Digestive Health Concerns on the Rise

The best way to aid the digestive system and trends to watch for.

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Digestive issues and conditions are becoming all too common. As a result, many consumers are turning to dietary supplements and different lifestyles like gluten-free or vegan to maintain a healthy digestive system. A study from the Center for Celiac Research and Treatment at the American Gastroenterological Association finds that 18 million Americans believe they have trouble digesting gluten and 50 million report discomfort from ingesting dairy products. What advice can you give to your customers?

Healthy Bacteria
Generally the word “bacteria” has negative connotations. Lately, more and more consumers are associating bacteria with the words “good” or “healthy.” “There are actually more probiotics in your gut than cells in your body!” says Alan Rillorta, marketing director, AIDP, City of Industry, CA. “Your digestive system alone hosts about 1,000 different types of bacteria.” Newer research relates gut health to overall health.

Cheryl Myers, chief of education and scientific affairs at EuroPharma, Inc, Green Bay, WI, comments on how widely accepted probiotics are nowadays. “Even if people don’t understand the mechanisms of action behind probiotics, they know that ‘the good bacteria found in yogurt’ is going to help improve their health. And that has a lot to do with the frontline education they get at their health food stores,” she says.

Many factors can lead to depletion of beneficial gut bacteria including high-meat or low fiber diets, antibiotic use, travel and stress, says Thomas A. Bowman, Ph.D., senior scientist, Jarrow Formulas, Los Angeles, CA. So how do we ensure that we are maintaining these good bacteria?

Probiotic Families
Probiotics have been believed to be beneficial for many years, but just recently we’ve developed the science and technology to truly study their benefits. Probiotics are defined as live micro-organisms which, when administered in adequate amounts, confer a health benefit on the host. Probiotics are essential to good gut health and can easily be compromised by environmental and dietary impurities, according to GT Dave, founder and CEO of GT’s Living Foods, Beverly Hills, CA. “Consuming probiotics — especially living probiotics — helps to keep the natural system in balance.”

Bowman notes that the population of microbes differs in the intestines of individuals, causing different digestion patterns and utilization of nutrients. Each person has a different makeup, which can cause varying digestive disorders.

Having more strains is not necessarily better. The choice of probiotic strains taken by consumers depends on their specific health needs.

“Having more strains is not necessarily better. The choice of probiotic strains taken by consumers depends on their specific health needs,” Bowman explains. Jarrow recognizes this isn’t a one-size-fits-all issue; so tailors products to fit different needs and even ages. Bowman stresses the importance of strain transparency — applying that principle to products and packaging.

When asked about different probiotic strains, Trisha Sugarek MacDonald, BS, MS, senior director of research and development/ national educator of Bluebonnet Nutrition Corp., Sugar Land, TX, shared, “Lactobacillus and Bifidobacteria are the most common types of microbes used as probiotics, but certain yeasts and bacilli are also beneficial.” Common probiotic families and their uses include:

Lactobacillus. More than 50 species of Lactobacilli exist and are naturally found in the digestive, urinary, and genital systems. They are found in fermented foods (yogurt for example), and dietary supplements contain these bacteria. They can be beneficial for conditions such as, “yeast infections, urinary tract infection, irritable bowel syndrome, antibiotic-related diarrhea, traveler’s diarrhea, diarrhea resulting from Clostridium difficile, treating lactose intolerance, [and] skin disorders (fever blisters, eczema, acne, and canker sores),” says MacDonald. This type of bacteria works by helping to break down food, absorbing nutrients and fighting off “unfriendly” organisms that can cause conditions like irritable stomach or diarrhea (1).

Bifidobacteria. There are about 30 species in this family, and similarly to Lactobacillus, they are found in fermented foods. About 90% of healthy bacteria found in the colon are from this family. They are also found in the mouth, vaginal area and in the intestinal tract shortly after birth. Different strains in this family have many benefits including regulation of intestinal microbial homeostasis, inhibition of pathogens and harmful bacteria, modulation of immune responses and aid in the production of vitamins (like folic acid). They also help with digestive issues like irritable bowel syndrome, and can help improve blood lipids.

Saccharomyces boulardii. A tropical strain of yeast found in both the small and large intestine. It can help traveler’s diarrhea and loose stool associated with antibiotic use, reduce colon inflammation, reduce side effects of treatment for Helicobacter pylori and even help reduce acne.

Streptococcus thermophilus. Found in fermented milk products and typically used in the production of yogurt, being as it is the most widely used bacteria in the dairy industry, Streptococcus thermophilus produces a large amount of lactase. This can potentially help alleviate lactose intolerance symptoms. It’s also shown in studies to aid in the growth of children when taken as supplement, and reduces the risk of antibiotic-associated diarrhea.

Enterococcus faecium. This is also found in fermented foods like cheese and vegetables, and is naturally found in the intestinal tract of humans and animals. Commonly used in food processing, it’s used against harmful bacteria in the GI tract and helps combat diarrhea from gastroenteritis.

Dave comments that fermented foods are great because they “act like nature’s ‘pharmacy,’ ensuring the probiotics work well with the body and remain viable, even in the gut’s acidic environment.” He has noticed the growing trend of consumers recognizing fermented foods and beverages such as kombucha as digestive aids. Dave adds that although supplements can be beneficial, it’s important we continue to seek nutrition from our food. However, because food manufacturing may kill a majority of healthy bacteria, many food and beverage manufacturers also incorporate supplemental probiotic bacteria in their formulas to enhance their ability to influence the microbiome. The most common product used in food and beverages is the proprietary BC30, manufactured by Ganeden, Mayfield Heights, OH, which has been found to be very stable in liquids and food.

There is a difference of opinion regarding when and how to take probiotics, but most experts agree several times per day is best. Along with many others, Myers suggests “taking probiotics with food as it may enhance the survival and vigor of the bacteria.” Dr. David Keller, vice president of scientific operations for Ganeden, states that probiotics are transient, so ideally they should be taken daily and consistently.

Prebiotics
Prebiotics are non-digestible carbohydrates that aid healthy gut microbes. They aid probiotics and essentially boost their benefits to give optimal results. As far as benefits go, Kate Phillips M.S., quality assurance advisor at Bragg Live Food Products, Santa Barbara, CA, says, “Prebiotics have been shown to enhance the bioavailability and uptake of minerals and promote satiety and weight loss and prevent obesity.” Their products contain acetic acid, which blocks certain enzymes from digesting carbs, and then those carbs travel through the digestive tract acting as a prebiotic.

John Deaton, vice president of science and technology for Deerland Enzymes, Kennesaw, GA, says prebiotics are typically fibers or starches found in legumes, whole wheat foods, oatmeal and vegetables like onion, cabbage and asparagus. A large amount is typically used for effectiveness when used in supplements (Deaton says around 20-40 grams).

Enzyme Supplementation
Enzyme deficiencies can trigger a number of digestive conditions, so supplementation is extremely important. “A consumer who has lactose intolerance, wheat/gluten intolerance or heartburn would not use the same formula for each of these conditions,” says Sugarek MacDonald. “This is because these are very unique situations, so different strategies are essential to getting the right care.” She adds that different enzymes perform different functions so it is important to view each case individually. Sugarek MacDonald highlights four common digestive issues and how enzymes can support them:

1. Lactose Intolerance. Many people suffer from lactose intolerance; however, it doesn’t necessarily mean a no-dairy diet. A common misconception is that this is the same thing as a milk allergy, yet intolerance doesn’t affect the immune function.

Most infants produce the lactase enzyme, which allows for milk consumption without digestive issues, but production of this enzyme stopped during aging to prepare for an adult diet. As humans evolved, a mutation occurred which allowed adults to still produce the lactase enzyme and continue consuming lactose. Today, some people who have a double copy variant in their DNA, synthesize little or no lactase. Now products exist like enzyme supplements rich in ingredients like lactase, protease and lipase that can be used to aid digestion if dairy is consumed.

2. Gluten Intolerance. This term encompasses different gluten sensitivities and prevents gluten from being digested in full. The inability to digest can cause many uncomfortable side effects ranging from diarrhea to the inability to absorb nutrients. Those sensitive to gluten typically are encouraged to avoid any of it in their diet. Recent studies show there are enzymes (aspergillopepsin, dipeptidyl peptidase IV and cysteine endoprotease) that have positive effects on digestive issues prevalent in gluten sensitivity. These can help in cases of intolerance, but celiac disease is a different story since it is an autoimmune disorder. This research is a step in the right direction for future studies to help those who suffer from celiac.

3. Heartburn. Heartburn is unlike lactose and gluten intolerance since it is a symptom that occurs with pre-existing conditions when the gut has trouble with digestion. The enzyme pepsin can be helpful with this issue because it helps digest protein in the gut and reduces acid reflux, therefore aiding in complete digestion.

4. Food Digestion. Enzyme supplements can certainly aid in digestion; and encapsulated enzymes can either be swallowed or mixed with food or drink. Sugarek MacDonald suggests, for digestive purposes, taking enzymes at the beginning or middle of a meal, and for a systematic effect, in between meals so they are absorbed into the bloodstream. She also warns that digestive enzymes should not be mixed with very hot foods or beverages to avoid inactivation. Deaton also points out that our bodies do not produce the enzyme cellulase, which allows the breakdown of cell walls of plants so the body can absorb nutrients. Supplementation in these areas can be beneficial for digestion.

Shaheen Majeed, worldwide president, Sabinsa Corp., East Windsor, NJ observes that “as consumers continue to become more proactive in supporting their digestive health, plant-based and microbe-derived enzymes offer great promise in the advancement of digestive enzyme therapy.”

Product developers and ingredient manufacturers are challenged with creating formulations that are stable, innovative, and taste great, yet provide all the benefits of the nutrient. Not an easy task!

Leaky Gut
Leaky gut syndrome is a condition in which the intestines experience damage in their lining causing food and toxins to leak into the bloodstream. The leak can cause an autoimmune response in the body with serious ramifications including migraines, stomach discomfort, fatigue, allergies, etc. With this condition, enzymes don’t produce properly and therefore complete digestion cannot occur. “Metabolic Endotoxemia (clinical leaky gut) is becoming recognized as a primary insult and driver of obesity, type 2 diabetes, heart disease, inflammatory bowel disease, cognitive decline, immune dysfunctions and even conditions like Parkinson’s disease” write the authors of a study published in the World Journal of Gastrointestinal Pathophysiology (2).

Tina Anderson, CEO/co-founder of Just Thrive Probiotic & Antioxidant, Park Ridge, IL, cites the study as demonstrating that probiotics can serve as a remedy for leaky gut. Bacillus strains were studied and found to reduce the “endotoxic response in the bloodstream by up to 42% after only 30 days. This result was without any other lifestyle changes and just 30 days after taking the strain subjects’ gut lining restored and inflammation significantly decreased (2).

Anderson notes that “consumers and retailers are learning more and more about the impact that leaky gut or metabolic endotoxemia has on a person’s overall health.”

Herbs
Ginger and peppermint are two herbs commonly mentioned as digestion aids — especially when used in conjunction with pre/probiotics. Both of these herbs have calming properties that are useful when experiencing discomfort. Sugarek MacDonald notes that ginger tea is often used to combat dizziness and nausea, and the herb is known for relaxing the intestines. Similarly, peppermint is used for motion sickness, nausea and dizziness. Peppermint tea can work similarly to an anesthetic for the stomach due to its menthol. Peppermint oil is commonly used for stomach discomfort.

Bowman suggests mastic gum from tree resin, which has been used for centuries, for upset stomach. It contains masticadienonic acid that has antiseptic properties and helps promote normal cell replication. He also suggests BroccoMax as a liver detox agent that also promotes healthy cell replication.

For those dealing with IBS or similar conditions, Myers recommends boswellia, an effective herb used to fight inflammation. “Inflammation through the small bowel and colon may be one of the physical causes and effects of IBS and other diseases. Because boswellia stops the 5-LOX cascade, it is a valuable ally,” says Myers. She cites a study in which Crohn’s disease patients were either treated with boswellia or the drug mesalazine and performed the same as the drug but without side effects.

Looking Ahead
Rillorta has noticed a recent increase in consumers’ awareness of the importance of prebiotics. “The benefits of probiotics have been popular for a while, evidenced by the popularity of yogurt, but only recently has the conversation begun to include prebiotics as a necessary fertilizer to enhance the benefits of probiotics.”

Consumers are also looking for different means of ingesting pre/probiotics. The industry is pumping out products containing them like desserts, bars, drinks, etc. Rillorta comments on this interesting trend: “Product developers and ingredient manufacturers are challenged with creating formulations that are stable, innovative, and taste great, yet provide all the benefits of the nutrient. Not an easy task!”

Majeed has also noticed trends in delivery methods to consumers. In addition to traditional capsules or tablets, consumers are looking to consume pre- and probiotics in a food or beverage form. He says other cultures have long focused on digestive health, while the U.S. is now catching up. “It began with probiotics, and has more recently expanded to digestive enzymes, bitters and prebiotics.”

Popularity of spore-based probiotics has surged, according to Anderson. She suggests spore-based probiotics may have advantages that other strains may not, like surviving longer in the gastric system as well as colonizing in the gut. “While there is a surge in popularity with spores in the United States, these strains have been around for the past 60-plus years, used as pharmaceuticals and over-the-counter products in Europe and Asia,” she says.

“Spore-forming bacteria have the ability to generate endospores to protect themselves from harsh conditions until they enter target sites such as the GI tract,” explains Deaton. Because of their resilience they can tolerate a wide temperature range eliminating refrigeration needs, survive stomach acidity and rid harmful gut bacteria. Consumers are becoming more aware of spore bacteria and this may continue to be a growing trend in the industry.

Keller agrees that consumers are looking for something different. He shares that in an SSI Consumer Survey 79% of consumers would prefer to consume probiotics in a food or beverage vs. supplements (3). He concludes that we have seen a trend in consumers paying closer attention to their digestive health and they are seeking products that will fit into a busy lifestyle and certain dietary preferences.

“That’s why fortifying everyday foods and beverages with probiotics has become a top solution as a digestive remedy,” Keller says. He shares another interesting statistic that 45% of consumers would pay 10% more for a food/beverage when a probiotic is added — he notes this is a great opportunity for manufacturers (3).

The National Commission on Digestive Disorders in the U.S. reported in 2009 that 60 to 70 million Americans are affected each year by digestive diseases and a staggering $100 billion in direct medical expenses. This is a time where consumers more than ever will seek natural remedies in the digestive realm. WF

References

  1. MedlinePlus, “Lactobacillus,” https://medlineplus.gov/druginfo/natural/790.html
  2. McFarlin et al., “Oral spore-based probiotic supplementation was associated with reduced incidence of post-prandial dietary endotoxin, triglycerides, and disease risk biomarkers,” https://www.wjgnet.com/2150-5330/full/v8/i3/117.htm
  3. Ganeden, “Probiotics for Hot Beverages,” https://www.ganedenprobiotics.com/innovative-ideas/probiotics-for-hot-beverages

Published in WholeFoods Magazine January 2018

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