The popularity of products containing probiotics has soared in recent years. But what exactly do probiotics do? And how much do consumers know about them? Bernice Hurst investigates the world of “friendly” bacteria.

If the original Greek word, bios, means “fit for life” then antibiotics could be defined as “against” life (or at least the lives of organisms that are harmful to human life) and probiotics defined as “for” life. Or, as vitamin manufacturer Seven Seas says about its Multibionta supplement, “it puts back what life takes out”.

The purpose of products containing probiotics, organisms that are described as “friendly” bacteria, is to maintain a healthy balance within the intestinal tract, thereby helping the immune system function efficiently. Preventing “bad” bacteria from colonising and outweighing “good” bacteria, according to Dr Ron Hoffman of the American College for the Advancement of Medicine, means that digestion proceeds more smoothly and the body’s natural resistance to infection is more effective.

“Humans cultivate flora automatically,” explains Hoffman, “but we do many things to disturb our interaction with them.” Daily doses of probiotic products are designed to help the body do what it does most naturally.

Japanese doctor Minoru Shirota produced the first commercial probiotic, Yakult, in 1935 by using bacteria to ferment milk. Japan is now one of the largest importers of milk from New Zealand, using it to create a product that has been marketed in some countries for more than 30 years. Since launching in the UK in 1996, sales are said to have grown to £29m (US$52.2m) per annum.

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Mental and emotional benefits

Competitor Actimel is so confident of its results that it has launched a moneyback promise to anyone who does not “feel better” after a fortnight’s regular consumption.

Other applications, extending beyond yoghurt and fermented milk products, are also coming onto the market. Probiotics can be taken in the form of pills (available in the US and the UK) and, more recently, nutritional bars. Infant formulas, fruit juices and cereals are also being targeted as products likely to benefit from the addition of probiotic ingredients. Even animal feed is being looked at as a likely area for development to replace antibiotic growth promoters.

In Scandinavia, particularly, research is culminating in new product launches. Skane Dairy, in Sweden, won what is promoted as the country’s first health claim for the benefits of probiotic bacteria in its fruit juice. Swedish company Procordia Foods is about to use probiotic bacteria Reuteri in its health food brands. Rhodia Food, in France, introduced its contribution to probiotic-enriched products with a chocolate covered cereal bar to compete with that of German manufacturer Dr Quendt.

According to the Datamonitor report on functional food and drink published in December 2003, “gut health products generated the most sales by value in 2002 (£111m), and are predicted to reach £159m in 2007. The reason for this is that gut health products offer consumers far more benefits than merely improved health. Consumers asked why they buy gut health products list such values as ‘general wellness’ and ‘lightness and energy’ as reasons for choosing probiotic yoghurts. In other words, there are mental and emotional benefits to knowing that one is eating healthy.”

Food or medicine?

UK manufacturers may be at pains to make clear that probiotic products are food and not medicine, but in the US the subject seems to come under the more general heading of alternative and complementary medicine. Hoffman, for example, trained in conventional medicine but currently practises a combination of this and alternative therapies.

In New Zealand, too, the philosophy seems to indicate that good intestinal health is inextricably linked to overall mental, emotional and spiritual health, as well as physical well-being. According to Probiotics NZ Ltd spokesperson Nichola Johns, probiotics can help with everything from a lack of vitality to Attention Deficit Hyperactive Disorder, mood swings and depression.

The distinction between food and medicine will assume increasing significance in coming months as European Union (EU) food supplement directives come into effect, face the inevitable challenges and are eventually resolved.

Regardless of whether probiotics are food or medicine, there is less than total agreement about their benefits. The general consensus, certainly amongst consumers, seems to be that taking something that might be good for you is a sensible precaution.

Doctors at the Berkshire Cancer Centre have nothing against probiotics but don’t go as far as recommending them. While they believe that no harm is likely to be done, they also stress that there are, as yet, no proven benefits for prevention of cancer or reduction of recurrence.

Hoffman would not entirely agree. His firm contention is that we all need to maintain the balance of our internal flora and that this can be “absolutely” helped by taking probiotic supplements either in the form of dairy products or pills.

Consumer education

It is difficult to identify the fine line between education and marketing where foods with potential health benefits are concerned. Anna Ibbotson, food research manager with consultants Frost & Sullivan, maintains that “there is a general acceptance that raising consumer awareness is one of the key challenges facing the probiotics market.” contributor Chris Lyddon points to experts who believe that “food companies who don’t invest time in explaining their product to consumers risk failure”.

As Hoffman and others point out, however, consumers are often confused and must try to work out risk/benefit ratios when deciding what is best for them. Nutritionist Dr Toni Steer of Britain’s Medical Research Council agrees. Telling Lyddon about the historic evidence of longevity in people who eat live yoghurt, she adds that “it seems to be good for gastro intestinal health but there isn’t the trial to show that, yes, it does reduce the risk of intestinal cancer”, admitting that the reduction in risk has not yet been quantified.

Big promotions by manufacturers such as Danone (Actimel) and Yakult have supported retailers and resulted in increased sales. But this still begs the question of where the line can be safely drawn between marketing and education.