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Probiotics and Guts Health

It is widely known that the intestinal mucosa is responsible for the absorption of nutrients, in which influenced by the integrity of tight junctions. What are tight junctions? Tight junctions are the major complexes responsible for the adherence of intestinal epithelial cells to one another and are an important part of the intestinal barrier. Thus, maintaining the tight junctions integrity is critical for the nutrient absorption, host defense, and host immunity. Ingrid S. Surono, a probiotics expert from Indonesia presenting her study “Probiotics and Nutritional Benefits for Young Children” and proves that supplementation of dadih (the Indonesian traditional fermented milk) strain, Lactobacillus plantarum IS-10506 for 90 days at 1010 cfu/day significantly improved nutritional status of pre-school children, i.e. significant increased in bodyweight, serum zinc, and serum selenium. This evidence shows increased evidence that microbes used in the study could affect intestinal barrier function, and regulate the entry of nutrients.

Mazlyn MM et al, probiotics experts from Malaysia did a study to evaluate the efficacy of fermented milk with Lactobacillus casei Shirota (LcS) in adults with Rome II functional constipation. Their findings indicate that provision of LcS >3,0 x 1010 cfu) may play a role in alleviating severity of constipation and exert a stool softening effect. While Kazuyoshi Takeda and Ko Okumura, probiotics experts from Japan demonstrated that probiotics LcS also enhances NK (natural killer) cell activity independently of acquired immune cells (T and B cells), in which anti-interleukin (IL)-12 and Interferon (IFN)-gamma would be responsible for the NK cell activation.

Aside from probiotics, then what will be the health benefits of prebiotics? As presented by Glenn Gibson, from the United Kingdom, prebiotics serve to elicit changes in the gut microbiota composition that increase populations of purpoted beneficial gut bacterial genera. Some prebiotics can be obtained by extraction from chicory or agave, such as inulin, in which they can be commercially produced through hydrolysis (e.g. oligofructose from inulin) or through catabolic enzymatic reactions (e.g. fructooligosaccharides/FOS from sucrose or galactooligosaccharides/GOS or lactulose from lactose). He stated that as gastrointestinal problems are ubiquitous, prebiotics based fortification of positive gut bacteria is appropriate for anyone, in which the earlier and later stages of life are thought to be especially relevant. The following are situations where prebiotics use may benefit the clinical situations: acute gastroenteritis, anti-tumor effects, obesity and related disorders, irritable bowel syndrome and mineral bioavailability. However, there is a need to do further studies that include a functional, as well as compositional, assessment of microbiota changes following prebiotics use, and also studies into clinical outcomes, by using a safe and user friendly approach.

In deciphering host-gut microbiome interaction via metabolomics as presented by Ivan Yap KS from Malaysia, it is known that the mammalian gut contains hundreds of species of commensal and symbiotic microbes that mainly reside in the large intestine. The gut microbiota contributes to myriads of mammalian processes, including defense against pathogens at the gut level, immunity, intestinal microvilli development, non-digestible dietary fiber fermentation and protein putrefaction. They represent a level of biological evolutionary development, i.e. true symbiosis in which characterized by extensive ‘transgenomic’ modulation of metabolism and function, and the contribution of gut microbiome in human physiological functions and disease state.

Furthermore, epidemiological studies have shown that certain patterns of stool microbiota in infants may have an adverse influence on the immune system, and resulting in disorders such as eczema and allergic disease. Lee BW, pediatrician from Singapore lectured on the gut microbiota and development of allergic disease, and stated that colonization of the infant’s gut begins at birth. Aberrations in the pattern of the microbiota are influenced by lifestyle and environmental factors, i.e. the extension of the hygiene hypothesis that promotes the development of allergic diseases. Clinical evidence has shown some benefit of probiotic bacteria in a number of gut related disorders such as infective gastroenteritis, necrotizing enterocolitis (NEC) of prematurity, and antibiotic-induced diarrhea. However, it still remains controversial whether supplementation with probiotics has beneficial systemic effects on immunological disorders such as atopic eczema.

Community studies on the effectiveness of probiotics for the prevention of acute diarrhea among children in Indonesia and other developing countries showed that some probiotics, but not all, are promising in reducing the burden of diarrheal disease on top of dietary and hygienic improvements. Rina Agustina, probiotics expert from Indonesia suggested for more high quality studies to confirm the results before recommending a routine use of probiotics to prevent diarrhea in children of developing countries, such as Indonesia.

As conclusions, gut health is important for the human systemic health, especially for children. It promotes child growth and development. Therefore, gut health is perfectly important to support nutrition program to alleviate the high prevalent of nutritional problems. Some nutrients such as glutamine and zinc are effective to maintain gut health, as well as pre and probiotics as functional foods. Operational and translational research should be conducted in a multidisciplinary approach to help confirming the effects of some specific nutrients and pre-probiotics in maintaining gut health.

Reported by Saptawati Bardosono

(9th Asia Pacific Conference on Clinical Nutrition)

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