Irritable Bowel Syndrome (IBS)
In three independent studies, Lactobacillus plantarum 299v (LP299V®), was proven to have a positive effect on the intestinal health of people with irritable bowel syndrome (IBS). The symptoms for irritable bowel syndrome are alternating diarrhea and constipation, the formation of gas and pain. Approximately 10-20% of the population periodically suffers from such problems.
The studies were double blind and placebo controlled and were conducted in Sweden (Nobaek et al. 2000), in Poland (Niedzielin et al. 2001) and in India (Ducrotté et al. 2012). In the studies, test subjects with IBS were given a fruit drink or a capsule with or without Lactobacillus plantarum 299v (400 ml/day) and the IBS symptoms were monitored over a period of four weeks.
The formation of gas in the intestines decreased rapidly and significantly in the group that ingested Lactobacillus plantarum 299v, compared with the placebo group in the Nobaek et al. (2000) study, (see graph). At a follow-up examination 12 months later, the test subjects who had ingested Lactobacillus plantarum 299v were deemed to have better gastrointestinal function, compared with the placebo group.
In the Niedzielin et al. (2001) study, there was an improvement in the IBS symptoms in 95% of the test subjects in the Lactobacillus plantarum 299v group, compared with 15% in the placebo group (see graph).
Symptoms like abdominal pain and bloating was improved significantly in subjects that took Lactobacillus plantarum 299v in comparison with subjects that consumed a placebo product in the study by Ducrotté et al. (2012). After four weeks intake considered 78% of the subjects in the Lactobacillus plantarum 299v group that the effects on the IBS symptoms was good or excellent while only 8% of the subjects considered this in the placebo group (p<0.01, see graph).
Clostridium difficile associated diarrhea
Recurring Clostridium difficile associated diarrhea is a serious complaint that often requires long-term treatment with antibiotics. In a double-blind, placebo-controlled pilot study, an examination was conducted to see whether the intake of Lactobacillus plantarum 299v would prevent new diarrhoea episodes (Wullt et al. 2003). Fewer test subjects in the group that ingested LP299V®, combined with the antibiotic metronidazole, suffered from new diarrhea attacks (4/11), compared with the placebo group (6/9). More studies are needed to confirm that LP299V® can prevent recurring Clostridium difficile associated diarrhea.
It is generally known that probiotics have a beneficial effect on human health. This occurs through local effect in the intestinal tract but also through a systemic effect on other parts of the body. The latter of these effects is because about 70% of the body’s immune system is located in the intestinal tract. The bacteria’s interaction with the intestinal epithelial layer stimulates cooperation between various types of cells, such as dendritic cells, epithelial cells and lymphocytes, which, by producing a large number of signal substances, can lead to the activation or weakening of the immune system. Various probiotic bacteria strains stimulate and affect the immune system in different ways. Consequently, research and studies are vital to document the strain-specific immunological effects of probiotics and to increase knowledge to facilitate the correct choice of bacteria strain in connection with new applications.
Studies of healthy individuals who ingested Probi patented probiotics for two weeks showed that some bacteria can activate the natural immune system (Lactobacillus paracasei 8700:2), while others stimulate a cell-mediated immunity (Lactobacillus plantarum 299v). The phagocytic activity, the range of various cell populations, the stimulation of markers on the surface of cells and the secretion of various signal substances, such as cytokine, are examples of parameters examined to describe the effect of various strains on the immune system (Rask et al 2013).
In two placebo-controlled studies made on healthy subjects, the combination of two bacteria, Lactobacillus paracasei 8700:2 and Lactobacillus plantarum Heal 9, was shown to affect the immune system beneficially (Berggren et al. 2011, Busch et al. 2013).
The first study was performed during the winter/spring period 2007 at two different sites in Sweden (Berggren et al. 2011). A total of 272 subjects participated in the study, of these 135 was randomized to consume the product containing Lactobacillus paracasei 8700:2 and Lactobacillus plantarum Heal 9. The remaining subjects were given a product similar in taste and appearance but without any probiotic bacteria.
The number of days with common cold symptoms were significantly (p<0.05) reduced from 8.6 days in the control group to 6.2 days in the active group receiving probiotics for twelve weeks. Also, the incidence of acquiring one or more common cold episode was reduced from 67 % in the control group to 55 % in the active group (p<0.05). The total symptom-score was also significantly reduced during the study-period. The reduction of pharyngeal symptoms was significant (p<0.05) (Figure 1). In addition, after two weeks of intake a reduced proliferation in B cell population was also observed in the active group (p<0.05) in comparison with the placebo group.
Figure 1 . Bar graph illustrating the reduced risk of getting a cold after consumption of the probiotics Lactobacillus plantarum HEAL 9 and Lactobacillus paracasei 8700:2.
An additional study was performed during the winter/spring period the following year in Berlin (Busch et al. 2013). 310 healthy subjects with a history of at least two common cold infections the last 6 month period participated in the study. The study products were identical to those used in the previous study. In this study all recorded common cold symptoms were lower in the group receiving probiotics in comparison to the control group, and the total sum score of the symptoms was reduced with up to 33% (p<0.001) (Figure 2).
Figure 2. Graph illustrating the variation of the daily total sum score during the common cold episodes.
In addition, the subjects in the probiotic group recovered more quickly than the subjects in the control group if sick in a common cold infection (Figure 3) and only 37 % of the subjects in the probiotic group were sick for seven days or more in comparison to 88 % in the control group (Figure 3). This illustrates that intake of Lactobacillus paracasei 8700:2 and Lactobacillus plantarum Heal 9 reduces the duration of common cold episodes and promotes a quicker recovery.
Figure 3. Bar graph illustrating the length of the common cold episodes.
In addition, the subjects in the probiotic group recovered more quickly than the subjects in the control group if sick in a common cold infection and only 37 % of the subjects in the probiotic group were sick for seven days or more in comparison to 88 % in the control group (Figure 3). This illustrates that intake of Lactobacillus paracasei 8700:2 and Lactobacillus plantarum Heal 9 reduces the duration of common cold episodes and promotes a quicker recovery.
The common cold episodes were also evaluated by the subjects. The efficacy was globally evaluated by the subjects as “very good” or “good” for 70.1 % of the episodes occurring in the probiotic group and for 23.2% of the episodes occurring in the placebo group.
In another study, positive immunological response was measured in children infected with HIV who ingested Lactobacillus plantarum 299v for one month (Cunningam-Rundles 2000). The children’s general condition improved and Lactobacillus plantarum 299v was deemed safe to be used by people with suppressed immune systems.
In an animal model of multiple sclerosis (EAE; Enzyme-induced Autoimmune Encephalomyelitis), a combination of three probiotics, Lactobacillus paracasei 8700:2, Lactobacillus plantarum Heal 9 and Lactobacillus plantarum Heal 19 was shown to reduce the inflammatory conditions connected with the disease (Lavasani et al 2010).
Metabolic syndrome is a term used for a number of different risk factors that can cause cardiovascular disease, which is the most common cause of deaths in Sweden (Swedish Board of Health and Welfare – Health report 2005).
The risk factors included in the metabolic syndrome are:
- Insulin resistance implying that the body’s cells are insensitive to insulin, which in turn leads to excess production of insulin and frequently results in type 2 diabetes.
- Elevated blood lipids including increased triglycerides and LDL cholesterol or low HDL cholesterol values.
- High blood pressure (≥130/85 mmHg).
- Overweight (BMI>25) and in particular, abdominal fat.
It has become evident that probiotics are able to affect these risk factors positively. In food trials on humans, it was observed that a fruit drink fermented with Lactobacillus plantarum had an insulin-saving effect (WO2008150212). In addition, the intake of a drink containing Lactobacillus plantarum (LP299V®) in a placebo-controlled, double-blind clinical study of 38 healthy smokers had a positive effect on the systolic blood pressure and insulin (Naruszewicz et al. 2002). In the same study, fibrinogen also decreased (an independent risk factor for cardiovascular diseases) and other inflammatory markers (IL-6 and F2 isoprostanes) decreased significantly. The same drink with Lactobacillus plantarum 299v was also used in an earlier placebo-controlled study on men with a mildly elevated cholesterol level (Bukowska 1998). Intake of the product for six weeks showed a statistically significant reduction in total cholesterol (7.3%), LDL (9.6%) and fibrinogen (13.5%).
Stress and recovery (incl. nutrient uptake)
Increased antioxidative defence
When doing endurance sports an optimal function of the immune defence including the gastrointestinal tract is important to be able to make a good performance. Intensive training can disturb the intestinal microflora and can also influence the immune system negatively leading to an increased risk for systemic infections. Endurance sports as marathon and triathlon often give intestinal problems and a reduced immune defence with symptoms both in the upper and lower part of the gastrointestinal tract like heartburn, bloating, nausea and vomits, increased peristaltic movements and diarrhea, abdominal pain and an increased risk for upper respiratory infections.
Intake of probiotics can contribute to a well balanced intestinal flora and in this way improve the physical performance.
In a parallel double-blind study including subjects with a high work pace was the antioxidative capacity studied after intake of Lactobacillus plantarum DSM 9843 (LP299V®) and antioxidants (Önning et al. 2003). After 4 weeks intake was the antioxidative capacity in plasma increased with 7% in comparison with a placebo product without lactobacilli and antioxidants (p< 0.05) and two components in the antioxidative defence, selenium and selenoprotein P, was increased with 16–17 % in comparison with placebo (p< 0.001, see graph). Furthermore was the content of Lactobacillus plantarum 299v in faeces increased significantly.
Increased iron absorption
Iron deficiency and low iron stores is common in children, adolescents and women in child bearing age, both in the western world and in developing countries. This can give iron anemia, resulting in an impaired cognition and a weakened immune defence. It is therefore important to increase the intake of iron as well as the absorption of iron from the diet.
Probi has done several studies that have shown that intake of a probiotic bacteria can incease the iron absorption in women in child bearing age. Intake of 109 or 1010 cfu Lactobacillus plantarum DSM 9843 (LP299V®) in a fruit drink supplemented with iron gave an increased iron absorption with about 50 % in comparison with a control drink without lactobacili (Hulten & Hoppe 2007). Intake of freeze dried bacteria (1010 cfu Lactobacillus plantarum DSM 9843) together with iron in a capsule has in two studies increased the iron absorption significantly in comparison with intake of a control capsule without lactobacilli (Hulthén & Hoppe 2014a, 2014b).
Reduced risk for osteoporosis
Osteoporosis constitutes a major health concern that places a huge economic burden on the health care system and entails a lot of suffering for the patients. The increasing number of fractures associated with the increasing age of the population makes it of vast importance to develop alternatives for both prevention and treatment of the disease.
A recently published study in mice shows that intake of three strains from Probi; Lactobacillus paracasei DSM13434, Lactobacillus plantarum DSM 15312 and Lactobacillus plantarum DSM 15313, reduces the risk for bone loss which could in turn reduces the risk for osteoporosis and bone fractures (Ohlsson et al. 2014).