Prebiotics in follow-on foods

In the pre­vi­ous issue of HOCHDORF In­side, pub­lished in Au­tumn 2016, we fol­lowed ba­bies Emma and Noah through their first months of life. We saw how im­por­tant it was for the de­vel­op­ment of Emma and Noah to es­tab­lish healthy mi­cro­biota.

But what does healthy mi­cro­biota or gut flora look like? It com­prises nu­mer­ous harm­less strains of bac­te­ria like Lac­to­bacilli and Bi­fi­dobac­te­ria. These good bac­te­ria pro­tect us, from for­eign in­trud­ers and pathogens for ex­am­ple, and pro­duce im­por­tant di­ges­tive en­zymes and vi­t­a­mins. Re­searchers have dis­cov­ered that nu­tri­tion plays an im­por­tant role (1) in the num­ber of in­di­vid­ual strains of bac­te­ria that are es­tab­lished in our gut. Bac­te­ria also need en­ergy in the form of food. But not all types of bac­te­ria like the same food. Healthy bac­te­ria, for in­stance, pre­fer spe­cific car­bo­hy­drates such as galac­tooligosac­cha­rides (GOS), oligofruc­tose and in­ulin, which are all types of pre­bi­otics.

"Be­tween the age of six and 18 months, the mi­cro­biota alter quite dra­mat­i­cally as a re­sult of the change in diet."

The first months went per­fectly for Emma and Noah. Emma was breast fed and Noah was fed with an in­fant for­mula en­riched with GOS, con­tain­ing pre­bi­otics and all the im­por­tant nu­tri­ents re­quired for life. Now they are both ex­plor­ing the world with cu­rios­ity and ready for the next big step: the wean­ing phase and the move to their first solid foods. Both ba­bies need lots of en­ergy to grow. Be­fore they reach the age of one their birth weight will triple and their size will dou­ble; their brains will also grow dis­pro­por­tion­ately in the first three years. Breast milk or in­fant for­mula are no longer enough on their own. For healthy phys­i­cal and men­tal de­vel­op­ment, Emma and Noah need semi-solid food with ad­di­tional nu­tri­ents in­clud­ing pro­tein, iron and zinc, plus un­sat­u­rated healthy fatty acids such as DHA for healthy brain de­vel­opment (see HOCHDORF In­side, Issue 4, Win­ter/Spring 2016).

In­tro­duc­ing semi-solid food af­fects the mi­cro­biota

Var­i­ous sci­en­tific stud­ies have shown that the com­po­si­tion of in­testi­nal mi­cro­biota changes ­significantly when a child is be­tween six and 18 months old, de­pend­ing on their diet. New foods are ar­riv­ing on the menu every month for Noah and Emma and these can have a pos­i­tive or a neg­a­tive ef­fect on the com­po­si­tion of the mi­cro­biota. It is only once they reach the age of three that the mi­cro­biota (2) of both ba­bies will sta­bilise and be­come sim­i­lar to that of an adult. The phase of mov­ing to semi-solid foods can there­fore have a life-long im­pact on the mi­cro­biota and the health of Emma and Noah.

It’s worth start­ing early

Noah’s par­ents were aware of the im­pact that nu­tri­tion would have on the health of their son both now and in the fu­ture. Noah is now re­ceives a fol­low-on for­mula in­stead of in­fant for­mula. It con­tains more nu­tri­ents such as iron, zinc and the same pre­bi­otics as his in­fant for­mula. His par­ents should avoid cow’s milk ini­tially. Stan­dard cow’s milk is not par­tic­u­larly suit­able for young chil­dren; it con­tains too lit­tle iron, for ex­am­ple. Along­side the fol­low-on for­mula, Noah is also being in­tro­duced to a new fruit, veg­etable or ce­real por­ridge every other day to en­sure he re­ceives suf­fi­cient fibre. This step-by-step ap­proach al­lows his par­ents to check how Noah’s me­tab­o­lism re­acts to new foods. He is given unsweet­ened herbal teas and water to drink as Noah’s par­ents are keen to make sure he does not have any un­nec­es­sary sugar, fat or salt.

It’s worth start­ing early – the sooner Noah be­comes ac­cus­tomed to foods low in salt, sugar and sat­u­rated fat with nat­ural flavours, the less likely he will be to re­ject un­processed foods in the fu­ture. Chil­dren pre­fer the pri­mary foods that are pre­sented to them most often (3) so par­ents should per­se­vere in of­fer­ing those that are less pop­u­lar. Chil­dren then have the chance to shake off their re­luc­tance to try cer­tain foods be­fore it be­comes too en­trenched. Thanks to his par­ents’ ap­proach Noah is al­ready very healthy, which also strength­ens his im­mune sys­tem.

Emma has also de­vel­oped into a healthy and lively ­little girl. To the de­light of her par­ents, Emma is a good eater, al­though she knows ex­actly what she wants. It has to be sweet and colour­ful. She doesn’t like plain por­ridge or unsweet­ened fruit purées or drinks with­out sugar at all. Emma’s mum and dad tried a few times to give her plain foods but quickly aban­doned the at­tempt in the face of their daugh­ter’s com­mo­tion. Emma be­came ac­cus­tomed to the pleas­ant taste of sugar very quickly. Her par­ents couldn’t be­lieve that their daugh­ter was con­sum­ing lots of sugar and ad­di­tives in her solid foods and colour­ful chil­dren’s snacks. And they found it re­ally con­ve­nient to quickly pack a sweet apple puree or a colour­ful pot of chil­dren’s jelly to take with them when they were out or in the car on the way to nurs­ery. Of course, these are not a prob­lem if you also in­clude healthy meals and snacks.

Dys­bio­sis – im­bal­ance in bac­te­ria

Emma’s mi­cro­biota were not very happy on ac­count of the highly sug­ared fruit juice and chil­dren’s snacks. Emma may have been con­sum­ing too many calo­ries, but they didn’t pro­vide the food the healthy mi­cro­biota re­quired. There wasn’t enough di­etary fibre and healthy car­bo­hy­drate. Be­cause not all sugar is the same. Whole grain prod­ucts, fruits and pota­toes con­tain healthy oligosac­cha­rides and poly­sac­cha­rides which are good for the gut. The den­sity of the healthy bac­te­r­ial colonies on Emma’s in­testi­nal mu­cosa ­de­creased. In other words, the good bac­te­ria could barely in­hibit the growth of the path­o­genic bac­te­ria (4). The re­sult was a dis­turbed mi­cro­bial colony, or dys­biosis. There was an im­bal­ance in Emma’s mi­cro­biota and it began to cause her more harm than good. Emma’s im­mune sys­tem began to weaken and she often suf­fered from in­fec­tions, a pos­si­ble side ef­fect of dys­bio­sis (5).

The fact that the gut and brain are closely con­nected with each other and in­ter­act through the gut brain axis should not be un­der­es­ti­mated.

Dys­bio­sis is not some­thing to be un­der­es­ti­mated. The gut re­duces its en­zyme activ­ity and the body can ab­sorb fewer vi­t­a­mins, car­bo­hy­drates, amino acids and min­er­als. In the worst cases it can lead to mal­nu­tri­tion. Ac­cord­ing to some stud­ies, dys­bio­sis can cause chronic obe­sity and re­lated sec­ondary dis­eases such as di­a­betes and car­dio­vas­cu­lar dis­ease. A weak­ened im­mune sys­tem also leads to in­creased in­flam­ma­tions and to atopic dis­eases such as neu­ro­der­mati­tis or asthma (7). The fact that the gut and brain are closely con­nected with each other and in­ter­act through the “gut brain axis” should not be un­der­es­ti­mated. Dys­bio­sis can af­fect the mind and lead to de­pres­sion and autism in cer­tain cir­cum­stances (8, 9).

Emma was lucky. Fol­low­ing the first signs of neu­ro­der­mati­tis and an analy­sis of her eat­ing habits the pae­di­a­tri­cian pre­scribed a change in diet. Emma’s par­ents have con­sciously fed their daugh­ter the rec­om­mended amount of healthy car­bo­hy­drates and fibre since then. They watch that Emma doesn’t have too much fat and that any fat comes from healthy un­sat­u­rated fatty acids such as DHA.

In­fant for­mula and Kids’ Food from HOCHDORF – healthy and con­ve­nient

Since the change in diet, Emma has been in much ­better health. De­spite the ad­just­ment, her par­ents have not had to spend extra hours cook­ing. There are now prod­ucts on the mar­ket that offer con­ve­nience. At HOCHDORF, for ex­am­ple, we offer in­gre­di­ents for wean­ing foods based on milk pow­ders that also con­tain ad­di­tional ce­re­als, veg­eta­bles and fruits, de­pend­ing on the va­ri­ety. The prod­ucts just need to be mixed with warm water to pro­duce a healthy baby por­ridge with­out any ad­di­tional sugar or salt. Our range in­cludes healthy snack prod­ucts for older chil­dren, such as our well­ness crisps, as well as spe­cial­ist chil­dren’s snacks made from whole grain, maize and car­rots. Our dried veg­etable and fruit crisps are con­ve­nient and healthy for on the move. Our Mar­bacher Ölmühle di­vi­sion also of­fers healthy in­gre­di­ents for chil­dren. Our or­ganic rape­seed oil for in­stance is per­fect for mix­ing into ­children’s por­ridge.

Healthy nu­tri­tion for small chil­dren doesn’t stop at home; it is pos­si­ble any­where. At HOCHDORF we offer so­lu­tions that meet today’s nu­tri­tional trends and lifestyle – healthy nu­tri­tion wher­ever and when­ever we want.

Further information

• Short article "Health benefits of prebiotics"
• Overview "Dysbiosis"
• Article "Carbohydrates – It's all the mix"
• Article "Prebiotics in infant formula, part 1"
• Article "Functional gastrointestinal disorders"

Sources
1) Arumugam M, Raes J et al. Enterotypes of the human gut microbiome, published in Nature. 2011 May 12; 473(7346): 174–180.
2) Yatsunenko T, Rey FE et al. Human gut microbiome viewed across age and geography. Nature, 486 (2012), pp. 222–227.
3) SGE Schweizerische Gesellschaft für Ernährung: Hintergründe zur Ernährungsscheibe.
4) Frick J-St, Autenrieth IB. Wechselwirkung zwischen Darmflora und intestinalem Immunsystem, in: Probiotika, Präbiotika und Synbiotika, hg von Stephan C Bischoff, Thieme Verlag, Stuttgart 2009.
5) Oriá RB, Murray-Kolb LE et al. Early-life enteric infections: Relation between chronic systemic inflammation and poor cognition in children. Nutrition Reviews, 74(6), 374–386. DOI: 10.1093/nutrit/nuw008, published 2016. 
6) Graham C, Mullen A et al. Obesity and the gastrointestinal microbiota: a review of associations and mechanism. Nutr Rev (2015) 73 (6): 376–385. 2015. Published by Oxford University Press on behalf of the International Life Sciences Institute. 
7) Haahtela T et al.: The biodiversity hypothesis and allergic disease: world allergy organisation position statement. World Allergy Organ J. 2013 Jan 31;6(1):3. 
8) Borre YE et al.: Microbiota and neurodevelopmental windows: implications for brain disorders. Trends Mol Med. 2014 Sep; 20(9):509–18. 
9) Grenham et al.: Brain-gut-microbe communication in health and disease. Front Physiol. 2011 Dec 7;2:94.