top | item 17927802

Probiotics labelled 'quite useless'

83 points| pmoriarty | 7 years ago |bbc.co.uk | reply

127 comments

order
[+] sschueller|7 years ago|reply
Isn't the idea to give probiotics to people who do not have a healthy gut? Such as someone who had been taking antibiotic for a prolonged period of time? So why did they give the probiotic to 25 healthy individuals?

Also 25 seems like a very small sample.

Edit: it appears they also did a study on 46 people after taking antibiotics but that I still find to be a small sample size.

[+] NikolaNovak|7 years ago|reply
In Canada at least,probiotics are largely bought of the shelf by healthy people.

Last week I accidentally bought a bottle of water from seven eleven,which turned out to have probiotics added. Cost the same as regular water too...

[+] travisjungroth|7 years ago|reply
25 and 46 are plenty large sample sizes for something that should have a large effect. I agree that I've always thought of probiotics only for recovery after antibiotics or stomach illness.
[+] guelo|7 years ago|reply
In the article it mentions that they studied using probiotics after antibiotics and it actually did more harm than good.
[+] Havoc|7 years ago|reply
I'd conclude the opposite.

If in half the cases the newly introduced bacteria "lingered" before being expelled then that demonstrates some kind of traction. e.g. You might just need to combine that with a diet that favours the new bacteria you're trying to introduce.

i.e. Some sort of effect in 50% of the cases is better than I expected honestly

[+] jpmoyn|7 years ago|reply
I mean maybe, but that's just speculation, and it really doesn't get us anywhere.

The main point of the article is that off the shelf probiotics don't do the wonders they are toted to. You would have to have probiotics tailored to the unique bacterial composition inside of your gut.

[+] gdubs|7 years ago|reply
Yea, I agree. I'd also add that we know so little about the gut biome at this stage that it feels presumptuous to assume that just because the biome looked 'different' afterwards, means that it's a 'bad' outcome. Even among healthy individuals there seems to be a lot of variability in the gut biome, and I'm wary of claims that one is 'good' and the other is 'bad' without more evidence. On the other hand, seems like we can say with a high level of confidence that antibiotics are devastating to bacteria :)
[+] chadash|7 years ago|reply
> "The research group also looked at the impact of probiotics after a course of antibiotics, which wipe out both good and bad bacteria.

Their trial on 46 people, also in the journal Cell, showed it led to delays in the normal healthy bacteria re-establishing themselves.

Dr Elinav added: "Contrary to the current dogma that probiotics are harmless and benefit everyone, these results reveal a new potential adverse side effect of probiotic use with antibiotics that might even bring long-term consequences."

If you only read the first few paragraphs (where they discussed the effect of probiotics on healthy people) you might have missed this important piece of information.

This discovery is hardly surprising. Probiotics aren't regulated by the FDA as drugs, but rather as "food supplements", which basically means they have the same standard of regulation as regular food [1].

[1] To be sold as a drug (i.e. pharmaceutical) a product must undergo rigorous trials to show efficacy and find any unintended side effects. Clinical trials typically cost around $60-80 million, which is part of the reason drugs are so expensive.

[+] Bucephalus355|7 years ago|reply
Does anyone believe anything these articles say anymore?

About two weeks ago, two somewhat prominent doctors from Harvard Medical School got into an enormous disagreement over whether or not coconut oil was “healthy” or “killing you”. No one knows anything under the current system.

There is absolutely no way the public can reasonably believe yay or nay on any new thing about healthy living.

[+] collinf|7 years ago|reply
This is so true. I used to be consume articles about healthy eating, but it after all the contradiction I have decided that I'm done reading about it all. I keep it simple with the opinion that eating protein, your veggies and drinking water will be near optimal for most humans, and anything after is just not worth the effort to optimize. 80/20, people.
[+] ChrisSD|7 years ago|reply
There hasn't been any truly new thing in healthy living in decades. Everybody knows they should exercise regularly and eat a variety of fruits and vegetables.

Everything else is purely of academic interest at the moment.

[+] DoreenMichele|7 years ago|reply
If you have a specific diagnosis, an awesome bullshit detector and hang out in the right circles, it is possible to make some sense of things and make informed choices that make a meaningful difference in your life.

It's only nigh useless if you are some "standard issue normal human with no alterations (aka health issues)" and want generic advice about what works for everyone all the time. Then it's pretty eye-roll worthy, for what I feel are kind of obvious reasons.

[+] im3w1l|7 years ago|reply
For all the back and forth there are some things we do know. Get your macro- and micronutrients. Don't eat too many toxins and heavy metals. Too much sugar is bad.

You'll probably be mostly fine whether you eat coconut oil or not, as long as the quantities are not completely unreasonable.

[+] mogadsheu|7 years ago|reply
Agreed, it's sensationalism, both the writer and the conductor of the study.

My experience in academia is that researchers rely heavily on controversy and drama to further their studies. It's part of the game they have to play to continue to receive funding or gain attention in the public eye.

The author of the paper seems like he's marketing a problem that he'll try to solve in the coming years, by building a company that offers bespoke probiotic solutions based on analysis of an individual customer's microbiome. Not a bad business model honestly, it's spreadshirt for your gut.

NB: I run a nutrition company and have an MS

[+] YeGoblynQueenne|7 years ago|reply
The general public can rest relatively assured that, when there is a broad consensus on some subject, with numerous studies published over the years repeatedly finding similar results, it's a good idea to follow the scientific advice (that typically follows the consensus).

For example, in what regards coconut oil, it's far from just two doctors from Harvard recently saying that coconut oil is bad for you. From the wikipedia page on the vegetable fat:

Due to its high levels of saturated fat, the World Health Organization, the United States Department of Health and Human Services, United States Food and Drug Administration, American Heart Association, American Dietetic Association, British National Health Service, British Nutrition Foundation, and Dietitians of Canada advise that coconut oil consumption should be limited or avoided.

The same goes for various allegedly "controversial" subjects like saturated fat and heart disease, sugar, salt, etc. You can typically find advice by multiple public health organisations and multiple studies reporting findings very similar to each other, stretching back decades. Just because then a new study comes out that bucks the trend, which is immediately widely reported in the popular news as a "groundbreaking new study", or because someone (often, not an expert) writes a book that tells "the truth" about the subject, is no reason to get confused.

In science always follows the consensus, as in business always follow the money.

[+] thehnguy|7 years ago|reply
Sums up my feelings. At this point, I firmly believe that the negative physiological consequences from the stress about nutrition outweigh any benefits.

Eat intelligently (I think we can agree that processed foods and sugar is less good than fresh veggies), and lower the stress.

[+] tootie|7 years ago|reply
Citation? The pro-coconut oil camp seems to be mostly based on traditional medicine claims. The science seems pretty uniformly opposed. Every study yields fresh data but it usually takes many years and a longitudinal study to get confident conclusions.
[+] heisenbergs|7 years ago|reply
the issue is rather the quality of the articles and what we as humans in general prefer to read. we'd rather read about an extreme (this is the greatest, this is the worst) or a conflict (person a says the opposite to person b). it's basically just a symptom of decaying journalistic standards. incidentally it's often also cheaper to produce such content.

there is probably an academic consensus that goes one way or the other, but our journalism has decayed enough that they don't even bother researching this.

[+] nyae|7 years ago|reply
Well of course results vary from paper to paper. I'm sure we all know that science progresses as general consensus. It's important to follow larger trends, not the day to day experiments.
[+] hesarenu|7 years ago|reply
Coconut oil is the default cooking oil for most of South India. An analysis with north India might provide good data set.
[+] crankylinuxuser|7 years ago|reply
Yeah, I'm about considering tossing food in water. If it floats, witch (burn it!), and if it sinks, its not a witch.

Cause that's about as "scientific" our nutrition analysis is.

Aside not eating carbohydrates (that whole diabetes thing), I have no clue what's 'healthy' and what's not.

[+] always_good|7 years ago|reply
Well, the issue is that people will buy things like probiotics with the belief that it's helping them, and probiotics being universally healthy is one of the most dogmatic nutrition facts that anyone can recite.

If there is controversy here, then people would likely err better by not buying extra health supplements like probiotics that may be causing harm.

Same with coconut oil. I go out of my way to use it because I heard it was healthy despite it infusing everything I cook with a cheap coconut taste. If there is controversy, then I would just use other oil products.

It's not like it's a debate on which way to spool your toilet roll where inaction is inconsequential.

[+] kilo_bravo_3|7 years ago|reply
>There is absolutely no way the public can reasonably believe yay or nay on any new thing about healthy living.

There is nothing new about healthy living.

Eat plants. Drink water. Sleep well.

Don't add salt to anything. Avoid sugar. Eat meat only in moderation.

Fiber from beans makes you poo good.

Coffee and alcohol in moderation is alright. Drinking to the point of visible external intoxication is not "in moderation".

Exercise, even if only a walk in the evening.

If you are overweight, eat fewer calories each day than your body needs to function. If you are underweight, eat more calories each day than your body needs to function.

None of that sells books, or drives eyeballs to the latest ad-infested "Doctors say x will kill ya!" article.

[+] atomical|7 years ago|reply
You could say the same thing about any discipline where professionals have opposing viewpoints. It's nothing new that there is disagreement within a discipline. Some of the topics that people are complaining about are very new. So of course there are going to be contradictory findings before it is settled.

It's important to use accepted science like Cochrane collab.

https://us.cochrane.org/

[+] PaulHoule|7 years ago|reply
Probiotics always struck me as one of those pills that mother gives you that don't do anything at all.

These products were developed commercially based on what they could make and not on any analysis of what a person's intestinal flora should be, nor any proof that the deliver system worked.

[+] harshreality|7 years ago|reply
It doesn't seem very surprising that if you keep eating mostly what you normally eat, your microbiome is already well-adapted to that diet and will out compete almost anything new you try to introduce.

I would expect if they tried limiting their diet to foods compatible with the probiotics, they'd get more significant results, because the existing microbiome colonies would be stressed from lack of their usual junk/meat/fat and be weaker. (Almost all standard probiotics, other than dairy varieties [yogurt etc], are veg-carb-loving.)

Before refrigeration, there couldn't have been many probiotics consumed in isolated form rather than as fermented foods. Give the new bacteria some food to eat when they're trying to out-compete your existing (bad parts of your) gut microbiome. One of the most likely good foods for them to eat is what they've been cultured on.

It may not even be necessary to eat probiotics, if you already have some of the bacteria you want, you merely need to encourage it to out-compete bad microbiome bacterial strains. Eat food compatible with the good bacteria. But it's such a hassle to change diets, everyone wants a pill or a powder or one serving of probiotics they can add to their diet, keep everything else the same, and have the bad bacteria / imbalance miraculously disappear. Is it any surprise that's less likely to work?

[+] foobaw|7 years ago|reply
One of my friends who has severe dietary/gut problems did several isolated experiments on himself with different probiotics and found success from very specific ones like PHGG and GOS..
[+] maxxxxx|7 years ago|reply
It may also depends on how you get them. For example somebody told me that turmeric helps with joint inflammation. Bought some turmeric capsules and they did nothing. But then I used it in cooking and it definitely makes a difference for my joint pain. It comes back while traveling and I don't get turmeric. But as soon as I get home and eat my own food the joint pain gets better. It also gets worse when I stop using turmeric in my own cooking for a while.
[+] gascan|7 years ago|reply
Pill form never did anything for me, but live sauerkraut seems to calm things down when I'm in gastric distress.

(Personal anecdote of why I am inclined to believe your friend's experience)

[+] ghostbrainalpha|7 years ago|reply
I had chronic I.B.S. for many years, which I talk about here way too much.

Basically I used to poop my pants weekly and couldn't work in an office.

Probiotics and keeping my eating to an 8 hour window (Intermittent Fasting) basically solved the issue for me.

However it makes sense to me that probiotics wouldn't do anything for someone who already has healthy gut bacteria.

[+] kazinator|7 years ago|reply
> Basically I used to poop my pants weekly and couldn't work in an office.

Any office? Even the U.S. Patent Office?

[+] sorokod|7 years ago|reply
Looked at a actimel (https://www.actimel.co.uk/faq_about) and yakult (https://www.yakult.co.uk/) and was surprised by how little they attribute to the "good bacteria". Yakult promises that: is scientifically proven to reach the gut alive (!)

Was that always like that?

[+] TeMPOraL|7 years ago|reply
From the days I was a teenager and we had TV at home in Poland, I remember the brand "Actimel" being all about "good bacteria". So this must have changed recently. My guess is, the EU told them to stop spewing bullshit in commercials.

EDIT: This might indeed have had something to do with 2007 change in EU's health regulations, as per https://en.wikipedia.org/wiki/Actimel#Debates_surrounding_he....

[+] cwkoss|7 years ago|reply
This article is a great example of how scientifically illiterate modern society has become.
[+] dragonwriter|7 years ago|reply
It's funny that this research claims is spin to prove that supermarket probiotics are useless, but instead of broadly testing actual supermarket probiotics products, or even testing a single such product, it tests a single specific custom blend product created by the research team.

At best, they've shown that blend to be quite useless as tested.

[+] LinuxBender|7 years ago|reply
Probiotics used incorrectly can have mixed results; and thus, there will be endless religious debates on the matter.

If the reason you are taking them is to cull dangerous bacteria such as H.pylori, you would first have to bring their numbers down to a point where the probiotics have a fighting chance. This is typically either done with anti-biotics, or a combination of supplements such as aged garlic, mastic gum, coconut oil, etc... to first kill things off. Then after taking the probiotics, the candida overgrowth has to be purged with garlic extract. Very few people will take the time to go through the right steps throughout the days/weeks required to balance things out. This lends itself to a wide variability in results.

[+] blacksmith_tb|7 years ago|reply
H. pylori isn't a yeast? Or did you mean that the probiotics would include yeasts (possible, certainly, like S. boulardii, but it dies off by itself pretty quickly). Though of course the process you describe is similar to what anyone taking a course of antibiotics to treat an illness could do, I was hospitalized after being hit by truck and given lots of kefir along with my antibiotics.
[+] Someone1234|7 years ago|reply
Does this potentially also have consequences for fecal transplants? That has been an upcoming area of research and relies on a similar idea: You can colonise bateria. If they aren't going to stick around via probiotics, they may also not via fecal.
[+] WalterSear|7 years ago|reply
Different bacteria, different condition, different delivery methods.

As the article states - "The researchers said probiotics of the future would need tailoring to the needs of each individual."

[+] Jeff_Brown|7 years ago|reply
The main purpose of probiotics I've heard of is to repopulate a gut that's been wiped out by antibiotics. This experiment was performed on 25 healthy subjects; its results don't seem to bear on that purpose.
[+] yellowapple|7 years ago|reply
Seems like a pointless study if you're only sampling people who are already healthy. "Probiotics don't do anything if you already have a healthy gut." Yeah, no shit, Sherlock.
[+] evolve2k|7 years ago|reply
“These are very innovative studies, but they are preliminary findings that need replicating.”
[+] yeahdef|7 years ago|reply
one yakult a day has been highly beneficial to me.
[+] uslic001|7 years ago|reply
That's a nice anecdote.
[+] senectus1|7 years ago|reply
stop taking them for a month or two... see what happens.