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Probiotics: Are They Too Good To Be True? Bifidiobacterium animalis, Lactobacillus acidophilus, Bifidus regularis, Lactobacillus casei Immunitas®, and Saccharyomyces boulardii are the names of some of the “friendly” bacteria that are added to our food supply and touted for their role as probiotics. Probiotics are microorganisms (small single-celled living organisms) that are ingested to benefit health and help fight diseases. Probiotics are either bacteria or yeast. They are available as commercial probiotic supplements (tablets and capsules) and also are added to yogurt and cereals. These microorganisms are attached to claims such as “naturally regulates the digestive system,” “fights viruses and bacteria associated with diarrhea and gastrointestinal disease,” and “can help with diarrhea caused by antibiotics, food poisoning, traveling to other countries, and infections people pick up in hospitals.” Such claims raise the interest of our health-aspiring society. The question is: Are probiotics the real deal or are they too good to be true? Research in prebiotics (ingredients that stimulate the growth of probiotics) and probiotics is still in its infancy. Scientists still are trying to figure out how probiotics work, if they work best in single strains or in combinations, and what population is best served by taking them. Early results show the potential benefits likely outweigh the risks for several critically ill and immunosuppressed populations, but the average healthy person should have a good supply of naturally occurring probiotics working hard to regulate the digestive tract. For this group, supplementation is likely unnecessary. Probiotic research is most intimately tied to the following conditions: Allergies Cancer Colds Clostridium difficile infection Constipation Dental health Diarrhea Flu High cholesterol Indigestion Inflammatory bowel disease Pseudomembranous colitis Stomach ulcers Stress Urinary tract infections Vaginal infections Weight loss Because all probiotics work differently, studies are looking at dosage, timing, and other dietary and lifestyle factors to determine how to best use these microorganisms in the diet, for how long, and in what form. In addition, extrapolating one strain of a probiotic to use in a supplemental form may change its effectiveness. Not all probiotics are shelf stable, so if supplements are used, it is important to store them according to the manufacturer’s guidelines for time and temperature control in order to keep the microorganisms active. Some trials have convincing conclusions showing that certain strains of probiotics are effective for some conditions, but few clinical trials of the actual supplements that are on the market draw the same conclusions. Time and continued research will help to determine the role of probiotics in the American food supply. Biomarkers are not yet established and employed to identify microorganism strains with probiotic utility. It will take time to define the different positive health benefits of existing probiotics and incorporate them into dietary lifestyles of society. How most probiotic bacteria exert their health benefits remains unclear, and the question of which biomarkers accurately reflect efficacy remains unresolved. Despite the need for more research in this area, evidence does show that probiotics may help in treating many conditions. Studies have not shown evidence of danger in using probiotics for short-term treatment, so foods and supplements with these helpful bacteria are a legitimate option for recovery and care. Only time and further research will serve to prove their effectiveness. References and recommended readings Dekker J, Collett M, Prasad J, Gopal P. Functionality of probiotics—potential for product development. Forum Nutr. 2007;60:196-208. Elmer GW, McFarland LV, McFarland M. The Power of Probiotics: Improving Your Health With Beneficial Microbes (Haworth Series in Integrative Healing). Binghamton, NY: Haworth Press; 2007. Oral probiotics: an introduction. National Institutes of Health, National Center for Complementary and Alternative Medicine (NCCAM) website. NCCAM publication D345. http://nccam.nih.gov/health/probiotics/introduction.htm. Published January 2007. Updated December 2012. Accessed November 13, 2014. Sallit J. C. diff prevention and adjunctive therapy with prebiotics and probiotics. In: Dietetics in Health Care Communities Dietary Practice Group. Connections. 2010;35(2). Schardt D. Helpful bacteria: should you take probiotics? Nutrition Action. 2006;33:7-9. Review Date 11/14 G-1724