Probiotics are good for you. Of course that’s what the name “probiotic” means and far from newsworthy. In the past couple of decades we’ve been learning more and more and more. A couple of new findings about probiotics are especially interesting. Many years ago when I was offered a job at the University of Texas Medical Branch, I proposed several studies. One of those was to administer probiotics to newborn babies to see if we could reduce the rate of colic. A similarly designed trial of nearly 600 Italian infants was recently published. The probiotic (Lactobacillus reuteri DSM 17938) cut episodes of inconsolable crying by about half. The same was true of the frequency of regurgitation (spitting up/vomiting). It also reduced constipation in the newborns. Add that to previous studies showing probiotics reduce allergies and lower the rate of one of the most serious problems newborns suffer (necrotizing enter colitis). My decades-long advice to parents, advising them to start probiotics in pregnancy and give them to their newborn babies, seems better and better. Another of my probiotic predictions seems to be coming true. Taking a certain probiotic (lactobacillus rhamnosus) has been linked to weight loss. A range of studies and scientific evidence about why so many people are getting fat have been building towards this. Undoubtedly the problem is far more complicated and many of the factors, like environmental contamination with endocrine disrupting chemicals, we can’t change easily or quickly. Just as certainly, these findings demonstrate that there are actions we can take in addition to the vitally important diet and exercise improvements most people should make. The principle attention regarding specific probiotic species and weight loss is focused on the relative balance of two species (firmicutes and bacteroidetes). When firmicutes predominate, people tend to acquire and maintain more body fat. Animals, including humans, that live in colder climates tend to be larger, with higher levels of body fat. As the cold environment demands burning calories to keep warm, and fat is a rich source of calories, this would seem to be a good adaptation. Also, with the plethora of food sources available in tropical environments, animals do not need to store calories. A worldwide study of 1,200 people found that the balance of firmicutes and bacteroidetes paralleled those long-established observations. The closer people lived to the equator, the greater the predominance of bacteroidetes in their digestive tract. Observing a pattern does not establish causation, nor does it prove that changing the bacteria in our intestines will cause weight...
Twenty to thirty years ago we witnessed a massive rise in asthma rates among children. It came to be considered a public health emergency not only because asthma was becoming so very common, but more so due to the dramatic increases in hospitalization rates caused by asthma. Asthma, an allergic disease, was not just increasingly annoying, it was an increasingly serious health issue. There is good news. First, that asthma rates have stopped climbing so rapidly. Second, this wave of illness opened medical eyes to see greater complexity in the causation of asthma. The view that some exposure to bacteria and viral illnesses is an important part of healthy immunologic development, initially embraced by a few of us (especially me), is no longer considered radical. Medical science is increasingly accepting of the asthma-inducing influences of many factors, such as vitamin D and previously ignored environmental chemicals. There is also bad news. Food allergy rates are now rising with much the same ferocity we saw with the asthma epidemic. An especially disappointing story in the bad news is that many of our good efforts reduce food allergy rates have not helped. They actually back fired. What IS going on? Some of the reasons for increasing food allergy rates are the same. Living indoors makes us sick. Lower vitamin D, less exposure to the bacterial richness of soil, less physical activity, increased chemical exposures, too little animal contact at the beginning of life, etc., all appear to contribute to higher risk of food allergy as well as asthma. It might be that food allergies are slower to appear and we might then soon see an imminent plateauing of the disturbing food allergy numbers as we did with asthma. Although I just made up that sunnily hopeful theory, I have to shoot down my own optimism, or maybe blunt it (a lot). We have evidence that in many cases, food allergies develop much earlier in life than we thought. Australian researchers, entering patients into their studies at four to six months of age, found that 29% of children with eczema already had food allergies. As eczema is an allergic disease and I find dietary treatment highly successful, it is dismaying but not hugely surprising that so many had food allergies. In some their reactions where already so severe that they could even suffer lethal allergic reactions to foods. If allergic onset occurs in some individuals so very early in life, then one would expect that food allergy rates would plateau as rapidly...
Recent research is lengthening estimates of the time that antibiotics alter our internal ecology and consequently expanding medical concerns about the consequences of antibiotic overuse. The Swedish review of all published studies on the topic concluded that within one week of initiating antibiotic treatment, genes associated with antibiotic resistance reach high levels in the bacteria present in patients’ bodies with these changes persisting for two years. Although this degree of persistence is discouraging and in line with data collected for the last decade, unfortunately even the two year figure is not an endpoint. As the longest studies ended after two years, they could conclude there was a two year impact. They could not conclude that two years was the bounce back point. In other words, two years is a minimum. I think the obvious conclusion at this time is that bacterial populations in our bodies are irrevocably altered by antibiotic use. There is no gyroscopic tendency to return to the preantibiotic state. The choice to use an antibiotic is a one way path. Antibiotics are important and useful drugs which I would never want to wish out of existence. However, these data add additional incentive to be extremely selective in their use. The consequences of not using them must be weighed against our growing recognition of their ill effects....
I like being a doctor, I really do. I love my profession and am proud of my colleagues’ sincere dedication to helping the suffering but then again we can be really, really stupid…. Every one knows that probiotics are good for us. Humans have eaten fermented foods for health and taste as long as we have been humans. Probiotics are even more important in today’s over medicated world, so it is nice to see studies like this one. Necrotizing enterocolitis (NEC) is a disease every bit as scary as it’s name. Affecting mostly very small premature babies, it destroys the blood supply to segments of their intestines and kills roughly 25% of the children who get NEC. We do not really know what causes it but it seems like bacteria in the babies digestive tracts are part of the problem. The latest word on this horrible illness is not a new study. It is an analysis of the clinical research that has already been done on treating NEC with probiotics. Combining the results from 11 studies involving over 2,000 patients, investigators determined that using probiotics reduced the likelihood of developing NEC by roughly 65% and the death rate by 57%. Wow! Now comes the stupid part. A sizable percentage of my colleagues believe that we should not routinely give probiotics to premature infants to prevent NEC. Why? They feel that we don’t know the best probiotic to use, how much to use, whether it should be given to nursing or formula-fed babies…. By the way, there was no evidence that taking probiotic bacteria led to any other infections or problems. So, no downside, reduced risk of disease by 65% and death by 57% but we should wait until we know more? I seem to be missing something...
The mission of this site is to inform and empower you. Representing the sum of my experience as well as the latest clinical research, my perspective is often somewhat at odds with the simplistic articles appearing in the media. Applying the information here you can become healthier, stronger and hopefully happier. Look around and let me know what you think.
