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To drink or not to drink ? The probiotic dilemma

 

I have been asked a lot of times in my practice by the mothers about various probiotic drinks or probiotic laden yoghurts which are commercially available, and whether they can give it to their children routinely or not.  Probiotic drinks have recently gained popularity and are being consumed as a part of daily diet in most homes.

Probiotics can be a confusing concept for parents to grasp, and with an ever-growing array of foods now containing “the good or the healthy bacteria”, decisions about whether to use or buy these products may not be getting any easier.

 

So what are probiotics?

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Probiotics are defined as living bacteria that, when administered in adequate amounts, confer a health benefit on the host ().

Commonly probiotics are believed to restore the balance of intestinal bacteria and boost the immune system.

Although people often think of bacteria as harmful “germs,” many of these help our bodies function properly. Large numbers of microorganisms live on and in our bodies. For example, bacteria that are normally present in our intestines help digest food, destroy disease-causing microorganisms, and produce vitamins.  Many of the microorganisms in probiotic products are the same as or similar to microorganisms that naturally live in our bodies.

Strictly speaking, however, the term “probiotic” should be reserved for live microbes that have been shown in controlled human studies to impart a health benefit.

Probiotics are available in what forms?

Products sold as probiotics include foods (such as curd/yogurt), drugs, infant formulas, dietary supplements, and products that aren’t used orally, such as skin creams.

Classically, bacteria present in traditional fermented foods and beverages are not considered probiotics although they have many health benefits. Some do contain live microbes but not in quantity enough to label them as probiotics.

What are the common organisms in probiotics?

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Species of Lactobacillus and Bifidobacterium are most commonly used as probiotics, but the yeast Saccharomyces cerevisiae/boulardii and some E. coli and Bacillus species are also used as probiotics. These are added to foods, particularly fermented milk products, either singly or in combinations. They may also be available in isolation to be consumed as drugs.

The strain designation is important, as different strains of even the same species may have different health effects. Likewise dose also matters: a probiotic consumed at a higher dose may not necessarily have a greater health benefit than one consumed at a lower dose.

Lactic acid bacteria (LAB), including species of Lactobacillus (Gram-positive microbes that have been used for centuries in food production processes  of curd/yogurt, cheese, pickles etc. ) can serve a dual function by acting as agents of food fermentation and, in addition, potentially imparting health benefits.

Are probiotics really helpful?

Parents have misconceptions about the use of probiotics, their benefits, and their role in promoting health and treating diseases.

Part of the problem with probiotics is the way they are advertised. Inappropriate use of the term “probiotic” and failure to recognize the importance of the strain specificity and dose specificity is a concern today. Probiotics when produced as nutritional supplements, not drugs, undergo less regulatory scrutiny . None of the supplements or foods that contain these bacteria are approved to prevent or treat specific illnesses (barring one or two), but manufacturers are allowed to make general health claims. For example, food makers can say that their product “improves digestive health or improves gut health,” a vague phrase that’s not clearly defined.

This is a main reason for poor to non-existent efficacy and safety information on most commercial products.

But all said and done, some probiotics do help.

  • Their major role is to prevent diarrhea that’s caused by or associated with infections or antibiotics.
  • They may also help with symptoms of irritable bowel syndrome.
  • Couple of probiotics are also routinely prescribed in childhood gastroenteritis by the pediatricians.

But these above benefits I am talking about is of the probiotics available as drugs and not as probiotic drinks.

However again, benefits have not been conclusively demonstrated, and not all probiotics have the same effects. For example, if a specific kind of Lactobacillus helps prevent an illness, that doesn’t necessarily mean that another kind of Lactobacillus would have the same effect.

We also don’t know what quantity of the probiotic a child would have to take to benefit from it. The pitfalls of commercial probiotic drinks are delivery of inadequate quantity of probiotics to the lower gastrointestinal tract -specifically the acidic environment of the stomach. There is no idea about their shelf life and we don’t know whether the number of bacteria mentioned on the product are actually being delivered to your child’s gut especially after a prolonged storage.  Even for the conditions that have been studied the most, researchers are still working toward finding the answers to these questions.

Who should use probiotics?

Many probiotic products are regularly used by parents even if the child is completely healthy . They do so on the assumption that probiotics can retain their health and well being, and potentially reduce their long-term risk of diseases of the bowel, kidney, respiratory tract and heart. But it should be remembered that the use of probiotics should not replace a healthy lifestyle and balanced diet in otherwise healthy children.

No studies have yet been undertaken which analyse whether or not probiotic intake on a regular basis helps retain life-long “health/immunity” over and above dietary, exercise and other lifestyle measures (at least I couldn’t find one after extensive review).

However as stated above, probiotics might help to a certain extent in diarrheal and other gut related illnesses, but then they should be taken as a drug and not as a food supplement and that too on advice of your doctor.

So should you give your child that probiotic drink as a part of his daily diet?

I would say no.

Probiotics are not a “cure all” and it is not necessary to take them to be healthy.

Occasionally you might but don’t make it a regular habit.

 

So the question was not whether a probiotic is good for your child or  not, but whether that probiotic drink is needed daily?

Remember there is no such probiotic which is more effective than inculcating a healthy diet in your child’s routine. Parents are better off saving their money and using it to buy more fresh fruits and vegetables for their children. A healthy home made fresh meal is far more better than any supplement available in processed form.

A healthy lifestyle which includes a healthy diet and exercise is the best immunity booster that you can as a parent provide to your child instead of running after various supplements in the market. This will be helpful in the long run too when they become adults.

If my argument doesnt convince you then as I have said in my previous blog also, that if you want to know whether or not something is healthy for your child, please do read the labels. You will come to know by yourself whether that particular product is good for them or not. Figuring out Food labels; what to eat and what not to eat?

Most of these drinks/supplements are loaded with sugars to make them tasty. Infact the low sugar versions also contain a good enough amount of sugar. So imagine pumping up your child with loads of sugar first thing in the morning! Is it really going to help him/her or is it the start of a unhealthy habit. That’s for you to ponder over.

Although some probiotics have shown promise in research studies (single centre studies or clinical case reports), strong scientific evidence (multicentric randomized trials) to support specific uses of probiotics for most health conditions is lacking. The U.S. Food and Drug Administration (FDA) has not approved any probiotics for preventing or treating any health problem. Some experts have therefore cautioned that the rapid growth in marketing and use of probiotics may have outpaced scientific research for many of their proposed uses and benefits.

Points to remember:

  • Don’t replace scientifically proven treatments with unproven products and practices. Don’t use a complementary health product, such as probiotics, as a reason to postpone seeing your pediatrician about any health problem.
  • Not all products labelled “probiotic” are true probiotics
  • If you’re considering giving  your child a dietary supplement, such as probiotics, it’s especially important to consult your child’s pediatrician. Check the label or read the product insert carefully.
  • Certain probiotics can be given in gut illnesses on the advice of your pediatrician

I am not against probiotics and I personally find them useful but only when indicated and not as part of your child’s routine diet.

By this article, I might have earned the wrath of many people who advocate regular use of probiotics drink but I would still say….

Choose wisely & stay healthy

Healthy kids! Happy kids !!

Dr Garima| themoppetsclinic 🙂

Disclaimer: The views mentioned in this blog are my personal opinion entirely without any reference to any particular product. Your pediatrician’s or health care provider’s views might be entirely different than mine.  

 

 

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