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Prebiotics, Probiotics &GI Health
Rachel Dartt
Amanda Griffin
November 15, 2005
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Presentation Overview
Review of Prebiotics/ProbioticsPotential Benefits
Adverse EffectsMechanisms
Regulations
Case Study
Meal Plan
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Prebiotics Food Sources
Prebiotics are naturalfood ingredients thatare available in a variety
of food sources.Bananas, garlic, barley,onion, Jerusalem
artichoke tuber, wheat,asparagus, rye, andchicory root.
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Probiotics microbial foods orsupplements that can be used to changeor reestablish the intestinal flora and
improve the health of the host.Probiotics are non-pathogenic and improvethe balance of microorganisms in the colon.
Lactobacillus
Bifidobacteria
Probiotics
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Probiotics Food Sources
Usually found infermented dairyproducts
DanActiveStonyfield Farm Yogurt
Basics Plus Kefir
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Potential Benefits of Prebiotics
Improve bowel functionIncrease stool frequency
Increase stool weight
Increase production of short-chain fatty acids
Promote the growth of the health promotingbacteria Lactobacilli and Bifidobacteria
Restore gut flora during or after antibiotic
therapyInulin can reduce insulin concentrations andlowered triglyceride levels
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Potential Adverse Effects of Prebiotics
GI Distur bances:Constipation
Abdominal pain
FlatulenceBloating
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Potential Benefits of ProbioticsRestore the normal balance of microbes in the
intestinesTreatment of diarrhea
Treatment of gastroenteritis
Alleviate some of the symptoms of irritable bowelsyndrome such as:Constipation
Diarrhea
abdominal painFlatulence
bloating
Improve immune function
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Potential Benefits of Probiotics
Improve lactose digestion and tolerancePrevent cancer by:
decreasing fecal concentrations of enzymesand secondary bile salts
reducing absorption of harmful mutagensthat may cause colon cancer
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Potential Adverse Effects of Probiotics
GI Disturbances:Constipation
Abdominal Pain
FlatulenceBloating
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Prebiotic Mechanisms
Mechanisms by which prebioticsmodulate the immune system
Increases the amount of lactic acid
producing bacteria
Increases the amount of Short Chain FattyAcids (SCFAs)
Activates carbohydrate receptor immunecells
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Mechanism #1
Bifidobacteria and lactobazillus are bothnaturally occurring bacteria found in ourintestine.
Increase absorption of vitamins andminerals
Improve digestion
Increase protection against harmfulbacteria such as fungi and viruses
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Mechanism #1 Continued
Prebiotics Inulin and Oligofructoseincrease the amount of lactic acidproducing bacteria
Immune cells and epithelia cellsrespond to this shift in the microflora
This leads to the signaling of toll-like
receptors that activate the secretion ofpro-inflammatory cytokines
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Mechanism #1 Continued
Prebiotics Lactic acidbacteria
Flora Proinflammatory
Composition Activities
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Mechanism #2
When prebiotics such as Inulin andoligofructose are supplemented, it increasesthe number of SCFAs in the gut.
Butyrate, for example, if beneficial for theimmune system because it:
Suppresses lymphocyte proliferation
Inhibits cytokine production of certain
lymphocytesInduces T-lymphocyte apoptosis
Activates G-protein-coupled receptors
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Mechanism #2 Continued
Probiotics LigandConcentration
Activates G-protein-
coupled receptors
Found on leukocytes
Supplies fuel
to immune cells
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Mechanism #3
Certain phagocytes (immune cells) inthe gut express lectin type receptorsites
These sites mediate cellular cytotoxicreactions against foreign cells
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Mechanism #3 Continued
Example: Dectin-1Has a receptor site that can be activated byundigested prebioticsOnce activated, it induces aproinflammatory response
In Summary:The immune cells in the gut withlectin type receptors can be
stimulated by the undigested prebioticcarbohydrates and therefore increasethe activity of proinflammatoryreactions.
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Regulation of Prebiotics/Probiotics
Intended use of product determines how theproduct is regulated.
Biological product - a virus, bacteria, or
fungi that is used for the prevention,treatment, or cure of a disease/condition ofhuman beings.
Dietary supplement - a product taken bymouth that contains a dietary ingredientintended to supplement the diet.
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Regulation of Prebiotics/Probiotics
Biological products require pre-market review andapproval by the FDA; however, dietary supplementsdo not.
The safety, purity, and potency, as well as efficacy,
of a biological product must be demonstrated forapproval.
Dietary supplements are not required to demonstrateany of these properties to be marketed.
The FDAs Center for Food Safety and AppliedNutrtion (CFSAN) regulates probiotics and prebioticsmarketed as dietary supplements or food ingredients.
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Regulation of Prebiotics/Probiotics
The FDAs Center for Biologics Evaluation andResearch (CBER) regulates probiotic products whenthey are used for clinical indications.
CBERs Office of Vaccines Research and Review has
regulatory jurisdiction over most probiotic productsfor clinical use.
A probiotic product marketed or promoted as a
treatment, prevention, or cure for a specific diseaseor condition without an approved indication for sucha claim is considered unapproved and an illegal drug.
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Case Study Background
35 year old femaleHistory of Ulcerative Colitis
Three months pregnant
Is referred to us by her obstetrician toensure adequate nutritional intake
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Case Study Background
Currently not on any immunosuppressivetherapy and is not very symptomatic
Enjoys and tolerates milk products
Ht: 56
Weight: 140 lbs
BMI: 22.6
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Nutritional Needs for Pregnancy
Normal body weight range indicatesshe should gain ~25-35 lbs during pregnancy.
She is in her second trimester and therefore
should be eating an additional 300kcal/d over her pre-pregnancy needs.
She also has increased protein needs
for maternal blood expansion, uterus,breast and muscle tissue, and fetaland placental development.
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Nutritional Needs for Pregnancy
RDA27 mgIronAI5 gVitamin D
AI1000 mgCalciumRDA600 gFolate
1.1 g/kg70 gProtein40 kcal/kg~2500Calories
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Nutrition Needs for Ulcerative Colitis
Small, frequent mealsAvoid foods/practices that causeexacerbations such as:
high sucrose foods
lack of fruits and vegetables
low intake of dietary fiber
altered omega-6/omega-3 fatty acid ratios
Probiotic foods or supplements may help intreatment - more research is needed
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Meal Plan Day 1
Low Fat milk cupGraham crackers - 3
Stonyfield Farms Yogurt 6 ozGranola cup
Apple slices (med apple)Low-fat cottage cheese -1/2 cup
Evening SnackAfternoon SnackMorning Snack
Baked chicken 3 oz
Baked potato 1 medium
Spinach cup
Whole Wheat roll 1
Margarine 1 tsp
Sherbet cup
Lemonade 1 cup
Turkey Sandwich
2 oz meat
1 slice cheese
2 slices bread
Mayonnaise 1 tsp
Banana 1
Low Fat milk 1 cup
Grapefruit
Honey nut cheerios cup
Wheat toast 1 slice
Fruit Preserves - 1 tsp
Low Fat milk 1 cup
DinnerLunchBreakfast
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Meal Plan - Day 2
Low Fat milk cupTriscuits - 2
Bagel 1 (small)Cream cheese 2 Tbsp
Peach 1 (med)Whole-wheat Crackers 8
Peanut Butter 2 Tbsp
Evening SnackAfternoon SnackMorning Snack
Hamburger 3 oz
Whole-wheat bun - 1
Baby carrots 8
Tossed Salad 1 cup
Salad Dressing 2 Tbsp
Pudding cup
Fruit Punch 1 cup
Grilled Cheese Sandwich
2 oz cheese
2 slices bread
Three Bean Salad 1 cup
Low Fat milk 1 cup
Banana 1
Cooked Oatmeal 1 cup
English Muffin 1
Margarine 1 tsp
Banana-strawberry Kefir 8 oz
DinnerLunchBreakfast
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Meal Plan - Day 3
Low Fat milk cup
Granola Bar - 1
Strawberry DanActive 3.3 oz
Oatmeal cookies - 2
Pear 1 small
String Cheese 2 oz
Evening SnackAfternoon SnackMorning Snack
Grilled Steak 3 oz
Sweet Potato 1 small
Asparagus cup
Brown Rice cup
Margarine 1 tsp
Pineapple chunks cup
Low Fat chocolate milk 1 cup
Grilled-Chicken Sandwich
3 oz meat
1 whole wheat bun
Mayonnaise 1tsp
Ketchup 1 tsp
Orange 1
Low Fat milk 1 cup
Strawberries 1 cup
Whole-wheat Pancakes 3 small
Maple Syrup 2 Tbsp
Margarine - 2 tsp
Low Fat milk 1 cup
DinnerLunchBreakfast
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3 Day Average Nutritional Analysis
385 mcg600 mcgFolate
17 mcg27 mcgIron
7.5 mcg5 mcgVitamin D
1763 mg1000 mgCalcium
110 g70 gProtein
2476~2500CaloriesActualEstimated
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ADA Position Statement on Probiotics
Moderate strength of evidenceIn vivo, in vitro, and clinical evidenceshows that functional foods that contain
probiotics, such as fermented dairyproducts, help support gastrointestinalhealth.
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ADA Position Statement on Probiotics
The amount and frequency of intake recommendationfor probiotics is 1 to 2 billion colony-forming units perday
Example 1: DanActive1 bottle contains 10 billion active culturesIncludes S. thermophillus, L. bulgaricusand L. casei.
Example 2: Basics Plus Kefir
1 cup serving contains 10 billion active bacteriaIncludes 10 active probiotic cultures while most yogurts onlycontain two or three.
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Conclusion
Studies have shown possible beneficialeffects of probiotics and GI health
More studies are needed
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Questions??
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