American consumers are on an eternal quest for digestive wellness.
Need proof that we're a culture obsessed with being regular? More than 150 different commercial food products introduced in 2007 were enhanced with belly-friendly probiotics. The live, "active" bacteria, designed to help digestion, were responsible for more than $100 million in annual sales for just one small piece of that massive crop: Dannon's Activia yogurt.
That doesn't mean everyone who is feeling a little "off" should rush to chow down on a probiotic smoothie or cereal bar. Despite a growing public awareness of the value of live cultures in the diet, probiotics are still relatively new and remain under the microscope.
"It's hit or miss. Some people see a big difference after using probiotic products, some not at all," says Bob Greene, a nationally known nutritionist and creator of The Best Life Diet. He says the still-inconclusive research is why he has delayed endorsing any products enhanced with probiotics.
"Bottom line: It needs more research," says Greene, who is scheduled to appear from 1 to 3 p.m. today at Books-a-Million, 1520 Town Center Drive in Lakeland.
At best, probiotics are harmless additions to a diet, improving one's digestive tract and general wellness. Some research shows they can improve the health of people dealing with diarrhea, irritable bowel syndrome and urinary tract infections.
There are risks, however. Probiotics come in many species and strains and are designed to treat a specific condition. That means probiotics might not help and, in some cases, can produce uncomfortable side effects such as bloating and gas. In extreme cases, probiotics can lead to infections for people with underlying health issues, says the National Institutes of Health's Center for Complementary and Alternative Medicine.
Few consumers realize that the bacteria and yeast that are probiotics are designed to treat specific health concerns, says Patricia Raymond, a board-certified gastroenterologist in Virginia and a consultant for Florastor, a probiotic supplement.
"I don't believe you should take things to just take them," Raymond says. "Ask: Do you really need to take it?"
The people likely to benefit most from priobiotics aren't those suffering from run-of-the-mill constipation, Raymond says. It's the people who develop diarrhea as a result of taking antibiotics, were hospitalized recently or traveled recently to places where they may have picked up some funky bacteria.
You can find probiotics in any supermarket in products such as yogurt, cereal and chocolate bars. There are even probiotic topical creams that claim to reduce wrinkles. Mary Ellen Sanders, a probiotic food consultant and executive director of the International Scientific Association for Probiotics and Prebiotics, says she has seen developers pushing products that range from relish to pizza.
U.S. Food and Drug Administration guidelines prohibit the use of the probiotic label on a commercial food or supplement unless there is some clinical proof of a health benefit, Sanders says. However, there is little evidence that the FDA enforces the rule.
"It's hard for the consumer to know. ...You just have to trust the company when it says it," Sanders says.
Natasha Trenev, a longtime probiotics advocate and founder of supplement company Natren Inc., says she's "horrified" by all the new products claiming to contain probiotics. It's more marketing ploy than nutritional science, she says.
"You can say virtually anything because the public is generally ignorant," she says.
Trenev and other experts urge consumers to read up on the science behind a certain product, or ask a doctor or pharmacist to help you learn more. Companies promoting probiotic products should be able to provide you with the clinical studies that support their claims.
If not, be skeptical.
PROBIOTICS: THE PROS AND CONS
The probiotic label is being slapped on products all over the supermarket. Here are a few facts to help you decide whether you want to buy or skip these trendy foods designed to keep your belly happy.
What is it? Probiotic literally means "for life." According to the World Health Organization, probiotics are "live organisms which when administered in adequate amounts confer a health benefit on the host."
The organisms can be bacteria or yeast, and they come in a variety of strains. There isn't just one kind of probiotic, but the general term "probiotic" is usually used because the long scientific names (listing genus, species and strain description) are hard to pronounce, much less remember.
Also, probiotics are not the same as prebiotics, which essentially act as fertilizers for probiotics.
How does it work? The living microorganisms replenish beneficial microbes in your body, eating up sugar and bad bacteria in your stomach and bringing a healthy balance to your digestive tract.
What does it treat? There are studies that show these healthy bacteria can be beneficial to people dealing with problems such as lactose intolerance, diarrhea, inflammatory bowel disease and irritable bowel syndrome. There is also research looking at its effect on urinary tract and vaginal infections. Most recently, studies have started seeing how probiotics can be applied topically to reduce crow's-feet.
However, much of the research done on probiotics is emerging and has been done only on a small scale. Most experts recommend you consider probiotics involved in larger human studies. Also look at specific case studies tied to a food product pitching its health benefits.
How much do you need? Experts disagree about how much of a certain probiotic is needed to see a health benefit. Recommendations about the level of probiotics in a certain food can vary from 100 million to 2 billion "colony forming units" or CFUs. That's partly because clinical studies show the number of microbes needed to create a health benefit varies in different situations.
To add to the confusion, product labels aren't required to report these specifics, and it's not always clear if the bacteria in a food product is still active. Remember to look for ACTIVE cultures.
Where can I find it? Dairy products such as yogurt, cottage cheese and smoothies are the easiest place to find probiotics. Other sources include sauerkraut and specially labeled cheeses, cereal and cereal bars, chocolate bars and nutritional supplements.
How can I know it will help? You don't. If you're serious about implementing probiotics in your diet for a specific benefit, talk first with your doctor.