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SATURDAY, September 8, 2018 – They're sold everywhere, but probiotics – the good bacteria found in foods like yogurt and supplements – can they really help restore digestive health?
Maybe, but only for some people, suggests new research. Israeli researchers have discovered that some people's digestive systems retain the probiotics contained in a supplement. But in others, the body has expelled the good bacteria.
And in a second study, the same team found that probiotics, taken at the same time as antibiotics, could actually delay the return to normal intestinal bacteria.
The lead author of the study, Dr. Eran Elinav, said the findings suggest that one needs to be extra careful when using probiotics and that "it is safe to use". there should not be a single approach for probiotic supplements.
"The current practice – followed by millions of people who consume probiotics in hopes of improving their health and preventing disease – needs to be changed to an individual-centered system," said Elinav. He is a professor in the Department of Immunology at the Weizmann Institute of Science in Rehovot, Israel.
According to the US National Center for Complementary and Integrative Health (NCCIH), probiotics are living microorganisms, often bacteria, that would have beneficial health effects. They have been studied under various conditions, including antibiotic-related diarrhea, digestive disorders, tooth decay, allergies, eczema, liver disease and even colds. But there is no definitive proof that probiotics work for any of these conditions, says NCCID.
Still, probiotic supplements are very popular. According to a survey conducted in 2012, about 4 million Americans reported using a probiotic or prebiotic supplement (food substances promoting the growth of beneficial bacteria) over the past month, according to the NCCIH.
Elinav said that the use of probiotics should be subject to the same review as other medical treatments. "Any such intervention needs to be weighed against its potential advantages and disadvantages," he said.
The first study conducted by Elinav and his team included 25 volunteers. They underwent superior endoscopy and colonoscopy so that researchers could obtain samples of their "microbiome" (the native bacterium from the intestine) in different areas of the digestive system.
Fifteen people in this group were then randomly divided into two groups for four weeks. One group received a supplement containing 11 strains of the most popular probiotic strains. The second group received a placebo.
After three weeks, they were given another endoscopy and colonoscopy to see what changes, if any, occurred in the microbiome. The probiotic recipients had two different reactions to the supplements.
A group, dubbed the persistent, allowed probiotic microbes to settle in their digestive system. The other group – the "resistant" – expelled the probiotics without making significant changes to their microbiome, the investigators discovered.
The researchers said they could determine, based on a person's gene expression profile and microbiome, whether or not it was persistence or resistance.
In the second study, researchers sought to determine whether probiotic supplements could help restore the natural microbiome after antibiotic treatment.
The study included 21 people assigned to one of three groups: a surveillance group that allowed its microbiome to recover on its own; a probiotic group receiving a supplement of 11 strains for four weeks; and a third group treated with fecal transplantation, using their own bacteria collected before using the antibiotic.
The surveillance group and the probiotic supplement group had not regained their normal microbiome after four weeks, according to the study. The probiotic group had the slowest recovery in its initial microbiome. However, fecal transplantation resulted in a rapid return of the normal microbiome.
Elinav said these findings call for caution in the "indiscriminate" use of probiotics with antibiotics until long-term effects are better understood.
Licensed dietician Samantha Heller said the researchers "suggest that the microbiome is like our fingerprint – completely unique – and we can not assume that a supplement will have the same effect of a person at home. ;other."
But, she added, it's an emerging science and the research is still very recent. She said that she would be warning against the purchase of kits on the internet that promise to map your microbiome because there is not enough evidence yet to show that these tests work.
What can help, she noted, is to eat a more herbal diet.
"Those healthy creatures that live in our intestines have to eat what we eat, and they like plant fiber, they do not like the typical Western diet," Heller said.
The results of both studies were published on September 6 in the journal Cell.
More information
Learn more about probiotics at the US National Center for Complementary and Integrative Health.
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