1. Probiotics:
Bacteria as Medicine?

3. So, what are they?
“Live microorganisms, which, when administered in adequate amounts, confer a health benefit to the host."
The Food and Agriculture Organization of the United Nations (FAO)
Idea of probiotics first came about around 1908 when it was theorized that the longevity in Bulgarian peasants was due to fermented milk products

4. Most common Probiotics
Bifidobacteria
Lactobacillus
Acidophilus

5. Common Probiotics Bifidobacteria
Digest oligosaccharides from breast milk, plants
Help with peristalsis, IBS, dental cavities, serum lipids, glucose tolerance
Treatment for: IBS, dental cavities, improved blood lipids, and glucose tolerance

6. Common Probiotics Lactobacillus Found in fermented dairy products
Anti-carcinogenic
Treating and preventing infections
IBS
Diarrhea
Lactose intolerance
Skin disorders
bind carcinogenic molecules, secrete enzymes
Yeast infections, urinary tract infection, preventing respiratory infections
Treating traveler's diarrhea, diarrhea resulting from Clostridium difficile
(fever blisters, eczema, acne, and canker sores)

7. Common Probiotics Acidophilus bifidus Lowers cholesterol
Reduces growth of hostile yeasts

8. Related Terms
Prebiotic: Promote growth and maintenance of beneficial or commensal microorganisms
Synbiotic: Has the properties of both a probiotic and a prebiotic
Amphibiotic: A probiotic bacteria that also targets and kills pathogenic bacteria in the body
Prebiotic: polyphenols (cocoa, fruit, coffee, tea, leafy greens, red wine)
Example of synbiotic is breastmilk: has live microorganisms, as well as oligosaccharides that baby can’t break down.
Bifidobacteria utilize these oligosaccharides and they promote growth of beneficial bacteria
BALOs (Bdellovibrio-and -like-organisms) nonpathogenic and nontoxic to animals/humans and attack pathogenic bacteria

9. So, the bulk of the bacteria are in the large intestine
Over 400 bacterial species in GI tract alone
We are 90% microbes in weight, 99% of genome is from microbes (microbiome)

10. What do they do for us? Intestinal microflora aid in: Digestion
Synthesis of vitamins, hormones
Metabolism of some medications
Gut development and function
Immune system enhancement and function
Brain Development
Reducing Inflammation
Digestion: digest certain nutrients in foods, improve lactose tolerance
Vitamins: biotin and Vitamin K
Secrete fatty acids important for brain development
And more!!! Lower blood pressure, improve lipid profile, cancers…?

11. Acidophilus is the dominant probiotic in the small intestine
creates an acidic microenvironment which makes iron and other minerals more absorbable

12. How do we get them? Trans-placental Transfer Vaginal Birth Breast milk
Diet
Environmental Exposure
Infants born via c-section are colonized by bacteria on the skin of medical providers/parents (different)
There is a change when babies start eating solid foods
Hygiene practices, geography etc: a recent epi study demonstrated shifts in comp on a pop. level over the past decades-altered hygiene practices and changes in diet and nutrition
Mostly from infancy: stabilizes around 3 yrs, takes significant changes to create changes (abiox, diet, infection)

13. Risk Factors C-section Not breastfeeding Prematurity Poor food choices
Chronic stress/anxiety
Antibiotic overuse, other drugs
Prematurity: abiox, enteral feeding, NICU time
Poor food choices: trans fats, processed foods, high sugar, low fiber (western diet profile different)
Even lack of sleep…

14. Which means…. Diarrhea Muscle pain Fatigue Allergic Reactions
Autoimmune disorders
Infection
Autoimmune disorders: eg) ulcerative colitis, Crohn's disease, and rheumatoid arthritis
Infections: Important for immune function in two ways:
-direct defense against pathogens
-stimulating development and function of immune system cells; secrete certain factors (specific to bacteria)
ex) infectious diarrhea, Helicobacter pylori, skin infections, and vaginal infections

15. Listen to Your Gut They are key for immune function
They might lower your cholesterol
They produce anti inflammatory molecules
They enhance your antioxidants
They could impact your mental health
Linked to obesity
Obesity: release hormones that direct host fat storage
Not only is the presence of bacteria important, but also the relative proportions of microbial communities, specifically Firmicutes and Bacteriodetes, appear to be important in energy homeostasis.
Mental Health: help regulate neurotransmitters in your brain
may alter the prod. of hormones involved in brain function, mood, stress and anxiety
altered gut bacteria in mental illnesses like depression and schizophrenia, levels of serotonin in GF mice

16. So how do we harness these unsung heroes of the intestine?

17. What You Can Do Boost your fiber intake Eat a well balanced diet:
↑F&V ↓Sugar ↓Red meat & Sat.Fat
3. Add dietary sources of probiotics
4. Consider (with caution) prebiotic / probiotic supplements
Veggies, fruits, whole grains
Best sources of insoluble: oats, barley, beans and lentils, bananas and even *potatoes*
3. Food first! plain yogurt, kefir, miso, kimchi and sauerkraut (watch the salt)
Those with high cholesterol, digestive concerns or routine antibiotic use, consider supp. But children, weak immune system, elderly talk to doc first!!!
Supplements are not regulated by the FDA like a drug, they are a supplement and therefore limited regulation

18. Polyphenols Polyphenols!
Antioxidant properties, metabolized by microflora
Dark chocolate reduced urinary excretion of the stress hormone cortisol and catecholamines & partially restored stress related diffs in E metabolism and microbial profiles
daily consumption of 40 g of dark chocolate during a period of 2 weeks

19. The Probiotic Process When making probiotics:
Sudden freezing → damage to cell walls, intercellular structures
Oxygen and moisture → bacteria die
Many bacteria degraded in acidic stomach
Cryoprotectant (protect from temperatures)
Freeze drying (protect from moisture and oxygen)
Vitamin C
Prebiotic Fibers
Digestive enzymes (shield bacteria from stomach)

20. In Conclusion Probiotics generally believed to be safe
AAP supports administration for treatment of acute gastroenteritis and prevention of antibiotic associated diarrhea
Decreased incidence of NEC in preterm infants after breastfeeding (synbiotic) and probiotics

21. Considerations Look for USP seal
Compare genus, strain, and species to studies
Determine species specific to condition
Populations to be especially careful when considering probiotics:
Children, pregnant women, elderly people, and people with compromised immune systems
Don’t just take the supplement that provides the most kinds of organisms
Testing to confirm probiotic identity, purity, and microbe count, to ensure product safety, and health claims

22. More Research Required….
In all cases proposed as health claims to the European Food Safety Authority, the scientific evidence remains insufficient to prove cause and effect relationship between consumption of probiotic products and any health benefit