The World Gastroenterology Organization (WGO) recently released an updated guideline document, aimed at helping gastroenterologists and other physicians understand the appropriate clinical applications of probiotics or prebiotics. The guideline was created with input from experts in gastroenterology, probiotics and prebiotics, with efforts co-led by experts from the International Scientific Association for Probiotics and Prebiotics (ISAPP). To create these guidelines, experts comprehensively evaluated the evidence from randomized, controlled trials for gastrointestinal conditions, including which specific prebiotic strain or substance showed a positive effect. The guidelines present a list of conditions for which there is positive evidence for the effectiveness of probiotics and/or prebiotics.
The conditions for which probiotics/prebiotics prove beneficial are sometimes already well known:
– diarrheal conditions, irritable bowel syndrome, inflammatory bowel diseases and poor lactose digestion.
– For infants, infantile colic and necrotizing enterocolitis are included in the list.
Yet positive evidence also exists for some conditions that are not often associated with the benefits of probiotics/prebiotics: insulin resistance, nonalcoholic fatty liver disease, H. pylori infection, and even general health-related quality of life. The evidence summarized in the guidelines reinforces the idea that not all probiotics are equal and that positive trial results depend on the probiotics or prebiotic substances tested and their dose. Experts were careful to note that not all products that have been shown to be effective are found in every country.
Additionally, despite overall favorable evidence in the listed conditions, clinicians should not expect that all probiotics or prebiotics will be effective for every person. Most probiotics used today come either from fermented foods or from microbes colonizing a healthy human and have been used in products for decades. Based on the prevalence of lactobacilli in fermented foods, as normal colonizers of the human body, and the low level of infection attributed to them, their pathogenic potential is considered quite low by experts. Bifidobacterium species enjoy a similar safety record.
The majority of products are intended for consumption by the general population in good health. Consumption in sick individuals with weakened immune systems or serious underlying illness should be limited to certain strains under indications whose safety and efficacy have been proven in these same target patient populations.
Traditional labs long associated with fermented food, are generally considered safe for oral consumption as far as foods and dietary supplements are concerned for the general healthy population and at traditionally used consumption levels.
This new guide also recalls the definitions of the following keywords:
- Probiotics: Live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.
- Prebiotic: A selectively fermented ingredient that results in specific changes in the composition and/or activity of the gastrointestinal microbiota, thus conferring benefit(s) upon host health.
- Postbiotic: A preparation of inanimate microorganisms and/or their components that confers a health benefit on the host.
- Fermentation: A process by which a microorganism transforms food into other products, usually through the production of lactic acid, ethanol, and other metabolic end products.
To find out more, you can consult the complete guide at this link.
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New guideline for probiotics and prebiotics from WGO and ISAPP
The World Gastroenterology Organization (WGO) recently released an updated guideline document, aimed at helping gastroenterologists and other physicians understand the appropriate clinical applications of probiotics or prebiotics. The guideline was created with input from experts in gastroenterology, probiotics and prebiotics, with efforts co-led by experts from the International Scientific Association for Probiotics and Prebiotics (ISAPP). To create these guidelines, experts comprehensively evaluated the evidence from randomized, controlled trials for gastrointestinal conditions, including which specific prebiotic strain or substance showed a positive effect. The guidelines present a list of conditions for which there is positive evidence for the effectiveness of probiotics and/or prebiotics.
The conditions for which probiotics/prebiotics prove beneficial are sometimes already well known:
– diarrheal conditions, irritable bowel syndrome, inflammatory bowel diseases and poor lactose digestion.
– For infants, infantile colic and necrotizing enterocolitis are included in the list.
Yet positive evidence also exists for some conditions that are not often associated with the benefits of probiotics/prebiotics: insulin resistance, nonalcoholic fatty liver disease, H. pylori infection, and even general health-related quality of life. The evidence summarized in the guidelines reinforces the idea that not all probiotics are equal and that positive trial results depend on the probiotics or prebiotic substances tested and their dose. Experts were careful to note that not all products that have been shown to be effective are found in every country.
Additionally, despite overall favorable evidence in the listed conditions, clinicians should not expect that all probiotics or prebiotics will be effective for every person. Most probiotics used today come either from fermented foods or from microbes colonizing a healthy human and have been used in products for decades. Based on the prevalence of lactobacilli in fermented foods, as normal colonizers of the human body, and the low level of infection attributed to them, their pathogenic potential is considered quite low by experts. Bifidobacterium species enjoy a similar safety record.
The majority of products are intended for consumption by the general population in good health. Consumption in sick individuals with weakened immune systems or serious underlying illness should be limited to certain strains under indications whose safety and efficacy have been proven in these same target patient populations.
Traditional labs long associated with fermented food, are generally considered safe for oral consumption as far as foods and dietary supplements are concerned for the general healthy population and at traditionally used consumption levels.
This new guide also recalls the definitions of the following keywords:
To find out more, you can consult the complete guide at this link.
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