An increasing variety of probiotic products is available worldwide
Almost everyone has heard of probiotics: a simple Google search for “probiotics” produces over 56.8 million hits. Despite regulatory constraint in place since 2012, the term probiotic has far from left the minds of consumers. According to Google Trends, interest in the term “probiotic” has been on the rise in a number of European countries. It clearly highlights the fact that an increasing number of people are aware of probiotics and are searching for related knowledge.
Over the last 20 years, there have been more than 20,000 studies published on probiotics, according to PubMed
Thousands of articles have appeared in peer review scientific journals of the highest quality such as The Lancet, European Journal of Clinical Nutrition, Clinical Infectious Diseases, Gastroenterology and the British Medical Journal.
IPA Europe experts collaborate with scientific organisations on common goals, alliences with globally recognised scientists, with the goal of communicating positive messages that are scientifically based.
Taxonomic revision of the Lactobacillus genus
In April 2020 the nomenclature of the genus Lactobacillus, together with some other related taxa like the pediococci, leuconostocs, fructobacilli, etc., has been revisited. The results you can see here.
A team of 15 researchers from 12 different institutions and 7 countries was put together to apply whole genome analysis to analyze each Lactobacillus species. Their proposal, which was accepted for publication in the official journal of record for bacterial names, is that the species once contained within the Lactobacillus genus should now spread over 25 genera, including 23 novel genera.
To facilitate the conversion from old to new nomenclature, the team involved in this project has created a simple online tool to help with the conversion, which can be found here . But even if some genus names have changed, the parts of the names that indicate species were not: all new genera proposed for this group begin with the letter “L”, so the ‘L.’ genus abbreviation may still be used.
The use of a refined nomenclature allows for a much more detailed and reliable communication. Also, this will create a stable nomenclatural framework.
What happened afterwards?
As a consequence of the taxonomic change, in July 2020 the EFSA QPS list was updated by EFSA. For maintenance of continuity within the QPS list, all the strains belonging to a previous designed Lactobacillus species were transferred to the new species. Both the previous and new names will be retained and are included in the QPS list.
EFSA has published a table to clarify the correspondence between the previous and new designations of the QPS species, following the alphabetical order of their specific names (EFSA publication, Chapter 3.4).
What happens now?
A full transition from old to new nomenclature will take time, probably years. Consumers and administrators at this point need to get used to the new names appearing on the labels of foods and food supplements, and researchers and regulators too will need to be re-educated and start to use the new names.
IPA Europe has duly informed the Member State authorities about this taxonomic change, sending out an official communication (an example of this letter is available here)
How to correctly identify Probiotic food and food supplements?
Scientific experts from IPA Europe and the International Scientific Association for Probiotics and Prebiotics (ISAPP) have developed science-based criteria to provide clarity for the proper use of the term probiotic.
For many years, the probiotic sector in Europe has been working proactively to support and encourage responsible production and marketing of probiotic foods and food supplements, as per the latest scientific developments.
IPA Europe has initially developed this voluntary approach which consists of scientific-based criteria as a prerequisite to qualifying “the probiotic category of food and food supplements”. Then, IPA Europe scientific experts have been working in collaboration with the International Scientific Association for Probiotics and Prebiotics (ISAPP) to provide clarity on each criterion and detail how each of these four criteria can be assessed. This is now acknowledged in the open-access paper “Criteria to qualify microorganisms as ‘probiotic’ in foods and dietary supplements” published in Frontiers in Microbiology. This paper describes the minimum criteria that apply to a probiotic strain that will be used in foods and dietary supplements.
Specifically, to be qualified as a probiotic, a strain must be sufficiently characterized and safe for the intended use. It must be supported by at least one positive human clinical trial conducted according to generally accepted scientific standards or as per recommendations and provisions of local/national authorities when applicable. Finally, the strain must be alive in the product at an efficacious dose throughout shelf life, and Similar criteria may be applicable to other uses of probiotics.
The Authors consider that adherence to these principles will reduce the number of products in the marketplace that misuse the term “probiotic”.
IPA Europe contends that the wide adoption of these criteria is necessary to ensure the proper use of the word probiotic in scientific publications, on product labels, and in communications to regulators and to the general public. Also, the use of the term “probiotic” would then not require an EFSA health assessment, as long as no reference to specific health effect is made.
With the help of experts, IPA Europe members will continue to discuss issues pertaining the interplay between science, nutrition and regulatory issues for probiotics in food and dietary supplements.
IPA Europe Q&A in response to the “2020 AGA Clinical Practice Guidelines on the Role of Probiotics in the Management of Gastrointestinal Disorders”
The recently published Clinical Practice Guidelines on the role of probiotics in the management of gastrointestinal disorders by the American Gastroenterological Association (AGA) contains some interesting points on the role of probiotics, but also requires some clarifications. Probiotics should not be seen as the magic solution, just as drugs are not solving all the medical problems in the world.
IPA Europe welcomes the approach of analysing probiotic interventions individually, and not grouping different probiotic strains and combinations of strains into one meta-analysis. All studies indicate that the probiotic family is not a single uniform block: if several different probiotics have shown similar effects in different studies, their action depends on the strain, or the combination of strains used.
Much evidence for probiotics substantiates their use to support health and in preventing and mitigating disease and in a wider scope of conditions.
A large majority of trials are conducted in Europe (420 in Europe compared to 270 in North America in 2018). Excluding studies solely because they were not conducted in North America, as AGA states, could therefore reduce the relevance of AGA’s recommendations.
To find out more download the “IPA Europe Q&A on the publication of the American Gastroenterological Association (AGA) – 2020 Clinical Practice Guidelines of Probiotics in the Management of Gastrointestinal Disorders”.
The letter published on Gastroenterology in December 2020 brings additional arguments for the use of probiotics in prevention of diseases
The Authors, Maurizio Koch, MD, and Lucio Capurso, MD, comment on two clinical recommendations of the AGA. They bring additional arguments for the use of probiotics in the prevention of Clostridioides difficile infection, and on acute gastroenteritis in children, which are based on recent systematic review.
How trillions of microbes affect every stage of our life – from birth to old age
On December 17th 2019, National Geographic Magazine published an interesting article on the beneficial effects of microbes on the human body. IPA Europe has welcomed this very interesting article, hoping for more scientists investigating about the surprising impact of the “friendly bacteria”.
Health benefits of probiotics – ISAPP educational video
On September 30th 2019, ISAPP, International Scientific Association for Probiotics and Prebiotics, published a simple and effective video that explains what are probiotics and their main functions.
Resilience as a valid measure of health and the implications for health benefits of specific foods and food ingredients
In a recent ISAPP blog post, scientists explored the concept of ‘resilience’ in the context of human physiology, i.e. the ability to remain healthy even when exposed to stress, or to recover from stress faster, and concluded that the recent recognition by EFSA that maintenance of homeostasis is a valid measure of health, provides an opportunity to apply this concept to specific foods and food ingredients.
A scientific paper published in European Journal of Public Health reports that those who take probiotics as a preventive measure are less likely to receive antibiotic prescriptions
The systematic review, which was authored by an international group of ten scientists, reviewed studies that administered Lactobacillus or Bifidobacterium to healthy people, to determine the impact of probiotics on the incidence or duration of common infectious diseases. In all studies that also tracked antibiotic use, the study found that healthy infants and children who consumed probiotics, rather than a placebo, were at least 29% less likely to receive or consume antibiotics. No studies in adults were included because these studies did not track antibiotic prescriptions.
IPA Europe comments on the EFSA draft scientific and technical guidance
IPA Europe appreciates the opportunity provided by EFSA to comment on the revised draft guidelines for the preparation and presentation of a health claim application. IPA Europe continues to request the possibility of having a dialogue between the applicant and EFSA prior to the submission of a dossier.
IPA Europe comments on the revised EFSA guidance documents
On 18 January, the European Food Safety Authority (EFSA) published the revised guidance for health claims related to the immune system, the gastrointestinal tract and defence against pathogenic microorganisms, and also the general scientific guidance on health claim applications. IPA Europe is happy to see that these documents clarify some questions, and that the consultation procedure has therefore been productive. However, there are also still a number of points that IPA Europe believes have not been adequately considered.
The Clinical and Economic Impact of Probiotics Consumption on Respiratory Tract Infections: Projections for Canada
The aim of this study was to assess the impact of probiotic use in terms of number of RTI episodes and days averted, and the number of antibiotic prescriptions and missed workdays averted, in the general population of Canada. In addition, the corresponding economic impact from both a healthcare payer and a productivity perspective was estimated.
The science of ferments, fermentation, the microbiota & the health of yogurt
This paper, published by Danone, describes the vision of two extraordinary men: Elias Metchnikoff, the first person to observe the health benefits of microorganisms and Isaac Carasso, who was later inspired by the work of Elias Metchnikoff and subsequently founded Danone in order to produce a delicious food with health benefits.
Probiotic consumption makes economic sense
A recently published study has calculated the economic impact of probiotic consumption (Lenoir-Wijnkoop et al., 2015). This study was sponsored by the Global Alliance for Probiotics (GAP) that have recently joined forces with the Yogurt and Live fermented milks Association (YLFA) and the International Probiotic Organization (IPA) to form IPA Europe.
Probiotics, prebiotics and the gut microbiota
The purpose of the monograph is to discuss in understandable terms the current abundant scientific knowledge on prebiotics, probiotics and the intestinal microbiota, including the resulting effects on the host. The monograph does not address the detailed regulatory aspects of the topic. The challenge in nutritional sciences is not to tackle disease with a pharmaceutical approach, but rather to maintain and support health and thereby reduce the risk of disease.
Potential economic impact of probiotics in respiratory tract infections
Public health and budget impact of probiotics on common respiratory tract
Two recent meta-analyses by the York Health Economics Consortium (YHEC) and Cochrane demonstrated probiotic efficacy in reducing the duration and number of common respiratory tract infections (CRTI) and associated antibiotic prescriptions. A health-economic analysis was undertaken to estimate the public health and budget consequences of a generalized probiotic consumption in France.
Gut microbiota, probiotics and their impact throughout the lifespan
A major symposium hosted in Boston at the Harvard Medical School looked at “Gut Microbiota, Probiotics and Their Impact Throughout the Lifespan”. Leading researchers from around the world convened to discuss current and emerging science in four areas of the age spectrum (Pregnancy, Neonatal Period, Adult Period, Older Adults). The Executive Proceedings provides a brief view of the topics covered in each of these areas.
The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic
An expert panel convened in October 2013 by the International Scientific Association for Probiotics and Prebiotics (ISAPP) to discuss the field of probiotics. This document represents the conclusions of the ISAPP consensus meeting on the appropriate use and scope of the term probiotic.
The potential for emerging therapeutic options for Clostridium difficile infection
The potential for emerging treatment options and efficacy of anti-C. difficile vaccines are discussed in this review.