Sifting through probiotic claims

Kathleen Goldhar tried for years to figure out what was causing her
young daughter to suffer from persistent, sometimes agonizing stomach pains.

Since age three, the now
seven-year-old girl had complained of intense cramps that would stick around
for a couple of nights, subside and then return days or weeks later, usually
when she ate.

With little insight from doctors,
at least one trip to the hospital with cramps that caused the little girl to
writhe in pain, and myriad tests producing no answers, the single mom took the
advice of a nutritional consultant who recommended probiotics.

Goldhar began adding the powdered
supplement to her daughter’s juice and within a couple of weeks noticed her
complaints diminished as the pain appeared to lessen.

“They seem to work,” she said from
Toronto. “It does seem to be a digestion issue and she seems to be able to sort
of handle her food better. Her stomach doesn’t hurt as much.”

Goldhar is one of a growing number
of people who have turned to the bacterial critters for a host of health
reasons, including candida, digestion, brain development, diarrhoea and
boosting the immune system.

Live organisms

Probiotics are live organisms,
usually helpful bacteria similar to those found in the human gut, which can
change or restore the intestinal flora. They are present in such foods as
sauerkraut, miso and fermented products, but can also be taken in pill or
powder form.

There are billions of bacteria in
the body — on skin, in the mouth, the intestines and other body parts — that
can maintain general health by raising resistance to harmful bacteria.

The World Health Organization
defines probiotics as “live micro-organisms, which when administered in
adequate amounts confer a health benefit on the host.”

The surge in popularity comes after
manufacturers homed in on the potential benefits and began adding them to
everything from yogurt, infant formula and juices to bread, chewing gum and
chocolate. They can even be found in some floor cleaners and aftershaves.

Marketers have claimed the
naturally occurring bacteria can shorten the duration of colds, prevent
diarrhoea, overcome allergies and even reduce the risk of certain cancers.

But health experts say the hoopla
over probiotics has overshadowed actual scientific proof that they improve
health, leading to confusion for consumers deluged with claims about products
containing the micro-organisms.

Gregor Reid, who specializes in the
study of probiotics, was on the panel that created the WHO’s definition of
probiotics and says many of the products claiming to contain them actually
don’t because they haven’t been proven in a human study to confer a specific
health benefit.

“The majority of products on the
market are not in fact probiotics,” said Reid, chair of human microbiology and
probiotics at the Lawson Health Research Institute in London, Ont.

“When you call something a
probiotic, there should be an expectation that it’s been clinically tested and
shown to have a benefit, and unfortunately many products don’t. So the first
step is getting companies to do the studies.”

The problem is that there are many
different strains of friendly bacteria that perform many different functions.
Most have not been proven to be effective in clinical trials.

Confusion

For consumers, it’s not clear on
food labels how much and what type of bacteria a product contains, making it
difficult to know if the probiotics are best suited for a particular health
ailment.

Only some companies, like yogurt
maker Dannon, list the specific bacteria that have been shown in trials to help
with certain health issues, like regularity and digestion. The company settled
a $35-million lawsuit last year with customers dissatisfied over health claims
it was making about some yogurt products, leading to more explicit labelling.

Some experts say that shouldn’t
scare off consumers from using probiotics for conditions where there is some
agreement on benefits, such as helping with some types of diarrhoea, bowel
regularity, colds and irritable bowel syndrome.

John Bienenstock, a professor of
pathology and molecular medicine at McMaster University in Hamilton, said
people have to look very carefully at a particular product and determine
exactly what it is.

“They have to look through the
literature carefully, recognizing there is this problem of a lack of
consistency of information and lack of consistency of products,” said Bienenstock,
who’s also director of the Brain Body Institute.

“From a consumer point of view,
it’s very important that when you go out and see what’s on the shelf, you know
what’s on the bottle and what it can do … There are health benefits and there
is hype.”

Regulatory agencies are trying to
rein in the multi-billion-dollar industry, which saw consumer spending on
probiotic supplements triple in the United States between 1994 and 2003.

Labelling scheme

The International Probiotics
Association is planning a labelling scheme that would include a minimum
bacterial count and an identification of the bacterial strain.

There is also a move afoot in
Europe to control the claims with regulation that demands companies produce the
scientific evidence to support their labelling.

Health Canada has developed a
probiotics monograph, which includes detailed information on acceptable health
claims, associated doses, source materials and required risk information.

It has also developed a guidance
document that spells out when health claims can be made about food. The
department website states that food products containing probiotics may have to
remove the word if they’re not accompanied by “specific, validated statements
about the benefits or effects of the micro-organism.”

Researchers say people need to scrutinize
prebiotics just as closely. The sugar-type molecules are non-digestible foods
that make their way through the digestive system and help good bacteria
flourish. They are mostly found in carbohydrate fibres and can be taken in
supplements or foods.

Reid said consumers have to
research probiotic products themselves, using online sites like PubMed to see
what studies have been done to prove a company’s claims.

He would like to see it made easier
to know the strain of bacteria, its properties, what it does, how long it lasts
if it’s in powder form and where it goes in the body. Otherwise, he worries
that scepticism over probiotics’ actual benefits will sully ones that have been
scientifically proven to work.

“There needs to be more clinical
evidence or companies need to stop calling their products probiotics,” he said.

“It shouldn’t be a fad. I think the
ones that are properly scientifically documented will be here to stay, but the
other ones hopefully don’t spoil it for everyone else.”

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