Be Proactive with Probiotics!

Taught by: Vy Doan, Dietetic Intern (Class of 2016)

Date: 10/28/15
I.

COURSE IDENTIFICATION
A. Class: Probiotics and Prebiotics
B. Length: 60 minutes

II.

DESCRIPTION
Through lecture, handouts and active discussion, participants will
learn about probiotics. This class will discuss what a probiotic is,
their sources, and benefits. Participants will be more aware and
knowledgeable about probiotics and its impact on our bodies, as
well as how prebiotics play a role. This class will also discuss how to
incorporate more probiotics and prebiotics into their own diet.

III.

OBJECTIVE OF THE CLASS

Upon completion of this course, each participant will:
A. Verbalize the definition of a prebiotic and probiotic: Know the
difference.
B. Name and identify at least 3 of the probiotic rich sources.
C. Identify at least one benefit of adding probiotics and/or prebiotics
in the diet.

IV.

MATERIALS/EQUIPMENT
A. White board and White board markers
B. Pictures of probiotics/prebiotics (2 sets of copies)
C. Note Cards (Family Feud Game)
D. Scotch Tape
E. Probiotic handouts
F. Pens

V.

COURSE PRESENTATION
A. Introduction
1.
Ask patients about their knowledge on probiotics and
prebiotics.
2.
Explain that todays class we will be learning about
probiotics and prebiotics: a general overview and its
importance in gut health.
B. Lecture/Discussion
1.
Probiotics: What are they?

Probiotics come from the Greek word, meaning For

life termed by Nobel laureate Metchnikoff in 1908.
They are also often called good bacteria.
Probiotics are live bacteria and yeasts that are good
for health, especially the digestive system.
Probiotics are naturally found in the body. The
intestines house 10 times more microbes than
human cells. The bacteria are classified into 6 Types:
(Kovacs, 2015)
a. Lactobacillus: There are more than 50 species
of lactobacilli and are naturally found in
digestive, urinary, and genital systems. It is
mostly found in fermented foods like yogurt
and dietary supplements. Common species are
acidophilus and bulgaricus. Studies have been
done in linking Lactobacillus treating yeast
infections, urinary tract infection, irritable
bowel syndrome, antibiotic-related diarrhea,
travelers diarrhea, clostridium dificile induced
diarrhea, lactose intolerance, skin disorders,
and prevention of respiratory infections.
b. Bifidobacteria
There are approximately 30 species of this
family. It is mostly found in breastfed infants
and are thought to be the best marker of
intestinal health. Studies have shown that
bifidobacteria can help with improving blood
lipids and glucose tolerance. It can also
improve IBS symptoms like pain/discomfort,
distention/bloating, urgency, and digestive
disorders.
c. Saccharomyces Boulardii
Known to be the only yeast probiotic. Some
studies have shown that it is effective in
preventing and treating diarrhea associated
with use of antibiotics and travelers diarrhea.
It has also been reported to treat acne and
reduce side effects of treatment for H.Pylori.
d. Steptococcus thermophilus
Known for prevention of lactose intolerance
because it produces large quantities of the
enzyme lactase.
e. Enterococcus faecium

Found in intestinal tract of humans and

animals.
f. Leuconostoc
Used extensively in food processing however
Lactobacillus and Bifidobacterium have
emerged as two of the most commonly used
probiotics ( Ouwehand et al., 2002)

Health starts with the Gut:

o Probiotics regulate the balance of microflora in our
gut

Good and natural bacteria found in the gut

can be lost after taking antibiotics, but
probiotics can help replace them.
o Reduce harmful bacteria

Probiotics also line the epithelium and

prevents pathogenic bacteria from invading.

o Relieve diarrhea and constipation

The main function of the gastrointestinal

tract is to digest food and absorb nutrients.
Probiotics aid in digestion by containing
enzymes that the human body does not

naturally produce.
o Strengthen the immune system

Probiotics crowd out harmful bacteria as

well as by generating signals to our immune
system, Chait, MD, gastroenterologist with
Columbia Doctors Medical Group in

Hartsdale, New York.

Studies continue to look into the application
of probiotics in the treatment of a wide
variety of conditions, including inflammatory
bowel disease, vaginal yeast infections, and

high cholesterol.
o Increases the availability of vitamins and minerals
o Improve lactose intolerance


2.

3.

Bacteria like S. Thermophilus produce more

lactase to aid in lactose tolerance.

Probiotics: Feed It with Prebiotics
Prebiotics are defined as non-digestible substances
that provide a beneficial physiological effect to the
host by selectively stimulating the growth or activity
of bacteria. (Slavin, 2013).
Benefits include improved gut barrier function and
host immunity (reduction in Leaky gut syndrome),
improved satiety, and reduction in potential
pathogenic bacteria. (Slavin, 2013).
Prebiotics are fiber, but not all fiber are prebiotics.
(Slavin, 2013).
a. Classifications of a prebiotics requires that the
ingredient are as follows:
i. Resists gastric acidity, hydrolysis by
enzymes and absorption in the upper
gastrointestinal tract
ii. Fermented by the intestinal microflora
iii. Selectively stimulates the growth and/or
activity of intestinal bacteria potentially
associated with health and well-being.
Sources can be found in certain plant foods such as
asparagus, onions, tomatoes, garlic, wheat, oats,
soybeans, and leeks. (Slavin, 2013).
Other sources include fruit such as berries and
bananas, whole grains including oatmeal, barley, flax
seeds and wheat, and from legumes including lentils,
kidney beans, chick peas, navy beans, white beans,
and black beans. (Otles, 2013)
Benefits
Anxiety
a. Recent research has shown Lactobacillus
strains decreasing anxiety as measured by
various behavior tests due to the Vagus Nervemediated changes in GABA receptor subunit
expression. Probiotics alter the expression of
the GABA receptor, glucocorticoid levels, and
other fear-involved circuits. (Bravo et al.,
2011).
b. Probiotics have been shown to decrease
corticosterone (cortisol equivalent; cortisol is

the primary stress-induced glucocorticoid

released in humans). (Gaureau et al., 2007).
Acne and Eczema
a. Probiotics modify several factors in the
pathophysiology of acne development,
including anti-inflammatory properties. (Kober,
2015).
b. Clinically, the topical application of probiotics
has also been shown to modify the barrier
function of the skin with a secondary increase
in antimicrobial properties of the skin.
Specifically, Streptococcus thermophiles,
applied as a cream for 7 days, has been shown
to increase ceramide production both in vitro
and in vivo. (Kober, 2015)
Depression
a. More studies are showing that increased
probiotics are associated with lower depression
rates and their role in signaling serotonin.
(Kober, 2015).
Nasal Congestion
a. Probiotics are now playing a role in reducing
allergy symptoms and even asthma (Kramer,
2014).
Oral Health
a. The gut-brain-skin axis suggests a mechanism
that links gastrointestinal health, influenced by
interactions with oral probiotics, to the health
and well-being of the skin (Bowe and Logan,
2011).
4.
Sources (Getz, 2011)
Yogurt: The most common source and widely available.
It is crucial to have the container saying Contains Live
Cultures to receive the full health benefits.
Pasteurization and heat kills the microorganisms. Also
choose whole yogurt, such as Greek yogurt without
any added sugars or colorings.
Kefir: Originated in Eastern European Caucasus
Mountains. Contains the major strain and beneficial
yeasts that arent found in yogurt. It is prepared from
goat, cow or sheep milk and fermented kefir grains.

Sauerkraut: helps in lowering allergy symptoms. It is

also rich in vitamin A, B, C, and E. Although it is low in
calories, it is high in sodium so use sparingly.
Kimchi: A fermented cabbage Korean side dish. They
provide calcium, iron, beta-carotene, and vitamins A,
B1, B2, and C.
Soy Milk: Make sure bottle says, Contains live
cultures.
Tempeh: It is firmer than tofu and can be used as a
meat substitute. Great source of protein and calcium
and is low in sodium.
Kvass: a fermented beverage commonly made from
black or regular rye bread.
Miso: fermented soy bean, brown rice or barley with a
fungus called koji. It is also low in calories and high in
protein.
Kombucha Tea: Dark tea mostly found in oriental
stores to improve energy, digestion, and weight loss.
5.
Be Proactive!: This Weeks Challenge
Ask patients, What are some combinations that would
complement well together and you could add into your
diet?
C. Conclusion
1.
Review main points discussed during lecture
What is a probiotics and prebiotic? What is the
difference?
a. Probiotics are living microorganisms that
provide us with an array of benefits while
prebiotics are the plant-sources that feed
probiotics.
What are the benefits of probiotics?
a. Some benefits include better immune system,
digestion, skin, decreased depression and
anxiety, and reduced nasal congestion/allergy
symptoms.
How can we use probiotics into our diet?
a. Probiotics can be added as a snack as a yogurt
or yogurt drink. Tofu for protein sources and
paired with prebiotic, such as leeks.
2.
Thank patients for their cooperation and time. Ask if
there are any questions.

References
Bowe and Logan, 2011 W.P. Bowe, A.C. Logan. Acne vulgaris, probiotics and
the gut-brain-skin axis: back to the future? Gut Pathog, 3 (2011), p. 1
Getz, L. (2011, October 1). A Healthful Dose of Bacteria - Yogurt Is the Best
Probiotic Source, but Clients Do Have Other Options. Retrieved October 18,
2015.
Kober, M., & Bowe, W. (June 2015). The effect of probiotics on immune
regulation, acne, and photoaging. International Journal of Women's
Dermatology, 85-89.
Kovacs, MS, RD, B. (2015, September 10). Probiotics: Health and Disease
Prevention - What are the different types of probiotics? - MedicineNet.
Retrieved October 18, 2015.
Kramer, M., & Heath, M. (2014). Probiotics in the Treatment of Chronic
Rhinoconjunctivitis and Chronic Rhinosinusitis. Journal of Allergy, 1-7.
Otles, S. (2013). Probiotics and Prebiotics: New Hope for Genitourinary
Health. In Probiotics and Prebiotics in Food, Nutrition and Health (1st Ed.).
CRC Press.
Ouwehand et al., 2002 A.C. Ouwehand, S. Salminen, E. Isolauri Probiotics: an
overview of beneficial effect. Antonie Van Leeuwenhoek, 82 (2002), pp. 279
289
Schaeffer, J. (2013, September 1). Friendly Bug Invasion. Today's Dietitian,
38-38.
Slavin, J. (2013, April 22). Fiber and Prebiotics: Mechanisms and Health
Benefits. Nutrients, 1417-1435.