Implications Of The Recommendations
The marketplace has many products carrying the label ‘probiotic’, but too often they do not meet minimum criteria, such as defined contents, appropriate viable count at end of shelf-life and suitable evidence for health benefit. The panel recommends that the term probiotic be used only on products that deliver live microorganisms with a suitable viable count of well-defined strains with a reasonable expectation of delivering benefits for the wellbeing of the host .
Table 1 Categories of live microorganisms for human use as defined by the expert panel
In addition, there is a need for clear communication to consumers and health-care providers on how to differentiate probiotic products. Unfortunately, this goal is difficult to achieve because of regulatory agency restrictions on what can be communicated on product labels. Restricting use of the term probiotic on foods, as has occurred in some countries in the European Union, is unwarranted when minimum criteria are met. A product-labelling approach that communicates the information known about the probiotic being sold would be more useful for consumers and health-care providers.
How To Determine Whether Probiotics Should Be Refrigerated
Generally, most supplement manufacturers say on the label whether probiotics are shelf stable or require refrigeration.
If there are no specific storage instructions listed on the label, your probiotic is likely shelf stable and doesnt need refrigerating.
Another way to determine whether you should refrigerate your probiotics is to consider how they were stored upon purchase.
For example, probiotics that require refrigeration are typically found in the refrigerated section of the store or pharmacy. Alternatively, if you buy a supplement online and its shipped in an ice pack or insulated thermal bag, its likely best to refrigerate it once it arrives.
Most probiotic supplements provide storage instructions on the label. Probiotics that are stored in the refrigerated section of the store or shipped with an ice pack may also require refrigeration.
Importance Of Microorganisms For Your Gut
The complex community of microorganisms in your gut is called the gut flora, gut microbiota, or gut microbiome .
The gut microbiota includes bacteria, viruses, fungi, archaea, and helminths with bacteria comprising the vast majority. Your gut is home to a complex eco-system of 300500 bacterial species .
Most of the gut flora is found in your colon, or large intestine, which is the last part of your digestive tract.
Surprisingly, the metabolic activities of your gut flora resemble those of an organ. For this reason, some scientists refer to the gut flora as the forgotten organ .
Your gut flora performs many important health functions. It manufactures vitamins, including vitamin K and some of the B vitamins .
It also turns fibers into short-chain fats like butyrate, propionate, and acetate, which feed your gut wall and perform many metabolic functions (
Probiotics and prebiotic fibers can help correct this balance, ensuring that your forgotten organ is functioning optimally .
Your gut flora consists of hundreds of types of microorganisms. These microorganisms perform numerous important bodily functions.
Probiotics are widely researched for their effects on digestive health .
Evidence suggests that probiotic supplements can help cure antibiotic-associated diarrhea .
When people take antibiotics, especially for long periods of time, they often experience diarrhea even long after the infection has been eradicated.
These unknowns include :
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Scientific Guidelines For Testing
First, probiotics must be alive when administered. One of the concerns throughout the scientific literature resides in the viability and reproducibility on a large scale of observed results for specific studies, as well as the viability and stability during use and storage, and finally the ability to survive in stomach acids and then in the intestinal ecosystem.
Second, probiotics must have undergone controlled evaluation to document health benefits in the target host. Only products that contain live organisms shown in reproducible human studies to confer a health benefit may claim to be probiotic. The correct definition of health benefit, backed with solid scientific evidence, is a strong element for the proper identification and assessment of the effect of a probiotic. This aspect is a challenge for scientific and industrial investigations because several difficulties arise, such as variability in the site for probiotic use and mode of application.
Third, the probiotic candidate must be a taxonomically defined microbe or combination of microbes ” rel=”nofollow”> strain level). It is commonly admitted that most effects of probiotics are strain-specific and cannot be extended to other probiotics of the same genus or species. This calls for a precise identification of the strain, i.e. genotypic and phenotypic characterization of the tested microorganism.
May Improve Irritable Bowel Syndrome Symptoms
With irritable bowel syndrome , people often experience abdominal pain, bloating, gas and bouts of diarrhea and constipation. A review of 15 studies published in World Journal of Gastroenterology found consuming probiotics to be associated with a reduction in abdominal pain and other symptom severityDidari T, Mozaffari S, Nikfar S, Abdollahi M. Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis. World J Gastroenterol. 2015 21:30723084. . Specifically, a review in Gastroenterology and Hepatology found that, there is growing evidence that B. infantis is becoming the frontrunner for treatment of IBSAragon G, Graham DB, Borum M, Doman DB. Probiotic therapy for irritable bowel syndrome. Gastroenterol Hepatol . 2010 6:39-44. .
What Are Probiotic Microorganisms
Probiotics are live microorganisms that can be formulated into many different types of products, including foods, drugs, and dietary supplements.
Species of Lactobacillus and Bifidobacterium are most commonly used as probiotics, but the yeast Saccharomyces cerevisiae and Bacillus species are also used as probiotics. Lactic acid bacteria , including species of Lactobacillus, which have been used for preservation of food by fermentation for thousands of years, can serve a dual function by acting as agents of food fermentation and, in addition, potentially imparting beneficial effects.
However, the term probiotic should be reserved for live microorganisms that have been shown in controlled human studies to accomplish their beneficial action. Fermentation of food provides characteristic taste profiles and lowers the pH, which can help in prevention of spoilage microorganisms and potential pathogens.
When To See A Doctor
You may be considering a probiotic supplement if youre experiencing gut issues. But its a good idea to schedule an appointment with a healthcare professional first, because your symptoms could be related to a condition that requires a specific treatment or medication.
Additionally, taking a probiotic can do more harm than good in some individuals, so its important to discuss options with a trusted expert before trying anything new (
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How Might Probiotics Work
Probiotics may have a variety of effects in the body, and different probiotics may act in different ways.
- Help your body maintain a healthy community of microorganisms or help your bodyâs community of microorganisms return to a healthy condition after being disturbed
- Produce substances that have desirable effects
- Influence your bodyâs immune response.
Health Benefits Of Consuming Prebiotics
A diet rich in prebiotics promotes digestive system health by stimulating the growth of beneficial microorganisms.
The fermentation of prebiotics produces short-chain fatty acids , including acetate, propionate, and butyrate. They play important roles in gut and metabolic health.
For example, SCFAs provide energy for colonocytes and are involved in mucus production, regulation of intestinal pH, and more.
In addition to gut health, prebiotics influence immune function, blood sugar regulation, appetite, and energy expenditure (
Studies suggest that when taken in specific amounts, prebiotics may improve health in various ways.
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Medical Definition Of Probiotics
- Medical Editor: Charles Patrick Davis, MD, PhD
Reviewed on 3/29/2021
Probiotics: live microorganisms that are similar to beneficial microorganisms found in the human gut that are taken as dietary supplements or found in foods. Most probiotics are bacteria similar to those naturally found in the intestine. Common examples are Lactobacillusand Bifidobacterium. They may occur naturally in yogurts and certain fermented foods. Probiotics have been used as treatment for various gastrointestinalconditions including irritable bowel syndromeand traveler’s diarrhea.
These Live Microorganisms Can Have Health Benefits
Probiotics are live microorganisms that may have health benefits when consumed in adequate amounts. Maintaining an adequate level of probiotics in your body has been shown to support immune function, aid digestive health and even boost your metabolism. Two of the most widely recognized probiotics for supporting digestive and immune health are bifidobacteria, most commonly found in the large intestine, and lactobacilli, which reside in the small intestine.
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How Are Probiotics Regulated In The United States
Government regulation of probiotics in the United States is complex. Depending on a probiotic productâs intended use, the U.S. Food and Drug Administration might regulate it as a dietary supplement, a food ingredient, or a drug.
Many probiotics are sold as dietary supplements, which donât require FDA approval before they are marketed. Dietary supplement labels may make claims about how the product affects the structure or function of the body without FDA approval, but they arenât allowed to make health claims, such as saying the supplement lowers your risk of getting a disease, without the FDAâs consent.
If a probiotic is going to be marketed as a drug for treatment of a disease or disorder, it has to meet stricter requirements. It must be proven safe and effective for its intended use through clinical trials and be approved by the FDA before it can be sold.
What Are The Benefits Of Taking Probiotics
Probiotic supplements have been shown to benefit health in a number of ways.
However, some of the purported benefits of probiotics arent supported by research, so its important to always consult a healthcare professional before taking a probiotic supplement, especially if youre hoping to improve symptoms related to a health condition.
Are There Any Storage Instructions For Probiotics
Several probiotic strains are very fragile and need to be protected from heat, oxygen, light and humidity. The probiotics might start to break down or die if they are exposed to these elements. Because of this, you may need to refrigerate your probiotics or store it in a particular place. Refrigerating certain probiotic strains ensures that theyre still viable when you go to use them and will still provide the full benefit of the probiotic. Always read the labels on any probiotic product you purchase to make sure you store it correctly and use it within the expiration date.
May Improve Symptoms Of Certain Gastrointestinal Diseases
Some of the most well-studied uses of probiotic supplements relate to the treatment of gastrointestinal diseases like IBS and IBD.
In one review of 11 studies, 7 of the studies reported significant improvements in symptoms like bloating and abdominal pain in people with IBS who took probiotic supplements, compared with a placebo. The remaining four studies didnt find significant improvements.
The review also found that multi-strain probiotics used for at least 8 weeks were the most effective for improving IBS symptoms (
If youre interested in taking a probiotic supplement, its important to first determine whether a probiotic supplement is necessary for your specific health needs.
If youre instructed to take a probiotic, please consider the following:
- Probiotic strains: Probiotics are not one-size-fits-all remedies, and certain probiotic strains are much more effective for certain medical conditions and symptoms than others. Look for supplements with specific strains based on your needs.
- Intended use: The effectiveness of probiotic supplements is not only strain-specific but also disease-specific, meaning the correct strain and dose must be appropriate for the condition or symptom intended to be treated (
While some people, including those with IBS and certain types of IBD, may benefit from specific strains of probiotics, in general, most healthy people who follow a nutritious diet and healthy lifestyle do not need to take probiotic supplements.
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The Role Of Strain Dose And Product Format In Probiotic Function
Strains of the same probiotic species can be different, which has been demonstrated both in vitro and in animals, although similar data in humans are rare. Thus, clinical results from one study are applicable only to the strain or strains being evaluated in that study. Given this, however, different strains may have the same effects, and similar immune effects have been documented for different strains . As research continues, certain species- or genus-specific attributes are likely to be found. Identification of genes or gene systems may make it feasible to predict in vivo function, and documentation of expression of these genes may become adequate substantiation for in vivo function. Functional genomics may greatly aid this research, which is progressing at a rapid pace . Currently, however, research specific to the strain or strain combinations should be used to substantiate claims of physiological benefits. Furthermore, the genus, species, and strain designations should be specified for all probiotic strains in a product.
Dose levels of probiotics should be based on levels found to be efficacious in human studies. One dose level cannot be assumed to be effective for all strains. For example, the efficacy of Bifidobacterium infantis 35264 has been documented at 10 8 cfu/day , whereas the recommended dose of VSL#3 is cfu/day, a 4-log cycle difference .
How Do Probiotics Work
The main job of probiotics, or good bacteria, is to maintain a healthy balance in your body. Think of it as keeping your body in neutral. When you are sick, bad bacteria enters your body and increases in number. This knocks your body out of balance. Good bacteria works to fight off the bad bacteria and restore the balance within your body, making you feel better.
Good bacteria keeps you healthy by supporting your immune function and controlling inflammation. Certain types of good bacteria can also:
- Help your body digest food.
- Keep bad bacteria from getting out of control and making you sick.
- Create vitamins.
- Help support the cells that line your gut to prevent bad bacteria that you may have consumed from entering your blood.
- Breakdown and absorb medications.
This balancing act is naturally happening in your body all of the time. You dont actually need to take probiotic supplements to make it happen. Good bacteria is just a natural part of your body. Eating a well-balanced diet rich in fiber every day helps to keep the number of good bacteria at proper levels.
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Revisiting The Term ‘probiotic’
Figure 1: Objectives of stakeholders in the probiotic field.
These objectives are compatible, so there is no apparent reason for obstruction of probiotic product development and marketing. Importantly, all stakeholders must work together performing their respective duties so that society benefits from the scientific advances in the field of probiotic research.
Are there core benefits that can be ascribed to the general category of probiotics, and, if so, should the probiotic classification include live microbes identified to the species level, which can be reasonably expected to impart general benefits?
Probiotics History: Background Information
The root of the word probiotic comes from the Greek word pro, meaning promoting and biotic, meaning life. The name probiotic is said to mean for life: pro + bios = for life. The beginning of the probiotics concept is credited to Nobel Prize recipient Eli Metchnikoff. In the year 1907, Eli put forward that the dependence of the intestinal microbes on the food makes it possible to adopt measures to modify the flora in our bodies and to replace the harmful microbes by useful microbes. Probiotics in Spanish are called probióticos
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How Should People Take Probiotics
The requirements for a microbe to be considered a probiotic are that the microbe must be alive when administered, it must be documented to have a health benefit, and it must be administered at levels to confer a health benefit. A rule of thumb often cited is to take at least a billion colony-forming units daily.
These are live microorganisms that will not provide the promised benefits if they don’t remain alive. The manufacturer and consumer must pay close attention to the conditions of storage at which the particular microorganism will survive and the end of their shelf life. The potency will indicate the number of viable bacteria per dose, and the purity has to do with the presence of contaminating or ineffective bacteria.
The other thing to remember is that these microorganisms are not all created equally. In fact, the genus, strain, and species all need to be the same for the results found in the study to be the results that one hopes to achieve when taking it. For example, with the strain Lactobacillus rhamnosus GG, the genus is Lactobacillus, the species is rhamnosus, and the strain is GG. If any one of those is different in your supplement, you may not attain the same results.
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What Are Prebiotics And Synbiotics
The prebiotic comes before and helps the probiotic, and then the two can combine to have a synergistic effect, known as synbiotics. A prebiotic is actually a nondigestible carbohydrate that acts as food for the probiotics and bacteria in your gut. The definition of the effect of prebiotics is the selective stimulation of growth and/or activity of one or a limited number of the microbial genus/species in the gut microbiota that confer health benefits to the host. The health benefits have been suggested to include acting as a remedy for gastrointestinal complications such as enteritis, constipation, and irritable bowel disease prevention and treatment of various cancers decreasing allergic inflammation treatment of nonalcoholic fatty liver disease , and fight immune deficiency diseases. There has also been researched showing that the dietary intake of particular food products with a prebiotic effect has been shown, especially in adolescents, but also tentatively in postmenopausal women, to increase calcium absorption as well as bone calcium accretion and bone mineral density. The benefits for obesity and type 2 diabetes are growing as recent data, both from experimental models and from human studies, have shown particular food products with prebiotics have influences on energy homeostasis, satiety regulation, and body weight gain.
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