"Please don’t squeeze the Charmin,” the longest running ad campaign in the history of television, was, until just a few years ago, the only US promotion to publicly recognize that Americans have a lower-gastrointestinal system. Via this famous phrase, supermarket manager Mr. Whipple suggests there is activity “down there” and promotes a product that can help — extra-soft and gentle Charmin toilet paper.
Times have changed. Today, you have Jamie Lee Curtis telling the country that the specific probiotics included in her preferred brand of yogurt keep her “regular.” Hollywood aside, there’s a lot of public discussion about digestion, regularity and general gastrointestinal health. Probiotics and fiber, many forms of the latter also described as prebiotics, have been shown to positively influence these health and wellness matters. Both terms — probiotics and prebiotics — are not federally defined, although they have been defined by leading global scientific authorities. But do consumers really know what the terms mean? Are they being used truthfully and honestly by ingredient suppliers and food marketers? Should bakers be adding these ingredients? Can they be effectively adding these ingredients to their products?
In 2001, the Food and Agriculture Organization of the United Nations (FAO) defined probiotics as “live microorganisms, which when administered in adequate amounts, confer a health benefit on the host.” With this definition, grammatically speaking, probiotics are a noun, not an adjective, which is how many marketers use the term, adding to the confusion and diluting the definition. In other words: “Cookie with added probiotics” is correct. “Probiotic cookie” is not.
The International Scientific Association for Probiotics and Prebiotics (ISAPP) recently issued a statement clarifying the FAO definition. According to this authoritative organization, a probiotic must be alive when administered; it must have undergone controlled evaluation to document health benefits in the target host; it must be a taxonomically defined microbe or combination of microbes (genus, species and strain level); and it must be safe for its intended use.
“Not all probiotics are created equal,” said Gregor Reid, PhD, ISAPP president and professor at the Lawson Research Institute, University of Western Ontario, London, ON, Canada.
A probiotic is defined by its genus (Lactobacillus, for example), species (rhamnosus) and strain designation (often a combination of letters or numbers). “Different strains of even the same species can be different,” added Mary Ellen Sanders, PhD, executive director of ISAPP and consultant with Dairy and Food Culture Technologies, Centennial, CO. “The concept of a bacterial strain is similar to the breed of a horse — all horses are the same genus and species, but different breeds of horses have different attributes , and different breeds are good for different tasks. “You cannot assume that different strains of the same species will have the same effects,” Dr. Sanders said. “The names of probiotics sound complicated, but they are important to connecting the specific probiotic strain to the strain’s published scientific literature.”
When it comes to commercially available probiotics, Dr. Reid cautioned, “Ingredient suppliers and food product manufacturers will often create a consumer-friendly name for the strain in their product. These names are not scientific names, and they do not reflect product quality. Never assume the ingredient is a true probiotic unless it meets the FAO definition and the specifics clarified by ISAPP. Most importantly, probiotics must be tested in humans and shown to have health benefits. Demand clinical proof before adding a probiotic into a product formulation,” he suggested.
Food formulators choosing to add a probiotic must proceed cautiously when promoting inclusion. “You cannot legally declare that the probiotic in a food or dietary supplement can cure, treat or prevent disease,” Dr. Sanders said. “Claims that relate the product to health are allowable. Any claim made on a product, no matter how general, is supposed to be truthful and substantiated, even though FDA approval is not required to make these claims,” she added. “Further, the product should contain the specific strain or strains of bacteria at the same levels as used in published research. The studies should be performed in humans and published in peer-reviewed, reputable journals.”
The term prebiotics (and for the record, also a noun) was authoritatively defined in Nutrition Research Reviews as “non-digestible (by the host) food ingredients that have a beneficial effect through their selective metabolism in the intestinal tract.” Prebiotics provide nourishment to normal, colonizing beneficial bacteria, yet prebiotics are non-viable food components/ingredients themselves. Hence, compared to probiotics, there are fewer concerns of misuse surrounding the term prebiotic among respected authorities. Still, safe consumption levels must be established and proven in clinical trials before any claims can be made.
In March, ISAPP published Prebiotics: A Consumer Guide for Making Smart Choices. The organization clarifies that prebiotics are selectively fermented, dietary ingredients that result in specific changes in the composition and/ or activity of gastrointestinal microorganisms, thus conferring one or more benefits upon host health.
“Certain prebiotics, when used in adequate amounts, have been shown to provide health benefits including improved digestive function and intestinal environment, positive modulation of immunity and metabolism, improved lipid metabolism and improved absorption of dietary minerals,” Dr. Sanders said. “Prebiotics can complement probiotic functions.”
ISAPP identified three criteria required for a prebiotic effect: resistance of the prebiotic to degradation by stomach acid, mammalian enzymes or hydrolysis; fermentation (breakdown, metabolism) of the prebiotic by intestinal microbes; and selective stimulation of the growth and/or activity of beneficial microorganisms in the gut. The latter is critical.
“To be selectively fermented, only a small number of beneficial bacteria should ferment the prebiotic, not a large number of microbes with ill-defined health effects,” Dr. Reid explained.
Further, to confirm prebiotic effects, well-conducted human trials are required. These should be replicated in different labs. And when the prebiotic is added to a food formulation, it must be at the same clinically proven levels in order to confer a measurable benefit.
The most widely added prebiotics to food formulations are fructooligosaccharides (FOS), inulin, which is a form of FOS, and galactooligosaccharides (GOS). There is a growing list of candidate prebiotics such as polydextrose, soybean oligosaccharides, isomalto-oligosaccharides, gluco-oligosaccharides, xylo-oligosaccharides, palatinose, gentiooligosaccharides and sugar alcohols, such as lactitol, sorbitol and maltitol. However, the evidence for these, especially in humans, is not as well advanced as it is for FOS and GOS, according to ISAPP.
“Many food ingredients are being touted as prebiotics when in reality they are not,” Dr. Reid said. “Many are simply fiber. Both are typically nondigestible carbohydrates, and both are typically fermented by gut bacteria. However, a prebiotic differs from fiber in that it needs to be selectively used in the gut — by only beneficial members of the gut microbial community.”
If you think it’s challenging for the industry to get a handle on foods and ingredients that qualify as probiotics and prebiotics, imagine what the average consumer understands.
According to Health & Wellness: The Purpose Driven Consumer, a report published by the International Dairy Deli Bakery Association, Madison, WI, in late 2008, more consumers recognize the term probiotics than the term prebiotics.
According to the national survey referenced in the report, 42% of those surveyed were aware of probiotics. Among these shoppers, 30% said that probiotics were “very/somewhat important” while only 13% of all shoppers said the same. Only 11% of respondents were aware of prebiotics. Of those consumers, 35% said that prebiotics were “very/somewhat important,” while only 4% of all shoppers said the same.
Other recent research confirms that the concept of probiotics is resonating with Americans. The 2009 Functional Foods/Foods for Health Consumer Trending Survey from Washington, DC-based International Food Information Council (IFIC) asked consumers, on an aided basis, whether they are aware of certain food components, their corresponding food sources and their associated health benefits. The most recognizable food/health associations continue to be those related to bone health, cardiovascular disease, cancer and benefits associated with fiber. With the exception of a few associations, awareness increased significantly since 2007. For example, recognition of using probiotics to maintain healthy digestive systems increased from 58% in 2007 to 72% in 2009. Similarly, awareness of probiotics used to maintain healthy immune systems increased from 54 to 71% between 2007 and 2009.
Of the 72% of consumers aware of the relationship of probiotics and a healthy digestive system, 38% said they were already consuming probiotics for this reason, while 47% were likely or somewhat likely to consume. Of the 71% aware of how probiotics maintain a healthy immune system, 41% said they were already consuming probiotics for this reason, while 42% were likely or somewhat likely to consume.
In the IFIC survey, 60% of consumers said they were aware of the relationship of prebiotic fiber and maintaining a healthy digestive system. Of this group, 45% said that they were already consuming prebiotics for this reason, while 47% were likely or somewhat likely to consume prebiotics.
Americans’ relationship with probiotics and prebiotics is in its infancy, with many manufacturers responding to consumer interest by incorporating either probiotics or prebiotics, or both, which is referred to as synbiotics, into more foods that people eat every day. This includes baked grain-based foods such as nutrition bars, muffi ns, cookies and even chips and crackers.
Probiotics are sensitive microorganisms and can lose viability when exposed to heat and other extreme conditions. In fact, probiotic supplementation has historically been limited to refrigerated and frozen foods, usually dairy foods, because even ambient temperature can decrease probiotic viability unless the microorganism is protected.
“The ability to bake cookies and other products with probiotics is something that was unheard of until recently,” said Mike Bush, vice-president for business development, Ganeden Biotech Inc., Cleveland, OH.
The company’s patented probiotic (Bacillus coagulans GBI-30, 6086) is protected by a hardened structure, or spore, which is analogous to a seed. This spore protects the cell’s genetic material from the heat and pressure of manufacturing processes, challenges of shelf life and the acid and bile to which it is exposed to during digestive transit. The viable spore is then able to grow and multiply into new cells in the small and large intestines, according to the company.
PC Brands, Solana Beach, CA, manufactures Pop Culture Probiotics Bars, shelf-stable grain-based nutrition bars that are enhanced with this spore-encapsulated probiotic.
“With its innovative probiotic strain, Ganeden Biotech is opening up new possibilities for consumers who want non-refrigerated probiotic-enhanced food products that can help regulate the digestive system,” explained Jack Kelly, president, PC Brands. These bars are a great way for consumers to get their daily dose of probiotics in a convenient, great-tasting, on-the-go shelf-stable form.”
Main Street Gourmet, Cuyahoga Falls, OH, a manufacturer of gourmet frozen bakery products, has introduced Activate, a new raisin bran muffi n fortified with the same probiotic.
“At first I was a bit skeptical, however, after collaborating with Ganeden labs, we were able to do something no company had done before,” said Harvey Nelson, c.e.o. of Main Street Gourmet. “We found a method to add probiotic bacteria to our mixing and baking process without affecting the muffi n’s taste or texture. That’s a big deal in the baking business.”
NakedPizza, formerly World’s Healthiest Pizza, New Orleans, LA, now offers the first delivery pizza in the US to be fortified with both probiotics and prebiotics. The probiotics are incorporated into the company’s original Prebiotic Multi-Grain Crust, enhancing the positioning of the pizza as an easy way to promote digestive health.
“The addition of probiotics to our Prebiotic Multi-Grain Crust will not affect taste and will enhance the nutritional profile of our great-tasting immuneboosting pizza,” said Jeff Leach, co-founder of Naked-Pizza. “This is a big deal for our business and consistent with our mission to demonstrate that pizza can be part of a healthy lifestyle.”
A way to overcome the challenges of losing probiotic viability through exposure to heat is to add probiotics after baking, possibly through a topping, frosting, coating, etc. For example, Barry Callebaut North America, Chicago, IL, introduced dark and milk chocolate ingredients enhanced with probiotics. Manufactured using a proprietary production process, the chocolate has a long shelf life and does not require refrigeration.
“While probiotics have been used in dairy foods like yogurt for some time, our studies have found that chocolate is a superior carrier for the intestinal delivery of probiotic bacteria,” explained Rich Benson, director of research and development at Barry Callebaut. “In fact, the survival rate of probiotics in chocolate was found to be three times higher than that of the milk matrix and probiotic yogurt drink we tested. There were virtually no negative effects from stomach acids.”
Numerous suppliers of probiotics and/or prebiotics use clinical studies to support claims. For example, a team of researchers at Denmark-based Danisco has shown the potential synbiotic effect of dietary supplementation with a probiotic culture (Lactobacillus acidophilus NCFM) and the prebiotic lactitol in healthy seniors. The study found the synbiotic combination increased the level of beneficial gut bacteria, improved immune and mucosal function and gave moderately enhanced bowel movements with no side effects.
This combination, as well as the many others involving clinically proven probiotics and prebiotics can be formulated into baked foods, either directly or indirectly, depending upon the ingredient. The popularity of probiotics and prebiotics will only continue as long as formulators and marketers follow the guidelines for usage and claims.