probiotics and prebiotics

1. Prebiotics & Probiotics
Dr. Azad A Haleem
MBChB, DCH, FIBMS PediatricsMBChB, DCH, FIBMS Pediatrics
LecturerLecturer
Pediatric departmentPediatric department
Medical college/ Duhok universityMedical college/ Duhok university
Heevi Pediatrics Teaching HospitalHeevi Pediatrics Teaching Hospital
azad82d@gmail.com

2.  Physiology of Human GIT
 Development of GIT Immunity.
 PRObiotics.
 PREbiotics.
My audience will STILL be AWAKE
by the end of the talk.
Goals of This Talk

3.  The intestine is an extremely complex system that
participates in protection of the host through strong defense
mechanisms from the external environment;
 Our Intestine = 400 square meter surface… i.e. the
surface area of a tennis court
 Defense task is based on three compartments that are in
permanent contact and dialogue with each other:
1- The ecological barrier (normal inhabitant flora within intestine)
2- Mechanical barrier (mucous epithelia)
3- Immune barrier (GALT, secretory IgA, intraepithelial lymphocytes,
macrophages, neutrophils, natural killer cells, Payer’s nodes and mesenteric
lymph node) (Mohajer, 2000)
Physiology

4.  Trillions living bacteria exist in the human intestine
 We have more bacteria in our bodies (10 times greater)
than the total number of our somatic and germ cells
 We carry about 2 kg of bacteria !!!!!!!!
 Over 500 species of bacteria present in human colon.
 Lactobacillus Bifidis and Acidophilus comprise the
majority of healthy bacteria in the colon along with other
disease producing bacteria.
GIT Immunity

5. Our gut Microbiota can
be pictured as a
MICROBIAL ORGAN
placed within a host
organ
Fact????

6.  It starts with creating a healthy digestive system which
plays a major role from infancy and throughout all our life
(about 80% of our immune system is found in the GIT)
“ This immature immune system
needs special measures for its
Protection and Support.”
“The intestine is not only a
digestive absorptive organ but it is the
largest immune organ
in our body.”

7. Sharing My Secrets of Health

8.  The gastrointestinal tract of a normal fetus is sterile.
 During the birth process: the aseptic or sterile, digestive tract of
the fetus is inoculated with bacteria (proximity of the birth
canal and the anus).
 Rapidly thereafter, effective methods of ensuring transmission
of microbes to the sterile GIT:
o parental expression of neonatal care: suckling, kissing and
caressing (mother’s flora)
o Genetic factor
o surrounding environment
o Feeding pattern: the first biggest challenge is one the
intestine becomes inhabited by microbes which are
characterized by instability and fragility.
Later the microbiota will stabilize according to the type of
feeding.
Early In Life ???

9.  The first colonization of the intestine is one of the most
profound immunological exposures faced by the newborn
infant (during the first days of life).
 The next great changes in the composition of the intestinal
microbiota come with the introduction of solid food and
weaning (Favier et al., 2002).
 Hygiene Hypothesis: Decreased bacterial stimulation
during infancy and childhood is asscociated with slower
postnatal development and delayed maturation of the
immune system. (L.E.M. Niers et al., 2005)
 Relatively small changes will take place by after years of
age where the child will have an adult-like microbiota and
then it remains practically unchanged (Zoetendal et al., 2008).
Early In Life ???

10. Probiotics VS Prebiotics

11. Probiotics VS Prebiotics

12. 
“PROBIOTICS”
gfbv

13. History
The concept of probiotics was first introduced
in the 20th
century by Noble prize winner, Elie
Metchnikoff(1845-1916).
He suggested that long and healthy life of
Bulgarian peasants resulted from their
consumption of fermented milk products.
He himself introduced in his diet sour milk
fermented with bacteria he called “Bulgarian
Bacillus, later called as Lactobacillus
delbrueckii subsp.” and found his health
benefited.

14.  Prof. Elie Metchnikoff.

15. ““PROBIOTICSPROBIOTICS””
The root of the word ‘ probiotic’ comes
from the Greek word pro, meaning
“promoting” and biotic, meaning “life”.
The Food and Agriculture Organisation
of the United Nation (FAO) defines
probiotics as“ live micro-organisms,
which, when administered in adequate
amount produce beneficial effect to the
host when taken orally”.

16. • They Only Transiently colonize the Gut and do not
typically become part of the permanent resident micro
flora of the host.
PRObiotics
(Journal of the American Dietetic Assosciatio,2008)

17. 400+ species of Probiotics in
our body.

18. List of probioticList of probiotic
candidatecandidate:-:-
Microorganisms Genus Species
Bacteria Lactobacillus L.acidophilus, L.brevis, L.reuteri, L.casei,
L.rhamnosum, L.bulgaricus, L.cellobiosus,
L.delbrueckii, L. fermentum.
Bifidobacterium B.thermophilus, B.infantis, B .longum,
B.bifidum, B.animalis.
Streptococcus S.lactis, S.thermophilus, S.cremonis,
S.alivarius.
Bacillus B.Coagulans
Pediococcus P.acidilactici
Leuconostoc L.mesenteroides
Enterobacter E.faecium, E.faecalis.
Fungi Aspergillus A.niger, A.oryzae.
Yeast Saccharomyces S.boulardii, S.cerevisiae, S.carlsbergensis.

19. Properties of
probiotics
It should be safe to the host.It should be safe to the host.
It should not produce any pathogenic or toxicIt should not produce any pathogenic or toxic
effect.effect.
It must be resistance to hydrochloric acid, bile andIt must be resistance to hydrochloric acid, bile and
pancreatic juice.pancreatic juice.
It should have anti-carcinogenic activity.It should have anti-carcinogenic activity.
It should produce lactic acid.It should produce lactic acid.
It should retain viability during storage and use.It should retain viability during storage and use.
It should stimulate the immune system of the body.It should stimulate the immune system of the body.
It should have the ability to colonize theIt should have the ability to colonize the
gastrointestinal tract.gastrointestinal tract.

20. Beneficial effects of probiotics in human:-
Diarrhoea:- Probiotic have preventive and curative effects on
diarrhoea.
Irritable Bowel Syndrome(IBS):- It can be prevented by the
Lactobacillus plantarum 299V.
Heicobacteriosis:-Probiotic had an in vitro inhibitory effect
reduce gastric inflammation.
Necrotising Enterocolitis:- Treating with B.infantis and
L.acidophilus to new born result in reduction of NEC.
Urogential infection:-It can be prevented by taking
L.fermentum and L.rhamnosus.
Colon cancer:-Lactic bacteria may act against colon cancer.
Blood pressure:-Milk fermented by lactic acid bacteria may
result in the reduction of this sickness.

21. “PREBIOTICS”

22.  The term prebiotic was introduced by Gibson and Roberfroid 1995
who exchanged “PRO" for “PRE" which means “Before“.
“Non-digestible food ingredients that beneficially affect the
host by selectively stimulating the growth and/oractivity of
one ora limited numberof bacteria in the colon that can
improve host health."Gibson et al., 2004)
PREbiotics
(Journal of the American Dietetic Assosciatio,2008)

23. Facts about PREbiotics
 Prebiotics; are simply speaking the preferential
“FOOD” for Friendly Beneficial Bacteria
colonizing the digestive tract.
“colonic food”
 They are dietary supplements that play a role in
Balancing the Intestinal Mucosal Immune
System

24. Limited hydrolysis and absorption in the
upper GIT(gastro-intestinal tract).
Selective growth stimulation of beneficial
bacteria in the colon.
Immuno stimulation.
Stimulation of beneficial flora that
promotes colonization resistance.
Criteria for eligibility as PREbiotic
(Gibson et al., 2007)

25. Established PREbiotics
Breast Milk oligosaccharides Original they represent the
third largest component of Human Milk 20 - 23 gm/l in colostrum &
12- 14 gm/ in mature milk.
 Polydextrose – Fructans
 Inulin Wheat, banana, onions, garlic, leek, chicory.
 FOS (Fructo-oligosaccharides or oligofructose) plants.
 GOS (Galacto-oligosaccharides) milk.
 Lactulose - Lactosucrose
 SOS (soy-oligosaccharides)
 XOS (xylo-oligosaccharides)
 IMO (isomalto-oligosaccharides) corn & wheat.
 Lactitol
(Journal of the American Dietetic Assosciatio,2008)

26. Top 10 food containingTop 10 food containing
prebioticsprebiotics
Food content
by weight
Raw Chicory root 64.6 %
Raw Jerusalem artichoke 31.5 %
Raw Dandelion greens 24.3 %
Raw Garlic 17.5 %
Raw Leek 11.7 %
Raw Onion 8.6 %
Cooked Onion 5 %
Raw Asparagus 5 %
Raw Wheat bran 5 %
Raw Banana 1 %

27. How do they workHow do they work??
Increase a number of bifidobacteriumIncrease a number of bifidobacterium
and lactic acid bacteria.and lactic acid bacteria.
Effect on the metabolism of lipids.Effect on the metabolism of lipids.
Suppression of putrefactive bacteria.Suppression of putrefactive bacteria.
Growth of bifidobacteria.Growth of bifidobacteria.
It helps to lower colon cancer risk.It helps to lower colon cancer risk.

28. Role of prebiotic
Prebiotic factor Origin Microbes stimulated Effects
Oligosaccharides Onion,garlic, chicory
root, burdock, asparagus,
Jerusalem artichoke,
soybean, wheat bran.
Bifidobacterium species Increase in bifidobacterium,
suppression of putrefactive
bacteria, prevention of
constipation and diarrhea.
Fructooligosaccharides
(inulin, oligofructo)
Same as for
oligosaccharides
Bifidobacterium species
Lactobacillus acidophilus,
Lactobacillus casei,
Lactobacillus plantarum
Growth of bifidobacteria and
acid promotion.
Fructan Ash-free white powder
from tubers of Jerusalem
artichoke.
Bifidobacterium species Growth of bifidobacteria
Human kappa casein and
derived glycolmacropeptide
Human milk:
chymotrypsin and pepsin
hydrolysate.
Bifidobacterium bifidum Growth promotion.
Stachyose and raffinose Soybean extract Bifidobacterium species Growth factor.
Casein macropeptide Bovine milk Bifidobacterium species Growth promotion.
Lactitol(4-O-β-D-
galactopyranosyl)D-glucitol
Synthetic sugar alcohol
of lactose
Bifidobacterium species Growth promotion.
Lactutose(4-O-β-D-
galactopyranosyl)D-fructose
Synthetic derivative of
lactose
Bifidobacterium species Growth promotion.

29. USES OF PREBIOTICUSES OF PREBIOTIC
Improve immune function in both the gut and
body.
Establish a healthier balance of bacteria in the gut.
Promote regular bowel movements.
Reduces the risk of an intestinal infection.
Modulation of gastro-intestinal peptides
production, energy metabolism and satiety.
Initiation (after birth) and regulation/modulation of
immune functions.
Enhance bone density and increase Calcium
absorption.
Increase in mineral absorption and improvement
of bone health.

30. Side effect
Excessive consumption of prebiotics
particularly those in the
oligosaccharides category may cause
abdominal discomfort and distension,
as well as significant levels of
flatulence. The Nutrition
Information Centre of South Africa's
University of Stellenbosch,
recommends that daily consumption
of prebiotics be held below 20 grams.

31. What are the health benefits of prebiotics inWhat are the health benefits of prebiotics in
infant Formula ?infant Formula ? Researches Review
 Nine studies are cited in the literature, investigating the effect
of different types of prebiotic OS supplementation in infants.
 These studies showed that depending on the age of the infant,
and the prebiotic OS used,
 1- effects may be seen on immune cells,in particular IgE levels.
 2- Results on the prevention and management of diarrhoea and
constipation are varying with four out of six studies showing
positive results.
 3- The role of prebiotics in reducing respiratory tract infections,
fever and use of antibiotics also looks promising with less
infections reduced use of antibiotics and reduced episodes of
fever seen in infants supplemented with prebiotic OS than
those who did not receive any supplementation.

32. ConclusionConclusion....

33. Thank your for your
paTience

34. 1. American Journal of Clinical Nutrition, Vol. 69, No. 5, 1035S – 1045S, May
1999.
2. Gastroenterology and Nutrition in infancy (GNI).
3. International Food Information Council (IFIC).
4. International Food Information Foundation’s Media Guide on Food Safety and
Nutrition.
5. Nutrition Information Centre University of Stellenbosch (NICUS).
6. HEALL: Health Education Alliance for Life and Longevity.
7. Can J Gastroenterol. 2004 Mar;18(3):163-7 Redefining lactose as a conditional
prebiotic.
8. Daniells, Stephen, Prebiotics Could Reduce Artery Hardening, Boost Heart
Health, NutraIngredients.com, 2 January 2007.
9. Hamilton-Miller, JMT, Probiotics and Prebiotics in the Elderly, 20 January
2004.
10. Marco ML et al; Towards understanding molecular modes of probiotic action.
Curr Opin Biotechnol 2006; 17:204–210.
References

35. 11. Prebiotics Could Improve Heart Health, NPICenter.com, 22 December
2006.
12. Saavedra, J.M. and Tschernia, A., Human Studies With Probiotics and
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References