- Contain live microorganisms.
- Be delivered live to the lower GI tract in efficacious quantities.
- Provide a health benefit.
Ganeden: 'The ‘Live & Active Cultures’ seal does not necessarily mean that the product is probiotic'
Yogurts, for example, are often cited as a great way to get probiotics into your diet, said Bush. But he added: “Yogurt is a great product, but unless the manufacturer has data to support that the strains benefit the host, using the ‘Live & Active Cultures’ seal does not necessarily mean that the product is probiotic.
“All it definitely means is that the product contained 100 million CFU of Lactobacillus bulgaricus and Streptococcus thermophilus per gram of yogurt (10 million for frozen) at the time of manufacture [according to the National Yogurt Association, the cultures must also be 'active' at the end of the stated shelf-life]. It is basically just saying that it was made with a certain number of cultures that turn milk into yogurt.”
“So for half of the yogurts you see with this seal [which refers to the genus and species of the cultures, but not the strain], who knows what the specific strains are, and whether they make it through the digestive tract to the large intestine, and whether they confer a documented benefit?
WHAT ARE PROBIOTICS? According to the World Health Organization, probiotics are “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.”
In a 2006 position paper on probiotics, the National Yogurt Association acknowledges that the health benefits of probiotics are strain-specific, but also says that it is reasonable to describe yogurts made with meaningful levels of live and active cultures as 'probiotic foods': "Live and active yogurts that contains the starter cultures Lactobacillus delbrueckii subspecies bulgaricus and Streptococcus thermophilus are 'probiotic foods' as they provide a beneficial effect related to lactose digestion.")
"Does the 'live & active cultures' seal mean 'probiotic'? You’d think this was a simple question, but in fact, it is not...
"The vast majority of yogurts contain live Lactobacillus bulgaricus (LB) and Streptococcus thermophilus (ST), the yogurt starter cultures, which have been shown to confer a health benefit, i.e., reduce symptoms of lactose intolerance for people with this condition. So, strictly speaking, in my interpretation of the definition of probiotic, all live yogurts contain probiotics.
"However, I think there is confusion for consumers. I think it is very relevant for consumers to be able to distinguish between yogurts with only LB/ST in them, and yogurts with an adequate level of an additional probiotic. I say this because the range of benefit that LB/ST confers is restricted to only those with symptoms from mal-digestion of lactose.
"Many consumers might be looking to their probiotic yogurt for more than that. So yogurts that contain ADDITIONAL live microbes, such as other strains of Lactobacillus or Bifidobacterium, have the potential to deliver benefits beyond lactose digestion. The LB/ST in yogurt do not survive intestinal transit. Only the additional probiotics do. So – although this will seem inconsistent with my initial statement – I think it’s best to advise consumers to look for additional probiotics beyond the yogurt starter cultures.
"So, the seal is a good start, but I would also encourage consumers to look at the product label and see if other probiotics are added – if other types of benefits are important to them."
Mary Ellen Sanders, Ph.D. Dairy & Food Culture Technologies
While many fermented foods such as sauerkraut use naturally occurring live cultures to begin the fermentation process, meanwhile, they are often pasteurized – a process involving heat that will kill good and bad bacteria alike – added Bush, who suggests manufacturers add clinically-studied probiotics to such products after they have been pasteurized if they want to reliably describe them as ‘probiotic’.
If fermented foods are raw, meanwhile, they will contain bacteria, he added, “but again, it’s not necessarily bacteria that can be called ‘probiotic.’ The organisms used to produce the fermented food most likely have not been studied to show that it provides a health benefit to the consumer, so we don’t really know what they do, or if they confer any health benefits.
“So for half of the fermented foods you see, who knows what the lactobacillus is, what strain it is, whether it has any effect beyond the fermentation of the cabbage, or whatever.”
In the EU, the term ‘probiotic’ is no longer permitted, making life very difficult for firms marketing probiotics, who have thus far failed to secure a single approved health claim for probiotics under the Nutrition And Health Claims Regulation (NHCR).
In the US, the regulatory environment is a little more accommodating, with firms allowed to make structure-function-type claims (eg. supports digestive health) about probiotics, provided they can be supported by scientific evidence.
Not all kombuchas contain probiotics
Kombucha, meanwhile (a fermented tea made by adding a culture of bacteria and yeast to a solution of tea, sugar and sometimes fruit juice), is another product that many consumers assume is loaded with probiotics by definition, when products in fact vary dramatically, said Bush.
Some brands, notably market leader GT’s, have added Ganeden’s BC30 strain to their products in order to ensure that they do contain probiotics, as stated on the label, he said. KeVita, similarly, fortifies its Master Brew Kombucha with probiotic strain Bacillus coagulans MTCC 5856 (‘LactoSpore’), which it claims remains active through the expiration date and is “added in sufficient quantities to provide the benefits of this live probiotic.”
However, you can’t make assumptions about what’s in many other kombucha brands unless the manufacturer explains exactly what probiotic strains are in there at the end of shelf life, whether they make it through the digestive tract, and once there, deliver a health benefit, said Bush [many brands just say something like ‘yeast and bacteria cultures’ on the ingredients list].
When you think about probiotics, you need to think about the genus, the species and the strain, says International Probiotics Association president Mike Bush. For example, for Lactobacillus rhamnosus GG (often referred to as LGG), the genus is Lactobacillus, the species is rhamnosus and the strain is GG. "And no two strains are the same," says Bush.
“if people are expecting to get all of their probiotic needs each cay by drinking a non-probiotic fortified kombucha, they would probably be better off buying a capsule [which offers a meaningful dose of a clinically studied strain with proven health benefits].”
How do you measure the benefits of probiotics?
But what benefits to probiotics confer, how are they measured, and do healthy people really need them (A recent article by the Daily Beast, entitled ‘Probiotics are a waste of money for healthy adults’ recently threw this issue into sharp relief)?
First of all, said Bush, you can’t generalize as every strain is different. “GanedenBC30 has been shown to support immune health at 500 million CFUs (colony forming units) and digestive health at one billion CFUs, but different probiotic strains are effective at different levels, and have different effects.”
In the case of immune health, there are validated biomarkers that can be measured in healthy people to determine if probiotics confer a benefit, but in the case of digestive health, there are not, so studies tend to focus on people with IBS or gastrointestinal issues such as pain and bloating, and multiple human studies have shown than BC30 can provide relief, said Bush.
“For healthy people, it’s harder – what do you measure? Some companies have looked at intestinal transit time, but it’s difficult. But there’s much more to probiotics than alleviating GI discomfort.”
Are probiotics 'a waste of time for healthy adults?'
The Danish meta-analysis that prompted the Daily Beast headline showed that taking probiotics over the course of a clinical trial did not meaningfully impact the composition of fecal microbiota in healthy adults, he said.
But that is not a hugely relevant determination of whether they are beneficial, he said, noting that probiotics achieve health effects via many different mechanisms of action and not just by wholesale modulations of gut microbiota: “We’re not looking to shift the whole microbiota; we don’t even know if that would be a good thing. You’ve got trillions of CFU of bacteria in the gut, so it would be really hard to move the needle in a short term study anyway.”
"Probiotics can restore intestinal microflora which often become unbalanced due to illness, stress, age, traveling or use of medication such as antibiotics." International Probiotics Association
As for broader claims about probiotics – which have been linked to a dizzying array of health benefits – the science is still emerging, he said. And manufacturers are cautious about claims both because they don’t want to get ahead of the science and because of the risk of litigation [Yakult – which has one of the best researched strains in the industry, and makes very conservative claims, was recently targeted [and ultimately prevailed] in a false advertising case].
“You consistently hear that people just feel better. But we don’t know why. We may find out that there are neurotransmitters modulated by gut bacteria that are truly making people feel better, but the science isn’t there yet.”
Products containing BC30 include the first probiotic burrito (from Sweet Earth Natural Foods), gum (from Focus Nutrition), baking mixes from Enjoy Life Foods, Forager cashew smoothies, Garden of Flavor cold-pressed energy drinks, JÙS By Julie probiotic cold brew coffee, Suja pressed probiotic waters, Brad's Raw Foods’ Broccoli Poppers, Naturally More nut butters, cheddar bites from The Probiotic Cheese Company, and ancient grain granola from Purely Elizabeth.
BC30 can be boiled, baked, frozen, pasteurized, microwaved, high-pressure-processed and extruded
Ganeden continues to generate strong growth as more food and beverage manufacturers seek to incorporate BC30 into everything from cold brew coffee to buttery spreads, said Bush.
"Products featuring BC30 generated revenues (retail sales) of more than $1bn in 2015.”
As BC30 can be boiled, baked, frozen, pasteurized, microwaved, high-pressure-processed and extruded and go on to survive stomach acid and move to the gut where it starts multiplying and proliferating, it has opened up a raft of food applications previously closed to probiotics, from hot tea and coffee to muffins, jam, soup, frozen yogurts and HPP-treated beverages, according to Bush.
Before they go to market, Ganeden conducts tests on the final products produced by its partners to ensure that they contain the level of BC30 claimed, rather than making assumptions about its resilience based on its performance in similar products, he said.
“We test every product before it goes to market and we won’t work with people that won’t put in an efficacious dose. We met with a company yesterday that said what if we just want to say it’s a probiotic and we just put in 100m CFU? And I said we won’t sell it to you."
Missed Mike Bush's presentation at the Healthy & Natural Show? Download it HERE.
Explore the probiotic & prebiotic scientific frontiers, their evolution and commercial application in food, supplements and more at the IPA World Congress + Probiota Americas. The event will be held in Chicago May 31-June 2. For more information and to register, please click HERE.