Probiotic supplements — capsules and powders full of various strains of so-called beneficial microorganisms — are just the latest in a long line of supplements marketed as “immune boosters.”
The companies that sell such supplements cannot legally claim that their products offer protection against specific ailments, like colds and the flu. Thus, they use oblique phrases like “provides seasonal immune support” and “enhances respiratory health and immunity.”
But do these products actually work? Can they fortify the immune system and ward off respiratory infections?
Or will probiotics end up like two previously highly touted “immune-boosting” supplements, vitamin C and Echinacea? They flopped miserably against respiratory ailments when they were put to the true test: a randomized controlled trial.
As science writer Chris Woolston reports in his latest “Healthy Skeptic” column for the Los Angeles Times, the jury is still out on probiotics, despite all the marketing and media hype around them.
Most of the research on probiotics thus far has been done on mice, writes Woolston, and what happens in mice does not necessarily translate to humans. Supplement companies “are taking evidence from animal studies and stretching their claims,” says one of the experts interviewed for the column.
Indeed, as Woolston also reports, a 2011 Cochrane Review, which analyzed the best studies to date on probiotics and respiratory infections, found only “weak” evidence that probiotics were better than placebo at reducing episodes of acute upper respiratory infections in people.
What isn’t weak is the cost of these supplements. Woolston cites two examples: one 90-capsule product that sells for $20 and another 30-capsule product that sells for a whopping $30. Both instruct users to take two tablets a day.
Even if probiotics are eventually proven to be effective at warding off colds and the flu, they may not help everyone. Writes Woolston:
Dr. Sonia Michail, a pediatric gastroenterologist at Children’s Hospital Los Angeles, says the basic idea behind so-called immunity-boosting probiotics makes sense. As she explains, the gut is a major front in the immune system’s war against pathogens, and the immune cells there must respond to the resident bacteria. If helpful bacteria can activate immune cells in the gut, the disease fighters will spread throughout the body.
But according to Michail, studies suggest that, for unknown reasons, only some people — perhaps as few as 1 in 30 — could hope to avoid a cold by taking probiotics. And, she adds, the evidence for even this modest benefit “is far from robust.”
Nor should everybody be taking probiotic supplements. To begin with, not much is known about the safety of these products. The Food and Drug Administration classifies probiotics as food supplements rather than drugs, so they’re not subject to the same safety studies as medications.
The supplements are generally considered safe for healthy people. But as some research suggests, probiotics should be used with extreme caution in premature babies and in individuals with certain medical diseases and conditions, including, ironically, illnesses marked by a seriously compromised immune system.
Oh, and there’s no good evidence that probiotics in fermented foods like yogurt and dairy drinks will help protect against colds and the flu (or aid digestion) either. In fact, the Dannon Company, makers of Activia yogurt and DanActive dairy drink, paid a $35 million multistate settlement in 2010 to reimburse consumers who bought its products based on unsupported advertising claims.
So, what can you do to strengthen your immune system? Science suggests an answer that won’t surprise anybody: Eat a wide variety of fruits, vegetables and whole grains, exercise regularly, and get plenty of sleep. And wash your hands frequently during the cold and flu season.
No supplement comes close to equaling the effectiveness of that advice.
Don’t be a skeptic, join us, the healthy and happy
The modern American diet is brimming with antibiotics, pesticides, herbicides, and chemicals (food colors, fragrances/flavors, preservatives). In addition, our diet is full of sugars and high glycemic carbohydrates that feed pathogenic yeasts such as candida in our gastrointestinal tract. All these combine to create an environment in the G.I. tract that is not hospitable to friendly, necessary bacteria – those bacteria we need to properly digest our foods, convert and absorb nutrition, and support healthy immune function.
Probiotics, when consumed with a healthy diet that avoids these toxins and yeast feeders, will help bring a person’s inner microbiota back into a healthy state.
I agree with Ms. Perry in that there are probiotic manufacturers that exploit our misguided desire for a quick fix, pill popping, sweet tasting solution. (It is no surprise that sugar-laden yogurt didn’t prove to help immune function – the sugar is counterproductive.) But they are few in number. The majority offer high quality products that have been tested. In our country it is up to the consumer to research and choose the quality products.
Additionally, I agree with Ms. Perry that the better solution is a healthy diet. Probiotics are best consumed as fermented foods such as raw sauerkrauts, cultured vegetables, or kefir (both dairy and non diary versions). Ms. Perry suggests fruits and whole grains – just be sure to limit fruit sugars and look out for high glycemic grains. Try quinoa – it won’t feed the bad yeasts and you’ll love the taste.
My wife and I experienced the power of a healthy diet and live fermented foods as a part of our approach to recovering our daughter from autism. I personally have seen the impact a gluten free, low sugar, low glycemic diet high in probiotics in the form of fermented foods has had on my own health. Don’t be a skeptic – join the revolution – we are healthier and happier than we’ve ever been.
http://tulasstory.wordpress.com/
Diets and miracle cures
Thank you Ms Perry for that excellent article about diets and supplements. And for not suggesting any miracle cures for serious conditions like autism.
Commercial probiotics
I understand the skepticism, and I agree. We should certainly question what companies are trying to sell us, claiming a panacea.
However, we shouldn’t allow that skepticism to color what we do know. We do know that our guts harbor microbes that help us. People who have had their guts ravaged by high doses of antibiotics suffer from a lot of problems, including sensitivity to foods that they weren’t sensitive to before. I believe that I read an article on MinnPost a few months back that introduced me to the concept that our appendices might be a safe-house for bacteria to recolonize should our gut flora be depleted.
So, we know that the *concept* of probiotics is a good one. The next question is, what bacteria are truly beneficial? (Are any of those capsules providing a true benefit? What about fermented foods–do they really help? To what degree if they do?) Beyond that, we as consumers, need to be smarter. While it MAY be that capsules of bacteria and yeast are beneficial to our gut, does this translate to any benefit when suffering from a cold? I highly doubt it beyond maybe helping increase general health and the body’s ability to defeat a respiratory infection. Even if we’re colonizing our respiratory system with “good bacteria,” once we’re sick, it’s too late to get any benefit. But then, to think of it this way requires some thought and general biological knowledge. I’m afraid that even outright scams will continue to be profitable if the public actually has to think critically to recognize that there’s no benefit.