How to choose the right probiotics

Probiotics have been called the "friendly bacteria," due to their wide range of health benefits. Here's how to choose the right probiotics for your needs

By Astrid Van Den Broek

How to choose the right probiotics

So you’re back from Mexico with Montezuma’s revenge, or maybe that stomach flu has left your insides discombobulated for weeks now. Can probiotics help?

Most definitely, say health experts. But where to start? With numerous probiotic strains out there, what works best for diarrhea? For treatment after a round of powerful antibiotics? And do they all work the same? Here’s what you need to know about buying and using probiotics.

What are probiotics?

There’s a reason probiotics are dubbed the "friendly bacteria." Because in fact, they are live microorganisms that provide many benefits, such as hindering the growth of bad bacteria—the kind that causes diseases such as food poisoning, flus, irritable bowel syndrome and infections—in your intestines. You can take them as a nutritional supplement daily, or acutely to help recover from diseases such as flus or stomach poisonings. They can also be delivered in the form of yogurts, fermented milk, soy drinks and even juices.

However, only a few supplements and foods actually have clinical trials backing their efficacy, warns Dr. Gregor Reid, the past president of the International Scientific Association for Probiotics and Prebiotics, and director of the London, Ont.-based Canadian Research & Development Centre for Probiotics. "There’s a difference between what the consumers see and what is real," he notes. "There are a lot of products in Canada called probiotics, but there are not many that actually are probiotic."

So how can you know what will work? Here’s a guideline to probiotics—with clinical evidence backing how well they work—taken from a 2008 review in The Canadian Journal of Gastroenterology.

During and post-antibiotic use

Lacidofil (Institut Rosell): This probiotic combining two Lactobacillus strains may help relieve antibiotic-triggered diarrhea.

Bio-K+ CL1285 (Bio-K+ International Inc.): Not included on this original list, but since then, its benefits in helping prevent antibiotic-associated diarrhea and C.difficile-associated diarrhea have been published in peer-reviewed journals. These fermented milk/rice/soy products and capsules contain L. acidophilus and L. casei.

Gastroenteritis (Including diarrhea/traveller's diarrhea)

Florastor (Medical Futures Inc.): Comprised of Saccharomyces boulardii lyo, this short-term probiotic (meaning it only temporarily resides in the human body) can lessen diarrhea symptoms and also prevent antibiotic-associated diarrhea.

Pouchitis/Ulcerative Colitis/Irritable Bowel Syndrome

VSL#3 (VSL Pharmaceuticals, Inc.): This capsule combines eight strains of Lactobacilli, Bifidobacteria and Streptococcus.

General health

Activia yogurt (Danone): Containing Bifidobacterium lactis, you can eat this yogurt daily to help your digestive comfort.

Shopping tips

When perusing the shelves for probiotics, note where your probiotics are stored, suggests Anne Marie Ford, a pharmacist and co-owner of Ford’s Apothecary in Moncton, N.B. "Some of the probiotics you’re going to find are in the refrigerator to keep the microorganisms active," says Ford. "There are a few that aren’t refrigerated, but it should state that clearly on the bottle." While some experts disagree on how many active cells should be taken daily, Ford recommends that people try to take one dose with each meal. "We try to get between 18-25 billion cells in a day," says Ford.

Reid cautions that not all probiotics offer the same benefits. "If you take a product that is called probiotic but has not been clinically tested, are you getting beneficial bacteria into your system? Probably, but such products should go by a different name," he says. "Only clinically-proven products should be called probiotic. It’s like when you take an Aspirin, you expect relief from a headache. So, when you take a probiotic, there should be an expectation that it has provided benefits."

Related:
Probiotics: Beneficial bacteria
Are fortified foods worth the price?
Natural home remedies: Diarrhea

Web exclusive, May 2010

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