Robert Hutkins (University of Nebraska, USA) explored the interactions between ingested microorganisms and the gut microbiota, and the way exogenous microorganisms can change the gut environment.

1. Bob Hutkins
University of Nebraska
Health benefits of fermented dairy foods:
microbiota and beyond
Fifth Global Summit on the Health Effects of Yogurt
International Congress of Nutrition
Buenos Aires, Argentina
October 18, 2017

2. Conflicts of Interests
Board of Directors, International Scientific
Association for Probiotics and Prebiotics
Research funding from companies that sell or
use probiotics or prebiotics in their products
(Mead Johnson Nutrition, Dannon, Prenexus, BioGaia)
Research funding from the National Dairy Board
and the U.S. Department of Agriculture
Owner/Partner of Synbiotics Solutions, LLC

3. Outline
Primer on fermentation and fermented foods
Diet, microbiota, and gut health
Health properties of fermented foods
Can fermented foods be considered as a
source of probiotics?

4. Fermentation Defined
Biochemical Definition: Process of deriving
energy from the oxidation of organic substrates
such as glucose, where the electron acceptor is
an organic compound

5. raw food fermented food
microorganisms
Food-Friendly Definition: Conversion
of raw foods into fermented foods
by microorganisms

7. Why fermented foods have been
popular for 10,000 years
Enhanced functionality
Enhanced preservation
Unique
Increased economic value
Enhanced nutritional value
Enhanced organoleptic properties

8. By Ted Weesner Globe Correspondent August 23, 2016
Fermented foods
Whole Foods Market top
food trends for 2016.
ROLE IN HEALTH

9. Fermented foods and the hygiene hypothesis
Why our western lifestyle is killing us?
or
Adapted from Sommer and Bäckhed, 2013, Nature Reviews Microbiology 11, 227-238
Chronic
inflammation
Metabolic
dysfunction
(dysbiosis)
altered intestinal microbiota

10. The gut microbiota - dysbiosis and disease

12. Restoring a healthy microbiota with
fermented foods
fermented foods may also contribute live
microorganisms to the gut microbiota
fermented foods provide many health benefits
vitamins, minerals, protein, fiber, phenolics
1. microbes that perform the fermentation
2. microbes added as probiotics
lactobacilli, streptococci
bifidobacteria, lactobacilli

13. Are fermented foods the same as probiotics?

14. Fermented Foods Probiotics≠
(but they share similar properties)
Probiotics: Live microorganisms that, when administered in
adequate amounts, confer a health benefit on the host

15. Factors affecting the gut microbiota

16. Factors affecting the gut microbiota
Microbes from raw foods
Aerobic/facultative bacteria
Microbes from fermented foods
Yeasts and other fungi
Anaerobic/facultative bacteria
Yeasts and other fungi
Lactic acid bacteria
Adapted from Graf et al., 2015. Microbial Ecology in Health and Disease
diet

17. Lactobacillus Strains evaluated in clinical trials
Lactobacillus johnsoni LA1 (Nestle)
Lactobacillus acidophilus NCFM (Danisco)
Lactobacillus acidophilus SBT (Snow Brand)
Lactobacillus acidophilus ADH (Dupont
Lactobacillus rhamnosus GG (Valio)
Lactobacillus reuteri DS2112 (Biogaia)
Lactobacillus casei strain Shirota (Yakult)
Lactobacillus plantarum 299v (Probi Foods)
Lactobacillus crispatus CTV05 (Osel, Inc.)
Lactobacillus casei F19 (Alra Foods)
Lactobacillus casei DN-114001 (Dannon)
Lactobacillus rhamnosus Lcr35 (Lycocentre)
Lactobacillus fermentum RC-14 (Urex Biotech)

18. Lactobacillus
Lactobacillus johnsoni LA1 (Nestle)
Lactobacillus acidophilus NCFM (Danisco)
Lactobacillus acidophilus SBT (Snow Brand)
Lactobacillus acidophilus ADH (Dupont
Lactobacillus rhamnosus GG (Valio)
Lactobacillus reuteri DS2112 (Biogaia)
Lactobacillus casei strain Shirota (Yakult)
Lactobacillus plantarum 299v (Probi Foods)
Lactobacillus crispatus CTV05 (Osel, Inc.)
Lactobacillus casei F19 (Alra Foods)
Lactobacillus casei DN-114 001 (Dannon)
Lactobacillus rhamnosus Lcr35 (Lycocentre)
Lactobacillus fermentum RC-14 (Urex Biotech)
Strains evaluated in clinical trials

19. Bifidobacterium
Bifidobacterium longum BB536 (Moringa)
Bifidobacterium bifidum (Yakult)
Bifidobacterium infantis (Shirota)
Bifidobacterium breve (Yakult)
Bifidobacterium lactis DS 920 (DSM Foods)
Bifidobacterium animalis DN 173010 (Dannon)
Bifidobacterium lactis Bb12 (Chrs. Hansens)
Bifidobacterium essensis (Danone)
Strains evaluated in clinical trials

20. Bifidobacterium
Bifidobacterium longum BB536 (Moringa)
Bifidobacterium bifidum (Yakult)
Bifidobacterium infantis (Shirota)
Bifidobacterium breve (Yakult)
Bifidobacterium lactis DS 920 (DSM Foods)
Bifidobacterium animalis DN 173 010 (Dannon)
Bifidobacterium lactis Bb12 (Chrs. Hansens)
Bifidobacterium essensis (Danone)
Strains evaluated in clinical trials

21. Health benefits of fermented foods
Some diets are associated with health or longevity
Are fermented foods, therefore, at least partially
responsible for longevity and other health benefits?
Some of those diets are rich in fermented food
Observational and epidemiological evidence
Evidence exist for various types of diet, and yogurt
in particular

23. Conclusions: Higher consumption of yogurt was
associated with reduced risk of MetS in individuals
TOTAL YOGURT
LOW-FAT YOGURT
WHOLE-FAT YOGURT
Reduced risk Increased risk

24. Conclusion: Yogurt consumption
was associated with less weight
gain in all cohorts.
Yogurt
cohort study of 120,000 U.S. adults
tracked subjects for 20 years

25. Health benefits of fermented foods
Possible mechanisms
It’s the microorganisms that reach the gut and
produce beneficial end-products
2.
It’s the transformation or change in the food
brought about by microorganisms
1.
lactose fermented (cheese, yogurt)
gluten degraded (sour dough bread)
vitamins produced (tempeh)
nutrients extracted or converted (wine)
anti-nutrients inactivated (phytic acid in cereals)

26. The role of fermentation-derived bacteria in the
gastrointestinal tract
microbes
from
fermented
food
1
5
2
3
6
4
Adapted from Crittenden, 2006.

27. “Our study supports the concept that [fermentation] bacteria
….. can be leveraged to re-engineer the gut microbiome and
improve dysbiosis-related diseases.”
“There is increasing evidence that food-borne bacteria
contained in fermented products are biologically active in the
colon… such activities might be part of the mechanisms
underlying beneficial effects.”
0
But do fermentation-derived bacteria
make it to the gut?

28. Organisms in fermented foods reach
the colon - alive and well!

29. Sauerkraut and sausage bacteria in the colon
F. Dal Bello, Walter, and Hammes, and Hertel, 2003. Microbial Ecology University of Hohenheim, Germany

30. Organisms isolated from healthy Korean adults
(> 80 years old) and from kimchi
Lactobacillus fermentum PL9988
was inhibitory to pathogens and
had immune-enhancing activity
and anti-inflammation activities
Journal of Functional Foods, 2016, 20:79–87

31. No significant changes in microbiota
Subjects (n= 4) consumed 250 g plain yogurt/day for 42 days

32. Fermented milk consumption  more lactobacilli, fewer anaerobes
Fermented milk consumption  fewer mutans streptococci
L. rhamnosus SD11 persisted even after consumption ended

33. Regular yogurt consumption maintains
bifidobacteria in the GIT
Bifidobacterium

34. Lactobacillusbulgaricus
Control Acidifed Yogurt
Streptococcusthermophilus
Control Acidifed Yogurt
LactobacillusrhamnosusGG
Control Acidifed Yogurt
IL6
Control Acidifed Yogurt
chemokineligand5
Control Acidifed Yogurt
TNFα
Control Acidifed Yogurt

35. Yogurt consumption  more yogurt bacteria in gut
Yogurt/acidifed milk  reduced inflammatory response

36. Consumption of probiotic-containing yogurt restored Bifidobacterium
Children infected with H. pylori contain fewer Bifidobacterium.
Yogurt consumption also suppressed H. pylori and reduced IL-6
Helicobacter 17:297-304 (2012)

37. Probiotics (and yogurt bacteria) are transient
members of the human GI tract
B
aseline
D
ay
0
D
ay
2
D
ay
4
D
ay
7
D
ay
10
5
6
7
8
9
Control
GOS
LODqPCR= 1 x 105 cells/g
Test of persistence
Log(DSM17938cells/gfeces)
Rattanaprasert et al., 2014, Journal of Functional Foods
Lactobacillus reuteri
L. reuteri + GOS
B
aseline
D
ay
0
D
ay
2
D
ay
4
D
ay
7
D
ay
10
5
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7
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Control
GOS
LODqPCR= 1 x 105
Test of persistence
start of
consumption

38. Probiotic =
Dose = 1010 CFU per day
Experimental Design
The unusual phenomenon of persistence
Bifidobacterium longum
subsp. longum AH1206
No surprise: B. longum AH1206
survives and reaches the colon
Big surprise: B. longum AH1206
appears to persist in the colon

39. 4
5
6
7
8
9
10
BL 7 284 8 15 50 100 200
Days of
consumption
Days of Washout
Detection limit
qRT-PCR
CellnumbersofAH1206infecal
samples(Log10cellspergram)
14
PersistersNon-persisters
A probiotic that lasts!

40. Accounting for persistence
Persister subjects were devoid of other B. longum
Open niche existed, so the new colonizer had a chance
New colonizer must have an ecological advantage
B. longum AH 1206 has carbohydrate-utilizing genes
Implication
Personalized nutrition based on one’s microbiome

41. All fermented foods are not the same
Whereas some fermented foods are good
sources of live bacteria, others are not.
Some fermented foods are heat-treated and are
essentially sterile!
Which fermented foods contain significant
numbers of live bacteria?
Follow Prof. Hutkins’ advice for a fermented
foods diet rich in live microorganisms.
Some foods that are thought to be “fermented”
are not, in fact, fermented at all!

42. My advice
Cultured dairy foods either with the “live and active”
seal or an ingredient statement that indicates live
organisms
1.
Cheese can also be a good source of live bacteria,
but it depends on the type of cheese.
2.

43. Fermented foods like kimchi or sauerkraut or
kombucha that are located in the refrigeration section
likely contain live cultures
3.
“Fermented” foods located on the store shelf are
often made without fermentation and/or are almost
always heat-processed for shelf-life.
4.

44. Some fermented foods do indeed contain live
organisms but are often heated in the kitchen
6.
Microorganisms do not live forever - long aged or
cured fermented foods will contain fewer organisms.
7.
Many fermented foods are heated
as part of their manufacture and
will not contain live organisms
5.

45. Thank you