Funcnutrition

   Presently, the concepts of pre- and probiotics are supplemented with that of the functional nutrition.

   The term “functional nutrition” was proposed by the Japanese authors in 1989. It implies the systematic consumption of the food products of natural origin, which produce the regulating effect on the human organism. The nutrition may be referred to as “functional”, if its products   exert a positive effect on one or more functions of the body. In this case the functional nutrition, along with the common nutritive effect, results in improvement of the state of health or in reduction of the risk of various diseases. There is no escaping the impression that  the concept “functional nutrition” combines the rational use of pre- and probiotics, though many aspects of its realization remain unsettled.  

The functional nutrition is to perform three basic functions:
[B.A. Shenderov (1991)]
-  nutritive function - the product acts on the human nutritive status;
-  sensory function – ability of the product and its ingredients to make  a positive effect on the human smell, taste and other sensors;
-  regulating function – involvement in regulation of the digestion process and immune,  endocrine,  nervous functions, etc.

   In the opinion of foreign researchers (K. Bzoek (1999), A. Woolen (1990), the basic components of functional nutrition include the products containing:  
-  bifidus bacteria;
-  oligosaccharides;
-  dietary fibers;
-  eicosapentaenoic acid;
-  amino acids, peptides;
-  cholines;
-  vitamins.

   According to the domestic scientists the functional nutrition products should include lactic bacteria, antioxidants, organic acids, etc.

The functional nutrition:

   Thus, the prebiotics, probiotics and synbiotics belong to the components of functional nutrition.

   Bifidogenic factors, which stimulate the growth of intrinsic intestinal microflora, are abundant in quantity.

   The factors influencing the gastrointestinal tract functions [B.A. Shenderov (1991)]

Group

Composition

Antioxidants

vitamins  А, С, Е, beta-carotene, glutathione, ubiquinone, selenium  

Unsaturated fatty acids

eicosapentaenoic acid

Organic acids

propionic, acetic acids, etc.

Oligosaccharides

soya bean, fruсtooligosaccharide, galactooligosaccharide, xylo-oligosaccharide, gentioligosaccharide

Monosaccharides

xylite, sorbite, xylobiose

Polysaccharides

pectins, dextrin, inulin

Peptides

soya, milk peptides, etc.

Ferments

b-galactosidases of microbial origin, saccharomycete proteases, etc.

Plant and microbial extracts

carrot, potato, corn-steep, rice, pumpkin, garlic, yeast extracts

Other

dietary fibers, lethicin, lactoferrin, para-amino benzoic acid


   The dietary fiber is the basic component of prebiotic constituent of the functional nutrition.  The originator of “the adequate nutrition” theory Academician A.M. Ugolev wrote that “the dietary fibers have been evolutionarily incorporated into the gastrointestinal  technological process, they are required for normal functioning of the digestive system and organism as a whole.  These substances form the basis of the gastrointestinal tract production at the expense of microflora of several groups of the most essential vitamins,  indispensable amino acids, some physiologically active hormone-like substances...”. 

   The dietary fibers are the sum of polysaccharides and lignin not digested by the endogenous secretion of human gastrointestinal tract [H. Trowell, D. Burkitt (1987)]. One of the most essential effects produced by the dietary fibers is the improvement of the body digestive function and formation of the healthy intestinal microflora. The dietary fibers are differentiated according to their properties.

Dietary fibers

Soluble

Insoluble

Mixed type

Synthesized

Pectins
Gums
Oligosaccharides
Inulin

Cellulose
Lignin

Bran

Lactulose


Dietary fiber content in the food products

Carrot, turnip, pumpkin, melon, sweet pepper, radish, prune, orange, red cowberry,  legume,  buckwheat, barley groats, Gerkules oats, rye bread

1 – 1.9 g/100 g of product

Bread of protein-branny flour, cranberry, red and black currant, blackberry, garlic

2-3 g/100 g of product

Dill, dried halved apricots, garden strawberry, raspberry, 3 g/100 g of product, black tea

4.5 g/100 g of product

Oat flour

7.7 g/100 g of product

Wheat bran

8.2 g/100 g of product

Oat bran

14 g/100 g of product

Dried briar berries

10 g/100 g of product


Prebiotics and their sources

Prebiotics

Sources

Galactooligosaccharides (GOS)

Breast milk, dairy products

Fructooligosaccharides (FOS)

Breast milk, oats, wheat, artichoke, banana, kurrat, chicory

Inulin

Artichoke and dandelion tubers

Lactulose

Unnatural, artificially  synthesized


   Oligosaccharides incorporate carbohydrates composed of monosaccharides linked by the glycoside  bonds.  The first oligosaccharide was obtained by  Yakult Honsa (Japan) in the process of milk treatment with beta-galactosidase, which was produced from Aspergillus  fungus. These days the obtained oligosaccharides are abundant. However, only fructo- and galactooligosaccharides (FOS and GOS) exhibit the proved prebiotic effect on children.

The end products of oligosaccharide fermentation include:

Physiological functions of the short chain fatty acids:

Inulin  is also a natural prebiotic suitable for enrichment of the food products. Fructose is a product of its hydrolysis.

Inulin properties (Van Loo, 1999):

 

   In view of the physiological qualities of inulin, its use for the food product enrichment is recommended to prevent phosphorus-calcium metabolism disorders of infants and teenagers as well as atherosclerosis and pancreatic diabetes.

   Lactulose is a synthetic prebiotic. Since the narrow intestine lacks disaccharidase required for its hydrolysis, lactulose enters the large intestine practically unchanged. Here it undergoes the bacterial disaccharidase hydrolytic splitting into monosaccharides and short chain fatty acids. 


Under the action of lactulose:
 

Vegetables and herbs inhibiting growth of the opportunistic pathogenic microflora  

Product

Inhibited microorganisms

Carrot

salmonella, clostridia

Onion

escherichia

Black radish

Proteus, klebsiella, Pseudomonas aeruginosa

Hot pepper

Proteus, klebsiella, fungi

Garlic

Proteus, klebsiella

Horse radish

Proteus, klebsiella, Pseudomonas aeruginosa

Dill

Proteus, klebsiella

Caraway

Proteus, klebsiella

Clove

escherichia, Proteus, klebsiella, fungi, Pseudomonas aeruginosa


Fruits and berries  inhibiting growth of the opportunistic pathogenic microflora 

Product

Inhibited microorganisms

Raspberry

Staphylococcus, streptococcus, shigella, enterococcus

Barberry

Staphylococcus, streptococcus, shigella, enterococcus

Blueberry

Staphylococcus, Proteus, klebsiella, enterococcus, shigella

Briar berry

Staphylococcus, escherichia

Cowberry

Fungi

Apricot

Proteus, klebsiella, Pseudomonas aeruginosa, staphylococcus

Pomegranate

Shigella, escherichia

Dogberry

Shigella, salmonella

Cranberry

Proteus, klebsiella, shigella, salmonella


PROBIOTICS

   Initially the term “probiotic” was proposed by D.M. Lilly and R.H. Stilwell in 1965 as an antonym to the antibiotic to designate the microbial metabolites capable of stimulating the growth of any microorganisms. In 1971 A. Sperti used the same word to denote various tissue extracts producing the stimulation action on microorganisms. Achievements that followed permitted changing the original definition of probiotics. In 1974 R. Parker applied the term “probiotic” to designate the microbic products exhibiting the capability of regulation of the intestinal microbial environment. According to his definition the probiotics are the microorganisms or their components, which are able to maintain the intestinal microflora balance.  Later, R. Fuller used the word “probiotics” to designate any products from live microorganisms, which have beneficial effect for the host organism at the expense of intestinal microflora correction.

 The probiotics are the live microorganisms, which get into the organism in definite quantities with meals and produce the beneficial health effect realized in the gastrointestinal tract. 

 The probiotics shall:


Microorganisms most commonly used in the probiotic products:

Basing on the quantity and quality of the types of used microorganisms,  it is possible to distinguish:
Mechanism of the normal microflora growth stimulation by probiotics  
B.A. Shenderov, 1997.

 

Action of antibiotics on the state of gastrointestinal tract

FERMENTED MILK PRODUCTS

   The fermented milk products popular in treatment of the intestinal disbacteriosis have occupied a prominent place in the human nutrition since ancient times. Mention of the lapper milk is met in the old manuscripts, Bible and other sacred books. Sumeria clay tablets display the scenes of milking, milk processing and milk product making. The written sources dated to the 800s-300s B.C. point to the lapper milk making by inhabitants of the Himalayas, Pamirs and other Asian regions. Two types of the lapper milk popular in Ancient Rome - “Opus Lactorum” and “Oxygala” were described in the biography of Elagabalus, the Roman Emperor from 218 to 222 B.C. The first knowledge of the oldest fermented dairy product on the Earth – the sour mare's milk (kumiss) is derived from the ancient Greek historian Herodotus who mentioned it in his Histories of the Greco-Persian Wars completed in 470 B.C. Nomadic cattlemen noted its benefit  when taken to satisfy thirst or avert general weakness at the digestion disorder. Later it was established that the kumiss is highly efficient in treatment of the lung tuberculosis, dystrophy, anemia. Information about the widely used fermented milk product ayran obtained as a result of lactic-acid and alcohol fermentation was revealed in the ancient manuscripts of the North Caucasian peoples.  The fermented dairy product called “buttermilk” received in the process of butter making has been known in Russia since the 18th century. The healers prescribed buttermilk for treatment of gastrointestinal disorders. Curative qualities of this product are attributed to its low fat content, presence of lecithin and high acidity. Presently the buttermilk is used for manufacturing dietary fermented milk drinks, dietary farmer cheese and soft cheese.

 

   Late in the 19th century the French microbiologist Louis Pasteur speaking at the meeting of French Academy of Medical Sciences assumed that the disease and various microorganisms of the human body are tightly bonded. At the end of the 19th century the great Russian microbiologist I.I. Mechnikov traveling in Bulgaria discovered that yoghurt, which was the routine meal of the Bulgarians, contained the specific bacteria. He identified them as the endemic bacteria of Bulgarian territory - Lactobacillus Bulgaricus and Streptococcus thermophilus. Due to this reason he defined the natural sour milk as the live bacterial culture of beneficial microorganisms, which consumption has a favorable action on the composition and metabolic activity of the intestinal microflora and serves as a prerequisite for longevity.  Research works completed by I.I. Mechnikov revealed that the impact produced on the human body tissues by toxins of the microorganism, which inhibit the skin, mucosae and  alimentary tract, is the cause of many diseases.  These works have become the scientific rationale of the fermented milk product manufacture. In 1908 the Nobel prize winner Russian microbiologist I.I. Mechnikov published his famous article “Prolongation of Life”, in which he popularized the sour milk as the source of good health and long life asserting that “our premature and unhappy senility is a consequence of the permanent intoxication with noxious substances released by some microbes of the large intestine.  It is obvious that decrease of the said microbe quantity permits postponing senility and mitigating its signs.” Early in the 20th century the scientist demonstrated the beneficial effect of lactic bacteria on the human intestinal microflora, lactose uptake and gastrointestinal motility. In 1908 I.I. Mechnikov proposed to use the lapper milk enriched with Lactobacillus bulgaricus for prevention of various diseases and for suppression of the putrefactive microflora of human intestines. Mechnikov assumed that the bacteria of Bulgarian yoghurt have the useful effect on intestinal microflora. At the same time he indicated that L. Bulgaricus discovered by the Bulgarian doctor S. Grigorov in 1905 was a passing microflora of gastrointestinal tract and it should be received by the intestines on a permanent basis. The fermented milk products had been known in Bulgaria 1 000  years  prior to Mechnikov's discovery. The word “yoghurt” was used by the local population residing at the territory of Bulgaria. In Thracian “yoghu” denoted “solid”, “rt” - milk, i. e. the yoghurt means solid milk.

 

   In the 90s the Soviet scientists developed new fermented milk products with protective factors in the form of bifidus bacteria like, for example, Bifilin (fermentation with pure bifidus bacterium culture). The fermented milk products are assigned to the products distinguished by probiotic activity. They exhibit the antimicrobial properties. The long-time experience of using the fermented milk products by those who suffer from the disturbed intestinal biocenosis  proved their high efficiency [I.B. Kuvayeva (1991)]. Better general state, normalization of the digestion processes, improvement of the body immune responsiveness and higher lysozyme level in the biological fluids, growth of the bifidus bacterium level, gradual normalization of the intestinal microflora have been noted.  


Strains of the microorganisms used in manufacturing the fermented milk products and their probiotic action
[K.S. Ladodo (2001), S.G. Gribakin (2003)].

Microorganisms

Probiotic action

Lactobacillus acidophilus
Lactobacillus casei
L. helveticus

proteolytic activity
antimicrobial activity
toxin neutralization
recovery of the intestinal acid-based balance
improvement of lactose uptake
immunomodularity effect

Streptococcus diacetilactis
Streptococcus thermophilus
Pediococcus acidilacti

stabilization of the acid-based balance
lactase activity

Bifidobacterium bifidum
Bifidobacterium breve
Bifidobacterium longus
Bifidobacterium adolescentus

inhibition of the opportunistic pathogenic flora growth
provision of enterocyte integrity
immunomodularity effect
synthesis of group B vitamins, folic acid
fermentative activity (lysozyme, casein-phosphatase)
reduction of the blood urea level
form the source of short fatty acids
reduction of the blood cholesterol level
Kefir fungi
generate lactic acid (stimulation of gastrointestinal secretory activity)
incorporate polysaccharides exhibiting the immunomodularity effect
prevent cancer progression (reduction of the fecal enzyme activity)

 

   The starters are classified into single-strain and multi-strain, which comprise several microorganism strains. According to the present-day requirements laid to the starters, use should be made of the strains of microorganisms featuring the qualities beneficial to human body with compulsory presence of lactic acid bacteria.

   The fermented products based on cow milk are assigned to the functional nutrition category only if their starters are prepared with the use of specially selected microorganism of human origin, which give the proved therapeutic and preventive properties to the milk. The fermented milk products prepared by fermentation of the adapted milk formulas with specially selected strains of lactic acid bacteria (lactic and bifidus bacteria) occupy a significant place in the nutrition of children above 1 year old. In the process of activity of lactic acid bacteria, which are brought by the starter, the fermented milk products accumulate a complex of the biologically active substances: ferments, amino acids, lactic and acetic acids, vitamins, antibiotic agents [P.F. Krasheninin, G.P. Shamanova (1994)].

 

   The research works completed in recent years point to efficiency of the fermented milk products with probiotics in treatment of the inflammatory bowl diseases, Crohn's disease and nonspecific ulcerative colitis [K.O. Laake (1999)]. The formula with probiotic effect, when prescribed to the infants having the functional disorder of large intestine showing up as constipation, facilitates normalization of the stool consistency and frequency (p<0.0001) [J.M. Saavedra (1998)]. L.V. Blokhina and A.M. Kochetkov (2001) demonstrated the high efficiency of fermented milk product Bifidok in treatment of functional constipation of the adult patients. Research works of the domestic and foreign scientists indicated the high efficiency of fermented milk products exhibiting the probiotic action in treatment of alimentary allergy, lactose intolerance, inflammatory bowl diseases, intestinal disbacteriosis, enteric infections and helicobacteriosis.   Italian scientists revealed that some species of the lactic acid bacteria used in preparation of the fermented milk products have a definite hypotensive action involving the synthesis of ACE inhibitors, which points to their probable use in treatment of arterial hypertension (2000).  Some of the works show the therapeutic efficiency of fermented milk products containing the probiotics for children having the respiratory infections. K. Hatakka et al (2001) discovered that if the children of the recurrent respiratory infection group get the milk fermented with  Lactobacillus GG culture, the quantity and severity of respiratory infection episodes go down to a large extent. In the double blind placebo-controled research of H. Szajewska and  J.Z. Mrukowicz et al (2001) the positive therapeutic effect showing as reduction of the diarrheal syndrome severity and duration was noted at prescription of  Lactobacillus GG to  the children with acute diarrhea. M. Juntunen et al (2001) demonstrated the preventive and therapeutic efficiency of formulas containing the strains of microorganisms Bb12 and LA-5 for the infants with rotavirus infection. The authors emphasized that a combination of several probiotics in the milk formula substantially raises the capability of adhesion of the  normal intestinal flora and stimulates the local immunity. J.M. Saavedra et al (1994) conducted the double blind placebo-controled research of preventive qualities of the Bb12-enriched formula for the infants aged 5-12 months staying in hospital environment. The work results disclosed that 39% of infants fed with the standard formula had the rotavirus infection during the hospital stay (17 days), whereas only 10% of infants of the group receiving the probiotic-enriched formula had the said infection. Another study  by Fucushima et al (1997) revealed that the use of subsequent Bb12 (NAN BF)-enriched formula for feeding the second-halfyear infants facilitates the bifidogenic flora growth in the infant intestines and reduces the content of lecithinase-negative strain of  Klostridi.