Probiotics: Bacteria as Medicine?

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

Most common Probiotics Bifidobacteria Lactobacillus Acidophilus

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

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)

Common Probiotics Acidophilus bifidus Lowers cholesterol Reduces growth of hostile yeasts

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

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)

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…?

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

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)

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…

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

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 http://no-baloney.com/2013/03/25/four-more-reasons-to-love-your-flora/

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

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 http://no-baloney.com/2013/03/25/four-more-reasons-to-love-your-flora/

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

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)

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

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

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