FFN in Gut health

FUNCTIONAL FOODS AND GUT HEALTH : 

FUNCTIONAL FOODS AND GUT HEALTH DR. MACS. R. SURENDRAN MANAGING DIRECTOR, SHENBEGAM MULTISPECIALITY HOSPITALS MADURAI

INTRODUCTION : 

INTRODUCTION The human gut is defined as either the lower part of the alimentary canal- the intestinal tract, or the entire gastro-intestinal tract; mouth, oesophagus, stomach, small intestine [duodenum, jejunum, ileum], large intestine & rectum. The gastrointestinal tract (GI) is designed to comminute & digest food to absorb & secrete nutrients & other compounds, including toxic compounds, & to excrete wastes.

STRUCTURE OF GUT WALL : 

STRUCTURE OF GUT WALL MUCOSA: Composed of three layers LAMINA PROPRIA: EPITHELIUM MUSCULARIS MUCOSA: Smooth muscle intermixed with the lamina propria. SUBMUCOSA: Collagenous connective tissue; vascular tissue; glands SUBMUCOSAL PLEXUS: Enteric nerves in the submucosa.

Slide 4: 

MUSCULARIS EXTERNA: MUSCULARIS CIRCULARIS: Circular Layer MYENTERIC PLEXUS: Enteric nerves between the two layers of external muscle. MUSCULARIS LONGITUDINALIS: Longitudinal Layer ADVENTITIA (SEROSA): Several layers of loose connective tissue; the mesentery.

NUTRIENTS AND GUT FUNCTION : 

NUTRIENTS AND GUT FUNCTION Gastrointestinal epithelial cells especially, but also other cells such as M-cells, enteroendocrine cells, intraepithelial lymphocytes and the multiple cell types of lamina propria, are all affected by nutrient intake. Many nutrients play an important role in the maintenance of normal mucosal function in the gut area.

Proteins and Amino acids : 

Proteins and Amino acids The gut utilizes a large proportion of the total protein intake and is responsible for the main part of the first-pass metabolism of dietary amino acids. Glutamine is an important fuel source for cells rapidly turning over, such as epithelial cells, lymphocytes, fibroblasts and reticulocytes. It is a nonessential amino acid under normal conditions.

Slide 9: 

Glutamate is another amino acid playing an important role as an enterocyte energy source but also elsewhere in intestinal physiology and metabolism. Arginine is also considered to be a non-essential amino acid. It may be essential during catabolic states such as trauma and sepsis.

Slide 10: 

Arginine-containing formulas seem to reduce infectious complications in some surgical patients. Dietary or luminal glycine and histidine may have protective effects on gastrointestinal tissues.

Vitamins and Minerals : 

Vitamins and Minerals Vitamin A is important for epithelial cell integrity and immune function. Zinc is needed in protein synthesis and transcription proteins and it is thus important to cells with a high rate of turnover.

Dietary fibre : 

Dietary fibre Dietary fibre consists of several different groups of molecules with different effects. Insoluble fibre contributes to laxation and normal bowel function. Fermentable/soluble fibre promotes faecal bulking through fermentation and microbial growth.

Slide 13: 

DEFINITION OF DIETARY FIBER   Dietary fiber is that part of the plant material – leaves, stems and seeds which are resistant to digestion by digestive enzymes of human beings (i.e) that cannot be broken down by human digestive enzymes.

Classification based on dispersion of water : 

Classification based on dispersion of water Soluble fiber Fibers that either dissolve or swell in water and are metabolized by bacteria in the large intestines Insoluble fiber Fibers that mostly do not dissolve in water and are not metabolized by bacterial in the large intestine Eg. Cellulose, hemicellulose, lignin

Slide 15: 

FUNCTIONS OF FIBER   Just like a sponge, absorbs water, swells up – increases faecal bulk. Stimulate the large intestine for peristaltic movements. Speeds up transit time Traps nutrients like glucose, fatly acids & bile salts and excretes.

Physiological aspects of DF : 

Physiological aspects of DF Laxation Fermentation Glucose metabolism Lipid metabolism

Laxative : 

Laxative Best known, most established physiological effect Can produce various GI responses, depending upon the segment of the digestive tract The responses are gastric distention, influences upon the rate of gastric emptying, enhancement of residue quantity (faeces bulk) and moisture content.

Faecal bulking : 

Faecal bulking Insoluble fibers such as wheat bran  intestinal transit time and  stool wt & vol. d stool vol. observed after high intakes of DF is due in part to indigestible remnants of plant cell walls & in part to d bacterial mass But certain DF may also result in d faecal nitrogen excretion

Fiber needed to maintain adequate stool wt. & transit time : 

Fiber needed to maintain adequate stool wt. & transit time Atleast 20 g per day Spiller, suggested 35 – 45g for a transit time of <2 days & a daily wet stool wt. of 160-200g. d fiber suggested for constipation, diverticulosis and irritable bowel syndrome. --- less pressure

Fermentation : 

Fermentation Fibers provide energy for microflora in human large intestine 70-80% of the fiber disappears during transit through the gut. Fiber CO2 H methane acetate butyrate propionate

Contd.. : 

Contd.. Df can influence fermn. by bact. in the colon as well as the turn over of specific bacteria species. Bactl. Popn. will  due to fiber fermentation. Bactl. presence may contribute as much as 45% of the fecal dry wt.

Degree of fermentation : 

Degree of fermentation Diff. fiber molecules are subject to varying levels of bactl. degradation in the colon. If cellulose molecules are tightly packed together, bactl. cellulases cannot get access to substrate. For instance, pectin, mucilages & gums seem to be almost completely fermented Cellulose and hemicellulose are only partially degraded.

Contd.. : 

Contd.. The non-carbohydrate nature of lignin allows it to go virtually unfermented In general, insol fibers are ‘resistant’ to microbial degradation --- and are partially fermented Most soluble fibers are completely fermented, but psyllium is only partially fermented The physical structure of plant itself may be associated with the degree of degradation of food fibers by intestinal bacteria. Eg. Fibers derived from fruits & veg. In general are more fermentable than those from cereal grains.

Products of Fermentation : 

Products of Fermentation VFAs namely acetate, propionate & butyrate About 200 to 300 mmol of SCFA are produced daily in the colon These SCFAs can be oxidised for ATP prodn. in mucosal cells of the colon wall Further more, these VFAs are fairly H2O sol & can be absorbed into the portal circulation. Colonocytes metabolize SCFAs as an energy source but some reach other tissues. Butyrates stimulates the growth of normal cells but inhibits the growth of cancer cells.

Other products : 

Other products Hydrogen gas, CO2 and methane These pdts may lead to occasional uncomfortable gas build up in the colon that may occur with high fiber consumption. The presence of H2 in the breath (H2 breath test) is often used clinically as an estimn of bactl fermtn.

Slide 26: 

Fiber & Diverticular Disease   High Fiber diet ( bulk, consistency, transit time)   Large volume of faeces   Wider diameter of colon lumen   Less segmentation   Less incidence of diverticulosis Low fiber diet  Faeces of abnormally high viscosity Pressurized segmentation of colon   Colon wall muscle thrown into ridges of varying thickness   Muscle weak between ridges   Mucosal herniation   Diverticular disease.

Slide 27: 

Fiber & Colon cancer Rapid transit time Less time for colonic bacteria to produce carcinogens.

Slide 28: 

Fiber and Hemorrhoids  Low fibre diet  Hard faeces  Straining during defaecation  Fissures formed at the anus  Haemorrhoids (Piles)  Anal Fissures Leading To Bleeding At The Time Of Defecation

Slide 29: 

Fiber and Appendicitis Prevents stagnation of waste materials   Lesser chances for elimination of undesirable microorganisms   Less incidence of appendicitis.

Slide 30: 

Fiber & Hiatus hernia  Low fiber diet  Hard faeces  Increased straining at stools  Intra – Abdominal Pressure exceeds Intra – Thoracic pressure at Defaecation  Pressure gradient across diaphragm Often & prolonged periods Gastro – Oesophageal junction Forced into Thoracic cavity Herniation

Colonic functional foods : 

Colonic functional foods Introduction   The microbiota of the human gastrointestinal tract plays a key role in nutrition and health. The gut bacteria metabolize various substrates to form end products such as short chain fatty acids ad gases. This anaerobic metabolism is thought to contribute positively towards hosts daily energy requirements. The human host lives in harmony with the complex gut micro biota.

PROBIOTICS : 

PROBIOTICS Live microbial feed supplement – beneficially affect the host gut health Ex - lacto bacillus casei Food sources: fermented products like yogurt

Slide 34: 

Established and proposed probiotic health effects

Antibacteral activity of Probiotics against gastrointestinal pathogens : 

Antibacteral activity of Probiotics against gastrointestinal pathogens The GIT can be infected by many pathogens such as E.Coli, Salmonella, Bacteroides fragilis, Campylobacter jejuni, Klebsiella pneumoniae, etc… Lactobacilli – Helicobacter pylori, Escherichia coli, Salmonella.

PRESENT PROBIOTIC FOODS : 

PRESENT PROBIOTIC FOODS Lactobacillus casei shrota – Yakult Lb. acidophillus – LA F, Vifit, leisure live Lb. rhamnosus GG – Gefilus, campina vifit, vitael, vivi vivo, emifit, vaelia Lb.casei – Actimel Lb. plantarum – Pro-viva Lb.johnsoni – LCI Lb. reuteri – Rela, bra-mjolk,stony field farm Bifidobacterium – Vifit, bio pot, biola, symbalance

PREBIOTICS : 

PREBIOTICS Non digestable food ingredient – selectively stimulate the growth of bacteria in the colon & improve the host health. Examples: inulin , sos , fos , sorbitol ,etc.. Food sources; fibre rich foods Whole cereals , vegetables.

Health benefits : 

Health benefits It relief constipation It reduce pH Maintain bacterial balance Boost up the immune system Prevents diarrhoea Reduce the risk –colon cancer Improve mineral absorption

SYNBIOTICS : 

SYNBIOTICS Mixture of pro & prebiotics – improve the host health. Health benefits: Anti microbial Anti carcinogenic Anti allergic It reduce serum fats 7blood sugar It regulate blood sugar

Slide 42: 

THANK YOU