1.1. Introduction
The important role of fermented milk in human nutrition is well documented and the benefits of these products have been known to humans since the ancient days of civilization. Several generations have experienced the medicinal and nutritional properties of various fermented foods. However, the scientific community gave impetus to these beliefs in 1910, when Élie Metchnikoff suggested that humans should consume milk fermented with lactobacilli to prolong life. He postulated the presence of desirable bacteria in Bulgarian milk that could help in suppressing undesirable and disease-causing bacteria in the intestine of human beings. This observation led the way for exploring the potentials of lactic cultures and cultured products in the relief of human and animal disorders. Recently importance has been given to the production of fermented milk with improved health attributes, particularly the therapeutic properties of these products [1].
Historically, the fermentation process involved unpredictable and slow souring of milk caused by the organisms inherently present in milk. However, modern microbiological processes have resulted in the production of different fermented milk products of higher nutritional value under controlled conditions. These products represent an important component of functional foods, and intense research efforts are under way to develop dairy products into which probiotic organisms are incorporated to make them more valuable [1]. A fermented milk product has been defined by the International Dairy Federation as a milk product prepared from skimmed milk or not with specific cultures. The microflora is kept alive until sale to the consumer and may not contain any pathogenic germs. The fermented milk products used in various countries may be broadly classified into three categories: (1) Moderately sour type with pleasant aroma, e.g., cultured milk; (2) sour and very high sour types, e.g., curd or yogurt; and (3) acid-cum-alcohol in addition to lactic acid, e.g., koumiss and kefir [2].
The consumer's interest in fermented milk products is gaining momentum owing to the development of new food-processing techniques, changing social attitudes, and scientific evidence of the health benefits of certain ingredients [3,4]. Some cultured dairy foods such as Biogurt, Yakult, Actimel, etc., are already being marketed as therapeutic and dietetic products.
1.2. Health Benefits
The health benefits of dairy products are the result of biologically active components that are present in native milk and also, owing to their suitably modulated activities, produced through the action of probiotic bacteria in fermented or sour milk products. In addition to modification of several milk components the probiotics may also act directly as preventive agents or in therapy for some contagious, atopic, tumorous, or other severe diseases [5–7]. The health-promoting effects of the prefermented functional foodstuffs materialize directly through interactions with consumed microorganisms (probiotic effect) or, indirectly, as a result of the action of microbial metabolites generated during the fermentation process (biogenic effect).
The most important biogenic metabolites include vitamins, proteins, peptides, oligosaccharides, and organic acids, including fatty acids. In many cases, the health-promoting mechanisms of probiotic action are not sufficiently known. However, the majority of them are based on the positive effect they exert on the immune response, i.e., on the immunomodulatory activity [8,9]. In most cases, this is due to the stimulation of natural immunity [10,11]. In doing so they modulate primarily the production of cytokines and antimicrobial peptides [12]. This is the mode of action of not just typical sour milk functional foodstuffs, such as sour milk, kefir, or yogurt, produced by the food-processing industry [13,14], but also that of the diet supplements containing probiotic bacteria in pure form. However, the latter are the products of the pharmaceutical industry and, in contrast to functional foodstuffs, they have a standard composition and known immunomodulatory characteristics, verified both experimentally and in controlled clinical studies. In terms of their quality and efficiency they are also under regular pharmaceutical control. It will be therefore more precise to call them immunobiotics, to distinguish them from classical probiotics in functional foodstuffs [15]. However, one major part of milk—whey—has traditionally not been paid as much attention as sour milk, because it is a by-product of cheese making.
During the Middle Ages whey was considered not only as a medicine but also as a skin balm and an aphrodisiac. Whey proteins, namely α-lactalbumin, β-lactoglobulin, lactoferrin, lactoperoxidase, and serum albumin, possess important nutritional and biological properties particularly with regard to prevention of diseases. Antimicrobial, anticarcinogenic, immunostimulatory, and other health-promoting activities of whey proteins have been recently reviewed by Madureira et al. [16]. Dairy products and their components contribute to the regulation of body mass by providing satiety signals. Therefore, whey proteins have a potential as physiologic...