Defending probiotics: Industry hits back at research and regulation criticism

30 Jun 2020 --- The nutrition industry is fighting back against allegations that probiotics lack industry regulation and sport insufficient scientific consensus over their health benefits. The Natural Products Association (NPA) has hit back against American Gastroenterological Association (AGA) guidelines that make no to few recommendations for probiotic use to manage gastrointestinal disorders. Meanwhile, in response to a “60 Minutes” television segment on probiotics titled “Do Probiotics Actually Do Anything?” the Council for Responsible Nutrition (CRN) asserts that the reporting “pitted one scientist’s view against another’s and left viewers confused about the category.”

Cautious of sensationalizing the effects of probiotics on gut health, the AGA recently issued new guidelines that do not recommend probiotics for children and adults with irritable bowel syndrome. Moreover, the guidelines only make a recommendation for using probiotics in adults and children with ulcerative colitis and Crohn’s disease “in the context of a clinical trial.”

The NPA has countered this position by stating that the AGA guidelines “falsely claim that the natural products industry is unregulated, despite being overseen by not one but two federal agencies to protect consumers from false advertising and bad actors.” 

Probiotics on the rise – forever?
The NPA’s stance is that the new guidelines are “at odds” with the overwhelming number of studies supporting the safety and efficacy of probiotics in modern medicine. However, the AGA maintains that the available evidence in favor of probiotic use to help manage gastrointestinal diseases is limited because of heterogeneity in study designs, patient populations and the specific probiotics that have been studied. 

“Conclusions drawn from meta-analyses or systematic reviews can be misleading if different studies with different patient populations, different reported endpoints and outcomes or different strains or combinations of probiotics are grouped together inappropriately,” the AGA guidelines read.

Nevertheless, the NPA underscores that “thousands of studies” have supported the safe use and efficacy of probiotics for a range of treatments. Some include managing irritable bowel syndrome, improving liver and gut health, reducing skin rash severity in children as well as the likelihood of infection during antibiotic treatments.

As the scientific community continues to research the effect of probiotics on the gut microbiome, Innova Market Insights reports that probiotic supplements are on the rise. While probiotics only represented 3 percent of supplement launches in 2015 and 2016, this rose to 10 percent in 2018. In 2019, 94 percent of launches included a digestive/liver health claim, while 49 percent were touted as supporting immune health, according to the market researcher’s data. 

Click to EnlargeThe television segment called into question by CRN focused on the “conflict among scientists” about whether probiotics provide any health benefit at all. The “chaos” of probiotic research
The television segment called into question by CRN focused on the “conflict among scientists” about whether probiotics provide any health benefit at all. What’s missing is sufficient high-quality research to recommend off-the-shelf probiotics, according to the news segment. Moreover, the reporting flagged that not all over-the-counter probiotics have their intended effect.

Addressing the critique points of the news segment, Dr. Andrea Wong, Senior Vice President, Scientific and Regulatory Affairs, CRN, issued a public statement highlighting: “The segment does not feature any new research and only highlights previously published scientific studies, each with their own limitations. For example, one of the featured studies reviewed the effects of a specific combination of probiotic strains on how they modify the microbiome of the host, but did not measure important clinical endpoints, like the prevention of diarrhea after taking antibiotics,” 

As the news segment further challenged the safety and regulation of probiotic products, Dr. Wong responded that: “The safety of probiotics is well-established through their long history of use and safety studies. Moreover, probiotic products marketed as dietary supplements are subject to comprehensive dietary supplement regulations that include current Good Manufacturing Practices (cGMPs), testing procedures, labeling and storage requirements and other practices enforced by regulatory agencies at both the federal and state levels.”

Encouraging more investigation
Ultimately, the 60 Minutes news report highlighted that many scientists are “hopeful about the possibility of improving health by manipulating the microbiome,” but emphasizes that more research is needed to ensure that probiotics can be beneficial for the microbiome in both the short term and the long term. 

Similarly, Dr. Wong states that CRN encourages more research into the benefits of changing the composition of the microbiome. “CRN reminds consumers to consult their healthcare providers if they have questions about the probiotic supplements they are taking or thinking about taking in the future,” she affirms.

Despite this debate, probiotics, as well as gut health in general, remain top of mind for consumers. In this sphere, World Microbiome Day took place last week, celebrated on June 27 annually. NutritionInsight spoke with experts from APC Microbiome Ireland, Chr. Hansen and OptiBiotix on the integral role the microbiome plays in maintaining good gut health.

Edited by Anni Schleicher

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