This is why yogurt can be consumed by lactose maldigesters and lactose intolerants. The European Food Safety Authority (EFSA) (24) has issued a scientific opinion that claims that the consumption of live yogurt cultures in yogurt, Lactobacillus delbrueckii subsp, bulgaricus and Streptococcus thermophilus, improves digestion of lactose in yogurt in individuals with lactose maldigestion. In order to bear the claim, the yogurt should contain at least 10 (8) live microorganisms per gram of yogurt.

References:

8. Amaretti, A et al. Appl Microbiol Biotechnol 2006;73:654-62.

24. Suchy, FJ et al. NIH Consens State Sci Statements 2010;27:1-27.

32. EFSA Panel on Dietetic Products, EFSA Journal 2010;8.

The past ten years we have seen remarkable new insights on gut microbiota. Three major elements of modern lifestyles have the strongest impact on the human-microbe symbiosis: nutrition, environmental exposures to chemicals and drugs, and conditions surrounding birth. When it comes to nutrition, research shows that an unbalanced diet, including a lack of fiber, could have detrimental effects on health through the gut microbiota. Fermented foods, like yogurt, also contribute to a diverse array of microorganisms or bioactive peptides into the existing gut microbiota and thus have the potential to affect health, especially cardiometabolic health (CMD- type 2 diabetes, obesity). A review of current gaps and challenges in identifying such effects, and a perspective on future research regarding the relationship between yogurt and CMD, will be provided by Prof Marette during the symposium.

Who is André Marette?

Dr. Marette is Professor of Medicine at the Heart and Lung Institute, Laval Hospital, and Scientific Director of the Institute of Nutrition and Functional Foods at the Laval University. He also holds a research Chair on the pathogenesis of insulin resistance and cardiovascular diseases (CVD). Dr. Marette is an international renowned expert on the pathogenesis of insulin resistance and cardiometabolic diseases and his research has advanced the understanding of the physiological/molecular mechanisms of inflammation, and opened new possibilities for prevention and treatment of type 2 diabetes and CVD. He is also studying how nutrition and food ingredients can modulate the gut microbiota to protect against obesity-linked intestinal inflammation, fatty liver disease and type 2 diabetes. He holds grants from the Canadian Institutes for Health Research, the Canadian Diabetes Association, and the Heart and Stroke Foundation of Canada. Dr. Marette has long-standing experience in leading international research programs, which all have in common the multidisciplinary nature of the teams and the implication of various end users (e.g. industry, government).

Dr. Marette has received several awards for his work, including the prestigious Young Scientist Award of the Canadian Diabetes Association and the Charles Best Award from the University of Toronto for his overall contribution to the advancement of scientific knowledge in the field of diabetes. He has published over 200 papers, reviews and book chapters. He has been invited to give more than a hundred lectures at various national & international conferences in the last 10 years.

He currently serves as Editor-in-Chief for the Am J Physiol: Endo & Metab. and has authored two books including the recent book Yogurt: Roles in Nutrition and Impacts on Health, edited by CRC press. See Marette explain the potential health benefits of fermented foods and yogurt in this video.

See you soon at ICN 2017 in Buenos Aires!

Despite the impact of fermented foods and beverages on gastrointestinal wellbeing and diseases, their many health benefits or recommended consumption has not been widely adopted by global food guidelines. In general, the approach of the legal systems regarding food guidelines is broadly consistent and their structures may be presented in different formats (pyramid, pie chart…). Some questions arose: Why is it useful to consume fermented food beyond their nutritional value? Which foods contain live microbes and which do not? Professor Seppo Salminen will present the case for such inclusion in dietary guidelines and some perspectives for challenging health authorities around the world to consider advocating for the many benefits of these foods.

Who is Seppo Salminen?

Seppo Salminen is Professor and Director of the Functional Foods Forum, University of Turku, Turku, Finland. He graduated in Food Science and Nutrition at the Washington State University (USA) with a MS Degree in Food Chemistry and with a MSc degree in Microbiology at the University of Helsinki (Finland). He is also certified with a PhD in Biochemistry and Toxicology from the University of Surrey in the United Kingdom

His research interests are mainly focusing on intestinal microbiota and health, microbiota modulation, probiotics, prebiotics, functional foods, novel foods, food and health and EU Food Regulations.

Professor Salminen is also an expert member in several regulatory committees on food and health (Finland and EU), including the European Food Safety Authority NDA Scientific Panel (9 years, from now).

He published over 400 refereed articles on topics like food and health, microbiology, probiotics, prebiotics, intestinal microbiota, food safety and functional foods, as well as several book chapters and text books about probiotics, prebiotics, food additives and functional foods themes.

Join us in Buenos Aires and register now!

The fifth edition of the Yogurt Summit is organized by the Yogurt in Nutrition Initiative for a Balanced Diet (YINI) in partnership with the American Society for Nutrition (ASN) and the Danone Institute International (DII). The event will gather the world’s leading experts in Argentina in order to review the latest research into gut microbiota and its growing relevance for overall health and improved nutrition. The conference comes at a pivotal time: recent scientific breakthroughs regarding gut bacterial communities are revolutionizing both medical research and nutritional interventions, while also gaining global attention. The goal of this summit is to pass on the most recent scientific advances to the medical and scientific communities that notably include scientists, gastroenterologists, pediatricians, nutritionists and dieticians.

In this page you can find the program and the speaker abstracts related to the summit. Join the conversation! #Yogurt2017

The Program of the Yogurt Summit

With microbiome research starting out more than a decade ago on the American continent, in Europe and in Asia, participants will receive an overview of the results over the last 10 years of research specifically related to health benefits of fermented foods on gut microbiota. The main topics to be discussed include : the state of the art on the association between gut dysbiosis and non-communicable diseases incidence, benefits of fermented foods consumption with a focus on yogurt,lactic acid fermentation and lastly new trend to include fermented foods into dietary guidelines. Professor Sharon Donovan (University of Illinois) and Professor Olivier Goulet (Hôpital Necker-Enfants Malades, Paris, France) will chair this 2017 edition of the Yogurt Summit.

The official program :

Keynote speaker abstracts from the Yogurt Summit

The Gut Microbiota:  The intersection between diet and health?

Prof. Sharon M. Donovan

Over the past decade, our understanding of the composition of the gut microbiota has been advanced through the use of next generation sequencing approaches. More than 50 bacterial phyla have been detected in the human gut, but, the gut microbiota aredominated by ~ 1000 microbial species belonging to the Bacteroidetes and the Firmicutes phyla. These microbes encode a substantially larger number of genes than the human host and interact with the host through specific receptors on gut epithelial, neural and immune cells as well as through the production of hormones and metabolites that signal to the host to influence health and disease. Studies in germ-free animals have shown that the gut microbiota is essential for normal gastrointestinal, immune, metabolic and cognitive development and function. Clinical and epidemiological studies have linked an imbalance of the normal gut microbiota, or dysbiosis, to gastrointestinal conditions such as inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), as well as extra-intestinal diseases such as obesity, type 2 diabetes, and atopy.  There is a broad interest in better understanding how microbial dysbiosis is associated with non-communicable diseases as well as to develop strategies to manipulate the gut microbiota to improve health outcomes through diet.  Two common approaches are the provision of fermentable substrates (fibers and prebiotics) or live microbes (probiotics).  Probiotics can be administered as supplements of single or multiple microbial species or by consumption of fermented foods containing live microbial species, such as yogurt. This presentation will focus on how dietary intake impacts the gut microbiome and the potential benefits of probiotics on the gut microbiome and disease.

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Health benefits of fermented dairy foods: microbiota and beyond

Prof. Robert Hutkins

Increased consumption of yogurt, kefir, and other fermented dairy products has been driven, in part, by the health benefits these products are thought to confer.  For example, epidemiological studies have shown that yogurt consumption is generally associated with reduced risks of type 2 diabetes (T2D), metabolic syndrome, and heart disease, and improved weight management.  Although these products are good sources of protein, calcium, and other nutrients, the live microorganisms present in these products are now considered responsible for many of these health benefits.  Included are the yogurt starter culture organisms, Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus, as well as strains of Bifidobacterium and Lactobacillus added specifically for their probiotic properties.  The physiological mechanisms by which these microbes interact with the gut microbiota and contribute health benefits are now the subject of considerable interest.  One major topic of research for establishing a role for these organisms is the well-known phenomenon of colonization resistance.  Specifically, the healthy human gastrointestinal tract contains a diverse, complex, and stable microbiota that is resistant to colonization by exogenous microorganisms. These could include pathogenic organisms as well as bifidobacteria and lactobacilli that are added to fermented milk products as probiotics.  Nonetheless, clinical studies have reported several health benefits from yogurt consumption for several conditions.  Among the most well-established effect is the role of yogurt bacteria on improving lactose digestion in individuals with lactose maldigestion, mediated via in vivo expression of the lactose-hydrolyzing enzyme β-galactosidase.  However, clinical evidence has also emerged showing that consumption of yogurt containing probiotics also improves both intestinal and extra-intestinal health.  Examples include infectious diarrhea, respiratory infections, and improved immune and anti-inflammatory response.  More recently, the effect of probiotics and probiotic yogurts on behavior and the microbiota-gut-brain axis has become an active area of research.

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Yogurt intake and prevention of cardiometabolic diseases: the role of fermentation products  

Dr André Marette

A healthy dietary pattern has been identified as a pillar for the prevention of weight gain and cardiometabolic diseases (CMD). A growing body of evidence suggests that yogurt consumption is linked to healthy dietary patterns, lifestyles and reduced risk of CMD, particularly type 2 diabetes (T2D). However, to date, there have been few to no randomized clinical trials (RCT) investigating yogurt intake in relation to cardiometabolic clinical outcomes. Furthermore, there has been little attempt to clarify the mechanisms that underlie the potential beneficial effects of yogurt consumption on CMD. Yogurt is a nutrient dense dairy food and has been suggested to lower weight gain and prevent CMD by contributing to intakes of protein, calcium, bioactive lipids and several other micronutrients. In this presentation we will focus on recent evidence that dietary proteins are key regulators of immunometabolic factors and the gut microbiota. In addition, fermentation with bacterial strains generates bioactive peptides from dairy proteins resulting in a potentially greater beneficial effect of yogurt on metabolic health compared with non-fermented dairy products such as milk. I will outline potential mechanisms that can underlie the inverse associations between yogurt intake and incidence of CMD and those are related to its bacterial constituents and bioactive peptides released during fermentation and compared with other fermented or non-fermented dairy products. A review of current gaps and challenges in identifying such mechanisms, and a perspective on future research needs that are necessary to validate the proposed role of yogurt in protecting against CMD will also be provided.

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Improving your diet with fermented foods: harmonizing dietary guidelines including fermented milks. 

Prof. Seppo Salminen 

Microbes are an essential part of our environment and food. Beneficial microbes derive mainly from fermented foods which have a long history of safe use. The species Lactobacillus has been defined as the 5th most important factor for human evolution due to the importance of lactobacilli in food fermentation and health promotion by strengthening intestinal mucosal barrier. Yogurt is defined as milk fermented with Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus (Codex  Standard Number 243/2003) with the organisms viable through the shelf life.

Yogurt and fermented milks are a significant source of viable bacteria and fermentation products which enhance nutritional quality and palatability of milk and provide metabolites, enzymes (e.g. lactase) and flavor components. In Europe, only one health claim has been approved for beneficial microbes : yogurt improves the handling of lactose. Five EU member states have national nutrition guidelines or recommendations that include either probiotics or yogurt with live bacteria. A recent report demonstrates that yogurt is recommended as a good source of nutrients in many countries (14   EU member states recommend yogurt as a recommended part of local diet and nutrition). Five of them explicitly mention probiotic beneficial effects and four give examples of probiotic bacteria. Several physiological effects of probiotics are well established.  Yogurt and yogurt with probiotics have benefits to humans: yogurt is easily digestible with live microbes. The inclusion of yogurt in food-based dietary guidelines has been suggested and knowledge on health benefits suggests opportunities for evidence-based  dietary guidelines with yogurt and yogurt with probiotic bacteria.

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Nutritional guidelines around the globe use very similar methods in presenting their concepts of the “ideal” dietary pattern, and give consumers a selection of recommended food groups. In this review, Victoria Bell et al. explain why traditional and supplemented fermented foods should be the new focus in national dietary recommendations for both adults and children.

A tipping point is the “point at which a series of small changes or incidents becomes significant enough to cause a larger, more important change.” This term applies the idea that consuming live microbes through fermented foods should be recommended by official governmental channels. Dating back millennia, fermented foods are among humanity’s oldest attempts to preserve food.

What is the state-of-the-art today in nutritional guidelines?

Despite a wild variation in their visual representation, nutritional guidelines around the globe are quite homogeneous when translating the nutritional needs – in terms of nutrients – into foods and food groups required to meet a balanced diet. These guidelines take into account cultural differences, and also food safety aspects. However, fermented foods are not consistently represented in these models. Fermented foods and beverages are lacto-fermented with natural bacteria or yeast creating lactic acid. The most popular fermented foods include: yogurt, cheese, soya, beans, fish, meat, cabbages and sauerkraut. In this review, the authors evaluated nutritional guidelines from various countries, checked their traditional and cultural value, and determined how they are represented in the models.

Fermented foods may provide health benefits

In their analysis, the researchers focused on the role of one common fermented food – the yogurt – and they found that several countries included yogurt (as part of dairy products) in their food-based dietary guidelines. It is the case in Switzerland, USA, Canada, UK, Australia, Japan, Sweden and Portugal. Although, fermented foods and probiotics have been part of the global human diet for a long time, and can provide certain health benefits, there still exists uncertainty as to their position as a category in the national food guides. This could be explained by the legal system, and the fact that health benefits of fermented foods have not been widely translated into global inclusion in the definition of food. Though, fermented foods are considered to be a boon for the gut – and in turn they do not only improve digestive health, but they possibly benefit allergies, weight loss or type 2 diabetes as well. Therefore, Bell et al. conclude that knowing the general benefits of traditional and supplemented fermented foods, they should be a daily topic in most national nutritional guidelines.

To learn more, read the original article.

Source: Bell V et al. Foods 2017;6:65.

However, because self-diagnosed or even diagnosed lactose intolerance can lead to an unfounded limitation or avoidance of dairy products, lactose intolerance could result in nutrient shortcomings, such as low calcium intake, which may result in adverse health effects. (23, 24, 28-30)

Nutritional recommendations for lactose intolerants

In order to consume the recommended daily intake of calcium among others, lactose intolerants can consume other forms of dairy products such as cheeses that contain low or no lactose, and more specifically yogurts that contain live bacteria, which improve the digestion of the lactose contained in yogurt. (24, 32)

Lactose intolerants can also consume food containing lactose in modest amounts, up to 12 g in one intake or up to 24 g (the equivalent of one or two bowls of milk, respectively), preferably in fractioned amounts across the day, during meals, without triggering any symptoms. (22, 33, 34)
The regular consumption of lactose-containing food by lactose maldigesters could even lead to colonic adaptation by the gut microbiota and may allow them to tolerate more lactose. (14)
Lactose-free food or total avoidance of dairy food is only needed for rare infants with congenital lactase deficiency. (6)
Nevertheless, the elimination of a particular type of food could lead to nutritional imbalances and may have significant health consequences.

*NMA (National Medical Association), NIH (the National Institutes of Health, a part of the U.S. Department of Health and Human Services), EFSA (the European Food Safety Agency), WGO (the World Gastroenterology Organization) and FAO (the Food and Agriculture Organization of the United Nations).

References:

6. Vandenplas, Y et al. Asia Pac J Clin Nutr 2015;24 Suppl 1:S9-13.
14. Szilagyi, A. Nutrients 2015;7:6751-79.
22. Suarez, FL et al. N Engl J Med 1995;333:1-4.
23. Suarez, FL et al. Am. J. Clin. Nutr., 1997, 65 1502-6.
24. Suchy, FJ et al. NIH Consens State Sci Statements 2010;27:1-27.
28. Black, RE et al. Am J Clin Nutr 2002;76:675-80.
29. Heaney, RP. J Am Coll Nutr 2000;19:83S-99S.
30. Heaney, RP. J Am Coll Nutr 2009;28 Suppl 1:82S-90S.
31. EFSA Panel on Dietetic Products, EFSA Journal 2010;8.
32. 31. EFSA Panel on Dietetic Products, EFSA Journal 2010;8.
33. Bailey, RK et al. J Natl Med Assoc 2013;105:112-27.
34. EFSA Panel on Dietetic Products, EFSA Journal 2010;8.
36. WGO. World Digestive Health Day. 10 global diet and lifestyle tips on how to improve digestive health. May 29, 2012.
37. Muehlho, E et al. Milk and products in human nutrition, 2013.

Numerous studies suggest that beneficial bacteria, found in probiotics, exert their health effect through the modulation of the gastrointestinal microbiota. Here, Lisko et al. show specific modification in the microbial community after a short-term period of yogurt consumption.

Monitoring the gut microbiota after yogurt consumption

The gastrointestinal (GI) tract encloses the gut microbiome, the ecological community of microbes and their genome. More and more data suggest that health benefits associated with probiotics food such as yogurt involves the gut microbiome. However, the change of the microbial composition and diversity of the GI tract is poorly documented. Here, the searchers used three different molecular methods to determine microbial community after ingestion of 250 g of yogurt (0% fat) per day, for a period of 42 days. The gut microbiota was monitored weekly. A subject who had never consumed yogurt was included as a control.

 Yogurt appears to increase microbial diversity

After already 7 days, and more markedly thereafter, authors found that microbial communities clustered together for subjects consuming yogurt. They report that regular consumption of yogurt appeared to increase the numbers of Lactobacilli (a strain that naturally occurs in the gut but is also present in yogurt cultures). The microbial diversity appears to slightly increase with yogurt consumption in some subjects. Many recent studies have underlined the association between a greater microbial diversity and better health conditions (lower inflammation, lower risk of types 2 diabetes and obesity), so this could be an important finding. However, authors call for more research to characterize the effects of yogurt on microbial community structure and diversity.

To learn more, read the original article.

Source: Lisko D J et al. Microorganisms 2017,5:6.

The Fourth Global Summit on the Health Effects of Yogurt took place in April 2016 in San Diego (US) during the annual Experimental Biology meetings. The scientific symposium was dedicated to yogurt and Type 2 Diabetes (T2D).

The proceedings are now published in The Journal of Nutrition:

• Donovan S M et al. Introduction to the Fourth Global Summit on the Health Effects of Yogurt, The Journal of Nutrition 2017;147:1449S-1451S.
• Salas-Salvado J et al. Yogurt and Diabetes: Overview of Recent Observational Studies, The Journal of Nutrition 2017;147:1S-10S.
• Wolever T MS. Yogurt Is a Low–Glycemic Index Food, The Journal of Nutrition 2017;147:1462S-1467S.
• Wen L, et al. Factors Influencing the Gut Microbiota, Inflammation, and Type 2 Diabetes, The Journal of Nutrition 2017;147:1468S-1475S.
• Tremblay A and Panahi S. Yogurt Consumption as a Signature of a Healthy Diet and Lifestyle, The Journal of Nutrition 2017;147:1S-5S.

A real medical diagnosis is especially important as, when it is performed, only 50 % of self-diagnoses of lactose intolerance are confirmed. (20, 22, 23) Furthermore, perceived or even diagnosed lactose intolerance is one of the reasons for limiting or avoiding dairy food, which could lead to possible nutrient shortcomings and health consequences. (24)

References:

20. Marteau, A et al. Cahiers de nutrition et de diététique 2005;40:20-23.

21. Hermans, MM et al. Am J Gastroenterol 1997;92:981-4.

22. Suarez, FL et al. N Engl J Med 1995;333:1-4.

23. Suarez, FL et al. Am. J. Clin. Nutr., 1997, 65 1502-6.

24. Suchy, FJ et al. NIH Consens State Sci Statements 2010;27:1-27.

25. Crittenden, RG et al. J Am Coll Nutr 2005;24:582S-91S.

26. Luyt, D et al. Clin Exp Allergy 2014;44:642-72.

For many years, humans have known that bacteria and other microorganisms are capable of transforming food substrates, making them both tasty and nutritious. More and more, chefs and other food-makers are putting bacteria to work to produce fermented foods. With delicious results. Besides flavour, though, are there other reasons to seek out fermented foods? Scientists around the world are trying to answer this question by studying the possible health benefits of consuming live cultures. Prof. Robert Hutkins (USA) is one of them. He studies bacteria in fermented foods and factors that affect their survival in the gastrointestinal tract and will be our guide in this promising area of investigation during the 5th Yogurt Summit.

Who is Robert Hutkins?

Professor Robert Hutkins is Professor of Food Microbiology in the Department of Food Science and Technology at the University of Nebraska. The Hutkins Lab studies bacteria important in human health and in fermented foods.  The lab is particularly interested in understanding how diet and various food components influence the bacteria that reside in the gastrointestinal tract. Specifically, the lab is focused on prebiotic fibers and how these food materials shift the intestinal microbiota in humans and animals and enhance human health. He also studies the physiology and metabolic functions of microorganisms used in the manufacture of fermented foods and beverages.

See you soon in Buenos Aires!