Eliminating Digestion Discomfort

Bloating, diarrhea, gas, heartburn ... the list goes on when it comes to discomforts associated with eating the wrong foods. For some, food intolerance is simply a nuisance; for others, it can be life-threatening.

The National Digestive Diseases Information Clearinghouse, a service of the National Institute of Diabetes and Digestive and Kidney Diseases with the National Institutes of Health, Bethesda, MD, reports that digestive diseases affect 60 million to 70 million people. Why the large range? Its because many digestive diseases go undiagnosed, as many people are unaware their occasional gastrointestinal (GI) discomfort has anything to do with diet. But, as awareness grows, consumers are seeking out foods that meet their dietary restraints. This presents food scientists with the opportunity to formulate products that dont contribute to digestive discomfort.

Living with lactose 

One of the first food components doctors recommend patients experiencing GI stress eliminate from the diet is lactose, a sugar found in milk and dairy products. Unfortunately, dairy is also one of the best natural sources of bone-building calcium, as well as vitamins, such as A and D.

Lactose intolerance, the inability to digest significant amounts of lactose, is caused by a shortage of lactase, an enzyme produced by the cells that line the small intestine. Lactase breaks down milk sugar into glucose and galactose, which are then absorbed into the bloodstream.

People sometimes confuse lactose intolerance with cows milk intolerance, because the symptoms are often the same. However, intolerance to cows milk is an allergic reaction triggered by the immune system; lactose intolerance is a problem in the digestive system.

Misdiagnoses run rampant, and many who are truly lactose intolerant are misinformed as to what and how much to avoid. Lactose-intolerant consumers tend to avoid dairy foods, unless clearly labeled as lactose-free. Some will avoid foods that may contain even small lactose amounts, such as bread and other baked goods; instant potatoes; sauces, soups and salad dressings; lunch meats; candies and other snacks; mixes for pancakes, biscuits and cookies; and nutritional beverages.

However, cultured dairy foods with live, active cultures are virtually void of lactose, as the bacteria ferment the lactose, breaking it into glucose and galactose. Research also indicates that lactose-intolerant consumers can comfortably drink small servings of milk throughout the day to meet their calcium needs.

Product designers can eliminate lactose from many products by including the lactase enzyme in formulations.

Beyond bread and pasta 

Celiac disease has serious consequences if not managed properly. Damage to the small intestines mucosal surface, caused by an immunologically toxic reaction to gluten ingestion, interferes with nutrient and, in some cases, water and bile salt absorption. Left untreated, damage to the small bowel can be chronic and life-threatening, causing an increased risk of associated disorders both nutritional and immune-related.

Statistics suggest more than three million Americans are afflicted with celiac disease, and it is estimated the number of sufferers of celiac disease will increase worldwide by a factor of 10 during the next few years. The only treatment for celiac disease is lifelong adherence to a glutenfree diet, which allows the small intestine to heal and overall health to improve.

Theres a growing trend toward formulating foods free of gluten, the protein found in all forms of wheat (including durum, semolina and spelt), rye, oats, barley and related grain hybrids, such as triticale and kamut. Often, when food scientists think of avoiding gluten in a product formulation, they only think of wheat flour. However, many sources of gluten lurk in food ingredients, and even the slightest amount can cause the celiac discomfort.

For example, some starches can be wheat-based, so a celiac would need to avoid this product. Or, the stabilizer can be rice- or corn-based and be safe for a celiac. Thus, it is helpful to label the source of a starch, i.e., modified corn starch, instead of simply modified starch. Some flavorings must also be avoided, because they are fermented in the presence of wheat. Acidulants, such as vinegar, if properly distilled, should not contain any gluten, but most celiacs arent willing to take the chance unless the product is labeled gluten-free.

Earlier this year, FDA proposed a rule regarding gluten free labeling. It appears in the Federal Register, Docket No. 2005N-0279, Food-Labeling: Gluten Free Labeling of Foods. FDA proposes to set the standard acceptable gluten level for products labeled gluten-free at no greater than 20 ppm gluten. More specifically, FDA proposes that the term gluten-free on food labels apply only to foods that are free of any or all of the following:

Developing foods with a gluten level below 20 ppm is difficult, because gluten is very common in foods. Also, attempts to remove the gluten ingredient in foods may result in the loss of nutritional balance.

One common option is rice and rice-based ingredients, which are naturally gluten-free and contain nutritious, hypoallergenic proteins. For example, rice starches can substitute for modified wheat starches in cream-based soups. They can help maintain the creaminess and consistency of soups that undergo freezing, because they are shear-resistant and freeze/ thaw-stable. The starches prevent separation of liquid from solid, and this helps improve the mouthfeel. Just a small amount of rice starch can emulsify oils and broth. An additional benefit of these starches, as noted by A&B Ingredients, Fairfield, NJ, is they do not impart off flavors.

Axiom Foods, Inc., Los Angeles, offers an array of wholegrain, brown-rice-based ingredients. The company has a complete line of rice protein concentrates, clear brown-rice sweetener syrups (Oryzose), rice sweetener powders, rice milk powders, rice starches and flours, and organic, short-grain brown rice. The company says these ingredients are hypoallergenic, vegan, gluten-free, kosher, non- GMO and contain virtually all the nutrition of the original rice.

Rice flour has been used in gluten-free bakery products, such as breads and cakes, which are traditionally made with wheat flour. Breads from nonwheat flours often have poor crust and crumb characteristics; however, Australian researchers have successfully made loaf breads using rice flour and potato starch, along with various hydrocolloids.

A prototype that included hydroxypropylmethylcellulose (HPMC) had the most-favorable effect on bread qualities. A recipe that included carboxymethylcellulose (CMC) had little effect, while one with guar gum had no effect. Interestingly, a combination of HPMC and CMC showed the most potential, resulting in a dough with the viscosity necessary to trap fermented gases, develop a rigid but porous cell structure, and produce good loaf volume (Food Australia, March 2004).

Chemists Fred Shih and Kim Daigle at the ARS Southern Regional Research Center, New Orleans, found flour made from rice and sweet potatoes can substitute for wheat in pancakes. The rice- and sweet-potato-based pancakes are not only suitable for those suffering from celiac disease and wheat allergies, theyre also standouts in terms of their antioxidant content, with 56% more beta carotene than traditional wheat-based pancakes. Shih and Daigle, whose findings were published in the Feb. 2006 issue of Journal of Food Quality (29:97-107), experimented with different amounts of sweet-potato flour and scrutinized the pancakes textural and nutritional properties.

In the world of gluten-free foods, textural qualities are especially important. Since gluten provides dough and batter with essential visco-elasticity, baked goods made without them run the risk of being flat, brittle and jaw-achingly dense. In the end, Shih and Daigle found the ideal pancake contained 20% to 40% sweet-potato flour. Textural properties, such as hardness and chewiness, of the cooked pancakes generally increased with time after cooking, whereas those traits decreased with higher sweetpotato flour replacement. On the other hand, cohesiveness decreased with time, but increased with higher levels of sweet-potato flour.

Suppliers are aggressively rolling out ingredients for gluten-free foods. For example, Corn Products International, Inc., Westchester, IL, has introduced a modified tapioca starch. This starch is said to provide a structure to finished products that is more like foods that include wheat gluten, while its clean flavor lets gluten-intolerant customers enjoy their favorite foods, like breads, cookies and pizza.

This starch has excellent water-binding and freeze/ thaw properties, clean flavor and non-GMO status. It has expansion properties that create structures and textures similar to wheat counterparts. It enhances the appearance, texture and flavor of bakery products; helps bread rise higher; creates a moist and expanded crumb; improves crispy texture; can reduce the amount of gums used; extends shelf life; and brings out the natural flavor of bakery products.

National Starch Food Innovation, Bridgewater, NJ, has introduced a new functional, native, potato-based starch that retains moisture in poultry products while eliminating the need for modified wheat starches, as well as other ingredients, such as sodium phosphate and carrageenan additives. Typical processed poultry products often include these ingredients in varying combinations to help retain moisture, which improves both yield and eating qualities. The new starch offers poultry producers a gluten-free option for preparing tumbled, injected, marinated, coated, parcooked, frozen and other packaged poultry products with gluten-free labels.

Because the starch is potato-based, it is inherently bland and does not affect the flavors of meats and marinades. Processors do not need to use any special processing techniques when this ingredient is included in products. The starch has a low gelatinization temperature, neutral pH, low shear and stress conditions, and is relatively stable at low cooking temperatures.

For gluten-free sweetening, Briess Malt & Ingredients Co., Chilton, WI, offers a special white sorghum syrup, a gluten-free malt-extract substitute that offers a solution to the challenge of browning cereals, crackers, snack foods, particulates, baked goods and other gluten-free foods. It differs from other sorghum syrups, because it is produced from the starchy heads of the grain, not the cane, of the sorghum plant. An all-natural nutritive sweetener with the same reducing sugars and amino acids as malt extract to promote browning and flavor development, the syrup possesses other characteristics similar to malt extract, including moderate- to long-lasting sweetness, humectancy and medium viscosity. It replaces malt extract 1:1 in existing formulations, or can comprise 1% to 3% of new formulas.

Whats going on down there?

Irritable bowel syndrome (IBS) is characterized by abdominal pain or discomfort often reported as cramping, bloating, gas, diarrhea and constipation. IBS affects the colon, or large bowel. IBS is not a disease. Its a functional disorder, meaning the bowel doesnt function correctly. Fiber may reduce constipation associated with IBS, because it makes stool soft and easier to pass. Thus, consumers with IBS often seek out high-fiber foods.

Tate & Lyle, Decatur, IL, recently launched a corn-based resistant starch that can help manufacturers add more fiber to baked products and snacks, including cereal, crackers, cookies, bread and pasta, with no impact on taste or texture, according to the company. It is also useful in gluten-free formulations.

Resistant starch resists digestion and acts as a dietary fiber. It acts as a prebiotic fiber that is well-tolerated and has a low glycemic response.

Other resistant starches do not survive well in extreme process conditions, says Jim Miller, director of product management, Americas, Tate & Lyle. Because of its process stability, Promitor Resistant Starch can be used in smaller quantities to deliver better results. This means it is cost-efficient and has less impact on the formulation than other products currently on the market, he notes.

It also has very low water-holding capacity, making it easy to formulate with when substituting for wheat flour in low-moisture systems such as crackers and cookies. In fried goods, the resistant starch reduces oil pickup by 15% to 20%, which means fewer calories and less fat in the end product.

A specific type of IBS, Crohns disease, often requires more dietary modifications than simply adding fiber. In fact, fiber sometimes worsens the situation. Crohns disease is an ongoing disorder that causes inflammation of the GI tract. Crohns disease can affect any area of the GI tract, from the mouth to the rectum, but most commonly affects the lower part of the small intestine, the ileum. The swelling extends deep into the lining of the affected organ, potentially causing pain and making the intestines empty frequently, resulting in diarrhea.

Crohns disease is often treated with antibiotics, which destroys the good bacteriaprobiotics naturally present in the GI tract. Thus, it is important for anyone using antibiotics to replenish their intestines with dietary sources of probiotics, such as yogurt.

Furthermore, researchers are currently investigating the use of probiotics and specific prebiotics (food substances metabolized by probiotics) for treatment of IBS and Crohns disease. Some evidence suggests that, alone or in combination, they may have significant benefits in the intestine.

Probiotics are bacterial strains that may provide a barrier against harmful bacteria, possibly through various mechanisms, such as excreting certain acids that inhibit harmful bacteria or competing with them for nutrients. Probiotics may also help maintain remission in patients with IBS and Crohns disease. The specific bacterial strains that might be beneficial, however, are not fully known. Some clinical studies show some strains of Lactobacillus and Bifidobacterium, the two most popular probiotic genera, alleviate symptoms of IBS and Crohns disease.

Globally, the benefits of probiotics have long been accepted. But only in the past few years have they caught on in the States. In general, yogurt containing live and active cultures has long been used to prevent or treat common intestinal problems, particularly chronic diarrhea in children. Since the turn of the century, researchers have published hundreds of studies examining probiotics effectiveness in relieving GI-tract discomforts, and this message is making its way to those suffering from GI distress.

Suppliers offer a variety of probiotic ingredientsoften specific strains that have been researched and have documented health benefits. Applications extend beyond dairy foods, with probiotics now showing up in bars and cereals.

These are just a few of the many digestive disorders affecting humans. But an increasing range of valuable ingredients can help product designers ease consumers discomfort. 

Donna Berry, president of Chicago-based Dairy & Food Communications, inc., has been writing about product development and marketing for 13 years. Prior to that, she worked for Kraft Foods in the natural-cheese division. She has a B.S. in Food Science from the university of Illinois in Urbana-Champaign. She can be reached at [email protected]. 

Aloe Vera and GI Conditions

The status of an individuals gastrointestinal (GI) health depends on a complex interplay of variables, including diet, genetic predisposition, stress and psychological well-being, use of tobacco and alcohol, composition of gut bacteria, systemic inflammatory status, and infection by pathogenic and parasitic organisms. Recent evidence suggests the ingestion of Aloe vera gel can play a role in preventing or ameliorating conditions related to inflammatory gastrointestinal diseases, such as gastritis and ulcerative colitis. Gastritis is inflammation of the mucosal lining of the stomach; ulcerative colitis is inflammation of the large intestine.

Two recent in vivo studies using animal models provide insight into the probable mechanisms behind the use of Aloe vera gel in the relief of chronic gastritis. The first studied the anti-inflammatory actions of aloe gel on leukocyte adhesion and TNF-á modulation in the gastric epithelium of male Sprague-Dawley rats. The aloe treatment significantly reduced both leukocyte-endothelium interactions and the levels of the pro-inflammatory cytokine, TNF-á, indicating aloe gel may be effective in alleviating the inflammation of the gastric mucosa that is characteristic of gastritis (Clinical Hemorheology and Microcirculation, 2006; 35:359-366).

In a second animal study, the effect of Aloe vera treatment was compared to that of sucralfate, a medication used to treat duodenal ulcers, stress ulcers and gastrointestinal reflux disease (World Journal of Gastroenterology, 2006; 12:2,034-2,039). Researchers concluded that both aloe and sucralfate facilitated gastric healing by promoting epithelial cell proliferation in the gastric mucosa and by stimulating the anti-inflammatory and cytoprotective prostaglandin, PGE2.

Two additional studies provide evidence that Aloe vera gel can alleviate the symptoms of ulcerative colitis. In the first trial of 44 patients, 18 to 80 years old, with ulcerative colitis, patients in the treatment group received 100 ml aloe gel twice daily over a four-week period; control patients received a placebo liquid with an identical appearance and taste. After four weeks, 30% of the aloe-treated patients displayed clinical remission, compared to 7% of placebo patients. Clinical improvement was observed in 37% of the treated group vs. 7% in the placebo group, while 47% of treated patients showed clinical response vs. 14% of the placebo group (Alimentary Pharmacology & Therapeutics, 2004; 19:739-747).

A second study assessed Aloe vera gels antioxidant properties in two cell-free systems and in chemiluminescence measurements of incubated rectal biopsy samples from patients previously diagnosed with active ulcerative colitis. In this assay, aloe gel added to the assay at high concentrations produced 100% inhibition of superoxide production; aloe gel added to the incubation elicited 50% inhibition at a dilution of 1:1,000. In chemiluminescence experiments measuring free-radical activity in colorectal biopsies, 50% inhibition of oxidation reactions was achieved at aloe dilutions ranging between 1:10 to 1:50 (Alimentary Pharmacology & Therapeutics, 2004; 19:521-527).

These results suggest that Aloe vera gel can promote healing of gastric lesions and prevent damage to the gastrointestinal system by infectious pathogens, chemical irritants or gastrointestinal reflux disease, all of which are frequently implicated as causes of inflammatory gastrointestinal diseases.

Ken Jones, Chief Science Officer, Aloecorp, Inc., Lacey, WA