Fiber
Fiber
Fiber
Probiotics and Prebiotics
Disclaimer
The texts, tables, figures and images contained in this
course presentation are not my own, they can be found on:
• References supplied
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• The web
Definitions
• Dietary Fiber = plant matter that can not digested by enzymes (some can
be digested by GI tract bacteria)
“Dietary fibre consists of remnants of plant cells resistant to hydrolysis
(digestion) by the alimentary enzymes of man”, whose components are
hemicellulose, cellulose, lignin, oligosaccharides, pectins, gums and waxes.
Trowell et al. (1985)
Ex. Wheat is 90% insoluble and 10% soluble
Oats are 50% insoluble and 50% soluble
Psyllium 10% insoluble and 90% soluble
(Water soluble/Well fermented)
Fibre Description Main food
component sources
Pectin Components of primary cell wall with D‐ Fruits,
galacturonic acid as principal components. vegetables,
Generally water soluble and gel forming legumes, sugar
beet, potato
Gums Secreted at site of plant injury by specialized Leguminous seed plants (guar,
locust bean), seaweed extracts
secretary cells. Food and pharmaceutical (carrageenan, alginates),
microbial gums (xanthan,
use. gellan)
Starch Bacterial Butyric (22)
+ Acetic (56)
Non‐starch Enzymes Propionic(61)
Polysaccharides
Dietary Fiber
• Physiologic Properties
1. Slows transit in small bowel
2. Increases stool bulk
3. Holds on to water
4. Forms gels
5. Binds minerals and organic substances
6. Stimulates bacterial growth
7. Metabolized to SCFA
Benefits of Dietary Fiber
• Large Literature on Benefits. Some Conflicts But General Consensus Is:
• Intake of greater than 25 to 35 gm/day associated with:
1. Prevention of Coronary Heart Disease and Hyperlipidemia Control
2.Decrease Stroke in Males
3.Prevention and Treatment of Diabetes
4.Treatment of Dietary Constipation
5.Prevention and Treatment of Diverticular Disease
6.Inverse Relationship with Colon Cancer Development
(AGA consensus)
Fiber in Cancer Prevention
• Numerous epidemiologic studies
• Prospective Decosse study in human familial
polyposis of the colon showed that subjects on bran
supplementation had less polyp formation
• Animal studies show that Lactobacilli degrade
carcinogens.
• Bifidobacteria with and without prebiotics decrease
carcinogen activity and tumor development in
numerous animal studies.
Functions and benefits of dietary fibre on
human health
Functions Benefits
Adds bulk to the diet, making feel May reduce appetite
full faster
Attracts water and turns to gel Lowers variance in blood sugar
during digestion, levels
trapping carbohydrates and
slowing absorption of glucose
Lowers total and LDL cholesterol Reduces risk of heart disease
Regulates blood pressure May reduce onset risk or
symptoms of metabolic syndrome
and diabetes
Functions and benefits of dietary fibre on
human health
Functions Benefits
Speeds the passage of foods Facilitates regularity
through the digestive system
Adds bulk to stool Alleviates constipation
Balances intestinal pH and May reduce risk of colorectal
stimulates intestinal fermentation cancers
production of short‐chain fatty
acids
Prebiotic Feed Probiotic
https://keepthetailwagging.com/how‐i‐cured‐my‐dogs‐chronic‐diarrhea‐naturally/prebiotic‐v‐probiotic/
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Concept of Probiotics and Prebiotics:
Harish and Varghese, 2006
Gut Microflora
The complex web of gut microbiota
contributions to host physiology
Microbial Endocrinology,
• the ability of probiotics to both synthesize and respond to
neuroactive compounds as a mechanism by which biological
processes of the host, both physiological and neurological, may be
influenced
• Neurochemicals isolated from various microbes (as from [140]).
Genus Neurochemical
Lactobacillus and Bifidobacterium GABA
Escherichia, Bacillus, and Saccharomyces Norepinephrine
Candida, Streptococcus, Escherichia, and Enterococcus Serotonin
Bacillus and Serratia Dopamine
Lactobacillus Acetylcholine
Factors affecting the intestinal micro
ecosystem
• Any action taken to kill ‘bad’ bacteria essentially kills ‘good’ bacteria
as well.
• Antibiotics and other drugs intake
• Microbial infections
• Diet (highly processed, low‐fiber foods)
• Chronic diarrhea
• Stress
Imbalance of intestinal micro flora results in
• Poor nutritional response
• Reduced efficacy of medications
• Physiological dysfunction
• Accelerated aging
• Cancer
• Deficient immune response
• Susceptibility to infection
• Physical discomfort
Diseases influenced by
gut microbial metabolism
PREBIOTICS
Supplements not digested by human enzymes that stimulate growth of
beneficial bacteria
• Fructo‐oligosaccharides
• Inulin
• Galacto‐,galactosyllactose‐,xylo‐,isomalto‐and soya oligosaccharides
• Pyrodextrins (glucose oligosaccharides)
• Lactulose
• Breast milk oligosaccharides
Oligosaccharides
• Usual pleasant slight sweet taste
• Add texture to foods
• Naturally occurs in artichoke, onion,garlic, chicory, leek, and to a
lesser degree in cereals
• Raffinose and stachynose are major CHO of beans and peas
• Commercially produced (FOS)
Benefits of Oligosaccharides
• Promote the growth of bifido‐and lactobacilli
• Lower colon pH
• Discourage growth of Clostridia
• Prevent constipation and diarrhea
• Have low glycemic index
• Water‐soluble and of low viscosity
• Do not bind minerals
Inulin
• Naturally occurs in fruits and vegetables
• Longer chain length than FOS
• Provides a fat mimicking texture when added to food
• Now available in a supplement
Clinical use of Prebiotic Inulin
• Constipation‐ 40g/d inulin for 19 days increased bifidobacteria and
produced soft stools (Kleeson‐AJCN,1997)
• IBS(Irritable Bowel Syndrome)‐ two studies‐ no significant effect
• IBD(Inflammatory Bowel Disease)‐ two Japan reports in open label
decreased symptoms.
• Controversial lipid lowering effect
• Main positive reports are increase in bifidobacteria in infants by use
of FOS (Fructooligosaccharides)
Prebiotic Substances Available Commercially
In USA
FOS (Ross),
Guar (Novartis)
Lactulose (Solvay and Bartek)
Inulin (Fibersourse,P & G)
In Japan and Europe many of the other oligosaccharides
Requirements for potential prebiotics
Elie Metchnikoff
• 1845‐1916 , Nobel Prize Winner
• Phagocytosis and Ageing
• “Intoxication from the gut flora”
• Putrefactive bacteria produced toxic substances absorbed from the
gut affecting the nervous and vascular systems causing ageing
• His radical solution for autointoxication was removal of the flora by
colectomy
• Another approach was to replace putrefactive bacteria with
carbohydrate fermenting bacteria
PROBIOTICS
• Live microbial food supplements which beneficially affect the host
animal by improving its intestinal microbial balance.
• Usually strains of bacteria (lactobacilli or bifidobacteria) or yeasts
(Saccharomyces)
• Administered in yogurts or capsules
• Survive passage thru the gut
PROPERTIES of PROBIOTICS
• Human origin
• Resist upper GI tract secretions
• Adhere to human intestinal cells
• Colonize the human intestinal tract
• Production of antimicrobial substances
• Antagonize carcinogenic/ pathogenic flora
• Safe in clinical use at > 1010
• Stimulate immune process
• Fermentation
Probiotics Used in Human Studies
• Analysis of 186 published human studies [1980‐2004]
• 171 controlled, 79 RDBPC (Montrose‐ JCG ’05)
‐ 173* used single organism
‐ 82* used multiple organisms
‐ 84% reported significant benefit
• Most common used single are L.acidophilus,L.reuteri,L.plantarum,L.GG,
B.bacterium, B.brevi, E.coli Nistle etc
• Most common multiple are combo of L.acidophilus & Bifidobacterium.
• VSL#3 has 8 organisms
Dose of Probiotic
• Varies greatly with product
• Live and active cultureYogurts must contain >108 [100 million]
• L.rhamnosus GG has 10 billion
• VSL#3 has 300 to 450 billion per packet
• Common OTC have millions
DOSE
• In Crohn’s Studies
• 12 billion organisms of L.rhamnosus GG did not prevent recurrence
post‐op in placebo controlled study
• 300 billion Saccharomyces were effective in decreasing symptoms and
preventing relapse in placebo and mesalamine controlled studies
• 300 billion of eight organisms in VSL#3 effective in preventive post‐op
relapse.
Clinical Relevance *
• Excellent evidence = A recommendation
• Studies mixed = B recommendation
• Too little information = C recommendation
*Floch. JClinGastro 2005;40:275
Probiotic Organisms in USE
Type Type Other Lactic Acid Other
Lactobacillus Bifidobacterium Bacteria Microorganisms
L. acidophilus (a),* B. adolescentis (a) Enterococcus Bacillus
L. amylovorus (b),* B. animalis (a),* faecium (a) clausii (a),*
L. casei (a),(b),* B. bifidum (a) Lactococcus Escherichia coli
L. gasseri (a),* B. breve (b) lactis (b),* Nissle 1917 (a)
L. helveticus (a),* B. infantis (a) Streptococcus Saccharomyces
L. johnsonii (b),* B. longum (a),* thermophilus(a),* cerevisiae
L. pentosus (b),* (boulardi)(a),*
L. plantarum (b),*
(a)
L. reuteri (a),* Mostly as pharmaceutical products;
(b) mostly as food additives;
L. * QPS (Qualified Presumption of Safety) microorganisms.
rhamnosus (a),(b),*
Probiotic based functional foods
Cultured Dairy Products Beneficial Bacteria
Yoghurt S. thermophilus, L. bulgaricus & L. acidophilus
Cheeses L. acidophilus, L. brevis, L. casei, L. caucasicus, L.
helveticus, L. lactis, L. plantarum, S. cremoris, S. faecium
Acidophilus milk L. acidophilus
Bulgaricus milk L. bulgaricus
Yakult L. casei,
Bifidus milk B. bifidum, B. longum
Buttermilk L. Lactis, S. cremoris
Sour cream S. cremoris
Kefir L. acidophilus, L. caucasicu
Selection criteria of probiotic strains (Safety)
• Human or animal origin.
• Isolated from the gastrointestinal tract of healthy individuals.
• History of safe use.
• Precise diagnostic identification (phenotype and genotype traits).
• Absence of data regarding an association with infective disease.
• Absence of the ability to cleave bile acid salts.
• No adverse effects.
• Absence of genes responsible for antibiotic resistance localised in
non‐stable elements.
Selection criteria of probiotic strains
(Functionality)
• Competitiveness with respect to the microbiota inhabiting the intestinal
ecosystem.
• Ability to survive and maintain the metabolic activity, and to grow in the
target site.
• Resistance to bile salts and enzymes.
• Resistance to low pH in the stomach.
• Competitiveness with respect to microbial species inhabiting the intestinal
ecosystem (including closely related species).
• Antagonistic activity towards pathogens (e.g., H. pylori, Salmonella sp., Listeria
monocytogenes, Clostridium difficile).
• Resistance to bacteriocins and acids produced by the endogenic intestinal
microbiota.
• Adherence and ability to colonise some particular sites within the host
organism, and an appropriate survival rate in the gastrointestinal system.
Selection criteria of probiotic strains
(Technological usability)
• Human or animal origin.
• Isolated from the gastrointestinal tract of healthy individuals.
• History of safe use.
• Precise diagnostic identification (phenotype and genotype traits).
• Absence of data regarding an association with infective disease.
• Absence of the ability to cleave bile acid salts.
• No adverse effects.
• Absence of genes responsible for antibiotic resistance localised in
non‐stable elements.
CLAIMS FOR PROBIOTICS
• Increase resistance to infection
• Decrease duration of diarrhea disease
• Stimulate immunity, modulate cytokine gene expression, stimulate
phagocytosis
• Beneficial effect on blood pressure,serum cholesterol, diabetes
mellitus,lactose digestion and allergy
• Regression of tumors and reduction in carcinogens
Colon cancer – Certain probiotics (Lactobacillus bulcaricus) may help prevent
colon cancer by preventing the
breakdown of enzymes (β- glucuronidase)
that contribute to the growth of cancer causing agents.
Lowering cholesterol ‐
a range of LAB able to break down
bile in the gut, thus inhibiting its reabsorption (which enters
the blood as cholesterol)
Blood pressure reduction ‐Consumption of milk fermented with various
strains of LAB may result in modest reductions in blood pressure, due to the ACE
inhibition‐like peptides produced during fermentation.
Side Effects of Probiotics
• Rare cases cause bloating, diarrhea, abdominal pain.
• If in excess cause infection that require medical attentions.
• People having on underlying disease or compromised immune system
cause potential health problems like skin rash, fever, bloody stools
etc.
• Sometimes interact with immunosupressive drugs leading to life
threating cnditions. So people taking such drugs should avoid it.
Fiber in Cancer Prevention
• Numerous epidemiologic studies
• Prospective Decosse study in human familial
polyposis of the colon showed that subjects on bran
supplementation had less polyp formation
• Animal studies show that Lactobacilli degrade
carcinogens.
• Bifidobacteria with and without prebiotics decrease
carcinogen activity and tumor development in
numerous animal studies.
Synbiotic
Synbiotic = Probiotic + Prebiotic
• The concept of synbiotics has been proposed to characterize
health‐enhancing foods and supplements used as functional food
ingredients in humans (Gibson, 2004).
• Potential synergy between pro‐ & prebiotics
• Improve survival in upper GIT
• More efficient implantation
• Stimulating effect of Probiotics
Mechanisms of action of synbiotics and their effects
References
1. “Dietary Fiber, Prebiotics, &Probiotics” Martin H.
Floch, M.D.MACG,AGAF (Yale University) (AGA Fellow’s
Nutrition Course – 2007)
2. “Dietary fibre in foods: a review” J Food Sci Technol.
2012 Jun; 49(3): 255–266.
3. “Effects of Probiotics, Prebiotics, and Synbiotics on
Human Health” Paulina Markowiak* and Katarzyna
Śliżewska*Nutrients. 2017 Sep; 9(9): 1021.
References
4. “Probiotics, prebiotics and synbiotics‐ a review
” J Food Sci Technol. 2015 Dec; 52(12): 7577–7587.
5. “PROBIOTIC FOODS: HEALTHY WAY TO HEALTHY LIFE”
Anmol Kaur1, Sanu Arora2 and Ravinder Nagpal