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Probiotics: A Common Sense Discussion

OverviewProbiotics are most simply defined as naturallyoccurring health-enhancing micro-organismsconsumed as a food component or dietary supplement. Other common terms for probiotics are “friendly” or “healthy” bacteria.

For centuries people have knowingly consumedprobiotics as a natural component of theirfood supply. Fermented milks have historicallybeen the most common foods containing probiotics. However it was not until 1908,when Elie Metchnikoff published his bookentitled “The Elongation of Life” that healthbenefits were first attributed to the consumptionof milk fermented with specific types of bacteria.

Bacteria promoted as probiotics should havean established history of safe use and documentation of efficacy. They should benormal inhabitants of the human body.Delivery in an effective dose, with viabilityguaranteed through shelf life under recommended storage conditions, is critical. Aminimum dose of billions of probiotic bacteriaper day is generally regarded as necessary toobserve health benefits. Storage under refrigeratedconditions is recommended to assure viability.

How do Probiotics Work?To understand how probioticswork, it is important to know alittle about the microbiology ofthe human body. Humans, likeanimals, are highly colonizedmicrobes. Microbes live onour skin, in our mouths, inwomen’s vaginal tract and

throughout our gastrointestinal (GI) tract(Figure 1). It is estimated that there are 1,014microbes associated with our bodies. That is 10times greater than the total number of cells ourbodies contain.

Since probiotics are consumed as food anddietary supplements, it is also helpful to reviewsome basic information on the human digestivesystem. The digestive process begins as soon asfood enters the mouth. The process of chewingincreases the surface area of food particles,making the food more susceptible to the digestiveenzymes, including those in saliva. Smallerfood particles also travel more easily (and therefore more quickly) through the GI tract.In the stomach food is mixed with gastric juice,containing digestive enzymes and hydrochloricacid. This mixture, known as chyme, is thenactively pumped out of the stomach and into

Figure 1

the small intestine. There more enzymes and bile aremixed with chyme, and the breakdown of dietary proteins, fats, and carbohydrates is completed.

Most nutrients are absorbed in the small intestine.Within about 4-6 hours of eating, what is left of thefood passes into the large intestine, or colon. Wastematerial accumulates, water and electrolytes areabsorbed and fecal matter is stored until it passes outthrough the rectum every 24-48 hours.

Gastrointestinal TractMicrobes are not very prevalentin the small intestine. The highacid and bile concentrationscoupled with the rapid transittime of contents is not favorableto microbial growth. However,toward the lower small intestine,microbes begin to attain higherpopulations (106-108/gram ofsmall intestine contents) and inthe colon they constituate about 1,011-1,012/gram of

colon contents. This is a huge number of microbes.

Considering the multitude of microbes in the intestinaltract, what are the effects of their presence? It is knownthat microbes in the large intestine complete the digestionprocess on any food components that were not digestedin the small intestine, such as lactose in lactose intolerantpeople or soluble fibers which are resistant to enzymepresent in the small intestine. But there is evidence ofnon-digestive microbial activity as well.

Certain intestinal microbes are known to produce vitamins.Also, in studies done with special microbe-free laboratoryanimals, evidence is strong that without normal microbialpopulations, the immune system functions poorly, andresistance to pathogenic bacteria is greatly reduced.Other evidence suggests that intestinal microbes mightact as mutagenic compounds. Depending on the specificmicrobe, mutagenic activity can either be increased ofdecreased.

Health Effects Of ProbioticsUsing probiotic cultures to promote health has an inherentadvantage in that it is a natural approach...There are hundreds of papers published on many

health benefits of probiotic cultures. Described in thesepublications are in vitro studies, studies in animalmodels and human clinical studies, all designed todetermine how probiotic cultures may influence a variety of health conditions. Of course, these are verycomplicated questions, and research is still activelybeing conducted to further define the role of probioticsin human health. But what can be said is that an evaluation of the body of research done on probioticcultures suggests that certain strains consumed at highlevels positively influence human health. Food sourcesof probiotics, like milk and yogurt can be healthy additions, but due to intolerance and lower culture levels,supplementation becomes a more viable option. Usingprobiotic cultures to promote health has an inherentadvantage in that it is a natural approach which doesnot disturb the natural colonizing flora of the humanbody. Perhaps the most compelling use of probiotic cultures is to decrease the degree of disturbance of thenormal intestinal microflora which comes with antibioticuse. The purpose of antibiotics is to kill harmful bacteria.Unfortunantly, they kill normal bacteria also. Instead ofwiping out bacteria, probiotics promote growth offriendly flora, which in turn fight disease and infectious-causing bacteria. The following describessome of the further proposed health benefits ofconsumption of probiotic cultures.

Immune System StimulationThe immune system provides an important defenseagainst microbial pathogens which have entered ourbodies. The immune system is extremely complex,involving both cell-based and anti-body based responsesto potential infectious agents. Immunodeficiency canresult from certain diseases (e.g. cancer, AIDS,leukemia) or to a lesser extent from more normal conditions such as old age, pregnancy, or stress.Autoimmune diseases (e.g. allergies, rheumatoidarthritis) can also occur due to misdirected immunesystem activity.

How are our Gut and Immune System Related?The gastrointestinal tract is the primary interfacebetween us and our outside environment. The totalmucosal surface area of the adult GI tract is about 300square meters, and is by far the largest body areaexposed to “foreign” substances like pathogens,harmless bacteria and food. The gut-associated lymphoid tissue (GALT) makes the GI tract our largest

Figure 2

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immune organ. It is through this mechanism that probiotics are thought to influence the immuneresponse. Probiotic cultures have been shown in a variety of test systems to stimulate certain cellular andantibody functions of the immune system. Animal andsome human studies have shown an effect of yogurt orprobiotic bacteria on enhancing levels of certainimmunoreactive cells ( e.g. macrophages, lymphocytes)or factors (e.g. immunoglobulins, interferon). In addition,some studies have shown improved survival ofpathogen-infected laboratory animals consuming probiotic cultures as compared to animals consuming acontrol diet. Results accumulated so far suggest thatwhen ingested, probiotics organisms are exposed to themucosal layer of the GI tract, providing an additionaltool to help your body protect itself.

HypertensionAbout 50-60 million people in the United States areestimated to have hypertension, or elevated blood pressure. Evidence suggests that some decrease in bloodpressure may result from the consumption oflactobacilli. Some studies done with hypertensive ratshave shown a positive effect. Studies with human subjects are limited. However, one study conductedwith subjects with hypertension showed a decrease of10-20mm Hg in systolic pressure. Attempts to isolatethe component implies that the cells need not be aliveto mediate this effect. Other research demonstrated thata compound produced when probiotic bacteria weregrown caused an anti-hypertensive effect. These resultssuggest that consumption of certain lactobacilli, orproducts made from them, may reduce blood pressurein hypertensive subjects, providing patients anothertool in managing elevated blood pressure.

VaginitisThe vagina and its microflora form a finely balancedecosystem. Disruption of this ecosystem can lead to amicrobiological imbalance and symptoms of vaginitis.Vaginitis used to be considered a mere annoyance, butnow is being examined for a role in serious conditionsincluding pelvic inflammatory disease, pregnancy related complications (e.g. low birth rate babies) andincreased susceptibility to AIDS infection. Vaginitis canbe caused by several different organisms, and in manycases, the causative agent may not be identified. What isknown is that lactobacilli predominate in the healthyvagina, and a lack of lactobacilli (especially those

producing hydrogen peroxide) is correlated to vaginitis.The lactobacilli are thought to maintain a favorablevaginal pH in the acidic range and to inhibit pathogensvia the production of hydrogen peroxide. Intravaginalapplications of lactobacilli have been shown somewhateffective in treating bacterial vaginitis. One study donewith 13 women showed that consumption ofLactobacillus acidophilus decreased the incidence andduration of vaginal infections.

DiarrheaMany types of diarrheal illnesses, with many differentcauses, exist. These can result in bacterial imbalance,leading to diarrhea. Replenishing the flora with normalbacteria during and after antibiotic use can improve themicrobial balance until the normal flora is reestablished.Probiotics have also been tested for effectiveness againstClostridium difficile colitis. In general, the results suggest that consumption of high levels of a qualityprobiotic may shorten the duration or decrease theincidence of certain diarrheal illnesses.

Small Bowel Bacterial OvergrowthUnder certain conditions, such as production of lowstomach acid or in patients with kidney disease, microbialpopulations in the small intestine can increase significantly beyond normal levels. This is termed smallbowel bacterial overgrowth. The high population ofthese microbes can produce by-products from theirgrowth, which can be toxic. Researchers have foundthat feeding high levels of Lactobacillus acidophilus cancontrol the toxic effects of these microbes. This isanother example of the ability of probiotic strains fedin high numbers to modulate the activity of other intestinal bacteria.

Lactose Intolerance The inability of adults to digest lactose, or milk sugar,is prevalent worldwide. People of northern Europedescent are unique in retaining the ability to producethe lactose digesting enzyme, lactase, into adulthood.Consumption of lactose by those lacking adequate levels of lactase can result in symptoms of diarrhea,bloating and flatulence. These symptoms are due to theundigested lactose reaching the large intestine andbeing fermented by the colonic microbes. Thesemicrobes can produce gases and products which lead towatery stool.

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The approach to coping with lactose digestion problems can be multifaceted, including moderatingintake of dairy products, ingesting lactase prior to eating dairy products, and consumption of productscontaining pre-digested lactose. Many consumers havealso noticed that they are better able to consume fermented dairy products, such as yogurt, with fewersymptoms that the same amount of unfermented milk,even though yogurt contains about the same amount oflactose as milk. Yogurt was found to aid digestion oflactose because the lactic acid bacteria used to makeyogurt produce lactase and digest the lactose before itreaches the colon. In addition to yogurt starter bacteria,Lactobacillus acidophilus and bifidobacteria have beenshown to improve digestion of lactose.

Elevated Blood CholesterolCholesterol is essential for many functions in thehuman body. It acts as a precursor to certain hormonesand vitamins and it is a component of cell membranesand nerve cells. However, elevated levels of total bloodcholesterol or other blood lipids are considered risk factors for developing coronary heart disease. Althoughhumans synthesize cholesterol to maintain minimumlevels for biological functioning, diet also is known toplay a role in maintenance of serum cholesterol levels,although the extent of influence varies significantlyfrom person to person. Probiotic cultures have beenevaluated for their effect on serum cholesterol levels.Although clinical studies on the effect of lowering ofcholesterol or low density lipid levels in humans havenot been conclusive, there have been human studieswhich suggest that consumption of probiotic-containingdairy foods in people with elevated blood cholesterolcan reduce this level.

OneWellnessPlace.com’s ProBioticFactors of Stability

By nature of the cultures, the choices of strains and carriers, manufacturing procedures, handling ofmaterials and storage are all critical to the viability ofthe end product. We start by using culture strains thathave the most recognized history of beneficial use -Lactobacillus (Figure 3) and Bifodobacterium (Figure 4).We can not justify the use of less potent strains, and cer-tainly not use those which, although retaining activity,are not beneficial to human gut terrain, like Faecium.

We have incorporated a proprietary process ofstabilization to protect the culture cell walls. We thenchose to use a patented Microcrystalline Cellulose carrier to make the effects of moisture as negligible aspossible on our culture.

We require controlled environments in the productionof raw materials and encapsulation, ensuring that theactive culture levels will remain viable. This control isnot only to safeguard against moisture levels, but temperature as well. “The cooler the better” is still therule. There has been a lot written about new technologiesthat allow products to retail their activity at room temperature. While there might be evidence to supportfurther research in this technology, the end result is nota reality today. Even if there were to wrap an impenetrableshield around these cultures, making it impossible formoisture to effect them in any way, they would still bedamaged by the heat of sitting on the shelf.

One other manufacturing decision was to guaranteelabel claim. While other companies publish C.F.U.numbers on their labels that relate to the amount of

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Various Studies have shown that healthy bacteria may improve our well-being via:

• Manufacture and assimilation of B vitamins.• Enhancement of dairy product digestion.• Reduction of serum cholesterol levels.• Improvement in digestive and bowel functions.• Stimulation of the immune system.• Reduction in antibiotic side effects• Exclusion of harmful microbes associated with

diarrhea, yeast infections, urinary tract infections,and small bowel bacterial overgrowth.

• Binding of mutagens by cell wall components (in vitro)• Reduction of lactose intolerance

Figure 3Located throughout the digestive tract,Lactobacillae are especially abundant inthe small intestine. Some of the mainhuman varieties are: Lactobacillus acidophilus, Lactobacillus rhamnosus,Lactobacillus plantarum, Lactobacillusbrevis and Lactobacillus salivarius.

Figure 4Located in the entire digestive tract,Bifidobacteria are especially abundant inthe large intestine. The system's first inhab-itants, these species evolve according to age,diminishing progressively towards the endof life. Some of the main varieties are:Bifidobacterium breve, Bifidobacteriuminfantis and Bifidobacterium longum inchildren, and Bifidobacterium bifidum andBifidobacterium longum in adults.

culture at the time of manufacturing, the label claim of15 Billion C.F.U./gram for OneWellnessPlace.com’sProBiotic is what our customers should expect to seethrough the life of the product. With choice of strains,carrier, bottle type, stability testing and proper handling,we have gone a long way to ensure that at the time oflast dosage, our product should still beat label claim.

ReferencesBifidobacteria. Natural Medicines Comprehensive Database Website. Accessed on October 21, 2006.

Floch MH, Montrose DC. Use of probiotics in humans: an analy-sis of the literature. Gastroenterol Clin North Am. (2005) 34 (3):547-70, x.

Fuller, R. 1991. Probiotics in human medicine. Gut 32:439-442.

Gilliland, S.E. 1996. Special additional cultures. In: Dairy StarterCultures, T.M. Cogan and J.-P. Accolas, Eds., VCH Publishers,Inc., New York, pp. 233-248

Goldin, B.R. and S.L. Gorbach. 1992. Probiotics for humans. In:Probiotics. The Scientific Basis, Roy Fuller, Ed., Chapman andHall, London, pp. 355-375

Golledge, C.L. and T.V. Riley. 1996. “Natural” therapy for infec-tious diseases. MJA 164: 94-95

Havenaar, R. and J.H.J. Huis in’t Veld. 1992. Probiotics: a generalview. In: The Lactic Acid Bacteria. Volume 1. The Lactic AcidBacteria in Health and Disease, B.J.B Wood, Ed., Elsevier AppliedScience, London, pp. 151-170

Kroger, M., J.A. Kurmann and J. L. Rasic. 1989. Fermented milks - past, present, and future. Food Technology. 43:92-98

Marteau, P. and J.-C. Rambaud. 1993. Potential of using lacticacid bacteria for therapy and immunomodulation in man. FEMSMicrobiol. Rev. 12:207-220

Mullan, W.M.A. (2002). Probiotics. Properties, benefits,mecha-nisms of action, safety and enumeration. [On-line] UK: Available:http://www.dairyscience.info/probiotics.htm. Accessed: 1 August2008. Revised 2004, December 2007, last revision February 2008.

O’Sullivan, M.G., G. Thornton, G.C. O’Sullivan and J.K. Collins.1992. Probiotic bacteria: myth or reality? Trends Food Sci.Technol. 3:309-314

Pedone C.A., Arnaud C.C., Postaire E.R., Multi-centric study ofthe effect of milk fermented by Lactobacillus casei on the inci-dence of diarrhoea. Int J Clin Pract (2000) 54 : pp 568-571.

Sanders, M.E. 1993. Effects of consumption of lactic cultures onhuman health. Adv. Food Nutr. Res. 37:67-130

Sanders, M.E. 1993. Healthful attributes of bacteria in yogurt.Contemporary Nutrition 18 (5).

These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.

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Serving Size: 2 Capsules (1 Gram)Servings per Container: 22.5

Amount per % DV*Serving

Lactobacillus Acidophilus 3.5 Billion CFU *Bifidobacterium Infantis 3.5 Billlion CFU *Lactobacillus Plantarium 2 Billion CFU *Lactobacillus Rhamnosis 2 Billion CFU *Bifidobacterium Breve 2 Billion CFU *Bifidobacterium Longum 2 Billlion CFU *

*Daily Value (DV) not establishedDV is based on a 2,000 calorie diet.S

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Other Ingredients: Gelatin (Capsule), In a Base of Microcrystalline Cellulose andFructo Oligosaccharides.

OneWellnessPlace.com’s ProBiotic | 45 Capsules |15 Billion C.F.U./gram

1-800-295-3591