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Prebiotics and probiotics: are they functional foods?

A probiotic is a viable microbial dietary supplement that beneficially affects the host through its effects in the intestinal tract. Probiotics are widely used to prepare fermented dairy products such as yogurt or freeze-dried cultures. In the future, they may also be found in fermented vegetables and meats. Several health-related effects associated with the intake of probiotics, including alleviation of lactose intolerance and immune enhancement, have been reported in human studies. Some evidence suggests a role for probiotics in reducing the risk of rotavirus-induced diarrhea and colon cancer. Prebiotics are nondigestible food ingredients that benefit the host by selectively stimulating the growth or activity of one or a limited number of bacteria in the colon. Work with prebiotics has been limited, and only studies involving the inulin-type fructans have generated sufficient data for thorough evaluation regarding their possible use as functional food ingredients. At present, claims about reduction of disease risk are only tentative and further research is needed. Among the claims are constipation relief, suppression of diarrhea, and reduction of the risks of osteoporosis, atherosclerotic cardiovascular disease associated with dyslipidemia and insulin resistance, obesity, and possibly type 2 diabetes. The combination of probiotics and prebiotics in a synbiotic has not been studied. This combination might improve the survival of the bacteria crossing the upper part of the gastrointestinal tract, thereby enhancing their effects in the large bowel. In addition, their effects might be additive or even synergistic.

Bifidobacterium↗

Functional foods and paediatric gastro-intestinal health and disease.

The application of molecular methods to gastro-intestinal diseases is giving insight into the way in which the resident intestinal microbiota interacts with the mucosal immune system. Using traditional culture techniques, the importance of mucosally-associated bacterial biofilms in maintaining mucosal integrity has been demonstrated in ways previously impossible. Changes in the balance of organisms at initiation of and during disease provide a rationale for interventions with functional foods which facilitate re-establishment of the homeostasis of healthy gut.

Bacteria↗

Depression of the glycemic index by high levels of beta-glucan fiber in two functional foods tested in type 2 diabetes.

OBJECTIVES: To determine the extent to which beta-glucan reduces the glycemic index (GI) of oat products and whether high levels of beta-glucan impair palatability. DESIGN: The study design was an open-label, randomized cross-over study with six treatment segments. SETTING: Free-living outpatients. SUBJECTS: Sixteen volunteers with type 2 diabetes (10 men, six women, 61+/-2 y, body mass index 29+/-2 kg/m(2), HbA1c 7.4+/-0.4%) were recruited from the St Michael's Hospital diabetes clinic. INTERVENTIONS: Volunteers were given, in random order, 50 g available carbohydrate portions of: white bread; a commercial oat bran breakfast cereal (4.4 g% beta-glucan); and a prototype beta-glucan-enriched breakfast cereal and bar, both high in beta-glucan (8.1 and 6.5 g% beta-glucan, respectively) and sweetened with fructose. Capillary blood samples were taken fasting and then 30, 60, 90, 120, 150 and 180 min after the start of the meal. Palatability was recorded using two different methods. RESULTS: The glycemic indices of the prototype beta-glucan cereal (mean+/-s.e.m.; 52+/-5) and beta-glucan bar (43+/-4.1) were significantly lower than the commercial oat bran breakfast cereal (86+/-6) and white bread (100; P<0.05). All foods were highly palatable and not significantly different. It was found that the GI of the test foods used in this study decreased by 4.0+/-0.2 units per gram of beta-glucan compared to our estimate of 3.8+/-0.6 for studies reported in the literature. CONCLUSION: Addition of beta-glucan predictably reduces the GI while maintaining palatability. In a 50 g carbohydrate portion each gram of beta-glucan reduces the GI by 4 units, making it a useful functional food component for reducing postprandial glycemia. SPONSORSHIP: Nestec, Switzerland.

Aged↗

Bioactive isoflavones in functional foods: the importance of gut microflora on bioavailability.

Isoflavones present in soy may have risk and benefits to human health. Human gut microflora have been shown to exert metabolic activities on isoflavones, which influences bioavailability and bioactivity. Absorption of isoflavones is likely to occur in the small intestine where there is a diverse range of microfloral species able to hydrolyze conjugated isoflavones, releasing the bioactive aglycone for absorption or further metabolism and reconjugation. The identification of gut microbes that metabolize isoflavone aglycones is not well established. Such information may lead to a better understanding of the bioavailability of isoflavones in functional foods.

Biological Availability↗

Chemical composition and potential health effects of prunes: a functional food?

Prunes are dried plums, fruits of Prunus domestica L., cultivated and propagated since ancient times. Most dried prunes are produced from cultivar d'Agen, especially in California and France, where the cultivar originated. After harvest, prune-making plums are dehydrated in hot air at 85 to 90 degrees C for 18 h, then further processed into prune juice, puree, or other prune products. This extensive literature review summarizes the current knowledge of chemical composition of prunes and their biological effects on human health. Because of their sweet flavor and well-known mild laxative effect, prunes are considered to be an epitome of functional foods, but the understanding of their mode of action is still unclear. Dried prunes contain approximately 6.1 g of dietary fiber per 100 g, while prune juice is devoid of fiber due to filtration before bottling. The laxative action of both prune and prune juice could be explained by their high sorbitol content (14.7 and 6.1 g/100 g, respectively). Prunes are good source of energy in the form of simple sugars, but do not mediate a rapid rise in blood sugar concentration, possibly because of high fiber, fructose, and sorbitol content. Prunes contain large amounts of phenolic compounds (184 mg/100 g), mainly as neochlorogenic and chlorogenic acids, which may aid in the laxative action and delay glucose absorption. Phenolic compounds in prunes had been found to inhibit human LDL oxidation in vitro, and thus might serve as preventive agents against chronic diseases, such as heart disease and cancer. Additionally, high potassium content of prunes (745 mg/100 g) might be beneficial for cardiovascular health. Dried prunes are an important source of boron, which is postulated to play a role in prevention of osteoporosis. A serving of prunes (100 g) fulfills the daily requirement for boron (2 to 3 mg). More research is needed to assess the levels of carotenoids and other phytochemicals present in prunes to ensure correct labeling and accuracy of food composition tables in order to support dietary recommendations or health claims.

Boron↗

DNA chip analysis of comprehensive food function: inhibition of angiogenesis and telomerase activity with unsaturated vitamin E, tocotrienol.

Inhibition of angiogenesis and telomerase activity with vitamin E compounds, especially for tocotrienol (T3), has been investigated. Nutrigenomic tools have been used for elucidating the bioactive mechanisms of T3. In the cell culture experiments, T3 reduced the vascular endothelial growth factor (VEGF)-stimulated tube formation by human umbilical vein endothelial cells (HUVEC). Among T3 isomers, delta-T3 appeared the highest activity. The T3 inhibited the new blood vessels formation on the growing chick embryo chorioallantoic membrane (CAM assay for an in vivo model of angiogenesis). In contrast, tocopherol did not. The findings suggested that the T3 has potential use for reducing angiogenic disorder. DNA chip analysis revealed that T3 specifically down-regulates the expression of VEGF receptor (VEGFR) in endothelial cells. It is well-known that VEGF regulates angiogenesis by binding to VEGFR. Therefore, T3 could block the intracellular signaling of VEGF via down-regulation of VEGFR, which resulted in the inhibition of angiogenesis. On the other hand, DNA chip analysis also revealed that T3 down-regulates the expression of protein kinase C (PKC) in the cultured HUVEC. Since PKC is involved with the control of telomerase activity, T3 has potential to act as anti-telomerase inhibitor via PKC inhibition. In this manner, DNA chip technology provides efficient access to genetic information regarding food function and its mechanism.

Allantois↗

Probiotics as functional food in the treatment of diarrhea.

PURPOSE OF REVIEW: A disturbance in microbial balance of the gastrointestinal tract is often associated with diarrhea. Therefore, probiotics, as beneficial microorganisms for host health, have attracted clinical attention for their potential therapeutic application in the treatment of diarrhea. This review focuses on new research findings relevant to the effects of probiotics on diarrhea prevention and treatment and potential mechanisms of action for this alternative therapy for diarrhea. RECENT FINDINGS: Clinical trials suggest potential beneficial effects of probiotic therapy for preventing and treating antibiotic-associated diarrhea, acute diarrhea including rotavirus-induced diarrhea, traveler's diarrhea, and diarrhea-predominant irritable bowel syndrome. The most extensively studied probiotics for diarrhea are Lactobacillus, Bifidobacterium and Saccharomyces, with potential mechanisms of therapeutic action based on the protection of intestinal epithelial cell and barrier function, prevention of enterotoxin binding to intestinal epithelial cells, and regulation of intestinal microbial environment. SUMMARY: Growing evidence suggests that probiotics may serve as a functional food in the treatment of diarrhea. Remaining challenges include identifying mechanisms of action to provide the basis of more refined hypothesis-driven clinical trials. The correct combination and concentration of probiotics applied to the appropriate gastrointestinal disorders may improve the efficacy of this approach for diarrhea and other diseases.

Bifidobacterium↗

Functional food science and substrate metabolism.

The present review addresses the role of food constituents in the aetiology of metabolic conditions and chronic diseases, mostly related to energy metabolism and substrate regulation, such as obesity and non-insulin-dependent diabetes mellitus. Second, attention is paid to malnutrition, a major cause of mortality and morbidity in developing countries, which may be a cause of concern in Europe because of the increasing number of elderly people in the population. Finally, the role of diet during exercise, a condition of enormous substrate demands, is evaluated. Based on a critical evaluation of the existing knowledge in the literature, implications for future research in relation to functional foods are discussed.

Adolescent↗

Gastrointestinal tract and the elderly: functional foods, gut microflora and healthy ageing.

Advances in science and medicine as well as improved living standards have led to a steady increase in life expectancy. Yet ageing is associated with increased susceptibility to degenerative or infectious diseases, which may be exacerbated by a poor nutritional status. The intestinal microflora will mediate crucial events towards the protection or degradation of health. It is hence essential and timely that strategies of preventive nutrition aimed at maintaining or improving the quality of life of the ageing population be developed. "CROWNALIFE" is a newly funded EuropeanUnion project, so called because of its emphasis on the preservation of the period of independence of the elderly, recognised as the "crown of life". The project aims at assessing age-related alterations and exploring strategies to restore and maintain a balanced healthy intestinal environment. Current knowledge on the composition and function of the human intestinal microflora is still improving with the use of better methodologies and yet their evolution with ageing has not been investigated in detail. There have been a few reports that putatively protective lactic acid bacteria, in general, and bifidobacteria, in particular, seem less represented in the elderly faecal flora. We have also observed an increase in species diversity of the dominant faecal microflora with ageing. This certainly warrants confirmation and is being addressed by the investigation of age-related changes in the structure and function of the intestinal flora of the elderly in countries across Europe. Ensuing results will constitute a baseline for functional-food based strategies aimed at providing health benefits for the elderly.

Adolescent↗

A functional food product for the management of weight.

More than half of Americans have a body mass index of 25 kg/m2 or more, which classifies them as overweight or obese. Overweight or obesity is strongly associated with comorbidities such as type 2 diabetes mellitus, hypertension, heart disease, gall bladder disease, and sleep apnea. Clearly, this is a national health concern, and although about 30 to 40% of the obese claim that they are trying to lose weight or maintain weight after weight loss, current therapies appear to have little effect. None of the current popular diets are working, and there is room for innovation. With the advancing science of nutrition, several nutrients - low-glycemic-index carbohydrates, 5-hydroxytryptophan, green tea extract, and chromium - have been identified that may promote weight loss. The first two nutrients decrease appetite, green tea increases the 24-h energy expenditure, and chromium promotes the composition of the weight lost to be fat rather than lean tissue. These have been assembled in efficacious doses into a new functional food product and described in this review. The product is undergoing clinical testing; each component has already been shown to promote weight loss in clinical trials.

5-Hydroxytryptophan↗

Isoflavones and functional foods alter the dominant intestinal microbiota in postmenopausal women.

Dietary phytoestrogens, such as isoflavones, are used as food additives to prevent menopause-related disorders. In addition to other factors, their bioavailability strongly depends on the activity of intestinal bacteria but the underlying interactions remain poorly understood. A randomized, double-blind, placebo-controlled study was undertaken with 39 postmenopausal women to characterize changes in the dominant microbial communities of the intestinal tract after 2 mo of isoflavone supplementation with and without pro- or prebiotic. The diversity and composition of the dominant microbiota were analyzed by temporal temperature-gradient gel electrophoresis (TTGE) and fluorescent in situ hybridization. Isoflavones alone stimulated dominant microorganisms of the Clostridium coccoides-Eubacterium rectale cluster, Lactobacillus-Enterococcus group, Faecalibacterium prausnitzii subgroup, and Bifidobacterium genus. The stimulation of the Clostridium coccoides-Eubacterium rectale cluster depended on the women's equol excretion and was transient, with the exception of a prolonged bifidogenic effect. Lasting changes in the diversity of the dominant species were also observed. The probiotic strain supplied could be detected by TTGE during its passage through the intestinal tract, and ingestion of fructooligosaccharides triggered a marked and specific bifidogenic effect. In conclusion, this is the first human study that shows changes in the diversity and composition of dominant bacterial communities in response to dietary supplementation with hormone-related compounds combined with functional foods.

Aged↗

Inventing probiotic functional foods for patients with allergic disease.

OBJECTIVE: The primary objective of this review is to discuss the rationale for and applicability of probiotics as part of the nutritional approach to the prevention and management of allergic disease. DATA SOURCES: This review represents a synthesis of recent literature published in the fields of probiotics, nutrition, and allergic disease. STUDY SELECTION: The expert opinions of the authors were used to select the relevant data for the review. RESULTS: The hygiene hypothesis suggests that allergic disease may arise from a lack of counterbalancing microbial exposure at an early age. Thus, the initial compositional development of gut microbiota is considered a key determinant in the development of both the immune responder phenotype and the normal gut barrier functions. A wide range of data documents the specific actions of selected probiotics. The regulatory role of probiotics in allergic disease has been demonstrated as improving the clinical course or preventing the development of atopic eczema in infants given a probiotic-supplemented diet. In addition, certain types of fatty acids and antioxidants have been proposed for protective effects against the development of allergy and to diminish the inflammatory response in allergic disease. CONCLUSIONS: The increase in the prevalence of allergic disease during the past decades is likely to be explained by changes in the environment, including reduced microbial exposure and altered food consumption. Scientifically composed functional foods containing probiotics and other functional components offer a nutritional strategy for both the prevention and the management of allergic disease. Further research is needed to characterize the gut microbiota and to clarify the mechanisms of action that control specific physiologic processes not only in the evolution of allergic disease in at-risk populations but also in the management of allergic diseases.

Complementary Therapies↗

Growth, development and differentiation: a functional food science approach.

Few other aspects of food supply and metabolism are of greater biological importance than the feeding of mothers during pregnancy and lactation, and of their infants and young children. Nutritional factors during early development not only have short-term effects on growth, body composition and body functions but also exert long-term effects on health, disease and mortality risks in adulthood, as well as development of neural functions and behaviour, a phenomenon called 'metabolic programming'. The interaction of nutrients and gene expression may form the basis of many of these programming effects and needs to be investigated in more detail. The relation between availability of food ingredients and cell and tissue differentiation and its possible uses for promoting health and development requires further exploration. The course of pregnancy, childbirth and lactation as well as human milk composition and the short- and long-term outcome of the child are influenced by the intake of foods and particularly micronutrients, e.g. polyunsaturated fatty acids, Fe, Zn and I. Folic acid supplementation from before conception through the first weeks of pregnancy can markedly reduce the occurrence of severe embryonic malformations; other potential benefits of modulating nutrient supply on maternal and child health should be further evaluated. The evaluation of dietary effects on child growth requires epidemiological and field studies as well as evaluation of specific cell and tissue growth. Novel substrates, growth factors and conditionally essential nutrients (e.g. growth factors, amino acids, polyunsaturated fatty acids) may be potentially useful as ingredients in functional foods and need to be assessed carefully. Intestinal growth, maturation, and adaptation as well as long-term function may be influenced by food ingredients such as oligosaccharides, gangliosides, high-molecular-mass glycoproteins, bile salt-activated lipase, pre- and probiotics. There are indications for some beneficial effects of functional foods on the developing immune response, for example induced by antioxidant vitamins, trace elements, fatty acids, arginine, nucleotides, and altered antigen contents in infant foods. Peak bone mass at the end of adolescence can be increased by dietary means, which is expected to be of long-term importance for the prevention of osteoporosis at older ages. Future studies should be directed to the combined effects of Ca and other constituents of growing bone, such as P, Mg and Zn, as well as vitamins D and K, and the trace elements F and B. Pregnancy and the first postnatal months are critical time periods for the growth and development of the human nervous system, processes for which adequate substrate supplies are essential. Early diet seems to have long-term effects on sensory and cognitive abilities as well as behaviour. The potential beneficial effects of a balanced supply of nutrients such as I, Fe, Zn and polyunsaturated fatty acids should be further evaluated. Possible long-term effects of early exposure to tastes and flavours on later food choice preferences may have a major impact on public health and need to be further elucidated. The use of biotechnology and recombinant techniques may offer the opportunity to include various bioactive substances in special dietary products, such as human milk proteins, peptides, growth factors, which may have beneficial physiological effects, particularly in infancy and early childhood.

Adolescent↗

Functional foods and food supplements for athletes: from myths to benefit claims substantiation through the study of selected biomarkers.

The development of the sports food market and industrial involvement have led to numerous nutritional studies to define the type of nutrients that are most suited to support energy metabolism, fluid balance and muscle function. The key question in many of these studies was: 'Does the product lead to a significant product/consumer benefit that can be used as a claim on the package?' New methods and techniques have been developed, partly with sponsorship of the food industry, with the goal of measuring the effects of specific nutrients and supplements on athletic performance and metabolism. In line with this development, a wide variety of supplements and sports foods/drinks labelled with various performance or health benefit statements have been launched on the sports nutrition market. Although a variety of products have been tested clinically, there are also many products on the market with benefit claims that cannot be supported by sound nutritional and sports physiological science. The current short review highlights some of the methods and biomarkers that are used to substantiate product/consumer benefit claims for foods and drinks that are marketed as functional foods for athletes.

Biomarkers↗

Effect of formulation and manufacturing parameters on process cheese food functionality--I. Trisodium citrate.

The objective of this research was to use a Rapid Visco Analyzer to study the effect of natural cheese age, trisodium citrate (TSC) concentration, and mixing speed on process cheese food (PCF) functionality. In this study 3 replicates of natural cheese were manufactured, and a portion of each cheese was subjected to 6 different PCF manufacturing treatments at 2, 4, 6, 12, and 18 wk of ripening. These treatments were factorial combinations of 3 levels of TSC (i.e., 2.0, 2.5, and 3.0%) and 2 mixing speeds during manufacture (450 and 1,050 rpm). Functional properties of the PCF evaluated included manufacturing properties [apparent viscosity after manufacture (VAM)], unmelted textural properties (firmness), melted cheese flow properties [hot apparent viscosity (HAV)], and cheese thickening during cooling [time at 5000 cP (T5)]. All 4 parameters (VAM, firmness, HAV, and T5) were significantly affected by natural cheese age and mixing speed, whereas VAM, HAV, and T5 were also significantly influenced by the amount of TSC. The VAM and firmness decreased as cheese age increased, whereas T5 values increased as cheese age increased. Similarly, VAM, HAV, and firmness values increased because of the increased mixing speed, whereas T5 values decreased. The age x mixing speed interaction was significant for VAM and firmness. The age x concentration of the TSC interaction term was significant for VAM, whereas the age x age x TSC concentration term was significant for HAV. The results demonstrate that natural cheese age, mixing speed during manufacture, and concentration of TSC have a significant impact on process cheese functionality.

Caseins↗

Effect of functional food ingredients: vitamin E modulation of cardiovascular diseases and immune status in the elderly.

Increased accumulation of free radicals over time reduces the effectiveness of antioxidant defense mechanisms and heightens the vulnerability of older individuals to a variety of oxidative insults and associated pathologic conditions. Both nutritive and nonnutritive components of foods may slow declines in certain body functions. Ingestion of vitamin E, an antioxidant nutrient, in amounts above current recommendations may reduce the risk of cardiovascular disease, enhance immune status, and otherwise modulate important degenerative conditions associated with aging. Early adoption of proper dietary habits helps adults to maintain quality of life as they age. Increased intake of vitamin E through selection of foods with large amounts of that vitamin and daily consumption of 5-8 servings of fruit and vegetables may reduce risk for cardiovascular disease and improve immune function in later life.

Adult↗

Exercise, oxidative stress and risk of cardiovascular disease in the elderly. Protective role of antioxidant functional foods.

Free radicals and oxidative stress are involved in the pathogenic mechanisms of cardiovascular disease (CVD), diabetes and cancer. Exercise is a useful strategy for preventing CVD but in elderly persons it can enhance oxidative stress, which is why some studies recommend antioxidant supplementation for exercising elderly subjects. This intervention study was performed on 320 elderly subjects following a Geriatric Revitalization Program (GEREPRO) to maintain physical health and reduce CVD risk. GEREPRO was based on regular exercise concurrent with a nutritional antioxidant treatment based on daily intake of a functional antioxidant food, Biofrutas. Sustained exercise (10 months, 3 sessions/week) significantly increased cardiorespiratory fitness and plasma HDL-cholesterol; it reduced some predictors of cardiovascular risk (arterial pressure, LDL-cholesterol, total cholesterol/LDL-C, LDL-C/HDL-C), but significantly enhanced some biomarkers of oxidative stress. Concurrent antioxidant supplementation did not produce any ergogenic effects but, meaningfully, enhanced some positive effects of exercise on physical health and the CDV risk index, and it totally prevented the exercise-induced oxidative stress. Our results show that regular and moderate exercise improves cardiorespiratory function and reduces CVD risk in elderly people, while concurrent antioxidant supplementation modulates oxidative insult during exercise in the elderly and enhances the beneficial effects of exercise.

Aged↗

Dietary supplements and functional foods: 2 sides of a coin?

Dietary supplements are used by more than one-half of the adult US population. In contrast to pharmaceuticals, dietary supplements may be sold in the United States with little regulation other than listing of ingredients and the potential health benefits. By contrast, herbal products in Germany are carefully regulated by the same standards as drugs, and efforts are under way to standardize their regulation in the entire European Union. Most herbal users do not inform their physicians that they are taking these supplements, and most physicians do not inquire. Although some herbal products have clinically proven benefits, it is increasingly apparent that many contain potentially toxic substances, particularly in relation to interactions with drugs. Hence, it is essential that practicing physicians develop a working knowledge of herbals-specifically, about claims for their usage and potential or proven efficacies and toxicities-and that they incorporate such knowledge into the evaluation and management of their patients. By contrast, functional foods-integral components of the diet that are understood to contribute added health benefits-are the subject of intense and widespread research in food and nutritional science. Examples include many polyphenolic substances, carotenoids, soy isoflavones, fish oils, and components of nuts that possess antioxidant and other properties that decrease the risk of vascular diseases and cancer. Practicing physicians are advised to stay abreast of these emerging findings in order to best advise their patients on the value of health-promoting diets in disease prevention.

Carotenoids↗