Do Probiotics Work?

This time of year, a lot of us are thinking about making changes to our diet to try and improve our health and fitness. In full knowledge of this, we’re bombarded with marketing for all kinds of “health foods”, “super foods”, “wonder products” and the like. One of these functional foods which has interested me for a while are probiotic yoghurts, which have seen a huge rise to popularity with the introduction of brands such as Activia. In 2006, Activia sold $130 million worth of yoghurt in America, so clearly this product is something that we want…but do we need them and are they worth the fuss?

The idea behind probiotics is that they contain cultures of (supposedly) live bacteria, with the aim to aid digestion. The principle of this is that we have “good” bacteria residing in our gut, which help us to break down certain foods, so supposedly, by adding more of these bacteria to our gut, we can help out the process of digestion. In fact, people have even been suggested by GPs to try probiotic yoghurts after stomach bugs or courses of antibiotics, to help regain the digestive system’s normal function. After a stomach bug, or a course of antibiotics, our gut bacteria are somewhat depleted, as they tend to leave our gut when we have a bug, and since antibiotics don’t discriminate between good and bad bacteria, while they remove a bacterial infection, they also decrease levels of “good” bacteria, which can often cause digestive problems after taking them, particularly with rich foods or those containing dairy. Probiotics can also be taken in tablet form and found in health stores.

So what’s the evidence for the use of probiotics?

First, I’ll give you the bad news:

Danone, the company who own Activia, were actually sued in 2010 for $21 million (not even a dent when you notice they made over $100 million in their first year) by the FDC for false advertising, after claims “Activia eaten every day is clinically proven to help regulate your digestive system in two weeks” were found to have no scientific supporting evidence. Since this, you’ll notice their packaging no longer uses the words “clinically” and “scientifically proven”. This doesn’t mean however, that Activia doesn’t work: it just means that at this time, they did not have enough scientific evidence to support their claims, though they are not necessarily completely false.

Questions being investigated involving probiotics include:

  • Do the bacteria survive the manufacturing process, transportation to shops and then storage?
  • Do bacteria survive the journey through our body to our intestines?

Probiotics can only have an effect if the bacteria in question are alive and able to colonise our gut. This requires over a billion colony forming bacterial cells in a yoghurt! So more research is needed into probiotics to find out whether or not they work.

What We Know

We do believe, at this point that probiotics can help maintain our bowels and reduce diarrhea, particularly after a course of antibiotics, and have been shown in several studies to improve symptoms of IBS. It is unclear whether they can be helpful in conditions such as Crohn’s Disease, which in theory could be helped by reducing inflammation using probiotics, but there is not yet evidence to support this. It’s very difficult to study probiotics, as it’s hard to tell whether the bacteria survive, and even harder yet to find out if they had any beneficial effect while in our bodies.

If you have a diagnosed digestive problem, such as IBS or Crohn’s disease the best thing to do is to research which strains of bacteria, which brands of probiotic have evidence supporting effectiveness for your specific condition. Strains of Bifidobacteria and Lactobacillus seem to be the most promising probiotics at the moment, so when looking for probiotics, these are the genus names to look for on packaging. It is also likely that probiotics from a health store are more effective than a yoghurt from a standard supermarket, so maybe check those out before choosing a potentially overpriced yoghurt from the supermarket. Probiotic yoghurts will always have details of the names of live cultures contained, so maybe give those a google and see if they’re any good! Normal yoghurts, while made from bacteria, do not possess any live bacteria, so are not probiotic.

In my mind, if it makes you feel good to take probiotics, then go for it. I have a probiotic yoghurt everyday; they taste good and I feel like I’m healthy… while this doesn’t confirm that they’re working, it’s nice to feel good, and just that feeling can make a big difference, whether it’s a placebo effect or not. There’s no harm in taking probiotics (with the exception of those with compromised immune systems and pancreatitis, so if you do have a condition you’re concerned about, ask the doctor!).

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