3. Definition
• We usually think of bacteria as something that
causes diseases. But the body is full of
bacteria, both good and bad. Probiotics are
often called "good" or "helpful" bacteria
because they help keep your gut healthy.
4.
5. Definition
• Probiotics are live bacteria and yeasts that are
good for and have beneficial effects on the
host by improving its intestinal microbial
balance.
6. HISTORY
• At the start of the 20th century, Russian noble
prize winner and father of modern
immunology, Elie Metchnikoff, a scientist at
the Pasteur institute, was the first
conceptualize “probiotics”.
8. • In 1907 Metchniokoff proposed that the acid
producing bacteria in fermented milk products
could prevent “fouling” in the large intestine
and if consumed regularly, lead to a longer,
healthier life
9. Initial Intentional Probiotic Use
• Eli Metchnikoff observed
–Bulgarians who drank milk fermented by
lactic-acid producing bacteria had long lives
–Lactic acid lowers gut pH and inhibits the
growth of some pathogenic bacteria.
10. • Metchnikoff began drinking fermented milk
and soon Parisian physicians did likewise.
• Henry Tissier at Pasteur Institute identified
bacteria common in breastfed infant stool:
Bifidobacter
• Lactobacillus acidophilus breaks down lactose
and allows lactose intolerant individuals to
drink milk
11. • In early 1930’s, in Japan, Minoru shirota
developed a fermented milk product called
Yakult (probiotic yogurt like product made by
fermenting a mixture of skimmed milk with a
special strain of Lactobacillus casei shirota).
• Probiotic term coined in 1965 by Lilly and
Stillwell.
12. Newborn Microbiota
Initially depends on
• Mother’s microbiota maternal vaginal and
intestinal flora constitutes the source of
bacteria, which colonizes the intestine of new
born.
• Mode of deliver
• Birth environment
13. • Rarely genetic factors
• After infantry probiotics supplied from raw
foods; such as lactic acid fermented foods
such as yogurt, cheese and probiotic
supplements.
14. Factors affecting the intestinal micro
ecosystem
• Antibiotics and other drug intake
• Microbial infections
• Diet (highly processed, low fiber foods)
• Chronic diarrhea
• Stress
• Chlorinated water
• Radiation and chemotherapy
• Colonic therapies for detoxification
15. Characteristics of Effective Probiotics
• Able to survive the passage through the
digestive system.
• Able to attach to the intestinal epithelia and
colonize.
• Able to maintain good viability.
• Able to utilize the nutrients and substrates in a
normal diet.
16. • non pathogenic and non toxic.
• Capable of exerting a beneficial effect on the
host.
• Stability of desired characteristics during
processing, storage and transportation.
• Anti-inflammatory, antimutagenic,
immunostimulatory.
21. Advantages
• Produce lactic acid- lowers the pH of
intestines and inhibiting bacterial villains such
as Clostridium, Salmonella, Shigella, E. coli.
• Decreases the production of a variety of toxic
or carcinogenic metabolites.
• Aid absorption of minerals, especially calcium,
due to increased intestinal acidity.
22. • Production of β- D- galactosidase enzymes
that break down lactose.
• Produce a wide range of antimicrobial
substances -acidophilin and bacteriocin etc.
help to control pathogenic bacteria .
• Produce vitamins ( Vitamin B and vitamin K)
• Act as barriers to prevent harmful bacteria
from colonizing the intestines
23. • Colon cancer – Certain probiotics
(Lactobacillus bulcaricus) may help prevent
colon cancer by preventing the
• Breakdown of enzymes (β- glucuronidase)
that contribute to the growth of cancer
causing agents.
24. • Lowering cholesterol : break down bile in the
gut, thus inhibiting its reabsorption (which
enters the blood as cholesterol)
25. • Blood pressure reduction - Consumption of
milk fermented may result in modest
reductions in blood pressure, due to the ACE
inhibition-like peptides produced during
fermentation.
26. Antibiotic associated diarrhea(AAD)
• 1. Results from an imbalance in the colonic
microbiota
• 2.Probiotic treatment can reduce the
incidence and severity of AAD
• 3.Efficacy of probiotic AAD prevention is
dependent on the probiotic strain(s) used and
on the dosage.
27. Allergy
• Degradation/structural modification of enteral
antigens.
• Normalization of the properties of aberrant
indigenous microbiota and of gut barrier
functions.
• Regulation of the secretion of inflammatory
mediators, and promoting development of the
immune system.
28. • Prevents food allergy by promoting
endogenous barrier mechanisms and
alleviating intestinal inflammation.
• Stimulating immune response and reduction
of serum IgE levels.
• Reduction of Th2 cytokine response.
29. Primary Pediatric Uses of Probiotics
• Manage lactose intolerance (L acidophilus)
• Antibiotic-associated diarrhea and
infectious diarrhea
• Decrease constipation
• Decrease dental caries
• Treatment of H pylorii infections
• Decrease colic
• Decrease risk of developing eczema
• Decrease upper respiratory tract infections
30. Probiotic strains
• Lactobacillus species
• L. acidophilus
• L. plantarum
• L. casei subspecies rhamnosus
• L. brevis
• L. delbreuckii subspecies bulgaricus
33. Intestinal Microflora: Location &
Prevalence
• Rare in the esophagus
• Uncommon in the stomach
• primarily gram (+)
• in the jejunum – primarily aerobes
• in the colon
• primarily anerobes
• more anerobes than aerobes
34. Probiotics: proposed mechanisms
• Adherence and subsequent stimulation
of gut immune system
–Up-regulation of mucin gene
–Enhance secretory IgA
–Maintain normal macrophage function
35. • Competition for essential nutrients
• Production of antimicrobial factors
• Provide favorable environment for growth of
other beneficial bacteria
• Production of short-chain fatty acids with anti-
inflammatory properties
36. Probiotic Consumption
• Minimum Consumption: 100g of a probiotic
food with 107 colony f forming unit (CFU)/ g.
• most probiotics do not permanently adhere in
the intestine, but exert their effects as they
metabolize and grow during their passage
through the intestine (colonization). Thus,
daily consumption of these bacteria is
probably the best way to maintain their
effectiveness
45. Probiotic Foods
• Yogurt
• Usually made from milk (rarely, from cream)
inoculated with Streptococcus thermophilus and
either Lactobacillus acidophilus or Lactobacillus
bulgaricus.
• Turkish in origin
• Available in innumerable forms and flavors
• 1. Lowfat chocolate yogurt
• 2. Drinkable fruit-flavored goat yogurt
• 3. Neon-colored yogurt in squeeze tubes
46. Frozen Yogurt
• LaLoo’s Goat’s Milk Frozen Yogurt, naturally
chock-full of S. Thermophilus, L. Bulgaricus, L.
Acidophilus and Bifidus.Juice
First probiotic juice launched in the fall of 2007 by
Next Foods.
Goodbelly, organic fruit juice-based probiotic
beverage , contains L.Plantarum 299v, has effects
on irritable bowel syndrome
Three initial flavors include Brilliant Blueberry,
Peach Mango and Strawberry Rosehip
47. • Attune Foods:Chocolate & Granola bars
Attune makes Wellness Bars in three chocolate
varieties and three yogurt and granola varieties.
All products contain “more than 5 times the live
active cultures in yogurt, with less sugar.
Kashi Vive Probiotic Digestive
Wellness Cereal
Vive contains one billion CFUs of Lactobacillus
acidophilus per serving.
48. • Yakult Dairy Drink
• Probiotic, cultured dairy beverage
• Has citrus flavor
• Sold in single-shot
• containers that contain around
• 8 billion live and active Lactobacillus
• casei Shirota cells per bottle
49. • Ricera Rice Yogurt
• An organic, non-dairy, rice “yogurt” with
whole grains and live, active cultures,
including Lactobacillus bulgaricus,
Streptococcus thermophilus, Lactobacillus
acidophilus and Bifidobacterium bifidum.
50. Effect of factors on Survival of
probiotics in FOOD
• physiological state of the added probiotic in
the food
• physicochemical conditions of food processing
• physical conditions of product storage, like
temperature
51. • chemical composition of the product, such as
content of nutrients, oxygen (Bifidobacterium)
or pH
• interactions with other product components,
that can be inhibitory or protective
52. Side Effects of Probiotics
• Rare cases cause bloating, diarrhea,
abdominal pain.
• If in excess cause infection that require
medical attentions.
• People having on underlying disease or
compromised immune system cause potential
health problems like skin rash, fever, bloody
stools etc.
53. • Sometimes interact with immunosupressive
drugs leading to life threating conditions. So
people taking such drugs should avoid it.
54. What is a prebiotic?
• Non-digestible food ingredients that
beneficially affect the host by selectively
stimulating the growth and/or activity of one
or a limited number of bacteria in the colon,
and thus improve host health”
• First identified in 1995
55. • Typically oligosaccharides:
galactooligosaccharides (GOS), fructo-OS
(FOS), xylo-OS (XOS), Inulin
• Found in: Breastmilk, Jerusalem artichoke,
chicory root, raw dandelion greens, leeks,
onions, garlic, asparagus, whole grains, beans,
banana
56. • Adding Prebiotics to Probiotics increases
production of gut Short-Chain Fatty Acids
(SCFA)
• It should increase the number and/or activity
of bifidobacteria and lactic acid
bacteria
57. Prebiotics
• Traditional dietary sources of prebiotics
include soybeans, inulin sources (such as
Jerusalem artichoke, jicama, and chicory root),
raw oats, unrefined wheat, and unrefined
barley .
58. • Some of the oligosaccharides that naturally
occur in breast milk are believed to play an
important role in the development of a
healthy immune system in infants, but these
are not considered prebiotics, as they do not
act through the intestinal microflora.
59. Prebiotics
• A prebiotic is a nondigestible component
which beneficially affects the host by
selectively stimulating the growth and/or
activity of one or a limited number of colonic
bacteria, thereby improving the health of the
host .
• Examples- insulin, garlic, onions, chicory root,
Asparagus, whole wheat, rye, barley
60. Characteristics of Prebiotics
• Should not be hydrolyzed or absorbed in the
upper part of G.I tract.
• Should be a selective substrate for one or a
limited number of potentially bacterial
commercial to the colon culture protagonist.
61. • Should be able to alter the colonic microflora
towards a healthier composition or selectively
stimulates the growth and or activity of
intestinal bacteria associated with health and
well being.
• Should help increase the absorption of certain
minerals such as calcium and magnesium.
• Favorable effect on the immune system and
provide improved resistance against infection.
62. • Prebiotics are a category of nutritional
compounds grouped together by the ability to
promote the growth of specific beneficial
(probiotic) gut bacteria. Inulin-type prebiotics
contain fructans of the inulin-type.
63. • Fructans are a category of nutritional
compounds that encompasses naturally
occurring plant oligo- and polysaccharides in
which one or more fructosyl-fructose linkages
comprise the majority of glycosidic bonds.
64. • To be “inulin-type” a fructan must resist
enzymatic hydrolysis by human salivary and
small intestinal digestive enzymes.
66. • Some inulin-type prebiotics are relatively high
in free sugars (the monosaccharides fructose
and glucose and the disaccharide sucrose),
while others have most or all free sugars
removed.
67. • Processing can also result in mixes consisting
exclusively of inulin-type oligosaccharides,
polysaccharides, or both. Because inulin,
oligofructose, and FOS resist enzymatic
digestion in the upper gastrointestinal tract,
they reach the Colon virtually intact where
they undergo bacterial fermentation.
68. • . All inulin-type prebiotics are bifidogenic –
stimulating the growth of Bifidobacteria
species. The effects they have on other gut
organisms are less consistent.
69. • A minimal dose of inulin-type prebiotic
appears to be needed to produce a bifidogenic
effect. However, intraindividual response to an
identical dose of the same inulin-type
prebiotic, in terms of stimulation of total
number of Bifidobacteria and individual
Bifidobacteria species, can be variable.
70.
71. • Thus, the desirable bacteria (bifidobacteria
and lactobacilli) become more prominent in
the gut, and this is beneficial for the human
host. In addition, some of the fermentation
end-products such as short chain fatty acids
(SCFAs) help to promote human health.
72. • Therefore a prebiotic should fulfil three criteria:
1- Resists gastric acidity, hydrolysis by mammalian
enzymes and gastrointestinal absorption.
2- Is fermented by the intestinal microflora.
3- Stimulates selectively the growth and/or activity
of intestinal bacteria associated with health and
• wellbeing.
73. • This concept implies that prebiotics must be
stable in the stomach, i.e. that acid would not
influence them, and they should not be
absorbed in the small intestine and thus able
to reach the colon, where they are selectively
fermented by specific bacteria which exert the
beneficial effect on the host .
74. What Is scFOS?
• Fructans have been defined as “any
compound where one or more fructosyl–
fructose linkages constitutes a majority of
linkages …
75. • Fructans can vary with respect to the
following :
• Sources:
• Plant
• Bacteria
• Fungi •
76. Synbiotics
• PROBIOTICS + PREBIOTICS
• Foods containing the combination of
probiotics and prebiotics are referred to as
sybiotics.
• Improved survival in upper GIT and more
efficient implantation.
77. Take home points…
• Good evidence for:
– Infectious diarrhea, tx
– Antibx-assoc diarrhea
– NEC; premature mortality
• Promising evidence for:
– Preventiong atopic
conditions
– Constipation
• In the future we may be using
probiotics as we use
antibiotics today: with specific
strains used for certain clinical
situations guided by controlled
studies
• Prescribing
– Lactobacillus GG best
studied to date
– Combination products
not well studied, but
may work as well
– 10 billion organisms/d
– Keep refrigerated
(except Culturelle and
BioGaia)
– Give in cool food/drink
– 2% risk bloating/gas