Probiotic
Probiotics are live microorganisms in that are intended to support or improve the health and wellbeing of a host organism. They are commonly used in both humans and animals. Although the term refers to the microorganisms themselves, probiotics can be consumed through a range of products including yogurt, cheese, certain fermented foods, as well as capsules containing a single strain or a defined mixture of strains.
Probiotics are regarded as generally recognised as safe by the U.S. Food and Drug Administration, which supports their safety when used as intended, although this designation does not establish their effectiveness or specific health benefits. Many claimed health benefits, such as treating eczema or curing vaginal infections, lack substantial scientific support.
The first discovered probiotic was a certain strain of bacillus in Bulgarian yoghurt, called Lactobacillus bulgaricus. The discovery was made in 1905 by Bulgarian physician and microbiologist Stamen Grigorov. The modern-day theory is generally attributed to Russian Nobel Prize laureate Élie Metchnikoff, who postulated around 1907 that yoghurt-consuming Bulgarian peasants lived longer.
A growing probiotics market has led to the need for stricter requirements for scientific substantiation of putative benefits conferred by microorganisms claimed to be probiotic. Although some evidence claimed benefits are marketed towards using probiotic, such as reducing gastrointestinal discomfort, improving immune health, relieving constipation, or avoiding the common cold, such claims are strain-specific and cannot be extrapolated to other strains. As of 2019, numerous applications for approval of health claims by European manufacturers of probiotic dietary supplements have been rejected by the European Food Safety Authority for insufficient evidence of beneficial mechanism or efficacy.
Definition
An October 2001 report by the World Health Organization defines probiotics as "live microorganisms which when administered in adequate amounts confer a health benefit on the host." Following this definition, a working group convened by the Food and Agriculture Organization /WHO in May 2002 issued the Guidelines for the Evaluation of Probiotics in Food. A consensus definition of the term probiotics, based on available information and scientific evidence, was adopted after the aforementioned joint expert consultation between the FAO of the United Nations and the WHO. This effort was accompanied by local governmental and supra-governmental regulatory bodies' requirements to better characterize health claims substantiations.That first global effort was further developed in 2010; two expert groups of academic scientists and industry representatives made recommendations for the evaluation and validation of probiotic health claims. The same principles emerged from those two groups as were expressed in the "Guidelines" of FAO/WHO in 2002. This definition, though widely adopted, is not acceptable to the European Food Safety Authority because it embeds a health claim that is not measurable.
A group of scientific experts assembled in Canada in October 2013 to discuss the scope and appropriate use of the term "probiotic", adjusting the definition to be "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host."
In food
Live probiotic cultures are part of fermented dairy products, other fermented foods, and probiotic-fortified foods.Lactic acid bacteria, which are food fermenting bacteria, have the ability to prevent food spoilage and can improve the nutritive value of the foods they inhabit. Acid fermentation, remains one of the most practical methods of preservation of fresh vegetables, cereal gruels, and milk-cereal mixtures due to its low cost and energy requirements.
Fermented products that contain lactic acid bacteria include vegetables such as pickled vegetables, kimchi, pao cai, and sauerkraut; sourdough bread or bread-like products made without wheat or rye flour, amino acid/peptide meat-flavored sauces and pastes produced by fermentation of cereals and legumes; fermented cereal-fish-shrimp mixtures and fermented meats; soy products such as tempeh, miso, and soy sauce; dairy products such as yogurt, kefir, buttermilk; and non-dairy products such as bee pollen.
More precisely, sauerkraut contains the bacteria Leuconostoc mesenteroides, Lactobacillus plantarum, Pediococcus pentosaceus, Lactobacillus brevis, Leuconostoc citreum, Leuconostoc argentinum, Lactobacillus paraplantarum, Lactobacillus coryniformis, and Weissella spp. Kimchi contains the bacteria Leuconostoc spp., Weissella spp., and Lactobacillus spp. Pao cai contains L. pentosus, L. plantarum , Leuconostoc mesenteroides , L. brevis, L. lactis, and L. fermentum.
A list of many other bacteria found in several Asian fermented fruits and vegetables also is available. Kefir contains Lactobacillus acidophilus, Bifidobacterium bifidum, Streptococcus thermophilus, Lactobacillus delbrueckii subsp. bulgaricus, Lactobacillus helveticus, Lactobacillus kefiranofaciens, Lactococcus lactis, and Leuconostoc species. Buttermilk contains either Lactococcus lactis or L. bulgaricus. Other acidic bacteria, said to be probiotic, can be found in kombucha, including Gluconacetobacter xylinus,'' Zygosaccharomyces sp., Acetobacter pasteurianus, Acetobacter aceti, and Gluconobacter oxydans''.
Dosage
Probiotics are measured in colony forming units, which indicates the number of viable microorganisms in a product. The effective dose depends on the intended use with typical amounts ranging from 1 - 10 billion CFU/dose. It is important to note that products with higher CFU counts are not necessarily more effective than those with lower counts.Side effects
The manipulation of the gut microbiota is complex and may cause bacteria-host interactions. Though probiotics are considered safe, some have concerns about their safety in certain cases. Some people, such as those with immunodeficiency, short bowel syndrome, central venous catheters, and cardiac valve disease, and premature infants, may be at higher risk for adverse events. In severely ill people with inflammatory bowel disease, a risk exists for the passage of viable bacteria from the gastrointestinal tract to the internal organs as a consequence of bacteremia, which can cause adverse health consequences. Rarely, consumption of probiotics by children with lowered immune system function or who are already critically ill may result in bacteremia or fungemia, which can lead to sepsis, a potentially fatal disease.Probiotic supplements typically contain between one and ten billion colony-forming units per dose. A higher number of CFUs does not provide additional probiotic effects, but may have unintended consequences of causing digestive discomfort, such as bloating, gas, and diarrhea.
Lactobacillus species have been suggested to contribute to obesity in humans, but no evidence of this relationship has been found.
Consumption
In 2015, the global retail market value for probiotics was US$41 billion, including sales of probiotic supplements, fermented milk products, and yogurt, which alone accounted for 75% of total consumption. Innovation in probiotic products in 2015 was mainly from supplements, which produced US$4 billion and was projected to grow 37% globally by 2020. Consumption of yogurt products in China has increased by 20% per year since 2014.Regulation
, the European Food Safety Authority has rejected all petitions by commercial manufacturers for health claims on probiotic products in Europe due to insufficient evidence for a cause-and-effect mechanism for benefit, thus inconclusive proof of effectiveness. The European Commission placed a ban on putting the word "probiotic" on the packaging of products because such labeling misleads consumers to believe a health benefit is provided by the product when no scientific proof exists to demonstrate that health effect.For food labeling in Canada, the federal government requires product labels using the term "probiotic" to have a government-approved health claim about the live specific microorganism contained in the food.
In the United States, the Food and Drug Administration and Federal Trade Commission have issued warning letters and imposed punishment on various manufacturers of probiotic products whose labels claim to treat a disease or condition. Food product labeling requires language approved by the FDA, so probiotic manufacturers have received warning letters for making disease or treatment claims. The FTC has taken punitive actions, including a US$21 million fine coordinated by 39 different state governments against a major probiotic manufacturer for deceptive advertising and exaggerated claims of health benefits for yogurt and a probiotic dairy drink.
In Vietnam, the Vietnam Food Administration under the Ministry of Health, in collaboration with other relevant authorities, oversees and addresses violations related to probiotic products. This includes issuing warnings, imposing administrative penalties, demanding product recalls and coordinating with other agencies.