Pharmaceutical (pending)

Levels Needed?Levels Needed?

��How much is needed to have an How much is needed to have an affect?affect?

��Questions still remainQuestions still remain–– Levels needed in combination w/ Levels needed in combination w/

other functional foodsother functional foods–– Multiple dietary sourcesMultiple dietary sources–– Strain interactionsStrain interactions

��Dosages not knownDosages not known --consumption consumption is known to be beneficialis known to be beneficial

Live & Active CultureLive & Active Culture

��NatNat’’ l Yogurt Assocl Yogurt Assoc–– Established criteria for L&A Established criteria for L&A

culturecultureRefrigerated dairy products must contain Refrigerated dairy products must contain 100M cultures/gm100M cultures/gm

Frozen Frozen –– 10M/gm10M/gm

��Seal Seal –– front panelfront panel

* Meets National Yogurt Association criteria for Live and Active Culture Yogurt

Probiotic FoodsProbiotic Foods�� Yogurt Yogurt -- most commonmost common�� CheeseCheese�� CerealCereal�� JuiceJuice�� Frozen yogurtFrozen yogurt�� Kefir (fermented milk drink)Kefir (fermented milk drink)�� Daily dose drinksDaily dose drinks�� Fresh sauerkrautFresh sauerkraut�� buttermilkbuttermilk

Viability of a ProbioticViability of a Probiotic��Adding fermented foods to dietAdding fermented foods to diet

–– Many do not contain live cultures in Many do not contain live cultures in the finished productthe finished product

Sourdough bread Sourdough bread –– bakedbaked

Cheese baked into pizzaCheese baked into pizza

Fermented meats Fermented meats –– smoked or cookedsmoked or cooked

��Filtration of wine & beer removes Filtration of wine & beer removes all microbesall microbes

��Foods treated with preservativesFoods treated with preservatives

Maintaining ViabilityMaintaining Viability

��Technological challengeTechnological challenge��Sensitive to environmental Sensitive to environmental

factors:factors:–– HeatHeat–– MoistureMoisture–– OxygenOxygen–– Acid Acid

SupplementsSupplements

��Widely availableWidely available��Differing strains, dosesDiffering strains, doses��Minimal efficacy dataMinimal efficacy data��Shelf life? Buyer bewareShelf life? Buyer beware

SuperFoodsSuperFoods Rx Rx

��F/VsF/Vs��Whole grainsWhole grains��ProteinProtein��Healthy fatsHealthy fats��Food for thoughtFood for thought

–– Daydream, friendships, laughterDaydream, friendships, laughter

SuperFoodsSuperFoods RxRx�� Dark chocolateDark chocolate�� CinnamonCinnamon�� Extra virgin olive oilExtra virgin olive oil�� GarlicGarlic�� HoneyHoney�� KiwiKiwi�� Tea Tea �� BlueberriesBlueberries�� BeansBeans ……………………………………………………………………..

Is more better?Is more better?

��NO!!!!NO!!!!–– Balance and varietyBalance and variety

��We can be getting too muchWe can be getting too much–– Energy drinksEnergy drinks

B vitamins, caffeine, amino acidsB vitamins, caffeine, amino acids–– And we still take supplementsAnd we still take supplements

–– Fortified cereals, flour, pastaFortified cereals, flour, pastaThen take too many supplements too!Then take too many supplements too!

��Too much of a good thing is NOT Too much of a good thing is NOT a good thing!a good thing!

ConclusionConclusionA symbiotic affectA symbiotic affect

��Balanced dietBalanced diet��Moderation of stressModeration of stress��Appropriate physical activityAppropriate physical activity

““ ItIt ’’s not a diet or an exercise s not a diet or an exercise program or a magic bulletprogram or a magic bullet ””

““ For general health, For general health, incorporating more incorporating more probioticprobiotic --rich foods may lead to better rich foods may lead to better nutritional status nutritional status –– overall overall improved healthimproved health ””

ResourcesResources

www.usprobiotics.orgwww.usprobiotics.org

www.medicinalfoodnews.comwww.medicinalfoodnews.com

www.eatright.orgwww.eatright.org (Am Dietetic (Am Dietetic Assoc)Assoc)