Everyone's Health

Gut reactions

Consuming probiotics – beneficial live bacteria – can balance harmful digestive tract bacteria. Eating live organisms sounds like a grotesque “Fear Factor” episode or a crude fraternity prank. But some nutrition and medical experts say eating live bacteria may be just what the doctor ordered.

Called probiotics, these beneficial live bacteria are found naturally in most yogurts, tofu, sauerkraut, miso and other fermented products such as buttermilk and blue cheese. Probiotics reportedly help balance harmful bacteria in the digestive tract and create a more harmonious internal environment.

Several studies have shown that various strains of probiotics have been helpful in easing and preventing everything from gastrointestinal problems to vaginal infections and allergies. It's no surprise that a number of new products – from special yogurts and drinks to cereals and snack bars – are jumping on the probiotic bandwagon.

Dannon has two new probiotic products that claim to do different things. Activia, a flavored yogurt containing the company's trademarked bacteria, Bifidus Regularis, is supposed to speed food through the digestive tract. DanActive, a yogurt drink with trademarked L. casei Immunitas, promises to strengthen the immune system.

Recently, San Diego-based Kashi introduced Vive with Lactobacillus, the first probiotic cereal “to help achieve digestive balance,” and Garden of Life has a probiotic snack bar with “a fermented Super Seed blend” to promote “microbial balance in the gut.”

Probiotics are also available in supplements. The bacteria are dormant in dried form and grow again when they reach the moist environment in your body.

The problem for consumers is figuring out which strains work for which conditions and which probiotic products actually work as promised.

“Today there's a compelling number of controlled clinical studies that indicate that probiotics can have a real impact on human health,” says Mary Ellen Sanders, a microbiologist from Denver and the executive director of the International Scientific Association of Probiotics and Prebiotics. “But how they work and which products are really good is still a big subject of study and debate.”

Some medical experts say it may be worth the time, effort and money to investigate probiotics further.

“Probiotics show a lot of promise. They may decrease (the chances) of a pathogen getting into the blood stream,” says Dr. Robert Bonakdar, director of pain management at the Scripps Center for Integrative Medicine. “Since 70 percent of our immune response is from our gut, it just makes sense to have billions of bacteria be your friend rather than your enemy.”

Our bodies carry about 100 trillion bacteria (and more than 400 types), mostly in the lower colon. The majority are the healthy kind that live and grow there and help prime our immune system so we can fight infection.

But there are some harmful bacteria lurking about. Stress, poor diet, illness, lack of rest and the use of antibiotics can disrupt the balance between good and bad bacteria, and that's when infections and disease can happen.

Probiotic products appear to build colonies of healthy bacteria in the intestines that create a barrier to keep unhealthy bacteria from taking over in the bloodstream.

The elderly, the very young and those with a compromised immune system should steer clear of probiotics because of a risk of an infection from ingesting live organisms.

While healthy people may not require probiotics, regular doses of beneficial active bacteria in foods or supplements usually won't hurt and may actually help maintain wellness by adding more positive flora in the gut. For these people, it's enough to just eat some yogurt (with active cultures), tofu or another special probiotic product on a regular basis and not worry about which strain of good bacteria they're getting.

But if you're taking probiotics to specifically relieve particular symptoms or a medical condition, you must take the appropriate probiotic strain to see any results.

“You can't generalize that all probiotics will do something like help diarrhea or strengthen the immune system. Different strains of probiotics have different characteristics and do different things,” Sanders says. “Consumers need to realize that just because one strain has been shown to be effective for diarrhea, for example, not all other strains of probiotics (will be effective) for that condition.”

Shopping for the right probiotic can be confusing and frustrating for consumers, she says, because most products and supplements don't list the exact bacteria strain on the label. It's also unclear how much of the bacteria is in a dose.

“When it comes to probiotics, you definitely want a high count,” Bonakdar says, adding that although there's no official recommendation, 1 billion to 10 billion colony-forming units (CFU) of bacteria once or twice a day are usually needed to get health benefits.

A study by Consumerlab.com, a White Plains, N.Y.-company that tests dietary supplements and foods and publishes results on its subscription Web site, concluded that about one-third of probiotic products do not contain the level of active bacteria they claim. Because these products are not regulated by the Food and Drug Administration, it's strictly “buyer beware.”

And don't expect to see a probiotic product that lists diseases and medical conditions that can be helped its by active bacteria.

“The manufacturers' hands are tied. They can't mention anything about disease because then they'd be considered a drug and the FDA would be on them,” Sanders says.

So, what's the answer to finding an appropriate probiotic? As unscientific as it may seem, you may need to resort to good old trial and error.

“Use a manufacturer you trust or one recommended to you by a nutritionist or health care practitioner, and try the product for a month,” Sanders says. “If it doesn't help, try another product or two, (preferably in a) food. That way, you're getting other nutrients and the probiotics are just an added bonus.”

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