Welcome to the latest edition of the LLS Blog. At LLS we like to provide factual product overviews and try to deliver this information in the simplest way possible.
This time we will be looking at Probiotic Support Supplements.
Probiotic foods and supplements have seen a massive surge in popularity in recent years fuelled by an increasing awareness and knowledge of their potential health benefits.
We all have nice friendly bacteria in our guts but the presence of illness, stress and poor diets can reduce them which allows bad bacteria to grow and make us ill. We should therefore counteract this by increasing our levels of friendly bacteria with a daily helping of probiotic foods, such as sauerkraut, kimchi, kombucha, kefir and yoghurt or a probiotics supplement to help keep the baddies at bay.
Let's take a closer look to identify what probiotics are, what they do, their effectiveness in preventing illness, any potential side effects from taking them and specifics regarding probiotic supplements.
Just for the record, did you know people have been eating live yoghurt as a digestive aid since Roman times.
The father of probiotics, Russian scientist Elie Metchnikoff, was intrigued by the fact that so many Bulgarian peasants lived to be 100. In 1907 he concluded it was because they ate so much yoghurt and began to do so himself, confidently expecting to live to be 150.
He managed 70… oh dear!
What are Probiotics?
The World Health Organization's 2001 definition of probiotics is "live micro-organisms which, when administered in adequate amounts, confer a health beneﬁt on the host". 
They are effectively live bacteria and yeasts which are naturally found in the body and can offer health benefits when consumed. They often described as “good” or “friendly” bacteria because they benefit the body, specifically the digestive system.
We have 100 trillion (100,000,000,000,000) bacteria in our bodies, mainly in the digestive system. Around 400 different species live in the gut, mainly to ward off pathogens - harmful bacteria.
They also help the digestive process and produce vitamins and minerals. Probiotics are normally consumed in fermented foods with active live cultures, such as the ones mentioned earlier. Probiotics are also available in supplement form as capsules, liquid and chewables.
There are many different strains of probiotics, but the most common strains available today in are Lactobacillus and Bifidobacterium.
What do Probiotics do?
There is evidence to suggest that Probiotics can:
- Improve digestive function
- Reduce persistent diarrhoea
- Reduce antibiotic-associated diarrhoea (AAD)
- Help to treat Irritable Bowl Syndrome IBS
- Improve tolerance to lactose
- Enhance immune function
So let’s look at each benefit in more depth to analyse the evidence.
Improve digestive function
Probiotics help move food through your gut so there is a strong link between micro flora of the gut and your ability to digest and absorb foods properly. Dr David Williams writes in detail about healthy gut bacteria and how acidifying the colon can normalise bowel movements. 
Reduce persistent diarrhoea and reduce antibiotic-associated diarrhoea (AAD)
There’s some evidence that probiotics can shorten a period of persistent diarrhoea by about a day. Cochrane Collaboration meta-analysis on the use of probiotics to treat acute infectious diarrhea based on a comprehensive review of medical literature through 2010 (35 relevant studies, >4500 participants) reported that use of any of the various tested probiotic formulations appeared to reduce the duration of diarrhoea by a mean of 25 hours 
A review assessing the work of 16 different studies representing the evaluation of more than 3,400 patients concluded that the evidence gathered suggested a protective effect of some probiotics in this condition. This comprehensive review identified that patients treated with ≥5000 million CFUs/day (including L. rhamnosus and Saccharomyces boulardii) had 60% lower relative risk (95%CI: 44–71%) of experiencing AAD than untreated patients. 
Help to treat Irritable Bowl Syndrome
IBS Probiotics may help reduce abdominal bloating and flatulence in some people with IBS, and they may help relieve pain and provide general relief. Uncertainty still remains around which type of probiotic works best, and around the size of the effect. 
Improve tolerance to lactose
Lactose intolerance is a common digestive problem, when the body is unable to digest lactose (a type of sugar found mainly in milk and dairy products). It's usually the result of a lactase deficiency. Lactase is an enzyme (protein) normally produced in your small intestine. It is needed to break down lactose and to enable you to digest milk.
Lactobacillus acidophilus is thought to help with the digestion and absorption of lactose by producing lactase. These active strains may help lactose-intolerant individuals tolerate more lactose than they would otherwise have tolerated. 
Enhance immune function
Researchers at the Harvard Medical School have found evidence of a relationship between such “good” bacteria and the immune system. For instance, it is now known that certain bacteria in the gut influence the development of aspects of the immune system, such as correcting deficiencies and increasing the numbers of certain T cells. .
Clinical trials have demonstrated that probiotics may decrease the incidence of respiratory-tract infections 
What types of Probiotic bacteria are effective? Many types of bacteria are classified as probiotics. They all have different benefits, but most come from two groups.
This may be the most common probiotic. Different strains can help with diarrhea and may help with people who can’t digest lactose, the sugar in milk. Acidophilus inhibits pathogens, and produces such natural antibiotics as lactocidin and acidophilin, which enhance immunity.
Bifidum prevents pathogenic bacteria and yeast from invading. Bifidum creates favourable changes in pH levels by producing lactic and acetic acids. In addition, this species increase absorption of iron, calcium, magnesium and zinc.
How many Billion CFU are recommended?
CFU stands for colony forming unit and is a method of allowing you to know how many good bacteria you are getting.
The number of colony forming units that you need really depends on a number of things. For general good health, most experts recommend between 6 to 10 billion cfu each day. This is also written as 6x109 to 10x109.
For a specific minor health problem a dose of around 20 to 30 billion is often used. Take the dose suggested on the bottle or used in successful medical trials for that health problem.
For a major health problem you need to be guided by your personal health professional. 
What are Prebiotics?
The industry definition is: A prebiotic is a selectively fermented ingredient that allows specific changes, both in the composition and/or activity in the gastrointestinal microflora that confers benefits upon host well-being and health. Or in simple terms, Prebiotics are a source of food for probiotics to grow, multiply and survive in the gut. Common prebiotics include: inulin, Fructooligosaccharides (FOS), galactooligosaccharides (GOS), lactulose and lafinose.
Combinations of probiotic and prebiotic supplement (called a synbiotic) are usually sought to ensure they are feeding their levels of friendly bacteria.
Some probiotic supplements are enteric coated, but....
What is Enteric Coating?
It means the supplement is coated with a material that permits transit through the stomach to the small intestine before the medication is released.
These formulas are “gastro-protected” which allows the probiotic cultures to pass through stomach acid unharmed until it reaches the higher pH environment of the intestines. Here the probiotic cells are released, ensuring the full dose of the probiotic formula is getting exactly to the area where you need it.
Is it safe?
Yes, there’s wide agreement that unless you are severely ill, they both pose no risks and have no unpleasant side effects. In short, taking them won't do any harm.
The most common adverse effects include bloating and flatulence; however, these are typically mild and subside with continued use.
So, Do Probiotics Work?
There is relatively strong evidence to suggest that probiotic supplements have the ability to prevent and treat various medical conditions, particularly those involving the gastrointestinal tract.
They do however, need to further research to substantiate and reinforce all of the health claims.
 Schlundt, Jorgen. "Health and Nutritional Properties of Probiotics in Food including Powder Milk with Live Lactic Acid Bacteria" (PDF). Report of a Joint FAO/WHO Expert Consultation on Evaluation of Health and Nutritional Properties of Probiotics in Food Including Powder Milk with Live Lactic Acid Bacteria. FAO / WHO. Retrieved 17 December2012.