Your Smart Guide to Probiotics

Your Smart Guide to Probiotics
Your Smart Guide to Probiotics.

Probiotics can be found in countless consumer goods including dietary supplements, food and beverages, and even skin care products. Known as beneficial bacteria, probiotics increasingly appeal to those whose desire is to enjoy better health by optimizing their intestinal flora. In fact, in 2013 the global market for the probiotic industry was estimated at 32 billion dollars, a growing trend that is expected to climb to 52 billion dollars by 2022.

According to the World Health Organization (WHO), probiotics are defined as “live microorganisms which when administered in adequate amounts confer health benefits.” Most often, the use of probiotics is intended to promote or improve digestive symptoms. But with the discovery of how our complex gut flora plays a role in other health conditions, many have turned to probiotics in hopes of treating everything from allergies to autism.

To help you be an educated consumer, here are four smart facts to know about probiotics.

The Types of Bacteria Found in Probiotics Already Exist in Your Colon

Microorganisms outnumber our body cells 10:1 and the majority of these are found in the digestive system. In fact, there are literally trillions of bacteria living in your colon. Currently, science has identified over 400 different species of these bacteria.

While there is still much to learn, research has already dispelled the myth that all bacteria are harmful to the body.

Instead, now we know that bacteria help our bodies function properly. Some of these functions include helping digestion, fighting bad bacteria, and producing vitamins. We also know that bacteria are found naturally in the colon and are already at work to keep us healthy without the use of any additional probiotic products.

 

Probiotics Do Not Require FDA Approval

It may be surprising to know that the Food and Drug Administration does not have an official definition for probiotics and that approval is not needed before products are placed on the market. Instead, the FDA’s regulation for probiotics depends on the type of product being sold – either as a dietary supplement or as a food ingredient.

Probiotics are commonly sold as a dietary supplement as either a powder, pill, capsule, or liquid. In fact, there are currently over 100 commercially available probiotic supplements. Dietary supplements do not require FDA approval. They are allowed on the market as long as their advertising includes only how the supplement affects the structure or function of the body and refrains from making specific claims that the product reduces the risk of a disease. In addition, dietary supplements can make statements regarding their safety and effectiveness without first being tested by the FDA.

When a probiotic is considered a food ingredient, the FDA’s primary focus is whether the ingredient falls under the umbrella category of “GRAS” meaning it is “generally regarded as safe.” Since commercial probiotics are in fact the same or similar to the bacteria already living in your colon, most doctors agree that for healthy individuals they are generally safe to use.

However, for those who may have underlying conditions such as impaired immune systems, serious complications related to their use have occasionally been reported.

Regardless, the overwhelming majority of probiotics available in the US market have not been tested or approved by the FDA.

Probiotics Are Not One-Size-Fits-All

Probiotics are microorganisms thought to possibly be good for our health. These microorganisms are usually bacteria but can also include yeasts. The two most common groups of bacteria found in products are Bifidobacterium and Lactobacillus, but there are many other types of bacteria are also considered probiotics.

Bacteria are classified in groups with each group containing multiple species and each species containing multiple strains. This is important because each strain acts differently in the body and may be useful for different purposes. Researchers are still studying which probiotic strains should be used for which health or disease state.

Since probiotics are not standardized, different brands that appear to contain similar strains may actually vary significantly. Each product is truly unique and may or may not be useful for their intended purpose.

More Research Is Needed on Probiotics

Much research has already been devoted to probiotics, especially in the area of digestive health. While some studies have shown that probiotics may be useful as a supplement to medical treatment of digestive conditions, other research has been inconclusive.

One focus area of research has been whether probiotics are helpful in managing the symptoms associated with IBS (irritable bowel syndrome). Expert consensus from both the U.S. and Europe state that there is reasonable rationale for why probiotics may work in IBS. That being said, long term meta analysis data of many studies have not shown probiotics to fare better than placebo past 6 months. Keep in mind that these studies were reviews of smaller studies so there were a lot of variables which come into play.

Another area that has been studied has been whether probiotics can play a role in preventing diarrhea caused by antibiotic use or associated with infections, such as c-diff (a bacterial infection that causes severe diarrhea and occurs in those who have been hospitalized or who have taken strong doses of antibiotics for other infections). Since antibiotics are known to kill both good and bad bacteria, the hope has been that probiotics may replenish the beneficial bacteria lost when antibiotic treatment is necessary.

In fact, in an article published in the American Journal of Infection Control, it was reported that from 2006-2012, 96 percent of the 145 hospitals studied in the United States gave probiotics to patients in hopes of preventing these digestive complications. However, in their randomized double-blind study, researchers found that the probiotics given were no more effective than placebos in treating the diarrhea associated with these conditions.

Conversely, other studies have concluded that probiotic use can decrease the risk of antibiotic-associated diarrhea by 50-60 percent if co-administered with antibiotics – with the most effective strains found to be Saccharomyces boulardii (a yeast) and Lactobacillus rhamnosus GG. So again, more research is needed since the results of multiple studies have not yielded consistent or definitive results confirming the role probiotics can play in managing these conditions.

Probiotics have also been studied for their role in multiple other conditions based on our growing understanding of how an imbalance of good and bad bacteria in the body can be linked to overall health. Some of the conditions studied have included skin infections, mental illness, allergies and asthma, childhood stomach and respiratory infections, sleeping problems, fibromyalgia, joint stiffness, lactose intolerance, as well as any number of clinical scenarios involving the immune system and prevention of infection. These studies have all been very limited without any conclusive evidence supporting the use of probiotics.

Sources:

American College of Gastroenterology – Probiotics for the Treatment of Adult Gastrointestinal Disorders.

National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/probiotics/introduction.htm

Degnan FH. The US Food and Drug Administration and probiotics: regulatory categorization. Clin Infect Dis. 2008 Feb 1;46 Suppl 2:S133-6; discussion S144-51. doi: 10.1086/523324.

Yi SH, Jernigan JA, McDonald L C. Prevalence of probiotic use among inpatients: A descriptive study of 145 U.S. hospitals. American Journal of Infection. Published online: January 25, 2016. http://dx.doi.org/10.1016/j.ajic.2015.12.001

Sanders ME, Lenoir-Wijnkoop I, Salminen S, Merenstein DJ, Gibson GR, Petschow BW, Nieuwdorp M, Trancredi DJ, Cifelli CJ, Jacques P, Pot B. Probiotics and prebiotics: prospects for public health and nutritional recommendations. Ann N Y Acad Sci. 2014 Feb: 1309: 19-29. Doi: 10.1111/nyas.12377

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