the fermented food frenzy - rediscover dairy · 1. defining the fermented food –history of...
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1. Defining the Fermented Food
– History of Fermented Foods
– Fermented Food Around the World
– Fermented food with and without live culture
2. Fermented Dairy
– Kefir
– Maas
– Yoghurt
3. The Role of Fermented Dairy Foods in Health
– Hypertension
– Cardiovascular disease
– Cancer
– Weight
– Gut Health
4. Conclusion
Outline
Type of food or beverage made by extensive microbial growth
Defining Fermented Foods
Lactic acid bacteria, moulds and yeasts (present or added)
Improve preservation, taste, structure and nutritional value
Fermented
Foods
Salameh et al, 2016; Praagman et al, 2015; Chilton et al, 2015
The science of fermentation is called
zymology.
The first zymologist was Louis
Pasteur.
Oldest and most economical
method of production and
preservation of food.
History of Fermentation
Foods underwent fermentation naturally, but today the addition of a
starter culture has helped make fermentation more automated,
reproducible, reliable and controlled.Chilton et al, 2015
Over 3500 fermented foods, divided into 250 groups, make up 1/3 of
foods in the human diet Tamang et al, 2016
8000 years ago: Cheese making started in Tigris and Euphrates
2000 – 4000 years ago: Wine making started in Ancient Egypt
7000 years ago: Fermented foods consumed in Babylon
Kimchi
Korean
condiment
made from
cabbage
Sauerkraut
Germany
Sour cabbage
Kefir
Russia
Alcoholic milk
with added
kefir grains
Kombucha
Russia and
China
Black, green,
white, oolong
tea with sugar Maas
South African
sour milk
Miso
Japanese
soybeans
Yoghurt
Greece or
Turkey
Around the World With Fermented Foods
Cheddar and
Stilton
UK
Fermented
sausage
Spain,
Portugal, Italy
and Greece
Tamang et al, 2016; Chilton et al, 2015
Value of Fermented Foods
Source of live,
active cultures
Improved
taste, texture
and
digestibility of
food
Increase food
safety and
shelf-life
Increase
vitamins and
bioactive
compounds
Remove/
reduce toxins
(mycotoxins)
or anti-
nutrients
(tannins,
phytic acid)
Chelule et al, 2010; International Scientific Association for Probiotics and Prebiotics, 2016
▪ Softens food texture and alters composition:▪ Less energy/fuel for cooking
▪ Eliminates need of preservation (lowered pH improves
shelf-life without refrigeration)
▪ Highly desirable where resources for cooking and
preservation scarce
▪ Improves food quality: essential amino acids,
vitamins and protein
▪ Generates income, improves food security
▪ Low cost technology in food preservation
increases accessibility and availability
▪ Malnutrition:▪ Complete food fortification programs from WHO
▪ Contribute to protein requirements
▪ Reduce childhood mortality
Fermented food products play a significant socio-economic role in Africa
Why Africa Needs Fermented Foods
Franz et al, 2014; Chelule et al, 2010
Not all fermented
foods are equal
Fermented foods retaining live cultures
Yoghurt and maas
Kimchi and kefir
Some cheeses
Fresh sauerkraut
Fresh sour dill pickles
Traditional salami
Water/ brine cured olivesFermented foods consumed without
living cultures
Most beer and wine
Most soy sauce
Chocolate
Sourdough bread
TempehInternational Scientific Association for Probiotics and Prebiotics, 2016
Maj
or G
roup
s of
Fer
men
ted
Foo
ds Fermented cereals
Fermented legumes
Fermented roots and tubers
Fermented vegetables and bamboo shoots
Fermented and preserved meat products
Fermented, dried and smoked fish products
Miscellaneous fermented products
Alcoholic beverages
Fermented milk products: kefir, maas, yoghurt
Tamang et al, 2015
Kefir
Originated in the Tibetan or Mongolian mountains over 2000 years BC.
Keif: Well-being or living well; considered a source of family wealth.
Kefir grains with specific and complex mixture in a symbiotic relationship:
LAB, acetic acid bacteria, lactose fermenting and non-fermenting yeast.
Codex Alimentarius
▪ 2.7% protein
▪ 0.6% lactic acid
▪ <10% fat
▪ 107 CFU/ml
▪ Alcohol % not established
Kefir grains produce acidic
fermented milk
Slightly carbonated with small
amounts of alcohol
Similar in taste to maas
Rosa et al, 2017; Affane et al, 2015
Production of Kefir
Whole, low fat or fat free,
pasteurised milk from cow, buffalo,
goat, camel or sheep
8 - 10C
for 10 – 40 hours
Grains separated from fermented milk by a sieve
May be reused and thus more cost-effective
During cooling, accumulation of
CO2, ethanol and B complex
vitamins and reduction of
lactose content (30%)
Rosa et al, 2017
Phy
siol
ogic
al E
ffect
s of
Kef
irRosa et al, 2017
Kefir
Insulin
resistance
Blood
Pressure
Colon
cancer
IBS
Cholesterol
Amasi by Numbers (per 100g)
3,7g total
fat
2.35g SFA
At least
1 x 107
CFU/g of
viable lactic
acid
162mg
calcium
190g
potassium
270kJ
3.3g protein
(R260: Min
3.0g/100g)
4.5g
carbohydrate
Per 100g
Vorster et al, “Have milk, mass or yoghurt every day”: a food-based dietary guideline for South Africa, SAJCN, 2013
R260 Regulations relating to the classification, packing and marking of diary.
pH of less
than 4.6
▪ Lactic acid bacteria is the dominating
microbe in maas:▪ Leuconostoc
▪ Lactococcus
▪ Lactobacillus
▪ Commercial maas production:▪ Lactococcus lactis lactis
▪ L. lactis cremoris
▪ Lb. plantarum
▪ E. faecalis
▪ Maas pasteurised after fermentation
▪ Shelf life of 21 days at 4C
First scientific record of traditional maas production: 1939
Originally prepared by storing unpasteurized cow's milk in calabashes,
clay pots, milk-sacks, stone jars or baskets.
Amazing Amasi
Chelule et al, 2010; Osvik et al, 2013; Jans et al, 2014; Vorster et al, 2014
11.00
11.20
11.40
11.60
11.80
12.00
12.20
12.40
320 000
340 000
360 000
380 000
400 000
420 000
440 000
460 000
Jun
. 2
01
5
Jul.
20
15
Au
g 2
01
5
Se
p.
20
15
Oct.
20
15
No
v.
20
15
De
c.
20
15
Jan
20
16
Fe
b 2
01
6
Ma
r 2
01
6
Ap
r. 2
01
6
Me
i 2
01
6
Jun
. 2
01
6
Jul.
20
16
Au
g 2
01
6
Se
p.
20
16
Oct.
20
16
No
v.
20
16
De
c.
20
16
Jan
20
17
Fe
b 2
01
7
Ma
r 2
01
7
Ap
r. 2
01
7
Me
i 2
01
7
Jun
. 2
01
7
R/litreLitres per dayMaas average sales volume per day and Average price per month
Sales Volume per day Average price
Amasi Average Sales Volume and Price
Nielson, June 2017
Volume : source Danone.
Yoghurt
PCC
4.66 Kg
66%
10%
19%
61.7%
26.6%
10.8 kg
7.2 kg
3.9 kg
Population
Avg HH monthlyIncome
LSM 8-9
LSM 4-7
LSM 1-3
10.1M
36.3M
5.2M
Maas
PPC
2.8 kg
4.7 kg
4.2 kg
3.84 Kg
LSM 10 6%3.4M
1.9%
9.9%
0.9 kg 0.8 kg
R 38200
R 21300
R7300
R 38200
Total Population Category Consumption
Low PCC
of maas
73g per
week
Low PCC
of yoghurt
<100g
per week
Danone Southern Africa, August 2017
Starter cultures added to
milk
Milk deliveredto factory
Lactobacillus Bulgaricus
and Streptococcus thermophilus
Milk ferments for
8 hrs
(up to 15 hr for maas)
Whey protein,
Stabilisers, flavours, skim
milk powder, and sugar added
Converts lactose to lactic acid
(hence acidity of yoghurt)
Packaged in various
units
Shelf life of 21 days
How
Yog
hurt
is M
ade
▪ 53% eating more yogurt than 3
years ago.
▪ Yoghurt is a dessert in France,
a snack in Poland , and a
beverage in China.
▪ Drinking yoghurt dominates
the Chinese yoghurt market
▪ 49% prefer it as a drink
▪ 11% prefer yoghurt as a
spoonable yoghurt
▪ Greek yoghurt is increasingly
popular in the United States
▪ The Chinese have been eating
more probiotic yoghurt over
the last three years.
http://www.dairyfoods.com/articles/91062-yogurt-is-a-dessert-in-france-a-snack-in-poland
March 2015
Altered gut
microbiota & gut
hormone response
Decrease in
glycaemic and
insulin response
Replacement/
displacement
of less healthy
snack foods
Low kJ
Whey protein
induces
satiety
Health Benefits of Yoghurt
Phanahi et al, 2016; Eales et al, 2016
Low pH delays
gastric
emptying
Low GI
Cardioprotective
effects of dairy
Increase in
body fat loss
and lean body
mass gain
Fermented Milk as an Anti-Hypertensive
Bioactive peptides: hydrolysates with specific amino acid sequences that
exert a positive physiological influence on the body.
Fermented dairy are potential sources of bioactive peptides
Inhibition of ACE: angiotensin I angiotensin II (potent vasoconstrictor)
lowers blood pressure
Milk contains potassium and calcium, minerals known to have a positive effect on
blood pressure.
50% of reduction in blood pressure of DASH diet attributed to dairy
Low milk intake in NHANES I associated with high incidence of hypertension
Low sodium to potassium ratio
Vorster et al, 2014; Beltran-Barrientos et al, 2015
Other reasons?
V
↓24.2% LDL-chol
s
↓13.8% Total-Chol
C
Fermented soy once
daily for 42 days
N=49
D
Canallini et al, 2016
Fermented Foods and Cancer Risk
▪ EPIC cohort in Netherlands >34 000 participants
▪ Investigate the relationship between fermented foods (dairy
products, cheeses, vegetables and meat) and mortality due to all
causes, cancer, and CVD.
✓ Fermented food intake not associated with mortality due to all
causes, cancer, and CVD.
✓ Cheese was moderately inversely associated with CVD mortality
and stroke mortality (p=0.046)
▪ No strong evidence that intake of fermented foods, particular
fermented dairy, is associated with mortality.
Praagman et al, 2015
Yoghurt in Weight Management
✓ In epidemiological studies, yoghurt consumption associated
with:▪ ↓ BMI
▪ ↓ Body weight/weight gain
▪ ↓ Waist circumference
▪ ↓ Body fat
✓Modest but beneficial effect of yoghurt consumption for
prevention of weight gain and management of obesity.
✓ Availability of yoghurt (a nutrient-dense food) and its ease of
introduction to most diets suggests that educating the public to
eat yoghurt as part of a balanced and healthy diet may
potentially contribute to improved public health.Eales et al, 2016
Dairy consumption associated with a lower risk of childhood
overweight/obesity.
For each 1 serving/day of dairy, risk of overweight/obesity ↓13%.
Similar results are being found more specifically with yoghurt consumption
Yoghurt in Children’s Weight
Children (8–18 years) who eat yoghurt
regularly (1 x/week) have a healthier diet:
▪ 23% more fruit.
▪ 30% more wholegrains.
▪ Higher intakes of Ca, vitamin D,
and potassium.
▪ Dec WC
▪ Dec BMI
▪ Dec %BFNHANES, Keast et al, 2015
National Food Consumption Survey sugar
intakes in the diets of children 1-9 years:
1. Sugar added at the table (62.7%)
2. Cold drink, sweets and jams (23.0%)
3. Fruit (3.4%)
4. Confectionary (2.90%)
5. Milk and milk products (2.5%)
6. Cocoa based products (1.2%)
Sugar in Yoghurt
Milk and milk products, including
flavoured milk and drinking
yoghurt are
not the drivers of sugar intake
in SA children
Milk SA, 2017
Organised Dairy Industry Submission On The Taxation Of Sugar-Sweetened Dairy Beverages
Fermented Foods in Gut Health
Food matrix of dairy
plays a role in protecting
bacteria during passage
through gut and
enhanced delivery of
viable bacteria
Live cultures of
fermented foods
potentially
increase
microbes in gut
10 000-fold.
Marco et al, 2017; Uriot et al, 2016; Nichols 2007; Holzapfel et al, 2002; Pyne et al, 2012
>400 species of
bacteria in gut.
Gut is sterile at
birth, but this is
being
challenged
Gut home to
10x more bacterial
cells than human
cells.
Bacterial cells weigh
up to 2kg
The Functions of Gut Microbiota
▪ Enhances integrity of intestinal barrier
▪ Absorption and digestion
▪ Produces some vitamins (e.g. folate, B12, K)
▪ Secretion of immune cells (GALT)
▪ Produce anti-microbial agents
▪ Compete for binding sites
▪ Regulates energy balance: energy harvesting from the diet and energy
storage in the host
o Fermenting unavailable energy substrates such as fiber to short-
chain fatty acids (SCFAs).
o Glucose metabolism
Rad et al, 2016; Pyne et al, 2012
Fermented dairy considered
part of our South African
heritage and a supplementary
staple food, with great cultural
importance.
Healthcare professionals should offer patients/clients assistance in
ways to include fermented dairy as part of their daily diet.
The expansive use of, and benefits gained from, fermented foods
supports their greater inclusion in dietary guidelines around the world.
Conclusion
Well-established in the human
diet for thousands of years, with
or without appreciation for or
understating of their underlying
health benefit.
Thank You!
@MoniquePiderit
Monique Piderit Registered Dietitian
Nutritional Solutions