Probiotics — microorganisms that are supposed to help your digestion and boost your immune system — are one of the hottest food trends of the decade.
Just like these "good" bacteria, the number of yogurts, drinks, pills and so on has multiplied in the past few years.
But whether you're spending that money on help or hype is a confusing question, especially in light of a class-action lawsuit settled for $35 million last month against the Dannon Co.
The suit claimed that Dannon falsely represented the health benefits of the probiotics in Activia, Activia Lite and DanActive products, to encourage people to buy a more costly product.
A statement on Dannon's Web site said that as part of the settlement, Dannon will make the scientific names of the probiotic bacteria strains it uses more visible on product labels, and it will reimburse qualified consumers for the cost of buying the products. But the company admitted no wrongdoing. A Dannon spokesman said the company settled to "avoid the distraction and expense of litigation."
Yes, probiotics can be good for you, but it depends on the strain of bacteria and the amount consumed, according to Chris Cifelli, director of the nutrition research for the National Dairy Council, who was in Salt Lake City last month to give a presentation on probiotics to Utah dietitians.
The dairy industry is a major player in the probiotic trend. Between 2004-06, U.S. beverage manufacturers introduced more than 500 new yogurt and dairy-based probiotic drink products, according to Cifelli. Last year, 31 probiotic products came out from May-November 2008, and about 70 percent of them were dairy-based.
The generally accepted definition of probiotics is "live microorganisms, which when consumed in adequate amounts, confer a health benefit to the host."
We usually think that bacteria are bad. But yogurt and cheese are examples of what "good" bacteria can do when they ferment milk.
Actually, each person harbors two to three pounds of more than 400 different species of bacteria in their body. "We've living in their world; there's way more of them than us, and it's mostly a symbiotic relationship," Cifelli noted.
In healthy individuals, there is a balance of "good" and "bad" bacteria. The balance can be disrupted in the gastrointestinal tract by stress, infection or when a person takes antibiotics. This can allow more "bad" bacteria to grow, with unpleasant consequences such as diarrhea or infections. The theory is that ingesting probiotic bacteria can help restore the balance, and keep other harmful bacteria from gaining entrance. In order to be considered "probiotic," a particular strain of bacteria should be documented in clinical studies for a specific beneficial effect.
Different strains and species of bacteria behave differently, said Cifelli. "One may be beneficial, another may not do anything," he said.
So while the "live and active cultures" in yogurt are good at fermenting milk, they're not deemed a "probiotic" unless it's that specific strain has shown a specific health effect in studies.
Also, because these bacteria travel through the intestine and out of your body, they need to be consumed regularly in order to maintain the health benefit.
Research strongly supports the role of probiotics in reducing infectious and antibiotic-associated diarrhea, and in preventing "pouchitis," or inflammation that happens when a person's colon is removed, Cifelli said. Probiotic bacteria also have been shown to alleviate symptoms of lactose intolerance, because the bacteria digest the lactose in the milk product.
In a study published in 2007 British Medical Journal, 135 hospitalized patients over age 50 who were on antibiotics were given milk fermented with Lactobacillus casei during their stay and one week after. A significant amount didn't develop diarrhea, compared to those who took a placebo.
There's also some evidence that probiotics can improve immunity against colds and flu, at least in young children. In a six-month study involving 326 Chinese preschoolers, a daily supplement of Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 strains significantly reduced the incidence symptoms, such as fever, runny nose and coughing.
Some studies also indicate that certain probiotics may help in reducing the development of allergy in children, decreasing the growth of ulcer-causing H. pylori bacteria, managing some inflammatory bowel conditions, decreasing the risk of certain cancers, and decreasing dental-caries-causing microbes in the mouth.
But, how do you know whether a given product will be effective for a particular health issue?
Good question, since there are no label standards for probiotics.
Unfortunately, you have to read labels and trip over long names of bacteria to figure out if you're getting the right strain, and in an amount that's going to do you any good.
Various strains of probiotics have been shown to be effective at different levels, varying from 50 million colony-forming units to more than 1 trillion CFU per day. So it's not possible to provide one rule-of-thumb "dose" for all types of probiotics.
"The onus falls on you to go to the Web sites for these products and do your homework," said Cifelli. Consumers should check the product label or Web site for the following information:
The genus, species and strain of each probiotic present in the product.
The list of citations of published human studies that have been conducted on the product or on the specific probiotic strain in the product.
Assurance that the product contains the level of probiotics through the end of shelf life as was shown to be effective for each strain in the published studies. (If the bacteria die before you eat them, they won't do you any good.)
Some product labels aren't as helpful as they could be. Yoplait's Yo-plus doesn't give the name of the probiotic strain anywhere on the package. One must visit www.YoPlus.com to find out that a serving provides at least one billion live and stable Bifidobacterium lactis, which "appears to reduce the duration of diarrhea and help alleviate constipation."
To add to the confusion, some companies make up a trademark name for the bacteria they use. For instance, Dannon uses Lactobacillus casei in its DanActive product, but calls it L. Casei Immunitas.
"These names are not scientific names and they do not reflect product quality," according to the International Scientific Association for Probiotics and Prebiotics. The group has a Web site, www.isapp.net, with guidelines for choosing probiotic products.
Another Web site, USProbiotics.org, gives updates on research studies.
Probiotics may be good for you; but it's not easy to figure out if they're worth the extra cost.
e-mail: vphillips@desnews.com