Probiotic action and health and well-being of children. Seppo Salminen Functional Foods Forum Finland

Transcription

1 Probiotic action and health and well-being of children Seppo Salminen Functional Foods Forum Finland

2 DEFINITION OF A PROBIOTIC Probiotic:...a living microbial preparation, which beneficially influences human health, when given in the right dose health effects and safety have to be demonstrated strains identified clearly and deposited in public culture collections WHO 2002 Seppo Salminen

3 INTESTINAL MICROBIOTA A PROTECTIVE AND ACTIVE ORGAN SYSTEM Barrier and energy harvest: protection Acute gastroenteritis, allergies, respiratory tract infections, stunting, Protection: pathogens, viruses Underlying factors for overweight and obesity

4 CAN IT BE MODULATED TO BE MORE PROTECTIVE WITH PROBIOTICS? Risk aberrancies Origins of microbiota Target timepoints: how early Changes in knowledge and dogma

5 Hygiene Hypothesis/Probiotic Basis The newborn: Immunologically immature early microbial stimulation -maternal factors, delivery, microbiota, breastfeeding aberrant immune responses to antigens later in life Disease risk: infections, sensitization, Western life-style diseases

6 Microbiota Impact: Current Thinking

7 BREASTMILK MICROBIOTA Bacteria in breastmilk lactic acid bacteria bifidobacteria Oligosaccharides

8 BREASTMILK MICROBIOTA 0,00 0,50 1,00 1,50 2,00 2,50 3,00 3,50 4,00 4,50 5, Sample Log cells/ml 2,78 ± 1,12

9 BIFIDOBACTERIAL SPECIES IN BREAST MILK 100 % 90 % 80 % 70 % 60 % % of ocurrence 50 % 40 % 30 % 20 % 10 % 0 % B. longum group B. catenulatum group Gueimonde et al 2007 B. bifidum B. breve B. lactis group B. adolescentis Species-groups

10 MILK MICROBIOTA COMPOSITION AND MODE OF DELIVERY MODE OF DELIVERY (colostrum) MODE OF DELIVERY (6 months of breastfeeding) Cabrera-Rubio et al 2012 Am J Clin Nutr

11 BREASTFEEDING REPORTED TO BE PROTECTIVE Diarrheal disease Allergic diseases Obesity development

12 SPECIFIC PROBIOTICS AND ALLERGIC DISEASE STATE OF THE ART? Work during the last 20 years Hygiene hypothesis driven Information on microbiota host interactions

13 Differences in Microbiota Composition Preceding Allergy HITChip * p-value # p-value Children developing eczema: less Bacteroidetes and Clostridium cluster IX bacteria at 18 mo * # # * qpcr of Bifidobacterium spp: children developing atopy have significantly less B. longum/infantis at the age of 6 months (Nylund et al. 2013, BMC Microbiol)

14 HEALTH PROMOTING DIVERSITY OF EARLY MICROBIOTA? Children developing allergic disease have higher diversity in microbiota at 6 and 18 months Less diverse similar to microbiota of healthy breast-fed infants Bifidobacteria often dominate in breastfed infants

15 HIGH ß-DIVERSITY PERSISTS POSTPARTUM AND OCCURS IN INFANTS Ley et al 2012 Koren et al 2012

16 Adapted from: Rautava, Salminen, Isolauri 2012, Nature Reviews in Gastroenterolgy ORIGINAL INOCULUM REVISITED

17 Growth Antigen load + Gut barrier dysfunction ABERRANT Microbiota Inflammation Symptoms Specific Probiotic Nutrition Environment BALANCED Microbiota

18 TIMING AND CONTROL OF INTERVENTION?

19 Seppo Salminen

20 PROBIOTICS INTERACT WITH VIRUSES Salminen et al 2010

21 Microbiota and Human History Hunter-gatherers Food supply not safe Important to build reserves Food scarce No overweight problem Regulation of barrier against pathogens & energy intake towards storage Seppo Salminen

22 BMI Obesity = Blood pressure Hyperglycaemia Hyperinsulinaemia But also low grade systemic inflammation

23 WEIGHT GAIN DURING PREGNANCY Koren et al 2012

24 OVERWEIGHT MOTHERS? Obese mother Lean child Koren et al 2012

25 Log cells/gr Log cells/gr Early Bifidobacteria in children who were normal weight or overweight children at 5 years * * 11 6 months 12 months * * * 10 * * FISH FC-FISH qpcr 6 FISH FC-FISH qpcr overweight normalweight overweight normalweight Seppo Salminen Collado et al. 2007/2008 Am J Clin Nutr Seppo Salminen

26 ABERRANT MICROBIOTA AND DISEASE? Obese infants: different microbiota composition Deviations precede overweight development Mother infant transfer of microbiota impacts Bifidobacteria and clostridia often differ

27 RESULTS ON PROBIOTICS & OVERWEIGHT: The risk of central adiposity defined as waist circumference 80 cm or more was lowered in women in the diet/probiotics group Nutrition counselling effective, but combined with probiotics even more effective Impact on blood glucose and waist circumference of the mothers positive Laitinen et al Br J Nutr. 2010;103:179 Luoto et al. J Ped Gastro Nutr 2011

28 Why Probiotic Effects Differ? Probiotic Genome Strains vary/production type Dose/administration time Viability usually poorly assessed Gene expression Host Genetics, Microbiome Diet/Geographical location Type of microbiota & health Duration of breastfeeding Colonization process Compliance/adherence Environment Mode of delivery Transfer of microbiota Breastfeeding Antibiotics Toxins

29 STATE OF THE EVIDENCE Scientifically interesting results suggesting a benefit High quality evidence backing specific strains to support clinical practice and clinical recommendations Not yet enough to satisfy regulatory requirements for EU health claims for healthy consumers

30 FUTURE CHALLENGES EU health claim legislation changing the scheme Studies in healthy populations or in at risk populations New probiotics?

31 Microbiota and health benefits Health benefit Intestinal microbiota Nutrition Inflammation Probiotics Food Matrix