• Overview
  • Dietary Advice for General Health
  • Diet Evaluation Standards
  • Special Training and Licensure
  • Organizations and Agencies in Nutrition
• Disease States
  • Cardiovascular Disease
  • Type 2 Diabetes
  • HIV+
  • Hypertension
  • Weight Loss and Maintenance
• Interventions
  • Supplements
  • Multivitamins
  • Probiotics
  • Antioxidants
• Resources
  • Clinician Resources
  • Journals, Newsletters, Magazines, Websites
  • Lifecycle

Probiotics

Medical Uses  |  Mechanisms of Action  |  Safety

1. What are probiotics?
   "Probiotics are viable microbial preparations in foods and feeds or dietary supplements designed to improve the health of humans and animals" [1]
   
2. What are the medical conditions in which probiotics have been used or suggested to be helpful?
   1. GI problems (diarrhea, constipation, lactose intolerance, etc.)
   2. Allergies (food allergies, etc.)
   3. Urogenital infections
   4. Liver disease
   5. Alleviation of radiotherapy side effects
   6. Vaccine adjuvant
   7. Colon cancer prevention
   8. Inflammatory bowel disease
   9. Side effect and opportunistic infections resulting from various diseases, such as, Cystic fibrosis and AIDS [1], [2], [3], [4]; Nutrition Today 1996; 31, no.6: 1s – 52s.
      
3. What is the rationale or mechanism of action for probiotic intervention or treatment?
   The following mechanisms among others have been proposed for the therapeutic action of probiotics:
1. Antimicrobial action
2. Enhancement of immune system
3. Bacterial displacement
4. Specific modulation of GI antigenic response
5. Alteration of GI microecology
6. Alteration of exogenous compounds (i.e., drugs)
7. Alteration of endogenous compounds (i.e., cholesterol)
   [5], [4]
   
4. Are there any potential negative short or long-term effects resulting from the use of probiotics?
1. Most probiotics are lactic acid bacteria used in fermentation of foods
2. "GRAS" (Generally Recognized As Safe) designation by the FDA.
3. There are rare cases of bacteremia, endocarditis, and abscesses in which Lactobacillus or other probiotics have been implicated.
   [7], [8]
   
5. What data are available to support the usefulness of probiotics?
   1. Clinical studies
   2. Case reports and anecdotal reports
   3. Commercial and product claims [9], [1], [10]
      
6. Are there any special interest groups or economic benefits involved with probiotics?
   1. There are numerous companies that benefit from the sales of probiotics
   2. Food companies, dairy companies
   3. Nutrition supplement companies
   4. Drug companies
      

Resources

• Guidelines for the Evaluation of Probiotics in Food: Joint FAO/WHO Working Group meeting, London Ontario, Canada, 30 April-1 May 2002

• Health and nutritional properties of probiotics in food including powder milk with live lactic acid bacteria, a joint FAO/WHO expert consultation. Cordoba, Argentina, 1 - 4 October 2001

• Food and Agriculture Organization of the United Nations