Probiotics: Beneficial or Media Hype?

Companies have added “probiotics” to various food products for supposed health benefits. Are probiotics beneficial? Do they carry health risks? Are people with immune-compromising conditions recommended to use or not use probiotics? Are they effective for combating diarrhea triggered by antibiotics? Is the media hype of probiotics another media hyped “health cure?”

What are probiotics? “Probiotics are live microorganisms (in most cases, bacteria) that are similar to beneficial microorganisms found in the human gut. They are also called "friendly bacteria" or "good bacteria" (http://nccam.nih.gov/health/probiotics). They are available in dietary supplements, foods, and yogurts as well as oral products, suppositories and creams. Overall, probiotics are classified as dietary supplements; therefore, they are not subject to approval by the FDA (food and drug administration) for safety and effectiveness before they are marketed.

Examples of probiotics: those found naturally in the intestines include Saccharomyces boulardii (a yeast) and bacteria in the Lactobacillus and Bifobacterium families of microorganisms. Foods containing probiotics include fermented and unfermented milk and buttermilk, some soy drinks, kefir, sauerkraut, pickles, miso, and of course, yogurt. Dietary probiotic supplements are available in tablet, capsule, liquid, and powder forms. A commonly used supplement is acidophilus.

What do probiotics do; how are they helpful? According to the Health Hub of the Cleveland Clinic, the body does not need the addition of food and supplements that contain probiotics to be healthy. However, probiotics may help keep a person healthy by:

• “decreasing the number of "bad" bacteria in your gut that can cause infections or inflammation
• replacing the body's "good" bacteria that have been lost (when taking antibiotics, for example)
• restoring the body's "good" versus "bad" bacterial balance, which then helps to keep your body functioning properly” (Healthy Hub at Cleveland Clinic). “But no one can predict whether consuming Lactobacillus or Bifidus regularis in yogurt or other beneficial bacteria in food or capsule form will make you healthier.” http://health.clevelandclinic.org/2012/07/can-probiotics-solve-your-digestive-woes
• How safe and effective are probiotics?

“Probiotics may trigger allergic reactions. They may also cause mild stomach upset, diarrhea, or flatulence (passing gas) and bloating for the first few days after starting to take them. However, since probiotics already exist naturally in the body, probiotic foods and supplements are generally considered to be safe” (http://health.clevelandclinic.org/).

Co-author Sydne Newberry (nutritionist/researcher for the Southern California Evidence-Based Practice Center at the RAND Corp. in Santa Monica) commented on an analysis (reported in Journal of the American Medical Association) of earlier studies that found probiotics to have a potential in alleviating diarrhea that afflicts about one-third of people treated with antibiotic medications. Diarrhea is more common with certain antibiotics, particularly at high doses needed to treat serious infections. Newberry suggested that the new study provides little specific guidance to patients or their doctors because the studies didn’t provide details such as the specific bacteria strain.

“Probiotic research is moving forward on two fronts: basic science (laboratory studies) and clinical trials to evaluate the safety and efficacy of probiotics for various medical conditions. Many early clinical trials of probiotics have had methodological limitations, and definitive clinical evidence to support using specific probiotic strains for specific health purposes is generally lacking. Nevertheless, there is preliminary evidence for several uses of probiotics, and more studies are under way. In particular, a recent review of the scientific evidence on the effectiveness of probiotics in acute infectious diarrhea concluded that there was evidence that probiotics may shorten the duration of diarrhea and reduce stool frequency but that more research was needed to establish exactly which probiotics should be used for which groups of people” http://nccam.nih.gov/health/probiotics/introduction.htm. “If you’re healthy and are not planning to take antibiotics, go into the hospital, or maybe take a trip out of the country, there is no benefit from taking probiotics,” says microbiologist Lynne McFarland of the Veterans Administration Puget Sound Health Care System in Seattle, Washington” http://www.cspinet.org/new/pdf/nah_probiotics.pdf.

Web sites that might be of interest to the reader: http://www.cspinet.org/new/pdf/nah_probiotics.pdf provides the lowdown on Stonyfield Farm Yogurt, DanActive Drink, Kashi Vive Cereal, Culturelle, Align, Multibionta, and Florastor.        The J Pediatr Gastroenterol Nutr, Vol. 43, No. 4, October 2006, includes a table (3) that summarizes the quality of evidence for the use of probiotics in different diseases. For example, efficacy possible for irritable bowel syndrome and no efficacy supported for use of chronic stomach inflammation and ulcers caused by Helicobacter pylori bacterium or Crohn’s disease. “Clinical Efficacy of Probiotics: Review of the Evidence With Focus on Children” at this site: http://www.naspghan.org/user-assets/Documents/pdf/PositionPapers/probiotics.pdf

Note: the TV ad for Activia has changed from “clinically proven to help naturally regulate your digestive system in two weeks” to Activia tastes good! It is the taste now because there is no scientific evidence to back earlier claims. Check: probiotics\Activia - Wikipedia, which discusses the litigation of Activia (Danone corp.) promotion ads.

In summary, “The marketing message of “improving overall immune health” deserves to be scrutinized whenever and wherever it appears.” http://www.healthnewsreview.org/review/the-healthy-skeptic-probiotics- could-help-in-cold-and-flu-season/