25

Probiotics and Prebiotics

Edward R. Farnworth
CONTENTS

I. Probiotics
A. Criteria for Probiotics
B. Probiotic Products on the Market
II. Prebiotics
III. Microbiology of the Gastrointestinal Tract
IV. Probiotic Products
A. Yogurt
1. Lactase Deficiency
2. Cholesterol Metabolism
3. Immune Function
4. Diarrhea
5. Cancer
6. A Vehicle for Other Nutrients
B. Kefir
1. Fabrication
2. Health Benefits
V. Fermented Vegetables and Other Foods
VI. The Future for Probiotics and Prebiotics
References

I. PROBIOTICS
Within the definition of functional foods there is a subset of foods believed to be good
for
health that are produced by or that contain live microorganisms. These foods are called
probiotics.
The earliest definition of a probiotic was very narrow and applied specifically to animals
(see Table 25.1). As (1) the metabolism of bacteria became better defined, (2) more
studies
pointed out the role that microorganisms play in human health and disease resistance,
and (3)
more microorganisms were identified that may be included in probiotic products, there
has been
a need to expand the definition of a probiotic. It should be noted that discussions of
probiotics
are usually limited to bacteria; the use and importance of yeasts in probiotic foods
have not
received much attention.

A. CRITERIA FOR PROBIOTICS

As researchers and food manufacturers started to appreciate the potential for including
microorganisms
in probiotic foods, various criteria were suggested to screen candidate microorganisms
that would at the same time satisfy regulatory bodies and ensure consumer acceptance
(see Table
25.2). It is difficult to rank the criteria in order of importance; the first three criteria
address practical
TABLE 25.1
Evolving Definitions of Probiotics
Animal feed supplements that have a beneficial effect on the host animal by

affecting its gut microflora1

A live microbial feed supplement which beneficially affects the host animal
by improving its intestinal microbial balance2
A viable mono- or mixed culture of micro-organisms which, when applied
to animals or man, beneficially affects the host by improving the properties
of the indigenous microbiota3
A microbial preparation which contains live and/or dead cells including their
metabolites which is intended to improve the microbial or enzymatic balance
at mucosal surfaces or to stimulate immune mechanisms 4

aspects of selection of appropriate microorganisms for inclusion in probiotic foods, and

the later
two may be more important from a consumer acceptance and regulatory point of view.
The ideal
probiotic bacteria would possess all of the criteria. However, at this time, the list of
bacteria that
meet several of the criteria and, in particular, those that have sound scientific evidence
of efficacy
and that have been incorporated into foods, is not long.
Several of the criteria listed in Table 25.2 are obviously related. To be effective, the
probiotic
bacteria must arrive at the site of action in large enough numbers to exert their effect.
This may
most easily be achieved by using resistant bacteria or by providing large numbers of
live bacteria
when consumed, to compensate for losses during passage through the upper
gastrointestinal (GI)
tract. Knowledgeable consumers are now looking for products that advertise that they
contain live
bacteria. Meanwhile, manufacturers are becoming more aware of the need to provide
accurate
information about the levels and types of bacteria in their products. 4 The setting of a
minimum
number of viable microorganisms in a food to ensure probiotic effects is an important
decision.
The Fermented Milks and Lactic Acid Bacteria Beverages Association in Japan has set a
minimum
of 107 bifidobacteria/g or ml.10 Others have suggested a lower level (105).5 Recent
results would
indicate that metabolic changes can be observed at such levels of microbial intake. 11
However,
experimental evidence in which various levels of bacteria were fed and viable numbers
counted
after passage through the stomach would indicate that probiotic products may have to
deliver even
higher (>1010 to 1011) levels of microorganisms to survive the conditions of the GI
tract.12 This
conclusion is supported by in vitro
13,14 This wide diversity of opinion may reflect only the differences in
the ability of different bacteria to survive passage through the stomach. To set one
level for all
bacteria may be unrealistic, because the numbers of bacteria required to produce a
certain metabolic
change will vary depending on the effect to be achieved.

TABLE 25.2
Proposed Criteria for Microorganisms to be Included
in Probiotic Foods/Drinks59
1. Microorganism of human origin
2. Resistance to acid conditions of stomach, bile, and digestive enzymes
normally found in the human GI tract
3. Ability to colonize human intestine
4. Safe for human consumption
5. Scientifically proven efficacy

Only bacteria that can survive passage through the stomach and can colonize the
intestines will
exert any effect on the host. This was most clearly shown by Pedrosa and colleagues. 15
In healthy
elderly persons fed yogurt containing Lactobacillus bulgaricus and Streptococcus
thermophilus
changes in three bacterial enzyme activities. When healthy subjects were fed live Lb.
gasseri (Lb.
acidophilus strain MS 02), a human strain capable of adhering to intestinal cells, the
organism was
found in all subjects and the activities of -glucuronidase, nitroreductase, and
azoreductase were
all significantly reduced.
This study emphasizes the need to measure both the fate of the ingested
bacteria and metabolic effects to ensure proper interpretation of results. This is
particularly true
when no metabolic response is observed.
Various reports have included lists of bacteria that can be considered as candidates for
inclusion
in probiotic products (Table 25.3). The whole premise of a functional food is that certain
commonly
eaten foods contain active ingredients that can fight or prevent disease and infection.
With advances
in analytical techniques the identification of new active ingredients is occurring every
day. For
probiotics, however, the identity of the active ingredient may not be as straightforward,
because
there is always more than one possibility. The active agent could be one or more of the
live
microorganisms in the food, or it could be a metabolite produced by one of the
microorganisms,
or it could be a fermentation product that has been formed due to the action of the
microorganism(s)
on the original product. Indeed, depending on the probiotic in question each of the
above arguments
had been used to explain the beneficial effects of the probiotic.

B. PROBIOTIC PRODUCTS ON THE MARKET

1981 established the Japan Bifidus Foundation to encourage research on bifidobacteria
which in
part may explain why, by 1993, 53 probiotic products containing bifidobacteria were for
sale in
Japan.10 Japan is often held up as a example of how cooperation between industry and
government
health agencies can lead to system of approval and labeling of foods that are good for
health. The

foods for specific health uses or FOSHU system provides consumers with products
with a
distinctive logo indicating that the product (or product ingredients) have been judged
as being good
for health. There are 11 categories of functional components that qualify under the
FOSHU system.
Three of these categories, namely, dietary fiber, oligosaccharides, and lactic acid
bacteria, refer
specifically to intestinal function and control. By 1998, over 70% of products being
marketed with
the FOSHU label were directed toward intestinal bacteria and GI conditions. 16
Reuter 4 pointed out that in both Germany and Switzerland there is wide consumer
interest in
probiotic products. He lists 21 products (produced in seven European countries) for sale
in Germany
of either a yogurt-type or a yogurt drink format in 1997. Regulatory concerns may have
slowed
the introduction of such products in North America.

II. PREBIOTICS
The concept of a prebiotic arose from two observations: (1) bacteria like any other
living organism
have (sometimes specific) nutrient requirements17 and (2) some nutrients, particularly
complex
carbohydrates, pass undigested into the colon where they are utilized by resident
bacteria.18 In 1995
Gibson and Roberfroid19 defined a prebiotic as a nondigestible food ingredient that
beneficially
affects the host by selectively stimulating the growth and /or activity of a limited
number of bacteria
in the colon. Rather than supplying an exogenous source of beneficial bacteria, the
concept of a
prebiotic proposes to increase the number of certain target bacteria already in the
colon. The
targeting of in situ bacteria obviously satisfies most of the criteria listed in Table 25.2.
Attention
has centered mainly on the increase of Lactobacillus and Bifidobacterium as the two
main groups
TABLE 25.3
Possible Probiotic Microorganisms
Lactobacillus bacteria
Lb acidophilus
Lb acidophilus LC1
Lb. acidophilus NCFB 1748
Lb. plantarum
Lb. casei
Lb. casei Shirota
Lb. rhamnousus (strain GG)
Lb. brevis
Lb. delbrueckii subsp. bulgaricus
Lb. fermentum
Lb. helveticus
Bifidobacterium bacteria
B. bifidum
B. longum
B. infantis
B. breve
B. adolescentis
Other bacteria

5,7,8

Streptococcus salvarius subsp. thermophilus

Lactococcus lactis subsp. lactis
L. lactis subsp. cremoris
Enterococcus faecium
Leuconostoc mesenteroides subsp. dextranicum
Propionibacterium freudenreichii
Pediococcus acidilactici
Escherichia coli
Yeasts
Saccharomyces boulardii
Note: The identification and classification of bacteria
and yeasts change as more sophisticated methods are
used. The nomenclature used throughout this chapter is
that found in the references cited to avoid confusion.

of friendly bacteria to increase.2023 Variation in individual response is often high and

as cautioned
by Roberfroid24 the prebiotic effect may depend on the initial level of target bacteria.
The carbohydrates
of interest as prebiotics are listed in Table 25.4.
The goal of increasing selected bacteria by feeding prebiotics often has been the
production of
various short-chain fatty acids (SCFAs) because of their impact on the lower gut
environment,
metabolism, and disease prevention.2527 The SCFAs are quickly absorbed and can serve
as an
energy source for the host, especially between meals. They contribute to fecal pH and
thereby
influence colonic function and perhaps the risk of cancer. 28 Other beneficial health
effects have
been proposed. However, as in the case of the effects of feeding a prebiotic such as
galactooligosaccharide
on constipation, the results are not conclusive.29
The combination of live bacteria in a food and the inclusion of nutrients (usually sugars)
that
can be used by those bacteria as the two traverse the GI tract has resulted in what has
been termed
TABLE 25.4
Some Proposed Prebiotics31,32
Neosugars
(GFn n = 1 4
Inulin-like fructans (fructo-oligosaccharides of chain length up to 60 units)
Soy oligosaccharides
Galacto-oligosaccharides
Isomalto-oligosaccharides
Gentio-oligosaccharides
Xylo-oligosaccharides
Lactulose (fructose-galactose disaccharide)
Raffinose
Stachyose
Sorbitol
Xylitol
Palatinose
Lactosucrose

symbiotic foods.24 The most popular combination to date appears to be Bifidobacterium

and fructooligosaccharides,
but other combinations are possible, if not practical. 23,30

III. MICROBIOLOGY OF THE GASTROINTESTINAL TRACT

The human microflora is complex, difficult to study, and is influenced by many factors.
Study
of the microorganisms that populate human GI tracts is hampered by the fact that
sampling
opportunities are limited, variation between individuals is great, there is no totally
relevant animal
model, such research is time-consuming and expensive, and advances in this area of
research
are obviously dependent on advances in microbiology. Even the simplest questions,
such as how
many and what kind of bacteria are important in the human GI tract, are not easy to
answer or
to find a consensus in the literature. Indeed, at least one author has stated that due to
difficulties
in obtaining proper samples, the crudeness of the methods used to count the various
types of
bacteria, and the short duration of most diet intervention studies, very little is really
known about
the human microflora and factors that affect it.33 To date, most of our understanding of
the human
microflora comes from analyses of fecal contents, which may severely limit our
understanding
of events farther up the GI tract.
There is agreement about the changes (in general terms ) in the bacterial population
that occur
during the passage from newborn to infant to adult. Vaginally delivered babies have
nearly sterile
GI tracts, which soon become colonized, either with large numbers of Bifidobacterium
and Lactobacillus
in the case of breast-fed babies or Bacteroides sp. and Eschericha coli in the case of
bottlefed
babies.34 Bifidobacterium are considered as desirable, and so attempts have been made
to add
prebiotics to infant formula to encourage the growth of Bifidobacteria. 35 By adulthood,
over 400
different species may be present (see Table 25.5), but only the most abundant bacteria
have been
well identified. Resident bacteria can be found starting with the mouth and working on
down the
GI tract. The stomach and the upper small intestine may have as many as 105 colonyforming units
(CFU) the ileum 107, and the colon 1011 to 1012.36 Anaerobic bacteria outnumber aerobic
by a factor
of 1000 to 1.37
The bacteria that reside in the human intestinal tract have both beneficial and harmful
effects
on the host. The production of vitamins, SCFAs, some proteins, the role played in
digestion and
absorption of nutrients, the production of protective bacteriocins, and the stimulation of
the immune
system are all positive effects of the intestinal microflora. 10,31,38 At the same time,
intestinal bacteria

TABLE 25.5
Bacteria Found in Human
Intestinal/Fecal Samples39,40
Bacteroidaceae Eubacteria
Peptococcaceae Bifidobacteria
Streptococci Enterobacteriaceae
Lactobacilli Vellonella
Clostridium perfringens Clostridia
Magasphaera Fusobacteria

produce carcinogens and mutagens directly during their metabolism, and also enzymes
that convert
digesta contents into carcinogens and mutagens. Products of fermentation such as
ammonia, amines,
and phenols may be harmful and some bacteria are pathogenic. 39,40 Mitsuoka39 and
Gorbach40 list
the many enzymatic reactions of intestinal bacteria and the impact on health, disease,
and infection.
Because of the difficulties in identifying and enumerating various microorganisms that
inhabit
the GI tract, several authors have suggested that a more sensitive and perhaps more
relevant approach
is to measure effects on the metabolic activities of the bacterial flora, because of their
potential
impact on disease.9, 33,37 Carman and colleagues41 used the term microflora-associated
characteristics
(MACs) and argued that changes in MACs brought about by dietary (probiotic or not)
interventions were true indicators of changes in the intestinal flora, and a more useful
way of
establishing the consequences of such changes. Goldin and Gorbach 42 used much the
same reasoning
when they measured bacterial enzymes associated with the production of carcinogens
in the
intestine. Table 25.6 lists the MACs suggested by Carman and colleagues. 41 Other
characteristics
could be added that also reflect changes to the intestinal tract.

IV. PROBIOTIC PRODUCTS

A. YOGURT

Yogurt is defined as a fermented milk obtained by specific lactic acid fermentation,

brought about
by Lb. bulgaricus and S. thermophilus. Other bacteria may be added to enhance
organoleptic
properties, or more recently, to increase the probiotic properties. Yogurt can now be
found that
contains Lactobacillus, Streptococcus, Leuconostoc, and Bifidobacterium bacteria.
Pakistani yogurt
or dahi has been shown to have an even more complex microflora. 43
The amount of research on yogurt far surpasses any other probiotic product. Yogurt has
been
studied to determine its effects on lactase deficiency, cholesterol metabolism,
immunity, infantile
diarrhea, and certain cancers with varying levels of success.
TABLE 25.6
Microflora Associated Characteristics Indicative of Intestinal
Microflora Changes

1. Cellular fatty acid profiles of washed bacteria pellet of fecal or cecal contents
2. Primary to secondary bile acid ratio
3. Ratio of primary to secondary sterols
4. Molar ratio of SCFAs in intestinal material
Source: Carman, R.J. et al., Vet. Hum. Toxicol., 35 (Suppl. 1): 1114; 1993. With
permission.

. Lactase Deficiency
Yogurt has been shown to be a diary product that may be tolerated by people with a
lactase (galactosidase) deficiency. It is more accurate to refer to a lactase deficiency as
opposed to a lactose
intolerance. Lactase is the digestive enzyme found in the intestinal brush border
responsible for
the hydrolysis of milk sugar lactose into glucose and galactose. Lactase deficiency
results in the
buildup of unabsorbed lactose which acts osmotically to retain water. The deficiency is
characterized
by diarrhea, excessive flatulence, bloating, and abdominal pain after the ingestion of
milk or milk
products. Measurement of the enzyme activity, the concentration of
lactose/glucose/galactose in
digesta, or the measurement of breath hydrogen are ways of evaluating the treatment
effects on
lactase activity.
In 1984, two groups, Kolars and colleagues44 and Savaiano and colleagues,45
demonstrated
that yogurt reduced the symptoms of lactase deficiency and they speculated this was
due to the
live bacteria in yogurt. Yogurt was said to be able to autodigest lactose and it was
apparent that
the enzyme responsible survived passage through the stomach. 46 Subsequent studies
have built on
this initial work and have added to the understanding of the mechanism involved.
Yogurt, but not
heat-treated yogurt, improves lactose digestion indicating that the live bacteria in
yogurt are
responsible, and long-term ingestion (8 days) does not seem to change this. 47,48 The
bacteria in
yogurt survive passage through the stomach due to the enhanced protective
(buffering) properties
of the yogurt compared with milk. However, the buffering capacity of yogurt may also
slow
hydrolysis until the digest passes to a point in the intestinal tract where the pH favors
galactosidase activity.47 The -galactosidase activity in commercial yogurts has been
found to
vary depending on the manufacturer, whether fruit is added and whether the yogurt is
frozen or
not. Frozen yogurt that is pasteurized before freezing has no -galactosidase activity. To
overcome
this, some manufacturers add starter culture to the pasteurized yogurt before freezing,
but this
does not necessarily increase enzyme activity. 49
In addition to the in vivo bacterial hydrolysis there also appears to be a slower rate of
stomach

emptying after a yogurt load compared to milk. This effect may contribute to the
enhanced digestion
of lactose in yogurt.50
The beneficial effects of yogurt on healthy individuals may not be as obvious as for
those who
have a defined medical problem. Guerin-Danan et al.51 saw few changes in the fecal
bacteria, and
the bacterial enzyme activity of healthy infants (10 to 18 months old) over a 1-month
supplementation
trial. Branch-chain and long-chain fatty acid levels were significantly reduced during
yogurt
consumption, however.
2. Cholesterol Metabolism
The research into the effects of yogurt consumption on blood cholesterol has been
difficult to
understand because of the contradictory results that have been reported over the
years. It is now
clear that in many cases, results and conclusions from one experiment cannot be
compared with
others because of differences in experimental protocol. The sex, age, general health
status, initial
cholesterol level, and level of activity all influence cholesterol metabolism. The diet
before and
during the experiment can also influence results, as can the time of day the yogurt is
consumed,
whether it is consumed with other food or not, and the position in the meal (beginning
or end of
meal). One of the most important details of many yogurtblood cholesterol
experiments, namely,
the type of yogurt fed (including details of the levels and types of bacteria in the test
yogurt or
fermented milk), are often not described. This, together with the fact that proper
controls for such
feeding trials were often not included, reduces the scientific validity of many studies. 52
The observation that the Maasai of Africa had low blood cholesterol levels (compared
with
Western standards) and were free of signs of coronary heart disease prompted Mann
and Spoerry53
to carry out their much reported study involving fermented milk. Yogurt trials carried
out since
that time use this as a starting point in spite of the fact that Mann 54 later emphasized
that he believed
that it was a milk factor responsible for the hypocholesterolmic effect, which was
enhanced by
fermentation to yogurt. Taylor and Williams52 list 12 publications (13 trials) in which
yogurt has
been fed in an attempt to lower blood cholesterol. As they point out, many of the study
protocols
can be criticized too few subjects, too short of a feeding trial, no or improper control
diets, and
unrealistic feeding levels. Of the 13 trials, 8 reported reduced blood total cholesterol
levels, 1
reported an increase, and 4 reported no difference from control. A recent study by de
Roos and

colleagues55 can be added to the no difference from control group.

Various suggestions have been made regarding the possible active ingredient(s) or the
mode of
action of yogurt, which might affect cholesterol metabolism. 56 In vivo cholesterol
synthesis may
be related to and controlled by the availability of certain SCFAs in the gut; interest has
centered
on acetate and propionate.57,58 Several bacteria have been shown to be capable of
hydrolyzing bile
acids, which would prevent reabsorption in the intestine and facilitate the elimination
from the
body. Bile acids are formed from cholesterol in the liver and therefore any increase in
elimination
of bile acids from the body would increase the rate of conversion of cholesterol to bile
acids.
3. Immune Function
The organs of the immune system are varied and within this system the leukocytes or
white blood
cells provide specific or nonspecific immunity. A wide variety of parameters including
levels of
specific immunoglobulins, numbers of different cell types, and measurement of specific
metabolite
concentrations are used to measure immune function. At the present time several
hypotheses have
been put forward regarding how yogurt might improve the immune system. Interaction
of the yogurt
bacteria with intestinal bacteria could produce indirect effects or the gut associated or
systemic
immune system might be affected by metabolites of the bacteria themselves or
fermentation products
in the yogurt.59
Perdigons group60,61 has published several studies using animals that show that yogurt
does
improve immune function. Wheeler and colleagues 59 measured a wide variety of
cellular, humoral,
phagocytic, and mucosal immunity parameters, in patients with preexisting atopic
disease and found
no significant differences in any parameters whether the patients were consuming
yogurt or milk
(control). Spanhaak and colleagues62 similarly reported no changes in immunity
parameters in
healthy subjects who had been fed milk fermented with Lb. casei strain Shirota even
though fecal
bacteria patterns were changed and fecal enzyme activities were significantly
decreased.
Gills63 review of the literature emphasized the difficulties in comparing the results from
different studies, but concluded that there is enough evidence to suggest that certain
lactic acid
bacteria, given at adequate levels of intake, can influence immune function.
4. Diarrhea
Diarrhea, particularly in young children, can be problematic because of the need to
rehydrate the
patient as quickly as possible, combined with the problems associated with decreased
nutrient

intake. The detrimental consequences of complete withdrawal of food from infants as a

treatment
have been defined, but withholding food during early stages of diarrhea is still
widespread.64
Fermented milk or yogurt can supply liquid and at the same time may supply natural
antibiotics
produced by the lactic acid bacteria to prevent or reduce the severity of infantile
diarrhea. Gonzalez
and colleagues65 showed that milk fermented with Lb. casei and Lb. acidophilus could
be used to
prevent the incidence of diarrhea (17% vs. 59% for controls receiving unfermented
milk) in infants
5 to 29 months old, and that the protective effect of the fermented milk appeared to be
correlated
to the level of fecal lactic acid bacteria. Isolauri and co-workers 66 used milk fermented
with the
human strain Lb. casei sp. strain GG to reduce the duration of acute diarrhea in
children. This same
strain of bacteria was shown to be effective in the prevention of antibiotic
(erythromycin) associated
diarrhea, due in part to its ability to colonize the intestinal tract. 67 However, these
positive results
appear only to be applicable in infants who are otherwise well nourished. 68
5. Cancer
The beneficial effects of yogurt consumption on reduced cancer incidence is not
established. The
article published by vant Veer and colleagues 69 is often quoted as proof of a link
between yogurt
consumption and a low incidence of breast cancer. Based on a daily food consumption
questionnaire
of newly diagnosed breast cancer patients or a group of healthy women (control), they
concluded
that fermented milk products (yogurt, buttermilk, Gouda cheese) may have a
protective effect
against breast cancer. Two more recent studies came to different conclusions about the
effect of
yogurt (fermented milk products) on colorectal cancer. 70,71
The work of Goldin and Gorbach42 and Goldin and colleagues72 supports the idea that
the Lb.
acidophilus found in yogurt may impact on marker enzymes related to cancer. They
found two to
sixfold reductions in the activities of -glucuronidase, nitroreductase, and azoreductase
enzyme
activities after 4-week supplementation with 109 to 1010 viable Lb. acidophilus. These
bacterial
enzymes produce proximal carcinogens from procarcinogens in the lower intestine. This
work
together with positive in vitro and experimental animal results suggest that the
bacteria in yogurt
and other probiotic bacteria deserve further study. 7376
Other work on the cancer-fighting properties of yogurt has centered on the isolation
and
identification of bioactive peptides. Caseins found in milk are themselves
antimutagenic; totally

hydrolyzed caseins are not. A wide variety of peptides of various lengths are formed
from milk
during fermentation, or in the stomach during the digestion of yogurt. 7779 The peptides
vary in
length, physiological activity, and ability to be absorbed into the bloodstream from the
GI tract.
These relatively short peptides have a wide variety of activities in vitro and in vivo,
including
antimutagenic and antitumor properties that may explain beneficial effects of yogurt
toward cancer.
In addition, milk peptides have been shown to have opioid, antihypertensive,
immunomodulating,
antibacterial, antiaggregating, and antithrombotic effects.
6. A Vehicle for Other Nutrients
The popularity of yogurt has prompted several studies that have investigated the
feasibility of using
yogurt as a vehicle for other important nutrients that normally would not be of
importance in yogurt.
Fernandez-Gartcia and colleagues80 have recently shown that oat fiber can be added to
plain yogurt
while still maintaining commercially acceptable sensory qualities.
In spite of the potential problems of off-flavor and encouragement of growth of
contaminating
bacteria, Hekmat and McMahon81 were able to produce a yogurt with up to 40 mg/kg of
added
iron that was acceptable particularly to untrained consumers.

B. KEFIR
Kefir is a fermented milk drink that has its origins in the Caucacus Mountains of the
former U.S.S.R.
Traditionaly it was made from goats or cows milk that was stored in skin bags. Over
time a mass
of bacteria/yeast/protein/carbohydrate precipitated out from the drink that was used to
innoculte
new milk. This mass is called kefir grains, and it is the grains that give kefir its texture,
taste, and
possible health benefits. Kefir has a long oral tradition for its health-promotion
properties in Eastern
Europe and has only recently been produced in North America on a commercial scale. 82
A product
of the fermentation process is CO2 gas, which continues to be produced after packaging
and results
in a thick drink with a sparkling mouth-feel when consumed. This has prompted some
to refer
to kefir as the champagne of dairy products.
Unlike yogurt, which requires only two well-defined bacteria for production, the
microbiology
of kefir is much more complex and has been shown to vary from country to country,
thus making
a comparison of its properties difficult (Table 25.7). Changes that occur during
fermentation promote
the growth of certain microorganisms, while reducing the growth of others. Therefore,
reports of
the composition and properties of the grains may not be totally applicable to the
finished product.

TABLE 25.7
Microorganisms Reported to be Found in Kefir and Kefir
Grains83,9092
Lactobacillus Bacteria Lactococcus Bacteria
Lb. acidolphilus L. lactis subsp. lactis
Lb. johnsonii L. lactis subsp. cremoris
Lb. kefirgranum L. lactis subsp. lactis biovar diacetylactis
Lb. helveticus
Lb. delbrueckii subsp. bulgaricus
Leuconostoc Lb. kefiranofaciens Bacteria
Lb. casei Ln. lactis
Lb. zeae Ln. mesentroides subsp. mesentroides
Lb. rhamnosus Ln. mesentroides subsp. cremoris
Lb. plantarum Ln. mesentroides subsp. dextranicum
Lb. brevis
Lb. buchneri
Lb. fermentum Other Bacteria
Lb. kefir Streptococcus thermophilus
Lb. parakefir
Yeasts
Saccharomyces Yeast Kluyveromyces Yeasts
S. cerevisiae K. marxianus var. marxianus
S. unisporus K. marxianus var. lactis
Other Yeasts
Candida kefyr
Torulaspora delbrueckii
Geotrichum candidum Link

The microflora of kefir drink is not merely a dilution of the microflora of the kefir grains,
because
during the production process conditions may favor the growth of certain bacteria and
discourage
the growth of others.
1. Fabrication
Three different types of kefir drink are produced traditional kefir, Russian-type kefir,
and
industrial kefir depending on whether the grains or a mother culture from the grains
is used to
innoculate pasteurized milk.82,83 No studies have been published that compare the
properties (health
benefits or otherwise) of kefir produced by different processes. Incubation is carried out
at 20 to
22C for 18 to 20 h until a specific pH is reached, and then packaged, or a maturation
period can
be introduced.83 The grains themselves have a strong yeasty taste, and, therefore,
using a mother
culture or sieving out the grains may be ways of making a product closer to buttermilk
in taste.84,85
A double-fermentation process was proposed by Marshall and Cole 86 as a way of making
the taste
of traditional kefir more acceptable to the consumer. 87 Today, commercial kefir is only
produced
from cows milk, but other milks can be fermented with kefir grains. 88 In terms of
volume, kefir is
the dairy product most consumed in Russia.
Studies of the microflora of kefir grains led to the formation of less complex starter
cultures
that could replace kefir grains. A method using as few as four bacteria and one yeast
type has been

reported as being used to produce kefir. 84 However, apart from very gross
characteristics, there

is little reason to believe that the two beverages (produced from traditional grains or
starter cultures)
are the same.89
2. Health Benefits
The (Western) scientific literature to support the beneficial health claims for kefir is not
extensive
and few human feeding trials using kefir have been carried out. The Russian literature
lists peptic
ulcers, biliary tract diseases, chronic enteritis, bronchitis, and pneumonia as all being
treated with
kefir.82 Kefir is included as a regular part of hospital diets, is a recommended food for
nursing
mothers, and is often used as a first weaning food for babies in Russia. Both kefir grains
and the
drink itself have been shown to have antitumoral, antibacterial, and antifungal
properties that may
explain the diverse list of diseases and infections it is used to treat. 93 In the tests
carried out by
Cevikbas and colleagues93 the kefir grains were more effective than the drink. Osada
and co-workers94
reported the isolation of a sphingomyelin species isolated from kefir grain which they
showed
enhanced interfereon- production in a human cancer cell line that had been
challenged with a
chemical inducer. They concluded that this sphingomyelin could be important in viral
diseases.
Several Japanese publications in experimental animals have indicated anticancer
properties of
kefir for a variety of cancers.95100 These studies have used kefir grains or kefir grain
polysaccharide
both to prevent the onset of cancer, if given before a cancer challenge, or to slow the
growth and
spread of cancer, if given after the cancer challenge. However, to date such
experiments have not
been carried out in humans.
Vujicic and colleagues101 incubated milk samples with kefir grains from six different
sources and
showed that, after 24 h, between 22 and 63% of the cholesterol originally in the milk
was assimilated;
they concluded that the grains possessed a cholesterol-degrading enzyme system. In a
recent study
in which hypercholesterolemic men were given 500 ml of kefir daily for 1 month, no
changes
(compared with values obtained after one month of milk feeding) were measured in
serum cholesterol
levels or cholesterol metabolism, in spite of the fact that a reference organism (Lb.
brevis) could be
found in fecal samples and changes in fecal volatile fatty acids were found. 11,27,102

V. FERMENTED VEGETABLES AND OTHER FOODS

Fermented vegetables are known throughout the world. Fermentation is often viewed
as an effective

method to preserve vegetables, without regard to any health benefits. Reddy and
colleagues.103 list
23 legume-based fermented foods, the majority of which are soybean products. Only
natto, a popular
fermented soybean product from Japan, is mentioned as encouraging the growth of
Bifidobacterium
in animals.104 Most reports of fermented vegetables have centered on the organism(s)
used to
produce the fermentation and on any increases in the protein, amino acid, and vitamin
concentrations
of the final product, not any possible probiotic effects.105107
Various other foods have been tested as possible vectors to carry probiotic bacteria.
The
verification of the efficacy of these products has not been the focus to date, but, rather,
investigation
of whether the bacteria will survive in the food matrix and during processing and
storage. Cheddar
cheese containing Enterococcus faecium,108 B. longum in frozen yogurt,109 and B.
longum, B.
infantis, and B. brevi,30 L. acidophilus, and B. bifidum107 in ice cream are examples.
Lee and Salminen5 predicted that probiotic infant formulae, baby food, fermented fruit
juices,
fermented soy products, cereal-based products, as well as disease-specific products,
are products
of the future.

VI. THE FUTURE FOR PROBIOTICS AND PREBIOTICS

The market for probiotic and prebiotic products will continue to grow as our knowledge
of the
intestinal microflora and its role in the maintenance of health and disease resistance
advances. Food
manufacturers will have to be able to produce products that maintain viable bacteria
up until the
time of consumption and in many cases will also have to provide encapsulation or other
protective
mechanisms for the live microorganisms in their products to be able to deliver bacteria
to the correct
site of action in the GI tract.

dudas que aun tengo

de LOURDES
ESTHER ZELAYA
SAENZ - sbado, 13
de octubre de 2007,
23:59

Profesor haciendo mi resumen del tema de probioticos y prebioticos me

surgieron nuevas preguntas y dudas :
- cuando se extrae la inulina de la achicoria esta inulina sale con un
porcentaje de azucar proveniente de la misma achicoria y por esta razon
es hay inulina standar y de bajo contenido de azucar? osea que en la
refinacion al jugo de la chicoria es donde se determina hast que nivel de
pureza va llegar la inulina?
- que cosa es el Dalhia y oriundo de donde ?
- Los Fos son usados como edulcorantes sin embargo endulzan menos
que la sacarosa...cuando se menciona en la separata que disminuyen el
contenido calorico es debido a que en si los fos aportan menos kcal/gr de
fos que la sacarosa? y si es asi el hecho de que endulze menos y por lo
tanto se use mas fos no viene a dar el mismo contenido de calorias q la
sacarosa?
- en el tema de probioticos, cuando se habla de que forman resistencia a
los enteropatogenos se explica que es porque disminuye los sitiso de
adhesion a la mucosa intestinal esto es por que lo probioticos estan
usando una zona de la mucosa y por lo tanto le quita el supuesto espacio
que usarian los patogenos?
- si me puede explicar mas o menos la relacion entre disminucon de
colesterol y aumento de secrecion de sales biliares
- que es una lesion neoplastica
- cuano habla de q los probioticos modulan el crecimiento celular y la
diferenciacion a que se refiere?
- la hoja del lactobacillus casei me confunde un poco: indica acaso que el
lactobacillus casei es el GG y luego se le dio el nombre de lactobacillus
rhamnosus qu es el LGG.
bueno profesor o quien me responda todas estas dudas..gracias de
antemano .saludos

Dentro de la definicin de productos de alimentacin funcionales hay un subconjunto de

productos de alimentacin credos estar bien para la salud que es producida por o esto
contiene microorganismos vivos. Llaman probiotics a estos productos de alimentacin.
La definicin ms temprana de un probiotic era muy estrecha y se aplic expresamente a
animales (mirar la Mesa 25.1). Como (1) el metabolismo de bacteria se hizo mejor
definido, (ms 2) estudios indicaron(advirtieron) el papel que los microorganismos juegan
en la salud humana y la resistencia de enfermedad, (y ms 3) microorganismos fueron
identificados que puede ser incluido en productos probiotic, hubo una necesidad de ampliar
la definicin de un probiotic. Debera ser notado que las discusiones de probiotics por lo

general son limitadas con la bacteria; el empleo y la importancia de levaduras en productos

de alimentacin probiotic no han recibido mucha atencin.
A. LOS CRITERIOS PARA PROBIOTICS Como investigadores y fabricantes de alimentos
comenzaron a apreciar el potencial para la inclusin de microorganismos en productos de
alimentacin probiotic, varios criterios fueron aconsejados proteger los microorganismos de
candidato que al mismo tiempo satisfaran cuerpos reguladores y aseguraran la aceptacin
de consumidor (mirar la Mesa 25.2). Es difcil de alinear(clasificar) los criterios por orden
de la importancia; la tres primera direccin de criterios prctica
los aspectos de seleccin de microorganismos apropiados para la inclusin en productos de
alimentacin probiotic, y los dos posteriores pueden ser ms importantes de un consumidor
el punto de vista de la aceptacin y regulador. El ideal probiotic la bacteria poseera todos
los criterios. Sin embargo, en este tiempo, la lista de bacteria que encuentra varios de los
criterios y, en particular, aquellos que tienen la prueba cientfica sana de eficacia y esto ha
sido incorporada en productos de alimentacin, no es largo.
Varios de los criterios catalogados en la Mesa 25.2 obviamente son relacionados. Para ser
eficaz, la bacteria probiotic debe llegar al sitio de accin en nmeros bastante grandes para
ejercer su efecto.
Esto el ms fcilmente puede ser alcanzado por usando la bacteria resistente o por
proporcionando los nmeros grandes de bacteria viva cuando consumido, compensar
prdidas durante el paso por el superior gastrointestinal (el soldado) la extensin.
Consumidores bien informados ahora buscan los productos que anuncian esto ellos
contienen la bacteria viva. Mientras tanto, los fabricantes se hacen ms conscientes de la
necesidad de proporcionar la informacin exacta sobre los niveles y los tipos de bacteria en
su products.4 el ajuste de un nmero mnimo de microorganismos viables en un alimento
para asegurar que los efectos de probiotic son una decisin importante.
El Fermentado Chupa y la Asociacin de Bebidas de Bacteria de cido lctico en Japn ha
puesto un mnimo de 107 bifidobacteria/g u Otros ml.10 han sugerido un nivel inferior
(105) .5 resultados Recientes indicaran que cambios metablicos pueden ser observados en
tales niveles de entrada 11 microbiana Sin embargo, pruebas experimentales en las cuales
varios niveles de bacteria fueron alimentados y nmeros viables contados despus de que el
paso por el estmago indicara que productos probiotic deberan entregar an ms alto (>
1010 a 1011) los niveles de microorganismos para sobrevivir las condiciones de la
extensin 12 de soldado Esta conclusin es apoyada por in vitro
13,14 Esta amplia diversidad de opinin puede reflejar slo las diferencias de la capacidad
de bacteria diferente de sobrevivir el paso por el estmago. Poner un nivel para toda la
bacteria puede ser poco realista, porque los nmeros de bacteria requerida para producir un
cierto cambio metablico variarn dependiendo(segn) el efecto para ser alcanzado.
Slo la bacteria que puede sobrevivir el paso por el estmago y puede colonizar los
intestinos ejercer cualquier efecto sobre el anfitrin. Pedrosa el ms claramente mostr
esto y colleagues.15 En personas sanas ancianas al yogur alimentado que contiene

Lactobacillus bulgaricus y Streptococcus thermophilus a cambios de tres actividades de

enzima bacteriales. Cuando sano sujeta fueron alimentados la Libra viva. gasseri (Libra.
acidophilus estiran(filtran) a SRA. 02), una tensin humana capaz de adhesin a clulas
intestinales, el organismo fue encontrado en todo sujeta y todos considerablemente
redujeron(obligaron) las actividades de -glucuronidase, nitroreductase, y azoreductase.
Este estudio acenta la necesidad de medir tanto destino de la bacteria ingerida como
efectos metablicos para asegurar la interpretacin apropiada de resultados. Esto es en
particular verdadero cuando ninguna respuesta metablica es observada.
Varios informes han incluido las listas de bacteria que puede ser considerada como
candidatos por la inclusin en productos probiotic (la Mesa 25.3). La premisa entera de un
alimento funcional es que cierto los productos de alimentacin comnmente comidos
contienen los ingredientes activos que pueden luchar o prevenir la enfermedad y la
infeccin. Con avances
en tcnicas analticas la identificacin de nuevos ingredientes activos ocurre cada da. Para
probiotics, sin embargo, la identidad del ingrediente activo no puede ser como francamente,
porque hay siempre ms que una posibilidad. El agente activo podra ser uno o varios de los
microorganismos vivos en el alimento, o esto podra ser un metabolite producido por uno
de los microorganismos, o esto podra ser un producto de fermentacin que ha sido
formado debido a la accin del microorganismo (s) sobre el producto original. De verdad,
dependiendo(segn) el probiotic en cuestin cada uno de los susodichos argumentos haba
sido usado explicar los efectos beneficiosos del probiotic.