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  1. 1. NaturalDigestive Well-being<br />
  2. 2. 2<br />Presentation Outline<br />Introduction to Digestive Wellness<br />Probiotics: What, Where, How ?<br />Probiotic health benefits<br />Probiotic products<br />Delivery of probiotics<br />
  3. 3. 3<br />Introduction<br /><ul><li>Currently, people is facing an epidemic of digestive illness directly related to the foods they eat and the way they live.
  4. 4. One-third to one-half of all population have digestive illness.</li></li></ul><li>4<br />Introduction<br /><ul><li>GI system is the primary gateway by which the external environment interacts with the body.
  5. 5. It’s allowing or denying entry</li></li></ul><li>5<br />Digestive Wellness<br />Gershon M. The Second Brain. Harper Collins, 1998.<br />
  6. 6. 6<br />Digestive Wellness<br />Stipanuk MH. Biochemical and Physiological Aspects of Human Nutrition. WB Saunders Co: Philadelphia, 2000.<br />
  7. 7. 7<br />Digestive Wellness<br />Chronic Gut irritability<br />i<br />Leaky gut<br />i<br />Food allergies<br />i<br />Bact. or yeast overgrowth<br />i<br />Accumulated toxin<br />
  8. 8. 8<br />The Critical Functions of Normal Flora:<br />Metabolic processes:<br />Fermentation<br />Vitamin synthesis<br />Energy production<br />Trophic stimulation:<br />Epithelial cell differentiation<br />Immunomodulation<br />Pathogen protection:<br />Competing for nutrients, space, adherence<br />Producing bacteriocidins<br />
  9. 9. 9<br />Today’s Knowledge:Human Microbiota is essential for health<br />
  10. 10. 10<br />
  11. 11. 11<br />
  12. 12. 12<br />Today’s Diet, Yesterday’s Genes<br />
  13. 13. 13<br />Today’s Diet, Yesterday’s Genes<br />Most common today dietary patterns compares with the characteristics of ancestral diets.<br /> Alterations in:<br />Glycemic load<br />Fiber content<br />Essential fatty acid composition<br />pH balance<br />Macronutrient/micronutrient composition<br />
  14. 14. 14<br />Digestive Well-being<br />The alteration in commensal flora present in IBS in both colonic biopsy samples and stool analysis.<br />Swidsinski A, Ladhoff A, Parnthaler A, et al. Mucosal flora in inflammatory bowel disease. Gastroenterology. 2002; 122: 44-54.<br />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.<br />
  15. 15. 15<br />Digestive Well-being<br />Small bowel bacterial overgrowth (SBBO)<br />Bacteria from large bowel produce deleterious effects within the small bowel.<br />Normally, the gas production will increase when the food has passed into the large bowel, but SBBO has this increase much earlier.<br />Dysbiosis has been noted to be present in 78% of IBS who positive with SBBO.<br />With antibiotic, 48% improve from IBS. ( Probiotic? )<br />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.<br />
  16. 16. 16<br />Digestive Well-being<br />Several other chronic diseases have a high degree of overlap with IBS, including fibromyalgia, intestinal cystitis, and chronic fatigue syndrome.<br />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.<br />
  17. 17. 17<br />Digestive Well-being<br />Studies in patients with fibromyalgia have shown that 100% and 77% also have SBBO.<br />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.<br />Pimental M, Chow EJ, Hallegua D, et al. Small intestinal bacterial overgrowth: A possible association with fibromyalgia. J Musculoskelet Pain. 2001; 9: 107-13.<br />
  18. 18. 18<br />Presentation Outline<br />Introduction to Digestive Wellness<br />Probiotics: What, Where, How ?<br />Probiotic health benefits<br />Probiotic products<br />Delivery of probiotics<br />
  19. 19. 19<br />Definition of Probiotics<br />
  20. 20. 20<br />Definition of Probiotics<br />Derived from the Greek = “for life”<br />First used in 1965 to describe a function that is opposite to that of antibiotics.<br />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”<br />Schrezenemeir J, deVrese M. Prebiotics, and synbiotics-approaching a definition. Am J Clin Nutr. 2001; 73:: 3615-645.<br />
  21. 21. 21<br />Probiotics<br />Lactobacilli <br />Bifidobacteria<br />Streptococcus thermophilus<br />Enterocoocus faecium<br />Yeast : Saccharomyces boulardii<br />
  22. 22. 22<br />How do probiotics confer health benefits?<br />
  23. 23. 23<br />Definition<br />Prebiotic:<br />“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”<br />Combinations of prebiotics and probiotics are “Synbiotics”.<br />Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics.J Nutr. 1995; 125:: 1401-12.<br />
  24. 24. 24<br />What is Probiotic / Prebiotic ?<br />BACTERIA<br />CULTURE<br />FOOD<br />Synbiotic:<br />A mixture ofprobiotic<br />culture and prebiotic<br />Prebiotic:<br />Non-digestible foodingre-<br />dients that are selevtively<br />stimulating growth and acti-<br />vity of“friendly” bacteria in<br />the colon, thus improving<br />health of the host <br />Probiotic:<br />Live microbialfood supple-<br />ment that beneficially affects<br />the host byimproving its <br />intestinal microbial balance<br />Live good bacteria <br />in diet<br />e.g. Lactobacilli<br />Bifidobacteria<br />Inulin <br />Oligofructose <br />Galacto-oligofructose<br />Stomach<br />Small<br />Intestine<br />Colon<br />Stimulation of<br />Activeexogenous active endogenous<br />bacteria Friendly bacteria<br />Excretion<br />
  25. 25. 25<br />Presentation Outline<br />Introduction to Digestive Wellness<br />Probiotics: What, Where, How ?<br />Probiotic health benefits<br />Probiotic products<br />Delivery of probiotics<br />
  26. 26. 26<br />Probiotic research for digestive health<br />
  27. 27. 27<br />PB<br />PB<br />PB<br />Optimal mucosal barrier function<br />Normal functional <br />immune system<br />Normal intestinal<br />motility<br />Balanced intestinal<br />Flora, optimal host-<br />microbe interaction<br />Insult<br /><ul><li> Acute pancreatitis
  28. 28. Major surgery
  29. 29. Trauma
  30. 30. Burns</li></ul>Disturbance of mucosal barrier function<br />Disturbed immune <br />system<br />Disturbed intestinal <br />motility<br />Vicious<br />circle<br />Bacterial<br />overgrowth<br />Disturbed mucosal barrier function<br />increase in bacterial translocation<br />Infectious complications<br />