Table of Contents
- What are probiotics?
- What are probiotics? (Continued)
- What are prebiotics and synbiotics?
- What are microbes and their role in our health?
- What are the health benefits of probiotics?
- What are the health benefits of probiotics? (Continued)
- What are the different types of probiotics?
- What are the different types of probiotics? (Part 2)
- What are the different types of probiotics? (Part 3)
- What foods contain probiotics?
- What foods contain probiotics? (Part 2)
- What foods contain probiotics? (Part 3)
- What are the side effects and risks of probiotics?
- How should people take probiotics?
Quick GuideDigestive Health: Top Foods for Probiotics
What are probiotics? (Continued)
In October 2013, the International Scientific Association for Probiotics and Prebiotics (ISAPP) organized a meeting of clinical and scientific experts on probiotics (with specialties in gastroenterology, pediatrics, family medicine, gut microbiota, microbiology of probiotic bacteria, microbial genetics, immunology, and food science) to reexamine the concept of probiotics. They define probiotics as "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host." They also differentiated between products containing probiotics and those containing live or active cultures and established the following criteria:
- Live or active cultures criteria:
- Any food with fermentation microbe(s)
- Proof of viability at a minimum level reflective of typical levels seen in fermented foods, suggested to be 1 × 109 CFU per serving
- No specific research or evidence is needed to make this claim.
- Probiotics criteria for products that do not make a health claim:
- A member(s) of a safe species, which is supported by sufficient evidence of a general beneficial effect in humans or a safe microbe(s) with a property (for example, a structure, activity, or end product) for which there is sufficient evidence for a general beneficial effect in humans
- Proof of viability at the appropriate level used in supporting human studies
- Probiotics criteria for products that make a health claim:
- Defined probiotic strain(s)
- Proof of delivery of viable strain(s) at efficacious dose at the end of shelf life
- Convincing evidence needed for specific strain(s) or strain combination in the specified health indication
Our body normally has what we would call good or helpful bacteria and bad or harmful bacteria. Maintaining the correct balance between these bacteria is necessary for optimal health. Age, genetics, and diet may influence the composition of the bacteria in the body (microbiota). An imbalance is called dysbiosis, and this has possible links to diseases of the intestinal tract, including ulcerative colitis, irritable bowel syndrome, celiac disease, and Crohn's disease, as well as more systemic diseases such as obesity and type 1 and type 2 diabetes. How do you know if you need probiotics? This article will help you decide.
Alm, L. "Therapeutic Properties of Fermented Milk." Elseveir Science (1991): 45-64.
Baquerizo Nole, K.L. "Probiotics and Prebiotics in Dermatology." J Am Acad Dermatol. 71.4 Oct. 2014: 814-821.
Beighton, D. "Oral Bifidobacteria: Caries-associated Bacteria in Older Adults." J Dent Res 89.9 Sept. 2010: 970-974.
Bellaguarda, E. "IBD and the gut microbiota--from bench to personalized medicine." Curr Gastroenterol Rep. 17.4 Apr. 2015: 15.
Brown, K. "Diet-induced dysbiosis of the intestinal microbiota and the effects on immunity and disease." Nutrients 4.8 (2012): 1095-1119.
Delorme, C. "Safety assessment of dairy microorganisms: Streptococcus thermophilus." Int J Food Microbiol 126.3 Sept. 2008: 274-277.
Dimidi, E. "The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials." Am J Clin Nutr. 100.4 Oct. 2014: 1075-1084.
Dupont, A.W. Nat Rev Gastroenterol Hepatol Aug. 2011; Epub ahead of print
Fijan, S. "Microorganisms with claimed probiotic properties: an overview of recent literature." Int J Environ Res Public Health. 11.5 May 5, 2014: 4745-4767.
Fisberg, M., and R. Machado. "History of yogurt and current patterns of consumption." Nutr Rev. 73 Suppl 1:4-7 Aug. 2015.
The Food and Agriculture Organization of the United Nations
Goyal, R. "The Enteric Nervous System." NEJM 334 Apr. 1996: 1106-1115.
Guarner, F. "Gut Flora in Health and Disease." Lancet 361.9356 Feb. 2003: 512-519.
Hadhazy, Adam. "Think Twice: How the Gut's 'Second Brain' Influences Mood and Well-Being." Scientific American Feb. 12, 2010. <http://www.scientificamerican.com/article.cfm?id=gut-second-brain>.
"Health Benefits of Taking Probiotics." The Harvard Medical School Family Health Guide Sept. 2005. <http://www.health.harvard.edu/fhg/updates/update0905c.shtml>.
Hickson, M. "Probiotics in the prevention of antibiotic-associated diarrhea and Clostridium difficile infection." Therap Adv Gastroenterol 4.3 May 2011: 185-197.
Hill, C. "Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic." Nat Rev Gastroenterol Hepatol 11.8 Aug. 2014: 506-514.
Ishibashi, N. "Probiotics and Safety." Am J Clin Nutr 73.2 Suppl Feb. 2001: 465S-470S.
Iyer, C., et al. "Probiotic Lactobacillus reuteri promotes TNF-induced apoptosis in human myeloid leukemia-derived cells by modulation of NF-kB and MAPK signaling." Cell Microbiol 10.7 July 2008: 1442-1452.
Kabeerdoss, J. Nut J 10.138 Dec. 2011.
Kabir, M.A. "Role of Saccharomyces boulardii in diarrhea predominant irritable bowel syndrome." Mymensingh Med J 20.3 July 2011: 397-401.
Kathari, D. "Therapeutic spectrum of nondigestible oligosaccharides: overview of current state and prospect." J Food Sci. 79.8 Aug. 2014: R1491-8.
Kaur, R. Int J Paediatr Dent 10 Feb. 2012: 1363-1365.
Khalesi, S. "Effect of probiotics on blood pressure: a systematic review and meta-analysis of randomized, controlled trials." Hypertension 64.4 Oct. 2014: 897-903.
Kochan, P. Clin Microbiol Infect 10 June 2011: Epub ahead of print
Kong, X.Y. "Probiotics' preventive effect on pediatric food allergy: a meta-analysis of randomized controlled trials." Chin Med Sci J 29.3 Sept. 2014: 144-147.
"Lactobacillus." MedlinePlus. Dec. 9, 2011. <http://www.nlm.nih.gov/medlineplus/druginfo/natural/790.html>.
López-Cepero, A.A. "Association of the Intestinal Microbiota and Obesity." P R Health Sci J 34.2 June 2015: 60-4.
Makowiak, P. "Recycling metchnikoff: probiotics, the intestinal microbiome and the quest for long life." Front Public Health 1 (2013): 52.
Margolis, K. Curr Opinions Gastroenterology 25.6 Nov. 2009: 503-511.
Meini, S. "Breakthrough Lactobacillus rhamnosus GG bacteremia associated with probiotic use in an adult patient with severe active ulcerative colitis: case report and review of the literature." Infection May 30, 2015. [Epub ahead of print]
Murooka, Y. "Traditional healthful fermented products of Japan." J Ind Microbiol Biotechnol 35.8 Aug. 2008: 791-8.
National Institute of Health
Ostadrahimi, A. "Effect of probiotic fermented milk (kefir) on glycemic control and lipid profile in type 2 diabetic patients: a randomized double-blind placebo-controlled clinical trial." Iran J Public Health 44.2 Feb. 2015: 228-37.
Park, K.Y. "Health benefits of kimchi (Korean fermented vegetables) as a probiotic food." J Med Food 17.1 Jan. 2014: 6-20.
Picard, C. Aliment Pharmacol Ther 22.6 Sept. 2005: 495-512.
"Probiotic/Prebiotic Science." International Scientific Association for Probiotics an Prebiotics." <http://www.isapp.net/Probiotics-and-Prebiotics/The-Science>.
Quigley, E. "Small Intestinal Bacterial Overgrowth: Roles of Antibiotics, Prebiotics, and Probiotics." Gastroenterology 130.2 Suppl 1 Feb. 2006: S78-90.
Roberfroid, M. "Prebiotic effects: metabolic and health benefits." Br J Nutr 104 Suppl 2 Aug. 2010: S1-63.
Saez-Lara, M.J. "The role of probiotic lactic acid bacteria and bifidobacteria in the prevention and treatment of inflammatory bowel disease and other related diseases: a systematic review of randomized human clinical trials." Biomed Res Int (2015): 505875.
"Safety of Probiotics Used to Reduce Risk and Prevent or Treat Disease." Agency for Healthcare Research and Quality. Apr. 2011 <http://www.ahrq.gov/clinic/tp/probiotictp.htm#Report>.
Swain, M.R. "Fermented fruits and vegetables of Asia: a potential source of probiotics." Biotechnol Res Int (2014): 250424.
Theodoru, V. "Effect of commensals and probiotics on visceral sensitivity and pain in irritable bowel syndrome." Gut Microbes 5.3 May-June 2014: 430-436.
United States. Centers for Disease Control and Prevention.
United States. National Center for Complementary and Alternative Medicine. "Oral Probiotics: An Introduction." Nov. 2011. <http://nccam.nih.gov/health/probiotics/introduction.htm>.
United States. National Institutes of Health. "NIH Human Microbiome Project Defines Normal Bacterial Makeup of the Body." June 13, 2012. <http://www.nih.gov/news/health/jun2012/nhgri-13.htm>.
United States. Department of Health & Human Services
Whorwell, P.J. Am J Gastroenterol 10.7 July 2006: 1581-1590.
The World Health Organization
Wu, G.D. "Linking long-term dietary patterns with gut microbial enterotypes." Science 334.6052 Oct. 7, 2011: 105-108.
Zhang, W., et al. "Probiotic Lactobacillus acidophilus enhances the immunogenicity of an oral rotavirus vaccine in gnotobiotic pigs." Vaccine 26.29-30 July 2008: 3655-3661.
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