Probiotic Pandemonium
by Lori Dahm
The buzz about probiotics and their health effects is becoming louder.
It seems that we are nearing the long-awaited probiotic revolution at last. After hearing for several years of an imminent probiotics proliferation in dairy products, finally probiotic cultures are making a splash, as witnessed with Dannon’s new Activia product and its accompanying marketing push and consumer education campaigns.
The reasons that probiotics are finally being embraced by consumers are multiple. For one, although consumers still may not know the accurate definition of a probiotic culture, they are learning that certain bacteria are good for them. This change in attitude has paved the way for particular kefir and fermented milk products from Europe and Japan to cross the water and debut in the United States. In addition, the recent popularity of yogurt translated to an explosion of drinkable yogurts and smoothies, which propelled consumers’ trust of yogurt products and their understanding of live and active cultures as a part of the health equation in these dairy products.
All told, with the recent introduction of several new products declaring their probiotic content, and the latest scientific research that probiotic culture strains can be helpful for consumers’ overall health, probiotics are on their way to becoming a better understood and better utilized component in dairy products.
Probiotics in Products
The accurate definition of a probiotic culture goes beyond simply being a “live and active” culture. In official terminology, a probiotic culture is a live microorganism usually isolated from a human intestinal tract, animal intestinal tract or from dairy products, and when consumed in adequate amounts results in health benefits. There are probably about 30 different documented probiotic culture strains with research documenting their positive health effects.
In addition to the required Lactobacillus bulgaricus and Streptococcus thermophilus included in yogurts for SOI regulations, Lactobacillus acidophilus is the most commonly used probiotic culture strain in the United States food industry, included in many yogurt products already on the market. Bifidobacterium is another commonly included probiotic bacteria strain in many yogurt products labeled to contain “live and active” cultures.
A few yogurt manufacturers have led the way in including additional probiotic cultures in yogurt products and labeling them appropriately. Stonyfield Farm, Londonderry, N.H., may have been the forerunner in this regard, including six probiotic cultures in all of the company’s yogurt products for the past five years.
One of the most innovative aspects of Stonyfield Farm’s use of probiotic cultures has been that the company manufactures the only yogurt in the United States which includes the probiotic culture Lactobacillus reuteri, a bacterium of recent scientific study and interest.
Specifically, studies published in the journal Environmental Health in November 2005 demonstrated that regular ingestion of L. reuteri resulted in fewer absences from work due to illness, significantly reducing respiratory and gastrointestinal infections in adults in the study. In a January 2005 Pediatrics article, a study demonstrated that infants fed L. reuteri experienced improved health including fewer doctor visits, days with fever, diarrhea incidences, childcare absences and instances of required antibiotics.
“What has struck me recently are the studies conducted on probiotic cultures that are focused on healthy people and how probiotics can keep healthy people healthy,” says Dr. Mary Ellen Sanders, consultant with Dairy and Food Culture Technologies, Centennial, Colo, “Studies are showing decreasing workplace absences or incidences of cold and other respiratory dysfunctions, and the powerful message is that eating a yogurt product with probiotics may be appealing to the group of people whose goal is to keep healthier, and keep from getting sick.”
Stonyfield Farm’s yogurts include six total probiotic cultures including L. reuteri, and all of the company’s yogurt products also lay claim to the more general health benefits realized through probiotic cultures, such as improved gastrointestinal function, helping to suppress pathogenic bacteria and improving overall immune function.
The DanActive drinkable yogurt product introduced by Dannon in the United States last year includes the probiotic culture Lactobacillus casei in significant amounts; DanActive contains 10 billion live cultures of L. casei in each bottle. When introduced, Dannon took care to broadcast the health message of improved immunity that DanActive offers. The product packaging informs consumers that DanActive “helps naturally strengthen your body’s defense system” with a banner of “immunity” on the label.
But Dannon stepped out even further into the probiotic playing field this year with Activia, a yogurt product that contains a particular strain of Bifidobacteria that Dannon has trademarked Bifidus Regularis. The name Dannon chose for the Bifidobacterium is telling, as the probiotic culture has been shown to decrease intestinal transit times.
“Dannon has developed a body of research to look at people with normal, somewhat long and long gut transit times, and the effect of the strain of Bifidobacteria that Dannon uses in the formulation of their new yogurt Activia,” Sanders says. “Several publications and peer-reviewed studies documented that consumers who eat Activia can shorten what is considered to be long gut transit times.”
But Dannon has to be careful not to mention “constipation” in any of their marketing messages or materials about Activia, because the FDA considers constipation a disease and food products cannot make claims to cure a disease without an FDA-approved health claim. However, Dannon’s Web site and marketing materials provide a plethora of information to the consumer about the scientific mechanisms behind the probiotic culture Bifidus Regularis and how it survives the intestinal tract to reach the colon, thereby helping to regulate intestinal transit.
Apparently 26 million Americans regularly suffer from constipation, and Dannon’s Activia claim is that consumers can experience a beneficial effect to their gastrointestinal regularity within 14 days of beginning regular consumption of Activia. Further indication that consumers struggle with irregularity is evidenced by the widespread buzz which has already infiltrated Internet blogs and irritable bowel syndrome chat groups which are promoting the use of Activia as a method to combat irritating gastrointestinal disturbances. The introduction of Activia with Bifidus Regularis may be the publicity push that moves probiotics front and center on the average consumer radar.
Other Research
Meanwhile, studies upon the health effects of other probiotic strains continue. There have been more than 300 clinical studies conducted on probiotic cultures and their effects upon health. It is somewhat surprising, given that amount of research, that probiotics have not emerged in the public domain and awareness more rapidly.
“Although there is steady research with probiotics, unfortunately we do not have a unified goal or government-sponsored research program to drive it,” Sanders says. “Probiotic research is largely industry funded in the United States, and as such it is focused on potential commercial entities. The published studies span a range of strains, strain blends and health targets with the resulting body of research being rather piecemeal in nature. That jigsaw puzzle has to be put together to create the bigger picture of all of the health possibilities that probiotics hold.”
Recent research into probiotics has discovered a positive effect upon irritable bowel syndrome (IBS) through probiotic ingestion. This is particularly relevant now considering that one of the most popular western medicine drugs for IBS was pulled off the market a few years ago.
“Estimates are that 10 to 25 percent of the people in the United States suffer from IBS, ranging from mild to severe. Some recent, small scale studies have suggested that some probiotics may offer symptom relief for some IBS sufferers,” Sanders says. “This is a very attractive option for people who are mild or moderate sufferers with IBS looking for dietary interventions which may help them manage their condition.”
Other recent studies have begun documenting the effects that certain probiotic strains have upon blood serum cholesterol levels and blood pressure. Much of this work is inspired by the fermented milks in the retail market in Japan and Europe that contain probiotics and claim to help regulate blood triglyceride levels and lower blood pressure in mildly hypertensive subjects.
These recent studies have produced promising, although sometimes conflicting, results. In some studies, probiotic cultures produced a decrease in total serum cholesterol levels in subjects with moderate hypercholesterolemia. Other studies demonstrated an increased HDL level after six months of probiotic consumption, an improved ratio of HDL (“good”) to LDL (“bad”) cholesterol and a decreased total cholesterol level. However, other studies showed no significant changes. It is possible that such conflicting results may be halting probiotics from achieving the publicity and press that has been expected for the last several years.
Another of the problems may be that studying probiotic strains is a difficult proposition. Determining which specific strain of a culture to test and then isolating it is only the first step, then studies must determine how much of the culture is to be ingested in order to survive the digestion process and reach the intestine or the colon, and then results must be documented. All of this translates to probiotic research being a challenge, above and beyond the prospect of disseminating research results to the public to drive probiotic acceptance.
Use Considerations
Because manufacturing processes can affect the viability of the live organisms, products formulated to offer a probiotic health effect should be formulated with sufficiently high levels of probiotics so significant numbers of the cultures remain alive throughout the shelf life of the product. And although many dairy products such as fermented milks and fluid milks are the perfect vehicle for carrying probiotic cultures because they are refrigerated, the acid level in some yogurt products can cause a reduction in the count of surviving probiotic cultures.
 “The dairy industry seems well positioned to take advantage of the burgeoning probiotic situation, because yogurt is a good match being refrigerated and because the organisms tend to be comfortable in those environments. But whether dairy retains ownership of the probiotic concept remains to be seen,” Sanders says. “For example, nutrition bars and fruit smoothies rather than milk-based smoothies are an attractive possible carrier for probiotics, so the range of these types of products is likely to expand.”
Recent developments include the appearance of probiotics in products outside the dairy category. For example, there are cereals that feature yogurt pellets including probiotic bacteria.
One significant gap exists between talking about probiotics in a general sense and identifying how products with probiotic cultures impact consumers. This is because one consideration with probiotics is shelf life — how many cultures a product contains that make it through the manufacturing and shipping proposition to the consumer, and then again how many cultures make it through the gastrointestinal system to have a net effect upon the body’s functions.
“In the current situation, a yogurt product may claim to contain acidophilus, but nowhere does the label proclaim which strain of acidophilus and what level is realized through shelf life,” Sanders says. “So consumers have no information to go on, except that they know there are perhaps some probiotics contained, but whether the level is physiologically meaningful or not is not clear.”
And this speaks to the future path for probiotics. Research is being published indicating probiotics can help keep healthy people healthy. This suggests a reason for a wide group of consumers to include live, active cultures as part of their diets.
At the same time, more focused probiotic strain research is revealing which probiotic strains specifically offer which health effects. In our current market climate where consumers are looking for specific health benefits and looking to realize these benefits through their diet rather than western medicine drug intervention, the possibility that products with particular probiotic strains designed to offset particular issues such as cholesterol imbalance, hypertension or cardiovascular risk is a powerful proposition.