Consumers sift through health claims about probiotics

Gregor Reid, professor of Microbiology &
Immunology and Surgery at the University of Western Ontario, is shown in
a lab at the Lawson Health Research Institute in London, Ont., Tuesday,
July 27, 2010. (Dave Chidley / THE CANADIAN PRESS)
Kathleen Goldhar tried for years to figure out what was causing her
young daughter to suffer from persistent, sometimes agonizing stomach
pains.

Since age three, the now seven-year-old girl had complained of
intense cramps that would stick around for a couple of nights, subside
and then return days or weeks later, usually when she ate.

With little insight from doctors, at least one trip to the hospital
with cramps that caused the little girl to writhe in pain, and myriad
tests producing no answers, the single mom took the advice of a
nutritional consultant who recommended probiotics.

Goldhar began adding the powdered supplement to her daughter's juice
and within a couple of weeks noticed her complaints diminished as the
pain appeared to lessen.

"They seem to work," she said from Toronto. "It does seem to be a
digestion issue and she seems to be able to sort of handle her food
better. Her stomach doesn't hurt as much."

Goldhar is one of a growing number of people who have turned to the
bacterial critters for a host of health reasons, including candida,
digestion, brain development, diarrhea and boosting the immune system.

Probiotics are live organisms, usually helpful bacteria similar to
those found in the human gut, which can change or restore the intestinal
flora. They are present in such foods as sauerkraut, miso and fermented
products, but can also be taken in pill or powder form.

There are billions of bacteria in the body -- on skin, in the mouth,
the intestines and other body parts -- that can maintain general health
by raising resistance to harmful bacteria.

The World Health Organization defines probiotics as "live
micro-organisms which when administered in adequate amounts confer a
health benefit on the host."

The surge in popularity comes after manufacturers homed in on the
potential benefits and began adding them to everything from yogurt,
infant formula and juices to bread, chewing gum and chocolate. They can
even be found in some floor cleaners and aftershaves.

Marketers have claimed the naturally occurring bacteria can shorten
the duration of colds, prevent diarrhea, overcome allergies and even
reduce the risk of certain cancers.

But health experts say the hoopla over probiotics has overshadowed
actual scientific proof that they improve health, leading to confusion
for consumers deluged with claims about products containing the
micro-organisms.

Gregor Reid, who specializes in the study of probiotics, was on the
panel that created the WHO's definition of probiotics and says many of
the products claiming to contain them actually don't because they
haven't been proven in a human study to confer a specific health
benefit.

"The majority of products on the market are not in fact probiotics,"
said Reid, chair of human microbiology and probiotics at the Lawson
Health Research Institute in London, Ont.

"When you call something a probiotic, there should be an expectation
that it's been clinically tested and shown to have a benefit, and
unfortunately many products don't. So the first step is getting
companies to do the studies."

The problem is that there are many different strains of friendly
bacteria that perform many different functions. Most have not been
proven to be effective in clinical trials.

For consumers, it's not clear on food labels how much and what type
of bacteria a product contains, making it difficult to know if the
probiotics are best suited for a particular health ailment.

Only some companies, like yogurt maker Dannon, list the specific
bacteria that have been shown in trials to help with certain health
issues, like regularity and digestion.

The company settled a $35-million lawsuit last year with customers
dissatisfied over health claims it was making about some yogurt
products, leading to more explicit labelling.

Some experts say that shouldn't scare off consumers from using
probiotics for conditions where there is some agreement on benefits,
such as helping with some types of diarrhea, bowel regularity, colds and
irritable bowel syndrome.

John Bienenstock, a professor of pathology and molecular medicine at
McMaster University in Hamilton, said people have to look very carefully
at a particular product and determine exactly what it is.

"They have to look through the literature carefully, recognizing
there is this problem of a lack of consistency of information and lack
of consistency of products," said Bienenstock, who's also director of
the Brain Body Institute.

"From a consumer point of view, it's very important that when you go
out and see what's on the shelf, you know what's on the bottle and what
it can do ... There are health benefits and there is hype."

Regulatory agencies are trying to rein in the multi-billion-dollar
industry, which saw consumer spending on probiotic supplements triple in
the United States between 1994 and 2003.

The International Probiotics Association is planning a labelling
scheme that would include a minimum bacterial count and an
identification of the bacterial strain.

There is also a move afoot in Europe to control the claims with
regulation that demands companies produce the scientific evidence to
support their labelling.

Health Canada has developed a probiotics monograph, which includes
detailed information on acceptable health claims, associated doses,
source materials and required risk information.

It has also developed a guidance document that spells out when health
claims can be made about food. The department website states that food
products containing probiotics may have to remove the word if they're
not accompanied by "specific, validated statements about the benefits or
effects of the micro-organism."

Researchers say people need to scrutinize prebiotics just as closely.
The sugar-type molecules are non-digestible foods that make their way
through the digestive system and help good bacteria flourish. They are
mostly found in carbohydrate fibres and can be taken in supplements or
foods.

Reid said consumers have to research probiotic products themselves,
using online sites like PubMed to see what studies have been done to
prove a company's claims.

He would like to see it made easier to know the strain of bacteria,
its properties, what it does, how long it lasts if it's in powder form
and where it goes in the body. Otherwise, he worries that skepticism
over probiotics' actual benefits will sully ones that have been
scientifically proven to work.

"There needs to be more clinical evidence or companies need to stop calling their products probiotics," he said.

"It shouldn't be a fad. I think the ones that are properly
scientifically documented will be here to stay, but the other ones
hopefully don't spoil it for everyone else."