STUDIES & EXPERT OPINIONS

Synbiotics are beneficial in case of gestational diabetes.

Probiotics, especially synbiotics (probiotics combined with fiber), are very important for pregnant women with gestational diabetes. Results of a study published in the British Journal of Nutrition demonstrated that Lactobacilus acidophilus, L.casei and Bifidobacterium bifidum together with inulin lowered insulin levels, as well as low-density lipoprotein cholesterol and triglycerides in pregnant women after just 6 weeks of use. [1]
The study included 70 patients – women aged 18-40 with diagnosed gestational diabetes. Over the course of six weeks half of the subjects were given a supplement of Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidum (2x109/ g of each strain) together with 800 mg inulin. After six weeks their insulin metabolism improved significantly (insulin levels and insulin resistance (HOMA index) was reduced, the function of insulin producing pancreatic β –cells and insulin sensitivity improved significantly). The subjects supplementing synbiotics had significantly lower blood lipids – the level of triglycerides fell, as did the concentration of low-density lipoprotein cholesterol. The results of this study show that 6 weeks of synbiotic supplementation improved insulin metabolism and concentration of triglycerides and low-density lipoprotein cholesterol in patients with gestational diabetes.

Ahmadi S, Jamilian M, et al. The effects of synbiotic supplementation on markers of insulin metabolism and lipid profiles in gestational diabetes: a randomised, double-blind, placebo-controlled trial. Br J Nutr. 2016 Sep 29:1-8.

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Babies born via Cesarean delivery may have a different intestinal flora up to the age of 7.

A child’s microflora is closely linked to the method of delivery. The microbiome of the very first days of life develops and impacts health throughout a person’s life. During vaginal delivery, the baby comes in close contact with the mother’s vaginal and intestinal microflora. These bacteria then spawn the first bacterial colonies in the baby’s body. Babies, that for objective reasons are born via Cesarean delivery, do not get this close contact with the mother’s microflora, therefore the first bacteria to enter their bodies are bacteria from the outside world, i.e. the operating room. [1]
The microflora content acquired in the first days of life may have a long-term impact on the intestines of breast-fed babies. For example, one study found that the intestinal flora in babies born via Cesarean delivery was disrupted even 6 months after birth.[2] Another study indicated the intestinal microflora in babies born via vaginal delivery and Cesarean differed even at the age of 7. [3] There are conclusive results that the intestinal microflora affects the development of a child’s immune system. Since it is clear that the microflora of babies delivered by Cesarean differs from that of babies delivered naturally, the development of their immune systems will also thus be different. Available studies show that Cesarean babies are more prone to atopic diseases, such as asthma, allergic rhinitis and atopic dermatitis. Furthermore, they also show higher susceptibility to celiac disease, type 1 diabetes and more frequent diarrhea. [1]

[1] Neu JRushing J. Cesarean versus vaginal delivery: long-term infant outcomes and the hygiene hypothesis. Clin Perinatol. 2011 Jun;38(2):321-31

[2] Grönlund MM, Lehtonen OP, Eerola E, et al. Fecal microflora in healthy infants born by different methods of delivery: permanent changes in intestinal flora after cesarean delivery. J Pediatr Gastroenterol Nutr. 1999; 28(1):19–25.

[3] Salminen S, Gibson GR, McCartney AL, et al. Influence of mode of delivery on gut microbiota composition in seven year old children. Gut. 2004; 53(9):1388–9.

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Normal vaginal microflora is best restored and maintained by Lactobacillus rhamnosus and L. reuteri.

As regards the delicate health of the vagina and urinary tract, the Lactobacillus strain is especially beneficial for women suffering from vaginal inflammation – bacterial vaginosis or yeast infections (candidosis). Several studies have concluded that normal vaginal microflora is best restored and maintained by two lactic acid bacteria - Lactobacillus rhamnosus and Lactobacillus reuteri. It has been discovered that these bacteria improve the immune response, reduce the amount of pathogenic bacteria that enters the vagina from the large intestine and inhibit bad bacteria from surviving and forming colonies. [1]

A double-blind, placebo controlled study by Reid et al found that 32 healthy women displayed a significant increase in the amount of lactic acid bacteria in the vagina after oral supplementation of L.rhamnosus GR-1 and L.fermentum RC-14 bacteria, as compared to the placebo group. The study lasted 2 and 4 weeks. The 64 subjects of the study displayed signs of asymptomatic bacterial vaginosis, but after 2 and 4 weeks of the study their vaginal microflora was rated as normal on the Nugent score. The placebo group displayed significantly less improvements. A similar result was demonstrated in another double-blind study by the same author where 59 subjects were given the same strain of bacteria or a placebo. [2]

[1] Reid G. Probiotic Lactobacilli for urogenital health in women. J Clin Gastroenterol. 2008 Sep;42 Suppl 3 Pt 2:S234-6.

[2] Reid GCharbonneau DErb JKochanowski BBeuerman DPoehner RBruce AW. Oral use of Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 significantly alters vaginal flora: randomized, placebo-controlled trial in 64 healthy women. FEMS Immunol Med Microbiol. 2003 Mar 20;35(2):131-4.

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Bifidobacterium lactis help treat constipation.

Functional constipation affects 5-20% of the population. Intestinal microflora has a significant impact on intestinal motility. Probiotics can improve intestinal motility. Based on a summary of 11 randomized, double-blind studies with a total of 464 subjects, it has been concluded that probiotics can increase intestinal transit time. [1] Bifidobacterium lactis stran bacteria are the most effective in this regard.

In a 2-week study involving 100 subjects (average age – 44), one group received a dose of B.lactis (17.2 billion CFU, n=33), one received a low dose (1.8 billion CFU, n=33), and one was a placebo group (n=34). After 2 weeks the overall intestinal transit time, i.e. the time it takes for the intestines to empty, had significantly decreased in the two B.lactis groups, while remaining unchanged for the placebo group. [2]

Probiotics speed up intestinal transit because they reduce the formation of methanogens, which can hinder intestinal transit by producing methane, which, in turn, blocks intestinal motor function or motility. It has been found that people with slow intestinal transit have more methane producing bacteria in the intestines as compared to healthy individuals. Furthermore, probiotics promote fermentation processes in the intestines thus boosting the peristalsis, i.e. the frequency of contraction, of the large intestine thus speeding up transit time. [3]

[1] Miller LEOuwehand AC.Probiotic supplementation decreases intestinal transit time: meta-analysis of randomized controlled trials. World J Gastroenterol. 2013 Aug 7;19(29):4718-25.

[2] Waller PAGopal PKLeyer GJOuwehand ACReifer CStewart MEMiller LE. Dose-response effect of Bifidobacterium lactis HN019 on whole gut transit time and functional gastrointestinal symptoms in adults. Scand J Gastroenterol. 2011 Sep;46(9):1057-64.

[3] Chang Hwan Choi and Sae Kyung Chang. Alteration of Gut Microbiota and Efficacy of Probiotics in Functional Constipation. J Neurogastroenterol Motil. 2015 Jan; 21(1): 4–7.

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Saccharomyces boulardii reduce risk of diarrhea when travelling or beginning kindergarten.

Traveler’s diarrhea is characterized by diarrhea or constipation, abdominal pain and other gastrointestinal disorders that are experienced upon being attacked by foreign bacteria in an unfamiliar environment. Traveler’s diarrhea affects 5-50% of people, depending on their destination.

A summary of 12 double-blind, placebo controlled studies shows that probiotics are a promising preventive treatment for traveler’s diarrhea. A combination of Saccharomyces boulardii and two probiotic bacteria - Lactobacillus acidophilus and Bifidobacterium bifidum – has been shown to be very effective. [1] Incidence of traveler’s diarrhea in the groups using S.Boulardi was 5-11%. [2] [3]

To date the most extensive study on the positive effects of Saccharomyces on traveler’s diarrhea has been carried out by Kollaritsch et al. The main conclusion – probiotics are an effective preventive treatment. If used approximately one week prior to travelling, they can reduce the risk of contracting traveler’s diarrhea. One study involved 1231 Austrian tourists travelling to exotic destination. They took a dose (250 or 500 mg) of S.boulardii or a placebo over a course of three weeks. The tourists began the course of probiotics 5 days prior to travelling and continued it throughout the holiday. Traveler’s diarrhea was experienced by 43% of the placebo group, but incidence was significantly less in the 250 mg S.boulardii dose group (34%) and the 500 mg group (32%).[2] Another study by Kollaritsch et al involving 1016 Austrians travelling to Northern Africa, the Middle and the Far East, subjects were given 250 mg/d (5 × 109) S. boulardii, 1000 mg/d (2 × 1010) S. boulardii or a placebo, and they began taking the doses 5 days prior to travelling. S.boulardii significantly reduced the number of tourists who experienced traveler’s diarrhea: 39% of the placebo group, but only 34% of the 250 mg S. Boulardii group and 29% or 500 mg S. Boulardii group were afflicted (P < 0.05).[3] 

[1] McFarland LV. Meta-analysis of probiotics for the prevention of traveler's diarrhea. Travel Med Infect Dis. 2007 Mar;5(2):97-105. Epub 2005 Dec 5.

[2] Kollaritsch H, Kremsner P, Wiedermann , G , Scheiner O. Prevention of traveller’s diarrhea: comparison of different non-antibiotic preparations. Travel Med Internatl. 1989;7:9–18.

[3] Kollaritsch H, Holst H, Grobara P, Wiedermann G. [Prevention of traveler's diarrhea with Saccharomyces boulardii. Results of a placebo controlled double-blind study] Fortschr Med. 1993;111:152–156

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