Kefir, a traditional fermented food, has numerous health benefits due to its unique chemical composition, which is reflected in its excellent nutritional value. Physicochemical and microbial composition of kefir obtained from fermented milk are influenced by the type of the milk, grain to milk ratio, time and temperature of fermentation, and storage conditions. It is crucial that kefir characteristics are maintained during storage since continuous metabolic activities of residual kefir microbiota may occur. This study aimed to examine the nutritional profile of kefir produced in traditional in use conditions by fermentation of ultra-high temperature pasteurized (UHT) semi-skimmed cow milk using argentinean kefir grains and compare the stability and nutritional compliance of freshly made and refrigerated kefir. Results indicate that kefir produced under home use conditions maintains the expected characteristics with respect to the physicochemical parameters and composition, both after fermentation and after refrigerated storage. This work further contributes to the characterization of this food product that is so widely consumed around the world by focusing on kefir that was produced in a typical household setting.
Diet has a fundamental role in the homeostasis of bodily functions, including the skin, which, as an essential protective barrier, plays a crucial role in this balance. The skin and intestine appear to share a series of indirect metabolic pathways, in a dual relationship known as the “gut-skin axis”. Hence, the gut-skin axis might be receptive to modulation via dietary modification, where probiotics can be included, thus representing a potential therapeutic target in inflammatory skin diseases, such as atopic dermatitis (AD), in order to control and/or ameliorate symptoms. Kefir is one of the most ancient fermented foods, with probiotic characteristics that have been associated with a wide variety of health-promoting benefits, and it presents a microbiological diversity that makes its application as a probiotic in the gut-skin relationship of the utmost interest. However, the impact of a diet containing kefir on skin health has yet to be reported in scientific literature. This study aimed to assess the impact of the intake of homemade kefir in the skin of healthy and atopic volunteers. The intervention resulted in a boost on barrier function in both skin types verified only in the respective kefir intake groups. An improvement in the degree of severity of AD was also confirmed for the kefir intake group. Atopic individuals may benefit from kefir intake, especially in regard to their skin hydration. Finally, the effects observed on skin barrier function in this study probably culminate from the effects of all the ingredients in kefir, including the complex microbiota, its metabolites and macro- and micronutrients resulting from the fermentation. This work opens the way for more advanced research on the impact of the probiotic kefir on cutaneous health, further clarifying its mechanism of action namely via gut-skin axis.
The human gastrointestinal (GI) tract is a dynamic system influenced by various environmental factors, including diet and exposure to ingested probiotics, and prone to various functional impairments. These impairments are mostly related to any combination of motility alterations, visceral hypersensitivity, and changes in the mucosa, immune function, and intestinal microbiota. Intestinal microbial imbalance and immunological dysfunction have been linked to several chronic inflammatory disease states, including atopic dermatitis (AD). Disruption of the intestinal microbial balance, known as gut dysbiosis, has been demonstrated to negatively impact skin function by increasing the intestinal permeability. Consequently, the gut–skin axis may be receptive to modulation via dietary modification, namely, via ingestion of probiotics, thus representing interesting potential as an AD therapy. Kefir is an ancient probiotic food that has been demonstrated to positively impact the general condition of the digestive system, including the intestinal microbiota. However, the literature is still scarce on the impact on the gut–skin relationship of a diet containing kefir. This study, continuing research in our group, aimed to evaluate the impact of kefir intake on GI symptoms in healthy and AD skin subjects. Results showed a significant improvement in GI status, namely, in functional constipation, abdominal pain intensity, and abdominal distension, thus supporting the hypothesis that kefir intake is positively associated with improvement in GI status. The existence of a relationship between the improvement in skin parameters and the improvement in GI status after kefir consumption was established, thus reinforcing the role of homemade kefir as a potential modulator of the gut–skin axis in both healthy and atopic individuals.
Determination of relevant endpoints to evaluate the in vivo barrier function in cutaneous health Determinação de "endpoints" relevantes para a avaliação in vivo da função "barreira" na saúde cutânea
Kefir, a symbiotic consortium of diverse bacteria and yeasts, is one of the most popular probiotic foods on the market. Its consumption has been referred to as beneficial in human skin health, namely in the reinforcement of skin’s barrier function. This benefit likely results from the productive activity of lactic acid bacteria during kefir fermentation. Lactic acid is naturally present in the skin, and actively contributes to epidermal water dynamics and “barrier.” Few studies have been conducted regarding the impact of probiotic consumption in human epidermal water homeostasis. Therefore, this study was designed to explore the impact of the regular consumption of kefir on the skin water dynamics in a group of participants with healthy skin. Participants (n = 27) were healthy female volunteers from whom twelve consumed 100 mL of kefir every day for eight weeks as part of their diet. The remaining (untreated) participants served as the control group. Epidermal water balance was assessed by measuring transepidermal water loss (TEWL) and stratum corneum (SC) hydration on three different occasions—at baseline (T0), after four weeks (T4) and after eight weeks (T8) of interventive kefir consumption. Our study revealed a significant reduction in TEWL (p = 0.043) in the kefir group after eight weeks of regular consumption. In the same period, no differences were found for TEWL in the control group (p = 0.997). Regarding hydration, skin dryness was progressive in the control group, with a significant reduction in SC hydration (p = 0.002) at T8 in comparison to T0. In the kefir group, SC hydration was preserved between T0 and T8 (p = 0.997), which we believe to be related to epidermal “barrier” reinforcement. Our study seems to confirm that the regular consumption of kefir does improve cutaneous water balance even in healthy skin.
The intestinal microbiota is linked to important functions in the host. Alterations in its composition and/or its by-products, causing loss of homeostasis, contribute to dysfunctions in other organic systems, including the skin, hence suggesting a gut-skin relationship. The oral administration of probiotics, widely associated with improved intestinal health, can act through an immunomodulatory response, both locally and systemically, presenting itself as potentially beneficial in inflammatory skin diseases such as atopic dermatitis. Traditional kefir, consumed for centuries as a health-promoting natural food, has its biological activity attributed both to the presence of a complex microbiota and to the action of the metabolites released during fermentation. The biological activity of kefir has been demonstrated in part by its ability to positively impact the intestinal microbiota, mainly based on animal models and in vitro, thus providing limited information. The nutritional and microbiological value of kefir makes its application as a probiotic in the gut-skin relationship a topic of of significant interest. This review aimed to explore the impact of probiotics as regulators of the gut-skin axis, focusing on the current knowledge of kefir as a health-promoting food. Keywords: kefir, probiotic, gut-skin axis, skin health, atopic dermatitis
Fermented foods, such as kefir, tend to be characterized by their unique flavor and aroma. Sensory perception of this type of food or beverage is a key factor for the general consumer acceptance of the product, which can be assessed through sensory tests. Conventional sensory tests include acceptance tests where consumers, not trained panelists, are asked to express their degree of like on a hedonic scale, where the level of acceptability of foods does not require a choice between alternatives. The most commonly used scale for testing consumer acceptability of foods is the 9-point hedonic scale. An average score of 7 or higher on the acceptability test indicates a high sensory quality and represents a good acceptance of the product by the panel. This study aimed to evaluate the acceptance of a kefir drink in a sample of Portuguese consumers. The acceptability test of the kefir obtained by fermentation of Portuguese milk with CIDCA AGK1 kefir grains was conducted in a group of 19 consumers using a 9-point hedonic scale and produced a mean score of 7.00 ± 1.15, which correlates with a qualitative rating of “Like moderately.” This work is part of an ongoing study, designated DermapBio, conducted by our research center, with an aim to evaluate the benefits of kefir ingestion for cutaneous health.
Malnutrition has important health impacts, especially in the elderly. Oral nutritional supplements (ONS) are effective strategies to help balance the nutritional needs of malnourished persons. Multiple ONS are available at community pharmacies, enabling pharmacists to have the possibility to implement strategies for prevention and monitoring of malnourished patients. The aim of this study was to characterize the experience of community pharmacists with the counseling and follow-up of users of ONS. A sample of 19 pharmacists from 19 different community pharmacies were interviewed. Apart from dispensing ONS to support patients that are preparing for diagnostic tests, the most frequently mentioned clinical condition for ONS counseling was malnutrition and dysphagia. When pharmacists consider dispensing ONS, three themes emerge: patient care, related to counselling tailored ONS to each patient’s needs; interprofessional collaboration, with a special focus in the collaboration with registered dietitians; and training and education on ONS, looking to improve their knowledge and skills in ONS counselling and follow-up. Future studies exploring new forms of interaction between pharmacists and dietitians in this context should be developed, aiming to determine the workflow of an interdisciplinary service addressing the needs of community dwelling malnourished patients.
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