probiotics
Dr Carrie Ruxton is a freelance dietitian who writes regularly for
academic and media publications. A contributor to TV and radio, Carrie
works on a wide range of projects relating to product development,
by Carrie Ruxton PhD, RD claims, PR and research. Her specialist areas are child nutrition, obesity
Freelance Dietitian
and functional foods. www.nutrition-communications.com
Probiotics and health: an update
Now widely available in the UK, probiotics are products which contain live bacteria. Following consumption,
the bacteria bypass the hostile conditions of the upper gastro-intestinal tract to take up residence in the colon,
where they modulate gut function. The most common probiotic species, i.e. Lactobacillus and Bifidobacterium,
are well researched and have been associated with benefits to gut health, immune function, infection risk,
cancer risk, vaginal health and blood glucose control.
Probiotics are believed to work by with chronic constipation to receive The authors concluded that probiotic
altering the colonic environment to Lactobacilli or a placebo for four weeks supplementation may be helpful during
inhibit the establishment of pathogenic (5). It was found that consumption of peak periods of cold/flu infection.
bacteria, by producing short-chain fatty probiotics significantly improved consti-
acids which have metabolic effects, pation from week two of the interven- Claims
and by interacting in a positive way tion. European regulations prohibit the
with the host’s immune system (7). The use of health claims on foods unless
efficacy of probiotic products depends Benefits to immune function they have been assessed as evidence-
upon sufficient bacteria being present Probiotics may be helpful in main- based. Many hundreds of claims are
and/or the application of enteric coat- taining a normal immune function now being evaluated by the European
ing to protect the bacteria from the and managing allergic conditions. Food Safety Authority (EFSA). Dietitians
extremes of pH found in the gut. This makes sense when one consid- may be aware that EFSA has yet to
ers that the gut-associated lymphoid issue approval for any probiotic-related
Benefits to the gut system (GALT) represents a major line of claims. In October, most of the 181
Much research has focused on the defence against pathogenic bacteria submitted dossiers were rejected, not
effects of probiotics on the gut. This and allergens. Probiotic bacteria assist because of poor science, but due
includes conditions such as diarrhoea, GALT by firstly repelling exogenous bac- to insufficient characterisation of the
constipation, bloating and irritable bow- teria and, secondly, by helping to main- bacterial strains used in the clinical tri-
el syndrome. A study of 466 children tain the integrity of the barrier between als. Industry has been asked to provide
found that probiotics significantly re- the gut and the systemic circulation (7). further details on strains in order for
duced antibiotic-associated diarrhoea Cases of hayfever and allergic rhinitis decisions on claims to be made.
compared with a placebo group (3). have doubled since the 1970s and now
This was confirmed by a meta-analysis affect 15 to 35 percent of teenagers Conclusions
of six randomised controlled trials (RCT) and adults in the UK. Probiotics appear Probiotics are well-established
which revealed that the risk of antibiot- to aid symptoms as shown by a blind in- functional ingredients supported by
ic-associated diarrhoea reduced from tervention in 80 subjects with rhinitis who a considerable evidence base. The
28 percent to 12 percent when probiot- were given a daily measure of ferment- new claims regime needs time to
ics were used (9). A Cochrane review ed milk with or without added Lacto- unfold before approved claims can
also confirmed that probiotics help bacilli (10). After 30 days, the frequency be communicated to the public. In
prevent infectious diarrhoea (1). and discomfort of nasal symptoms de- the meantime, dietitians can access a
Irritable bowel syndrome (IBS) is a creased significantly in the Lactobacilli wide range of published reviews and
condition that affects six million people group, but not in the placebo group. meta-analyses.
in Britain, causing diarrhoea and/ Probiotics in early infanthood appear
or constipation. Emerging research to reduce the long-term risks of allergies The author declares no conflicts of interest in relation to
suggests a benefit for probiotics. In a and infections. One study found that a
this article.
randomised placebo-controlled trial Lactobacillus probiotic used from birth
References
1 Allen SJ et al (2004). Probiotics for treating infectious diarrhoea.
of 50 adults with IBS, the intervention lowered the incidence of childhood Cochrane Database Systematic Reviews 2: CD003048
group was given a mix of Lactobacilli eczema. While 46 percent of babies in
2 Di Stefano M et al (2004). Probiotics and functional abdominal
bloating. Journal of Clinical Gastroenterology 38, S102-3
and Bifidobacteria (8). After 14 days, the placebo group developed eczema 3 Erdeve O et al (2004). The probiotic effect of Saccharomyces bou-
reported abdominal pain decreased by the age of four, the figure was 26
lardii in a pediatric age group. Journal of Tropical Pediatrics 50, 234-6
4 Kalliomaki M et al (2003). Probiotics and prevention of atopic
by 50 percent in the probiotics group, percent in the group receiving probiot-
disease: 4-year follow-up of a randomised placebo-controlled trial.
Lancet 361, 1869-71
but only by 10 percent in the placebo ics (4).
5 Koebnick C et al (2003). Probiotic beverage containing Lacto-
group. Probiotics have also been used A daily probiotic supplement has
bacillus casei Shirota improves gastrointestinal symptoms in patients
with chronic constipation. Canadian Journal of Gastroenterology
successfully to treat abdominal bloat- been shown to alleviate symptoms 17, 655-9
ing, possibly because they encourage of cold and flu (6). Children (n=112)
6 Leyer G et al. (2009) Probiotic effects on cold and influenza-like
symptom incidence and duration in children. Pediatrics 124, e172-9
the growth of non-gas producing bac- took two probiotic supplements, or a
7 Oelschlaeger TA et al. (2009). Mechanisms of probiotic actions: a
teria in the colon (2). placebo daily for six months. Follow-ups
review. International Journal of Medical Microbiology 300, 57-62
8 Saggioro A (2004). Probiotics in the treatment of irritable bowel
Constipation affects both children revealed a significantly lower incidence
syndrome. Journal of Clinical Gastroenterology 38, S104-6
9 Szajewska H et al (2006). Probiotics in the prevention of antibiotic-
and the elderly. Probiotics may offer an of cold and flu symptoms; fever re- associated diarrhea in children: A meta-analysis of randomized
alternative to the prescription of laxa- duced by 73 percent, coughing by 62
controlled trials. The Journal of Pediatrics 149, 367-367
10 Wang MF et al (2004). Treatment of perennial allergic rhinitis with
tives. A study randomised 70 patients percent and runny noses by 59 percent. lactic acid bacteria. Pediatric Allergy and Immunology 15, 152-8
8 NHDmag.com Mar '10 - issue 52
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