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Fermented milks: a historical food with modernapplications a review
AY Tamime1*
1Dairy Science and Technology Consultant, Ayr, Scotland, UK
Background: This paper was presented at the symposium which was organized by Instituto Danone Mexico in May 2001, and itprovides an overview of the current scientific knowledge on fermented milks concerning the historical developments,manufacturing stages, classification of such products, and nutritional aspects. Particular attention has been paid to thehuman health benefits associated with the consumption of these products, the use of probiotic starter cultures and theirindustrial applications, and the significance of using a trained sensory panel for the evaluation of probiotic fermented milks madewith different commercial blends of starter cultures. The paper also highlights the future research areas for the exploitation ofstarter microflora (Lactobacillus, Bifidobacterium and Enterococcus species) in fermented milk products.Conclusion: This review indicates that the complex metabolism of the starter cultures is well established; however, moreinformation is still needed on specific microbial metabolites such as polymerization of milk sugars for the production ofexopolysaccharides and the modification of the milk peptides and secretion of bacteriocins. More clinical studies are stillrequired to establish the functional health benefits of probiotic fermented milks to humans.Sponsorship: The visit to Mexico City was supported by Instituto Danone Mexico.European Journal of Clinical Nutrition (2002) 56, Suppl 4, S2 S15. doi:10.1038/sj.ejcn.1601657
Descriptors: review; fermented milks; starter cultures; probiotic microflora; health benefits
IntroductionFermented milks are widely produced in many countries.
This type of process is one of the oldest methods used to
extend the shelf-life of milk, and has been practised by
human beings for thousands of years. The exact origin(s) of
the manufacture of fermented milks is difficult to establish,
but it is safe to assume that it could date to more than
10 000 y ago as the way of life of humans changed from food
gathering to food producing (Pederson, 1979). This change
also included the domestication of certain mammals such as
the cow, sheep, goat, buffalo and camel; it is most likely that
the transition occurred at different dates in different
countries. However, archaeological evidence of certain
civilizations (Sumerians, Babylonians, Pharos and Indians)
suggests that they were well advanced in agriculture and in
the production of fermented milks.
It is likely that the origin of these products was the Middle
East and the Balkans, and the evolution of fermented milks
through the ages could be attributed to the culinary skills of
the inhabitants living in these regions. Todays fermented
milk products are manufactured in many countries, and the
stages of manufacture, which is still a complex process,
combine the art of such ancient craft and science (micro-
biology and enzymology, physics and engineering, and
chemistry and biochemistry) together.
This article summarizes the research findings on yoghurt
and probiotic fermented milk products made from cows
milk over the past century.
Diversity of fermented milksFermented milks are manufactured throughout the world,
and approximately 400 generic names are applied to tradi-
tional and industrialized products (Kurmann et al, 1992), but
in actual essence the list may only include few varieties. In
the 1980s, Kurmann (1984) attempted, in part, the classifica-
tion of fermented milks into a family tree (see Figure 1;
Bylund, 1995), which was based primarily on the optimum
*Correspondence: AY Tamime, Dairy Science and Technology Consultant,
24 Queens Terrace, Ayr KA7 1DK, Scotland, UK.
E-mail: [email protected]
European Journal of Clinical Nutrition (2002) 56, Suppl 4, S2S15 2002 Nature Publishing Group All rights reserved 09543007/02 $25.00
www.nature.com/ejcn
growth requirements of the starter cultures (ie mesophilic
and thermophilic microflora).
Nevertheless, taking into account the microorganisms
that dominate the product, including their principle
metabolites, Robinson and Tamime (1990) proposed a
scheme for the classification of fermented milks as follows:
lactic fermentations (a) mesophilic type, eg culturedbuttermilk, filmjolk, tatmjolk and langofil; (b) thermo-
philic type, eg yoghurt, Bulgarian butter-milk, zabadi,
dahi; and (c) therapeutic or probiotic type, eg acidophilus
milk, Yakult, ABT, Onka, Vifit); products within this
group constitute by far the largest number known
worldwide;
yeast lactic fermentations (kefir, koumiss, acidophilusyeast milk); and
mould lactic fermentations (villi).Tamime and Marshall (1997) have detailed the manufac-
turing stages of these types of fermentations. However, the
so-called fermented milk drinks and=or beverages including
the carbonated products should be classified separately
rather than being known as fermented milks; such an
approach will minimize confusion among consumers. Never-
theless, some closely related products are manufactured from
fermented milks by de-wheying, and some examples are
labneh, skyr and ymer. The different methods available to
manufacture concentrated fermented milks are as follows:
(a) cloth bag or Berge system; (b) mechanical or nozzle
separators; (c) ultrafiltration (UF); and (d) product formula-
tion (Tamime & Robinson, 1999).
Patterns of consumptionUntil the 1950s, production and=or consumption of yoghurt
(ie natural type) was confined to communities in the Middle
East, the Balkans, India, Eastern Europe, to ethnic groups
living in different parts of the world, and to those who
perceived that the product was beneficial to health. How-
ever, consumers attitudes towards yoghurt have changed,
possibly for the following reasons: (a) as refrigeration became
widespread worldwide, the product became widely distribu-
ted and readily available on the market; (b) the introduction
of a new generation of yoghurts (eg addition of fruits and
sugar) gave the product an entirely fresh image and it
became an inexpensive snack or dessert; and (c) the advent
of incorporation of probiotic bacteria into the product have
enhanced the health benefits of fermented milks.
Consumption figures reflect the expanding markets in
some selected countries between 1970 and 1999 (Table 1).
Until the early 1990s, fermented milks were classified as
buttermilk, yoghurt and others according to the statistical
data published by the International Dairy Federation, and
such information provided consumption preferences of con-
sumers in different countries; the current approach of
Figure 1 The family tree of fermented milk types. Adapted from Kurmann (1984).
Fermented milks a reviewAY Tamime
S3
European Journal of Clinical Nutrition
per capita consumption figures covers milk drinks and fer-
mented milks including yoghurt. It could be argued, how-
ever, that this classification of these products may not
provide a clear picture or patterns of consumption. Further-
more, in some countries, the consumption of buttermilk is
not properly defined because:
traditional=natural buttermilk is the by-product of buttermaking from ripened or cultured butter;
cultured buttermilk is the fermentate of skimmed milkfollowed by the addition of butter flakes; and
sweet buttermilk is not fermented; hence the data forbuttermilk in such statistical tables have to be assessed in
a cautious manner.
It is safe to conclude that fermented milk products that
fall within the category of lactic fermentations (mesophilic
type) are widely consumed in northern European countries,
whilst the yeast lactic fermented milks are popular in the
Russian Federation, eastern European countries and Mongo-
lia. Conversely, natural yoghurt is popular in countries
between the Balkans and the Indian sub-continent, while
the fruit flavoured and=or flavoured products are normally
consumed in the rest of the world.
Little data is available on the world production figures of
probiotic-fermented milks but during the last decade produc-
tion has increased dramatically in some selected countries.
For example, the French market of fermented milk
containing Bifidobacterium spp. and Lactobacillus acidophilus
increased from 1500 to >91 000 tonnes between 1986 and
1990 (Renard, 1998).
Definition and terminology of fermented milksincluding yoghurtThe existing legal standards or the provisional regulations of
yoghurt in many countries classify the product on the basis
of chemical composition or fat content (full, semi-
skimmed=medium or skimmed=low); the reviews by Robin-
son and Tamime (1976), Pappas (1988), Anonymous (1989,
1996), FAO=WHO (1990), and Tamime and Robinson (1999)
are recommended for further reading.
The International Dairy Federation (IDF, 1992a,b) pub-
lished general standards of identity of fermented milks that
could be briefly defined as follows: Fermented milks are
prepared from milk and=or milk products (eg any one or
combinations of whole, partially or fully skimmed, concen-
trated or powdered milk, buttermilk powder, concentrated or
powdered whey, milk protein (such as whey proteins, whey
protein concentrates, soluble milk proteins, edible casein
and caseinates), cream, butter or milkfat all of which
have been manufactured from raw materials that have
been at least pasteurized) by the action of specific
microorganisms, which results in a reduction of the pH
and coagulation. It is of interest that in some countries the
fortification of milk components with dried dairy ingredi-
ents during the manufacture, of yoghurt for example, is
against the existing legal standards.
Other IDF specifications include the following aspects: (a)
the starter cultures shall be viable, active and abundant
(107 cfu=g) in the finished products at all times of sale forconsumption; (b) these products may or may not be homo-
genized, must at least be pasteurized, contain certain per-
mitted additives (optional), and have a shelf-life up to 30
days at 4 7C; (c) post-fermentation heat treatment shallnot be allowed; and (d) de-wheying after fermentation is
only permitted during the manufacture of concentrated
fermented milk products such as labneh, ymer, skyr and
stragisto. Furthermore, the identity of the starter cultures is
also detailed and, in the case of yoghurt, Streptococcus thermo-
philus (formerly known as S. salivarius subsp. thermophilus)
and Lactobacillus delbrueckii subsp. bulgaricus are normally
used because of the associative growth that exists between
these two microorganisms, whilst in some countries, Lacto-
bacillus helveticus and Lactobacillus delbrueckii subsp. lactis (ie
non-traditional organisms) are sometimes mixed with the
starter culture. However, the name(s) of the so-called bio,
therapeutic and=or probiotic fermented milks is not well
established and should be addressed because consumers
and=or some manufacturers in different countries consider
all these products to be yoghurt (for more details refer to
subsequent section).
The milk fermentates by mesophilic microorganism
include the products that are grouped under lactic and
yeast lactic fermentations. The starter microorganisms of
Table 1 Per capita annual consumption (kg=head) of milk drinksand fermented products including yoghurt
Country 1975 1980 1990 1999
Australia 1.0 1.8 3.5 5.8
Austria 7.9 9.8 10.4 15.1
Belgium 11.8 7.7 8.4 20.3
Canada 5.1 2.3 3.7 4.2
Chile NRa
1.4 3.9 6.7
Czech=Slovakia 3.9 7.3 NR 20.0
Denmark 36.1 26.7 21.6 29.8
Federal Germany 16.5 10.1 14.2b 25.5b
Finland 32.6 41.0 38.3 NR
France 9.6 9.3 16.4 27.4
Iceland 1.7 5.7 24.6 NR
Israel 14.1 14.3 NR 29.3
Italy NR 1.3 4.0 NR
Japan 2.5 2.4 7.8 NR
Netherlands 24.7 27.3 32.5 NR
Norway 9.8 10.1 14.9 19.9
Poland 3.2 2.0 NR 7.9
Spain 3.4 6.0 8.0 15.4
Sweden 24.1 23.5 29.1 30.2
Switzerland 16.4 14.8 19.0 NR
UK 1.7 2.8 4.4 NR
USA 9.9 3.1 3.5c NR
aNRnot reported.
bData includes German Democratic Republic.cData for 1993.
Data compiled from Tamime and Robinson (1999) and IDF (2000).
Fermented milks a reviewAY Tamime
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European Journal of Clinical Nutrition
the former group belong to the genera of Lactococcus(Lac. lactis
subsp. lactis, Lac. lactis subsp. lactis biovar diacetylactis and Lac.
lactis subsp. cremoris) and Leuconostoc (Leu. mesenteroides
subsp. cremoris and Leu. mesenteroides subsp. dextranicum),
and they are normally used as mixed cultures. However, the
microflora of the latter products is complex and not always
constant; numerous species of lactic acid bacteria, yeasts and
moulds have been found, for example, in the kefir grains.
Tamime and Marshall (1997) have detailed the organisms that
have been identified by many researchers in many countries.
Traditionally, many products are made from natural
yoghurt in the Balkans and the Middle Eastern countries
and these can be briefly described as follows: (a) dilution of
the fermentate with water for the production of drinking
yoghurt; (b) concentration of the yoghurt by de-wheying for
the manufacture of strained yoghurt and yoghurt cheese; the
latter product is formed into small balls and preserved in
olive oil; (c) cultured butter and=or ghee can be made by
churning full-fat yoghurt, and the aqueous phase is either
utilized as drinking yoghurt or mixed with parboiled cracked
wheat which is later sun-dried and milled into powder (such
product is known as Kishk); and (d) surplus of yoghurt is
preserved by drying or gently heating yoghurt for few hours
over low and smokey fires (the end product is known as
smoked yoghurt). Nevertheless, at present the classical
approach to categorize yoghurt products is based on its
physical characteristics as shown in Table 2 and, in particu-
lar, yoghurt is further sub-divided into different groupings
based on the following aspects:
legal and=or proposed standards classify the product, forexample, on the fat content (full, medium or low);
physical nature of the product (ie set or stirred; drinkingyoghurt is normally considered as stirred-type of low
viscosity);
flavours of yoghurt are divided into plain=natural,fruit or flavoured; the latter two products are normally
sweetened;
probiotic, bio and=or therapeutic yoghurts containnon-traditional organisms beside Lb. delbrueckii subsp.
bulgaricus and S. thermophilus (see Table 5);
miscellaneous yoghurts include pre-fermentation proces-sing (lactose hydrolysis or replacement of the animal fat
with vegetable oil) or post-fermentation processing (vita-
min fortification or heat treatment).
Technology of manufactureCurrently, the technological aspects of fermented milks are
well established and extensively reviewed (Rasic & Kur-
mann, 1978; IDF, 1984, 1986, 1988, 1992c; Chandan,
1989; Tamime & Marshall, 1997; Tamime & Robinson,
1999). The principal manufacturing stages and=or processes
for all fermented milk products (set- or stirred-type) have
many features in common, which can be briefly described
as follows:
Preparation of the milk base
The fat and the non-fat solid (SNF) contents of the milk are
standardized and fortified to ensure compliance with exist-
ing legal standards. The fat level may range between
Heat treatment
Different temperatures are used for the heat treatment of the
milk base during the manufacture of fermented milk, and
can vary depending on the time and temperature combina-
tions. Some examples are: (a) 85C for 30 min; (b) 90 95Cfor 5 min; and (c) 105C for 10 s. Thermal treatment of themilk base induces numerous physical and chemical changes
that are complex and multi-functional; the topic has been
extensively studied (see the reviews by IDF, 1995; Tamime &
Marshall, 1997; Tamime & Robinson 1999), and in the
context of fermented milks the effects of heat treatment are:
destruction and=or elimination of pathogens and othermicroorganisms present in the milk base and, hence, the
processed milk provides a good growth medium for the
starter cultures;
changes in the physical chemical properties of themilk constituents, mainly the denaturation of the b-lactoglobulin, which forms a complex with k-casein;such interaction minimizes syneresis and improves the
firmness of the gel; the protein=fat interaction in milk
should not be overlooked;
production of components that are stimulatory to thestarter cultures.
Starter culture
The heated milk base is cooled to the desired incubation
temperature of the product; some examples are: (a) yoghurt
at 40 45C for up to 3 h, at 30C for 18 h or 5 h whenusing direct-to-vat inoculation (DVI) starter culture; (b) pro-
biotic products at 37C for a few hours or up to 5 7 daysdepending on the organism(s) used; (c) buttermilk at 20
30C for up to 10 20 h; and (d) kefir at 22C for 16 24 hdepending on the type of kefir grains used (Tamime &
Marshall, 1977; Wszolek et al, 2001).
Gel formation in milk is mediated by acid coagulation
due to the activity of the starter cultures and their enzymes
to hydrolyse the lactose and to a lesser degree the proteins.
The mechanisms involved of casein dissociation and aggre-
gation during acid-induced gelation of milk are pH-, ion
concentration- and temperature-dependant, and these
aspects of gelation are similar for set- or stirred-type fer-
mented milks; in the former type, the milk is incubated in
the retail container, whilst for the stirred product the milk
is incubated in large fermentation tanks.
Cooling and miscellaneous handling
Cooling is only method used to control the metabolic
activity of the starter cultures and their enzymes in order
to retain an abundant count of these organisms in fermen-
ted milks. The primary objective is to cool the product to
5C, and the process of cooling commences at 4.6 pH,which is carried out using a one- or two-phase cooling. The
latter method is widely applied during the manufacture of
fruit-flavoured fermented milk products; the first stage of
cooling, for example for yoghurt, reduces the temperature
from 45 to 20 25C prior to the addition of fruit and packa-ging, and the second phase of cooling takes place in the cold
store (chill tunnel is optional), where the product is cooled to
countries. Nevertheless, who could have imagined in the
1950s that these products would be used successfully for the
treatment of certain human diseases in the 1980s or 1990s?
(See also Shortt, 1999.)
Probiotic microorganismsThe current definition of probiotics, as agreed by European
scientists, is a live microbial feed supplement that is
beneficial to health (Salminen et al, 1998a). However, the
microflora of the human intestinal tract in both infants and
adults is highly complex and many bacterial species have been
identified; the topic has been extensively researched, and the
following selected reviews provide relevant information with
specific emphasis on probiotic microorganisms and their
health applications to humans (Robinson, 1991; Fuller,
1992, 1997; Sanders, 1994; Salminen et al, 1996a, 1998b, c;
Marshall & Tamime, 1997a; Holzapfel et al, 1998; Salminen &
von Wright, 1998; Dunne et al, 1999; Hirayama & Rafter, 1999;
Lee et al, 1999; Tannock, 1999; Fuller & Perdigon, 2000;
Salminen, 2001). Periodically, Danone Vitapole Recherche
publishes monographs (Capron et al, 2000; Malagelada et al,
1999; Denariaz et al, 1999; Gibson et al, 2000; Hartley et al,
2001) and World Newsletter (23 issues have been published)
updating the health aspects associated with fermented milks.
As mentioned earlier, lactic acid bacteria, yeast, moulds or
combinations of these are widely used in the production of
fermented milks and cheeses. The characteristics of these
microorganisms have been recently reviewed by Tamime
(2002), and only the relevance of probiotic microflora in
fermented milks will be discussed. It is evident that these
bacterial species have to withstand the acidic and bile salts
conditions in the gastro-intestinal tract of humans when
compared with traditional dairy starter cultures, and reach
and=or colonize the large intestine. Researchers in different
countries have identified many probiotic microorganisms,
and Table 3 illustrates some examples.
The recent taxonomy and physiology of probiotic lacto-
bacilli species have been reported by Klein et al (1998), and
these species belonged to: (a) Lb. acidophilus group; (b) Lb. casei
group; and (c) Lb. reuteri=Lb. fermentum group; most Lb.
acidophilus strains used in the manufacture of probiotic
fermented milks have been identified as Lb. johnsonii or
Lb. gasseri; both species are members of the Lb. acidophilus
group. Hence, the issue of health-promoting properties of
such products is questionable, and it cannot be assumed that
all strains of Lb. acidophilus have or possess the desirable
properties of probiotic microorganisms (Salminen et al,
1996b; Hamilton-Miller & Gibson, 1999; Ouwehand et al,
1999); furthermore, not all the commercial probiotic fer-
mented milk products disclose the strain or species used or
the actual numbers (Hamilton-Miller, 1999; Sanders & Huis
int Veld, 1999). In some instances, researchers have referred
to Lb. rhamnosus GG as Lb. acidophilus, Lb. casei subsp. casei
or Lb. paracasei subsp. paracasei.
Until the mid 1980s, the genus Bifidobacterium was classi-
fied as Lactobacillus spp. and currently 30 different species of
bifidobacteria have been identified. The six organisms that
have been used in dairy products are shown in Table 3 but,
according to Klein et al (1998), most of the strains used in
Table 3 Examples of probiotic micro-organisms thatare used during the manufacture of fermented milks
Genera Microbial species
Lactobacillus Lb. acidophilus
Lb. acidophilus strains LC1,
La5, La1, La7, Gilliland
Lb. casei strains Shirota, GGa
or LGG,a Imunitass, NCC208
Lb. rhamnosus strain GG
Lb. johnsonii
Lb. helveticus
Lb. delbrueckii subsp. bulgaricus
Lb. gasseri
Lb. plantarum
Lb. paracasei subsp. paracasei
and subsp. tolerans
Lb. reuteri
Pediococcus P. acidilactici
Bifidobacterium B. bifidum, breve, longum,
adolescentis, infantis,
lactis, animalis
Lactococcus Lc. lactis subsp. lactis
Enterococcus E. faecium, faecalis
Saccharomyces S. boulardiib
aThis strain could be confused with Lb. rhamnosus GG due
to latest nomenclature classification.bMost likely application is during the manufacture of kefir.
Data compiled from Tamime et al (1995), Tamime and
Marshall (1997), Shortt (1997), Lee et al (1999) and
Sanders and Huis int Veld (1999).
Table 4 A summary of some health-promoting activities inhumans associated with probiotic fermented milks
Action=effect Alleged health benefit
In digestive tract Active against Helicobacter pylori
Enhanced lactose digestion
Stimulation of the intestinal immunity
Stabilization of Crohns disease
Stimulation of intestinal peristalsis
On intestinal
microflora
Improves balance between
microbial populations
(eg increase in faecal bifidobacteria)
Decrease in faecal enzyme activity
Colonisation of the intestinal tract
Reduced carrier time for Salmonella spp.
On diarrhoea Prevention=treatment of
acute and of Rotavirus diarrhoeas
Prevention of antibiotic-induced diarrhoea
Treatment of relapsing Clostridium difficile
diarrhoea
Other effects Improved immunity to disease
Suppression of some cancers
Reduction in serum cholesterol
Reduction in hypertension
Adopted from Tamime and Robinson (1999).
Fermented milks a reviewAY Tamime
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European Journal of Clinical Nutrition
probiotic fermented milks are B. animalis, although they
are declared on some labels as B. longum. B. animalis was
renamed B. lactis in the late 1990s (Meile et al, 1997), and
now it is re-classified as B. animalis (Cai et al, 2000). In my
view, the term bifidus should not be used because it is old
terminology (Lactobacillus bifidus), and can cause some con-
fusion to the reader.
The 16S rRNA sequencing within the genus Entrococcus
has revealed the presence of three species groups: E. faecium
and E. durans are found in the first group, whilst E. faecalis
forms an individual line of descent. However, the pathogeni-
city of these organisms should not be overlooked when they
are used in probiotic fermented milk products.
Limited data are available on the use of the probiotic yeast
(Saccharomyces boullardii) in fermented milks (Lourens-
Hattingh & Viljoen, 2001a), and the most likely application
is Kefir and Koumiss making. Other non-lactic acid bacteria
that have been used in probiotic products around the world
include Bacillus cereus, Escherichia coli and Clostridum
butyricum (Shortt, 1999).
Therapeutic properties of bio-fermented milksIt is well established that the probiotic microorganisms
shown in Table 3 have therapeutic properties, and when
they are added with traditional starter cultures during the
manufacture of fermented milks (see later), such products
have certain health-promoting activities in humans; Table 4
attempts to highlight the possible advantages. However, up-
to-date reports on some of the clinical=nutritional studies on
humans using probiotic fermented milks and their successful
applications in the treatment of certain human diseases,
include the following: (a) adherence of probiotic microor-
ganisms to human intestinal cells; (b) decreasing faecal
mutagenecity; (c) improvement of constipation; (d) produc-
tion of bacteriocins; (e) effects on superficial bladder cancer;
and (f) effect on the human salivary microflora (Mattila-
Sandholm & Salminen, 1998; Salminen et al, 1998b; Mattila-
Sandholm et al, 1999a,b; Ouwehand et al, 1999; Petti et al,
2001). Some selected studies on nutritional aspects relating
to humans have been reported by Oberhelman et al (1999),
Alander et al (1999), Lee et al (1999), Kar (1999), Ashar and
Table 5 Some examples of probiotic fermented milk products available in different countries
Product Country Microorganismsa
I. Fermented milks
ABT, Biogarde1, Philus Germany Lb. acidophilus B. lactisb or bifidum S. thermophilusUK
Denmark
Sweden
ACT4 Austria Similar to ABT Lb. caseiVifit, Gefilus Germany Yogurtc B. bifidum Lb. acidophilus Lb. rhamnosus GG
UK
Netherlands
Belgium
Finland
SymBalance Switzerland Lb. casei Lb. reuterix Lb. acidophilus BifidobacteriadActimel France Yogurt Lb. casei strain ImunitasseBiola Norway B. lactis Lb. rhamnosus Lb. acidophilusGaio Denmark S. thermophilus E. faecium
UK
Germany
Finland
BRA Sweden B. infantis Lb. reuteri Lb. acidophilusII. Fermented milk beverages
Onaka He GG Japan Yogurt Lb. rhamnosus GGYakult Japan Lb. casei strain Shirota
Brazil
Some Asian countries
Caldus Japan B. longum Lb. acidophilusVitagen Malaysia Lb. acidophilus
Singapore
Aktifit Switzerland Similar to ABT Lb. rhamnosus GGfLC1 or LC1 GO Many European countries Lb. acidophilusg or Lb. helveticus
aLb. Lactobacillus; S. Streptococcus; B.Bifidobacterium; E. Enterococcus.
bCurrently it is reclassified as B. animalis (Cai et al, 2000).
cYogurt Lb. delbrueckii subsp. bulgaricus S. thermophilus.dYogurt starter cultures have been found in the product rather than bifidobacteria (Sanders & Huis int Veld, 1999).eLb. casei Lb. delbrueckii subsp. bulgaricus were the only organisms identified in the product (Sanders & Huis int Veld, 1999).fLb. rhamnosus was the only organism present in the product (Sanders & Huis int Veld, 1999)gLb. johnsonii S. thermophilus were found in the product (Sanders & Huis int Veld, 1999).
Data compiled from Tamime et al (1995), Tamime (1998), Sanders and Huis int Veld (1999) and Lee et al (1999).
Fermented milks a reviewAY Tamime
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European Journal of Clinical Nutrition
Prajpati (1999), Arunachalam (1999), Barone et al (2000),
Heyman (2000), Arunachalam et al (2000), Ahn et al (2000),
Chiang et al (2000), Meydani and Ha (2000), Armuzi et al
(2001), Collins (2001), Volpe et al (2001), Kawase et al (2001),
Perdigon et al (2001) and Reid et al (2001).
Another aspect, which has links with gut health, involves
prebiotics; they are defined as non-digestible food ingredi-
ents that beneficially affect the host by selectively stimulat-
ing the growth and=or activity of one or limited number of
bacteria in the colon, that have the potential to improve the
host health (Gibson & Roberfroid, 1995). Most potential
prebiotic food ingredients are carbohydrate-based compo-
nents such as oligosaccharides (Hartemink, 1999; Gibson &
Angus, 2000). However, a mixture of probiotic microorgan-
isms and prebiotic food ingredient is known as synbiotic.
Commercial probiotic fermented milk productsSome of the critical aspects that can affect the quality of
fermented milks are: (a) good make which is attributed to
fast acid development using traditional starter cultures; acid
development of probiotic starter cultures is poor in compar-
ison with Lb. delbrueckii subsp. bulgaricus and S. thermophilus;
(b) stable product after manufacture where few undesirable
microorganisms can withstand the rapid acid development
or initiate growth at pH 4.6; and (c) the lactic and sour
flavour is the characteristic flavour acidity of majority of
traditional types of mesophilic and thermophilic fermented
milks, and the action of acid on the milk proteins (mainly
the casein) is important in texture formation of the product.
However, the heterofermentation by the bifidobacteria
results in lactic and acetic acid production; the latter acid
has a harshness which is undesirable for milk products
(Marshall & Tamime, 1997b).
As a consequence, the majority of commercially avail-
able probiotic fermented milks in different markets of the
world (ca 80 100) are made with a mixture of non-tra-
ditional and traditional starter cultures, and detailed exam-
ples have been reported by Hoier (1992), Tamime et al
(1995), Tamime & Marshall (1997), Holzapfel et al (1997)
Table 6 Some selected bacteriocins produced by dairy starter cultures and probiotic microflora
Genera=microorganisms Bacteriocins Molecular mass range (kDa)
I. Lactococcus
Lac. lactis subsp. lactis Lactostrepcin, Nisin, Lacticin, Bacteriocin,
Dricin, Lactococcin
1.3 >10
Lac. lactis subsp. lactis biovar diacetylactis Bacteriocin, Lactococcin, Lactocin, Diacetin 3.4 5.8
Lac. lactis subsp. cremoris Lactococcin, Bacteriocin, Diplococcin 3.4 8.5
II. Leuconostoc
Leu. mesenteroides subsp. mesenteroides Mesenterocin, Leucocin 2.5 100
IV. Lactobacillus
Lb. acidophilus Lactacin, Acidophilin, Acidophilicin,
Acidocin, Acidolin, Bacteriocin
0.2 50
Lb. johnsonii Lactacin 2.5 > 300
Lb. gasseri Bacteriocin, Gassericin 4.5 5.6
Lb. reuteri Reutericyclin, Reutericin 0.4 > 200
Lb. casei Caseicin 41Lb. plantarum Plantaricin 1 5.9
Lb. rhamnosus Bacteriocin
and Tamime (1998) (see Table 5); hence, probiotic micro-
organisms are used as therapeutic adjuncts in fermented
milk products (see also the review by Lourens-Hattingh &
Viljoen, 2001b).
Exopolysaccharides (EPS) productionMicrobial EPS material is synthesized by certain strains of
lactic acid bacteria, and it can enhance the rheological
properties (ie minimize syneresis, improve the texture and
modify the structure) and sensory perception (ie firmness
and creaminess) of fermented milks and other dairy pro-
ducts. The topic has been extensively reviewed (IDF, 1998;
Cerning & Marshall, 1999), and illustrations of the micro-
structure of both mesophilic and thermophilic fermented
milks have been reported by Tamime and Marshall (1997)
and Tamime and Robinson (1999).
Quantitative and qualitative properties of EPS material are
influenced by the following aspects: (a) microbial strain; (b)
composition of the growth medium and=or growth factors;
and (c) processing conditions that include the growth tem-
perature and time of fermentation. In 2001, the scientific
papers presented at the first Symposium on EPS from Lactic
Acid Bacteria provided an up-to-date review of this field,
including their applications in the dairy industry and the
structures of EPS (Monsan et al, 2001; de Vuyst et al, 2001;
Boels et al, 2001; Jolly & Stingele, 2001; Degeest et al, 2001;
Duboc & Mollet, 2001; Marshall et al, 2001). However, some
of these EPS materials contain gluco- and=or fructo-oligosac-
charides and may generate short-chain fatty acids upon
hydrolysis in the intestinal tract by the colonic microflora,
and may have potential health (eg an anti-tumor effect,
cholesterol-lowering effects or immune-modulators effects)
and nutritional benefits as a prebiotic to the intestinal
microflora.
Bacteriocin productionBacteriocins are antibacterial substances produced by
certain groups of microorganisms including probiotic and
lactic acid bacteria; they are also known as colicin-like
inhibitory substances. Incidentally, bacteriocins are usually
segregated from antibiotic compounds, and such naturally
produced metabolites inhibit the growth of undesirable
microorganisms in food and dairy products. In the case
of lactic acid bacteria, the bacteriocins produced could be
used to replace added chemical preservatives and, hence,
the shelf-life of the product could be extended by natural
means; however, these inhibitors can also affect certain
strains of starter cultures.
At present more than 70 different types of bacteriocins
have been identified as produced by lactic acid bacteria.
Table 6 summarizes some selected characteristics (for further
information refer to de Vuyst & Vandamme, 1994; Holzapfel
et al, 1995; Desmazeaud, 1994; Nes et al, 1996; Richard, 1996;
Marshall & Tamime, 1997a).
Partial characterization of the quality ofprobiotic fermented milksMany diversified probiotic dairy products are currently avail-
able to consumers in many markets, and some examples are:
pasteurized liquid milk, cheeses, ice-cream, milk powder feed
for infants and fermented milks (Tamime & Marshall, 1997).
However, fermented milk products are the most popular
vehicle used in the industry for the implantation of the
probiotic microflora in humans. In the mid 1990s, a colla-
borative research programme was established between the
Scottish Agricultural College (SAC) and the Hannah Research
Institute (HRI) to evaluate the quality (chemical composi-
tion, microbiological analysis, rheological properties and
sensory perception) of different types of newly developed
Table 7 The microorganisms used in commercial mixed starter cultures
Bifidobacterium spp. Lactobacillus spp.
Streptococcus
Code Supplier Typea bifidum lactisb longum infantis acidophilus bulgaricusc thermophilus
AB Chr. Hansen FD P P PAC=BL Rhodia FD P P PDVB-100 SBId FD P P PMSK 2 Visby DF P P PABT 1
eChr. Hansen FD P P P P
ABT 3 Chr. Hansen FD P P P PMSKB 2
eVisby FD P P P P
MY 087f Rhodia FD P P
aFD freeze dried, DFdeep frozen.
bCurrently it is reclassified as B. animalis (see text).
cLb. delbrueckii subsp. bulgaricus.dSBI Systems Bio-Industries Ltd.eThe starter cultures produces exopolysaccharide (EPS) materialfThis is a yoghurt starter culture, which is used as a control.
The symbol (P) denotes the presence of the microorganism in the starter culture.
Fermented milks a reviewAY Tamime
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European Journal of Clinical Nutrition
fermented milk products (eg vegetable oil yoghurt, kishk,
yoghurt made with fat substitutes, kefir and probiotic fer-
mented milks). In this paper, some aspects of the quality of
probiotics fermented milks will be reported, and for further
details refer to La Torre (1997), Hartley et al (2001) and La
Torre et al (2002).
In the first instance, single strains of Bifidobacterium spp.
(B. adolescentis NCFB 2230, B. bifidum NCFB 2715, B. breve
NCFB 2258, B. infantis NCFB 2205 and B. longum NCFB 2259,
were obtained from National Collection of Food Bacteria;
B. longum BB 46 and B. bifidum BB11 B. longum BBL and BL
and B. infantis 410 B. longum 2 and 913 were obtained from
Chr. Hansen, Rhodia and Visby, respectively) were used to
manufacture fermented milks. The quality of the products
made with the NCFB strains did not satisfy the minimum
requirements, the pH values were borderline (eg between 4.8
and 5.4), excessive whey separation was evident, the coagu-
lum was extremely week and, in some cases, the odour and
taste were unpleasant. However, slight improvement in the
quality of the product was evident, especially when the milk
bases were fortified with Raftaline1 or Jerusalem artichoke,
but the overall pHs ranged between 4.79 and 5.91 after 24 h
of incubation (with the exception of strains of B. longum BBL
and 2; pH 4.6). As the results were not satisfactory, it wasdecided that commercial mixed blends of starter cultures
containing lactic acid bacteria and different Bifidobacterium
species would be used (see Table 7).
The quality of the fermented milks was superior to those
made with single strains of bifidobacteria, and the results
could be summarized as follows:
Acidification of the milk base (total solids, protein and fatwere 14.5, 5.5 and 1.5 g=100 g, respectively) ranged
between 6 and 10 h or 13 and 22 h for pH 4.4. Organic acid profiling indicated that the starter cultures
produced appreciable quantities of lactic acid, and only
two cultures (AB and AC=BL) produced the high levels of
acetic acid (3229 and 2794 mg=g, respectively; figures areaverages of three trials and of fresh and stored products).
The viable cell counts in fresh and stored products forbifidobacteria varied (eg two cultures (AB and AC=BL)
showed an increase, three cultures (DVB-100, ABT 3 and
MSKB 2) remained constant, and two cultures (ABT 1 and
MSK 2) exhibited a slight decline); Lb. acidophilus
increased during production but, in some products (DVB-
100, MSK 2, ABT 1 and 3 and MSKB 2), the counts were
Figure 2 Sensory space maps for probiotic fermented milks, factorscores on first two dimensions are shown. For starter cultures symbolsrefer to Table 7. After La Torre (1997).
Figure 3 Interpretation of sensory results for fermented milk products. After La Torre (1997).
Fermented milks a reviewAY Tamime
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European Journal of Clinical Nutrition
decreased after storage; S. thermophilus counts of all starter
cultures showed a remarkable increase during production
and survival during storage.
Syneresis values of fermented milks ranged between 2.5and 3.0 ml for fresh products and decreased to 1.5 2.5 ml
after 20 days storage at 5C; the rate of decrease wasdependent on the starter culture used.
The firmness measurements of all fermented milksincreased over time, and the rate was independent
of the starter culture used; after the storage period, the
firmness values ranged between 1.8 and 2.5 N for the EPS
cultures MSKB 2 and ABT 1, respectively.
Sensory analysis indicated the following: (a) acid,creamy and=or other characters (for the odour, flavour
and after-taste attributes) were significant (P
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Fermented milks a reviewAY Tamime
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European Journal of Clinical Nutrition