Updated 14 February 2013

Probiotics: food for thought?

The probiotics trade is the blue-eyed boy of the $500 billion-dollar functional food industry. But beneath the calm surface of the yoghurt tub, something is stirring. Or is it?

The probiotics trade is the blue-eyed boy of the $500 billion-dollar nutraceutical and functional food industry.

Worldwide, millions of consumers are trying out these "good bugs" to see for themselves if the health claims – that these microbial foods and supplements can change or re-establish the intestinal biota of the host – hold true.

But beneath the calm surface, something is stirring.

While most consumers simply have an "Ag, let's give it a shot" attitude when it comes to probiotics, the industry seems to be in turmoil. Not only is it the food topic most frequently published in scientific journals ever, but it is also a very loaded one.

Controversial and emotional
"The topic of probiotics is a deeply controversial and emotional one," says Prof Trevor Britz from the Department of Food Science at the University of Stellenbosch, "but the emotional stirring is happening within the production companies."

Earlier this year, Health24 published an article by dietician Dr Ingrid van Heerden that put into perspective what seemed like false label claims made by probiotics manufacturers (read Probiotics claims investigated). This article highlighted the many issues surrounding probiotics – and is just one take on the heated debate currently raging.

Now, yet another research study – this one by the University of Stellenbosch – revealed that only 54,5% of a sample of South African probiotic yoghurts contained the micro-organisms stated on the label. Products available in tablet or capsule form fared even worse: only a third contained the stated micro-organisms

Unfortunately the debate is resulting in confusion among consumers.

Probiotics a great health booster
Probiotics can undoubtedly have a positive effect on the health of the consumer. This isn't news: Ayurvedic texts dating back to 6000 B.C. said that "fermented milk leads to a long and healthy life," and the Roman historian Pliny advocated the use of fermented milk for gastro-intestinal infections as early as 76 A.D.

Health benefits, supported by sound modern-day scientific evidence, include easing of lactose tolerance symptoms, reduced cholesterol levels and the control of intestinal infections.

But if these bacteria have such clear-cut benefits, why is evidence mounting that many of the products available on the market don't contain the amount and/or type of probiotics claimed on the label?

Claims difficult to measure
According to South African draft regulations, probiotic claims can only be made if the bacteria added to the product are "live organisms indigenous to the human intestinal tract".

It's important to note that the probiotic bacteria should be present in adequate numbers (more than 1 x 10 to the power of 8 colony-forming units per 100ml, according to regulations) at the end of the product's shelf life for it to have a beneficial effect on the consumer.

Furthermore, draft regulations state that the probiotics should: be able to survive passage through the digestive tract; not be destroyed by acid, bile and/or enzymes; adhere to the intestinal epithelium; colonise the intestinal tract; proliferate in the gut; produce anti-microbials which control and destroy pathogenic bacteria, viruses, yeasts and fungi; play a role in the maturation and stimulation of the human immune system; and display no drug or antibiotic resistance.

Tough criteria indeed

Yet many a product makes bold claims, like that it "realigns the gut", "gives physical energy", "retards ageing", "invigorates the mind" and "reduces wrinkling" – claims that can be quite difficult to prove scientifically.

Difficult to adhere to regulations
Such claims aside, manufacturers seem to find it difficult just adhering to the above-mentioned draft regulations.

In 1998, a South African study indicated that L. acidophilus was indeed present at 10 to the power of 8 colony-forming units per 100ml (which is within the guidelines) in three brands of plain and flavoured yoghurt studied, but that B. bifidum was present at less than 10 to the power of 2 colony-forming units per 100ml.

In a more recent study of nine probiotic products, researchers found that only five of the products had the probiotic effects they claimed, while only three of the products contained the amount of bacteria specified on the labels.

And now, in the 2005 study by the University of Stellenbosch, it was found that only 55% of the 11 dairy products studied contained the probiotics indicated on the label, while only 33% of the probiotic capsules/tablets contained the ingredients claimed.

The researchers also found that some Bifidobacterium species were incorrectly identified on the product labels and that various micro-organisms were detected that were not listed – some even potentially dangerous.

Small wonder then that the researchers concluded there was "a general lack of accuracy in the identification and naming of probiotic micro-organisms as presented on the labels of various South African probiotic-containing products."

Deliberate or not?
However, the companies aren't necessarily aware of the fact that their products aren't living up to their claims.

"My feeling is that the manufacturers aren’t making the false claims on purpose," says Britz, who worked on the Stellenbosch study. "I can also say that I've never encountered a manufacturer who tried to hide something."

Britz reckons that companies are finding it difficult to overcome technical problems, especially in terms of keeping the micro-organisms alive under unfriendly conditions. "It's not always possible to control the growth factors." And organisms are killed or inhibited as a result.

Nevertheless, consumers may not be getting their money's worth – and they have a right to feel cheated.

Call for action
Britz emphasises that "probiotics are an asset to the consumer" – but that there is a lot companies can, and should, do to ensure that their probiotic products live up to their claims.

Companies should:

  • do regular shelf-life studies on their products;
  • ensure that what they add to their products is what they intend to add;
  • check that the organisms can survive in each one of their products, under every single condition to which it might be subjected;
  • make doubly sure that the claims they make are correct and acceptable in terms of the regulations.

In the meantime, consumers shouldn't just discard the use of their probiotic products. Many of the products available on the market do contain the health-boosting micro-organisms indicated on the labels.

But the industry needs to pull up its socks – in their own and in the consumers' interests.

As a final call for action, Britz says that the government should make it a priority to ensure that the draft regulations are passed as legislation – as long as the regulations remain in draft form, the government cannot enforce them and the consumer will keep getting the short end of the stick. – (Carine van Rooyen, Health24)


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