Supplements & functional ingredients
effective, that’s going to take some time.” Sanders has helped numerous food and supplement companies develop and communicate about probiotic products over the last 30 years, as well as authoring over 120 peer-reviewed publications on efficacy substantiation, microbiology and regulatory issues pertaining to probiotics. She says that the pre-clinical stage of trials can be particularly challenging.
“Researchers must ask themselves, ‘What are the traits I’m looking for in a probiotic that is going to express the right clinical endpoint in the person?’” she says. “They’re clever and take their best guess on what kinds of properties they think these microbes need to express. Then you move them into clinical trials. But you’re not necessarily right.” Sanders says negative depictions of probiotic research in the media aren’t helping the development of the field. “A study will come out showing that a trial showed no benefit expressed and the headline is: ‘Probiotics don’t work!’ But which probiotic? Which specific endpoint was tested?” she says. Invariably, the negative outcomes of probiotics are often overreported, undermining the huge potential these microbes have to alter and impact bodily processes in many positive ways.
“The reality is that the majority of clinical trials fail,” Sanders admits. “You go into a trial with a specific hypothesis and it’s a very specific endpoint that you’re making your best guess on. And a lot of times you’re wrong, you learn something from that trial and you have to go back. That’s the nature of research. If those negative trials weren’t published, I would say that the probiotic field is doing something wrong but the way it’s reported oftentimes in the popular press really penalises companies for trying to do the right thing.”
Are live microbes officially good for you?
Alongside her role as a consultant, Sanders is the executive science officer for the International Scientific Association for Probiotics and Prebiotics. For the past couple of years, they have been looking into whether there is sufficient evidence to develop a rationale that consuming live microbes should be a dietary recommendation. In other words, that live microbes – in the form of probiotics or fermented foods – are officially good for you.
“The whole probiotics field is very focused on specific strains for specific outcomes and we’re looking at this from a different point of view,” she explains. “If you look at aggregate information based on fermented foods that contain live microbes and probiotics, can we say in a very general sense, like they do for fibre, that there is a compelling totality
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of evidence that they’re good for you?” They haven’t reached any conclusions yet. “We’re looking at what the data says and if we
don’t have the evidence yet, what evidence is needed and how do we go about generating it?” Sanders explains. The work has attracted the interest of microbiota researchers, nutritionists, the fermented food industry and probiotic developers.
“The whole probiotics field is very focused on specific strains for specific outcomes and we’re looking at this from a different point of view.”
“Right now, there isn’t the data to say it’s necessarily good for you. The thinking is that it makes sense because we live in such a sanitised world and take antibiotics and many babies are born via C-Section. There are all these reasons why our microbiota isn’t where it should be,” she adds. For Sanders, the most important thing is not to talk about hypothesis as if it was fact. “You’ll see a lot of people marketing fermented foods and saying that live microbes are good for you,” she explains. “But oftentimes, those claims are overstated. They’re not harmful and I would never discourage someone from consuming fermented foods. In fact, I’m happy to encourage it. But when someone asks why, you have to say, there’s a lot of thinking that this is good for you, but so far, we don’t have real data.”
Like any scrupulous researcher or scientist, Sanders doesn’t do intuition. Instead, as far as probiotics are concerned, she is steadfastly committed to rigorously testing how microbes can impact and benefit the body. In the vast, endlessly intricate minefield of the microbiome, gut feelings just aren’t enough. ●
The negative results of probiotic clinical trials are often misreported.
90%
The efficacy rate of faecal microbial transplants for multiple recurrent CDI.
Dr Sanders 35
Mongkolchon Akesin/
Shutterstock.com
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