Team:UGent2 Belgium/Human Practices

Human Practices

The Timeline

Timeline Bubbly

  • Kombucha: Our Initial Idea!

    Our initial idea was "we'll do something with kombucha" because it is a complex culture of yeast and bacteria which is in itself already a source of prebiotics and probiotics. It is also cheap and easy to make for people all over the world, so i we would come up with an enhancement it could potentially be of use for people all over the world.

  • Our First Expert!

    Professor Dr. Peter Vandamme, an expert in fundamental and industrially applicable microbial diversity, provided us with the theoretical background of kombucha. To further investigate the content surrounding kombucha, we looked deeper into what makes it a popular drink.

  • Experts In The Field!

    We talked to an expert in the field, Yannick Claerman from Yugen kombucha in Gent, Belgium. The everyday struggles identify themselves in the balance between natural shelf life and extended shelf life by pasteurization or UHT treatment. We did not find these topics appealing to us, so we moved on. Eventually, we decided that we wanted to incorporate vitamin producing bacteria in the SCOBY due to the high incidence of vitamin deficiencies.

  • Reality Check...

    Professor Dr. Ir. John Van Camp pointed out that vitamin deficiencies are often due to a person's lifestyle and is depending on the age and cultural background. So, there is no one size fits all solution for vitamin deficiencies. If we were to add vitamins to a drink, it would not be any different from existing supplements, even though our solution is more accessible, cheaper and feels more natural. The vitamins would miss their site of uptake in the gut or stomach if the person drinking it had a vitamin absorbtion problem.

  • The New Idea!

    Through literature, experiments and with the help of our principle investigators Professor Dr. Ir. Wim Van Crieckinge en Marjan Professor Dr. Ir. De Mey we switched our focus from kombucha to vitamins and more specifically to making a carrier system for these vitamins.

  • Market Investigation!

    We contacted an expert in the field of business to assess what was necessary to bring such a concept to the market. Professor Dr. Ir. Benedikt Sas gave us a reality check about the legislation and safety demands which are obliged for bringing the pearls to the market. Living in a European country, we would fall under the legislation of EFSA. EFSA has the most stringent rules in the world, making it hard for new products to obtain specific health claims. However, this gives certainty to the consumer that the food contains what the package says.

  • Final Idea!

    Although bringing the idea to the market and applying to all obligatory rules is highly challenging, we still believed in our concept. Hence we scheduled a meeting with Tom Van Damme to discuss the potential of our pearl both towards customers as towards the marketing. His opinion was optimistic about the potential of our pearl, and we decided to stick to the concept. And so our edible pearl, Bubbly, was born.

  • Back To Research!

    With this pearl came an enhanced potential so we went back to the literature to explore what the maximal benefit could be and how we could influence the world. We contacted Prof. Dr. Marie Joossens and Professor Dr. Ir.Tom van de Wiele for in-depth information about the gut microbiome and specific delivery of supplements and vitamins. It became clear to us that inflammation in the gut is one of the main reasons for lots of different physical and mental illnesses to people all around the world. Most anti-inflammation drugs give a lot of side effects and influence a lot more than just the gut. Inflammation in the GI-tract is most of the time related to dysfunctional behaviour of the gut microbiome. When adding 1 and 1, we concluded that two things were necessary to let our consumers benefit.

  • Naringenin and Vitamin B12!

    We found out about the need for anti inflammatory flavonoids and the need for vitamin B12 to promote the growth of certain species of "good" bacteria. So we contacted Ir. Lien De Wannemaeker for more information about the production of naringenin. From our discussion we noticed potential for improvement in the production of naringenin. If this would be successful, we could create the basics for producing naringenin in a more suitable host. Due to corona, time was not in our favour, but we were still able to make substantial progress in setting the basics for further cloning and trial procedures. If the production process is continued, naringenin would be affordable to multiple layers of society.

  • Kojibiose!

    While researching prebiotics we stumbled across kojibiose, a sweetener with prebiotic effect. This was perfect because now our pearl would not only deliver prebiotics it would also taste better without the need for sugars. We contacted professor Prof. Dr. Ir. Tom Desmet because he and his research team have found a way of making large amounts of kojibiose for a much lower price.

  • Finally, our pitch!

    We met with Petra Van Gucht, founder of CosmoGroup and her personal expertise aided us in developing a more streamlined pitch. She also helped by offering to help in the formulation of the pearl.

  • Final Insights

    We contacted Dr. Nathalie Michiels to gain further insights in what the current treatments are and if there is potential as an alternative or adjuvant treatment for depression. But why depression? Depression is one of the most common mental disorders worldwide and still copes with a negative connotation. This is a disorder/illness that knows no boundaries, makes no difference in respect to culture, ethnicity, wealth, or gender. Everyone around the world can be affected by it at any time. With our concept we can help millions worldwide and we also want to make the topic more discussable. To bring people awareness that it has different causes and that an easy to take supplementation can offer solace to people suffering from depression. The drugs that are now available cause multiple side effects. Some examples are mood swings, losing appetite, losing libido, nausea, fatigue, etc …. All unwanted effects when already suffering from depression.

  • Help Along the way

    We talked to Dr. Massimiliano Simons of the department philosophy and Moral sciences. Key elements from this discussion are given below. There could be a moral hazard about our product, it is a supplement that can be a treatment or an adjuvant towards depression.

Our Full Story

Human Practices

Our concept has come a long way; we had done many thought experiments before we went to a final idea of the edible pearl. Throughout the process, we had much interaction with experts in different fields.

Kombucha And Vitamins

Our iGEM idea started with kombucha; this is an easy-to-produce drink based on fermented tea known in multiple cultures for thousands of years. Fermentation takes place by putting a SCOBY (Symbiotic Culture of Bacteria and Yeast) on top of the tea. Let it ferment for a (few) week(s) until it has a taste and acidity that you like.  
Kombucha production is accessible and cheap in most countries; it has the potential to reach a multitude of cultures and areas around the world. It is a source of prebiotics, and it could introduce beneficial effects on the gut microbiome. Since it contains many microorganisms and has a significant market value, it seemed the optimal starting goal for us. Professor Dr. Peter Vandamme (21/02/20), an expert in fundamental and industrially applicable microbial diversity, provided us with the theoretical background of kombucha.  

To further investigate the fuzz about surrounding kombucha, we looked deeper into what makes it a popular drink. 
The popularity of the drink, it is one of the most popular low-alcoholic fermented beverages in the world, comes from the claimed health benefits. However, there are no clinical trials that studied the health benefits of kombucha that can support health claims. There have been studies about kombucha but claiming that something is healthy is a difficult task to do so. Even the definition of something being healthy is up for debate. Furthermore, the commercial kombucha often contains lots of added sugars to appeal to the public in general.  
So we tried to find a way to support health claims, make kombucha with more beneficial effects or help with struggles present in current kombucha production facilities. For the latter, we talked to an expert in the field, Yannick Claerman (06/03/2020) from Yugen kombucha in Gent, Belgium. The everyday struggles identified themselves in the balance between natural shelf life and extended shelf life by pasteurization or UHT (Ultra High Temperature) treatment. Pasteurization and UHT treatment will kill most of the living bacteria, meaning that the probiotics might also get killed. On the other hand, when UHT and pasteurization are not used, the kombucha keeps on fermenting and needs cooling to be stored. Since kombucha is also often depicted as a durable environmental friendly drink, this cooling and the energy needed for its cooling does not suit the image. We did not find these topics appealing to us, so we moved on. Eventually, we decided that we wanted to incorporate vitamin producing bacteria in the SCOBY due to the high incidence of vitamin deficiencies. 

Vitamin deficiencies occur all over the world and can be linked with insufficient access to a variable diet, a sedentary lifestyle, living too much indoors and disease. Many products have added vitamins to fight the general deficiencies present in society. Most production methods for vitamins use non-renewable sources (for example, malononitrile in the synthesis of vitamin B1) and create hazardous waste streams. So letting microorganisms produce vitamins for you in a beverage that you can make at home would be cost-effective, maintain accessibility for all and easy. If we were to add the microorganisms in the SCOBY permanently, then it would be a sustainable solution for vitamin deficiencies. To define what vitamins are genuinely giving a benefit to society, we contacted Professor Dr Ir. John Van Camp (8/7/20). He pointed out the critical fact that vitamin deficiencies are often due to a person's lifestyle and is dependent upon the age and cultural background. Therefore, there is no one-fits-all solution for vitamin deficiencies. Although our solution is more accessible, cheaper and feels more natural, merely adding vitamins to a drink might not be superior compared to current supplementation methods. 

Furthermore, there were technical issues to the production of vitamins in the SCOBY. As a first, vitamins are not stable in the low pH range that a reasonable kombucha demands. Secondly, the vitamins producible by GRAS microorganisms is minimal. If we were to incorporate microorganisms producing vitamins in our kombucha, the lack of GRAS organisms makes it a burdensome process in terms of legislation and regulation. As a final item, due to the high safety regulations involving genetically engineered microorganisms, we would not be able to introduce a DIY SCOBY. No DIY SCOBY means that our kombucha would only be accessible through stores and it would not be personalized. Access through stores would limit accessibility to only more wealthy countries and layers of the society that can afford our kombucha. Whilst we see that people with less financial means have a less diversified diet, and they need vitamin supplementation the most.   

An Edible Pearl

Experts and literature led us to the conclusion that we needed something different. Our team obtained crucial input by Prof. Dr. Ir. Marjan De Mey and Prof. Dr. Ir. Wim van Crieckinge for the concept development of a carrier system. The carrier system can protect vitamins or other supplements when ingested. It makes delivery towards a target site in the body possible. We contacted two experts in the field of legislation of new food products to assess what is necessary to bring such a concept to the market. Prof. Dr. Benedikt Sas (22/07/20) gave us a reality check about the legislation and safety demands that is obliged for bringing the pearls to the market. As a European country, we fall under the legislation of EFSA (European Food Safety Authority). EFSA has the most stringent rules in the world. However, the stringency in legislation gives certainty to the consumer that the food contains what the package says. And when it is said that a product is healthy, it has been proven to improve health. We want to give our customers added value by buying our products. It is a way to establish a brand with a trustworthy name and to show we care about the wellbeing of our customers. Therefore, we support the stringent legislation although it makes it harder to put a product with specific claims on the market. There is a higher cost, more knowledge and human resources attached to such stringent legislation, and this needs to be kept in mind when wanting to start a business out of the idea.  

Although bringing the idea to the market and applying to all obligatory rules is highly challenging, we still believed in our concept. So, we scheduled a meeting with Tom Van Damme (15/07/2020) and discussed the potential of the pearl on the market. Tom Van Damme is one of the founders of DO!, 'durf ondernemen!' or 'Dare to venture!'. He aids students with their start-ups by bringing them in contact with the right partners. His opinion was optimistic about the potential of our pearl, and we decided to stick to the concept. And so our edible pearl, Bubbly, was born.  

With this pearl came a broad potential, so we went back to the literature to explore what the maximal benefit could be and how we could influence the world. We contacted Prof. Dr. Marie Joossens (27/8/2020) and Prof. Dr. Ir. Tom van de Wiele (17/8/2020) for in-depth information about the gut microbiome and specific delivery of supplements and vitamins. It became clear to us that inflammation in the gut is one of the main reasons for lots of different physical and mental illnesses to people all around the world. Most anti-inflammation drugs give many side effects and influence a lot more than just the gut. Inflammation in the GI-tract is most of the time related to dysfunctional behaviour of the gut microbiome. Mental illnesses are linked to inflammation in the gut and to dysfunctional behaviour of the gut microbiome. 

One mental illness, like depression, is present around the world and still copes with a negative connotation. It is a disorder/illness that knows no boundaries, makes no difference in respect to culture, ethnicity, wealth, or gender. Although there are slight differences in the number of depressions depending on the characteristics above, everyone can be a potential victim of depression. With our edible pearl, we can help millions worldwide, and we also want to make depression more discussable. To make people aware that it has different causes and that an easy to take supplementation can offer some solace to people suffering from depression. 
After revising the discussions we had with the professors, we concluded that two things were necessary to let our consumers benefit.  

The first was to reduce inflammation; for this, we investigated flavonoids. We contacted Ir. Lien De Wannemaeker (18/08/2020) for more information about the production of naringenin. From this interview, our take-home message was that there is still ample room for improvement in the production of naringenin.  Due to corona, time was not at our side. However, we were still able to make substantial progress in setting the basics for further cloning and trials procedures. If the production process is continued, naringenin would be affordable to multiple layers of society.  

The second was to enhance the growth of bacteria that can restore the gut microbiome; for this, we investigated kojibiose and vitamin B12. The relation of these to the gut is discussed in the engineering success theoretical background. Prof. Dr. Ir. Tom Desmet (17/07/2020) and his research team have found a new way to produce massive amounts of kojibiose via biocatalysts.  

Our pearl needs a specific formulation so it can reach people worldwide; it should also be tasty and easy to implement in different cultures. We met with Petra Van Gucht (16/09/2020) and Prof. Dr. Ir. Paul van der Meeren (10/08/2020) to discuss the composition of our pearl. Petra Van Gucht is founder of Cosmo Group and offered to aid us in the formulation and testing of the pearls.  

We contacted Dr. Nathalie Michels (5/10/2020) to gain further insights into what the current treatments for depression are and if there is potential as an alternative or adjuvant therapy. The drugs that are now available cause multiple side effects. Some examples are mood swings, losing appetite, losing libido, nausea, fatigue, et cetera. All unwanted effects when already suffering from depression.  

Integrated Human Practices

Finally, we wanted to discuss the hypothetical pitfalls of our edible pearls when bringing it to the market and presenting it to the world. We talked to Dr. Massimiliano Simons (15/09/2020) of the Department of Philosophy and Moral Sciences at Ghent University. Key elements from this discussion are given below.

Moral Hazard?

It is a supplement that can be a treatment or an adjuvant towards depression. Would the free distribution of supplements make people less willing to change their trigger of depression? Would it create a mindset 'as long as I take the supplementation, I do not need to change my environment'? Of course, depression is a combination of multiple triggers and believing that we need to distance people from their distress is a typical Western idea. (Pogosyan, 2017) When looking in the context of the western theories, bubbly might give this hazard. Hence sensibilization is necessary. For example, we can state that it is a supplement that can help. However, professional help is essential when symptoms persist.  

On the other hand, western theory does not apply to all. In certain cultures, people are well surrounded socially and don't see themselves as sick. Advising to seek medical help might cause distress and might worsen the depression. A more subtle approach is necessary, where key terms like mental health should be used instead of depression. People can live in a stressful, disabling situation but remain in good mental health. (Carod-Artal, 2017) 

These are questions that can also be applied to the modern, medicine targeted treatments of depression and other mental diseases. "Let's take a pill, and everything will disappear". We do not want this to occur, so we need to invest in sensibilization that the supplement ought to be taken as an adjuvant together with therapy.   
 

Socioeconomic Background

Most studies that study depression and the medical treatments thereof are based on white western males and hence do not apply to the world's population nor to different socioeconomic backgrounds. A solution to circumvent this bias is by doing clinical trials all over the world and including people from different cultural, ethnical, gender and wealth backgrounds. 

People with a lower socioeconomic status (SES) have a higher risk on depression and depression seems to be more persistent. (Schlax et al., 2019) Some people have less access to medicines, so our supplement can be a solution, and in certain countries, drugs and access to doctors are limited or very expensive (WHO, 2017).  Although as stated above, our supplement should not be an alternative to proper health care. It could be useful to include public healthcare systems or private health insurance companies, so our supplement can be refunded. This could reduce the boundary between rich and poor people and their respective access to our pearl. It is our task to make the pearl as available as possible so that everyone has access to it. In the meantime, we also need to inform about depression or mental health and proper treatment if the symptoms persist. 

Depression And Bubbly In Different Cultures

"All happy families are alike; each unhappy family is unhappy in its own way."  
Leo Tolstoy 1828-1910 

The risk factors for depression are similar across cultures. Gender, unemployment and traumatic events are among the main factors. In general, these risk factors can be categorized as a loss of some sort. It is how people handle the distress and what people make of their losses that differ enormously across cultures.  

Depression is a form of suffering triggered by a loss of some sort. The meaning given to this suffering varies among cultures. In traditional Catholic contexts, there are two different perspectives given to suffering. The first is that excessive grief keeps you away from your goals and can be seen as a sin. But on the other hand, when suffering still allows you to participate in your life, it is thought to bring you closer to god.  
In contrast, Buddhism sees suffering as an essential characteristic of life. Hence one ought to be mindful about it but does not need to chase it away. (Pogosyan, 2017) 

How does Bubbly fit in this context? It is not a straightforward answer. There is a culture-specific approach necessary. It is essential to understand the cultural dynamics and social roles that a patient of depression plays within the culture. (Bailey et al., 2019)  To get full support from the public, bubbly's approach should also be in line with the mental health policies present. Preferably we work together with public and private health institutions to get an in-depth understanding of the social and cultural environment.  
 

As the last point, although we work on a supplement that can be an adjuvant to therapies or an alternative to treatments of depression, prevention remains most critical.  

References

Bailey RK, Mokonogho J & Kumar A (2019) Racial and ethnic differences in depression: Current perspectives. Neuropsychiatr. Dis. Treat. 15: 603–609 Available at: /pmc/articles/PMC6390869/?report=abstract [Accessed October 27, 2020]

Carod-Artal FJ (2017) Social determinants of mental health. In Global Mental Health: Prevention and Promotion pp 33–46. Geneva Available at: https://apps.who.int/iris/bitstream/handle/10665/112828/9789241506809_eng.pdf;jsessionid=1651C8143AE0E2C9F08F47BC327401E7?sequence=1 [Accessed October 27, 2020]

Pogosyan M (2017) How Culture Affects Depression. Psychol. Today Available at: https://www.psychologytoday.com/us/blog/between-cultures/201712/how-culture-affects-depression [Accessed October 27, 2020]

Schlax J, Jünger C, Beutel ME, Münzel T, Pfeiffer N, Wild P, Blettner M, Kerahrodi JG, Wiltink J & Michal M (2019) Income and education predict elevated depressive symptoms in the general population: Results from the Gutenberg health study. BMC Public Health 19: 430 Available at: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6730-4 [Accessed October 27, 2020]

WHO (2017) World Bank and WHO : Half the world lacks access to essential health services , 100 million still pushed into extreme poverty because of health expenses. WHO: 2017–2020 Available at: https://www.who.int/news/item/13-12-2017-world-bank-and-who-half-the-world-lacks-access-to-essential-health-services-100-million-still-pushed-into-extreme-poverty-because-of-health-expenses [Accessed October 27, 2020]