1. DEFINITION OF A PROBIOTIC
Probiotics are live micro-organisms that, when consumed in adequate amounts, provide a health benefit to the host
Viability and resistance to digestion must be demonstrated by a probiotic. The most common species of micro-organisms are Lactobacilli and Bifidobacteria, but others exist and are well-documented. The genus, species, and strain must be identified. The adequate dosage and health benefits must be documented and present until the end of the shelf life
2. SAFETY OF PROBIOTICS
Probiotics are usually safe in healthy populations. However, before choosing a strain and / or product, one should verify the history of Safe Use and/or ask for Safety data on the specific strain.
3. NOT ALL BACTERIA ARE PROBIOTICS
Some products which contain probiotic metabolites, non-live or fragmented probiotic cells even if they are efficient, do not comply with the definition above and cannot be qualified as probiotics; examples include some household cleaning agents, drain cleaners and even cosmetic products.
4. HEALTH EFFECTS OF PROBIOTICS
Various health benefits have been described for probiotics and although some health benefits appear to be fairly common, others have been shown to be very specific. Thus, no probiotic can be expected to provide all suggested health benefits; different probiotic strains may have diverse benefits.
5. LEVEL OF EVIDENCE
No probiotic will have all of these combined effects, though selected strains / combinations have shown their efficacy for specific health benefit
HEALTH BENEFITS | LEVEL OF EVIDENCE | COMMENTS |
Reducing risk for antibiotic associated diarrhea | Good | Numerous studies |
Reducing risk for necrotising enterocolitis | Good | Numerous studies |
Reducing risk for respiratory tract infections | Good | Numerous studies |
Clostridium difficile associated diarrhea | Good | Many studies |
Prevention of atopy | Good | Many studies |
Irritable bowel syndrome (IBS) | Fair | Many studies not all positive |
Inflammatory bowel disease (IBD) | Fair | Many studies not all positive |
Slow intestinal transit | Fair | Moderate Effect |
Serum cholesterol | Fair | Moderate Effect |
Bacterial vaginosis (BV) | Fair | Heterogeneous studies |
Control of type-2 diabetes | Weak | Few studies |
Gestational diabetes | Weak | Few studies |
Periodontitis management | Weak | Few studies |
Improving psychological symptoms / depression | Weak | Few studies |
Adjunct to H. pyolri eradication therapy | Weak | Few studies |
Infantile colic | Weak | Few studies |
Allergic rhinitis | Weak | Few studies |
Blood pressure | Poor | Few studies not all positive |
Dental caries | Poor | Few studies not all positive |
Ventilator associated pneumonia | Poor | Few studies not all positive |
Weight management | Poor | Few studies of poor quality |
Cystic fibrosis | Poor | Few studies of poor quality |
Urinary tract infection (UTI) | Poor | Few studies of poor quality |
Treatment of acute pancreatitis | No evidence | Few studies inconclusive results |