1. HAVE A LAUGH
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2. QuickTime™ and a
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Shortcut to Six-pack Abs
Thinking about doing this
to Brad……………………
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3. Yes, I’m Going to Talk About
Poop……. Again
Probiotics: The Forgotten Immune
Organ
By Michelle Libby RDH

4. Review of Digestive System
http://www.youtube.com/watch?v=qyJx_UVEgQI
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5. What Makes Up the
Digestive System
• Mouth
• Esophagus
• Stomach
• Small Intestine
• Large Intestine (aka the colon)
• Rectum
Note: the nose and bladder are included in some literature

6. W hat Does the Healthy
Gastrointestinal Tract Do?
• Process foods to provide nutrients to the body
• Functions as 70-80% of the body’s immune system
• Hosts micro-flora that aids in digestion and immune response
• Produces digestive aiding products such as acids and enzymes
• Protects the body from invasion unwanted organisms and toxins-the permeable lining of the tract
allows for proper digestion and absorption of nutrients in controlled stages
• Contains its own nervous system (called the enteric nervous system-often called “the second brain”)
and acts almost independently from the brain
– The ENS surrounds GI tract and contain sensory and motor neurons
– Detects changes in the GI tract, regulates secretion and motility
– Produce hormones that travel through the body and return to stimulate digestion activities
• Technically, anything that enters the digestive system is not truly inside the body until it is broken down
into smaller parts through a complex process-until it goes through this process, the body cannot receive
nutrients

7. How Do W e Get Our Microbiome?
• The GI tract is sterile at birth-bacteria from mother and surrounding environment then
begin to colonize
– A first colonizer immediately after birth is Streptococcus salivarius
– During the first year when teeth appear, Streptococcus mutans and Streptococcus sanguinis
begin to colonize on teeth and gingiva (other strains of Streptococci will be found to
colonize to gums and cheeks, but not on the teeth at this time)
– There are obvious changes with the vaginal microbiome when pregnancy occurs, theorized to
prepare for bacteria introduction to the baby
– Vaginal and Caesarean births differ in colonization rates
– Types and numbers of bacteria differ with breast fed babies and those bottle fed; studies show
Bifidobacterium exposure through breastfeeding may lower childhood asthma risks
– Children may not be getting exposure to important bacteria due to our over-protecting
influences with anti-bacterial cleaning, limits in play that would expose them to soil, and food
production (use of irradiation and pasteurization)

8. The Developed Microbiome
• The human body hosts approximately 10 trillion bacterial cells. We carry anywhere from 2-5lbs in our bodies and over 2lbs
comes from the intestines (weight of a brick)
• The gut consists of about 400-500 species of bacteria
• Over 99% are anaerobes
• Bacteria make up to 60% of the dry mass of feces
• Out of all of the DNA we have in our bodies, only 1% is human DNA-the rest belongs to microbes!
• Healthy digestive flora promote our good health by:
– breaking down carbohydrates into fatty acids and fermenting unused energy substrates
– stimulating cell growth
– preventing invasion or overgrowth of pathogens, including viruses and yeasts
– hormone production
– vitamin production such as Biotin and Vitamin K
– training immune system to respond to pathogenic bacteria
– communicating with the entire body (even the brain!)
• It is believed that healthy gut flora plays an important role in preventing serious health consequences such as diabetes,
cancer and even obesity
– Some genera of bacteria, such as Bacteroides and Clostridium, have been associated with an increase in tumor growth rate, while other genera, such as
Lactobacillus and Bifidobacteria, are known to prevent tumor formation
• Most of the bacteria found in the DS are beneficial, but some are harmful. If beneficial bacteria are reduced enough,
this can allow harmful bacteria and potentially other microbes, such as yeasts and viruses to overtake and create health
problems

9. Bacteria and Their Locations
B acteria of the Oral Cavity
• 500-600 different kinds of bacteria inhabit the oral cavity
• Streptococci, lactobacilli, staphylococci, corynebacteria, and various anaerobes, in particular
Bacteroides
• W e know that particular strains of bacteria are associated with periodontal disease and most gram
negative
• Streptococci mutans and sobrinus as well as some strains of lactobacilli are associated with tooth decay
• It is thought that lower amounts of Streptococcus mutans allows overgrowth of Streptococcus
pneumoniae, which is associated with pneumonia

10. B acteria of the Stomach
• Few microbes are able to survive the acidic environment and apparently are not necessary
for functioning in this part of the DS
- Helicobacter pylori is a gram negative bacterium that can survive in the stomach
by burrowing into the stomach lining to a depth that has a neutral pH
- Strong evidence that suggests that it is a cause of peptic ulcers and has an
association with stomach cancers

11. B acteria of the Intestines
• Most belong to the genera Bacteroides, Clostridium, Fusobacterium, Eubacterium, Ruminococcus,
Peptococcus, Peptostreptococcus, and Bifidobacterium
• Other genera, such as Escherichia and Lactobacillus, are present to a lesser extent
• Species from the genus Bacteroides alone constitute about 30% of all bacteria in the gut, suggesting that
this genus is especially important in the functioning of the host
• Clostridium difficile is the most common antibiotic-related complication
– Associated with broad spectrum antibiotics which wipe of good flora
– High numbers of the bacteria then release toxins causing diarrhea, bloating, abdominal pain; it
can become severe and life-threatening with at risk patients
– 14,000 patients die yearly from C. difficile complications

12. Examples of Beneficial Bacteria and W hat
They Can Do
• Lactic Acid Bacteria Strains
– in the gut prevents diarrhea
– inhibit growth of Helicobacter pylori and prevent yeasts (including vaginal yeasts).
– There is evidence that they may also assists in prevention of colon cancer, high cholesterol and blood
pressure, IBS and other inflammatory diseases.
– Lactobacillus reuteri (found in meats and dairy) in a study showed to lower LDL levels nearly 12% more
in participants than in the placebo participants; overall, cholesterol was lowered by 9%
• E. Coli helps to digest food in the colon, produces Vitamin K and B complex vitamins
• Bifidobacterium some strains promote better digestion motility, antibacterial properties, and prevents
overgrowth of vaginal yeasts
• Streptococci strains such as sanguinis and mitis are considered beneficial oral bacteria
– S. mitis interferes with adhesion of cariogenic bacteria
– S. sanguinas may be a factor in offering protection against periodontal disease

13. • Bacteriodes
– those who eat plenty of protein and animal fats have predominantly Bacteroides bacteria
– those who consume more carbohydrates the Prevotella species dominate-these are associated with MANY
infectious diseases, including; periodontal disease, heart disease and aspiration pneumonia
– Having enough beneficial strains prevent colonization of opportunistic pathogens
It is important not only to have enough good bacteria in the DS, but to also have the
right combination-bacteria have a symbiotic relationship and work together to thrive.

14. Human Microbiome Project
transcription from Wisconsin Public Radio June 20, 2012 interview featuring Owen White (Professor of Epidemiology and Public Health
and Associate Director of Genome Science at the University of Maryland School of Medicine) and Dirk Gevers (Group Leader of Microbial
Systems and Communities
at the Broad Institute of MIT and Harvard)
• 5 year federal study
• The purpose was to develop a baseline study on what microbes are present with a healthy person
• 200 scientists at 80 institutions sequenced genetic material from bacteria taken from 250 healthy people
• There can be as many as a thousand of bacteria strains outside and inside the body
• They found people had different amounts and variances of bacteria; people of different cultures can
have very different variances
• Inhabitants of isolated locations of the world that do not have the genes present of antibiotic resistant
strains
• They believe that there are microbial links between the microbiome and disease-the obvious
connection seems to be inflammatory diseases
• They’ve found a possible link (not a singular causative agent) between Caesarian births and obesity-the
diversity of bacteria in the gut is important to fat metabolism
• Gut microbes actually talk to the brain and may actually have influences on our behaviors such as
extraversion and introversion
• The microbiome “changes” when someone takes antibiotics; there can be a long term impact when
they are taken, particularly at an early age
• W e also need to consider the impact on humans consuming animals treated with antibiotics

15. Some Terms to Know
• Prebiotic - non-digestible ingredients in foods that are used to spur the growth of probiotic bacteria in
the body by providing a suitable environment in which the probiotics themselves can flourish
• Probiotic -a general term for living microorganisms; usually known as "friendly" bacteria, or yeast
which have health benefits in the body. Many are similar to organisms that are naturally found in the
body, especially in the digestive tract.
• Synbiotic - combinations of prebiotics with probiotics

16. Foods that Naturally Contain Good Bacteria
• Yogurts
– Made of milk that is treated with billions of non-harmful bacteria that turn lactose into lactic acid
– Most well known source of bacterial cultures
– Most commonly used bacteria in yogurt production are Lactobacillus bulgaricus and Streptococcus thermophilus
in fermentation
– The fermentation process give these yogurts a “tart” flavor
There are no regulations ensuring that companies have to show evidence of live cultures; some may
not contain “live active cultures” because some commercial yogurts are heated to kill bacteria after
fermentation
Yogurt cannot legally be classed as probiotic unless bacteria that are specifically considered
probiotic are added to it, such as the Bifidus regularis in Activia
The National Yogurt Association (NYA) has established a special Live & Active Cultures seal
The seal is a voluntary identification available to all manufacturers of refrigerated yogurt whose
products contain at least 100 million cultures per gram at the time of manufacture, and whose frozen
yogurt contains at least 10 million cultures per gram at the time of manufacture.
Fewer people may be exposed to active cultures because lactose and casein intolerance.

17. • Example of Other Foods That are Fermented
– Sauerkraut
– Kimchi
– Soy in Tempah
Fermentation can create new nutrients. For example, the fermentation process in
making kombucha tea creates B vitamins and certain acids that can aid in liver health

18. Live Active Cultured Yogurt Brands on the
Market
Lactobacillus bulgaricus
Lactobacillus acidophilus
Stonyfield Organic Yogurt 6 Bifidus
Streptococcus thermophilus
Lactobacillus casei
Lactobacillus rhamnosus
S. thermophilus
L. bulgaricus
Oikos Organic Greek Yogurt 5 L. acidophilus
Bifidus
L. casei
L. bulgaris
Activia 3 S. thermophilus
B. regularis (a.k.a. Bifidobacterium Lactis DN 173-010)
Activia uses what they call an exclusively developed culture of Bifidobacterium, Bacterium animalis and is marketed as Bifidus
regularis® to help with slow intestinal transit, allowing food to move quickly through the system; it is thought to be beneficial because
it survives well through the pH changes of the DS
This a culture found in the flora of animals, including humans

19. Probiotic Recommendations and Safety
• The commercially available products that contain probiotic strains from the following genera are
considered safe for healthy adults according to the American Dietetic Association: Lactobacillus,
Bifidobaterium, Streptococcus thermophilus and Saccharomyces (a yeast)
• Because probiotics are considered supplements, the FDA does not approve them
• Typical daily dose is 1 to 10 billion live organisms, usually taken in 3-5 divided doses
• It is best to take them with food, as it lowers acid exposure and kills fewer microbes
• Probiotics sold as non-refrigerated, pill-form supplements may not contain enough active bacteria to be
effective
• Heat, oxygen, or moisture may render many of these bacteria inactive; refrigerated products are
recommended
• Gas, bloating and diarrhea are the most common side effects; other side effects are rare, but allergic
reaction (usually to other ingredients used in supplement), and infection with highly immune repressed
individuals has occurred
• Large amounts of Saccharomyces boulardii can cause constipation
• There is questions as to whether health benefits are based on long term use or can continue after short
term therapies
• There have not been any findings to show adverse effects to fetus or during breast milk with probiotic
use
• Studies have shown better outcome with bacteria reestablishment when probiotics are take with the
antibiotic(s)