Probiotics & Prebiotics

Doctors, nutritionists, dieticians promote probiotics and prebiotics in your everyday diet and even prescribe pills that contain these. I have often seen doctors prescribe such pills along with an antibiotic so that the good bacteria grows and out competes the bad ones in the gut. Recently, an ENT doctor prescribed a probiotic pill for my daughter for helping her with her allergies. The probiotic pill was far costlier than a regular pill and the label contained lactic acid bacteria (LAB) as the main ingredient.

Our body (mouth to anus) is home to more than thousands of species of bacteria that is called microbiome. This develops over time and various with every individual. From time immemorial, probiotics and prebiotics have been part of our diet contributing to this microbiome. May it be our morning idlis, dosas, ragi or millet koozhu or a afternoon meal with curd rice, curd based drinks like lassi, or fermented pickles, we eat probiotic rich food. Ethnic cuisine that includes fermented foods like kemchi, kefir, miso, kombucha, tempeh are other examples rich in probiotics. Garlic, leek, onion, artichokes, chicory root used in coffee blends are well known prebiotics. A famous brand by the name Yakult has been providing a probiotic drink for many years. And as mentioned above, the nutraceutical industry has been providing them in the form of tablets, capsules, and liquid suspensions.

Probiotics are non-pathogenic live microorganisms belonging to the Lactobacillus and Bifidobacterium genera that help in bringing about a balance of intestinal microflora. This balance is disrupted by various factors such as ingestion of antibiotics, environmental factors, stress, surgery and irradiation treatments that increase the numbers of pathogenic microorganisms in the intestine. Apart from this, ingestion of probiotics lowers blood ammonia, stimulates the immune response, reduces the risk of infectious and inflammatory diseases, eases bloating and flatulence symptoms.  It is proven science that Probiotic Dietary Therapy supports treatment of illness associated with gastrointestinal tract like irritable bowel syndrome (IBS), pouchitis, Crohn’s disease, ulcerative colitis (UC), Helicobacter pylori infections (2, 3, 4).

Prebiotics are dietary components that are non-digestible and reaches the colon intact so that they can be selectively fermented by the indigenous beneficial bacteria. The fermentation of these substrates induces systemic effects in the host and can specifically modulate the growth of health-promoting bacteria. Some of the proven potential prebiotics which is non-digestible and completely fermentable are inulin, oligofructose, lactulose and galactooligosaccharides. Many kinds of cereal, fruits and vegetables contain prebiotics naturally in them. For example, inulin is present in Chicory root that is typically used in coffee blends in South India. Fructo-oligosaccarides (FOS) is a common sugar replacer in packaged food. However, there are limitations of their use due to flatulence and low bio-availability (5, 6).

The recommended dosages of probiotics and prebiotics varies by strain and are treatment specific. It is important to understand their efficacy, resistance to acidic conditions of the stomach and colonization in the human intestine while we design foods or delivery systems. For example, to claim probiotic for a yogurt, regulations require the presence of active and live cultures of probiotic strains at 10-100 million cells/ml or gram of product. Also, to claim on a specific health benefit, results of bio-availability studies in vitro (lab) or in vivo (mice models) and clinical studies are required. Encapsulation of the compounds using a micro or nano emulsion helps in food design, delivery and effectiveness at lower dosages  (7, 8).

As a consumer, one could consume probiotics in the form of traditional fermented food and prebiotics in form of vegetables, fruits, whole grains and fibre sources on regular basis to boost immunity and enhance health, especially during Covid times. However if one is seeking immediate and targeted benefits, one could consult experts for specific diets, supplements and therapies using probiotics and prebiotics.

If one wants to manufacture or market packaged food claiming probiotic or prebiotic benefits in India, one will have to follow FSSAI’s new standards for “Foods for special dietary use” as given in https://fssai.gov.in/upload/uploadfiles/files/Nutraceuticals_Regulations.pdf . In this regulation, the specific probiotic strains along with dosages and ingredients specified for prebiotic are given.

REFERENCES

[1]         Y. Rivera-Espinoza and Y. Gallardo-Navarro, “Non-dairy probiotic products,” Food Microbiol., vol. 27, no. 1, pp. 1–11, 2010, doi: 10.1016/j.fm.2008.06.008.

[2]         E. Isolauri, “6 Manipulation of the gut microbiota: probiotics,” Best Pract. Res. Clin. Gastroenterol., vol. 18, no. 2, pp. 1–15, 2004, doi: 10.1053/ybega.2004.443.

[3]         N. T. Williams, “Probiotics,” Am. J. Heal. Pharm., vol. 67, no. 6, pp. 449–458, 2010, doi: 10.2146/ajhp090168.

[4]         R. George Kerry, J. K. Patra, S. Gouda, Y. Park, H. S. Shin, and G. Das, “Benefaction of probiotics for human health: A review,” J. Food Drug Anal., vol. 26, no. 3, pp. 927–939, 2018, doi: 10.1016/j.jfda.2018.01.002.

[5]         P. S. Panesar and V. Bali, “Prebiotics,” Encycl. Food Heal., vol. 18, no. 2, pp. 464–471, 2015, doi: 10.1016/B978-0-12-384947-2.00560-2.

[6]         M. Roberfroid, “Prebiotics: The concept revisited,” J. Nutr., vol. 137, no. 3, 2007, doi: 10.1093/jn/137.3.830s.

[7]         D. Granato, G. F. Branco, F. Nazzaro, A. G. Cruz, and J. A. F. Faria, “Functional foods and nondairy probiotic food development: Trends, concepts, and products,” Compr. Rev. Food Sci. Food Saf., vol. 9, no. 3, pp. 292–302, 2010, doi: 10.1111/j.1541-4337.2010.00110.x.

[8]         F. C. Prado, J. L. Parada, A. Pandey, and C. R. Soccol, “Trends in non-dairy probiotic beverages,” Food Res. Int., vol. 41, no. 2, pp. 111–123, 2008, doi: 10.1016/j.foodres.2007.10.010.

Co-Author: Anupriya Senthilkumaran, a final year BTech Food Tech student from Anna University with a passion for food science and writing.