Yogurt and Probiotics - Part 1

Probiotics are the name under which companies try to sell bacteria to you. I've deliberately put that in the worst sounding way, of course. Bacteria are not simply germs that make you ill. Hundreds of varieties of bacteria naturally live in our bodies, especially in our colons. They tackle the job of digesting some of the foods that don't get digested by the rest of the intestines. Whether this is a good thing or not depends both on the type of bacteria and the food they eat. If the food is undigested lactose, then some bacteria may cause the fermentation that leads to the gas of lactose intolerance. Others digest the lactose and free us of this problem. Adding these "good" bacteria to our systems suddenly sounds a whole lot better. And people pay big money for products like Lactagen, DairyEase, and Digestive Advantage, which claim to do exactly that.

The food industry has known for many years that it doesn't work well to make offering you bacteria a selling point. When dressed up as "live and active cultures," bacteria suddenly sound much better. Cultures are merely bacteria, usually Lactobacillus bacteria. They naturally make yogurt and other fermented and cultured dairy products.

Selling just plain yogurt is no longer enough in the ultra-competitive world of supermarket sales. Even touting the general health benefits of yogurt isn't enough. Remember one marketing campaign of years past in which a group of yogurt eaters often lived to be over 100 years old? We're way past that. Yogurt now has to be an actual cure for actual diseases.

As I warned you many times in the past, though, yogurt isn't necessary yogurt. At least, the sugared, sweetened, fortified, fruit-laden, whipped, frothed, chocolately, milk solids-added concoction that is found in American supermarket dairy cases bears little resemblance to the thin, sour product that yogurt originally was. That product was good for lactose intolerants because it was auto-digesting. In other words, the cultures were sufficient to digest all or most of the lactose in the milk, making it a suitable product for anyway with mild LI. Today's products, with all those extra milk solids to make them creamier or smoother or milder or better-tasting are a crap shoot for the LI consumer.

And it's the same thing for consumer who want the health benefits of Lactobacillus bacteria. As Tara Parker Pope reported in her New York Times column:

But while there are thousands of different probiotics, only a handful have been proved effective in clinical trials. Which strain of bacteria a given product includes is often difficult to figure out.

There is no standard labeling requirement to help buyers make sense of probiotic products. The word “probiotic” on the label is not enough information to tell whether a given product will be effective for a particular health concern. Just as a doctor would prescribe different antibiotics for strep throat or tuberculosis, different probiotic species and strains confer different health benefits. ...

"Lactobacillus is just the bacterium," said Gregor Reid, director of the Canadian Research and Development Center for Probiotics. "To say a product contains Lactobacillus is like saying you’re bringing George Clooney to a party. It may be the actor, or it may be an 85-year-old guy from Atlanta who just happens to be named George Clooney. With probiotics, there are strain-to-strain differences."

Pope mentions a panel that looked at the medical literature and listed those problems for which clinical studies showed that probiotics could be helpful. That seems to be Recommendations for Probiotic Use-2008, by Martin H. Floch et al., Journal of Clinical Gastroenterology: July 2008 - Volume 42 - Issue - pp S104-S108 doi: 10.1097/MCG.0b013e31816b903f. (The full article is not available online.)

Their highest recommendations went to four uses:
• acute childhood diarrhea
• prevention of antibiotic-associated diarrhea
• preventing and maintaining remission in pouchitis
• immune response for the treatment and prevention of atopic eczema associated with cow's milk allergy

Those are rather specialized, although the last is good news for some people with milk allergies.

So what about all those ubiquitous yogurt commercials that make so many more claims? Oops.

Dannon, one of the biggest sellers of probiotic yogurts, settled a class-action lawsuit this month over its Activia yogurts and DanActive yogurt drinks, which claimed to help regulate digestion and stimulate the immune system. As part of the $35 million settlement, Dannon agreed to reimburse dissatisfied consumers and make labeling changes, among them adding the scientific names of probiotic strains it uses.

I'll talk about that case and the others that are pending, tomorrow.