pre- and pro- biotics

what besides digestion does microbiome maybe contribute to

• modulate the systemic and local immune system

• break down potentially toxic food compounds

• synthesize certain vitamins and amino acids

• provide GI barrier

• influence disease development, which is where much research is focused

what are prebiotics

Prebiotics support the enteric microbiota and typically are substances that are fermented in the colon

what are NEGATIVE effects of microbiome (gut) — meaning a poor microbiome

chronic kidney idsease

metabolic diseases/obesity

gastro-intestinal disorders

colon cancer developlment

what do prebiotics do

must stimulate growth or activity of bacteria in the colon

what can only be broken down by probiotics

dietary fiber

• releases short-chain fatty acids are produced by fiber breakdown by bacteria

what is most common type of prebiotic (not fiber)

Inulin-type fructans and fructooligosaccharides

what is the MOST most common prebiotic

fiber

what SCFA affects brain-gut axis

butyrate

Inulin-type fructans and fructooligosaccharides natural sources

bananas, asparagus, onion, leek, garlic, seaweed, soy and wheat

Inulin-type fructans and fructooligosaccharides what bacteria increase

bifidobacteria

what do people wnat to use Inulin-type fructans and fructooligosaccharides for? does it usually use?

• stool bulking

  • requires really high side affects— 5-8 g a day up to 20 g a day

what are side effects of Inulin-type fructans and fructooligosaccharides

bloating, flatulence, GI discomfort

Human Milk Oligosaccharides where from

human milk

what bacteria benefits form Human Milk Oligosaccharides

Bifidobacterium longum infantis

what is downside to only lactose, no Human Milk Oligosaccharides to b. infantis

surivives but no benefit to rest of body

what does Bifidobacterium longum infantis do when exposed to HMO

• encourage adhesive proteins in gut cells and down reg imflammation to boost immune system

• brain growth

  • protect preemies form necrotizing enterocolitis

what are probiotics

nonpathogenic, living microorganisms that have a beneficial effect on host functions when consumed in adequate amounts

probiotics why have to take frequently

after infancy they cannot permanently stay in GI tract

what is Dysbiosis

alteration in microbiome balance— higher levels of bad, lower levels of good

Dysbiosis what conditions could cause

• autoimmunity/allergies

• Gi stuff— c dif, chron’s, ibs

• CBS— alzheimers, parkinsons

• metabolic— obesity

• c-section babies— higher incidence of asthma, infection, colic

food sources taht have probiotics

fermented/dairy stuff

• Brined olives, kimchi, miso, sauerkraut, yogurt, kefir, cultured

  milk (sweet acidophilus milk and buttermilk)

does yogurt have to have live cultures to give probiotics

no

what does NOT give probiotics

kombucha— it just grows whatever is already there

what HINDERS probiotics from being metabolized

• Processing, storage, and delivery to host

• Gastric acid

• Bile acid lysis

• Pancreatic enzyme digestion

do dairy products natually have good bacteria

no its added

good effects of probiotics

• Maintain GI barrier function

• Secrete antimicrobial substances

• Compete for nutrients necessary for pathogen survival

• Modify immune system

• Regulate inflammation and allergic response

• Reduce cell proliferation in cancer

when would probiotics be most effective

in very young/old/sick when microbes are least healthy

what are the dose units for probtiocs

colony forming unites= CFUs

• 1 CFU is 1 bacterium capable of dividing and forming colonies

what should a dose of probiotic contain at least in CFU

at least 10^9

• a billion

  • no optimal dose known

what are indications of probiotics that actualyl have a “robust” evidence

• GI – diarrhea, inflammatory bowel disease, irritable bowel

• disease, H. pylori infection, necrotizing enterocolitis prevention,

• constipation

• Hepatic encephalopathy

• Cardiovascular risk factors – cholesterol, weight

• Mastitis

• Women’s health – bacterial vaginosis and candidiasis

• Colic in infants

what are indications that may have some positive evidence for with probiotics

• Allergy – eczema, atopic dermatitis, and allergic rhinitis

• Prevention of upper respiratory tract infections

• Depression

• Periodontitis

• Prevention of strep throat

• Diabetes

when to take probiotic pills

with or after a fat-containing meal to protect from stomach acid

• esp if don’t have enteric coating

what is time of manufacter vs best by date

• best by is better

• at time of manufacture means less than a billion cells when actually picked up

what are potential ad eff of probiotics

cramping, nausea, soft stool, flat, taste disturbance

when to not use probiotics

immunocpm pts, valvular heart disease— don’t give to people that could get sick

• hiv

• organ transplant

• long term steriods

• chemo

avoid in just really sick people too

are probiotics ok in preg/lactation

yes for right now

what do probiotics contain taht could cause trouble for pts with milk allergy

• lactobacilli, Bifidobacterium

• can have residual milk protein

does refrigeration help with probiotics

nope

counseling on storage for probiotics

• keeps products out of heat and light

  • keep away from moisture to prevent orgs from activating, then dying

  • should not be frozen