Pre Bio Tics & Pro Bio Tics Presentation

8/3/2019 Pre Bio Tics & Pro Bio Tics Presentation

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Prebiotics, Probiotics &GI Health

Rachel Dartt

Amanda Griffin

November 15, 2005


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Presentation Overview

Review of Prebiotics/ProbioticsPotential Benefits

Adverse EffectsMechanisms

Regulations

Case Study

Meal Plan


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Prebiotics Food Sources

Prebiotics are naturalfood ingredients thatare available in a variety

of food sources.Bananas, garlic, barley,onion, Jerusalem

artichoke tuber, wheat,asparagus, rye, andchicory root.


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Probiotics microbial foods orsupplements that can be used to changeor reestablish the intestinal flora and

improve the health of the host.Probiotics are non-pathogenic and improvethe balance of microorganisms in the colon.

Lactobacillus

Bifidobacteria

Probiotics


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Probiotics Food Sources

Usually found infermented dairyproducts

DanActiveStonyfield Farm Yogurt

Basics Plus Kefir


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Potential Benefits of Prebiotics

Improve bowel functionIncrease stool frequency

Increase stool weight

Increase production of short-chain fatty acids

Promote the growth of the health promotingbacteria Lactobacilli and Bifidobacteria

Restore gut flora during or after antibiotic

therapyInulin can reduce insulin concentrations andlowered triglyceride levels


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Potential Adverse Effects of Prebiotics

GI Distur bances:Constipation

Abdominal pain

FlatulenceBloating


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Potential Benefits of ProbioticsRestore the normal balance of microbes in the

intestinesTreatment of diarrhea

Treatment of gastroenteritis

Alleviate some of the symptoms of irritable bowelsyndrome such as:Constipation

Diarrhea

abdominal painFlatulence

bloating

Improve immune function


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Potential Benefits of Probiotics

Improve lactose digestion and tolerancePrevent cancer by:

decreasing fecal concentrations of enzymesand secondary bile salts

reducing absorption of harmful mutagensthat may cause colon cancer


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Potential Adverse Effects of Probiotics

GI Disturbances:Constipation

Abdominal Pain

FlatulenceBloating


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Prebiotic Mechanisms

Mechanisms by which prebioticsmodulate the immune system

Increases the amount of lactic acid

producing bacteria

Increases the amount of Short Chain FattyAcids (SCFAs)

Activates carbohydrate receptor immunecells


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Mechanism #1

Bifidobacteria and lactobazillus are bothnaturally occurring bacteria found in ourintestine.

Increase absorption of vitamins andminerals

Improve digestion

Increase protection against harmfulbacteria such as fungi and viruses


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Mechanism #1 Continued

Prebiotics Inulin and Oligofructoseincrease the amount of lactic acidproducing bacteria

Immune cells and epithelia cellsrespond to this shift in the microflora

This leads to the signaling of toll-like

receptors that activate the secretion ofpro-inflammatory cytokines


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Prebiotics Lactic acidbacteria

Flora Proinflammatory

Composition Activities


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Mechanism #2

When prebiotics such as Inulin andoligofructose are supplemented, it increasesthe number of SCFAs in the gut.

Butyrate, for example, if beneficial for theimmune system because it:

Suppresses lymphocyte proliferation

Inhibits cytokine production of certain

lymphocytesInduces T-lymphocyte apoptosis

Activates G-protein-coupled receptors


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Probiotics LigandConcentration

Activates G-protein-

coupled receptors

Found on leukocytes

Supplies fuel

to immune cells


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Mechanism #3

Certain phagocytes (immune cells) inthe gut express lectin type receptorsites

These sites mediate cellular cytotoxicreactions against foreign cells


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Example: Dectin-1Has a receptor site that can be activated byundigested prebioticsOnce activated, it induces aproinflammatory response

In Summary:The immune cells in the gut withlectin type receptors can be

stimulated by the undigested prebioticcarbohydrates and therefore increasethe activity of proinflammatoryreactions.


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Regulation of Prebiotics/Probiotics

Intended use of product determines how theproduct is regulated.

Biological product - a virus, bacteria, or

fungi that is used for the prevention,treatment, or cure of a disease/condition ofhuman beings.

Dietary supplement - a product taken bymouth that contains a dietary ingredientintended to supplement the diet.


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Biological products require pre-market review andapproval by the FDA; however, dietary supplementsdo not.

The safety, purity, and potency, as well as efficacy,

of a biological product must be demonstrated forapproval.

Dietary supplements are not required to demonstrateany of these properties to be marketed.

The FDAs Center for Food Safety and AppliedNutrtion (CFSAN) regulates probiotics and prebioticsmarketed as dietary supplements or food ingredients.


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The FDAs Center for Biologics Evaluation andResearch (CBER) regulates probiotic products whenthey are used for clinical indications.

CBERs Office of Vaccines Research and Review has

regulatory jurisdiction over most probiotic productsfor clinical use.

A probiotic product marketed or promoted as a

treatment, prevention, or cure for a specific diseaseor condition without an approved indication for sucha claim is considered unapproved and an illegal drug.


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Case Study Background

35 year old femaleHistory of Ulcerative Colitis

Three months pregnant

Is referred to us by her obstetrician toensure adequate nutritional intake


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Case Study Background

Currently not on any immunosuppressivetherapy and is not very symptomatic

Enjoys and tolerates milk products

Ht: 56

Weight: 140 lbs

BMI: 22.6


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Nutritional Needs for Pregnancy

Normal body weight range indicatesshe should gain ~25-35 lbs during pregnancy.

She is in her second trimester and therefore

should be eating an additional 300kcal/d over her pre-pregnancy needs.

She also has increased protein needs

for maternal blood expansion, uterus,breast and muscle tissue, and fetaland placental development.


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Nutritional Needs for Pregnancy

RDA27 mgIronAI5 gVitamin D

AI1000 mgCalciumRDA600 gFolate

1.1 g/kg70 gProtein40 kcal/kg~2500Calories


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Nutrition Needs for Ulcerative Colitis

Small, frequent mealsAvoid foods/practices that causeexacerbations such as:

high sucrose foods

lack of fruits and vegetables

low intake of dietary fiber

altered omega-6/omega-3 fatty acid ratios

Probiotic foods or supplements may help intreatment - more research is needed


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Meal Plan Day 1

Low Fat milk cupGraham crackers - 3

Stonyfield Farms Yogurt 6 ozGranola cup

Apple slices (med apple)Low-fat cottage cheese -1/2 cup

Evening SnackAfternoon SnackMorning Snack

Baked chicken 3 oz

Baked potato 1 medium

Spinach cup

Whole Wheat roll 1

Margarine 1 tsp

Sherbet cup

Lemonade 1 cup

Turkey Sandwich

2 oz meat

1 slice cheese

2 slices bread

Mayonnaise 1 tsp

Banana 1

Low Fat milk 1 cup

Grapefruit

Honey nut cheerios cup

Wheat toast 1 slice

Fruit Preserves - 1 tsp

Low Fat milk 1 cup

DinnerLunchBreakfast


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Meal Plan - Day 2

Low Fat milk cupTriscuits - 2

Bagel 1 (small)Cream cheese 2 Tbsp

Peach 1 (med)Whole-wheat Crackers 8

Peanut Butter 2 Tbsp


Hamburger 3 oz

Whole-wheat bun - 1

Baby carrots 8

Tossed Salad 1 cup

Salad Dressing 2 Tbsp

Pudding cup

Fruit Punch 1 cup

Grilled Cheese Sandwich

2 oz cheese

2 slices bread

Three Bean Salad 1 cup

Low Fat milk 1 cup

Banana 1

Cooked Oatmeal 1 cup

English Muffin 1

Margarine 1 tsp

Banana-strawberry Kefir 8 oz



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Meal Plan - Day 3

Low Fat milk cup

Granola Bar - 1

Strawberry DanActive 3.3 oz

Oatmeal cookies - 2

Pear 1 small

String Cheese 2 oz


Grilled Steak 3 oz

Sweet Potato 1 small

Asparagus cup

Brown Rice cup

Margarine 1 tsp

Pineapple chunks cup

Low Fat chocolate milk 1 cup

Grilled-Chicken Sandwich

3 oz meat

1 whole wheat bun

Mayonnaise 1tsp

Ketchup 1 tsp

Orange 1

Low Fat milk 1 cup

Strawberries 1 cup

Whole-wheat Pancakes 3 small

Maple Syrup 2 Tbsp

Margarine - 2 tsp

Low Fat milk 1 cup



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3 Day Average Nutritional Analysis

385 mcg600 mcgFolate

17 mcg27 mcgIron

7.5 mcg5 mcgVitamin D

1763 mg1000 mgCalcium

110 g70 gProtein

2476~2500CaloriesActualEstimated


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ADA Position Statement on Probiotics

Moderate strength of evidenceIn vivo, in vitro, and clinical evidenceshows that functional foods that contain

probiotics, such as fermented dairyproducts, help support gastrointestinalhealth.


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ADA Position Statement on Probiotics

The amount and frequency of intake recommendationfor probiotics is 1 to 2 billion colony-forming units perday

Example 1: DanActive1 bottle contains 10 billion active culturesIncludes S. thermophillus, L. bulgaricusand L. casei.

Example 2: Basics Plus Kefir

1 cup serving contains 10 billion active bacteriaIncludes 10 active probiotic cultures while most yogurts onlycontain two or three.


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Conclusion

Studies have shown possible beneficialeffects of probiotics and GI health

More studies are needed


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Questions??

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