Everything about Probiotic totally explained
Probiotics are
dietary supplements containing potentially beneficial
bacteria or
yeasts. 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’.
Lactic acid bacteria (LAB) are the most common type of
microbes used. LAB have been used in the food industry for many years, because they're able to convert
sugars (including
lactose) and other
carbohydrates into
lactic acid. This not only provides the characteristic
sour taste of
fermented dairy foods such as
yogurt, but also by lowering the
pH may create fewer opportunities for spoilage organisms to grow, hence creating possible health benefits on preventing
gastrointestinal infections.. Strains of the genera
Lactobacillus and
Bifidobacterium, are the most widely used probiotic bacteria.
Probiotic bacterial cultures are intended to assist the body's naturally occurring
gut flora, an
ecology of
microbes, to re-establish themselves. They are sometimes recommended by doctors, and, more frequently, by
nutritionists, after a course of
antibiotics, or as part of the treatment for gut related
candidiasis. Claims are made that probiotics strengthen the
immune system to combat
allergies, excessive
alcohol intake,
stress, exposure to
toxic substances, and other diseases. In these cases, the bacteria that work well with our bodies (see
symbiosis) may decrease in number, an event which allows harmful
competitors to thrive, to the detriment of our health.
Maintenance of a healthy gut flora is, however, dependent on many factors, especially the quality of food intake. Including a significant proportion of
prebiotic foods in the diet has been demonstrated to support a healthy gut flora and may be another means of achieving the desirable health benefits promised by probiotics.
History of probiotics
Probiotics, which means "for life", have been used for centuries as natural components in health-promoting foods. 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. Metchnikoff, at that time a professor at the
Pasteur Institute in
Paris, produced the notion that the ageing 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.
Henry Tissier, also from the Pasteur Institute, was the first to isolate a
Bifidobacterium. He isolated the bacterium from a
breast-fed infant and named it Bacillus bifidus communis. This bacterium was later renamed
Bifidobacterium bifidum. Tissier showed that bifidobacteria are predominant in the gut flora of breast-fed babies, and he recommended administration of bifidobacteria to infants suffering from
diarrhea. The mechanism claimed was that bifidobacteria would displace the proteolytic bacteria that cause the disease.
German professor Alfred Nissle, in
1917 isolated a strain of
Escherichia coli from the
feces of a
First World War soldier who didn't develop
enterocolitis during a severe outbreak of shigellosis. In those days,
antibiotics were not yet discovered, and Nissle used the strain with considerable success in acute cases of infectious intestinal diseases (
salmonellosis and
shigellosis).
Escherichia coli Nissle 1917 is still in use and is one of the few examples of a non-LAB probiotic.
In
1920 Rettger demonstrated that Metchnikoff’s “Bulgarian Bacillus”, later called
Lactobacillus bulgaricus, couldn't live in the human intestine, 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
US. 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. 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”. Fuller’s definition emphasizes the requirement of viability for probiotics and introduces the aspect of a beneficial effect on the host.
In the 1960s the
dairy industry began to promote fermented milk products containing
Lactobacillus acidophilus. In subsequent decades other
[Lactobacillus] species have been introduced including
Lactobacillus rhamnosus,
Lactobacillus casei, and
Lactobacillus johnsonii, because they're intestinal species with beneficial properties.
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 faeces disappear within days when supplementation ceases.
While the oral use of probiotics is considered safe and even recommended by
World Health Organization under specific guidelines
(External Link
), in some specific situations (such as critically ill patients) they could be potentially harmful. In one therapeutic clinical trial, a probiotic cocktail have been shown to increase the death rates of patients with acute pancreatitis, but was given through tube feeding directly in the intestine instead of the usual oral way. Some other therapeutic use of probiotics have been shown to be beneficial for other types of patients
(External Link),
(External Link).
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.
All effects can only be attributed to the strain(s) tested, not to the species, nor to the whole group of LAB (or other probiotics).
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'd have otherwise. Animal studies have demonstrated that some LAB can protect against colon cancer in rodents, though human data is limited and conflicting. Most human trials have found that the strains tested may exert anti-
carcinogenic effects by decreasing the activity of an enzyme called β-glucuronidase
Clinical trials have demonstrated that probiotics may decrease the incidence of respiratory tract infections and
dental caries in children. LAB foods and supplements have been shown to be effective 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.
Antibiotic-associated diarrhea
A meta-analysis suggested probiotics may reduce antibiotic-associated diarrhea. A subsequent randomized controlled trial also found benefit in elderly patients. and decrease the risk of
atopic eczema in children.
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.
Prevents 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.
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. Another probiotic bacterium, Lactobacillus plantarum 299V, was also found to be effective in reducing IBS symptoms.
Additionally, a probiotic formulation, VSL3, was found to be effective in treating ulcerative colitis
Bifidobacterium animalis DN-173 010 may help.
Synbiotics
It is also possible to increase and maintain a healthy bacterial gut flora by increasing the amounts of
prebiotics in the diet such as
inulin, raw
oats, and unrefined
wheat.
As probiotics are mainly active in the small intestine and prebiotics are only effective in the large intestine, the combination of the two may give a synergistic effect. Appropriate combinations of pre- and probiotics are synbiotics.
Synbiotics have also been defined as metabolites produced by
ecoorgan or by synergistic action of prebiotics and probiotics for example short chain fatty acids, other fatty acids, amino acids, peptides, polyamines, carbohydrates, vitamins, numerous antioxidants and phytosterols, growth factors, coagulation factors, various signal molecules such as cytokine-like bacteriokines.
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.
| Proven probiotic strains. Source: |
Bifidobacterium animalis DN 173 010
| Activia |
Danone |
Stabilises intestinal passage |
| Bifidobacterium animalis subsp. lactis BB-12 |
|
Chr. Hansen |
Immune stimulation, improves phagocytic activity, alleviates atopic eczema, prevents diarrhoea in children and traveller's diarrhoea |
| Bifidobacterium breve Yakult |
Bifiene |
Yakult |
|
| Bifidobacterium infantis 35624 |
Align |
Procter & Gamble |
Irritable Bowel Syndrome (IBS) |
| Bifidobacterium lactis HN019 (DR10) |
Howaru Bifido |
Danisco |
Immune stimulation |
| Bifidobacterium longum BB536 |
|
Morinaga Milk Industry |
positive effects against allergies |
| Escherichia coli Nissle 1917 |
Mutaflor |
Ardeypharm |
Immune stimulation |
| Lactobacillus acidophilus LA-5 |
|
Chr. Hansen |
|
| Lactobacillus acidophilus NCFM |
|
Danisco |
reduces symptoms of lactose intolerance, prevents bacterial overgrowth in small intestine |
| Lactobacillus casei DN114-001 (Lactobacillus casei Immunitas(s)/Defensis) |
Actimel/DanActive |
Danone |
Diarrhea and allergy reduction, immune stimulation, reduction of duration of winter infections, H. pylori eradication, antibiotic associated diarrhea & C. difficile infections (see Actimel) |
| Lactobacillus casei CRL431 |
|
Chr. Hansen |
|
| Lactobacillus casei F19 |
Cultura |
Arla Foods |
Improves digestive health, immune stimulation, reduces antibiotic-associated diarrhoea, induces satiety, metabolizes body fat, reduces weight gain |
| Lactobacillus casei Shirota |
Yakult |
Yakult |
Maintenance of gut flora, immune modulation, bowel habits and constipation (see Yakult) |
| Lactobacillus johnsonii La1 (= Lactobacillus LC1) |
|
Nestlé |
Immune stimulation, active against Helicobacter pylori |
| Lactococcus lactis L1A |
|
Norrmejerier |
Immune stimulation, improves digestive health, reduces antibiotic-associated diarrhoea |
| Lactobacillus plantarum 299V |
GoodBelly ProViva |
NextFoods Probi |
IBS, used post-operative |
| Lactobacillus reuteri ATTC 55730 (Lactobacillus reuteri SD2112) |
|
BioGaia Biologics |
Immune stimulation, against diarrhoea |
| Lactobacillus rhamnosus ATCC 53013 (discovered by Gorbach & Goldin(=LGG)) |
Vifit and others |
Valio |
Immune stimulation, alleviates atopic eczema, prevents diarrhoea in children and many other types of diarrhoea |
| Lactobacillus rhamnosus LB21 |
Verum |
Norrmejerier |
Immune stimulation, improves digestive health, reduces antibiotic-associated diarrhoea |
| Lactobacillus salivarius UCC118 |
|
|
positive effects with intestinal ulcers and inflammation |
| Saccharomyces cerevisiae (boulardii) lyo |
DiarSafe and others |
Wren Laboratories and others |
against antibiotic-associated diarrhoea and Clostridium difficile infections; to treat acute diarrhoea in adults & children... |
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 |
tested as mixture:
mixture of 8 strains of Streptococcus thermophilus & four Lactobacillus spp & three Bifidobacterium spp strains |
VSL#3 |
Sigma-Tau Pharmaceuticals, Inc. |
|
tested as mixture:
Lactobacillus acidophilus CUL60 & Bifidobacterium bifidum CUL 20 |
|
|
reduction of Cl. difficile in faeces |
tested as mixture:
Lactobacillus helveticus R0052 & Lactobacillus rhamnosus R0011 |
A'Biotica and others |
Institut Rosell |
prevents diarrhoea in children, prevents upset stomachs for patients on antibiotics., active against Helicobacter pylori |
Some commonly used bacteria in products, but without probiotic effect (yoghurt bacteria):
Some other bacteria mentioned in probiotic products:
Bacillus coagulans
Lactobacillus bifidus - became new genus Bifidobacterium
Some fermented products containing similar lactic acid bacteria include:
Pickled vegetables, ,
Fermented bean paste such as tempeh, miso and doenjang
Kefir
Kimchi
Kombucha
Pao cai
Sauerkraut
Soy sauce
Tempeh
Zha cai
Research
Research about probiotics shows both benefits and harm.
A 2007 study at University College Cork in Ireland showed that a diet including milk fermented with Lactobacillus bacteria prevented Salmonella infection in pigs.
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 diarrhoea and C difficile-associated diarrhoea.
In a double-blind, placebo-controlled therapeutic study on the effects of a probiotic cocktail on pancreatitis at University Medical Center Utrecht (UMC), 24 out of 296 patients died between 2004 and 2007, with more deaths among those receiving the probiotic coktail directly in the intestine. According to the spokesman of UMC, it's likely that some of these deaths wouldn't have occurred without the probiotics, although other therapeutic trials conducted on probiotics were more positively conlusive (External Link).
Further Information
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