What is ‘good’ research into probiotics?

This is an important question with a very different answer depending on whether you are a person using a probiotic, a company making a probiotic or a scientist investigating one. The amount of published research about probiotics has increased ten-fold in the past decade. This has been driven largely by two factors; doctors and academics who see probiotics as a possible solution to various digestive disorders and want to understand more about them, and the functional food or so-called ‘nutraceutical’ industry which wants to support the value of its products.

There are of course competing interests at work here, the medical community valuing scientific rigour above all else, and industry looking to market their products in the most favourable possible light. The consumer is stuck somewhere in the middle, looking to the researchers for good quality information but dependent upon commerce for awareness of products and ways of accessing the benefits that probiotics can deliver.

Recently there has been much in the media pointing an accusatory finger at companies making health claims for probiotic products that are not entirely supported by the facts. It’s classic rose-tinted spectacles territory where a truly objective assessment of the data might not support the same bold claims as the subjective view of the marketers who live and breathe the brand they are promoting.

So how do we maintain objectivity and equip the consumer to make an informed choice? One way is simply to leave research to the researchers; the best research should be carried out by independent experts adopting best practise techniques, unfettered by interference from a sponsor company. In the field of food supplements this means gastroenterologists, nutritionists and dietitians carrying out research to agreed best practise guidelines, such as the Rome III criteria (internationally agreed standards for research in digestive diseases). It also means companies being willing to accept the results, good or bad of such research.

There are now hundreds of published studies which were paid for by industry, and relatively few truly independent ‘investigator-led’ studies. It’s interesting and perhaps not entirely surprising that most of the published sponsored studies of probiotics support their use, whilst a far greater proportion of rigorously designed, investigator led studies are more ambivalent in their conclusions.

So what should we look for in a good study? As a rule of thumb, if a product has substantial, investigator-led, double blind, placebo controlled, randomised design food evaluations behind it in a population of people representative of the end user then it’s on the right track; indeed the European regulator for probiotics EFSA have been saying precisely this for more than a year as the row over health claims has unfolded.

If on the other hand the best data for a product is in people with conditions you haven’t heard of, or uses strange surrogate markers for effectiveness in a handful of people in rural China, it may be sensible to take any marketing claims based on this with a pinch of salt.

Symprove is the subject of two independent food evaluation studies at King’s College Hospital London, one in people with irritable bowel syndrome (IBS) and a second in people with Crohn’s disease or ulcerative colitis (IBD). Both studies are placebo controlled, double blind and randomised design meeting Rome III criteria making them amongst the most robust and largest independent studies ever carried out on a probiotic product.

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