Éva Hil Hamilton DipNT(Dist) mbantmntoi Nutritional Therapist, Lecturer

Transcription

1 The First 1000 days the role of the microbiome Éva Hill Hamilton DipNT (Dist) mbant mntoi Nutritional Therapist, Lecturer NTOI AGM 18 th April 2015

2 This short timeframe offers a unique window of opportunity to shape healthier futures by having a profound impact on the child s ability to grow & develop and improve educational achievement. Ita Saul, Paediatric Dietitian.

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4 Roles of the gut flora in humans Protection from invaders production of anti-microbial substances increase acidity

5 Roles of the gut flora in humans Initiate tight junction protein formation SCFA to nourish enterocytes

6 Roles of the gut flora in humans Immunity Upregulate SecIgA and T reg cells Detoxification Phase III antiporter system, inhibition of Beta-glucoronidase Vitamin production & activation - Vitamin K2 & Vitamin B s Role in stress response & mental health

7 Collins, S M Bercik P, The Relationship Between Intestinal Microbiota and the Central Nervous System in Normal Gastrointestinal Function and Disease GASTROENTEROLOGY 2009;136:

8 Granham S. et al (2011) Brain-gut-microbiome communication in health and disease Front Psysiol. 2:94 Epub PubMed PMID:

9 Obesity link Inflammatory signalling has emerged as a potentially important mediator of leptin resistance. (Guyenet, S.J & Schwartz, M.W (2012) J Clin Endocrin Metab 97) (Caniet al 2007)

10 Diversity is key Over 100 trillion microbial cells, outnumbering human cells 10 to 1 and adding over 8 million genes to our set of 22,000 More than 500 species have been noted, each with numerous strains identified by molecular probes. Studies demonstrate that bacteria differentially colonize the intestines based upon a number of environmental factors: i. mode of delivery ii. hygiene measures iii. environmental contaminants iv. type of feeding v. maternal microflora Gill SR. et al. (2006) Metagenomic analysis of the human distal gut microbiome. Science 312: doi: /science Whitman WB, Coleman DC, Wiebe WJ (1998) Prokaryotes: the unseen majority. Proc Natl Acad Sci U S A 95: Heavey PM, RowlandIR The gut microflora of the developing infant:microbiology and metabolism. Microbial Ecol Health Dis. 1999;11:75-84 Harmsen HJ, et al. Alalysis of intestinal flora development in breast fed and formula fed infants. J Pediatr. Gastroenetrol Nutr. 2000; 30:61-67

11 Colonisation While the general dogma is that the placental barrier keeps infants sterile throughout pregnancy, increasing evidence suggests that an infant's initial inoculum can be provided by its mother before birth and is supplemented by maternal microbes through the birthing and breastfeeding processes. DiGiulio DB, Romero R, Amogan HP, Kusanovic JP, Bik EM, et al. (2008) Microbial prevalence, diversity and abundance in amniotic fluid during preterm labor: a molecular and culture-based investigation. PLoS ONE 3: e3056 doi: /journal.pone DiGiulio DB (2012) Diversity of microbes in amniotic fluid. Semin Fetal Neonatal Med 17: doi: /j.siny Jimenez E, Fernandez L, Marin ML, Martin R, Odriozola JM, et al. (2005) Isolation of commensal bacteria from umbilical cord blood of healthy neonates born by cesarean section. Curr Microbiol 51: doi: /s Jimenez E, Marin ML, Martin R, Odriozola JM, Olivares M, et al. (2008) Is meconium from healthy newborns actually sterile? Res Microbiol 159: doi: /j.resmic

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13 The developing brain and immune system The evolving cognitive activity is critically dependent on the microbiota and its metabolic outputs. Recent studies have demonstrated a clear association between changes in the microbiota and cognitive behaviour, including learning and memory. M. G. Gareou (2014) Microbial Endocrinology: The Microbiota-Gut-Brain Axis in Health and Disease Advances in Experimental Medicine and Biology 2014, pp At birth the immune system is Th2 biased environmental microbes influence balance

14 Maternal microflora influence Microflora stimulates the development of the immune system in infants (Forchielli & Walker, 2005) 75% of gut bacteria in breast fed infants is Bifidobacteria, compared to 3% in adults (Macfarlane, 1995) Alterations in this level is associated with higher risk of atopic eczema and atopic sensitisation later in life (Suzuki et al, 2007) Short term administration of Lactobacilli species in late pregnancy increased Bifidobacteria levels in infants (Lahtinen et al, 2009) Enomoto et al (2014) have found that perinatal probiotic supplementation can reduce immune problems during the first 18 months of life

15 Maternal microflora influence Caesarean delivery increase risk of developing atopy and allergic rhinitis by twofold (Pistiner M. et al, 2008) due to preoperative prophylactic antibiotic administration (Baaquel, H. et al 2012) In two long-term studies by Kalliomaki et al (2007) and Kuitanen et al (2009) decreased frequency of eczema and IgE associated diseases were found in Caesarean delivered babies when supplemented with probiotics both pre- and postnatal. They speculated that antenatal supplementation is required for best effects. Luoto et al (2012) compared dietary intervention on its own or with added probiotics compared to control group during pregnancy and their effect on colostrum adiponectin levels and found significant difference in the intervention groups. The frequency of gestational diabetes was significantly lower in the probiotic group.

16 Maternal microflora influence Obesity connection: Bifidobacteria lower in children with subsequent obesity (Kalliomakiet al 2008). Epidemiologic studies indicate an association of Caesarean section with the development of childhood obesity (Blustein et al., 2013; Huh et al., 2012; Li et al., 2013) In particular, antibiotic exposure in early life, just when host adipocyte populations are developing has been associated with the development of adiposity in humans (Ajslev et al., 2011; Trasande et al., 2013).

17 Quality for therapeutic outcome Probiotic strains in the product Viability (until the end of best before date) Survival Adherence to intestinal wall Colonisation Diversity

18 All Bio-Kult Probiotics The beneficial bacteria are coated with a cyto-protectant layer before the freeze drying process No refrigeration required (stable up to 25 0 C for 2 years) Guaranteed stability (and count) until end of 2 year shelf life Protected from the harsh acid environment of the stomach Acid Stability of Bio-Kult s Probiotic Strains - In vitro growth at ph 2.0 for two hours

19 All Bio-Kult Probiotics Bio-Kult blister packs offer higher protection against moisture and fluctuating temperatures than pots moisture is known to be a main factor to spoiling viability & effectiveness 3 month stability testing for 27 months using independent UKAS accredited laboratories Manufactured to a very high standard cgmp (current Good Manufacturing Practice) accreditation ensures high standard manufacturing Audited by the MHRA

20 All Bio-Kult Probiotics Vegetarian Society Approved Gluten, Corn & Wheat Free Non-GMO Suitable for pregnant women & children (with HCP approval) Capsules can be pulled apart and added to food or drink Cellulose base (no longer maltodextrin or magnesium sterate) Contains traces of soya & milk at a level which would not affect lactose intolerant sufferers (but should be avoided by those with severe milk allergy)

21 Bio-Kult Advanced Multi-strain Formula Formulated by Dr Natasha Campbell McBride 14 different strains - 5 different genera Bifidobacterium breve PXN 25 Bifidobacterium infantis PXN 27 Bifidobacterium bifidum PXN 23 Bifidobacterium longum PXN 30 Lactobacillus acidophilus PXN 35 Lactobacillus plantarum PXN 47 Lactobacillus helveticus PXN 45 Lactobacillus casei PXN 37 Lactobacillus rhamnosus PXN 54 Lactobacillus salivarius PXN 57 Lactobacillus Bulgaricus PXN 39 Lactococcus lactis PXN 63 Streptococcus thermophilus PXN 66 Bacillus subtilis PXN 21 2 billion CFU/capsule (2x10 9 CFU/capsule) 10 billion CFU/g (1x10 10 CFU/g)

22 Conditions where we recommend Bio-Kult During Pregnancy & Lactation During and after Antibiotic / OCP use Traveller's Stomach Digestive complaints (including IBD) Immune imbalances Autism / ADHD Sports nutrition

23 Bio-Kult Easy to swallow 160mg vegetable capsules Directions for use: 1-2 capsules once/twice daily with food Children under 12, half adult dose safe from birth No contraindications and no risk of overdose Gradual build-up recommended in sensitive patients and children Boxes of 30, 60 and 120 Capsules

24 Bio Kult Infantis - for babies & young children Multi-strain Probiotics (7) 1 billion CFU Lactobacillus casei PXN 37 Lactobacillus rhamnosus PXN 54 Lactobacillus acidophilus PXN 35 Lactobacillus bulgaricus PXN 39 Streptococcus thermophilus PXN 66 Bifidobacterium breve PXN 25 Bifidobacterium infantis PXN 27 Added Vitamin D3 and Omega 3 Preplex (FOS and guar gum)

25 Bio Kult Infantis - for babies & young children Designed for young infants and children up to two years of age Safe from birth Tasteless soluble powder May be added to formula or any food or drink May be administered directly under the lip of the baby

26 Clinical studies: Functional constipation Childhood constipation Acute gastroenteritis Atopic dermatitis Paediatric Helicobacter Pylori Infantile Colic Neonatal Pneumonia Reduce faecal Calprotectin in COPD Adjunct therapy in NASH, Metabolic syndrome & Bacterial Vaginosis

27 Bio-Kult Probiotics The experts in probiotics

28 Bio-Kult Candéa For maintaining natural defences against Candida overgrowth Probiotic 7 strains Lactobacillus casei PXN 37 Lactobacillus rhamnosus PXN 54 Lactobacillus acidophilus PXN 35 Lactobacillus delbrueckii ssp. bulgaricus PXN 39 Streptococcus thermophilus PXN 66 Bifidobacterium breve PXN 25 Bifidobacterium longum PXN 30 1 billion CFU/capsule (1x10 9 CFU) Garlic (60mg) Grapefruit seed extract (130mg) 2 x 400mg capsules daily with food Contraindications pharmaceutical medication that warns against the consumption of grapefruit juice e.g. statins and some blood pressure tablets

29 Introducing Bio-Kult Pro-Cyan Advanced formula for healthy urinary tracts Per 2 capsule dose 1. Cranberry extract (Cranmax ) 36mg 2. Probiotics 2 strains Lactobacillus acidophilus PXN 35 Lactobacillus plantarum PXN 47 1 x 10 9 CFU (1 billion) 3. Vitamin A (Retinol) 320 mcg Dosage - 2 x 400mg capsules once or twice daily - 1/day maintenance

30 Lepicol Range

31 Psyllium husks (Plantago ovata forsk) Water retentive absorbs times its weight in water Forms a soft gel - induces peristalsis and eases the stool along the lower digestive tract Much gentler than some common fibres (such as wheat bran) that can be irritating to a sensitive bowel

32 Probiotics Probiotic strains: 5 strains Lactobacillus rhamnosus PXN 54 Bifidobacterium bifidum PXN 23 Lactobacillus acidophilus PXN 35 Lactobacillus plantarum PXN 47 Lactobacillus bulgaricus PXN 39 (present in our superior probiotic Bio-Kult) Probiotic strength: Minimum of 120 million CFU/g (1.2 x 10 8 CFU/g) 600 million per 5g/1 tsp serving

33 Prebiotics Non-digestible carbohydrates (e.g. GOS, FOS and inulin) that selectively increase bacteria already present in the microflora Fermented by bacteria in the gut to aid their growth Fermented by probiotic bacteria to aid their growth Lactobacilli and especially Bifidobacteria are more efficient at this process than pathogenic bacteria Lepicol s prebiotic fibre is Inulin from chicory root

34 Consider recommending Lepicol Constipation Diarrhoea Alternating IBS Diverticular disease Weight loss regimes (satiety) Detoxification Cholesterol lowering protocols

35 Lepicol Powder D O S A G E S N O T E Adults: 1-2 (5-10g) heaped teaspoons once or twice daily Children: (2.5-5g) heaped teaspoon once or twice daily Children under 11 years need to be monitored by a healthcare professional ml of liquid needs to be consumed for every 5g/heaped teaspoon and plenty of water throughout the day Take 30 minutes before meals 2 hours apart from medications

36 Lepicol Capsules A different method of administration to suit preferences The amount of fibre taken with the capsules is smaller due to it containing the fine (ground down) psyllium which is very effective in small doses It is slower to absorb water and form a gel like substance so the amount of fibre in the capsules is less weight wise 90 and 180 capsule pot D O S A G E S Vegetable capsule (Hydroxy-propyl-methane-cellulose) Adults: Take 2-8 capsules once or twice daily Children: 2-5 capsules once or twice daily The capsules can be opened and the contents poured into water or juice if preferred

37 Lepicol Plus 180g powder pot Added digestive enzymes & soothing herbs: protease, betaine HCL, ginger root, papain, peppermint leaf, fennel seed, bromelain Same directions for use as Lepicol original powder but most ideal to take 10 minutes before a meal

38 Thank you Please find us at the SCOPE Healthcare Stand