The Truth Behind Probiotics
The market for probiotic supplementation in food is exploding. Why?
Over 100 years ago Mechnikov first reported the extraordinary health of Bulgarians living in the mountains, who he identified as amongst the longest-lived people on the planet. Their love of live bacterial cultured yoghurts led the future Nobel Laurette to propose that consuming lactic acid bacteria through fermented milk leads the ‘Bulgarian bacillus’ to seed the human intestine with good bacteria. This came to be termed the ‘Probotic concept’.
Since then we have identified over 1000 bacterial species hosted by humans. The microflora on our skin, in our intestines contains 3 Million genes, compared to just 22,000 human genes, and some speculate our role is serve bacteria and not the other way around. In fact a human carries only 43% human cells! Our microflora is now known to influence our longevity, resistance to disease, immunity, digestion and even brain health.
So why probiotics now?
There are 70 billion reasons why probiotics are the hottest item in the food business, $70 billion being the 2024 projection for the market for probiotics used in foods, drinks, sports bars, supplement pills, by 2024. Although assumed that humans are going to living longer and longer, researchers projecting we will live to 150, recent reports progress in the US suggest that will be challenged by new diseases. Crohn’s disease, IBD and even antibiotic resistance and various forms of intestinal disorders. Interesting also is the link between the microbes that live inside of us with cancer, obesity and mental acuity in later life. Recent peer reviewed medical research links poor microbial diversity with autism, opening up new avenues for treatment. As we have made our world cleaner and cleaner the number and diversity of bacteria in our intestines and on our body has been reduced, degraded. Have we gone too far?
How clean is too clean. Some have suggested that we stop cleaning our houses, stop using disinfectant soaps, stop using NSAID pills, stop prescribing antibiotics. The desire to control and kill however seems to be fundamental to humans. We want to control the weeds in our lawns, bacteria in our kitchens and our toilet seats. We understand and feel comfortable with the concept of control through chemicals in a manner that we struggle with when it comes to fostering a balanced natural microflora.
Some startups offer microflora testing, and offer advice on diet, lifestyle and supplement strategies to achieve a healthier gut (www.Ubiome.com). One colleague who was tested while attending a SingularityU even was recommended to ‘Get a Dog, roll in the dirt more’.
Can we simply just change our eating habits?
Poor microbial biodiversity is highly correlated with eating processed foods and living in an urban environment. Eating a greater diversity of fruit and plant fiber does help increase microbial diversity and these functional fibers act as ‘prebiotics’ and as our microbes ferment fibers they produce very beneficial short chain fatty acids. Live yoghurts can help (those truly alive and not those where a strain or two of probiotics is added afterwards to a pasteurized yoghurt). Unpasteurized cheeses and milks might help to support microflora development but they also introduce real food risks that you need to be aware of and for this reason doctors recommend against consuming unpasteurized or raw foods. Probiotics can also be found either in probiotic rich or fermented foods, such as miso soup, kefir, sauerkraut, pickled vegetables and kombucha. Novel foods could include Nigerian fermented milk products such as Kindirmo & Nono (similar to yoghurt) and Warankasi (Cheese) act as probiotics . Fermented cabbage Kimchi/Kimchee provides L.Mesenteroides and L. plantarum.
As the importance of having good bugs has grown so has the interest in more aggressive strategies. Fecal microbiota transfer (FMT) has been embraced as a solution to clostridium difficile intestinal infections but the long-term effects aren’t known, and two recent deaths have brought into question the likelihood of FDA imposing regulation on the proceedure in the US.
Probiotic products.
Danone and Yakult are among the most recognized probiotic yogurt drink brands, and these feature L.Casei and L.acidophilus strains. Irish company Alimentary Health patented Zenflore from the bacteria strain B. Longum 1714 with a claim to improve the ability to cope with stress. Nestlé has launched an infant formula Good Start Natural Cultures.the first US baby formula to contain probiotics. Nestle also launched BioGaia Probiotic Drops for infant colic relief.
Probiotic startups to watch include hangover cure US startup ZBiotics who have created a probiotic drink that breaks down acetaldehyde (which is a harmful byproduct of alcohol and thought to cause hangovers) from system after alcohol consumption. “Good bacteria” found in ultramarathon athletes has been shown to break down carbohydrates faster than in an average person. FitBiomics is sequencing the microbiome to identify and isolate novel bacteria to improve sports performance and recovery. Sun Genomics has focused on personalized “precision” tailored probiotics by analyzing the gut microbiome signature. Prota Therapeutics is an Australian company developing probiotic food oral immunotherapy technology to address allergies such as that to peanuts. The company is in clinical development and commercialization. Unibiome wants to enhance foods such as bread by increasing the bioavailability of nutrients, vitamins, trace elements in commonly fermented foods. Unibiome has created a bakers yeast that increases the absorption of iron from bread Chile based startup Novalact (2014) has focused on alleviating the symptoms of gastrointestinal illnesses, and engineering probiotics to create non-dairy milk yoghurts, for example from almonds.
Probiotic applications includes adding probiotic microorganisms to cosmetics and mattresses.
So do Probiotics really work?
The answer is it depends. The human microbiome is resistant to change and as such probiotics often don’t show positive results, with one report last year suggesting probiotics are useless. The reality is that we have trillions of bacteria in our intestine and while adding millions or billions maybe beneficial to non healthy individuals in particular the microflora's tendancy is to return to a baseline over time. The microflora you develop is a function of the twin forces of nature and nurture. Genetics influence the sugars or carbohydrates in your intestine, which favors certain bacteria, and the nuture influence is also strong, depending on your environment, from your mother, where you grew up, what foods you typically eat etc .
To change your microflora by adding a probiotic to your diet seems unlikely. Certain situations favor success.
Post antibiotics
Post diarrhea
Digestive upsets
Overall it seems that the more likely way to success is to consume fermented foods, or probiotic products with a large range of different live strains. The clear challenge is that even with modern analytical techniques to profile the GI microfloral DNA the process is dynamic and the requirement for probiotics, the appropriate dose and frequency are poorly understood.
Three things we learned from using Probiotics in Pets, Livestock
Probiotics have been added to diets of companion and livestock animals now for over 50 years. My career in Alltech gave me unique experience in this area having sold, tested, trialed and filed patents working with Dogs, Cats, Horses, Chickens, Calves, Pigs, Fish and even Zoo animals. Restrictions or removal of antibiotics from livestock diets this has accelerated this trend and has made the use of probiotics and prebiotics ubiquitous. Probiotics and prebiotics form part of what veterinarians call ‘competitive exclusion’ or a strategy fostering probiotic colonization in order to prevent colonization by pathogenic bacteria. The farm microbial environment is relatively controlled, and makes it easier to do research than with humans. Thousands of animal studies have clearly demonstrated benefits of probiotics on growth and health, and since animals cannot experience a ‘placebo effect’ when they don’t work probiotics either improve digestion/ prevent diarrhea, disease because if they don’t, they stop growing or even die.
My three lessons are-
More is better. Chose the product with the greatest number of different strains and types of bacteria; Microbial diversity is the key, not searching one or two probiotic strains to be a magic bullet.
Concentrated is better. Chose products with the most numbers of bacteria; this is measured in Colony forming units (CFU) and more is better. Learn the difference between millions and billions (10.6 is not as good as 10.9!)
Support your probiotics. Prebiotics are important to support probiotic development; artichokes, asparagus, garlic, onions, and whole grains offer these compounds. Oligosaccharides such as inulin, FOS, GOS, XOS promote bacterial growth and for probiotics to colonize the intestine. MOS can help to remove pathogens.
Probiotics and human longevity?
As we now understand in cellular terms we are 43% microbes, so maybe our medical efforts should be refocused to understand and manage how our microbes interact with our DNA. Genome sequencing costs are falling rapidly and the understanding of probiotics and symbiotics will improve exponentially. The use of new biotic interventions are coming in the form of phages (https://www.next-biotics.com/) and peptides (https://www.nuritas.com/).
Towards a smarter future?
As we learn more about probiotics, the human microbiome, and all of the interactions that can occur we will understand more about smarter ways to use probiotics. Smarter, precise may take different forms. Specific strains for medical applications treating specific conditions, diseases and gastroenteritis. Multi strains for general human health. Fecal Microbiota transplants will be replaced with a characterized multispecies bacterial mixture that could be safer, free of allergens or viruses, and offering similar benefits. We must be prepared for research showing risks or even negative effects. One research group has suggested probiotics might Probiotics maximum benefits will be achieved once we have the technology to fully catalogue their pathways and interactions.
Probiotics don’t always have to be alive. We are also learning the benefits of postbiotics or paraprobiotics and applications in functional foods. These terms refer to the non-live products produced by bacteria, which in themselves can be very powerful agents for health.
The Probiotic concept is more than a fad, and will lead to a different way of thinking about what it means to be human. In the meantime increasing the microbial diversity of your life, reducing pre-processed foods, avoiding antibiotics and antimicrobials where possible are good lessons for life.
Thank you to David Hunt and Isha Munde for their contributions
