Summarized by Group 4, Fourth Year (42th Generation)
Academic Year: 2020-2021 Content
I. Principles application of microflora of upper GI and lower GI tract (Page 3)
II. Definition and Health Benefits of Prebiotics & Probiotics (Page 4-5)
III. Food Source of Probiotics (Page 6-7)
IV. Food Source of Prebiotics (Page 8)
V. Synbiotics and Health Benefits (Page 9)
VI. Risks and Side Effects of Probiotics and Prebiotics (Page 9)
VII. Multiple Choice Questions + Answers (Page 10-16)
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2 I. Principles application of microflora of upper GI and lower GI tract Upper Gastro-Intestinal (GI) ★ The stomach contains few bacteria because of its high acidity. ★ Helicobacter Pylori, now are proven to be the cause of most (greater than 95%) cases of gastritis and peptic ulcers.
Lower Gastro-Intestinal (GI)
★ The small intestine usually contains small numbers of Streptococci, Lactobacilli, and yeasts, particularly Candida Albicans. ★ Larger numbers of these bacteria are found in the terminal ileum. ★ The large intestine, or colon, is the main site for bacteria in the body. Roughly twenty percent of the faeces of a normal person consists of bacteria. ★ The main bacteria in the colon are Bacteroides, Bifidobacterium, Eubacterium, Coliforms (e.g. E. coli), Streptococcus, Lactobacillus and Clostridium.
Intestinal Flora of Breastfeed Infant
★ The breast milk is rich in prebiotic oligosaccharide and probiotics that play an essential role in the composition of gut microbiota in the newborn. ★ Some prebiotic can be beneficial for infants by promoting the growth of healthy gut bacteria, supporting the immune system, stimulating bowel movement and softer stool. ★ The most widely used probiotics are live bacteria such as lactobacillus and bifidobacterium. ★ Human breast milk contains an average of 5–15g of oligosaccharides per liter. ★ The total number of microbial genes in the human body is 1000-10000 bacteria per milliliter.
Human milk oligosaccharide (HMO)
★ HMO gives newborn multiple layers of protection: -Protect against pathogenic infections -Promote the development of health -Help establish the gut microbiota -Stimulate the maturation of immune system ★ HMO content in colostrum 15-32 double level of mature milk. ★ Through their action on the gut, HMOs positively influenced the infant’s mucosal and systemic immunity.
3 II. Definition and Health Benefits of Prebiotics & Probiotics: 1. Definition of Probiotics: ➢ They are live microorganisms that provide health benefits. ➢ They are created by the process of fermentation in foods. ➢ They are classified into two groups: ★ Lactobacillus: is found in yogurt and other fermented foods. It helps for infectious diarrhea, antibiotic-associated diarrhea and also for general digestion problems. ★ Bifidobacterium: In some dairy products for treating the irritable bowel syndrome (IBS), preventing constipation and reducing of certain carcinogenic enzymes.
Health Benefits of Probiotics
Probiotics may play a beneficial role in several medical conditions, including diarrhea, gastroenteritis, irritable bowel syndrome, inflammatory bowel disease, cancer, depressed immune function, infant allergies, failure to thrive, hyperlipidemia, hepatic diseases, Helicobacter pylori infections, and others.
4 2. Definition of Prebiotics: ★ Prebiotic fiber is a non-digestible part of foods. ★ They are presented in fiber-rich foods like bananas, onions, garlic, asparagus, barley, apple, etc. ★ It is fermented in the large colon to feed beneficial bacteria colonies. ★ Fructooligosaccharides, inulin, oligofructose, lactulose, galactooligosaccharides and oligosaccharides is also prebiotic due characteristics such as resistance to gastric acidity and hydrolysis by mammalian enzymes.
Health benefit of prebiotics
Prebiotics are helpful in increasing the helpful bacteria already in the gut that reduce disease risk and improve general well-being.
5 III. Food Source of Probiotics
Yogurt is one of the best sources of probiotic which is made from milk that has been fermented by lactic acid bacteria and bifidobacteria. The benefit of yogurt includes: Improved bone health, Beneficial for people with high blood pressure, help reduce the diarrhea caused by antibiotics, suitable for people with lactose intolerance…. etc.
However, not all yogurt contains live prebiotic, in some cases the live bacteria have been killed during processing. Making sure to choose yogurts with an active or live culture and always read the label on yogurt before buying it.
Kefir contains several major strains of friendly bacteria and yeast, making it a diverse and potent probiotic. The benefits of kefir include: Well tolerated by people who are lactose intolerant, improve bone health, help with some digestive problems and protect against infection.
Sauerkraut is rich in fiber as well as vitamin C, B and K. It is also high in sodium
and contains iron, manganese, antioxidant lutein and zeaxanthin, which are important for eye health, pregnancy…etc.
Tempeh is originally from Indonesia but has become popular worldwide because of containing vitamin B12. This makes tempeh a great choice for vegetarians as well as anyone looking to add a nutrition probiotic to their diet.
6 Kimchi is a fermented, spicy Korean side dish cabbage is usually the main ingredient. It contains the lactic acid bacteria, high in some vitamins and minerals, including vitamin K, riboflavin and iron also may benefit digestive health.
Miso is a Japanese seasoning. It is a good source of protein and fiber, also high in various vitamins, minerals and plant compounds, including vitamin K, manganese and copper. Miso has been linked to some health benefits.
Natto is a fermented soybean product, it is rich in protein, vitamin K2 which is
important for bone and cardiovascular health. Consuming natto on a regular basis was associated with higher bone mineral density.
7 VI. Food Source of Prebiotics
The easiest and the commonest way of getting our daily dose of probiotic is by having onions. Onions are rich in inulin which helps in boosting the immunity of the gut.
Rich in pectin, apples help in maintaining the right pH of the stomach
and prevent the growth of bad bacteria. An apple a day can really keep the stomach happy. it.
Honey also contains a mix of oligosaccharides, which have been shown
to promote the growth of bifidobacteria and lactobacilli, two important probiotic strains.
Your gut loves bananas. It is not only rich in fibre and potassium but is indeed a very good source of prebiotic.
Wholegrains like oats, barley, wheat, etc. are also very rich in prebiotics.
Consuming whole grains will not only keep your gut healthy but also help your body in absorbing calcium and even prevent bloating.
Bean is rich in oligosaccharides (a form of carb needed for feeding the
good gut bacteria). Beans are strong digestive boosters. Do not forget to include them in your diet.
8 VI. Synbiotics and Health Benefits Synbiotic is a combination of probiotics and prebiotic. Example: Bifidobacteria strains + fructo-oligosaccharides (FOS).
Health benefits ➔ Improved survival of live bacteria in food product, prolonged shelf life. ➔ Stimulation in the colon of the growth and implantation of both exogenous and endogenous bacteria.
VII. Risks and Side Effects of Probiotics and Prebiotic
★ They are not recommended: in patient who have sensitive with symptoms of irritable bowel syndrome and SIBO (intestinal bacterial overgrowth) ★ They are generally safe for healthy people. ★ They are nott regulated according to drug standards by FDA, it means that being used in probiotics has not been evaluated according to strict safety measures.
Side effects ➔ Allergic reaction ➔ Upset stomach, gas, diarrhea, or bloating (the first time you consume).
9 Multiple Choice Questions (MCQs + Answers)
1. The main bacteria in the lower gastro-intestinal are, except:
a) Bacteroides b) Clostridium c) Corynebacterium d) Lactobacillus
2. Human breast milk contains ___ of oligosaccharides per liter.
a) 5-10 g b) 5-15 g c) 5-25 g d) 5-30 g
3. All the following are prebiotic fiber foods, except:
a) Apple b) Garlic c) Brined olives d) Tomatoes
4. Where's prebiotics and probiotics end up?
a) Duodenum b) Jejunum c) Ileum d) Colon
5. What is the bacteria infection in upper grastro-intestinal give cause gastritis and peptic ulcers? a) Escherichia Coli b) Staphylococcus aureus c) Helicobacter pylori d) Salmonella & Shigella
6. Which one is the correct answer of Upper Gl Anaerobic gram positive?
a) Lactobacillus & Bifidobacteria b) Bacterioides c) Staph spp & Strep viridians d) Helicobacter pylori
7. Which one is the correct answer of Upper Gl Anaerobic gram negative?
a) Helicobacter pylori b) Escherichia Coli c) Bacterioides d) Lactobacillus & Bifidobacteria
10 8. Which of the following is not the main bacteria in the colon? a) Staphylococcus b) Bacteroides c) Bifidobacterium d) Streptococcus
9. Bacteria, proven to be the cause of most cases of gastritis and peptic ulcers is? a) Lactobacillus b) Clostridium c) Helicobacter pylori d) E. coli
10. Why is human milk oligosaccharide important to newborns?
a) It tastes good b) It gives newborns multiple layers of protection c) It helps to form cell membrane d) It provides energy
11. Small numbers of Streptococci, Lactobacilli, yeasts, and Candida Albicans are found in: a) Stomach b) Terminal ileum c) Duodenum d) Colon
12. The main site for bacteria in the body is?
a) Large intestine or colon b) Ileum c) Duodenum d) Stomach
13. The breast milk is rich in?
a) Prebiotic b) Oligosaccharide c) Probiotic d) A B C are correct
14. Why does the stomach contain few bacteria?
a) Its high alkaline b) Its high NaCl c) Its high acidity d) Its high virus
11 15. Prebiotic fiber could be found in the following foods except: a) Bananas b) Kimchi c) Beans d) Onions
16. Where will the prebiotic fiber be fermented?
a) Small intestine b) Stomach c) Large colon d) Mouth
17. Which of the following is the benefit of prebiotic?
a) Lower number of desirable bacteria b) Reduced disease risk c) Fight probiotic bacteria d) Feed beneficial bacteria
18. Which of the following statements is not true about probiotics?
a) Live beneficial virus b) Obtained through process of fermentation c) Commonly available in yogurt, sauerkraut, miso soup d) Found mostly in group of Lactobacillus and Bifidobacterium
19. Probiotics could be retrieved from the following foods. Which one is not true? a) Yogurt b) Chicory root c) Miso soup d) Kimchi
20. Below is the property of Lactobacillus except:
a) Increase diarrhea b) Digest milk sugar c) A common probiotic d) Help people with lactose intolerance
21. The following statements are the property of Bifidobacterium. Which one is not true? a) Prevent constipation b) Boost immune system c) Fight bacterial flora d) Reduce concentration of certain carcinogenic enzymes
12 22. Fermented foods with the rich sources of probiotic bacteria are: a) Kefir, sauerkraut, yogurt b) Kefir, yogurt, garlic c) Kefir, sauerkraut, apples d) Sauerkraut, canola, olive
23. Based on a study in 2012, how many adults consumed probiotics?
a) More than 4 million adults b) 4 million adults c) 40 million adults d) Almost 4 million adults
24. Probiotic is originated from Greek word meaning
a) For life b) Antibiotics c) Against life d) Kill life
25. “Probiotics are substances and organisms which contribute to intestinal microbial balance”. Who gives this definition? a) Lilly and Stillwell in 1965 b) Fuller in 1989 c) Parker in 1974 d) Elie Metchnikoff in 1908
26. Lactobacilli and Bifidobacterium are:
a) Gram negative bacteria b) Lactic acid-producing bacteria c) Gram positive virus d) Acid-fast bacillus
27. Yogurt is beneficial because:
a) Improve bone health b) Provoke irritable bowel syndrome c) Contain harmful bacteria d) Aggravate irritable bowel syndrome
28. Kefir is:
a) A fermented prebiotic b) A fermented probiotic milk c) A protein supplements d) A vitamin supplements
13 29. The amount of bacterial species in the human intestinal tract are: a) Less than 400 species b) Only 400 species c) Less than 200 species d) More than 400 species
30. Eating yogurt is associated with many health benefits except:
a) Improved bone health b) Relieve the symptoms of irritable bowel syndrome c) Protect against infection d) Reduce diarrhea in chicken
31. The word “probiotic” come from Greek word “pro bios” which means: a) For health b) For life c) For digestion d) For animal
32. Kefir contain several major strains of:
a) friendly bacteria b) Yeast c) Friendly bacteria and yeast d) Common yeast
33. _______are non-digestible parts of foods like bananas, onions and garlic: a) Probiotics b) Prebiotic Fibers c) Proteins d) Lipids
34. _______ are live beneficial bacteria that are naturally created by the process of fermentation in food: a) Probiotics b) Prebiotic c) Proteins d) Lipids
35. Lactobacillus and bifidobacterium species are the most commonly used as: a) Prebiotic fiber b) Proteins c) Probiotics d) Lipids
14 36. Lactobacillus is the most common probiotic found in: a) Breads b) Fibers c) Beans d) Yogurt and other fermented foods
37. In children, yogurt may help reduce:
a) Fever b) Cough c) Diarrhea d) Headache
38. Yogurt may be suitable for people with:
a) Fructose intolerance b) Lactose intolerance c) Lactose tolerance d) Fructose tolerance
39. Prebiotics and probiotics have been suggested as treatment for:
a) Hypertension b) Hyperglycemia c) Hypoglycemia d) Obesity
40. In addition to its prebiotic qualities, Sauerkraut is rich in
a) Fiber b) Vitamins C, B and K c) Sodium and ion d) All of the above
41. Tempeh is a) A fermented soybean product b) A meat product c) American Pickle d) None of the above
42. Tempeh is well known as _____ .
a) High in lipid b) High-protein meat substitute c) Spicy flavor d) A great choice for semi-vegetarian
15 43. Kimchi contains a kind of friendly bacteria called: a) Lactobacillus kimchi b) Escherichia coli c) Salmonella d) Botulism
44. The following statements are the property of Miso. Which one is incorrect? a) High in various vitamins, minerals and plant compound b) Made from soybeans c) Fermented by Koji fungus d) Contains Helicobacter pylori
45. Which of the following is the main source of probiotic?
a) Macaroni and peas b) Bread and flour-based products c) Mackerel, walnuts and Canola oil d) Pickles, traditional buttermilk and Natto
46. Which of the following is fermented food?
a) Sauerkraut b) Tempeh c) Kimchi d) All of the above
47. Why are prebiotics used for patients who are on antibiotic treatment? a) To repopulate the colon with desirable bacteria b) To wipe of bacteria c) To reduce antibiotic efficacy d) None of the above
48. What are the benefits of probiotics?
a) Fighting off bad bacteria b) Improvement of immune system c) Improvement of metabolism d) All of the above
49. What are the roles of probiotics in immunomodulation?
a) Balanced immune response which helps control of IBD b) Alleviate food allergy symptoms in infants c) Strengthen innate immunity d) All of the above
16 50. How do probiotics act in the body to improve metabolism? a) Lower level of toxicogenic or mutagenic reactions in the gut b) Lactose hydrolysis c) Bile salt deconjugation and secretion d) All of the above
51. What are the results of probiotics consumption on metabolism?
a) Lower serum cholesterol b) Improved lactose tolerance c) Reduction in risk factors for colon cancer d) All of the above
52. What are prebiotics?
a) Indigestible fermented food substrates b) It selectively stimulates the growth, composition, and activity of microflora in gastrointestinal tract c) Improve hosts’ health and well-being d) All of the above
53. What are the new compounds that are developed as prebiotics? a) Oligosaccharides b) Sugar alcohols c) Polysaccharides d) All of the above
54. Where are prebiotics found?
a) Bananas, onions, garlic b) Grains c) Asparagus, honey, beans d) All of the above
55. What are the benefits of prebiotics?
a) Help with various digestive problems b) Boost the immune system c) Improve metabolic health d) All of the above
56. Synbiotics are:
a) Prebiotics and probiotics used in combination b) The synthesis of probiotics c) The synthesis of prebiotics d) None of the above
