Probiotics Update 2006

Probiotics are one of the hottest topics in nutrition research today. Almost daily, it seems new benefits of these good bugs are being identified. This report will examine some of the recently published research on the benefits of probiotics, the good bacteria that live in your digestive system. In addition to probiotics, prebiotics–the nutrients that feed the bacteria–have also been researched and are included in this update. Inflammatory Bowel Disease (IBD) IBD includes Crohn’s disease and irritable bowel syndrome. In a recent review article, Ewaschuk and Dieleman examined over 100 clinical trials to see what benefits prebiotics and probiotics may have on these bowel diseases (1), if any. Probiotics were most effective in initiating the remission of both irritable bowel syndrome and Crohn’s disease, but were less effective in sustaining the remission. In layman’s terms, when subjects started using the probiotics, the symptoms of pain and inflammation in the bowel were reduced.Probiotics were less effective in sustaining the changes. That makes sense–long-term treatment of IBD requires other changes in lifestyle to keep the disease in remission, but probiotics can help begin the healing process. Prebiotics were also effective in starting the healing process. Again, that makes sense–the bacteria need a steady supply of the right foods in order to grow, primarily fructooligosaccharides (FOS) and other oligosaccharides. These sugars can also be found in fruits–another reason to eat an apple a day and other fruits as well. Atopic Dermatitis Dermatitis seems to be increasing, especially in infants. To examine what effect probiotics may have on atopic dermatitis, researchers examined the effects of probiotics in children 6-18 months old in a double-blind, placebo-controlled study (2). After eight weeks of using the probiotics, children had less severe dermatitis as assessed by independent evaluators using the Severity Scoring of Atopic Dermatitis (SCORAD) index when compared to controls. Even better, the results were sustained eight weeks after the end of the study, which implies that the benefits continued after the treatment was completed.But another question arises: is it the prebiotic or the probiotic that’s important for reducing atopic dermatitis and boosting the immune system of infants? The problem may be that the bacteria are in the infants’ systems but not receiving the proper nutrients from breast milk or formula. In another study, researchers provided a prebiotic mixture of galacto- and long-chain fructo-oligosaccharides to infants (3). The objective was to see if there were differences between the experimental group and controls for development of dermatitis. In fact, infants fed only the prebiotics had less dermatitis than control infants. This study implies that the colonies of bacteria may be present in the infants but are not being provided with the right nutrients. By providing the correct nutrients, the bacterial flora grew to help immune function and reduce the incidence of dermatitis. These results may have implications for adults as well. Most adults have been exposed to antibiotics at some point in their lives, which can diminish the microflora. Simply providing the proper nutrients may help the colony grow to improve colon health. What should you do? The research on probiotics continues, especially in determining how these bacteria benefit our health, but that doesn’t mean you must wait until all the research is complete before you act. While various strains of bacteria have been used in the aforementioned studies, most are found in supplements currently available. Here are some tips:• Use a probiotic product with several strains of bacteria including Lactobacillus rhamnosus, Lactobacillus acidophilus, Lactobacillus plantarum, and Bifidobacterium breve. These were the most commonly used probiotics in a majority of the studies. • Eat yogurt and other products that include live cultures of probiotics. The more varieties of bacteria you eat, the better. • Be sure to use a product that also contains prebiotics such as FOS to provide nutrients for the bacteria to grow. It also helps to eat more fruit of all types. • Prebiotics and probiotics can be used daily. This is not like using a medication–they belong in your gut and should be eaten every day. As with any change in nutrition, you may notice a difference in bowel habits; that’s typical but shouldn’t last. Good digestive health depends on making sure the good bacteria are healthy and well fed. The benefits to your body and your family’s health are tremendous–there’s no downside. Reference: 1. Ewaschuk JB and Dieleman LA. Probiotics and prebiotics in chronic inflammatory bowel diseases. World J Gastroenterol 2006; 12(37): 5941-5950. 2. Weston, S et al. Effects of probiotics on atopic dermatitis: a randomized controlled trial. Arch Dis Child 2005;90:892–897. 3. Moro G, et al. A mixture of prebiotic oligosaccharides reduces the incidence of atopic dermatitis during the first six months of age. Arch Dis Child. 2006; 91(10):814-9.