In October 2013, the International Scientific Association for Probiotics and Prebiotics (ISAPP) organized a meeting of clinical and scientific experts on probiotics (with specialties in gastroenterology, pediatrics, family medicine, gut microbiota, microbiology of probiotic bacteria, microbial genetics, immunology, and food science) to reexamine the concept of probiotics. They define probiotics as "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host." They also differentiated between products containing probiotics and those containing live or active cultures and established the following criteria:
CFU: This is the number of "colony forming units" present in each dose, which are measured in the billions. And while more isn't always better, "you want at least 20 to 50 billion CFU," says Dr. Nazareth. Just for reference, a very high dose is 400 CFU, which most experts agree is not necessary unless your health care practitioner specifically recommends this for you. It's also important to check for the guaranteed CFU upon expiration, which should be listed clearly. "Some products only guarantee the CFU number at the time of manufacturing, therefore will be less potent by the time the product reaches your home," she says.
The discovery of the benefits of probiotics began with sour milk. Today we have many other options to get various bacteria from our foods, although it's not as simple as just adding them to the food. For there to be health benefits, the microorganism has to be able to survive the passage through the gastrointestinal tract, survive the food manufacturing process, and grow and survive during the ripening or storage period. Also, the bacteria must not negatively affect product quality and be included on the Generally Recognized as Safe (GRAS) list.
We are clearly getting to the strain level by going beyond “Saccharomyces boulardii” and to “Saccharomyces boulardii CNCM I-745”. They did a great job by actually putting it on the label so you don’t even have to contact the company to see exactly what strain you’re getting. (P.S. this is a well-researched strain that I highly recommend, especially for preventing antibiotic-associated diarrhea.)
There’s good and bad bacteria in there (fascinating fact: an estimated 100 trillion bacteria live inside your digestive tract): When the good outweighs the bad, your immune health soars; when the bad overpowers good, you get sick. You have diarrhea. Your immune system tanks. Your IBS, lactose intolerance, and other gut problems are exacerbated. It throws your entire system out of whack.
More and more evidence shows that the gut microbiota may play an important role in the development of obesity, obesity-associated inflammation and insulin resistance. Obesity and Type 2 diabetes are associated with changes in gut microbiota. Several studies describe differences between the microbiota of lean individuals and those who are obese. The potential for using probiotics in weight management and obesity and diabetes prevention is exciting.