Pre- and Probiotics - Dickinson College · Pre- and Probiotics •Definition = “live...
Transcript of Pre- and Probiotics - Dickinson College · Pre- and Probiotics •Definition = “live...
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Pre- and Probiotics
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• Definition = “live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host”
• How measured• colony forming units (CFUs)• # live microbes it contains
Probiotics
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Probiotics: Sources
• Bacteria, Viruses, Yeasts• Lactobacillus• Bifidobacterium• No two strains or species alike
• Found in and added to foods and dietary supplements• Yogurt, fermented milk (kefir), miso, tempeh,
soy drinks
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• 500+ species bacteria in GI tract• Role of “good” bacteria• How “good” bacteria (probiotics) work
Probiotics: “Good” Gut Flora
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• Diarrhea & Antibiotics •can recommend probiotics, but dosing need more evidence (level B)•Cdiff
• lactobacillus GG & s. boulardii to treat recurrence•Antibiotic associated diarrhea (AAD)
• lactobacillus GG & s. boulardii•Acute diarrhea and traveler’s diarrhea
• s. boulardii; L. acidophilus & bifidobacteriumbifidum
•Radiation-induced diarrhea
Probiotics: Health Benefits
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Probiotics: Health Benefits
•Inflammatory bowel disease (e.g. Crohn’s, Ulcerative Colitis)
•E. coli strain Nissle 1917 shown as effective as mesalazine (Asacol) for remission of UC (level B)•VSL #3 more effective than mesalazine for remission of Crohn’s (level B)• Some trials show no improvement•More evidence needed to routinely recommend probiotics however (Level B)•Area of opportunity: match species, dose, age,
and disease phase
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Probiotics: Health Benefits
•Irritable Bowel• Small # of studies show symptom improvement• Bifidobacterium infantis w/ dose 108 CFUs (Level B)• Need more randomized, controlled trials
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• Emerging areas of application & research• Pouchitis, H Pylori infections, vaginal
infections, heart disease (lipid levels), oral diseases, diabetes
• General population infection prevention (e.g. daycare centers, eldery)
Probiotics: Health Benefits
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• Acute Pancreatitis (Level A)• ICU – use & outcomes of probiotics unpredictable
(Level C)
Probiotics: Contraindications
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• Dietary supplement • Low-risk intervention
• Still need further research for interactions b/w probiotics, medications, herbal supplements and vitamin/minerals
• Variation in species and strains• Not enough research to make clear recommendations
for dosing levels for specific effects• Studies researched CFUs 50million to 1 trillion
daily
Probiotics Overall
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• Pick trusted manufacturer• Strain• CFU• Suggested serving size• Storage conditions• Corporate contact info• See Clinical Guide
International Scientific Association for Probiotics and Prebiotics
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• Definition = “nondigestible food ingredients that selectively stimulate the growth and/or activity of beneficial microorganisms already in people’s colons”
• function as food source for probiotics
Prebiotics
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• Fructans, most commonly inulin and phlein• Oat gum• Pectin • General good food sources are those high in fiber:
• Artichokes• Apples• Bananas• Chicory (e.g. endive, root)•Barley, quinoa, millet, oats• Berries• Legumes
Prebiotics: Sources
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• Reduce constipation and treating/preventing diarrhea (Level B)
• Emerging research for IBS & weight control• no consistent evidence as independent effect risk of colon
cancer
Prebiotics: Health Benefits
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• Low risk with supplementation• Potential side effects:
• may reduce bioavailability of carotenoids & vit E• may reduce absorption of lycopene & lutein (21)
Prebiotics: Overall
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References & Resources
• Adapted from Probiotics and Prebiotics as produced in Nutrition Dimensions by Elizabeth Chiodo, RD, LDN
• International Scientific Association for Probiotics and Prebiotics www.isappscience.org