The Science of Digestive Health (Digesting the Facts: Probiotics, Prebiotics and Enzymes for Improved Digestion)

“Things sweet to taste prove in digestion sour.”

            --William Shakespeare

Natural products catering to digestive health are positioned as the next big “thing”, as reports trickle in suggesting digestive health will dethrone heart health from the number one spot of top health concerns, especially as Americans report more digestive problems than ever before. National statistics confirm a rise in gastrointestinal (GI) problems; according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 60 million to 70 million Americans are afflicted with digestive diseases. The cumulative effect includes 50 million physician visits and 10 million hospitalizations annually, with a direct and indirect cost on the economy of more than $107 billion.

“Currently in Western societies, the healthy intestinal flora of many people is compromised due to the modern diet, consumption of antibiotics and other prescribed or recreational drugs, smoking, and other factors such as stress and pollution,” said Michael Shahani, director of operations, Nebraska Cultures Inc. “As a result, many people have symptoms of poor digestion, gas, bloating, constipation and diarrhea.”

Increasing numbers of Americans are open to enhancing their digestive health with natural products. According to the Natural Marketing Institute (NMI), more than 15 percent are managing constipation, 14 percent irritable bowel syndrome (IBS) and 4.5 percent for stomach ulcer. NMI also found 20 percent of households turned to fiber and more than 10 percent used acidophilus probiotics in 2007.

What could be considered a renaissance or renewed interest in probiotics for digestive support is also driving interest toward other natural nutrients. Probiotics have garnered more mainstream acceptance, thanks in part to marketing campaigns from mega-brands entering the functional food category with items such as Danone’s Activia® yogurt and Yoplait’s Yo-Plus™. According to the technical research report, “The Probiotics Market: Ingredients, Supplements, Foods” from BBC Research, the global market for probiotic ingredients is on an upward swing. It is expected to be worth $15.9 billion in 2008 and reach $19.6 billion in 2013.

Its popularity can also be attributed to the growing amount of research suggesting probiotics can lower the risk or limit the progression of digestive ailments, including constipation and diarrhea, IBS, general intestinal viruses and antibiotic-associated infections. “A healthy population of gut flora (probiotics) has been proven as a requirement for good digestive health,” said Tim Gamble, vice president of sales and marketing, Nutraceutix. “Without it, the digestive tract struggles to assimilate nutrients and is more prone to digestive ailments and overgrowth of pathogenic bacteria. Many digestive disorders stem from a decreased population of healthy, natural probiotic organisms and the imbalance that occurs as a result.”

Hundreds of bacteria species reside in the human digestive tract gut; some are potentially pathogenic or putrefactive, and others are friendly. Beneficial bacteria, often known as probiotics, can be defined as live microorganisms in a supplement or food form that when administered in adequate amounts exert health effects on the host when consistently ingested.

Once a child is born, colonization of bacteria begins in the newborn’s intestines.¹Bfidobacterium infantis (B. infantis) and B. breve are the most predominant friendly bacteria in infants; however, proportions vary. For example, a breast-fed infant may have more Bifidobacterium and fewer Enterococci than formula-fed babies.² In a study from the University of Bari Policlinico, Bari, Italy, researchers studied the effects of probiotics on feeding tolerance, bowel habits and gastrointestinal motility in 30 preterm newborns. Ten were exclusively breast-fed, and the remaining 20 were given either Lactobacillus reuteri (L. reuteri) ATCC 55730 or placebo for 30 days. Children receiving probiotics showed a significant decrease in regurgitation and mean daily crying time and a larger number of stools compared to those given placebo. Gastric emptying rate was significantly increased and the fasting antral area was significantly reduced in both the newborns receiving L. reuteri and breast-fed newborns compared with placebo.³

Research in the area of children’s health and the use of probiotics is impressive: from improving the immune response of HIV-infected children,⁴ to its potential impact on children’s oral health,⁵ the use of probiotics in the prevention of atopic disease and the association between the disease and the composition of a child’s intestinal microbiota,⁶ its influence in asthma and respiratory conditions,⁷ and the potential for restoring the gut flora of autistic children.⁸ Supplementation with probiotics during a child’s early development has been found to also reduce the incidence of infections and diarrhea. In a double blind, randomized trial of children in day care, researchers examined whether long term consumption of a probiotic milk containing Lactobaciullus rhamnosus GG could reduce gastrointestinal and respiratory infections.⁹ Results indicated children in the Lactobacillus group had fewer absences because of illness; a slight reduction of severity and number of respiratory infections were also noted.