Healthy Living with Prebiotics and Probiotics Yong D Hang PhD Professor Emeritus Cornell University Food Science Department Ithaca, New York

Latest health claims ✔ Prebiotic intake reduces anxiety and prevents stroke, heart disease. ✔ Probiotics reduce the risk of cold-like symptoms. ✔ Probiotic Lactobacillus reuteri reduces gastrointestinal disorders in infants. ✔ Probiotics in yogurt are beneficial to brain function.

Prebiotic health claims ✔ beta-glucan (soluble fiber from oat) A daily dose of at least 3g may reduce blood cholesterol levels and heart disease. ✔ Inulin (fructo-oligosaccharides) A daily dose of 5 g may promote growth of good bacteria in the gastrointestinal tract and enhance health benefits.

Global Market Trend The global market value for prebiotic & probiotic products was $16 billion in 2008 and will reach $30 billion by 2015. Global Industry Analysis (2012)

Statistics Product Percent (%) Food 91 Supplement 7 Ingredient 2 Total 100

What are prebiotics? Prebiotics are defined as non-digestible food ingredients that beneficially affect the host by selectively stimulating the growth and/or activity of beneficial bacteria present in the gastrointestinal tract. Gibson & Roberfroid (1995)

Prebiotics FOS (Fructo-oligosaccharides) Inulin FOS (Fructo-oligosaccharides) GOS (Galacto-oligosaccharides) XOS (Xylo-oligosaccharides) AXOS (Arabinoxylo-oligosaccharides) GIOS (Gluco-oligosaccharides) Soybean oligo-saccharides

Source of inulin Food Percent (%) Chicory root 65 Jerusalem artichoke 32 Dandelion green 24 Garlic 17 Onion 9 Asparagus 5 Wheat bran 5 Banana 1 Moshfegh et al (1999)

Chicory roots

Jerusalem artichoke

Dandelion

Garlic

Inulin

FOS (Fructoologosaccharides)

Fiber Choice (Inulin)

Prebiotic coffee Cover Photo-.webloc Cover Photo-.webloc

Beta-Glucan

Cereal with oat beta-glucan

Cereal with wheat beta-glucan

Yeast beta-glucan

Products with yeast beta-glucan

Yogurt with yeast beta-glucan

Ganoderma lucidium

Inulin  A non-digestible fiber  A polymer of fructose (DP=2-60) DP = 2 (glu-fru) DP = 3 (Glu-fru-fru) DP = 4 (Glu-fru-fru-fru) DP = 5 (Glu-fru-fru-fru-fru)

FOS (Fructooligosaccharides) The commonly known health-promoting FOS (fructo-oligosaccharides) include: Nystose (Glu-Fru-Fru) Kestose (Glu-Fru-Fru-Fru) Fructosylkestose (Glu-Fru-Fru-Fru-Fru)

Oligosaccharides Fructosyltransferase Galactosyltransferase Fructo-oligosaccharides  Sucrose Galactosyltransferase Galacto-oligosaccharides  Lactose Glucosyltrasferase Gluco-oligosaccharides  Maltose Soybean oligo-saccharides Raffinose (DP=3) Stachyose(DP=4)

Health benefits of prebiotics Beneficial bacteria Calcium absorption Blood cholesterol Stroke and heart disease  Anxiety ✔Control weight gain and fat mass

Effect of prebiotics on probiotics by mouse fecal microflora Prebiotic Bifidobacteria Lactobacilli Enterococci Mean Log CFU/g wet stool Control 5.8 7.6 5.3 FOS 7.3 9.3 3.5 GOS 6.9 9.0 3.5 MOS 6.6 9.1 4.0 Pan et al. ( 2009)

Health benefits of prebiotics Treatment Prebiotic Dose Diarrhea FOS 4 g, 3X/day (C. difficile) Constipation FOS >20 g/day Body wt gain Inulin 5% or 10%, 4 wks Body wt gain FOS 10%, 4 wks Body wt gain inulin 9% , 3 wks Saad et (2013); WGO

Prevention of stroke by prebiotics High dietary intake (HDI) has an impact on the incidence and risk of stoke in generl population (Casiglia et al. 2013) The risk of stoke can be significantly reduced when the daily intake of soluble fiber is more than 25 g or insoluble fiber is >47 g.

What are probiotics? FAO/WHO 200) Probiotics are defined by a United Nations and World Health Organisation Expert Panel as live microorganisms which when administered in adequate amounts, confer a health benefit on the host FAO/WHO 200)

Probiotics Lactic acid bacteria and bifidobacteria are used as probiotics. Bacillus coagulans and yeast (Saccharomyces boulardii) are also beneficial orgamisms. Probiotics are commonly used as active live starter cultures in a wide variety of fermented food products.

Probiotic bacteria Lactobacillus Bifidobacterium L. acidophilus B. adolescentis L. casei B. animalis L. paracasei B. bifidum L. plantarum B. breve L. reuteri B. infantis L. rhamnosus B. lactis

Lactobacillus acidophilus

Bifidobacterium bifidum

Bacillus coagulans

Mode of probiotic action ✔ Inhibit pathogenic growth ✔ IgA I(immunoglobulin A) production  ✔ Short-chain fatty acids (SCFA)  Bacteriocin production Superoxide radicals  Compete for adhesion with pathogenic bacteria. WGO

Health benefits of probiotics Pathogens (H. pylori, C. difficile, E.coli) Control antibiotic associated diarrhea Lactose metabolism  Blood cholesterol, stroke, heart disease Immune system  Inflammatory bowel disease (IBD) Brain functions  Cold-like symptoms

Health benefits of Probiotics Prevention of antibiotic associated diarrhea Probiotic Dose L. casei 1010 CFU, 2x/d S. boulardii 2 x 1010 CFU/d L. rhamnosus 1010 CFU, 2x/d WGO

Health benefits of probiotics Eradication of Heliobacter pylori Probiotic Dose L. Rhamnosus 2 x 109 CFU, 2x/d S. Boulardii 5 x 109 CFU daily L. casei 1010 CFU, 2x/d WGO

Health benefits of probiotics Prevention of the recurrence of Clostridium difficile diarrhea Probiotic Dose L. casei 1010 CFU, twice daily S. boulardii 2 x 1010 CFU/d L. acidophilus 2 x 1010 CFU each/d + B. bifidum WGO

Health benefits of probiotics Alleviation of Irritable bowel syndrome Probiotic Dose B. infantis 108 CFU, once daily L. rhamnosus 1010 CFU, once daily B. animalis 1010 CFU, 2X/d WGO

Prebiotic and probiotic products A wide variety of prebiotic and probiotic products are commercially available. They are widely consumed for prevention of intestinal disorders. The health claims must be based on the clinical test results accepted by the scientific community.

Description of a probiotic product ✔ Genus, species and strain (Example: Lactobacillus casei Shirota) ✔ CFU at the end of shelf-life ✔ Storage conditions ✔ Recommended dose Health effect allowable by law Contact information WGO

Dairy-based probiotic products Acidophilus milk (US) Chobani Greek yogurt (US) Yakult (Japan) Dannon Activia yogurt (France, US) DanActive drink (France, US) Prima Liv (Sweden)

Examples of probiotic foods Prima Liv (Sweden) A milk-based product with L. plantarum 299v Yakult (Japan) A probiotic drink with Lactobacillus casei Shirota. Bifiene (Japan) A dairy-based beverage with B. breve Yakult Dannon Activia (France & USA) A low-fat yogurt contains B. animalis. Dannon DanActive (France & USA) A dairy-based drink with L. casei.

Probiotic drink with L. casei Shirota

Probiotic drink with L. casei DN114

Probiotic yogurt

Probiotic drinks

Probiotic Greek yogurt

Non-dairy probiotic products ProViva fruit beverages (Sweden) Good Belly splash (US) Probiotic soymilk and yogurt Tipton Mills instant coffee Naked pizza

Non-dairy probiotic foods ProViva (Sweden) An oatmeal-based fruit drink made with Lactobacillus plantarum 299V. Goodbelly (US) An oatmeal-based fruit drink produced with Lactobacillus plantarum 299V.

Production of ProViva Oatmeal & water  Malted barley flour  Heat treatment Fermentation (L. plantarum 299v) at 370C Cooling to 4-8oC Fermented oatmeal gruel (Active constituent in ProViva)

ProViva  A probiotic fruit drink launched in 1994 in Sweden.  A fermented oatmeal gruel mixed with fruit juice.  It contains > 1 x 1010 CFU of Lactobacillus plantarum 299v/L.  The product can be stored at refrigerator temperatures for 30 days without loss of probiotic viability.

Production of acidophilus milk Pasteurized milk  Inoculation with 5% L. acidophilus Fermentation overnight at 37oC Cooling to 5oC Bottling & Storage at 5oC

Yogurt

Yogurt production Pasteurized milk  Addition of S. thermophilus & L. bulgaricus Fermentation at 40-45oC for 2.5-6 h Stirring & Cooling to 4-80C Filling & Storage

Greek yogurt It takes 300 kg of milk to make 100 kg of Greek yogurt. Greek yogurt is the yogurt that has been strained to remove more liquid (whey). It takes 300 kg of milk to make 100 kg of Greek yogurt. Greek yogurt is more nutritious and healthier than traditional yogurt. Greek yogurt has gone viral in America in recent years.

Greek yogurt(5.3 oz, nonfat, plain) Total fat: 0 grams Cholesterol: 10 milligrams Sodium: 50 milligrams Sugar: 6 grams Protein: 15 grams Calcium: 15 percent on a 2,000-calorie diet

Regular yogurt(6 oz. nonfat, plain) Total fat: 0 grams Cholesterol 5 milligrams Sodium: 120 milligrams Sugar: 12 grams Protein: 9 grams Calcium: 30 percent on a 2,000-calorie diet.

Probiotics in yogurt Greek yogurt Traditional yogurt S. thermophilus S. thermphilus L. bulgaricus L. bulgaricus L. acidophilus L. casei Bifidobacterium bifidus

Synbiotics Synbiotics are the products that contain both prebiotics and probiotics. Synbiotics would have the beneficial health effects of both prebiotics and probiotics.

Benefits of synbiotics Consumption of B. coagulans BC30 and subsequent use of prebiotics has resulted in elevated populations of beneficial bacteria and increased production of short chain fatty acid (SCFA). Nyangale et al (2014)

Health effects of synbiotics L. rhamnosus LGG has negated the beneficial effect of a prebiotic ingredient (FOS) in a piglet study. The probiotic organism produces less butyric acid and has a significantly adverse effect on the activity of colonic beneficial bacteria. Barnes et al (2012)

SCFA SCFA (short chain fatty acids) produced during fermentation play an important role in maintaining good health and prevention of infection and intestinal disorders. Butyric acid is the preferred energy source for colonic epithelial cells and is involved in many cellular processes. It can be used as a biomarker to identify the synergistic prebiotic and probiotic combination for therapeutic use in individuals with intestinal failure. Tappenden, 2012

Effect of diet on SCFA production by human fecal microflora Diet SCFA (mmol/L/h) Acetate Propionate Butyrate Glucose 21.2 5.0 2.2 Soy oligosaccharide 12.3 6.6 5.8 FOS 15.8 5.5 2.8 Inulin 13.5 7.8 5.3 Cellulose 9.3 11.8 1.0 Besten et al (2013)

Effect of diet on SCFA production by human fecal microflora Diet SCFA (mmol/g/h) Acetate Propionate Butyrate Corn fiber 0.18 0.07 0.06 Oat bran 0.55 0.19 0.13 Wheat bran 0.29 0.08 0.06 Besten et al (2013)

Impact of SCFA on IBD SCFA ((umole/g) HS P Acetic 210 162 Propionic 93 66 Butyric 176 87 P: Patients with IBD (Inflammatory bowel disease) HS: Healthy Subjects Huda-Faujan et al. (2010)

Conclusions Prebiotic and probiotic foods have many beneficial health effects.  calcium absorption lactose metabolism Cholesterol, anxiety, stroke & heart disease diarrhea and IBD body weight gain and fat mass

Conclusions ✔ Not all prebiotics and probiotics are effective for all the health benefits. ✔ Each prebiotic or probiotic health benefit is oligosaccharide-specific or strain-specific. ✔ Consumption of prebiotics and probiotics could prevent intestinal disorders and provide better health.