“With health claims unproven and scientists divided on the benefits: Are Probiotics Just a Waste of Money?” ran the Daily Mail headline in December 2014 for a story that seemed to largely pour scorn on the supplements and certain foods that contain ‘live native bacteria’.
Then earlier this month the Mail ran another story headlined “What friendly bacteria really CAN do for you… but probiotic makers are banned from telling us about” which seemed to paint a much more positive light on the same types of products. The story also highlighted the issues with the ‘p’ word now faced by manufacturers and suppliers of such products.
Are you confused by the contrasting stories from the same publication above? Or the use of the ‘p’ word? Or perhaps by the “… but probiotic makers are banned from telling us about” part of the headline? Well the ‘p’ word is probiotics (woops we have said it now!) and we won’t use the word ourselves in this article again – why? As we are not allowed to based on European legislation governing ‘health claims’ for foods and food supplements. Hence the “banned from telling us about” headline.
So instead we and other supplement companies in Europe use (or are meant to use) phrases such as ‘Live Native Bacteria’, or ‘Friendly Native Bacteria’, or ‘Friendly Bacteria’ and other variations – anyway I think you get the gist of the terminology. However it’s interesting to carry out an online search today and see how many supplement companies still use the ‘p’ word to describe their products, including a leading high street brand.
The ‘P’ Word?
So what is all the fuss about using the ‘p’ word? Well we wrote on this matter nearly a year ago and you can read this article – ‘Goodbye P*******c, Hello Live Native Bacteria!’– for more detail. But basically EFSA (the European Food Safety Authority) who regulate what can and can’t be said about foods and food supplements (in Europe) ruled that the ‘p’ word couldn’t be used as a generic descriptor for food products. And in the UK the ASA (Advertising Standards Authority) have been enforcing this judgement.
The impact of EFSA in relation to supplements and foods is most commonly seen by their decisions on ‘permitted health claims’ typically in relation to vitamins, minerals and natural nutrients. So what health claims are scientifically deemed appropriate for a nutrient – and therefore what can be said about the nutrient in relation to a product such as a supplement or where the nutrient is in a food, for example vitamin D in a cereal. And fair enough, we can’t live in a modern world where snake oils are promoted as a cure all!
But what has been odd, and infuriating to many, is that in the case of the ‘p’ word EFSA say it can’t be used innocuously on a product (e.g. “contains ‘p’”) as this generic descriptor could imply a positive effect on health – and thus mislead the public in their buying decision. The second part of this tale is that there are no existing permitted health claims for ‘p*******cs’ or their common strains. This is despite many claims having been submitted to EFSA and all rather flatly rejected, despite what many would argue is a vast body of worldwide scientific, eminent and valid research into the efficacy of ‘p*******c’ strains. And much to the bemusement of many health professionals.
An Implied Health Claim
The greatest puzzlement at the restrictions on the ‘p’ word is the fact that manufacturers and suppliers of products affected by the legislation were (in the main) not making excessive claims on the capabilities of the product – they simply wanted to use the ‘p’ word. So it’ not an argument about lots of companies making false claims but simply using the ‘p’ word as a ‘descriptor’. But as we have mentioned EFSA deemed this word to imply a positive effect on health? One wonders what is next, for example I think most people who were asked what they associated with the word vitamins would suggest positive things – so is this word going to be ‘banned’ too?!
Perhaps it is the origins of the ‘p’ word that have got the legislators worried? It comes from the Latin word ‘pro’, meaning ‘for’, and the Greek word ‘bio’, or ‘life’. Perhaps EFSA are concerned that there are a daily throng of classics multi-linguists thronging the supermarkets and health shops of Britain and getting the wrong idea about a yoghurt? It certainly seems that EFSA are unhappy with the success of the food supplements, and ‘drinks’ and yoghurts in particular that mentioned the ‘p’ word.
Yoghurts and Drinks
“The market for pills and yoghurts containing ‘friendly’ bacteria is worth $28bn..” commented the Guardian (see below). Whilst the Daily Mail article noted that “last year consumers in the UK spent £740 million on probiotic products”. And it would seem that the focus of ‘concern’ for EFSA and ASA was the proliferation, and success of the many yoghurts and drinks that included ‘p*******c’ strains.
Live native bacteria supplements have of course become increasingly popular over recent years, typically in a capsule of powder form. Although it would appear that it is the yoghurt and ‘drink’ products that drew the attention of EFSA. Many people would argue that most yoghurts contain strains that are not necessarily the most effective for humans. Also the lack of clarity regarding what strains a yoghurt product contains and whether they are resistant to the acid (bile) of the human gut. Plus we have the issue for many of not wanting dairy products. Hence the increased popularity for live native bacteria supplements which typically incorporated multiple strains and other attributes.
Certain fermented foods are an excellent natural food source of bacterial cultures and we have a recent article that covers this topic. With the EFSA assault on ‘p*******cs’ prebiotics have been increasingly talked about and marketed. Prebiotics are dietary substances such as fructo-oligosaccharides or Inulin, which stimulate the growth of bifidobacteria and other healthy native bacteria in the gut. However we wouldn’t currently recommend that you take a supplement solely containing prebiotic. For example with some of our supplements prebiotic is present to supply a food source for the live friendly native bacteria when they are rehydrated. It does not act as a food source for pathogens.
So prebiotics can be talked about but not ‘p*******cs’, but does any of this help the public when looking to make informed decisions about their health? Nevertheless the ‘fight goes on’ as a number of companies continue to battle EFSA in the European courts arguing for an overturning of the ‘p’ word ban. However an EFSA ruling last month shows that they are maintain their position – “Application for the term ‘probiotico’ to be used as generic descriptor in Italy – A presentation was given by the Commission on Italy’s application to use the term – which translates to ‘probiotic’ in English – as a generic description. Following a discussion among Member States, it was concluded that “Probiotico” is not considered to be a generic descriptor as it is a health claim, as established in the Commission guidance on the use of the term “probiotic.””
Rarely Out of The Media
For an alternative mainstream media story the Guardian reported in November last year that “Probiotics: Myth or Miracle? – The market for pills and yoghurts containing ‘friendly’ bacteria is worth $28bn, but do claims for them stack up? Can they really alter our gut flora? And are we healthier if they do? You may find the answers surprising.” You can follow the link to their story which includes overviews (and links) to various worldwide research studies with positive indications for live native bacteria supplements.
We started this article by quoting two articles in the Mail Online. And some health purists may not consider this a news medium sufficiently serious to comment on such matters. However they are a media organisation very proactive on reporting on health and nutritional matters. Their articles also contain information on pertinent research studies, so helpful for those seeking to research this topic.
However we would take issue with a number of their comments including “Many people who take probiotics for no specific reason ‘are taking them unrealistically”. In our experience very many people are taking a live native bacteria supplement for a specific purpose, having researched the topic or on the recommendation of a health professional.
And in terms of the Mail comment that “Bacteria in capsules and tablets were likely to be killed off by the acid in the stomach long before they reached the gut” indeed we would agree that many ingested bacteria do get killed off by the stomach acid. Which is why when you are looking for a suitable supplement you should choose one that contains cultivated strains which will survive the challenges of stomach acid and bile in the human GI tract. See further below for further suggestions on what to look for in a live native bacteria supplement.
Live Native Bacteria Supplements
Time for a brief reminder of why most commonly people take a live native bacteria supplement. First and foremost is in relation to digestion and the GI (gastro-intestinal) tract including IBS (irritable bowel syndrome) and related conditions. Then there is the influence of gut health on the immune system and our mood where managing the bacterial balance in our stomach is important.
Our immune system is essentially linked with our gastro-intestinal system; so if the latter is performing poorly it will impact on the former. Additionally our gut is the major producer of the vital mood and cognitive moderator serotonin, most people may think it occurs in the brain but it’s the gut. So again if our gut health is impaired it will affect this vital bodily function.
Then there is the relevance for taking live native bacterial supplements whilst on antibiotics, where unfortunately the drug can frequently affect the digestive health, particularly in terms of diarrhoea. We wrote about this topic in June 2013 following a Cochrane Collaboration report –‘Antibiotics & Diarrhoea’. Live native bacteria supplements are also popular with many who are travelling abroad and on holiday. There is also a good deal of research into live native bacteria supplements and allergies and skin conditions.
Live native bacterial supplements come in either a capsule, tablet or powder form. These are our suggestions below as to what you should look for when selecting such a supplement. Please note that you should always follow the manufacturer’s directions for usage and read the contraindications.
- Contains multiple good bacterial strains with wide-ranging activity
- With strains suited to age (e.g. baby, child, adult, adult 50+)
- Contains cultivated strains which will survive the challenges of stomach acid and bile in the human GI tract (acid and bile resistant strains)
- Stable at room temperature (no need to refrigerate)
- Where appropriate suitable for vegetarians and vegans and dairy free
- Contains pure naturally fermented strains
- Contains antibiotic resistant strains
- Assess the live viable count (of bacteria) in the supplement
- Provides strains designed to have activity throughout the whole GI tract
- Consider supplements including a small amount of prebiotic to supply a food source for the live friendly native bacteria
How to Find Out More
So what should you do if you want to find out more about live native bacteria supplements? You may have many questions and the first might be establishing which strains and therefore supplements are best suited to you and other family members including children. Reputable manufacturers and suppliers are a good starting point as they can supply information. At Cytoplan for example we have a body of research from our own suppliers on the efficacy and specific activities of the strains in our products.
Then of course there is the internet. Researching this topic by simply searching online with relevant phrases will produce a wealth of relevant peer reviewed research information from scientific and medical institutions worldwide that offers interpretations on the efficacy of live native bacterial strain supplements. Three websites that provide excellent research information which is easy to find via their search function (just type in the ‘p’ word!) are:
Science Daily; Nutraingredients.com and the National Center for Biotechnology Information, U.S. National Library of Medicine (ncbi.nlm.nih.gov).
For example the most recent relevant item on Nutraingredients.com is –‘Clinical trial backs probiotic strain to help reduce cold and flu in times of stress’. Just one of many balanced and contemporary research articles that can easily be found online (see link below). As well as the existing Cytoplan blogs linked to above there are a number of additional articles that cover a range of topics in relation to our digestion and live native bacteria. These currently are:
If you have any questions regarding this article, any of the health topics raised, or any other health matters please do contact me (Amanda) by phone or email at any time.
Amanda Williams, Cytoplan Ltd
firstname.lastname@example.org, 01684 310099