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Bob Hutkins University of Nebraska Health benefits of fermented dairy foods: microbiota and beyond Fifth Global Summit on the Health Effects of Yogurt International Congress of Nutrition Buenos Aires, Argentina October 18, 2017

YINI symposium IUNS 2017 Argentina - Prof. Hutkins

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Page 1: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Bob Hutkins

University of Nebraska

Health benefits of fermented dairy foods:

microbiota and beyond

Fifth Global Summit on the Health Effects of Yogurt

International Congress of Nutrition

Buenos Aires, Argentina

October 18, 2017

Page 2: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Conflicts of Interests

Board of Directors, International Scientific

Association for Probiotics and Prebiotics

Research funding from companies that sell or

use probiotics or prebiotics in their products

(Mead Johnson Nutrition, Dannon, Prenexus, BioGaia)

Research funding from the National Dairy Board

and the U.S. Department of Agriculture

Owner/Partner of Synbiotics Solutions, LLC

Page 3: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Outline

Primer on fermentation and fermented foods

Diet, microbiota, and gut health

Health properties of fermented foods

Can fermented foods be considered as a

source of probiotics?

Page 4: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Fermentation Defined

Biochemical Definition: Process of deriving

energy from the oxidation of organic substrates

such as glucose, where the electron acceptor is

an organic compound

Page 5: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

raw food fermented food microorganisms

Food-Friendly Definition: Conversion

of raw foods into fermented foods

by microorganisms

Page 6: YINI symposium IUNS 2017 Argentina - Prof. Hutkins
Page 7: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Why fermented foods have been

popular for 10,000 years

Enhanced functionality

Enhanced preservation

Unique

Increased economic value

Enhanced nutritional value

Enhanced organoleptic properties

Page 8: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

By Ted Weesner Globe Correspondent August 23, 2016Fermented foods

Whole Foods Market top

food trends for 2016.

ROLE IN HEALTH

Page 9: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Fermented foods and the hygiene hypothesis

Why our western lifestyle is killing us?or

Adapted from Sommer and Bäckhed, 2013, Nature Reviews Microbiology 11, 227-238

Chronic

inflammation

Metabolic

dysfunction

(dysbiosis)

altered intestinal microbiota

Page 10: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

The gut microbiota - dysbiosis and disease

Page 11: YINI symposium IUNS 2017 Argentina - Prof. Hutkins
Page 12: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Restoring a healthy microbiota with fermented foods

fermented foods may also contribute livemicroorganisms to the gut microbiota

fermented foods provide many health benefits

vitamins, minerals, protein, fiber, phenolics

1. microbes that perform the fermentation

2. microbes added as probiotics

lactobacilli, streptococci

bifidobacteria, lactobacilli

Page 13: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Are fermented foods the same as probiotics?

Page 14: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Fermented Foods Probiotics≠(but they share similar properties)

Probiotics: Live microorganisms that, when administered in

adequate amounts, confer a health benefit on the host

Page 15: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Factors affecting the gut microbiota

Page 16: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Factors affecting the gut microbiota

Microbes from raw foods

Aerobic/facultative bacteria

Microbes from fermented foods

Yeasts and other fungi

Anaerobic/facultative bacteria

Yeasts and other fungi

Lactic acid bacteria

Adapted from Graf et al., 2015. Microbial Ecology in Health and Disease

diet

Page 17: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Lactobacillus Strains evaluated in clinical trials

Lactobacillus johnsoni LA1 (Nestle)

Lactobacillus acidophilus NCFM (Danisco)

Lactobacillus acidophilus SBT (Snow Brand)

Lactobacillus acidophilus ADH (Dupont

Lactobacillus rhamnosus GG (Valio)

Lactobacillus reuteri DS2112 (Biogaia)

Lactobacillus casei strain Shirota (Yakult)

Lactobacillus plantarum 299v (Probi Foods)

Lactobacillus crispatus CTV05 (Osel, Inc.)

Lactobacillus casei F19 (Alra Foods)

Lactobacillus casei DN-114001 (Dannon)

Lactobacillus rhamnosus Lcr35 (Lycocentre)

Lactobacillus fermentum RC-14 (Urex Biotech)

Page 18: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Lactobacillus

Lactobacillus johnsoni LA1 (Nestle)

Lactobacillus acidophilus NCFM (Danisco)

Lactobacillus acidophilus SBT (Snow Brand)

Lactobacillus acidophilus ADH (Dupont

Lactobacillus rhamnosus GG (Valio)

Lactobacillus reuteri DS2112 (Biogaia)

Lactobacillus casei strain Shirota (Yakult)

Lactobacillus plantarum 299v (Probi Foods)

Lactobacillus crispatus CTV05 (Osel, Inc.)

Lactobacillus casei F19 (Alra Foods)

Lactobacillus casei DN-114 001 (Dannon)

Lactobacillus rhamnosus Lcr35 (Lycocentre)

Lactobacillus fermentum RC-14 (Urex Biotech)

Strains evaluated in clinical trials

Page 19: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Bifidobacterium

Bifidobacterium longum BB536 (Moringa)

Bifidobacterium bifidum (Yakult)

Bifidobacterium infantis (Shirota)

Bifidobacterium breve (Yakult)

Bifidobacterium lactis DS 920 (DSM Foods)

Bifidobacterium animalis DN 173010 (Dannon)

Bifidobacterium lactis Bb12 (Chrs. Hansens)

Bifidobacterium essensis (Danone)

Strains evaluated in clinical trials

Page 20: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Bifidobacterium

Bifidobacterium longum BB536 (Moringa)

Bifidobacterium bifidum (Yakult)

Bifidobacterium infantis (Shirota)

Bifidobacterium breve (Yakult)

Bifidobacterium lactis DS 920 (DSM Foods)

Bifidobacterium animalis DN 173 010 (Dannon)

Bifidobacterium lactis Bb12 (Chrs. Hansens)

Bifidobacterium essensis (Danone)

Strains evaluated in clinical trials

Page 21: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Health benefits of fermented foods

Some diets are associated with health or longevity

Are fermented foods, therefore, at least partially

responsible for longevity and other health benefits?

Some of those diets are rich in fermented food

Observational and epidemiological evidence

Evidence exist for various types of diet, and yogurt

in particular

Page 22: YINI symposium IUNS 2017 Argentina - Prof. Hutkins
Page 23: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Conclusions: Higher consumption of yogurt was

associated with reduced risk of MetS in individuals

TOTAL YOGURT

LOW-FAT YOGURT

WHOLE-FAT YOGURT

Reduced risk Increased risk

Page 24: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Conclusion: Yogurt consumption

was associated with less weight

gain in all cohorts.

Yogurt

cohort study of 120,000 U.S. adults

tracked subjects for 20 years

Page 25: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Health benefits of fermented foods

Possible mechanisms

It’s the microorganisms that reach the gut and

produce beneficial end-products

2.

It’s the transformation or change in the food

brought about by microorganisms

1.

lactose fermented (cheese, yogurt)

gluten degraded (sour dough bread)

vitamins produced (tempeh)

nutrients extracted or converted (wine)

anti-nutrients inactivated (phytic acid in cereals)

Page 26: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

The role of fermentation-derived bacteria in the

gastrointestinal tract

microbes

from

fermented

food

1

5

2

3

6

4

Adapted from Crittenden, 2006.

Page 27: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

“Our study supports the concept that [fermentation] bacteria

….. can be leveraged to re-engineer the gut microbiome and

improve dysbiosis-related diseases.”

“There is increasing evidence that food-borne bacteria

contained in fermented products are biologically active in the

colon… such activities might be part of the mechanisms

underlying beneficial effects.”

0

But do fermentation-derived bacteria

make it to the gut?

Page 28: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Organisms in fermented foods reach

the colon - alive and well!

Page 29: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Sauerkraut and sausage bacteria in the colon

F. Dal Bello, Walter, and Hammes, and Hertel, 2003. Microbial Ecology University of Hohenheim, Germany

Page 30: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Organisms isolated from healthy Korean adults

(> 80 years old) and from kimchi

Lactobacillus fermentum PL9988

was inhibitory to pathogens and

had immune-enhancing activity

and anti-inflammation activities

Journal of Functional Foods, 2016, 20:79–87

Page 31: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

No significant changes in microbiota

Subjects (n= 4) consumed 250 g plain yogurt/day for 42 days

Page 32: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Fermented milk consumption more lactobacilli, fewer anaerobes

Fermented milk consumption fewer mutans streptococci

L. rhamnosus SD11 persisted even after consumption ended

Page 33: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Regular yogurt consumption maintains

bifidobacteria in the GIT

Bifidobacterium

Page 34: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

La

cto

bacill

us b

ulg

aricus

Control Acidifed Yogurt

Str

ep

toco

ccus th

erm

op

hilu

s

Control Acidifed Yogurt

La

cto

bacill

us r

ha

mn

osu

sG

G

Control Acidifed Yogurt

IL6

Control Acidifed Yogurt

ch

em

okin

e lig

an

d 5

Control Acidifed Yogurt

TN

Control Acidifed Yogurt

Page 35: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Yogurt consumption more yogurt bacteria in gut

Yogurt/acidifed milk reduced inflammatory response

Page 36: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Consumption of probiotic-containing yogurt restored Bifidobacterium

Children infected with H. pylori contain fewer Bifidobacterium.

Yogurt consumption also suppressed H. pylori and reduced IL-6

Helicobacter 17:297-304 (2012)

Page 37: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Probiotics (and yogurt bacteria) are transient

members of the human GI tract

Bas

elin

e

Day

0

Day

2

Day

4

Day

7

Day

10

5

6

7

8

9

Control

GOS

LODqPCR= 1 x 105 cells/g

Test of persistence

Lo

g (

DS

M 1

79

38

ce

lls/g

fe

ce

s)

Rattanaprasert et al., 2014, Journal of Functional Foods

Lactobacillus reuteri

L. reuteri + GOS

Bas

elin

e

Day

0

Day

2

Day

4

Day

7

Day

10

5

6

7

8

9

Control

GOS

LODqPCR= 1 x 105 cells/g

Test of persistence

Lo

g (

DS

M 1

79

38

ce

lls/g

fe

ce

s)

start of

consumption

Page 38: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Probiotic =

Dose = 1010 CFU per day

Experimental Design

The unusual phenomenon of persistence

Bifidobacterium longum

subsp. longum AH1206

No surprise: B. longum AH1206

survives and reaches the colon

Big surprise: B. longum AH1206

appears to persist in the colon

Page 39: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

4

5

6

7

8

9

10

BL 7 284 8 15 50 100 200

Days ofconsumption

Days of Washout

Detection limitqRT-PCR

Cell

nu

mb

ers

of

AH

1206 in

fecal

sam

ple

s (

Lo

g10 c

ells p

er

gra

m)

14

Pers

iste

rsN

on-p

ers

iste

rs

A probiotic that lasts!

Page 40: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Accounting for persistence

Persister subjects were devoid of other B. longum

Open niche existed, so the new colonizer had a chance

New colonizer must have an ecological advantage

B. longum AH 1206 has carbohydrate-utilizing genes

Implication

Personalized nutrition based on one’s microbiome

Page 41: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

All fermented foods are not the same

Whereas some fermented foods are good

sources of live bacteria, others are not.

Some fermented foods are heat-treated and are

essentially sterile!

Which fermented foods contain significant

numbers of live bacteria?

Follow Prof. Hutkins’ advice for a fermented

foods diet rich in live microorganisms.

Some foods that are thought to be “fermented”

are not, in fact, fermented at all!

Page 42: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

My advice

Cultured dairy foods either with the “live and active”

seal or an ingredient statement that indicates live

organisms

1.

Cheese can also be a good source of live bacteria,

but it depends on the type of cheese.2.

Page 43: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Fermented foods like kimchi or sauerkraut or

kombucha that are located in the refrigeration section

likely contain live cultures

3.

“Fermented” foods located on the store shelf are

often made without fermentation and/or are almost

always heat-processed for shelf-life.

4.

Page 44: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Some fermented foods do indeed contain live

organisms but are often heated in the kitchen6.

Microorganisms do not live forever - long aged or

cured fermented foods will contain fewer organisms.7.

Many fermented foods are heated

as part of their manufacture and

will not contain live organisms

5.

Page 45: YINI symposium IUNS 2017 Argentina - Prof. Hutkins

Thank you