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How to Choose the Best Probiotic Supplement?

These living organisms have been linked to several beneficial effects for health, related to intestinal function and among others.

If you want to use probiotics to improve your health, it is important that you ensure which of the probiotic supplements mentioned below you can choose to obtain the results you want.

This article has a detailed look at the effects of probiotics, and provides recommendations for certain supplements that address some particular health problems.

What are probiotics?

At birth, our intestines acquire bacteria and later develop and diversify through a process called colonization.

Many of these bacteria are considered beneficial or "friendly". Its functions include: convert fiber into short chain fatty acids, synthesize certain vitamins and support the immune system.



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Taking probiotics can help increase the number of these friendly bacteria.

The formal definition of probiotics is: "living microorganisms, which when administered in adequate amounts provide a health benefit to the host".

That is, probiotics are microorganisms that provide beneficial effects when consumed in the right amounts.

Probiotics can be consumed in supplement form or in fermented foods such as sauerkraut, kefir and yogurt.

• They should not be confused with prebiotics, which are a type of fiber that serves as a food source for the bacteria that live in the colon.
• Summary: Probiotics are beneficial bacteria for health, found in the form of a supplement and in some foods. Taking probiotics can help increase the number of beneficial bacteria that reside in the intestine.

Learn more about "probiotic foods" in our article: 11 surprisingly healthy probiotic foods (scientifically confirmed).

Some probiotics may have specific benefits

• The intestinal microbiota, or intestinal flora, consists of a wide variety of bacteria.
• The exact composition is unique in each person.
• The colon contains billions of bacteria with more than 500 different species.
• The probiotics that have been found, which provide health benefits include several strains of: Bifidobacterium, Lactobacillus and Saccharomyces. Many probiotic supplements contain a combination of different strains in the same supplement.

Research has shown that some strains appear to be more effective than others in treating certain conditions.

Therefore, you are more likely to get better results when choosing probiotic supplements that have been shown to be effective for certain specific conditions.

In addition, it is important to consume probiotics in sufficient quantities.

Probiotics are typically measured in colony forming units (CFU). In general, it has been found in most studies that the higher the doses, the better results they produce.

However, some probiotics can be effective when doses of 1-2 billion CFU are delivered per day, while others may require at least 20 billion CFU to achieve the desired effects.

No adverse effects have been found from taking extremely high doses. One study gave participants up to 1.8 trillion CFU per day. However, it is expensive and does not seem to provide any additional benefit.

It is important to note that we still do not know everything about probiotics. Although research has expanded rapidly in recent years, much remains to be explored.
Summary: Different types of probiotic bacteria can provide health benefits. Integrating a good amount of the correct probiotic into the diet is important to achieve the desired effects.

Learn more about "the benefits of probiotics" in our article: 6 benefits of probiotics that have been demonstrated by science.

Probiotics that can help relieve constipation

Constipation is characterized by bowel movements that are bothersome, complicated and infrequent circulation. Everyone experiences constipation from time to time, but for some people it can become a chronic problem.

Chronic constipation is more common in the elderly and adults who spend a lot of time in bed under certain circumstances, although it can also occur in children.

In addition, some people with irritable bowel syndrome (IBS) experience persistent constipation as the main symptom. This is known as IBS of predominant constipation.

Conventional treatments usually include laxatives. However, in recent years, changes in eating habits and probiotic supplements have become increasingly popular treatments.

Several studies have shown that supplementation with certain probiotic strains can reduce constipation in both adults and children.

• In a study comparing probiotics and prebiotics in children with IBS, it was shown that the strain Bifidobacterium Lactis or B. lactis provides significant relief in terms of constipation.
• In addition, the group that was given probiotics experienced flatulence to a lesser extent, fullness and abdominal bulging after meals, compared to the group that was given prebiotics.
• Other probiotics that can improve constipation include: B. longum, S. cerevisiae and a combination of L. acidophilus, L. reuteri, L. plantarum, L. rhamnosus and B. animalis.
• Summary: Several probiotic strains have been shown to provide relief in constipation in children and adults when taken alone or together.

Learn more about "foods to relieve constipation" in our article: 14 Healthy Foods That Help With Constipation.

Probiotics that are effective against diarrhea.

Diarrhea is defined as both loose and fluid bowel movements that occur more often than normal.

It is usually short-lived, but it can become chronic in some people.

It has been found that probiotics reduce the frequency of stool in diarrhea related to the infection that occurs due to food poisoning and gastroenteritis, commonly known as "stomach flu".

A large review of 34 studies found that probiotics reduced the risk of diarrhea caused by several causes by 34%.

Effective strains included Lactobacillus rhamnosus GG, Lactobacillus acidophilus and Lactobacillus bulgaricus.

The use of antibiotics is another common cause of diarrhea. When the antibiotic kills the harmful bacteria that cause the infection, the beneficial bacteria are destroyed as well. The change in bacterial balance can lead to inflammation and diarrhea.

Studies in children and adults have shown that taking probiotics can help reduce diarrhea caused by antibiotic therapy.

A large review of 82 controlled studies found that taking probiotic supplements reduced the risk of developing diarrhea associated with antibiotics by 42%. However, the most effective probiotic strains were not discussed.

While some people with IBS struggle with constipation, others experience frequent situations of diarrhea, which is known as IBS of predominant diarrhea.

Research suggests that certain probiotics appear to be especially effective for IBD of predominant diarrhea, including B. coagulans, S. boulardii and a combination of several strains of Lactobacillus and Bifidobacterium.

However, one study found no significant improvement in diarrhea among patients with IBS treated with S. boulardii.
Summary: It has been shown that probiotic therapy helps reduce the severity and frequency of diarrhea related to infection, the use of antibiotics and IBS, among other causes.

Probiotics that can improve the symptoms of IBS

Sometimes the main symptoms of IBS are not related to the consistency or frequency of stool. On the other hand, some people experience bloating, gas, nausea and lower abdominal pain on a regular basis.

A review of 19 studies found that although some people reported improvement in IBS symptoms while taking probiotics, the results varied among individuals. The researchers could not determine which probiotics were more effective.

In addition, because the symptoms of IBS are so diverse, sometimes one symptom improves, while others do not.

For example, a study in people with IBS with predominant constipation found that although S. cerevisiae improved constipation, but did not have much effect on abdominal pain or discomfort.

In another study, participants with IBS with predominant diarrhea were given a supplement known as VSL # 3 (it is a medical food that is used as a probiotic), which contains strains of Lactobacillus, Bifidobacterium and Streptococcus.

The frequency and consistency of the bowel movement did not improve, but the symptoms in terms of swelling did improve.

Another study found significant reductions in pain and swelling during treatment with VSL # 3. Researchers believe that probiotics led to an increase in melatonin, a hormone that participates in digestive function.
Summary: It has been shown that certain probiotics help relieve bloating, abdominal pain and other symptoms of irritable bowel syndrome. However, taking probiotic supplements can not improve all the symptoms.

Learn more about "Irritable Bowel Syndrome" in our article: 9 Signs and Symptoms of Irritable Bowel Syndrome-IBS.

Probiotics that can help you lose weight

There is increasing evidence that the balance of bacteria in the intestine can profoundly affect body weight.

Some studies suggest that taking probiotic supplements can be useful for losing weight and a healthier body composition.

Studies in animals and humans have found that certain bacterial strains can lower the amount of fat and calories the intestine absorbs, promote a healthy balance of intestinal bacteria and reduce weight and fat in the abdomen.

According to an analysis in 2014 of several studies, probiotics that appeared to be effective for weight loss include: Lactobacillus gasseri, Lactobacillus rhamnosus and the combination of Lactobacillus rhamnosus and Bifidobacterium lactis.

In one study, obese men who took L. gasseri for 12 weeks experienced significant reductions in body weight and body fat, including up to an 8.5% decrease in abdominal fat. In contrast, the placebo group had very few notable changes in body weight or body fat.

In another study, obese women who took L. rhamnosus for three weeks lost twice as much weight as those who received a placebo.

In addition, they continued to lose weight during the maintenance phase of the study, while the placebo group gained weight.

Taking probiotic supplements can also help limit weight gain during a high calorie intake.

In a four-week study, thin young men ate 1,000 excess calories per day. Those who took the probiotic formulation VSL # 3 gained less weight than the control group.

However, because the results of some studies have not been impressive, the researchers feel that there is not yet enough evidence at this time to draw firm conclusions about the benefits of probiotics for weight loss.
Summary: The results of several studies suggest that certain probiotics can promote fat loss in obese subjects. However, more research is needed.

Learn more about "effective ways to lose weight" in our article: How to lose weight in 3 steps (without spending money).

Probiotics to support brain health

There is a strong connection between the intestine and brain health.

The bacteria in the colon digest and ferment the fiber in short chain fatty acids that nourish the intestine. Research has shown that these compounds can also benefit the brain and the nervous system.

A review of 38 studies on animals and humans found that several probiotics helped improve the symptoms of anxiety, depression, autism, obsessive-compulsive disorder and poor memory.

The strains most commonly used in these studies were: Bifidobacterium longum, Bifidobacterium breve, Bifidobacterium infantis, Lactobacillus helveticus and Lactobacillus rhamnosus.

Probiotics seem to be effective both for anxiety in general and for anxiety related to specific causes.

One study found that when patients with throat cancer took probiotics for two weeks before surgery, they had lower levels of stress hormones in the blood and their anxiety decreased by 48%.

In other studies, probiotics have been shown to improve general mood and reduce sadness in healthy individuals and people with chronic fatigue syndrome.

Taking probiotic supplements also seems to help people struggling with depression, including those with a major depressive disorder.

An eight-week study in patients with major depression, those who took L. acidophilus, L. casei and B. bifidum had a significant decrease in depression levels.

Moreover, they experienced reductions in insulin levels and inflammatory markers.
Summary: The brain and intestinal health are strongly connected. Taking certain probiotics can promote better mental health by reducing anxiety, sadness, depression and other symptoms.

Learn more about "brain health" in our article: 5 nutrients for the brain that are only available in meat, fish and eggs.

Probiotics that can improve heart health

Taking probiotics can help reduce the risk of heart disease.

Several studies have found that certain bacteria in yogurt or probiotic supplements can lead to favorable changes in the indicators of cardiac health.

These include a decrease in LDL (low density lipoprotein) or "bad" cholesterol and an increase in LAD (high density lipoprotein) or "good" cholesterol.

Specific bacterial strains that appear to be effective in reducing cholesterol levels include: Lactobacillus acidophilus, Bifidobacterium longum and Lactobacillus reuteri.

An analysis of 14 studies found that probiotics led to an acceptable reduction in LDL cholesterol, a slight increase in HDL, and in addition, a decrease in triglycerides.

There are probably several processes responsible for these positive effects on LDL cholesterol, including changes in the metabolism of fats and decreased absorption of cholesterol in the intestine.

Probiotics can also help lower blood pressure.

A review of nine controlled studies found a moderate reduction in blood pressure among those who took probiotics. However, only the treatment of more than eight weeks at doses exceeding 10 billion CFU per day had significant effects.
Summary: Taking certain probiotic supplements can help lower LDL cholesterol, increase LDL cholesterol, and lower blood pressure.

Learn more about "ways to lower blood pressure naturally" in our article: 15 natural ways to lower blood pressure.

Probiotics to increase immunity

Studies suggest that taking probiotic supplements can change the balance of intestinal bacteria in a way that increases the body's defenses against allergies, infections and cancer.

It should be noted that the effective strains are: Lactobacillus GG, Lactobacillus crispatus, Lactobacillus gasseri, Bifidobacterium bifidum and Bifidobacterium longum.

These types of bacteria seem to reduce the risk of respiratory diseases and eczema in children, as well as infections in the urinary tract in adult women.

In addition, probiotics have been shown to reduce inflammation, a known risk factor for many diseases.

In one study, older adults consumed a mixture of Lactobacillus gasseri, Bifidobacterium bifidum and Bifidobacterium longum or a placebo for three weeks each.

After taking probiotic supplements, their inflammatory markers decreased, anti-inflammatory markers increased and intestinal bacterial balances became more similar to the type of balance seen in healthy young people.

Some probiotics can also help prevent gingivitis, or infection of the gums.

A 14-day study looked at adults who refrained from brushing and flossing while being treated with Lactobacillus brevis or a placebo.

Gingivitis progressed more rapidly in the placebo group, suggesting that probiotics helped protect against infection.
Summary: Taking probiotics can help strengthen the immune system and help reduce the risk of infection and disease.

Probiotics for general health

In addition to promoting symptoms or specific disease conditions, you can also take probiotics to promote overall health.

A recent study in healthy adults showed that taking Bifidobacterium bifidum for four weeks helped increase production of short-chain beneficial fatty acids.

There is also some evidence to suggest that probiotics can promote better aging by reducing the inflammation that normally occurs as you get older.

Of course, it is important to make sure that you are consuming a healthy diet and also practice other favorable behaviors for your health. Nor can probiotics be expected to provide all the benefits.

In addition, although probiotics are safe for most people, they can cause harm to people who are seriously ill or who have compromised immune systems, including those with HIV or AIDS.
Summary: Probiotics can help maintain well-being in healthy people. However, taking probiotic supplements can be dangerous for people who are very sick or have compromised immune systems.

Learn more about "the ways in which probiotics help your health" in our article: 9 Ways Lactobacillus Acidophilus Can Benefit Your Health.

In conclusion

Having a healthy intestinal microbiota is extremely important.

Although research is still emerging, probiotics seem to provide beneficial effects for a number of different conditions and can also improve overall health.

Taking the right kind of probiotics can help treat specific health problems, and improve overall quality of life.

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Probiotics, good bacteria for the intestine

Probiotics are microorganisms that play a very important role in the regulation of intestinal function and proper digestion by balancing the intestinal microflora .

We could say that they are " good bacteria " for our intestine.

Probiotics are normally consumed in foods fermented with active live cultures , such as yogurt.

They are also available as a supplement in the form of capsules, drinkable or chewable vials. There are many different strains of probiotics, but the most common strains available today are Lactobacillus and Bifidobacterium .



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What are the health benefits of probiotics?

Certain strains of probiotics have shown positive results in the treatment of diarrhea and gastroenteritis. According to a report published in the Journal of Pediatric Gastroenterology and Nutrition , probiotics are

•     useful in the prevention or treatment of various gastrointestinal disorders, such as infectious diarrhea, antibiotic diarrhea, and traveler's diarrhea.

A study published in the Journal of Pediatrics , concluded that Lactobacillus species are a safe and effective treatment for children with infectious diarrhea. The researchers concluded that

•     The prophylactic use of Lactobacillus significantly reduces the risk of in-hospital diarrhea in newborns, especially intra-hospital rotavirus gastroenteritis.

However, researchers at the University of Swansea, Wales, UK, reported in The Lancet that probiotic supplements do not reduce diarrhea associated with antibiotics in the elderly.

Brain function

Probiotics can be beneficial for brain function. Researchers at UCLA found that brain function improved among healthy women who regularly consumed yogurt with probiotics.

In addition, probiotic bacteria may have the potential to change brain neurochemistry and improve anxiety and disorders related to depression , according to a study published in the Proceedings of the Journal of the National Academy of Sciences (PNAS).

Cholesterol

Research presented at the American Heart Association scientific sessions in 2012 revealed that a formulation of Lactobacillus reuteri NCIMB 30242 is capable of reducing blood levels of LDL cholesterol or "bad" cholesterol.

Blood pressure

Some studies have found that milk fermented with laboratory strains can help reduce high blood pressure.

Irritable bowel syndrome

There is growing evidence that probiotics can help treat IBS ( irritable bowel syndrome ).

Two review articles published in Nutrition in Clinical Practice , examined therapeutic approaches for irritable bowel syndrome and found that probiotics, specifically Bifidobacterium infantis 35624 (Bifantis®) , are very effective in the management of this intestinal syndrome.

Infection

A study published in the prestigious journal PNAS ( Proceedings of the National Academy of Sciences ), found that probiotic bacteria can protect against bacterial infection.

The research showed that Lactobacillus salivarius offers significant protection against Listeria infection.

Psoriasis and chronic fatigue syndrome

Scientists at the University of Cork, Ireland, concluded in a study that Bifidobacterium infantis 35624 may also have benefits for patients with psoriasis and chronic fatigue syndrome.

Probiotic strains

Probiotic cultures occur naturally in certain fermented foods. There are different strains of probiotic bacteria.

•     Bacillus coagulans GBI-30, 6086
•     Bifidobacterium animalis subscp. lactis BB-12
•     Bifidobacterium longum subsp. infantis 35624
•     Lactobacillus acidophilus NCFM
•     Lactobacillus paracasei ST11
•     Lactobacillus johnsonii La1
•     Lactobacillus plantarum 299v
•     Lactobacillus reuteri ATCC
•     Lactobacillus reuteri Protectis
•     Saccharomyces boulardii

What foods contain probiotics?

Foods that contain natural probiotics:

•     The yogurt
•     Kefir
•     Cured cheeses
•     The Kimchi
•     Sauerkraut (sauerkraut)
•     The Miso
•     Tempeh (similar to tofu but with fermentation)
•     Some soy drinks

There are also products available enriched with probiotics such as juices, chocolates, flours and cereals.

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Probiotics Help Fight 9 Serious Health Problems

Present in some foods, the friendly bacteria of our body are one of science's bets against troubles that plague from childhood to maturity

Just looking at the belly can not be distrusted, but there live at least 10 trillion microorganisms. A large population there - by comparison, across the planet we are currently 7.3 billion people. To this universe sheltered in the digestive tract was initially given the name of intestinal flora , duly renamed microbiota.

As in our society, the animals have family, name and surname. And most important of all, they perform numerous functions within the body. "In recent years, the number of evidence on the influence of microbiota on health has increased greatly," says Elisabeth Neumann, a professor at the Laboratory of Ecology and Physiology of Microorganisms at the Federal University of Minas Gerais ( UFMG ).



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This influence, it is good to say, is not always positive. "Unbalance in bacterial populations is associated with several diseases," says nutritionist Adriane Antunes, a professor at the Faculty of Applied Sciences at the State University of Campinas, Unicamp .

A very simple equation denotes this breach of equilibrium: potentially harmful microbes, which also inhabit the intestine, multiply to the point of overlapping influences on benefiting beasts. One way to prevent this from happening or to reverse the situation is to invest in probiotics , known to be beneficial bacteria that can be found in yogurts , fermented milks , cheeses , as well as capsules and sachets.

According to Yasumi Osawa, a pharmacist at Yakult , a pioneer in research on the subject, appropriate doses of these microscopic beings help repopulate the microbiota, this time with good-natured individuals. To keep them in shape and ensure their colonization, prebiotics also come on the scene, fibers that we can not digest. "They serve as food for probiotics," explains Yasumi.

The relationships and banquets locked inside the belly and their reflexes in the body are gaining so much importance that they demand a scientific event of their own, the Brazilian Congress of Pre, Pro and Simbiotics, the PreProSim. Held in June, together with Ganepão, one of the most important nutrition conferences in the country, the event left no doubt that we need to know and value the work of these bacteria. Below you will see how they impact immunity, heart and even mental health.

1. Low immunity

Here's a classic effect of probiotics: making our defense system sharper. According to Adriane, from Unicamp, the arrival of the bacteria in the intestine awakens the defense cells, which, in the fright, are still not sure if the bees are even allies. "This mechanism keeps the immune system active and more able to react to disease-causing microorganisms," she explains.

There are other actions that contribute to the screening against infectious agents. Dr Cristina Bogsan, a professor at the University of São Paulo (USP), says that defense cells that recognize the flu virus live longer when the individual takes a probiotic present in fermented milk, for example - long enough to spend the winter in a good mood.

2. Intestinal problems

Considering that 70% of the microbiota is in the region of the intestine, it is natural for us to see a direct impact there. "Currently, probiotics and symbiotics are part of the treatment of constipation," says Dr. Dan Waitzberg, a professor at USP and president of Ganepoo .

There are bacteria, such as Bifidobacterium animalis , present in certain yogurts, which incite peristaltic movements. It is they who make the stool to walk forward. "The fecal cake is transported but does not liquefy. That's why there is no diarrhea, "reassures Cristina. By the way, Waitzberg recalls that probiotics are also helpful against the popular loose bowel. Studies indicate that certain bacteria reduce the time of diarrhea as well as visits to the bathroom.

3. Obesity

Scientists have long known that the microbiota of an obese individual is different from that of someone with a healthy weight. And a micro-organism that is present in slender people has encouraged the research group, Akkermansia muciniphila . During a lecture at PreProSim, nutritionist Priscila Sala, from the São Camilo University Center in São Paulo, said that the bacteria decreased the body mass gain among guinea pigs by 40 to 50%.

"In experiments, its effect was preserved even when it was heated to 70 ° C," he says. A major differential, because foods with probiotics today are refrigerated to ensure the survival of bacteria. While Akkermansia does not hit the market, invest in red fruits, onions, chocolate and nuts, which create conditions for the pet to thrive.

4. Oral diseases

Here, there are two ways of acting. One is indirect: when probiotics reach the intestine, they minimize inflammation, which improves gum condition and adjacency. But the oral cavity has its own microbiota. Hence why some bacteria have direct (and local) impact on such problems as caries and periodontitis.

In studies, dentist Michel Messora, at the School of Dentistry of Ribeirão Preto, USP, noted that associating the standard treatment of periodontitis with probiotic supplements improved the patients' response to the intervention. "In addition, there was a risk of return of the disease," says Messora. To prevent the problem of cutting teeth, he says that you can bet on fermented yogurts and milks - as long as they are low in sugar.

5. Cholesterol and pressure

In these matters that afflict the heart, the findings are incipient, but exciting. Pharmaceutical Elisabeth, from UFMG, reveals that some strains of the genus Lactobacillus and Bifidobacterium would be able to assimilate cholesterol in the intestine. "This would reduce the levels available for absorption by the body," he teaches. But she says further studies are needed to confirm this outcome.

Other tests show that certain bacteria have the ability to induce the production of substances that regulate blood pressure, another risk factor for the heart. "But we can not dream of solving a problem of this magnitude only with the use of these microorganisms," says Elisabeth. "No pre or probiotic should be seen as a substitute for medication," emphasizes Cristina, from USP.

6. Intimate chatting

Candidiasis and vaginosis account for almost 90% of the most common discomforts in women of childbearing age. The worst is that they tend to be recurrent. "And antibiotics and antifungal drugs are less effective," says José Maria Soares Junior, deputy chief of the Department of Obstetrics and Gynecology, Hospital das Clínicas de São Paulo .

One way to get around this resistance is to get probiotics into play. "By ingesting them through supplements, it is possible to change the intestinal flora and thereby beneficially colonize the vagina," the doctor describes. Hence harmful micro-organisms do not find a way to proliferate. According to Soares Junior, probiotic foods would even aid in prevention. "But it's no use smoking, being sedentary and neglecting the rest of the diet. All this affects the microbiota, "warns the gynecologist.

7. Skin Irritations

Having a regulated gut - with the strength of probiotics - also leaves the skin more palpable. "It is that the toxins that interfere in the water barrier of the skin, for example, are eliminated," Yasumi of Yakult reports. With this, there is less space for wrinkles, dry skin ... But the good bacteria have other trumps in the dermatological area. There are strains, already available in sachets to be taken, that combat atopic dermatitis.

Probiotics, in this case, help contain the inflammatory process that leads to skin lesions. In that same line, according to new studies, some bacteria would still hit head-on with acne. To take advantage of these effects, the advice is to maintain a frequent intake of probiotics. Otherwise, the microbiota returns to its natural state, programmed there early in life. But it is likely that we will soon have creams with these bacteria.

8. Cancer

It is speculated that preventing dysbiosis - that is, the dominance of bad bacteria in the intestinal flora - would reduce the risk of tumors, particularly colorectal ones. "We would have less inflammation there, which, over the years, may predispose to the disease," says nutritionist Thaís Manfrinato Miola, of the ACCamargo Cancer Center in São Paulo. In this regard, a balanced diet containing food with probiotics would be welcome.

Today, in practice, we also see the indication of good bacteria during the treatment of the tumor. When indicating them to surgical patients, the physician Antonio Carlos Ligocki Campos, Federal University of Paraná , saw fewer infectious complications, less use of antibiotics and length of stay. According to Thaís, the measure is also useful for relieving adverse reactions from chemo and radiotherapy.

9. Stress and anxiety

No one doubts that there is a direct connection between intestine and brain. Therefore, there is a tendency to link probiotics to impacts on the nervous system. "Some bacteria produce precursor molecules of serotonin and stimulate the release of gaba," exemplifies Cristina, of USP. Complicated? "These are neurotransmitters associated with anxiety control and the feeling of happiness," he says.

She notes, however, that studies are heading to confirm such effects. The role of probiotics against Alzheimer's, Parkinson's and depression, as well as disorders affecting other areas of the body, is still under debate. "There is an unlimited universe of possibilities," says Elisabeth of UFMG. But do not expect to spoil your guests. They will return by leaving the house - that is, its body - in order.




The bacteria Bifidobacterium longum and Lactobacillus rhamnosus improve the absorption of antioxidants from orange juice

Researchers from the Institute of Agricultural and Fisheries Research and Training (IFAPA), at the Alameda del Obispo Center (Córdoba), in collaboration with the University of Lleida and the University of California (USA), have demonstrated the capacity of two types of bacteria to transform the antioxidants present in orange juice.

According to experts from Cordoba, the bacteria Bifidobacterium longum and Lactobacillus rhamnosus, naturally present in the intestinal tract, transform the antioxidants in orange juice, called flavanones, into simpler molecules. These compounds are responsible for the beneficial properties for the health of this juice.

These products of transformation of the antioxidants of the juice in the organism are detailed in a research published by the European Journal of Nutrition . According to the authors of the study, it is of great interest for the food industry, since these two types of probiotic bacteria will serve for the creation of functional foods or pharmaceutical products that seek to improve the absorption of antioxidants in the body and enhance their protective effects. health.

These two types of probiotic bacteria will serve for the creation of functional foods or pharmaceutical products that seek to improve the absorption of antioxidants

"There is research that shows the positive effects of the consumption of oranges or orange juice on chronic diseases such as cardiovascular diseases and cancer, properties attributed mainly to its composition rich in antioxidants," explains Gema Pereira Caro, IFAPA researcher and author of the article.

    According to experts from Cordoba, the bacteria Bifidobacterium longum and Lactobacillus rhamnosus, naturally present in the intestinal tract, transform the antioxidants in orange juice, called flavanones, into simpler molecules. These compounds are responsible for the beneficial properties for the health of this juice.

"In addition, there is scientific evidence that shows the important role played by the intestinal microflora in the absorption and assimilation of these compounds, so the knowledge of which bacteria are involved in the transformation, absorption and assimilation of the antioxidants of the orange is of utmost importance, "he adds.


Improve the absorption of juice

Based on a previous study, the scientists showed that the prolonged intake of one gram of the microencapsulated probiotic ( Bifidobacterium longum ) for one month improves the absorption and metabolization of the antioxidants in orange juice, and therefore, their beneficial health properties.

Once proven that probiotics facilitate the absorption of flavanones, the experts considered knowing the biochemical causes of the process taking the experiment to the laboratory to analyze how these two types of specific bacteria present in the colon act on flavonoids.

"The mechanism through which this probiotic bacteria influences the increase in absorption is not clear, so the in vitro study was considered, observing how both types of bacteria transform or metabolize the antioxidant compounds of orange juice to other simpler compounds. , responding to the results of the in vivo study, "says Pereira.

In the laboratory tests they kept the probiotic bacteria in an optimal culture medium, without oxygen and at a stable temperature of 37 ° C for 48 hours inoculated with flavanones from orange juice (naringenin, hesperetin, narirutin and hesperedina). Every 12 hours samples were obtained and the products of transformation of these compounds were identified by the action of the bacteria, called catabolites.

Through these tests they discovered that the enzymatic activity of the bacteria causes the breaking of the chemical bonds of the flavanones. Specifically, they determined that the antioxidants in the juice with the simplest structure are transformed by Bifidobacterium longum , while the bacterium Lactobacillus rhamnosus modifies both complex and simple antioxidants.

The results show, therefore, its potential implication in the in vivo transformation of the antioxidants of the orange and at the same time, the compounds that give this food its healthy capacity are defined.

The project is part of the research funded by IFAPA's own plan and European funds and proposes in the near future the creation of new products that include probiotics aimed at improving intestinal absorption and the bioavailability of phenolic compounds in foods.

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The probiotics An alternative in the treatment of diseases

INTRODUCTION

In the human intestinal flora there are more than 400 species of microorganisms that coexist in harmony synthesizing vitamins, beneficial substances, contributing to the absorption of nutrients, favoring the colonic metabolism of the fiber, improving the digestibility, neutralizing potentially pathogenic substances. The intestine offers substrates and the conditions for its development allowing the flora to promote a better intestinal function.

 In the intrauterine life the intestinal tract is sterile, and it is after birth when the intestinal flora develops. During the first days of life the bifidobacteria colonize the intestine protecting the child from infections. The main functions of the intestinal flora are to limit the growth of potentially pathogenic microorganisms in the intestine and to interact with non-absorbed substrates of the diet. However, the intestinal flora is vulnerable to certain conditions. In adults it varies markedly as they depend on several factors such as diet, genes, the environment, antibiotic treatments, stress, medications, infections, age, weather, surgical interventions in stomach or intestine, liver diseases, kidney disease, cancer . Having a stable and well-balanced flora is a guarantee of good health since it prevents the colonization and development of pathogenic microorganisms through various mechanisms such as competition and the synthesis of bacteriocins, bacteriophages. The disequilibrium of the flora can be prevented with the administration of live microbial cultures, these crops are called Probiotics.



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 ORIGIN OF THE PROBIOTICS

Hippocrates (460 BC-377 BC), the Greek doctor considered to be the creator of true Medicine, said: "Make your food your medicines and make your medicines your food"

Élie Metchnikoff (1845-1916) was a Russian zoologist and microbiologist who was awarded the Nobel Prize in Medicine and Physiology in 1908.

But Metchnikoff is as much or more known by others of his discoveries: he worked in the Bacteriological Institute of Odessa (1886-1887) and in the Pasteur Institute (1885-1916), of which he became its director, and the last decade of his Life fixed its attention on the fact that in Bulgaria there was an incredible number of centenarians, despite being one of the poorest European countries. The reason for that extraordinary longevity could not be the quality of their medical services either. But, what was evident was that the Bulgarians consumed large amounts of yogurt, which contains lactic fermenting bacteria. Metchnikoff managed to isolate the bacteria responsible for the production of yogurt and used it for his research. It was the official start of Probiotics.

Metchnikoff became a strong advocate of the concept that diet can protect the body from invading pathogens and consequently improve and prolong the quality of life. He was the first person to develop a therapeutic preparation using lactobacillus in the form of a capsule to ingest orally called Lactobacillin.

In 1965 Lilly and Stillwell used the term Probiotic for the first time, to name the products of gastric fermentation. This word is derived from two words, Latin -pro- meaning by or in favor of, and from Greek -bios- which means life.

This definition was modified and the term Probiotics was redefined as microorganisms and compounds that participate in the balance and intestinal microbial development. In 1989 R. Fuller defined the Probiotics as: "Those living microorganisms, mainly bacteria and yeast, which are added as a supplement in the diet and which beneficially affect the development of the microbial flora in the intestine"

And in 1998 the ILSI (International Life Science Institute, of the European Union) in Brussels defined Probiotics as live microorganisms, which when ingested in sufficient quantities, have beneficial effects on health, which goes beyond the nutritional effects conventional Affect beneficially to one or several functions of the organism. They provide a better state of health and well-being and / or reduce the risk of disease. They can be functional for the population in general or for particular groups of the same. It must be mentioned that, to be considered as Probiotic, a bacterium has to survive the strongly acid medium of the stomach and colonize the small and large intestine.

BACKGROUND

It was known, for example, that if it was administered to a newborn mouse, which still does not have microorganisms in its intestine, a culture with a habitual cause of acute diarrhea (E. coli) almost instantaneously died. If instead of giving it, was administered in conjunction with a natural inhabitant of the intestine, the mouse was still alive, because the second competed ecologically with the first and digested the dangerous toxins that segregated the latter.

Also known for some time, by the action of yogurt, the digestive and normalizing properties of lactic bacilli on intestinal function. Under these circumstances, it was entirely natural for children with diarrhea to be thought of in dealing with them. From there to the fermented milk there was only one step.

The central idea of ​​Dr. Oliver, extremely simple but revolutionary, was to propose the ecological normalization of intestinal flora, altered in children with diarrhea, by the implantation of lactic bacilli in his intestine.
The lactic bacilli that were selected for the treatment were not the Bulgarian strains of the common yogurt. It was thought of Lactobacillus casei, which - unlike the bacilli of yogurt - are part of the normal intestinal flora. For this reason, while the Bulgarian Lactobacilli are only transit through the intestine, disappearing when their intake is suspended, the strain chosen tends to remain and reproduce in it, that is, to be implanted, colonizing permanently once administered.

The CERELA researchers prepared a concentrated culture of Lactobacilli casei that they sent to the hospital's lactate to be incorporated into the pasteurized milk that the small patients took, in the dose of one teaspoon per bottle. It was called CERELA, as was the Center.

We have also known for a long time, by the action of yogurt, the digestive and normalizing properties of lactic bacilli on intestinal function. In these circumstances, it is natural to think about treating children with diarrhea with Lactobacilli.

PROBIOTIC MICROORGANISMS

• Lactobacillus acidophilus
• Lactobacillus casei var. Shirota
• Lactobacillus fermentum
• Lactobacillus casei
• Lactobacillus crispatus
• Lactobacillus reuteri
• Lactobacillus rhamnosus
• Lactobacillus plantarum
• Lactobacillus bulgaricus
• Lactobacillus cellobiosus
• Lactobacillus curvatus
• Lactobacillus lactis cremoris
• Lactobacillus GG
• Bifidobacteria
• Bifidobacterium longum
• Bifidobacteria adolescentis
• Bifidobacteria animalis
• Bifidobacteria infantis
• Bifidobacteria bifidum
• Streptococcus salivaris
• Streptococcus faecium
• Streptococcus diacetylactis
• Streptococcus intermedius
• Saccharomyces boulardii

EFFECTS OF PROBIOTICS IN VARIOUS PATHOLOGIES

The effects of the Probiotics are several including the modification of the flora avoiding the pathogenic colonization, the prevention of the imbalance of the intestinal flora, the reduction of the incidence and duration of diarrhea, the maintenance of the integrity of the mucous membranes, the modulation of the immunity by avoiding bacterial translocation, the production of vitamins such as B2, B6 and biotin, the assimilation of trace elements and the antitumor activity.

NUTRITIONAL EFFECTS

A. LACTOSE INTOLERANCE

About 70% of the world population, presents intolerance to lactose, related to the decrease of the activity of lactase in the intestinal mucosa, genetically determined. The undigested Lactose is fermented by the intestinal flora, with production of water, fatty acids and gas, which cause symptoms such as abdominal pain, flatulence and diarrhea.

The Probiotics contribute to improve the digestion of lactose and reduce the symptoms due to malabsorption, thanks to the Lactobacillus possess an enzymatic activity (lactase) that continues to function in the intestine and allows the digestion of sugar, which allows people with Lactose intolerance can consume milk, a source rich in proteins, vitamins and calcium; avoiding eventual symptoms such as diarrhea, abdominal pain, flatulence, etc.

The probiotics that act in the fermentation of yogurt such as Lactobacillus bulgaricus and S. thermophilus possess the enzyme. Lactobacillus and bifidobacteria have a favorable effect on the digestion of Lactose

B. REDUCTION OF CHOLESTEROL LEVELS

Some probiotics can exert hypocholesterolemic effects, that is, they contribute to the reduction of blood cholesterol in three different ways:

• Using cholesterol in the intestine and thus reducing its absorption
• Increasing the excretion of bile salts
• Producing volatile fatty acids in the colon that can be absorbed and interfere with the metabolism of lipids in the liver.

PROTECTIVE EFFECTS
Probiotics are microorganisms that stimulate the protective functions of the digestive tract, are also known as bioterapeutics, bioprotectors or bioprophylactic, are used to prevent enteric and gastrointestinal infections. In order for a microorganism to fulfill this protection function, it must possess characteristics such as: Being a normal inhabitant of the intestine, having a short time of reproduction, being able to produce antimicrobial compounds and being stable during the production, marketing and distribution process for that can be alive in the intestine.

The protection of these microorganisms is carried out through two mechanisms: The antagonism that prevents the multiplication of pathogens and the production of toxins that impede their pathogenic action. This antagonism is given by competition for nutrients or adhesion sites. Through immunomodulation they protect the host from infections by inducing an increase in the production of immunoglobulins, increased activation of mononuclear cells and lymphocytes.

The lactic acid bacteria can transiently colonize the intestine and survive during intestinal transit. Moreover, due to their adhesion to the epithelium, they modify the local immune response of the host.

Certain Probiotics can stimulate the immunity of the individual both at the intestinal level and at a general level, which translates into a higher production of antibodies and a better defense. Several studies suggest that the consumption of Probiotics could help to regulate the alterations of the immune system that are observed in cases of allergy and, therefore, to reduce the symptoms associated with this pathology.

Certain lactic bacteria protect the intestine against pathogens in different ways:

• Competing for physical space and nutrients
• Producing antibiotic substances active against these pathogens
• Stimulating the immune system of the intestine
• Contributing to the acidification of the colon content, which is unfavorable for the growth of pathogens
• Inactivation of certain toxins released by pathogens.

3. ANTICARCINOGENETIC EFFECTS

 Probiotics seem to have anticarcinogenic activity through the production of certain substances during their growth, which would act by reducing procarcinogenic substances by direct action on them. A known example is the passage of nitrites in foods to nitrosamines, carcinogenic substances. Lactobacteria are able to act both chemically and enzymatically on nitrites, and bifidobacteria are able to unfold nitrosamines. Therefore, these Probiotic microorganisms decrease the carcinogenic substances.

Also secondary bile salts from the degradation of bile have been linked as colon cancer initiating substances. In this sense, it is considered that a high number of lactobacilli in the intestine can reduce the biotransformation of bile salts and therefore decrease the risk of suffering from this type of cancer.

Probiotics can act on procarcinogenic substances indirectly through the enzymatic system that transforms procarcinogenéticos into carcinogenéticos. It has been seen that the consumption of probiotics causes a decrease in the enzymes that make the transition from procarcinogenic to carcinogenic, resulting in a decrease in carcinogenic substances.

4. PROBIOTICS ALSO INHIBIT THE PROLIFERATION OF TUMOR CELLS

The Probiotics do not only have an anticarcinogenic action, but also show an antagonistic action on the proliferation of tumor cells, perhaps due to stimulation of the immune system both locally (intestine), as systemic or general level. In this regard, experiments with animals fed yogurt have resulted in an increase in the percentage and antibacterial activity of B lymphocytes.

 The results of several studies carried out by Ian Rowland and collaborators (1998), of the School of Biomedical Sciences of the University of Ulster, in Northern Ireland, confirm how Probiotic principles can positively influence the reduction of tumor incidence. humans. In their experiments with rats they have observed that the joint administration of lactobacilli or bifidobacteria and azoxymethane, a colon carcinogenic agent, reduces the incidence of cancer foci in these. Even the combination of bifidobacteria and inulin, substrate for the growth of bifidobacteria, has been shown to be more effective than either treatment alone. In these studies, dietary treatments were provided after exposure to carcinogens, from which the suggestion is derived that during the activation phase of the carcinogenic process a protective effect was being exerted.

5. EFFECTS OF PROBIOTICS IN GASTROINTESTINAL PATHOLOGIES

A. ACUTE DIARRHEA

Diarrhea modifies the normal function of the gastrointestinal tract such as: Digestion, absorption and immunomodulation, to combat diarrhea, strategies such as antibiotics are used, implying the risk of developing resistance and reducing the non-pathogenic flora. The use of Probiotics represents a promising alternative in the prevention and treatment of diarrhea

Effect of the probiotic on acute diarrhea

• Production of Antibacterial Substances: Bacteriocins, Lactocins, Helveticins, Bifidines
• Production of fatty acids that acidify the intestinal lumen, inhibiting bacteria and maintaining the proper functioning of the intestinal mucosa.
• Decreased Intestinal Permeability
• Competitive Action
• Immunomodulation Increase in Ig A, Regulation of Cytokines and the immune response.

Bioterapeutic Probiotic Microorganism

Lactobacillus casei, Lactobacillus rhamnosus LGG, Bifidobacterium, S. thermophilus, Lactobacillus reuteri, Lactobacillus delbruckii

B. DIARRHEA ASSOCIATED WITH ANTIBIOTICS

The use of antibiotics can cause diarrhea, by altering the balance of the intestinal flora with decrease in Lactobacillus and Bifidobacteria, which are responsible for the resistance to colonization by pathogens, producing infections by opportunistic microorganisms such as:

• Clostridium difficile
• Klepsiella oxytoca
• perfringens
• S. aureus
• Candida sp.
• Salmonella sp.
• The Probiotics studied in the prevention of these diarrheas are Lactobacillus and Saccharomyces boulardii

C. TRAVELER'S DIARRHEA

Many travelers may develop acute diarrhea when visiting high risk areas, most cases is not severe, however prophylaxis is effective according to studies, by administration of Lactobacillus rhamnosus and Saccharomyces boulardii

D. INTESTINAL INFLAMMATORY DISEASE

Genetic predisposition, immunological alterations and pathogenic bacteria interact as triggering and perpetuating agents of inflammatory bowel disease.

The administration of Probiotics used as a therapy of bacterial antagonism, is able to displace the bacteria with pathogenic potential, with the subsequent increase of bifidobacteria, favorably modifying the exaggerated inflammatory response, improving the intestinal epithelium and decreasing its symptoms.

Probiotics with biotherapeutic effect:

Lactobacillus reuteri, Lactobacillus plantarum, Lactobacillus brevis, Bifidobacterium adolecentis, Saccharomyces boulardii

E. INFECTION BY Helicobacter Pylori
Gram-negative pathogen responsible for gastritis, peptic ulcer and gastric cancer. In vitro and human studies have shown that Probiotics have an antagonistic effect against H. pylori, inhibiting their gastric colonization and preventing the development of the related pathology, they inhibit the activity of the enzyme urease, necessary for the pathogen to remain in the environment stomach acid

Probiotic antagonists: Lactobacillus salivarius and Lactobacillus johnsonii

BIOTERAPEUTIC PROPERTIES

• Prevention and treatment of infectious diseases
• Decrease in cholesterol levels.
• Decreased diarrhea, either by viruses, bacteria or parasites.
• Treatment of lactose intolerance, acts in the digestion of lactose
• Stimulation of the immune system.
• Exclusion or reduction of pathogenic adhesion
• Persistence and multiplicity.
• Production of acids, hydrogen peroxide and bacteriocins antagonists to pathogenic growth.
• Formation of a balanced intestinal flora.
• Prevention of certain allergic manifestations
• Prevention of colon cancer
• Treatment against tumors
• They have antimicrobial effects.
• They have the ability to stick to cells

WHO CAN USE PROBIOTICS?

The use of Probiotics is recommended to anyone who wants to favor the balance of the intestinal flora. In people with antibiotic treatment, in the elderly, in pregnancy, in intestinal disturbances, to improve the intolerance to the latose. It is also used to reduce the effects of diarrhea and constipation, in inflammatory bowel diseases since modulating the intestinal flora increases the production of immunoglobulin A and these patients have decreased lactobacilli.

DOSE

Functional foods prepared with Probiotics must contain at least 10 million viable cells per 100 ml, ideal dose to achieve the desired effects and increase natural defenses, however the dose will depend on the microorganism used, the way of consumption and the desired effect.

One of the studies carried out in the University Corporation of Santander UDES Cúcuta in Colombia for the program of Bacteriology with children of 1-5 years of the I.C.B.F. It resulted that the dose of 1.4 * 1010 cell / ml of Lactobacillus casei was the ideal concentration to reduce the cases of diarrhea in 81% caused by intestinal pathogenic parasites (Giardia lamblia)

As Elie Metchnikoff said: "If the expected and intended effects do not appear, at least the consumer will be satisfied by the good taste of the product." Health!


THE IDEAL PROBIOTICS

For a probiotic to be ideal it must survive the gastrointestinal tract. Arriving intact to the intestine is lodged there for what needs to have the property of adherence to the epithelium to be able to colonize and thus increase the acidity, which prevents the development of bacteria that cause disease and above all things, must be innocuous. In the majority, the Probiotics are lactic acid bacteria, which constitute an important percentage of the native flora of the human intestine. Lactobacillus casei acts at the level of the small intestine and Bifidobacterium at the level of the colon.

To properly select the Probiotic supplement, it must be in refrigeration (liquid or capsules), the "freeze drying" preparations are more stable and maintain their properties for longer. It is advisable to check the expiration date, because if they have been stored for a long time, they may lose their beneficial effects.

The Most Employed Probiotic

Lactobacillus acidophilus is one of the most popular Probiotics and besides its benefits to the intestinal tract, it is noted:

Production of vitamin B complex (B6, B12, folic acid, riboflavin, Niacin, Biotin and pantothenic acid, improves calcium absorption, produces enzymes such as lactase, which helps the digestion of milk protein (lactose) and improve the symptoms of Irritable Bowel Syndrome, produces natural antibiotics that help in the control of intestinal pathogenic bacteria, helps in the digestion of food and control of intestinal candidiasis.

The Acidófilus can be consumed in the form of dairy products such as yogurt, cottage cheese and is also on sale in stores of natural products in the form of liquid or capsules, which provide a higher concentration of bacteria than milk, yogurt with Acidophilus or other cultured dairy products.

In addition to Lactobacillus acidophylus yogurt contains two other classes of beneficial bacteria that are: Lactobacillus bulgaricus and Streptococcus thermophilus, which help in the digestion of milk carbohydrates, property desired for those who suffer from protein intolerance of the milk (lactose) Look on the label of yogurt for the words: "live cultures" (active cultures) or "active cultures" (active cultures) and avoid products that have been heated during processing, since heat destroys beneficial bacteria.

Many people take Acidofilus when they travel to other countries, as a prevention for intestinal infections and as an aid for the recovery of the digestive tract, after a treatment with antibiotics, especially broad-spectrum antibiotics. It is also recommended to women with vaginal infections.


DEVELOPMENT OF FERMENTED MILK WITH PROBIOTICS

These probiotic bacteria develop very well in a milk medium. The first of these special milks is the maternal one: studies carried out on infants fed with breast milk, showed that in the intestine of these children there are bacteria (such as bifidobacteria) that made them less susceptible to infections than to children fed other milk . Therefore, another of the probiotic options found in the gondolas are fermented milks, added with bacteria. One of them, the biotic milk, has Argentine citizenship, more precisely from Tucumán and was developed by Dr. Guillermo Oliver, a researcher at CERELA (Center of reference for lactobacilli) dependent on Conicet, and his team, which investigated the issue to alleviate some of the child malnutrition and the terrible diarrheas that are experienced in the Argentine Northwest, but unfortunately are a universal heritage. For this last reason, in parallel, other similar milks, such as those that emerged in 1995, were added to GG in other parts of the world. All these milks defeat the pathogenic microorganisms, regulate the intestinal balance, facilitate the digestibility of food, increase the tolerance to lactose, improve the immunity of the digestive and respiratory systems and favor the absorption of calcium. In short, benefits that far exceed the nutritional values ​​of conventional milks.

ADVERSE EFFECTS

It must be taken into account that they are living organisms and theoretically may be responsible for adverse effects, such as infections and metabolic disorders. There have been isolated cases of septicemia due to S. boulardii and Lactobacillus.

PRODUCTION AND SCALING OF PROBIOTIC MICROORGANISMS

• Selection and / or isolation of the Strain
• Activation
• Cell Count
• Propagation
• Scaling
• Drying
• Lyophilization
• Feasibility tests, purity, pathogenicity
• Control of process variables

PROSPECTS AND INVESTIGATIONS

• Establishment of a maximum, safe and permissible intake
• Study of the transitory and permanent effects of the Probiotics.
• Establishment of the safety and security of long-term probiotic foods
• Investigation of new strains of Probiotics
• Specific studies of risk reduction of diseases sufficiently reliable and sensitive.
• Study of functional foods and their regulations or legislation for commercialization.

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Use and research of probiotics

Update its effects on the treatment or prevention of important gastroenterological conditions, cancer and anticancer therapy.

Introduction

If intestinal bacteria can cause disease, can they create a healthy state by changing them? This is where the concept of probiotics comes into discussion. Probiotics are living microorganisms which, when given in adequate quantities, confer a health benefit to the host. They act through various mechanisms that affect the microbiota. This effect may be evidenced through changes in bacterial populations or in bacterial metabolic activity.

A recent study showed that a probiotic yogurt changed urinary bacterial metabolites, but not populations of the fecal bacterial community. Such results suggest that probiotics may have the potential to affect the microbiome's function more than structure. They are currently subject to increasing basic and clinical research and have also been incorporated into a wide range of foods, nutritional supplements and pharmaceuticals.



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A more recent question, for researchers is how to measure the impact of probiotics on healthy individuals, for example, how to evaluate the reduction of risk of developing a disease or how to optimize physiological function within normal ranges.
Probiotics in health and disease

• Irritable bowel syndrome (IBS)

In the absence of accepted biomarkers, the definition of IBS is based on symptoms; recurrent chronic episodes of abdominal pain or discomfort associated with altered bowel rhythm, in the absence of organic disease; feeling of swelling with no visible abdominal distention; anxiety and several extraintestinal symptoms. Although preliminary evidence suggests that there are alterations in the intestinal microbiota in patients with IBS, it has not been determined whether these alterations are the cause or consequence of altered motility and intestinal secretion.

Recent preclinical data support the concept that intestinal microbiota and probiotics affect the enteric nervous system and brain signaling. In rodents beneficial effects have been reported on nociceptive visceral reflexes, but only some preliminary data suggest that such mechanisms may also play a role in healthy or IBS subjects.

There is a growing number of meta-analyzes but their results on the effectiveness of probiotics in IBS are disparate, in part because of the heterogeneity in various aspects of the trials. Better designed studies and larger samples are required to determine the extent to which certain probiotics are useful therapeutic strategies for the treatment of IBS symptoms.

• Infectious diarrhea

Enteric and diarrheal diseases are the leading causes of morbidity and mortality in children <5 years worldwide, with higher burden in low- and middle-income countries. Repeated infections lead to acute and chronic malnutrition, leading to more frequent and serious infections; which ultimately causes developmental deficits during growth and aptitude and cognition, which persist in adulthood with devastating human and economic consequences.

Greater knowledge of the intestinal microbiota and possible mechanisms of action of probiotics has led to studies evaluating its efficacy in acute infectious gastroenteritis and in the context of persistent diarrhea. Such approaches have the potential to help reduce the global burden of childhood illness. Treatment with probiotics for acute diarrhea appears to reduce the duration of diarrhea by approximately 1 day (predominantly in developed areas).

In developing areas, persistent diarrhea has been reduced by approximately 4 days, along with improved growth parameters. Several studies with probiotics, including Saccharomyces boulardi , Lactobacillus rhamnosus GG and other strains, report reductions in both rates of nosocomial diarrhea and antibiotic-associated diarrhea and recurrences of Clostridium difficile diarrhea. These effects include a 40-60% reduction in the frequency of antibiotic-associated diarrhea. In contrast, it has been observed that the reduction of C. difficile diarrhea is much lower and remains a controversial issue.

Nosocomial infections remain a major health concern, generating high medical costs, creating a need for preventive approaches. But the authors emphasize that in this regard, the results of the investigations are also controversial. Supplementation of infant formulas with B. bifidum and Streptococcus thermophilus reduced the frequency of episodes of acute infectious diarrhea.

L. rhamnosus GG was effective in reducing nosocomial gastrointestinal diarrhea and respiratory tract diseases in more than 2,000 children = 1 year without underlying emergency hospitalized diseases for reasons unrelated to gastrointestinal or respiratory conditions. Although probiotics are promising to reduce nosocomial infections in some populations, at this time they are not recommended for critical inpatients.

• Inflammatory bowel disease (IBD)

The probiotic treatments of IBD have yet to meet the high expectations derived from studies so far, especially for Crohn's disease. No consistent therapeutic or preventive effects have been observed in the relapse of Crohn's disease. In ulcerative colitis benefits have been observed for a combination of Lactobacillus, Bifidobacterium and Streptococcus probiotic while Escherichia coli Nissle was beneficial in inducing and maintaining remission of activity in mild to moderately severe ulcerative colitis. The primary prevention of pouchitis and the reduction of the likelihood of relapse after successful antibiotic treatment was also successful.

The following table shows the possible reasons for the current disparity in potential and actual clinical outcomes of current probiotic treatment in IBD and strategies to address them.

• Possible reasons and solutions for the poor therapeutic results of probiotic treatment of IBD and other conditions.
• Reason for Failure     Proposed solution
• Wrong goals     Individualize treatment based on the molecular pattern of dysbiosis.
• Poor choice of probiotic     Use protective enteral enteric species, which may be more suitable than probiotics derived from cultured milk or food, complex groups of species diners or even intact normal bacterial communities (fecal transplantation).
• Consider incorrect mechanisms of disease     Adapt the therapeutic agent to correct the underlying genetic / inflammatory defect pathway in an individual.
• Product power less than required     Genetically improve bacterial function through the addition or elimination of bioactive (pharmacological) genes.
• Product not administered at the beginning of the disease, when it can be effective     Direct the therapy to the stage of the disease process.
• Age of subject     Adapt the therapy to the age / stage of development of each subject.

Although created for IBD, this conceptual framework is important for other complex disorders such as colorectal and gastric cancer, nonalcoholic steatohepatitis and autoimmune diseases. In these diseases, interactions between genetics, microbial and environmental influences lead to heterogeneous phenotypes in subgroups of patients that are exceptionally sensitive to specific microbial manipulations. Functions associated with more than 160 genetic polymorphisms observed in IBD can be broadly grouped as defects in mucosal barrier function / cure, abnormal immunoregulation, and defective microbial recognition or death.

Immunosuppression in a patient with defective bacterial death may be counterproductive. Similarly, an individual with dysbiosis may respond better to the selective restoration of protective commensal species, such as Faecalibacterium prausnitzii or Clostridium species, than to exogenous agents such as probiotics. Polymorphisms in genes related to IBD, which regulate mucosal glycosylation, such as Fut2 (which encodes α1,2-fucosyltransferase and is associated with abnormal bacterial profiles) may selectively enhance response to alternative bacterial nutritional sources such as the prebiotics.

The extraction or synthesis of molecules derived from probiotics or enteral protective species could also be useful. For example, purified immunoactive products could be synthesized and administered as p40 from L. rhamnosus GG or Bacteroides fragilis polysaccharide A , with defined biological actions. On the other hand, the bacteria can be designed to produce interleukin 10, trefoil (clover) or elafin factors. An alternative approach is to identify and develop dietary strategies to selectively enhance the growth and function of endogenous diners or decrease the activity of harmful bacteria.

For example, prebiotics such as inulin or fructose oligosaccharides increase the endoluminal number of Bifidobacterium species and protective short chain fatty acid concentrations, which are important metabolic substrates for colonic epithelial cells. Unlike refined sugars and food additives, such as iron, they can increase the proliferation of harmful bacterial species, including E. coli , Klebsiella pneumonia and Enterococcus faecalis. These dietary substances could be avoided to provide better maintenance of healthy states.

A potential therapeutic approach for the treatment of IBD could be to induce rapid clinical remission and corticosteroid mucosal healing and / or biological therapy, followed by probiotic and / or prebiotic interventions to maintain remission. This new paradigm of treatment is not yet proven, but is thought to stimulate new clinical and translational research goals, which has the potential to improve therapeutic outcomes while decreasing toxicity and long-term costs.

• Necrotizing Enterocolitis (EN)

Differences in the intestinal microbiota of preterm infants versus term infants may be in the predisposition to EN of preterm infants. Particularly, the microbiota of infants with EN differs from the microbiota of other low birth weight infants in the decrease of Firmicutes and the increase of gamma proteobacteria.

At present, EN is associated with a 30% mortality, with severe and costly sequelae if the patient survives. The disease can be difficult to diagnose before intestinal perforation occurs. The immature intestine of premature babies is especially prone to inflammation and loss of epithelial integrity.

Since probiotics have the potential to interfere with this progression, they have been clinically tested in EN. Although the American Academy of Pediatrics recognizes that there is evidence that probiotics prevent EN in very low birth weight infants and prior to issuing clinical recommendations, they advise further studies to clarify the effective dose and probiotic strains. In these cases, the opinions of various experts regarding the effect of probiotics is discordant.

• Cancer and cancer therapies

There is a set of evidence indicating a prominent causal role of environmental factors, including obesity and diet, which are associated with changes in the intestinal microbiome. The authors note that the incidence and tumor mass are higher in conventional rodents than in germ-free rodents.

Taken together, these findings strongly support the notion that the microbiota plays some role in CRC, but causality has not yet been confirmed. There is evidence that enterotoxigenic B. fragilis can trigger the catabolism of cadherin E, cause intestinal inflammation and thereby increase the risk of colon cancer.

Others have suggested that in these patients bacterial diversity is lower, altered or accompanied by elevated levels of Fusobacterium nucleatum sequences. In rodents, it has been found that probiotic concentrate has effects on precancerous and tumoral lesions. Several possible mechanisms have been proposed: alterations in the metabolism of microbiota species and changes in colon pH, carcinogen binding or inactivation, improvement of immune responses, reduction of colonic inflammation, reduction of epithelial proliferation and increase of apoptosis.

Biomarker studies in humans show that symbiotics reduced genotoxic damage induced by fecal water and increased transepithelial resistance. A symbiotic combination of an inulin preparation enriched with oligofructose combined with two probiotics did not affect epithelial cell proliferation, but there was little evidence of fecal water-induced DNA damage in HT29 and colon epithelial cells.

In another study we found pronounced changes in barrier function, ls immune cell activity, proliferation of immune cells and apoptosis. A consistent observation is that a symbiotic preparation appears to be more effective in altering the risk biomarkers of CRC than a single probiotic or prebiotic.

A human study showed less recurrence of adenomatous atypia after 4 years of administration of Lactobacillus casei . Finally, in an Italian cohort, a 12-year follow-up of more than 45,000 volunteers with high yogurt intake found a reduction in CRC, but there was no comparative group. There are few human studies on CRC, but with diverse endpoints.

Probiotics have been evaluated to help control the side effects of radiotherapy and chemotherapy in abdominal and intrapelvic cancers. In mice and germ-free animals with microbiota modified by antibiotics that received probiotics they are more resistant to radiation toxicity. L. rhamnosus GG reduced intestinal damage and post-radiation apoptosis in the proximal jejunum of mice.

The protection seems to be mediated by an unusual mechanism of increased migration of mesenchymal stem cells into the lamina propria. Benefits were also found in patients with chemotherapeutic or radiant therapy. The studies point to the potential beneficial effect of probiotics to improve radiation damage and chemotherapy in the small and large intestines of cancer patients. Probiotics can effectively mitigate disabling diarrhea, dehydration and secondary malnutrition in cancer treatment.

• Allergy

Allergic disorders have been associated with an aberrant intestinal microbiota. Factors associated with allergy, such as type of delivery (cesarean section vs. vaginal delivery), use of antibiotics in diets for newborns and infants, and diets without breast milk have also been associated with changes in the intestinal microbiota. In the last decades, nearly 10% of children developed allergy in a clinical progression characterized by eczema-rhinitis-asthma, and probiotic supplementation in food has been studied to disrupt this progression.

When there is a family history of allergy, it is advisable to start the administration of probiotics early. However, they have no effect on the expression of posterior asthma during childhood. So far, evidence of efficacy is not convincing enough to warrant pediatric organizations to recommend the routine use of probiotics.

• Common infectious diseases

The intestinal microbiota is being recognized for its role in promoting resistance to non-enteric pathogens, possibly through improved barrier function, production of anti-pathogenic substances or immune function. A review of the research suggests that certain probiotics can regulate critical components of the immune system, such as lymphocytes, antibodies and natural killer cells, which could prevent infections, especially in the upper respiratory tract.

Taken together, studies suggest that probiotics in otherwise healthy individuals can reduce common infectious diseases. However, before treatment can be definitively agreed upon, recommendations for dietary management can not be made and a systematic approach is needed to assess the strength of evidence in order to identify limitations in existing clinical studies.
Challenges for studying the health effects of probiotics

Researchers designing clinical trials should take into account the current relevant regulations in the field of probiotics, and the potential problems imposed by regulatory frameworks, especially in the EE. UU. and Europe.

• Design of a clinical study on probiotics

The value of well-designed, well-designed human trials to elucidate probiotic efficacy is evident. However, the current higher demands of regulatory authorities on health issues, the announcement of benefits in packaging and advertising, combined with the strict interpretations of what constitutes pharmacological research, requires careful consideration of regulatory problems when it comes to do the design and launch of probiotic studies for food or supplements. There are many issues that need to be taken into account in the planning stages by the researchers and sponsors of the study.




Questions to Consider Before Designing, Conducting, and Reporting Probiotic Studies in Humans
- Will the study be done in healthy subjects or in a population disease? Food and dietary supplements are products generally intended for the healthy population. Therefore, trials designed to support claims for products in this category should be conducted on subjects representing the general population. If the target is a disease state, then the study must be performed on a properly selected population that represents the disorder, and the study must conform to the standards of a pharmaceutical product.

• - What is the regulatory approach in your jurisdiction for claims for health benefits, of the type of product you intend to market? Will the product be a food, supplement, drug or other? Efficacy standards, appropriate study endpoints. target populations and risk assessment vary for the different product categories as well as the clinical research program, and these points need to be well differentiated.
• - If you are looking for help to claim a food or probiotic supplement, what exactly is the claim and if it will be supported by the study you propose? The primary endpoint in the research study should be as close as possible to the benefit to be communicated. The results should be clear and measurable, and the study protocol should preferably include a randomized, double-blind, placebo-controlled design. The selected placebo should be very similar to the probiotic food in terms of nutritional profile, taste, texture, color and taste, but should be devoid of probiotic strains.
• - Are the selected strains adequately characterized, in terms of their genome, in vitro properties and activities in vivo, and the ability to survive transit through the gastrointestinal tract? The exhaustive characterization of the deformation is critical for a thorough understanding of the substance being studied, and also to ensure ease of repetition of the study by other research groups.
• - Has the proposed formulation been shown to maintain viability and efficacy over the proposed shelf life and in the environment in which it is likely to be marketed?
• - Has a plausible logic been developed for the use of this / these particular strain (s) in this indication? Although confirmation of a mechanism of action for functional food ingredients (or drug, in that case) is not considered essential, a plausible reason is preferred.
• - Has the optimal target population been clearly defined for this particular probiotic and the specific outcome to be modified? If the target population is any subgroup of the general population for a food or supplement, it is important that it is documented.
• - What dose will be tested? Is there any indication of an effective dose in previous studies? The dose used in the study should be high enough to confer the benefit, but not so much to make the product commercially unsustainable. Since the dose of the product must match the dose in the human test that showed benefit, it is very important to consider the dose used in the study.

A key conceptual problem in probiotics is that clinical trials often fail to address the importance of probiotic viability for physiological benefit, and non-viable controls are rarely used. Although many of the mechanisms proposed for probiotic activity probably require growth and metabolism at the site of physiological action, confirmation of the viability requirement through the design of clinical trials with non-viable control would clarify this problem.

However, a non-viable product is not considered a probiotic, since by definition it must be a living microbe. Such a product would fall under the more general term "pharmacological", which encompasses non-viable microbes and health promoting substances derived from microorganisms.

• Effect of regulatory frameworks on the development of probiotics

The approach to marketing probiotic products is inextricably linked to the regulatory framework. These frameworks, although different in each country, affect research approaches, communication strategies, manufacturing and product labels. At present, regulations have become very important.

The development of trials must meet the requirements of scientific research, but also comply with the regulatory definitions of what constitutes the appropriate end points for specific product categories. The development of pharmacological research is quite clear, but not the way that research should follow to obtain evidence that justifies a health benefit from a food or dietary supplement.

Many probiotic products are marketed as foods or dietary supplements, however, much of the research documenting health benefits is considered by regulators in some countries as endpoints for drug use.

Such research may not be considered appropriate to corroborate the health benefits of food, since they are not regulated as preventive or therapeutic measures of disease, but only to support or maintain normal body functions or reduce the risk of disease in the population general. (The claim that "Food" can treat or prevent disease makes it a drug). So the challenge is how to carry out meaningful studies to show that health has improved or even more that has kept a person healthy? What does "maintained" mean in relation to the primary outcome of a study?

The communication of health benefits in probiotic products emerged as a challenge for probiotic companies. For example, in Europe, no claims for health benefits derived from approved probiotics have been approved, apparently because the level of evidence does not meet the expectations of regulatory authorities. On the other hand, to approve that the probiotic reduces the risk of disease requires the demonstration of changes in the commonly accepted risk factors for specific diseases.

Changes in one clinical end point are not enough, and many of the diseases / disorders for which probiotics are being explored lack validated biomarkers. In the USA Claims presented as "structural / functional" (eg, "this probiotic improves digestive health") do not require approval, however, they should be checked in. Here the challenge is what types of studies support such a general claim.

In spite of the lack of clarity in the way of justifying the claims, in EE. UU. regulatory authorities have increased their inquiry into the structure / function claims, requiring for their justification that regulatory standards be met. There is increasing scientific evidence that some probiotic foods or supplements may prevent or mitigate some diseases or disorders. For consumers, these products can be considered as food or supplements, but for regulatory authorities are drugs.

The future

The association of alterations of the microbioma with a progression of health to the disease seems to be an already clarified concept. However, causality and disease reversal have not yet been demonstrated in response to probiotic-induced changes in the microbiome. Until a healthy microbiome has been clearly defined to establish a microbiological target for probiotic interventions, its benefits should be described in the context of physiological or clinical improvement.

Some immunological and gastrointestinal clinical objectives have been mentioned in this review, including rotavirus infantile diarrhea, antibiotic-associated diarrhea, C. difficile diarrhea, ulcerative colitis, pouchitis, IBD, EN and radiation enteritis . Beyond this, probiotic interventions with effects outside the gastrointestinal tract are increasingly recognized.

Perhaps the most intriguing goal is centered on diabetes conditions, influenced by microbiota, metabolic syndrome and obesity, where studies in animal models indicate the functional involvement of the microbiota. To what extent probiotic interventions affect these diseases is an active and evolving area of ​​research. In the future, probiotics developed to address the conditions associated with the microbiota will probably go beyond the microorganisms that are commonly used as probiotics today.

Genetically modified microorganisms can provide epitopes to develop efficient oral vaccines, improve the natural immune response or vaccines, or restore antigen-specific tolerance. Probiotic strains with altered cell surface components, such as lipoteicoic acid, provide a potential strategy for the treatment of inflammatory bowel disorders.

The use of fecal transplantation to replace dysbiotic bacterial communities with safeners to treat C. difficile , IBD or IBD infections has had some success. Recently, fecal microbiota transplantation of non-diabetic donors infused into the duodenum of patients with metabolic syndrome improved insulin sensitivity, highlighting the broad potential of this intervention.

However, defined microbial cocktails that impart key functionalities may provide a more acceptable approach. Finally, specific strains with useful unique properties, such as Oxalobacter formigines , F. prausnitzii (chronic intestinal inflammation), Bacteroidetes and Fusobacterium (cancer risk), should be further investigated in well-designed clinical trials.

The use of probiotics to extend remission of IBD by its benefits in pouchitis and ulcerative colitis is promising, but as for the benefit in Crohn's disease requires new approaches. Identification of specific protective molecules, such as interleukin 10, ganglioside and trefoil (clover) factors, which can be designed on probiotics to be released in situ.

Effective probiotic interventions for conditions associated with the microbiota require a better understanding of the interactions between genetic, microbial and environmental influences in each person. Such an approach will also facilitate the identification of subgroups of patients most likely to respond to manipulations of the intestinal microbiota and the optimal agents to be used in each subject.

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Probiotics for your overall health

Probiotics (meaning "pro life") are non-pathogenic live microorganisms (in simple words: good bacteria) that resist normal digestion to reach the living large intestine. They have beneficial effects on health when consumed in the right amounts and in a sustained manner over time.

Most probiotics currently marketed belong to the genera Lactobacillus or Bifidobacterium.

To be considered a probiotic, the bacteria must be of human origin (although some are from plants or dairy), must resist gastric acidity, conjugated bile salts and enzymes, surviving the transit in the digestive tract. They must also be able to adhere to the cells of the gastric, intestinal or colonic epithelium to facilitate the stay in the digestive tract.



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How do probiotics work?

•     They contribute to restore the microbiota, that is to say the microorganisms that normally live in the intestine, modifying the pH.
•     They compete with pathogenic microorganisms in the intestine, inhibiting bacterial toxins and avoiding infections. They protect us from bad bacteria.
•     They produce antimicrobial substances (intestinal mucosa) against other unwanted organisms.
•     They stimulate the immune system, restoring intestinal permeability.
•     They can act in diverse organs, for example in the respiratory, digestive, urinary system, etc.

Benefits :

•     Prevent and treat infectious diarrhea associated with the use of antibiotics.
•     They improve the immune system.
•     Prevent some allergic manifestations (rhinitis, atopic eczema).
•     Treat and prevent colic in the infant.
•     Reversal of symptoms of poor digestion.
•     Replacement of the microbiota caused by antibiotics.
•     They favor, depending on the strains of microorganisms, in the treatment of Helicobacter pylori eradication, high respiratory infections, irritable bowel syndrome among others.

Probiotics in food:

•     They can be found in fermented dairy products such as yogurt, dairy drinks, milks grown and cheeses, to which we have added live and known crops such as Bifidobacterium and Lactobacillus. Take care that the sources from which you get them do not contain added sugar since they are usually found in this type of products.
•     Other foods: sauerkraut and fermented soy drinks.
•     Pharmaceutical presentation.

Useful Data:

•     The properties of probiotics depend on specific strains.
•     Once your intake is suspended, the effect soon disappears, so you should try to consume them regularly.
•     When purchasing foods that contain probiotics and require refrigeration, it is important to keep the cold chain to survive microorganisms and be functionally active when consumed. This means that you do not leave, for example, the yogurt in the car since if it warms the microorganisms die.
•     There are nutritional supplements with probiotics and as in food, they are strains that have specific functions and it is recommended to use them preferably with medical indication.

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Good Bacteria: Know Everything About Probiotics and Their Vital Functions

We have more bacteria in our body than our own cells. This statement can generate a great deal of concern if we think of bacteria as synonymous with disease. But, fortunately, the advances of science show the exact opposite: there is an intimate positive relation of the bacteria that inhabit our body with the health of our organism . The intestinal microbiota, or intestinal flora, is the largest community of bacteria that inhabit our body and has the power to influence our health , our weight , our mood or even our immune response . Kefir, curd, fermented milk, sauerkraut (fermented cabbage preserve), miso, cucumber, some cheeses and soy sauce are some foods that contain probiotics, many times consumed via supplementation.

With this explosion of interest in the subject "intestinal microbiota," we can find on the supermarket shelves and in pharmacies a huge variety of probiotic products (products containing bacteria and living yeasts) that claim to be able to influence our intestinal microbiome for the better. But is this really possible?



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WHAT IS THE ORIGIN OF PROBIOTICS?

Fermented dairy products have long been associated with the ability to confer health benefits on those who consume them regularly, was Ellie Metchnikoff who in 1908 made the first theorizing of the impact of these foods on the bacterial microbiota of the intestine.

In fact, many of the foods that contain probiotics appear in the form of fermented dairy products such as yogurts and kefir. Probiotics are living microorganisms which, when administered in adequate amounts, confer a health benefit to the host as shown in several studies. Probiotics can be consumed in foods that contain these microorganisms in large quantities or in the form of supplements that are made up of these living organisms.

HOW DO PROBIOTICS ACT IN OUR ORGANISM?

One of the main ways in which probiotics can exert beneficial effects is in altering the intestinal microbiota. This can be done by introducing new species into the gastrointestinal tract or by promoting the growth of existing beneficial bacteria.

Some studies show that the consumption of probiotics is associated with an increase in bacterial strains considered beneficial, such as Lactobacillus and Bifidobacterium, while simultaneously decreasing harmful species such as Clostridium perfringens.

The consumption of probiotics was also able to reduce the severity of Giardia intestinalis infection by modulating the immune system. In addition, probiotics have been shown to inhibit the adherence of harmful bacteria such as Salmonella typhimurium and Escherichia coli. In general, studies using probiotics have found that there is a shift from an innate immune response to an adaptive immune response, as well as increases in immunoglobulin A (IgA) levels that relate to improved immune tolerance.

WHAT ARE THE BENEFITS OF PROBIOTICS FOR ALLERGIC AND AUTOIMUNE DISEASES?

Allergic diseases have been growing in developed countries for decades, leading to a higher incidence of diseases such as asthma and food allergies. Many allergies, especially those related to food, are developed early, with most food allergies developing in the first 2 years of life.

Although most food allergies developed early in life do not persist, some can become permanent conditions. Recent work has shown that an increasingly important factor in determining whether a child will develop an allergic disease, be it food allergy or asthma, is the level of complexity and specific organisms present in the intestinal microbiota.

Higher levels of lactobacillus (L. acidophilus, L. delbrueckii and L. helveticus) in the intestines of infants have been associated with a lower incidence of allergic disease in adult life .

Supplementation with Bifidobacterium, in turn, has been shown to influence the intestinal microbiota of newborns at weaning , reducing Bacteroides levels, which has been associated with a lower incidence of food allergy.

WHAT IS KEFIR AND WHAT ARE ITS BENEFITS?

Although not as popular as other fermented dairy products (such as yogurt and cheese), kefir has its benefits widely studied and associated with health. Present originally in communities of the Caucasus Mountains, it was discovered in the second millennium BC, which means that this is the oldest fermentation method that exists. One of the characteristics that distinguish kefir from many other fermented dairy products is the requirement for the presence of kefir grain for fermentation.

Kefir grains are a colony of symbiotic microorganisms immersed in a matrix composed of polysaccharides and proteins. Unlike yogurt that is fermented only by lactobacilli, kefir requires lower temperatures and is fermented by more than forty different types of microorganisms in its colony, including yeast. The preparation of this rich colony is traditionally made from cow's milk but can be prepared with goat's milk, sheep's milk, vegetable source or even water.

Due to the highly complex microbiota of kefir, there is a multiplicity of organisms and metabolic products present in fermented milk. This combination of live microbial organisms and metabolites contributes to a wide range of effects attributed to kefir, many of which are beneficial to health. It has been shown that Kefir grains are able to reduce milk lactose levels through the fermentation process and also to reduce cholesterol levels present in up to 84% after 24 hours of fermentation.

CARE, ADVANTAGES AND DISADVANTAGES OF KEFIR

According to nutritionist Luna Azevedo during the preparation of kefir, hygiene is essential. Reserve the utensils used in the preparation of the grain just for this purpose. It in water may have fungus contamination if the brown sugar is not properly stored and has contact with a lot of moisture. Do not leave the bottle with the kefir grains exposed to the sun. Store it in a kitchen cabinet and away from any chemicals. Never wash the beans, just wash the bottle, when you make milk or water + sugar. And do not use soap or detergent, just water.

Advantages: It has already been observed in laboratory tests that kefir microorganisms have the power to inhibit Salmonella and E. coli pathogens (bacteria that cause disease). This colony has more than 40 living microorganisms, being much more complete than any product in the lyophilized market.

Disadvantages : Keeping grain for years requires kefir to be prepared almost daily or some special conservation precautions. Kefir can be frozen for some time, but it has to be revitalized after a few weeks. The kefir of water + brown sugar should be taken care of conversation of sugar pada to avoid contamination and growth of fungi. It must be taken into account that water kefir does not contain the same microflora as kefir made with milk. Although microorganisms consume lactose (milk sugar), anyone who is severely intolerant may still feel sick.

It is worth remembering that the use of probiotics should be done with medical or nutritionist guidance. In fact, living microorganisms are extremely important in our health and deserve full attention. For them to remain alive in the intestinal tract, they should be administered preferably with prebiotics (nondigestible fibers and used "food" for these living beings). There are versions with pre and probiotic (symbiotic) as well, it is possible to receive your donation of kefir. Always have the guidance of your doctor and nutritionist for possible indication according to each case.