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Probiotic

 
Food and Nutrition: probiotics
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Preparations of live micro-organisms added to food (or used as animal feed), claimed to be beneficial to health by restoring microbial balance in the intestine. The organisms commonly involved are lactobacilli, bifidobacteria, streptococci, and some yeasts and moulds, alone or as mixtures. The idea that friendly bacteria in yogurt will crowd out pathogenic organisms originally propounded by Russian-French bacteriologist Ilya Metchnikoff (1845-1916) in The Prolongation of Life (1907). See also prebiotics.

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Alternative Medicine Encyclopedia: Probiotics
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Definition

Probiotics, as defined by the Food and Agricultural Organization of the United Nations (FAO), are "live microorganisms administered in adequate amounts which confer a beneficial health effect on the host." The microorganisms referred to in this definition are non-pathogenic bacteria (small, single celled organisms which do not promote or cause disease), and one yeast, Saccharomyces. They are considered "friendly germs," due to benefits to the colon and the immune system. The word probiotic is a compound of a Latin and a Greek word; it means "favorable to life." Probiotics is also sometimes used to refer to a form of nutritional therapy based on eating probiotic foods and dietary supplements. Although probiotic supplements have also been used with farm animals, most are produced for human consumption in the form of dairy products containing two types of microbes—lactobacilli and bifidobacteria. As with the extended use of royal jelly, probiotics are now also being used in face creams and similar cosmetic products.

A new category called prebiotics now also appears in the literature. Prebiotics refer mainly to certain foods, and occasionally to certain food products, that support probiotic microorganism viability, enhancing their survivability. Included among prebiotics are foods such as Jerusalem and regular artichokes, oats, leeks, onions, and whole grain breads or cereals. Examples of prebiotic food products are the Fructooligosaccharides (fructooligo-saccharides, or fruit derived, digestion resistant sugars) (FOS), also in honey, and the galactooligosaccharides (galacto-oligo-saccharides), sugars in galactose-containing foods like goats milk.

Origins

Although the term probiotics is relatively recent, as are science-based investigations, the use of probioticcontaining fermented foods in many cultures of the world predates the advent of refrigeration. The applied notion of improving health by supplementing the natural microflora of the human intestines with additional bacteria taken by mouth goes back to the late nineteenth century. At that time, some physicians attributed sickness and the aging process to a build up of waste products (or, putrefaction) in the colon (the lower part of the large intestine that empties into the rectum), and toxic materials leaking from the colon into the bloodstream. The process of leakage—now referred to as gut permeability or leaky gut syndrome—and the poisoning that resulted from it, were called autointoxication. The autointoxication theory assumed that dietary changes aimed at reducing toxic decomposition in the colon would be beneficial to health. Some observers knew about the use of lactic acid bacteria in sausage-making to ferment the meat and protect it from spoilage. Because these bacteria are harmless to humans, it was thought that adding them to the diet by eating fermented foods would reduce the amount of toxins produced in the colon. The Lactobacilli group of bacteria, some of which are found in yogurt, was the first identified probiotic. In the 1920s and 1930s, many doctors recommended acidophilus milk, which contains the lactobaccili bacterium called Lactobacillus acidophilus, for the treatment of constipation and diarrhea. This treatment was effective for many patients.

The next phase in the development of probiotics came in the 1950s, when medical researchers began to study L. acidophilus as a possible answer to some of the digestive side effects of taking antibiotics. It was known that antibiotic medications upset the natural balance of the intestinal microflora by killing of the beneficial as well as the pathogenic bacteria. The researchers thought that taking oral preparations of L. acidophilus might offset the side effects of the antibiotics.

One of the chief difficulties in benefiting from probiotic supplementation has been assuring survivability of the bacteria as it passes through the acidity of the stomach and the digestive processes of the small intestine and successfully colonizing in the colon. Recently, a new probiotic with exceptional survivability and colonization characteristics, as demonstrated in studies, has emerged. This probiotic, screened from many strains of lactobacilli and named after its co-discoverers, Sherwood Gorbach and Barry Goldin, is known as Lactobacillus GG (LGG). LGG was demonstrated effective against psuedomembranous colitis, an infection of the colon by Clostridium difficile as a result of antibiotic overkill of beneficial bacteria, and against atopic eczema in children due to gut permeability. LGG was demonstrated to have positive results against Candida in mice, as well. Three patents have been awarded on LGG from June 1989 to May 1995. In 1987, a Finnish dairy cooperative, Valio, Ltd., was granted a license to conduct research. About 1992, Valio released a fermented milk product with LGG called Gefilus. In 1996, a division of an American corporation was formed, called CAG Functional Foods, which markets LGG as the product Culturelle. One source reported significant benefit from the use of Culturelle when cultured in milk. Culturelle is currently available only in capsules, but a yogurt product is anticipated to be marketed soon.

Much of the research and marketing of proven probiotics is conducted outside the United States. One such research proven probiotic strain is Lactobacillus plan-tarum 299v. It has been particularly valuable in irritable bowel syndrome (IBS) and recovery from surgery. It's colonization ability was proven using biopsy. It is not currently available in the United States, but agreements with the makers and distributors of Danon yogurt may change that.

Two proven beneficial strains marketed in the United States are Lactobacillus reuteri, a Swedish product proven effective against diarrhea in children due to a rotavirus (a virus transmitted from feces), available in the Stoneyfield brand of yogurt, and Saccharomyces boulardii, a yeast product available in capsules effective against antibiotic associated diarrhea.

Benefits

Probiotic foods and dietary supplements have been recommended as treatments for a variety of diseases and disorders, ranging from problems confined to the digestive tract to general health issues.

Intestinal Complaints

To summarize, probiotic organisms, in particular the LGG strain, have been shown to be helpful in managing the following intestinal disorders:

  • Pseudomembranous colitis, a potentially life-threatening inflammation of the colon caused by an overgrowth of the bacterium Clostridium difficile as a result of the patient's having taken antibiotics that causes profuse watery diarrhea, cramps, and low-grade fever.
  • so-called "traveler's diarrhea"
  • acute nonbacterial diarrhea
  • rotaviral diarrhea
  • irritable bowel syndrome (IBS)
  • bacterial overgrowth in the small bowel by organisms such as Helicobacter pylori, implicated in gastric ulcers (studies have demonstrated benefit but not cure)

Lifestyle-Related Disorders

Some supporters of probiotics go beyond applications limited to treatment of intestinal disorders. In keeping with the theory of autointoxication, they maintain that probiotics are effective in treating a wide range of chronic and acute illnesses thought to result from a condition called intestinal dysbiosis, or poor intestinal health quality due to toxic buildup, putrefaction, and leaky gut syndrome. Intestinal dysbiosis is defined as an imbalance among the various microorganisms in the digestive tract. This imbalance is attributed to a combination of Western high-protein diets, stress, environmental pollution, and allopathic medications. Putrefaction is believed to result from a low fiber diet, chronic constipation or sluggish colon, and poor food combining leading to increased gut fermentation. Leaky gut syndrome is the term used to suggest that the effect of these toxins on the intestinal cell walls is damaging to intestinal integrity, and as a result, large molecules of relatively undigested food and toxins cross the intestinal membrane into the blood stream.

Some alternative practitioners maintain that the following diseases and disorders are directly related to intestinal dysbiosis or may also be beneficially treated with probiotics:

  • mental health problems
  • chronic fatigue syndrome
  • muscular soreness and stiffness
  • autoimmune disorders, including lupus, rheumatoid arthritis, ankylosing spondylitis, enteric arthritis, and Reiter's syndrome (by immune stimulation and repair of the leaking gut)
  • lactose intolerance (by increasing the presence of lactase)
  • infectious diseases
  • high blood pressure (research has demonstrated a systolic blood pressure decrease of 10–20 mm Hg with the use of a fermented milk product
  • high cholesterol, (clinical studies have not been conclusive; as one source said, "Evidence is not over-whelming")
  • cancer (by decreasing exposure from gene-altering substances)
  • menopausal problems in women (by improving the liver's ability to detoxify and eliminate hormonal metabolites)
  • vaginosis (once thought to be relatively benign, now implicated in easier transmission of sexual diseases, pelvic inflammatory disease, and pregnancy-related complications, improved by reducing vaginal pH which inhibits growth of unfavorable bacteria)
  • allergies and asthma (a double-blind placebo-controlled study demonstrated a 50% drop in children followed up to two years of age)
  • kidney stones, by inhibiting the absorption of oxalate from the intestines

More specifically, probiotic foods and dietary supplements are claimed to counteract intestinal dysbiosis in the following ways:

  • production of vitamins. Friendly bacteria are said to manufacture vitamin B3, vitamin B6, and folic acid.
  • anti-tumor and anti-cancer activity
  • suppression of pathogenic microorganisms in favor of the non-pathogenic
  • relief of anxiety symptoms through indirect detoxification
  • protection against radiation and other environmental toxins
  • support of the immune system, by reducing immune load
  • recirculation of female hormones in the bloodstream by a cleaner liver and cleaner blood, thus maintaining higher levels of estrogen in menopausal women
  • maintenance of smooth bowel functioning

Description

Products

Probiotics is a nutrition-based therapy and relies primarily on the addition of foods or supplements containing friendly bacteria to the diet. Some recommended foods are ordinary grocery store items that involve fermentation in their production; these include miso, pickles, sauerkraut and fermented dairy products such as yogurt and kefir. As mentioned, other food or food products called prebiotics, such as Jerusalem artichokes and FOS, are thought to support the growth of the beneficial bacteria in the intestines. Most users and recommenders of probiotics, however, encourage the use of loose powdered, refrigerated dietary supplements of friendly bacteria or LGG capsules. Some of these products are milk-based, while others are milk-free. Probiotic dietary supplements are over-the-counter (OTC) preparations that can be easily purchased at grocery or health food stores, or from European manufacturers over the Internet. The types of bacteria most often recommended are Lacto-bacillus GG, Lactobacillus acidophilus, Lactobacillus bulgaricus, and, especially for children Bifidobacterium bifidum. Breast milk is reported to contain nutrients that support bifidobacterium growth.

Dosage and Administration

Some practitioners distinguish between a therapeutic dose of probiotic products, which is given for 10 days, and a maintenance dose, which is used afterward. One source gives 2–5 level tsp (5–10 g) of powdered supplement as the daily therapeutic dose if the patient is taking L. acidophilus or B. bifidum, 1–3 tsp (3–6 g) if the patient is using L. bulgaricus. The maintenance dose of L. acidophilus is given as 0.5 tsp (1 g) daily; of B. bifidum, 2 tsp (4 g) daily; of L. bulgaricus, 0.5 tsp (1 g) with each meal. The recommended dose of LGG capsules is once daily. A dose two or three times daily may also be used initially to overcome acute symptoms.

Patients are advised to take these supplements with spring water, but not with juice or broth. These fluids are thought to stimulate the secretion of stomach acids that will destroy the friendly bacteria.

Preparation

The fact that probiotic products include some ordinary dairy and grocery items means that most people who use them do not think of them as medications and see no need to consult a health professional. Persons who are taking prescription medications and persons with compromised immune status, however, are advised to consult their doctors before using probiotic dietary supplements. These products often influence the bulk and frequency of bowel movements, thus increasing the elimination rate of some medications and necessitating a dose adjustment.

Some practitioners of nutritional therapies recommend cleansing the lower digestive tract with an enema or colonic treatment before beginning a course of probiotic supplements. Conversely, use of probiotics may be particularly recommended following colonic therapy as it is following antibiotic therapy.

Precautions

Although the bacteria in probiotic supplements are human-friendly, some persons may have food allergies or a digestive tract that is sensitive to miso, other fermented foods, or the milk powder that may be in some products.

Vegetarians or persons who cannot digest milk-based products may prefer probiotic supplements with a rice base.

Product reliability is a concern because probiotic dietary supplements are not regulated by the Food and Drug Administration (FDA) and because study after study demonstrates the difficulty of maintaining a live probiotic culture, in or out of the body. One study of the microorganisms in 25 dairy products and 30 powdered products found that more than one third of these products contained no living microorganisms, and only 13% of the products contained all of the bacteria types listed on the label. One practitioner suggests the following guidelines for evaluating the effectiveness of probiotic products:

  • Number of viable organisms. A number lower than 1 billion organisms per gram is considered inadequate for a therapeutic dosage.
  • Type of organism. Single-strain products are considered more useful than multi-strain products on the grounds that the different bacteria in multi-strain products may compete with each other.
  • Processing method. Products that have been put through a centrifuge or ultra-filtration system are thought to have fewer viable bacteria.
  • Additives. Products that do not have hormones or other chemicals added to stimulate the growth of the bacteria are considered more effective.
  • Form. Powdered supplements are considered preferable to liquids. Encapsulated powders are second-best, except in the case of LGG capsules.
  • Storage. Probiotic products that are not refrigerated are thought to lose much of their effectiveness.

Side Effects

The side effects of treatment with probiotics may include a condition called excessive drainage syndrome, which includes headache, diarrhea, bloating, or constipation. Another commonly reported side effect is intestinal gas. These side effects are attributed to the cleansing of toxins from the body and may last for some days. Practitioners recommend lowering the supplement dosage to reduce the side effects, or pretreating with colonic therapy, or stool softeners and fiber as tolerated or advised by a healthcare professional.

Research & General Acceptance

More studies of probiotics have been done in Europe than in the United States, which is reflected in the fact that the leading manufacturers of probiotic supplements are presently based in Europe. Some mainstream researchers in Europe as well as in the United States are skeptical of some of the claims made for probiotics. Their reasons include the following considerations:

  • The studies done in support of probiotics are mostly anecdotal or heavily reliant on test-tube experimentation rather than on clinical trials in human subjects. As of 2000, relatively few strains of probiotic bacteria have been shown to have clinical value. These strains are helpful in treating milk allergy and irritable bowel syndrome in humans, and in improving resistance to a yeast called Candida in immunocompromised mice.
  • The basic concept of probiotics is based on a misunderstanding of the role of microflora in the human digestive tract.
  • It is difficult to see how bacteria taken by mouth can survive the process of human digestion. At present, only two species of lactobacilli, L. GG and L. plan-tarum 299v, have been shown to be able to colonize the human gut.
  • Supporters of probiotics emphasize two types of bacteria, the lactobacilli and the bifidobacteria, and virtually ignore the hundreds of other species that live in the intestines.

More clinical studies examining the effects of probiotics on specific conditions are being conducted. One such study in the making will examine the effect of probiotics on hepatic steatosis, or fatty degeneration of the liver. An inclusion criteria was biopsy diagnosis of non-alcoholic fatty liver disease. The study is expected to be completed in October 2004.

Training & Certification

As of 2000, there are no training or certification programs specifically for probiotics. Most practitioners who recommend probiotics have been trained as nutritionists or naturopathic physicians.

Resources

Books

Chaitow, Leon, ND, and Natasha Trenev. Probiotics. Northampton, UK: Thorsons, 1990.

Organizations

American Academy of Alternative Medicine (AAAM). 16126 E. Warren, Box 24224. Detroit, MI 48224-0224. (313) 882-0641. Fax: (313) 882-0972.

Ontario College of Naturopathic Medicine. 60 Berl Avenue. Toronto, Ontario M8Y3C7.

Other

Bryan, Mike. "Probiotics and Prebiotics." 1997-2004. [cited June 4, 2004]. .

Clarke, Jane. "Bacteria." [cited June 4, 2004]. .

"Frequently Asked Questions: Probiotics, New Zealand." 2001[cited June 4, 2004]. .

"History of Probiotic Research." June 27, 2001 [cited June 4, 2004]. .

"Lactobacillus GG (LGG)." July 16, 2001 [cited June 4, 2004]. .

"Lactobacillus plantarum 299v (Lp299v)." March 14, 2004. [cited June 4, 2004]. .

Mercola, M.D., Joseph. "One Third of Probiotics, 'Good Bacteria' Products Like Acidophilus, Found to be Worthless." July 11, 2001 [cited June 4, 2004]. .

Solga, M.D., Steve. "Probiotics Effect on Hepatic Steatosis." September 2003 [cited June 4, 2004]. .

"Summary of Probiotic Strains." April 30, 2002 [cited June 4, 2004]. .

"What Are Probiotics?" USProbiotics.org. 2004 [cited June 4, 2004]. .

[Article by: Rebecca Frey, Ph.D.; Katherine E. Nelson, N.D.]

Veterinary Dictionary: probiotic
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1. hypothetical substances in the alimentary tract that are believed to aid in establishing the best balance of microorganisms.
2. live organisms which, when administered orally to establish in the digestive tract, are believed to be favorable to the health of the host.

  • feed p. — includes mechanical (crushing, crimping) thermal (boiling, exploding) chemical (acid or alkali treatment) and combinations of these.
  • meat p. — meat being exposed to any one of a series of curing or preserving processes such as salting, wet pickling, drying, cooking and canning, sausage manufacture, ham curing.
  • x-ray film p. — developing and fixing an exposed x-ray film. Some of this work is now done in automatic machines.
Wikipedia: Probiotic
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Probiotics are dietary supplements of live microorganisms thought to be healthy for the host organism. According to the currently adopted definition by FAO/WHO, probiotics are: "Live microorganisms which when administered in adequate amounts confer a health benefit on the host".[1] Lactic acid bacteria (LAB) and bifidobacteria are the most common types of microbes used as probiotics; but also certain yeasts and bacilli are available. Etymologically, the term appears to be a composite of the Latin preposition pro ("for") and the Greek adjective βιωτικός (biotic), the latter deriving from the noun βίος (bios, "life").[2]
At the start of the 20th century, probiotics were thought to beneficially affect the host by improving its intestinal microbial balance, thus inhibiting pathogens and toxin producing bacteria [3]. Today[when?] specific health effects are being investigated and documented including alleviation of chronic intestinal inflammatory diseases,[4] prevention and treatment of pathogen-induced diarrhea,[5] urogenital infections,[6] and atopic diseases.[7]

Contents

History of probiotics

The original observation of the positive role played by certain bacteria was first introduced by Russian scientist and Nobel laureate Eli Metchnikoff, who in the beginning of the 20th century suggested that it would be possible to modify the gut flora and to replace harmful microbes by useful microbes.[3] Metchnikoff, at that time a professor at the Pasteur Institute in Paris, produced the notion that the aging process results from the activity of putrefactive (proteolytic) microbes producing toxic substances in the large bowel. Proteolytic bacteria such as clostridia, which are part of the normal gut flora, produce toxic substances including phenols, indols and ammonia from the digestion of proteins. According to Metchnikoff these compounds were responsible for what he called "intestinal auto-intoxication", which caused the physical changes associated with old age. It was at that time known that milk fermented with lactic-acid bacteria inhibits the growth of proteolytic bacteria because of the low pH produced by the fermentation of lactose. Metchnikoff had also observed that certain rural populations in Europe, for example in Bulgaria and the Russian steppes who lived largely on milk fermented by lactic-acid bacteria were exceptionally long lived. Based on these facts, Metchnikoff proposed that consumption of fermented milk would "seed" the intestine with harmless lactic-acid bacteria and decrease the intestinal pH and that this would suppress the growth of proteolytic bacteria. Metchnikoff himself introduced in his diet sour milk fermented with the bacteria he called "Bulgarian Bacillus" and found his health benefited. Friends in Paris soon followed his example and physicians began prescribing the sour milk diet for their patients.[8]

Bifidobacteria were first isolated from a breast-fed infant by Henry Tissier who also worked at the Pasteur Institute. The isolated bacterium named Bacillus bifidus communis [9] was later renamed to the genus Bifidobacterium. Tissier found that bifidobacteria are dominant in the gut flora of breast-fed babies and he observed clinical benefits from treating diarrhea in infants with bifidobacteria. The claimed effect was bifidobacterial displacement of proteolytic bacteria causing the disease.

During an outbreak of shigellosis in 1917, German professor Alfred Nissle isolated a strain of Escherichia coli from the feces of a soldier who was not affected by the disease.[10] Methods of treating infectious diseases were needed at that time when antibiotics were not yet available, and Nissle used the Escherichia coli Nissle 1917 strain in acute gastrointestinal infectious salmonellosis and shigellosis.

In 1920, Rettger demonstrated that Metchnikoff's "Bulgarian Bacillus", later called Lactobacillus delbrueckii ssp bulgaricus, could not live in the human intestine,[11] and the fermented food phenomena petered out. Metchnikoff's theory was disputable (at this stage), and people doubted his theory of longevity.

After Metchnikoff’s death in 1916, the centre of activity moved to the United States. It was reasoned that bacteria originating from the gut were more likely to produce the desired effect in the gut, and in 1935 certain strains of Lactobacillus acidophilus were found to be very active when implanted in the human digestive tract.[12] Trials were carried out using this organism, and encouraging results were obtained especially in the relief of chronic constipation.

The term "probiotics" was first introduced in 1953 by Kollath (see Hamilton-Miller et al. 2003). Contrasting antibiotics, probiotics were defined as microbially derived factors that stimulate the growth of other microorganisms. In 1989 Roy Fuller suggested a definition of probiotics which has been widely used: "A live microbial feed supplement which beneficially affects the host animal by improving its intestinal microbial balance".[13] Fuller's definition emphasizes the requirement of viability for probiotics and introduces the aspect of a beneficial effect on the host.

In the following decades intestinal lactic acid bacterial species with alleged health beneficial properties have been introduced as probiotics, including Lactobacillus rhamnosus, Lactobacillus casei, and Lactobacillus johnsonii.[14]

Adverse effects

There is no published evidence that probiotic supplements are able to completely replace the body’s natural flora when these have been killed off; indeed bacterial levels in feces disappear within days when supplementation ceases.[15] While the oral use of probiotics is considered safe and even recommended by the World Health Organization (WHO) under specific guidelines,[1] in some specific situations (such as critically ill patients) they could be potentially harmful. In a therapeutic clinical trial conducted by M. Besselink and colleagues in The Netherlands, the consumption of a cocktail containing genetically modified strains of probiotic bacteria, increased the death rate of patients with acute pancreatitis[16]. Probiotics have been shown to be beneficial for other types of patients[17][18].

In a clinical trial conducted at the University of Western Australia, aimed at showing the effectiveness of probiotics in reducing childhood allergies, Dr Susan Prescott and her colleagues gave 178 children either a probiotic or a placebo for the first six months of their life, those given the good bacteria were more, not less, likely to develop a sensitivity to allergens.[19]

Some hospitals have reported treating lactobacillus septicaemia which is a potentially fatal disease caused by the consumption of probiotics by people with lowered immune systems or who are already very ill.[19][20]

Potential benefits

Experiments into the benefits of probiotic therapies suggest a range of potentially beneficial medicinal uses for probiotics. For many of the potential benefits, research is limited and only preliminary results are available. It should be noted that the effects described are not general effects of probiotics. Recent research on the molecular biology and genomics of Lactobacillus has focused on the interaction with the immune system, anti-cancer potential, and potential as a biotherapeutic agent in cases of antibiotic-associated diarrhoea, travellers' diarrhoea, pediatric diarrhoea, inflammatory bowel disease and irritable bowel syndrome.[21]

All effects can only be attributed to the individual strain(s) tested. Testing of a supplement does not indicate benefit from any other strain of the same species, and testing does not indicate benefit from the whole group of LAB (or other probiotics).[22]

Managing lactose intolerance

As lactic acid bacteria actively convert lactose into lactic acid, ingestion of certain active strains may help lactose intolerant individuals tolerate more lactose than what they would have otherwise.[23] In practice probiotics are not specifically targeted for this purpose, as most are relatively low in lactase activity as compared to the normal yogurt bacteria.

Prevention of colon cancer

In laboratory investigations, some strains of LAB (Lactobacillus bulgaricus) have demonstrated anti-mutagenic effects thought to be due to their ability to bind with heterocyclic amines, which are carcinogenic substances formed in cooked meat.[24] Animal studies have demonstrated that some LAB can protect against colon cancer in rodents, though human data is limited and conflicting.[25] Most human trials have found that the strains tested may exert anti-carcinogenic effects by decreasing the activity of an enzyme called β-glucuronidase[25] (which can generate carcinogens in the digestive system). Lower rates of colon cancer among higher consumers of fermented dairy products have been observed in some population studies.[23]

Lowering cholesterol

Animal studies have demonstrated the efficacy of a range of LAB to be able to lower serum cholesterol levels, presumably by breaking down bile in the gut, thus inhibiting its reabsorption (which enters the blood as cholesterol). Some, but not all human trials have shown that dairy foods fermented with specific LAB can produce modest reductions in total and LDL cholesterol levels in those with normal levels to begin with, however trials in hyperlipidemic subjects are needed.[23]

Lowering blood pressure

Several small clinical trials have shown that consumption of milk fermented with various strains of LAB can result in modest reductions in blood pressure. It is thought that this is due to the ACE inhibitor-like peptides produced during fermentation.[23]

Improving immune function and preventing infections

LAB are thought to have several presumably beneficial effects on immune function. They may protect against pathogens by means of competitive inhibition (i.e., by competing for growth) and there is evidence to suggest that they may improve immune function by increasing the number of IgA-producing plasma cells, increasing or improving phagocytosis as well as increasing the proportion of T lymphocytes and Natural Killer cells.[26][27] Clinical trials have demonstrated that probiotics may decrease the incidence of respiratory tract infections[28] and dental caries in children.[29] LAB foods and supplements have been shown to be aid in the treatment and prevention of acute diarrhea, and in decreasing the severity and duration of rotavirus infections in children and travelers' diarrhea in adults.[26][27]

Helicobacter pylori

LAB are also thought to aid in the treatment of Helicobacter pylori infections (which cause peptic ulcers) in adults when used in combination with standard medical treatments. However more studies are required into this area.[30]

Antibiotic-associated diarrhea

Antibiotic-associated diarrhea (AAD) results from an imbalance in the colonic microbiota caused by antibiotic therapy. Microbiota alteration changes carbohydrate metabolism with decreased short-chain fatty acid absorption and an osmotic diarrhea as a result. Another consequence of antibiotic therapy leading to diarrhea is overgrowth of potentially pathogenic organisms such as Clostridium difficile.
Probiotic treatment can reduce the incidence and severity of AAD as indicated in several meta-analyses.[31][32][33][34][35][34] However, further documentation of these findings through randomized, double blind, placebo-controlled trials are warranted. Efficacy of probiotic AAD prevention is dependent on the probiotic strain(s) used and on the dosage.[36][37] Up to a 50% reduction of AAD occurrence has been found.[35] No side-effects have been reported in any of these studies. Caution should, however, be exercised when administering probiotics to immunocompromised individuals or patients who have a compromised intestinal barrier.

Reducing inflammation

LAB foods and supplements have been found to modulate inflammatory and hypersensitivity responses, an observation thought to be at least in part due to the regulation of cytokine function.[26] Clinical studies suggest that they can prevent reoccurrences of inflammatory bowel disease in adults,[26] as well as improve milk allergies.[38] They are not effective for treating eczema, a persistent skin inflammation.[39]. How probiotics counteract immune system overactivity remains unclear, but a potential mechanism is desensitization of so-called T lymphocytes, an important compenent of the immune system, towards pro-inflammatory stimuli [40].

Improving mineral absorption

It is hypothesized that probiotic lactobacilli may help correct malabsorption of trace minerals, found particularly in those with diets high in phytate content from whole grains, nuts, and legumes.[41]

Preventing harmful bacterial growth under stress

In a study done to see the effects of stress on intestinal flora, rats that were fed probiotics had little occurrence of harmful bacteria latched onto their intestines compared to rats that were fed sterile water.[42]

Irritable bowel syndrome and colitis

B. infantis 35624, sold as Align, was found to improve some symptoms of irritable bowel syndrome in women in a recent study.[43] Another probiotic bacterium, Lactobacillus plantarum 299v, was also found to be effective in reducing IBS symptoms.[44] Additionally, a probiotic formulation, VSL#3, was found to be safe in treating ulcerative colitis, though efficacy in the study was uncertain.[45] Bifidobacterium animalis DN-173 010 may help.[46]

Managing urogenital health

Several in vitro studies have revealed probiotics' potential in relieving urinary tract infections[47] and bacterial vaginosis.[48] Results have been varied on these studies, and in vivo studies are still required in this area to determine efficacy.

Synbiotics

As probiotics are mainly active in the small intestine and prebiotics are only effective in the large intestine,[49] the combination of the two may give a synergistic effect. Appropriate combinations of pre- and probiotics are synbiotics.

Strains

The most common form for probiotics are dairy products and probiotic fortified foods. However, tablets, capsules, powders and sachets containing the bacteria in freeze dried form are also available.

Probiotic Research and Producer Information[50][51]
Strain Brandname Producer Potential effect in humans
Bacillus coagulans GBI-30, 6086 GanedenBC30 Ganeden Biotech Improves abdominal pain and bloating in IBS patients.[52] Increases immune response to viral challenge.[53]
Bifidobacterium animalis subsp. lactis BB-12 Chr. Hansen [citation needed]
Bifidobacterium breve Yakult Bifiene Yakult [citation needed]
Bifidobacterium infantis 35624 Align Procter & Gamble [citation needed]
Bifidobacterium animalis subsp. lactis HN019 (DR10) Howaru Bifido Danisco [citation needed]
Bifidobacterium longum BB536 Morinaga Milk Industry [citation needed]
Escherichia coli M-17 ProBactrix BioBalance [citation needed]
Escherichia coli Nissle 1917 Mutaflor Ardeypharm [citation needed]
Lactobacillus acidophilus DDS-1 Nebraska Cultures[54] [citation needed]
Lactobacillus acidophilus LA-5 Chr. Hansen [citation needed]
Lactobacillus acidophilus NCFM Danisco [citation needed]
Lactobacillus casei DN114-001 (Lactobacillus casei Immunitas(s)/Defensis) Actimel/DanActive Danone [citation needed]
Lactobacillus casei CRL431 Chr. Hansen [citation needed]
Lactobacillus casei F19 Cultura Arla Foods [citation needed]
Lactobacillus casei Shirota Yakult Yakult [citation needed]
Lactobacillus paracasei St11 (or NCC2461)[55] Lactobacillus fortis Nestlé
Lactobacillus johnsonii La1 (= Lactobacillus LC1, Lactobacillus johnsonii NCC533) Nestlé [citation needed]
Lactococcus lactis L1A Norrmejerier Immune stimulation, improves digestive health, reduces antibiotic-associated diarrhoea[56]
Lactobacillus plantarum 299V GoodBelly / ProViva/ TuZen NextFoods Probi Ferring [citation needed]
Lactobacillus reuteri ATTC 55730 (Lactobacillus reuteri SD2112) BioGaia Biologics Diarrhea prevention and mitigation in children[57][58], eradication of H. pylori infection[59], amelioration of gingivitis[60], general illness prevention in children[61] and adults[62].
Lactobacillus rhamnosus ATCC 53013 (discovered by Gorbach & Goldin(=LGG)) Vifit and others Valio [citation needed]
Lactobacillus rhamnosus LB21 Verum Norrmejerier Immune stimulation, improves digestive health, reduces antibiotic-associated diarrhoea[56]
Saccharomyces cerevisiae (boulardii) lyo DiarSafe and others Wren Laboratories and others against antibiotic-associated diarrhoea and Clostridium_difficile (cmd-click)">Clostridium_difficile (cmd-click)">Clostridium_difficile (cmd-click)">Clostridium_difficile (cmd-click)">Clostridium_difficile (cmd-click)">[[Clostridium difficile]] infections; to treat acute diarrhoea in adults & children.[63].[64].[65]
tested as mixture:
Lactobacillus rhamnosus GR-1 & Lactobacillus reuteri RC-14		 Bion Flore Intime Jarrow Fem-Dophilus Chr. Hansen Oral ingestion results in vaginal colonisation and prevention of vaginitis

[66]
tested as mixture:
Lactobacillus acidophilus NCFM & Bifidobacterium bifidum BB-12		 Florajen3 American Lifeline, Inc Reduction of C. difficile–associated disease (CDAD)[2].
tested as mixture:
Lactobacillus acidophilus CL1285 & Lactobacillus casei		 Bio-K+ CL1285 Bio-K+ International Improves digestive health. Prevents Antiobic Associated Diarrhea (AAD) and Clostridium Difficile (C Difficile).[67]

In vitro inhibition of Listeria monocytogenes and L. innocua, Escherichia coli, Staphylococcus aureus, Enterococcus faecalis and Enterococcus faecium.[68]
Reduction of symptoms of lactose intolerance and immune stimulation.[69]
Lactobacillus helveticus R0052 & Lactobacillus rhamnosus R0011 A'Biotica and others Institut Rosell [citation needed]

Some commonly used bacteria in products, but without probiotic effect (yoghurt bacteria):

Some other bacteria mentioned in probiotic products:

Some fermented products containing similar lactic acid bacteria include:

Multi-probiotic


Research is emerging on the potential health benefits of multiple probiotic strains as a health supplement as opposed to a single strain.[77][78] The human gut is home to some 400-500 types of microbes. It is thought that this diverse environment may benefit from multiple probiotic strains; different strains populate different areas of the digestive tract, and studies are beginning to link different probiotic strains to specific health benefits.

Supplement products that contain more than one probiotic strain:

Company Probiotic Strains Product
Nutri-Health Bifidobacterium bifidum, Bifidobacterium breve, Bifidobacterium infantis, Bifidobacterium lactis, Bifidobacterium longum, Lactobacillus acidophilus, Lactobacillus brevis, Lactobacillus bulgaricus, Lactobacillus casei, Lactobacillus gasseri, Lactobacillus paracasei, Lactobacillus plantarum, Lactobacillus rhamnosus, Lactobacillus salivarius, Lactococcus lactis, Streptococcus thermophilus Flora Source Multi-Probiotic Formula
Enzymatic Therapy Lactobacillus acidophilus, Bifidobacterium longum Acidophilus Pearls
Kyolic Lactobacillus acidophilus, Bifidobacterium bifidum,

Bifidobacterium longum

 Kyo-Dophilus
Renew Life Bifidobacterium bifidum, Lactobacillus acidophilus,mLactobacillus rhamnosus, Bifidobacterium breve, Bifidobacterium longum, Lactobacillus casei, Lactobacillus plantarum, Lactococcus lactis, Lactobacillus bulgaricus, Lactobacillus salivarius Flora Smart
OptiBac Probiotics Bifidobacterium longum Rosell-175, Lactococcus lactis Rosell-1058, Bifidobacterium breve Rosell-70, Lactobacillus rhamnosus Rosell-11, Lactobacillus acidophilus Rosell-52, Bifidobacterium bifidum rosell-71 OptiBac Probiotics For daily wellbeing

Research

Research about probiotics shows both harm[where?] and benefits.

A study in 2004 testing the immune system of students given either milk or Actimel over a 6 week exam period (3 weeks of studying, 3 weeks of exams) tested 19 different biomarkers. Of these 19 biomarkers only 2 were shown to be different between the two groups, increased production of lymphocytes and increased production of CD56 cells. The tests were not blind and show that probiotics have no overall effect on the immune system or on its ability.[79]

A 2007 study at University College Cork in Ireland showed that a diet including milk fermented with Lactobacillus bacteria prevented Salmonella infection in pigs.[80]

A 2007 clinical study at Imperial College London showed that preventive consumption of a commercially available probiotic drink containing L casei DN-114001, L bulgaricus, and S thermophilus can reduce the incidence of antibiotic-associated diarrhea and C difficile-associated diarrhea.[81]

The efficacy and safety of a daily dose of Lactobacillus acidophilus CL1285 in the prevention of AAD was demonstrated by Montreal’s Maisonneuve-Rosemont Hospital, in a clinical study of hospitalized patients.[67]

Criticisms

Some experts are skeptical on the efficacy of many strains and believe not all subjects will benefit from the use of probiotics.[82] Another criticism[by whom?] is the cost and value of probiotics products.[82]

See also

References

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  81. ^ Hickson M, D'Souza AL, Muthu N, et al. (2007). "Use of probiotic Lactobacillus preparation to prevent diarrhea associated with antibiotics: randomised double blind placebo controlled trial". BMJ 335 (7610): 80. doi:10.1136/bmj.39231.599815.55. PMID 17604300. 
  82. ^ a b Probiotics, not so friendly after all?

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Dietary supplements
Types
Vitamins and minerals
Other common ingredients
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Food and Nutrition. A Dictionary of Food and Nutrition. Copyright © 1995, 2003, 2005 by A. E. Bender and D. A. Bender. All rights reserved.  Read more
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