A Probiotic Recipe for Good Health

It sounds downright risky, but snacking on billions of live bacteria can actually improve digestion, support the immune system and bolster overall health.

Called probiotics, these “friendly” microbes with health benefits are found naturally in breast milk and fermented foods such as yoghurt, fermented milk drinks, aged cheese, miso and certain pickles and sauerkraut.  They work by keeping intestinal flora balanced and preventing not-so-friendly bacteria from taking over and causing disease.

But during the last 50 years, the increased use of antibiotics and a changing diet low in soluble fibre and high in refined carbohydrates have produced an “invisible epidemic of insufficient probiotics,” said Gary Huffnagle, professor of internal medicine and microbiology at the University of Michigan Medical School.  “We're not getting what we used to (through diet), and we're destroying what's there,” he said.  “As a result, the balance of our intestinal microbe population has changed, sometimes with disastrous effects on our immune system.”

Research on the topic is exploding.  The US National Institutes of Health recently announced that it will explore how bacteria in the body can promote health, and the food, supplement and cosmetics industries aren't about to be left behind.

The helpful bacteria and yeasts are being added to beverages, cereals, wellness bars, pet foods, infant formulas and even personal-care products.

As supplements, probiotics can be purchased as pills, liquids, capsules and powders.

The worldwide probiotic yoghurt category alone is expected to increase in sales to $US500 million ($A587.3 million) from $US294 million ($A345.33 million) by 2010, according to the market research firm Euromonitor International.

But finding the correct type of probiotic food or supplement can be daunting for consumers, especially because research is evolving, and many functional foods make unproven claims.

Only a few bacteria (members of the lactobacillus and bifidobacterium genuses) have been studied extensively, and scientists are still trying to figure out which bacterial strains are most effective for particular problems.

While the strain Lactobacillus rhamnosus GR-1 has been shown to help with vaginal yeast or urinary-tract infections, Sacharomycea boulardii lyo has a positive effect on diarrhoea and inflammatory bowel disease.

Another research focus is “figuring how we detect an 'imbalance' in a single human being,” Huffnagle said.  “When we look at groups of people, we can make generalisations, but for any single person, the generalisation may not hold true.”

Meanwhile, the marketplace is a free-for-all.  All products labelled “probiotic” should contain “live” material, but some don't; others don't contain enough.

When the testing service Consumerlab.com looked at 13 products, they found only eight contained at least 1 billion organisms in a daily serving, the generally recommended minimum dose.

But even the proper minimum dose isn't really known.  Some products have been shown to be effective at 100 million live cells, other show positive results at 1 trillion.

Still, “the potential of probiotics to improve health rivals drugs in terms of impact,” said Huffnagle, author of The Probiotics Revolution, who says probiotics are more than beneficial; they're essential and deserve their ow food group.

“We have more than a kilo of microbes inside us,” he said.  “The medical revelation is that when they cooperate and work together, they function in our body like an organ.  Microbes in our digestive tract have profound effects on our health.”

One of the most promising treatments uses probiotics to replenish the “good” bacteria and prevent or ease the symptoms of antibiotic-caused diarrhoea, a growing problem for hospitals because of antibiotic resistance.

Although antibiotics can be lifesaving drugs, they work by killing many bacteria in our microflora, including the beneficial ones.  Failure to restore the good bacteria can cause side effects.

But mounting research, including a recent study published in the British Medical Journal that looked at the strains used in a probiotic milk drink, have shown that probiotics can counter the side effects.  “This has the potential to decrease morbidity, health-care costs and mortaility if used routinely in patients aged over 50,” the researchers wrote in the BMJ.

Though not a routine practice in most hospitals, the National Jewish Medical and Research Centre gives probiotics to almost all of the infectious-disease patients who receive antibiotics.

For the last two years, Helen DeVos Children's Hospital in Grand Rapids, Michigan, has used them to improve the intestinal health of premature infants.

And paediatricians are increasingly recommending them for their young patients.

“They worked well,” said Chicago's Wendy Burgess, whose 2-year-old son, Henry, had diarrhoea after a round of antibiotics for an ear infection.  Burgess' doctor suggested Florastor, which contains the probiotic yeast Saccharomycea boulardii lyo.  “I didn't know what probiotics were, but if he were to go back on antibiotics, I'd start them to be proactive,” she said.

“The one time it makes sense to (use probiotics) is after antibiotics,” said Katherine Knight, chair of the department of microbiology and immunology at Loyola University Chicago Stritch School of Medicine, who believes a diet strong in fruits vegetable and dairy is a better way to build good intestinal bacteria.

Time will tell whether probiotics can help with other conditions.  Though they're safe, and good evidence shows certain strains can help with antibiotic-related diarrhoea, colitis and H pylori ulcers, the data is less definitive for obesity, lactose intolerance, cancer prevention, dental cavaties, common colds and allergic diseases.

“At this point, it seems the enthusiasm for probiotics use in most medical conditions has certainly outpaced the scientific evidence,” said Yehuda Ringel, an assistant professor of gastroenterology at the University of North Carolina School of Medicine who recently published a paper calling them a “safe” but unproven treatment for irritable-bowel syndrome.

Huffnagle, however, who has spent the last two decades studying the immune system, is hopeful.  A longtime allergy and asthma sufferer, he started incorporating a probiotic supplement yoghurt, fresh fruits, vegetables and whole grains into his diet.  Within a month, he realised his allergies no longer affected his daily life, and asthma attacks rarely occurred.

He credits his newfound bacterial friends.  “Modern medicine now appreciates that not all microbes are harmful,” he wrote.  “Some are our silent partners.”