Transcript danone
نقش پره بیوتیک و پروبیوتیک ها در دوران شیردهی دکتر آزاده نجارزاده ،متخصص تغذیه [email protected] • human breast milk contains over 700 different types of bacteria. • The most common strains include Lactobacillus, Streptococcus, Staphylococcus, Enterococcus and Bifidobacterium. In addition, breast milk contains types of prebiotics known as human milk oligosaccharides (HMOs), which are non-digestible food components used by bacteria to stimulate their growth and activity. Prebiotics • Human milk contains more then 130 different oligosaccharides that are fermented in part in the infant’s colon. • The concentration changes with the duration of lactation: ‐ Highest in colostrum at 20 to 23 g/L, ‐ about 20 g/L on day 4 of lactation, ‐ 9 g/L on day 120 of lactation شیر مادر مهمترین منبع مواد مغذی -نقش شیر مادر در پیشگیری از آلرژی وجود ترکیبات immunoactiveدر شیر مادر -نقش پروبیوتیک ها در افزایش ( CD14آنتی آلرژیک)TGF-β ،IgA ، DANONE BABY NUTRITION Importance of Human Breast Milk Optimal nutrient levels Appropriate amounts of Carbohydrate, Protein, and Fats Vitamins Hormones Minerals Digestive proteins Available Online [http://www.nlm.nih.gov/MEDLINEPLUS/ency/article/002451.htm] accessed on 15/03/09 DANONE BABY NUTRITION Importance of Human Breast Milk Optimal nutrient levels Milk leukocytes Secretory IgA Lactoferrin Lysozyme Bifidus factor Human Milk Oligosaccharides (HMOS) Milk lipids M. Nathaniel Mead, Environ Health Perspect. 2008 October; 116(10): A426–A434. Wagner CL, Anderson DM, Pittard WB. 1996. Special properties of human milk. Clin Pediatr (Phila) 35(6):283–293. DANONE BABY NUTRITION Importance of Human Breast Milk Prebiotics e.g. Human Milk oligosaccharides Kelly M. Jackson; Andrea M. Nazar, JAOA • Vol 106 • No 4 • April 2006 • 203-207 DANONE BABY NUTRITION Effects of Prebiotics Oligosaccharides Colonic Fermentation of Oligosaccharides Guarner F et al, Best Practice & Research Clinical Gastroenterology, Volume 17, Issue 5, October 2003, DANONE BABY NUTRITION Acquisition of gut flora in human infants “The infant tends to acquire the flora swallowed from the vaginal 1 fluid at the time of delivery” Colonization GUT is sterile “Infants delivered by cesarean section are colonized with more anaerobic bacteria, especially Bacteroides, than vaginally delivered infants ”2 Suhali Al-Shammri et al., Journal of the Neurological Sciences 15 July 2004 (Vol. 222, Issue 1, Pages 21-27) 1- Vanderhoof, Jon A.Journal of Pediatric Gastroenterology & Nutrition. 30 Supplement 2:S34-S38, March 2000. 2- Adlerberth I. et al , The Ontogony of Intestinal Flora, 1999, p 279-292 DANONE BABY NUTRITION Development of the gut flora Every individual has a particular combination of predominant and subdominant species that is distinct from that found in other individuals Bacteriods fragilis Bifidobacteria Lactobacillus acidophilus Clostridium Francisco Guarner (Spain), Digestion 2006;73(suppl 1):5–12 DANONE BABY NUTRITION The Prebiotics concept Prebiotics must “survive” acidic conditions Prebiotics must evade digestion in the small intestine Must stimulate one or a limited number of beneficial bacteria Prebiotics must be selectively fermented in the colon Fuller & Gibson, 1997, Scand J Gastroenterology Suppl (222):32-40 DANONE BABYTherapeutic NUTRITION Manipulation of the Intestinal Flora (Probiotics) “live microorganisms which confer health benefits on the host”, when administered in adequate amounts. Acute diarrhea in infants Needs research to prove safety & efficacy Francisco Guarner (Spain), Digestion 2006;73(suppl 1):5–12 DANONE BABY NUTRITION Acquisition of gut flora in human infants Breast-fed babies Bifidobacteria Formula-fed infants Enterobacteriaceae, enterococci, bifidobacteria, Bacteroides, and clostridia Suhali Al-Shammri et al., Journal of the Neurological Sciences 15 July 2004 (Vol. 222, Issue 1, Pages 21-27) DANONE BABY NUTRITION Acquisition of gut flora in human infants Differences in Development of Microbiota in Breast- and Formula-fed Babies Breast-fed baby Formula-fed baby 100 100 90 90 80 70 70 60 60 % % 80 50 50 40 40 30 30 20 20 10 10 0 0 0 0 5 10 15 20 5 10 15 25 Days Days Bifidobacteria Bacteroides E. coli Harmsen et al. (2000) JPGN 30:61-67 20 25 DANONE BABY NUTRITION Balance of the Gut flora Generalised scheme of predominant groups of colonic bacteria, indicating how the genera may exhibit potentially harmful and benefi cial functions Francisco Guarner (Spain), Digestion 2006;73(suppl 1):5–12 DANONE BABY NUTRITION The gut flora as a forgotten organ IEC: intestinal epithelial cell Ann M.O’Hara & Fergus Shanahan, EMBO reports VOL 7, NO 7, 2006 DANONE BABY NUTRITION Carbohydrate fermentation and absorption Increase growth of human gut cells Growth of indigenous bacteria. Reduce counts of damaging bacteria They increase the gut's absorption of water DANONE BABY NUTRITION Patented Prebiotics • Combination of short-chain GalactoOligosaccharides (GOS) and long-chain FructoOligosaccharides (FOS) • Amounts and molecular size and distribution similar to HMOS (0.8 g/100 ml, GOS:FOS 9:1) • Made from natural ingredients (lactose and chicory) Aim: Healthy gut microbiota similar to breast-fed infants, resulting in health benefits تاثیر مصرف پروبیوتیک ها در دوران بارداری و شیردهی بر درماتیت آتوپیک . Experimental design. Trial compound (4 g) was administered twice daily from 26 weeks of gestation to 1 month after delivery. FOS, fructo-oligosaccharides. • Comparison of the concentrations of IL-27 in (a) colostrum samples and (b) 1month milk samples obtained from the placebo and fructooligosaccharide (FOS) groups. The Mann–Whitney Utest was used to analyse differences between the experimental groups (bar, median) ((a) P<0·027; (b) P<0·040) • IL-27, together with IL-12, IL-23 and IL-35, belongs to the family of cytokines associated with Tcell differentiation. • IL-27 induces the differentiation of T helper (Th)1 cells, regulates the induction of Th17 cells, increases the production of IL10, and induces type 1 regulatory T cells (Tr1) • In contrast to the demonstrated effects of probiotics, no significant difference in colostrum TGF-b, total IgA and soluble CD14 concentrations between the FOS and control groups was observed in the present study. These data suggest that prebiotics may act differently when compared with probiotics. Probiotics and mastitis • In some cases, new mums can develop a painful inflammation of the breasts called mastitis. It usually occurs when milk ducts become blocked due to ineffective emptying of the breasts during breastfeeding. The trapped milk can quickly become infected with bacteria entering the breast through sore or cracked nipples leading to an infection that might require antibiotic treatment. • Studies have shown that an oral supplement with lactobacilli strains can reduce the number of pathogenic bacteria and lead to a faster recovery. • Probiotics have also been recommended to prevent thrush episodes following the antibiotic treatment. ایمنی مصرف پروبیوتیک ها در شیردهی • Probiotics do not appear to pose any safety concerns for pregnant and lactating women. • current literature does not indicate an increase in adverse pregnancy outcomes. DANONE BABY NUTRITION حاوی که تکامل مغزی بینایی نوزاد غنی. پودر شیر شود DHA موجب شده ببمام برای حمایت از شیردهی مادران و می DHA کلسی نوشیدن یک م لیوان ببمام در روز %50 از نیازهای ید تغذیه ای مادر را تأمین می کند. آهن فسف ر روی DANONE BABY NUTRITION DANONE BABY NUTRITION THANKS FOR YOUR ATTENTION