Hi, I'm investigating the health claims f... - Healthy Evidence
Hi, I'm investigating the health claims for probiotics.. Seen any dubious claims that you'd like to challenge? Thanks, Caroline
Great! Looking forward to hearing what you find out.
Everyone, here are our tips on how to Ask for evidence: senseaboutscience.org/pages...
There are quite a few claims about probiotics made in What Doctors Don't Tell You. Some have been addressed here: wwddtydty.com/?s=probiotics...
Boots says their Prebio7 capsules "fortifies traditional diets" which "are often deficient in friendly bacteria"...
boots.com/en/Prebio-7-Probi...
Not entirely sure either of these are valid statements.
Great topic! If you are looking for information to investigate any of these claims, it could be worthwhile checking the Cochrane Library via Cochrane Summaries to check what systematic reviews of probiotic interventions have been done and what the results of these systematic reviews have shown:
summaries.cochrane.org/sear...
Hope this is of use!
Dee
Thanks Dee, I'm on it! Cochrane is a really useful source 
Hi @Cazza,
I've just done a quick scout of the top brands being sold on Amazon, Boots & Lloyds Pharmacy websites. The things I've noticed in my unsystematic survey are:
1) Medical-sounding references. For example, several talk about "patients", others talk about "dose". As I understand it, probiotics are supposed to be regulated as foodstuffs not medicines and this feels like the advertisers have rather muddied the waters between the two.
2) Inconsistent adverse effect/contraindication warnings: Some warn not to exceed stated dose. Some warn not to be taken if "severely immunosuppressed patients, post cardiac surgery patients, patients with pancreatitis". Most don't.
3) Vague and waffly scientific claims: for instance this (feel free to skip) "Protexin Bio Kult - Advanced Probiotic FormulaBio Kult is an advanced probiotic formula, expertly developed by a team of doctors, nutritionists and scientists, in order to offer a very powerful and effective probiotic health supplement, which helps our digestive and immune systems.The healthy body system naturally host trillions of natural and beneficial bacteria; however, their essential functions can be compromised by stress and poor nutrition. It is fundamentally important that our bodies should be balanced with adequate levels of probiotic bacteria at all times. Bio Kult, with its fourteen strains of beneficial probiotic bacteria at a concentration of 10 billion per gram, is one of the most powerful probiotic supplements available and is specially developed for helping our immune and digestive systems against pathogenic and opportunistic organisms" - says very little other than "this is a probiotic product".
Perhaps you could include some probiotic shopping tips!
I'd also be very interested to know if there are any differences between the many and varied bacterial strains (and combinations of strains).
It strikes me that in the main stream market, the main problem is that it has not been shown that pro-biotics do anything for people who are healthy, fit and have no challenging condition (like being old or pregnant .. 
)
So, they are not necessarily lying about the benefits of the products, but rather being vague about who actually needs them.
The TV ad for Activia looks very dodgy to me. Have you seen it?
As a food, claims for probiotics are covered by the European Food Standards Agency and regulated in the UK by the Advertising Standards Authority. You can look up any health claim and see if it is authorised or not authorised. All decisions are backed by detailed scientific evidence, reviewed by their panel and linked to in their database..
You can search for any claims here: ec.europa.eu/nuhclaims/?eve... and I have written a short piece about it here: nightingale-collaboration.o.... The ASA's guidance is here: cap.org.uk/Advice-Training-...
Looking up 'probiotic' returns no authorised claims and 129 not-authorised claims! This means that no nutrition and health claims can be made for probiotics. However, I'm not entirely sure what is allowed and what isn't - I suspect they could get away with Woolly Weasel Words (tm), but the rules are quite strict.
ASA does not cover claims made on radio or television. My experience of clearing with the authorities is mostly substantiating the claim nice and clearly on a bit of letterhead and faxing it to the authority. However, they do collect information in case something comes up twice. You get this on radio where someone has some electronic gizmo that you attach to your nose and it cures all known cancers and it is being franchised out to gullible resellers. They have a list of those and they tend to get automatically rejected.
For more subtle things like Pro Biotics it is more difficult as the science is a) complicated and b) lots of different opinions. In those cases they tend to try and keep claims not too over the top (with mixed success). Where they are weakest is with products like shampoos (claims that protein is actually any use in shampoo, for instance), where there is really not a hell of a lot of good balanced advice to be had.
No, the ASA co-regulate TV and radio advertising with Ofcom:
"In practice, this means that the ASA system is responsible on a day-to-day basis for broadcast advertising content standards. The Broadcast Committee of Advertising Practice (BCAP) is responsible for writing and maintaining the UK Code of Broadcast Advertising, but Ofcom retains overall sign-off on major changes to the Code. The ASA is responsible for administering the Code, but is able to refer broadcasters to Ofcom for further action, if needed. This is extremely rare."
The Broadcasting Code (BCAP) is very similar to the non-broadcast code.
I have extensive experience with the ASA (and I usually win!) and have always found them highly professional. They require high quality evidence to back claims and will generally accept only peer reviewed., robust, DBRCTs. However, for food claims, these are decided by the European Food Standards Agency - the ASA enforce these and there are no authorised claims for probiotics that I can see.
However, when I get radio and TV scripts cleared (which I have done on a regular basis for 35 years) I never go near the ASA.
By Clearcast? They are separate, but the ASA sometimes rules against advice given to advertisers by Clearcast, eg asa.org.uk/Rulings/Adjudica...
The ASA are the final arbiters.
I'm interested to hear more about Optibac products, particularly the newly released 'For your cholesterol'. This is on special offer at the moment due to it being National Heart Month, which is a British Heart Foundation campaign. BHF stats are even featured in the advertising. I am concerned that this connection to the BHF might lend credibility to these products when there is somewhat limited evidence regarding their effects. The description of the product describes the cultures contained as 'extensively researched' so perhaps there is more evidence out there, but I haven't seen anything that seems credible.
For their Optibac 'For your cholesterol' product, they say that the ingredient Alpha-linolenic acid "helps to maintain normal cholesterol levels". The actual EFSA wording is "ALA contributes to the maintenance of normal blood cholesterol levels", so slightly different, but not sure if that is significant.
However, it also has all sorts of sciency-sounding other text but it would probably take an ASA complaint to rule on whether this was misleading or not. Of course, manufacturers are going to get 'creative' about how they present their products to maximise sales!
I'll be very interested to hear what you find Cazza, - please report back!
I've read a few things claiming that babies born by C-section should be given probiotics as they don't get a dose of gut flora from Mum on the way out (I can think of no non-disgusting way to make that clearer) and and this can lead to an increase in allergy. A lot of that comes from those keen to sell natural birth or natural products to make up for the lack of natural birth but I did find one paper from 2009, there may be more, I've not done an extensive search:
ncbi.nlm.nih.gov/pubmed/191...
And here is a product to solve the problem of your baby's tummy being upset by c-section, bottle feeding or "toxins"
Speaking of this have you guys looked into Truehope at all? This article is kinda related to the probiotic conversation.
nhs.uk/news/2014/01January/...
This user is just spamming the link to this article... how do I report it?
Done. For future reference there should be a "Report" link by the Recommend button.
The European Food Safety Authority (EFSA) reviewed the scientific basis for hundreds of health claims submitted about the benefits of probiotics for consideration on food labels, and rejected all of them. Info available from the EFSA website
The evidence base for probiotics is rapidly expanding, for example a recent double blind placebo-controlled RCT in non-alcoholic fatty liver disease demonstrated an improvement in liver function tests in the intervention group. (Eslamparast et al, Am J Clin Nutr 2014;99:535) Both groups were counselled on lifestyle improvements, from which both appeared to benefit, but the probiotic group improved significantly more and had evidence of reduced inflammation. The study was small, 52 patients, but the intervention was for 28 weeks.
One of the questions that should be asked of anyone proposing a benefit for probiotics, is which species and strain, as all 'probiotics' are not the same. Certainly survival rates of probiotics after passage through the stomach would vary considerably.
Sorry for the delay - I've now published my piece on probiotics:
nhs.uk/Conditions/probiotic...
It covers the few uses for which there is evidence of benefit, but the take-home message is there’s little evidence to support most health claims made for probiotics. No surprises!
Any feedback welcome
Hi
I've just found this site and would like to add some comments. Although it seems unlikely that a healthy individual may get any benefits from probiotics, there is some evidence that it may be helpful in certain medical conditions.
I have coeliac disease, which means that gluten damages the lining of my gut. Allowing this to repair means eliminating all gluten from my diet. In an attempt to help repair the gut it is often recommended that we take probiotics.
This research cites researchers in Finland who showed that probiotic bacteria appear to be able to reduce damage to epithelial cells and may accelerate healing.
ncbi.nlm.nih.gov/pmc/articl...
This research was on mice...
ncbi.nlm.nih.gov/pubmed/223...
It's worth trying good quality probiotics/fermented foods for some people.
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