Clinical studies support the multiple health benefits from probiotics, dietary fibers, botanicals and enzymes
In today’s fast-paced and stressful society, millions of consumers face a variety of digestive health disorders. These disorders include acute or chronic illnesses, intolerances and allergies. Manufacturers have a wide variety of beneficial ingredients at their disposal to address these issues—specifically, these include prebiotics, probiotics, dietary fibers, botanicals/herbals and enzymes. These ingredients can be added directly into foods or marketed as dietary supplements.
The digestive system is colonized by trillions—that’s “trillions” with a “t”—of bacteria that aid in maintaining a healthy existence through their mutually beneficial relationship with the host body. In fact, each person’s g.i. tract microbiome is as unique as their fingerprint. Without these passengers, human bodies would cease to function.
For example, probiotic bacteria are known to produce or aid in the production of scores of vital chemical compounds that are necessary for life. These include enzymes, B vitamins, folic acid, branch-chain fatty acids (BCAAs) and vitamin K.
Research into digestive health and probiotics has been ongoing for decades. The intricacy, depth and complexity of the relationship and role probiotic bacteria play in human health still was not understood until recently. The foremost link to digestion is key, because even before the immunity-digestion connection was established, its general role in overall health was assumed.
Today, scientific evidence demonstrates that proper types and levels of these resident guests are associated with multiple positive health benefits related to and beyond digestion. These benefits include energy balance; diabetes and mood improvements; reduction of the frequency of ear and bladder infections; improved oral health (including protecting against cavities, halitosis and gingivitis); alleviation of certain food and skin allergy symptoms in children; and promotion of cardiovascular health and strengthening of the body’s immune system.
Within the digestion milieu, probiotics have demonstrated a number of functions beyond mere balance. According to the International Probiotics Association (IPA) and other medical expert sources, clinical studies have demonstrated that probiotics can reduce the occurrence and duration of intestinal distress secondary to bacterial and viral illnesses, such as with rotavirus; compensate for the ill effects of, and perhaps reduce the need for, certain antibiotics; and alleviate digestive symptoms of lactose intolerance.
Global demand for probiotics is predicted to grow at a compound annual growth rate (CAGR) of 6.8% until at least 2018. The gastrointestinal health supplement category saw $1.4 billion in consumer sales in 2011, a 14% increase over the previous year, according to a late-2014 report titled, “Gut and Digestive Health Ingredients and Consumer Products - Market Trends and Insights,” by market researchers Canadean Ltd.
According to Frost & Sullivan’s assessment of the North American probiotics market, dairy-based food products account for 63% of the total market share, followed by dietary supplements at 36%. The yogurt category is segmented into products which are frozen, drinkable and spoonable. However, not all yogurt products contain live and active cultures. Currently, probiotic yogurts account for only a little more than a third of global yogurt sales.
Market experts also report the global prebiotics market will approach almost $6 billion by 2020. Impetus includes a renewed, positive outlook on dairy consumption, coupled with surging demand for sugar- and fat-free products, due to increased concerns over obesity. The food and beverage industry currently is the largest application segment for prebiotics (vs. supplements).
Ease of incorporation into foods and beverages, coupled with continued growth of consumer awareness of digestive health, in general, and probiotic bacteria specifically, is expected to drive demand even higher. Dietary supplements still are strong, however, and are a key application market expected to grow at over 9% from between now and 2020.
Be Our Guest
There are quite a number of different species and strains of probiotic bacteria. Moreover, various hybrids and subspecies are being developed each year to address a number of health factors. Among the most common in use in foods and beverages are those in the Lactobacillus, Bacillus and Bifidobacterium families. In fact, there are more than 50 species of lactobacilli alone.
Some of the lactobacilli found in fermented foods such as yogurt and dietary supplements include: L. acidophilus, L. acidophilus DDS-1, L. bulgaricus, L. rhamnosus GG, L. planta-rum, L. reuteri, L. salivarious, L. casei, and L. gasseri.
There are approximately thirty species of bifidobacteria. They comprise approximately 90% of the healthy bacteria in the colon. These bacteria appear in the intestinal tract within days of birth, especially in breast-fed infants. Some of the bifidobacteria used as probiotics are: Bifidobacterium bifidum, B. lactis, B. longum, B. breve, B. infantis, B. thermophilum, B. pseudolongum, and B. animalis spp. lactis
Numerous clinical trials in newborn pre-term infants and the elderly have shown doses up to 100 billion colony forming units (CFU) per day had no reported side effects. This strain has been shown to relieve constipation, enhance the immune response after vaccinations in adults and help restore the intestinal microbiota after a round of antibiotic treatment.
Available products containing this strain include bulk powder blends, capsules, chewable tablets, stick packs, sachets and infant formula powders.
A meta-analysis was conducted in 2009 that included 16 randomized, controlled trials evaluating the efficacy, safety and tolerability of probiotics in patients with irritable bowel syndrome (IBS). B. infantis 35624 was the only probiotic that showed any significant benefit in the composite symptom score of IBS patients. Bifidobacteria likely have a beneficial effect in symptom relief of IBS, either as a single agent or in combination with other probiotics.
An earlier 2006 study of 362 women involved administering B. infantis 35624 over four-week period. Patients showed improvement in their symptoms of abdominal pain, bloating, bowel dysfunction, incomplete evacuation, straining and the passage of gas.
Although research on the beneficial effects of probiotics has been going on for decades, data to support label health claims for probiotic products are sometimes difficult to provide. The experimental evidence to identify the specific probiotic microorganisms—and to demonstrate their efficacy in clinical trials by using reproducible, quantifiable results—is more challenging than for other potential functional foods, because effects are mediated by living microorganisms and can, therefore, be influenced by the status of these microorganisms, as well as the health status of their hosts.
However, last year, a rare probiotic digestive structure-function claim was granted by the European Food Safety Authority (EFSA) for the B. lactis HN019 strain, allowing its manufacturer to market it with a claim that it can help support digestion by reducing gut transit time.
In the US, in early 2014, Danone Food Co.’s Dannon’s Activia brand of yogurt made a structure-function claim related to minor digestive issues. The wording of the claim is “Activia is a probiotic yogurt that may help reduce the frequency of minor digestive issues like bloating, gas, rumbling and discomfort, when consumed twice per day for four weeks as part of a balanced diet and healthy lifestyle.”
This claim for Activia is based on the findings of two double-blind, randomized placebo-controlled studies the “gold standard” for scientific evidence. The study was reviewed by experts in the field of digestive health, and they support the scientific evidence for the claim. Unlike the EFSA system, in the US, this claim does not require FDA pre-approval, since it is a structure-function claim and not a health claim.
Food companies such as Danone must overcome manufacturing and stability challenges when formulating new products with probiotic bacteria strains, because the company must ensure that the strain remains viable in the finished product and that it has the appropriate CFU count.
“We work very hard to ensure that the benefit of a specific strain is realized in the different formats of the foods we make,” says Thierry Saint-Denis, PhD, Danone’s senior di-rector of R&D. “For example, with Activia in the US, we make traditional yogurt, Greek yogurt and drinkable smoothies, all of which have the B. lac-tis DN-171 010 strain.”
General Mills Inc.’s Yoplait has launched lactose-free yogurts and also has a line of fat-free probiotic Greek yogurt products (made using L. bulgaricus and S. thermophilus), that are 100 calories per serving and come in 20 flavors. Also, its new Plenti line of probiotic Greek yogurts contains whole-grain oats, flax seeds and pumpkin seeds, and delivers 12g of protein per serving.
Yakult USA Inc., the Asian pioneer of the probiotic beverage shot, has joined the trend of combining probiotics with prebiotics with its new line extension called Yakult Plus. The product features added fiber, 70% less sugar and is available in a number of new flavors.
One company, Good Culture LLC, recently launched a line of organic cottage cheese products containing two beneficial probiotic bacteria, L. acidophilus and B. lactis. Unusually for the cottage cheese category, the products are available in both sweet and savory flavors.
“Good Culture believes cottage cheese is an overlooked superfood and should be as widely consumed as yogurt,” says Jesse Merrill, co-founder. “We were tired of searching for great-tasting cottage cheese that wasn’t loaded with thickeners, stabilizers, hormones and high-fructose corn syrup-sweetened flavors, so we decided to create our own. We created a ‘disruptive’ cottage cheese line-up that offers real, organic ingredients and unique flavor varieties.”
Kefir is a comparatively recent popular cultured-milk beverage in this country, and rapidly growing in popularity. Because of the action of its probiotic bacteria, some kefir products can be up to 99% lactose-free and thus can be safely consumed by lactose-intolerant individuals. The leader in the field is Lifeway Foods Inc., which also makes probiotic soft cheese, frozen desserts and beverage shots. Each cup of Lifeway kefir contains 11g of protein and twelve live and active probiotic cultures delivering seven to 10 billion beneficial probiotic CFU per serving. It also is high in protein, calcium and vitamin D.
It is important to remember probiotic bacteria are living things—meaning they can’t do their jobs if they’re dead. Until a decade ago, one of the main challenges of getting probiotics into the part of the digestive system where they do their work was survival—the first hurdles are the extreme conditions of processing (such as pasteurization, cooking, pressure/shear, too-low pH)—in order to thrive and age.
The latter two are especially difficult for processors, in that the narrow conditions for keeping them alive to work also meant they could grow rampant and cause the product to ferment rapidly, leading to a short shelflife. For this reason, most consumers would find active cultures in cold dairy products (and cultured juices, such as those successfully manufactured since 2006 by NextFoods Inc., under the name GoodBelly).
In 2011, after more than a decade of development, the probiotic bacteria line B. coagulans GBI-30, 6086 was granted GRAS status by the FDA and opened the door to a vast array of application for digestive health-promoting foods and beverages. The unique, patented microorganism is not only backed by a score of studies for its ability to help with multiple health conditions, it is encapsulated in a spore.
This encapsulation allows GBI-30, 6086 to survive the extremes of processing and digestion until it hits the intestinal tract. (It should be noted that the strain has shown positive effects on oral health and is now been used in some brands of chewing gum, such as Focus Nutrition Inc.’s Xyloburst PURE Probiotic Gum.) It even has been incorporated into bottle caps and straws.
To date, GBI-30, 6086 is being used in more than 120 foods and beverages, from Prosperity Organic Foods, Inc.’s MELT Organic Buttery Spread brand, Temple Turmeric HPP beverages, Tipton Mills Inc.’s probiotic coffee, Om Boys Food Movement LLC’s Yumbutter Probiotic Plant Protein Almond Butter and one of Sweet Earth Natural Foods Inc.’s newly launched line of functional breakfast burritos.
The Sweet Earth burrito features a Korean- inspired blend of seasoned tofu, fermented red pepper, cabbage, edamame and fresh ginger. In addition to the probiotics, the burritos also are high in fiber and protein.
“This is the first probiotic burrito in the breakfast category, made with the heat-resistant probiotic strain B. coagulans GBI-30 3086,” says Kelly Swette, company CEO. “It delivers billion CFUs of live and active probiotics, along with 8g of fiber and 12g of plant-based protein per serving.”
Chocoholics will be glad to know there have been probiotic chocolate treats on the market for several years now. Wasatch Branding Concepts LLC’s Active D’Lite brand of confections are stevia-sweetened products containing both prebiotics, as well as probiotics. The bars, bites and ice cream claim 20 billion probiotics per serving, at time of manufacture. Active D’Lite chocolates provide a five multi-strain combination of beneficial bacteria adapted for both the upper g.i. (L. acidophilus NCFM and L. paracasei Lpc-37) and the lower intestinal tract (B. lactis BI-07, B. lactis BI-04, and B. lactis HN019).
Prebiotics are ingredients that help promote the growth of probiotic bacteria by acting as a food source for the probiotics. Prebiotics are more stable in acidic and heated conditions, whereas probiotics are not because they are living organisms.
Prebiotic fibers are non-digestible and pass through the small intestine to be fermented in the large intestine and are, therefore, lower in calories (1.5-2.0kcal/g), promote the growth of good bacteria and even regulate digestive health. The fermentation in the colon results in an increase of bacterial biomass, which improves bowel functioning and regularity, while also improving digestive efficiency.
Inulin is a term applied to a heterogeneous blend of fructose polymers found widely distributed in nature as plant storage carbohydrates. Oliggofructose is a subgroup of inulin, consisting of polymers with a degree of polymerization (DP) ≤10. Both inulin and oliggofructose are naturally occurring soluble dietary fibers extracted from chicory root.
Human clinical trials have shown that inulin significantly increases the absorption of calcium by lowering the pH of the large intestine to favor mineral absorption. Another mixed, short-chain carbohydrate ingredient that acts as a prebiotic fiber (giving it a digestion-resistant property) is isomalto-oliggosaccharide. The naturally sweet, low-calorie (1.5kcal/g) occurs naturally in a number of fermented foods, including rice miso, soy sauce and sake.
Inulin and oliggofructose are ideal as sugar and fat replacers. Both are also “bifidogenic,” that is, they promote the growth of Bifidobacterium species with a daily consumption of 5g/day. These ingredients also contribute to satiety, making them a very useful tool in the arsenal for weight management. Moreover, inulin increases calcium absorption, resulting in improved bone health.
Polydextrose is a synthetic polymer of glucose. It was developed in 1965, although not approved by the FDA until 1981. Polydextrose is a soluble, prebiotic fiber and frequently is used to increase the fiber content of foods. At only 1kcal/g, it often is used in low-carb and diabetic cooking recipes. One difficulty for processors can be that polydextrose is not as well-tolerated by some consumers and, thus, can cause digestive issues rather than help them.
Most prebiotic fibers are available in either a syrup or powder format and can readily be used in a variety of food products, including beverages, baked goods, plant-based “meat” analogs, dairy products and confections. They typically are non-GMO, gluten-free and certified as kosher.
Inulin is a humectant and can help food products retain their water content. Liquid inulin can be used as a low-viscosity ingredient in the dough and/or filling in cereal bar applications and can replace fat in yogurt applications, while maintaining texture and mouthfeel.
Both coffee and chocolate products have been developed containing prebiotic fiber. Brioni’s Coffee Co. launched a line of ultra-premium ground coffees using oliggofructose-enriched inulin as a prebiotic fiber. It works well in such formulations, because it is highly soluble and imparts a slightly sweet taste to the coffee. While standard ground-roasted, premium coffees deliver about 1g of dietary fiber per 12oz serving, Brioni’s provides 4g.
As probiotic interest continues to expand, so too does that of prebiotics. Predominantly, prebiotics are the fiber and fiber-like carbohydrate compounds that provide the food for probiotics. Of these, inulin is the largest ingredient segment in the food and beverage category in the digestive health subcategory, accounting for nearly half of the total market volume.
Galacto-oliggosaccharides (GOS), most typically used in infant formulas and baby foods, follow inulin demand in terms of volume. GOS accounts for almost a fifth of market volume and is expected to continue growing due to multiple benefits offered by the ingredient. These include increasing calcium absorption, prevention of colon cancer and improvement of the defensive immune system.
Besides inulin, a wide variety of both soluble and insoluble fibers increasingly are appearing in foods and beverages. These include those used for other functions (e.g. taste, structure and texture). Examples are hydrocolloids (such as guar, gum Arabic, carboxymethylcellulose and xanthan gum).
As a source of prebiotic and other digestive health fibers, millers are enjoying a surge in demand for healthful macro-ingredients, such as whole grains (wheat, oats, brown rice, barley) and seeds (chia, flax, hemp, quinoa, psyllium). However, certain starches with fiber-like function—specifically resistant starch and resistant maltodextrin—continue to gain inroads in food and beverage processing for digestive health.
According to a report by Markets and Markets titled, “Dietary Fiber Market by Product Type (Conventional/ Novel & Soluble/ Insoluble) and Application (Food & Pharmaceuticals)–Global Trends & Forecasts to 2019,” the dietary fiber market is expected to grow from $2.27 billion in 2013 to $4.21 billion by 2019, with a CAGR of 13.1% through 2019. In terms of revenue, North America has led the global market, followed by Europe and Asia-Pacific.
Nearly all health experts agree Americans are not consuming sufficient fiber. Women need 25g of fiber per day, and men need 38g. According to the FDA, the daily value (DV) for dietary fiber is 25g (based on a daily caloric intake of 2,000kcal). However, the fiber intakes of most Americans are far below these values.
Even after a generation of boosted awareness, the average adult still consumes only 15g of fiber per day, at most. In order for a food product to include a “good source” of fiber claim, it must contain between 10-19% of the DV. For a “high fiber” claim, the product must contain more than 20% of the DV.
Hold it Together
Hydrocolloids are rich sources of dietary fiber and offer other health benefits, as well. Acacia gum (gum Arabic) is derived from an all-natural tree exudate and has a soluble dietary fiber content of greater than 90%. Its high solubility and ability to build solids content without adding appreciable viscosity affords this gum the ability to be easily incorporated into beverages, baked goods, cereal bars and dairy products, as well as other applications.
Gum Arabic has a proven bifidogenic effect (prebiotic) and has a high gut tolerance at up to 50g per day.
Another soluble fiber available to food formulators is a galactomannan-based soluble fiber made from hydrolyzed guar gum. It is tasteless, colorless and odorless and can deliver a highly water-soluble fiber content with a low caloric contribution at 1.9kcal/g. It’s available as a non-GMO ingredient and is known to have excellent stability in formulation, making it ideal for a variety of beverage products.
Researchers at the University of Tasmania, Australia, demonstrated that fucoidan, a polysaccharide extracted from the seaweed species Fucus vesiculosus, could be effective at combatting the symptoms of certain inflammatory bowel disorders, such as ulcerative colitis. Fucoidan has been marketed for its immune-boosting potential, as well as a variety of other therapeutic benefits.
According to the researchers, evidence exists that “dietary fucoidan extracts are highly effective at ameliorating experimental colitis through a consistent down-regulation of a significant number of pro-inflammatory cytokines.”
One specialty breakfast cereal with an “interesting” name was developed in Canada several years ago to directly—and unequivocally—promote gut health. Called “Holy Crap,” and made by HapiFoods Group Inc., sales took off across Canada. It recently began making inroads into the US market. The nutritionally dense, filling, super-high-fiber cereal received its biggest boost when it was used by a Canadian astronaut on the International Space Station.
“Holy Crap cereal is 100% organic, gluten- and lactose-free, and contains 6g of fiber per two tablespoons [28g],” says Corin Mullins, HapiFoods co-founder. It contains just seven ingredients: chia seeds, buckwheat, hemp seeds, raisins, cranberries, apple bits and cinnamon. Unlike other fiber cereals of this type, it does not require hot water. It can be simply mixed with milk or other non-dairy beverages.”
One large category of formulating for digestive health involves mitigating existing digestive problems. A common source of digestive difficulties is the sensitivity to, or complete intolerance of, lactose, the primary sugar in dairy products. This is due to either enzyme deficiency or the occurrence of low levels of a particular enzyme, lactase, which digests the milk sugar known as lactose.
This disorder is especially common among people of African, Native American, Asian and Jewish/Eastern Mediterranean origin. Estimates are that as many as 50-90% of persons with such backgrounds are lactose sensitive or intolerant, at least to some extent. Overall, about 30-50 million in the US are considered lactose sensitive or intolerant. These individuals lack the ability to produce (or only produce low levels of) lactase.
Lactase deficiency means the ingestion of milk or other lactose-containing foods and beverages can cause mild-to-severe digestive distress. Symptoms include gas, bloating, cramping, pain and diarrhea. Lactase supplementation can halt these symptoms, when taken before lactose-containing dairy products are consumed.
Processors of such products as lactose-free dairy milks have been around for decades. The increased prevalence of Americans with the disorder is considered to have been the catalyst behind the explosion of non-dairy milk substitutes of the past dozen years. Lactose-free products have moved well beyond milk and milk analogs to include a panoply of dairy-based and dairy-analog items.
For example, McNeil Nutritionals LLC’s Lactaid brand of lactose-free milk—the leader in the category—produces other non-lactose containing dairy items, such as low-fat cottage cheese and six flavors of frozen desserts. All are enriched with calcium (in some items up to 20% more than in lactose-containing dairy items); plus, the milk has been enriched with vitamins A and D.
The gluten-free craze brought gluten into America’s consciousness. As noted in previous articles, experts, such as the National Foundation for Celiac Awareness, point out that only about 1% of Americans actually have celiac disease, the chronic auto-immune disease that leads to damage of the small intestinal lining, an inability to absorb nutrients and other health issues when the gluten proteins glutenin and gliadin in wheat, barley and related grains are consumed.
A much larger number of Americans, about another 4-5% or 18-20 million, who test negative for celiac disease still experience discomfort when they consume gluten. Still others have different wheat allergies. Before gluten-free became a trend (encompassing some 10 times as many consumers as actually need to eliminate it from their diet), baked goods such as breads, rolls, muffins and waffles were primary vehicles for delivering healthy fiber to consumers. Some consumers who shunned such foods saw their fiber intake drop precipitously.
The gluten-free craze, however, was a prime driver of alternate baked items that relied on certain seeds and native starches that are high in fiber, proving not only a boon to the baking industry but to overall fiber consumption in the US. (See “Superior Seeds and Grains,” PF October 2015.) Food For Life Baking Co., as an example, uses a variety of sprouted, non-wheat whole grains to create products that are high in dietary fiber and offer multiple health advantages, too.
“The benefits of sprouting include products with easier digestibility, enhanced mineral absorption and increased vitamin levels,” says Jay Torres, senior R&D technologist for Food For Life, referring to a number of studies that support these benefits. “Sprouting breaks down the starches in grains into simple sugars, so your body can digest them more easily. Sprouting also breaks down enzyme inhibitors, allowing minerals such as calcium, magnesium, iron, copper and zinc to be more easily absorbed.”
Torres also points out that sprouting is believed to increase levels of B vitamins and vitamin C. “Our breads contain at least 3g of fiber per slice, meeting the FDA requirement for a ‘high fiber’ claim,” he adds. “And, our tortillas and pastas contain 5 and 7g of fiber per serving, respectively.”
Resistant starch (and other fermentable starches and fibers) resistant maltodextrin provide the digestive health benefits of both insoluble and soluble fibers and offer food processors the ability to boost the fiber content of their food products without significantly increasing viscosity or changing taste. The term “resistant” refers to the product’s ability to resist the action of digestive enzymes.
Seeds, unprocessed whole grains, legumes, nearly ripe bananas and potatoes all contain resistant starch. (See “Hard Working Starches,” this issue.) Food products containing resistant starch help people stay fuller longer, because such foods are not as easily digested. Resistant starch derived from high-amylose corn also has been shown in studies to trigger chemical signals of satiety. Up to 45g of this starch can be consumed daily without significant digestive side effects.
Resistant maltodextrin is a soluble corn fiber that acts as a low-calorie bulking agent and contains 90% dietary fiber. As with resistant starch, both can be easily incorporated into all types of beverages, processed foods, dairy products, frozen desserts, confections and dietary supplements. Clinical studies have shown that resistant maltodextrin helps to relieve occasional constipation, and select studies show that it improves stool consistency.
Data from more than 15 years of feeding studies on animals and humans also suggest that, when taken with a meal, resistant maltodextrin could at-tenuate the rise in serum triglycerides following the meal. Thus, the ingredi-ent also could help maintain healthy serum triglyceride levels.
There are numerous botanicals and herbal ingredients that have been used across millennia for soothing digestive ailments. Ginger, fennel seed, peppermint and caraway have been used to relieve symptoms of irritable bowel syndrome, as well as nausea. These herbals relax and mildly anesthetize the gut, helping to reduce the frequency of g.i. spasms.
An herb called (Senna alexandrina)—a member of the legume family—has been shown to strengthen and help “retrain” the colon to improve natural regularity. Standardized senna extract formulations sold as powder or capsules are promoted as providing a healthier, more effective long-term solution than stimulant laxatives alone.
Some dietary supplement products combine senna with the action of several other powerful fibers and herbals. Yerba Prima Inc.’s Fiber Plus line of powders contain five insoluble and soluble fiber types, specifically: cellulose, hemicellulose, pectin, gum Arabic and psyllium. In addition, they also contain ginger root (known to act as a natural anti-cramping, anti-nausea remedy) and extracts from dandelion and red clover.
Other botanicals, such as cat’s claw, marshmallow, nettles and turmeric, have been used as digestive anti-inflammatory agents. Recent research indicates that combining curcumin with phospholipids has resulted in improved bioavailability, increasing its efficacy in treating gastrointestinal conditions.
Randomized, double-blind, crossover clinical trials of healthy subjects have demonstrated that both curcumin and total curcuminoid absorption were greatly increased (by 29 times) with the curcumin formulation containing 40% phospholipids, as compared against the native curcumin.
Processors seeking to support digestive health—and the multiple related health conditions that depend on a healthy digestive system—have ample opportunities for creating new foods and beverages in this category. Meanwhile, ingredient technology has opened multiple pathways to allow all types of products to include such healthy components.