2. 2 Presentation Outline Introduction to Digestive Wellness Probiotics: What, Where, How ? Probiotic health benefits Probiotic products Delivery of probiotics
3.
4.
5.
6. 6 Digestive Wellness Stipanuk MH. Biochemical and Physiological Aspects of Human Nutrition. WB Saunders Co: Philadelphia, 2000.
7. 7 Digestive Wellness Chronic Gut irritability i Leaky gut i Food allergies i Bact. or yeast overgrowth i Accumulated toxin
8. 8 The Critical Functions of Normal Flora: Metabolic processes: Fermentation Vitamin synthesis Energy production Trophic stimulation: Epithelial cell differentiation Immunomodulation Pathogen protection: Competing for nutrients, space, adherence Producing bacteriocidins
13. 13 Today’s Diet, Yesterday’s Genes Most common today dietary patterns compares with the characteristics of ancestral diets. Alterations in: Glycemic load Fiber content Essential fatty acid composition pH balance Macronutrient/micronutrient composition
14. 14 Digestive Well-being The alteration in commensal flora present in IBS in both colonic biopsy samples and stool analysis. Swidsinski A, Ladhoff A, Parnthaler A, et al. Mucosal flora in inflammatory bowel disease. Gastroenterology. 2002; 122: 44-54. Nobaek S, Johansson ML, Molin G, et al. Alteration of intestinal microflora is associated with reduction in abdominal bloating and pain in patients with irritable bowel syndrome. Am J Gastroenterol. 2000; 95: 1231-38.
15. 15 Digestive Well-being Small bowel bacterial overgrowth (SBBO) Bacteria from large bowel produce deleterious effects within the small bowel. Normally, the gas production will increase when the food has passed into the large bowel, but SBBO has this increase much earlier. Dysbiosis has been noted to be present in 78% of IBS who positive with SBBO. With antibiotic, 48% improve from IBS. ( Probiotic? ) Pimentel M, Chow EJ, Lin HC. Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome. Am J Gastro. 2000; 95: 3503-6.
16. 16 Digestive Well-being Several other chronic diseases have a high degree of overlap with IBS, including fibromyalgia, intestinal cystitis, and chronic fatigue syndrome. Aaron LA, Burke MM, Buchwald D. Overlapping conditions among patients with chronic fatigue syndrome, fibromyalgia, and temporomandibular disorder. Arch intern Med. 2000; 160: 221-27.
17. 17 Digestive Well-being Studies in patients with fibromyalgia have shown that 100% and 77% also have SBBO. Pimental M, Mayer AG, Park S, et al. Methane production during lactulose breath test is associated with gastrointestianl disease presentation. Dig Dis Sci. 2003; 48:: 86-92. Pimental M, Chow EJ, Hallegua D, et al. Small intestinal bacterial overgrowth: A possible association with fibromyalgia. J Musculoskelet Pain. 2001; 9: 107-13.
18. 18 Presentation Outline Introduction to Digestive Wellness Probiotics: What, Where, How ? Probiotic health benefits Probiotic products Delivery of probiotics
20. 20 Definition of Probiotics Derived from the Greek = “for life” First used in 1965 to describe a function that is opposite to that of antibiotics. Subsequently “a preparation of or a product containing viable, defined microorganism in sufficient numbers, which alter the micro-flora in a compartment of host and by that exert beneficial health effects on the host” Schrezenemeir J, deVrese M. Prebiotics, and synbiotics-approaching a definition. Am J Clin Nutr. 2001; 73:: 3615-645.
23. 23 Definition Prebiotic: “a non-digestible food ingredient which beneficially affects the host by selectively stimulating the growth of and/or activating the metabolism of one (or more) health-promoting bacteria in the intestinal tract” Combinations of prebiotics and probiotics are “Synbiotics”. Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics.J Nutr. 1995; 125:: 1401-12.
24. 24 What is Probiotic / Prebiotic ? BACTERIA CULTURE FOOD Synbiotic: A mixture ofprobiotic culture and prebiotic Prebiotic: Non-digestible foodingre- dients that are selevtively stimulating growth and acti- vity of“friendly” bacteria in the colon, thus improving health of the host Probiotic: Live microbialfood supple- ment that beneficially affects the host byimproving its intestinal microbial balance Live good bacteria in diet e.g. Lactobacilli Bifidobacteria Inulin Oligofructose Galacto-oligofructose Stomach Small Intestine Colon Stimulation of Activeexogenous active endogenous bacteria Friendly bacteria Excretion
25. 25 Presentation Outline Introduction to Digestive Wellness Probiotics: What, Where, How ? Probiotic health benefits Probiotic products Delivery of probiotics
30. BurnsDisturbance of mucosal barrier function Disturbed immune system Disturbed intestinal motility Vicious circle Bacterial overgrowth Disturbed mucosal barrier function increase in bacterial translocation Infectious complications
