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What are probiotics?
Intestinal flora
The human intestines contain an average of approximately 1014 microorganisms, made up of more than 400 different species. This microflora has a symbiotic relationship with the host organism and protects the body against infections, assists digestion, produces nutrients, and plays an important role in the immune system. A good microfloral balance in the intestines is essential for these functions and for the health of the host. When the intestinal flora is in balance, both beneficial and harmful microorganisms (pathogens) are present. This balance can be disturbed by factors such as the use of antibiotics, stress or an unbalanced diet. Disturbing the balance creates a risk that the beneficial intestinal bacteria will be suppressed and that the pathogenic bacteria will become dominant.
Probiotics
According to the definition contained in the report by the Food and Agriculture Organization of the United Nations and the World Health Organization (FAO/WHO), probiotics are: ‘Live microorganisms which when administered in adequate amounts confer a health benefit on the host’2.

The term ‘probiotics’ should only be used for products if:

  • The bacteria strains in the product are able to survive the stomach acid and bile, so that they reach the intestines alive in adequate numbers.
  • The bacteria strains have health improving features.
  • The probiotic activity is guaranteed throughout the entire production process, storage period and shelf life of the product.

Why probiotics?
Due to improvements in hygiene, human beings today are exposed to bacteria much less frequently than was formerly the case. This is certainly true for the undesirable (pathogenic) bacteria, but it also holds for useful, protective bacteria. Bacteria have been consumed by humans for many years, not only because they are used in traditional preparations such as yogurt, cheese, sauerkraut, sausage, etc., but also because they occur naturally in various foodstuffs. These foodstuffs contain bacteria that are now classified as beneficial to health. At present there are strict rules governing food safety. These products are therefore fermented under stringently controlled, hygienic conditions. Only a limited number of selected bacteria are as yet used to produce these products and in some instances products are no longer fermented but acidulated. In addition, more and more products are pasteurized or sterilized at the end of the production process, or are subjected to other purification steps, which destroy these beneficial bacteria.
As a result of all these changes the human body comes into contact with far fewer bacteria (both in terms of quantities and variety of species) than formerly. This has the advantage, of course, that many diseases caused by pathogenic bacteria can be avoided, but it also means that the human being comes into natural contact with beneficial and useful bacteria to a much lesser extent than was formerly the case.
Probiotics support the microbial balance in the intestines of the host and are therefore recommended as supplements to normal everyday nutrition. In addition, they are also used for their health benefits and are attracting a great deal of interest from scientists, as is apparent from a report of a FAO/WHO expert group in which the various potential health and nutritional benefits of probiotics are evaluated’3.
In principle, the situation with regard to bacteria is the same as that of vitamins, minerals and fibres: as the human being doesn’t consume enough of them from food and while the body cannot produce these substances itself, supplements are a desirable addition to normal nutrition.
Health claims
In the great majority of controlled studies with probiotics performed with children and adults, no adverse effects have been observed, not even in studies in which probiotics were administered to humans suffering from a severely compromised immune system12,13,14,15. Given the large amount of probiotic bacteria that have already been consumed for many years without any problems and the many studies that have demonstrated their health benefits, it can be confidently stated that the advantages of consuming probiotics far outweigh any risks.

References:
2. Report of a Joint FAO/WHO Working group on Drafting Guidelines for the Evaluation of Probiotics in Food, London Ontario, Canada, April 30 and May 1, 2002.
3. Report of a Joint FAO/WHO Expert Consultation on Evaluation of Health and Nutritional properties of probiotics in food including powder milk with live lactic acid bacteria, Córdoba, Argentina, 1-4 October 2001.
12. Naidu A.S., Bidlack W.R. and Clemens R.A., Probiotic spectra of lactic acid bacteria (LAB). Critical Reviews in Food Science and Nutrition 39: 13-126, 1999.
13. Wolf B.W., Wheeler K.B., Ataya D.G. and Garleb K.A, Safety and tolerance of Lactobacillus reuteri supplementation to a population infected with the Human Immunodeficiency Virus. Food and Chemical Toxicology 36: 1085-1094, 1998.
14. Aso Y., Akaza H., Kotake T., Tsukamoto T., Imai K. and Naito S., Preventive effect of a Lactobacillus casei preparation on the recurrence of superficial bladder cancer in a double-blind trial. European Urology 27: 104-109, 1995.
15. Gionchetti P., Rizzello F., Venturi A., Brigidi P., Matteuzzi D., Bazzocchi G., Poggioli G., Miglioli M. and Campieri M., Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial. Gastroenterology 119: 305-309, 2000.