ISAPP Board Member Prof. Dan Merenstein MD Elected to National Academy of Medicine

A longtime ISAPP board member, Prof. Dan Merenstein MD of Georgetown University School of Medicine, has received a prestigious honor: election to the US National Academy of Medicine. With this recognition, Prof. Merenstein joins an elite group of fewer than 100 American scientists, doctors and other professionals selected each year for exceptional achievements in medicine and dedication to service.

Prof. Merenstein’s work over the past 25 years has focused on building the evidence base for decisions that affect primary care – an often overlooked and underfunded area of medicine. His extensive research portfolio includes hundreds of published scientific papers, many that focus on the appropriate use of antibiotics and probiotics as well as a long-term study on individuals with HIV infection.

He also makes a conscious effort to involve undergraduates in clinical research, giving these future scientists and clinicians an opportunity to understand the value of scientific evidence in patient care.

“It really comes down to asking: ‘When I’m in the clinic with a patient, how can I treat this patient better?’” he says. “Hopefully, my research is helping to answer that question.”

Prof. Merenstein says that research on probiotics and antibiotics initially drew his interest because of issues raised by his patients in the clinic. Faced with a lack of evidence to help answer specific questions about yogurt and probiotic supplements, he decided to initiate research studies in this area. In the early 2000s he became a forerunner in documenting the health benefits of probiotics, and to this day remains a strong advocate for robust study design in probiotic trials.

As an esteemed colleague and active member of the ISAPP board of directors since 2014, Prof. Merenstein has steered numerous discussions and scientific publications that have served to advance the scientific field of probiotics, prebiotics and other biotics.

“The work I have done with ISAPP has been some of the most rewarding in my entire career,” says Prof. Merenstein. “The board members and industry partners who I have interacted with have challenged me to become a better, more well-rounded researcher. There is no chance my research would be recognized like this, without the collaborations made possible by ISAPP.”

In 2024, Prof. Merenstein completed a productive three years as ISAPP President and continues to serve on the board and steer the organization’s activities.

“Dan is highly passionate about achieving better patient outcomes and brings that purpose and dedication to everything he works on,” says ISAPP’s Executive Director Marla Cunningham. “Over his years of leadership within the ISAPP board, he has led and contributed to many projects that have been vital to move forward on practical and evidence-based implementation of biotic science. The ISAPP board is delighted to see him achieve this well-deserved recognition of his commitment to science in medicine.”

Welcoming ISAPP’s newest board member, Dr. Geoffrey Preidis MD PhD

At the 2024 annual scientific meeting in Cork, Ireland, the ISAPP board welcomed its newest member, Dr. Geoffrey Preidis MD PhD of Baylor College of Medicine and Texas Children’s Hospital.

ISAPP President Prof. Maria Marco PhD says, “We are thrilled to have Dr Preidis on our board. He is a great colleague and brings scientific excellence along with the extensive clinical experience needed to translate scientific advancements to patient populations and stakeholder groups.”

Dr. Preidis holds degrees from Harvard University and Baylor College of Medicine (BCM), and is a board-certified Pediatric Gastroenterologist and Associate Professor of Pediatrics at BCM. His research focuses on intestinal microbiome development in extremely premature infants and how probiotics may reduce the risk of necrotizing enterocolitis, sepsis, feeding intolerance, growth failure, and death.

Dr. Preidis has already made numerous valuable contributions to ISAPP-led initiatives in the past several years. For example, he coauthored a 2023 paper in JAMA Pediatrics, titled “Probiotics in the Neonatal Intensive Care Unit—A Framework for Optimizing Product Standards”, and has presented and contributed at previous ISAPP meetings on the topic of pediatric microbiome development and rational biotic use. Dr. Preidis was also featured in the 2024 annual meeting program, providing an expert overview of scientific and clinical state of affairs in an expert panel addressing the topic of probiotics for preterm infants.

Dr. Preidis says, “I’m excited for this opportunity to work with the distinguished experts on the ISAPP board to help advance the science of biotics and ultimately improve clinical care for children with gastrointestinal disorders.”

ISAPP Board Welcomes New President, Prof. Maria Marco PhD

At the ISAPP 2024 annual meeting in July, the ISAPP board of directors ushered in the beginning of the next leadership term, with the role of President being taken on by Prof. Maria Marco PhD from UC Davis (USA). Prof. Marco had served the previous three years as Vice President while Prof. Dan Merenstein MD served as President.

“Maria is a born leader, who has continued to push the board and me to think about what we want from ISAPP,” says Prof. Merenstein. “I’m excited to see where she helps take us in the next three years.”

Prof. Marco leads a lab at UC Davis that focuses on the role of microorganisms, and particularly lactic acid bacteria, in food microbiomes and gut health. The lab’s objectives are to investigate how probiotics alter intestinal function and to improve diets with foods that rely on microorganisms either during production (such as fermented foods) or within the digestive tract (such as dietary fibers). Meanwhile, Prof. Marco is also involved in many outreach activities to spread awareness about fermented foods and health. See one of her recent interviews about fermented foods here.

Prof. Marco has more than 120 publications to her name, and has mentored over 100 students, postdocs, and visiting scientists in her lab. In addition to being President of the ISAPP board of directors, she serves on numerous advisory and editorial boards.

The entire ISAPP board of directors welcomes Prof. Marco into the President role with full confidence that her leadership will help advance the fields of biotics and fermented foods.

Prof. Marco says, “I am so honored for this opportunity to lead the ISAPP board of directors. I have regarded ISAPP as the leading voice in probiotics and prebiotics research since starting in this field over 20 years ago. With our outstanding board and leadership team, we have tremendous momentum to continue to build ISAPP for advancing biotic science.”

Fermented Food Microbiology Researcher in Mohali, India Receives 2024 Gregor Reid Award for Outstanding Scholars in Developing Nations

ISAPP’s board of directors is happy to announce the 2024 winner of the Gregor Reid Award for Outstanding Scholars in Developing Nations: Dr. Rounak Chourasia PhD, a research associate at the National Agri-food Biotechnology Institute in Mohali, Punjab (India).

Dr. Chourasia’s work focuses on discovering microorganisms with specific properties that contribute to the enhanced health benefits of a traditional cheese called chhurpi from Sikkim Himalaya (a state in Northeast India). He has developed a process for the production of milk cheese using selected strains of lactic acid bacteria, resulting in the release of novel bioactive peptides with potential nutraceutical applications. Furthermore, he has applied selected microbial strains to develop bioactive peptide-enriched novel soybean cheese suitable for those with lactose intolerance. The research has not only contributed to knowledge about the functional properties of chhurpi, but has also provided a foundation for helping local farmers expand their entrepreneurial opportunities.

Dr. Chourasia received both a Bachelor and Master of Science in microbiology from the University of North Bengal, India, followed by a PhD in biotechnology in 2023 from the Institute of Bioresources and Sustainable Development (DBT-IBSD), regional centre, Sikkim, and Kalinga Institute of Industrial Technology (KIIT) University under the guidance of Dr. Amit Kumar Rai and Prof. Dinabandhu Sahoo.

The 2024 committee selected Dr. Chourasia from among the many qualified candidates for the Gregor Reid Award for Outstanding Scholars in Developing Nations in this inaugural year. ISAPP established the award in honor of Dr. Gregor Reid PhD, for the purpose of recognizing and supporting early career researchers within low and middle income countries (LMICs). Dr. Reid is a founding board member of ISAPP, former President of ISAPP, and founder of the ISAPP Students and Fellows Association (SFA), whose work in LMICs throughout his career showed his commitment to scientific excellence, innovation, and community development.

Dr. Chourasia will receive an award plaque and will speak about his work at the ISAPP annual meeting in July, 2024.

Microbiota-Gut-Brain Axis Researcher in Belgium Receives ISAPP’s 2024 Glenn Gibson Early Career Researcher Award

The ISAPP selection committee for the Glenn Gibson Early Career Researcher Award is pleased to announce that Dr. Boushra Dalile PhD, a postdoctoral fellow at KU Leuven (Belgium), is the recipient of this year’s award.

Dr. Dalile is a researcher who moved from studying psychology and cognitive neuroscience into biomedical sciences, completing her PhD in 2021. She now focuses on the gut-brain axis – specifically, the mechanistic role of colonic short-chain fatty acids (SCFAs) as mediators of prebiotic effects on stress-related mental disorders. In one of her group’s most recent studies, she used colon-delivery capsules to approximate the metabolic effects of prebiotic administration, and found that direct delivery of SCFAs successfully reduced physiological stress response (as measured by cortisol) in humans. She is interested in continuing to explore the potential of butyrate for modulating fear as well as anxiety-related learning and memory processes.

A multilingual researcher who lived in Germany and Sweden before coming to KU Leuven, Dr. Dalile currently has a postdoc project supported by The Research Foundation – Flanders, titled “INTERFEAR – Investigating the endogenous metabolite butyrate as an epigenetic modulator of fear memory”.

The 2024 award committee, composed of ISAPP board members and affiliates, identified Dr. Dalile as making important contributions in the biotics field early in her scientific career. The award is given annually to a researcher who is no more than five years past their terminal degree, in a field of study related to probiotics, prebiotics, synbiotics, postbiotics or fermented foods. She will receive a cash prize and a speaking slot at the ISAPP annual meeting in July, 2024.

Inaugural nominations open for ISAPP Award: The Sanders Award for Advancing Biotic Science

With this year’s retirement of ISAPP’s longtime Executive Science Officer, Dr. Mary Ellen Sanders PhD, the ISAPP board of directors sought a suitable way to honor her contributions in advancing scientific development in the fields of probiotics, prebiotics, synbiotics, postbiotics and fermented foods. Many scientists in these fields have commended Mary Ellen’s leadership, initiative, collaboration, and communication over the last 20 years.

Board members decided to launch a new award in Mary Ellen’s honor: The Sanders Award for Advancing Biotic Science. This award aims to promote excellence in the biotic field and recognize exceptional achievement across a range of potential endeavours including research, scientific communication and stakeholder engagement. A cash grant and travel to the ISAPP meeting will be awarded to the annual recipient starting in 2024.

Prof. Gregor Reid PhD, ISAPP co-founder and former board member, who championed the award, says: “What better way to applaud leadership and someone who has placed honesty, stewardship and evidence-based progress above all else, than to have an annual celebration of advancement in these critically important fields.”

The ISAPP board invited members of the ISAPP community to donate to a special endowment fund in order to sustain the Sanders Award over the long term, and this fund received over $34,000 of donations.

ISAPP President, Prof. Dan Merenstein MD, says: “We have really appreciated and been touched by the generous individual and company donations. But none of that is surprising because Mary Ellen has been a positive force in this field since the beginning and everyone who works with her respects and enjoys working with her.”

The award was launched in August, 2023 and nominations are open through to November, 2023.

Find out more about the award here.

Supercharging innovation: New session at ISAPP 2023 annual meeting brings industry and student members together to scientific innovation workshop in the field of biotics

Innovation in the biotics field is an important way to address some of our most important challenges in health, and ISAPP is the organization on the forefront of this innovation. This year ISAPP members are excited to debut a new workshop focused on innovation, June 26th at the 2023 ISAPP annual meeting in Denver. For this workshop, the Industry Advisory Committee (IAC) and the Students and Fellows Association (SFA) have joined forces and initiated a new way to share knowledge and promote networking opportunities.

How did the idea of the IAC-SFA innovation workshops come about?

The Innovation Workshops evolved from interest in how SFA and IAC might gain scientific insights from each other. What they have in common is a dedication to cutting-edge science. From this emerged the idea that these groups could convene several concurrent workshop sessions during the pre-meeting program focusing on innovation in the biotic field.

What will be discussed at the workshops?

The concurrent workshops will focus on four topics:

  • Innovation in prebiotics: What’s next? Chaired by Marla Cunningham
  • Latest advances in microbiome models and biotic screening techniques. Chaired by Brendan Daisley
  • Looking to the future for food and biotics. Chaired by Daragh Hill
  • Probiotic application beyond the gut: What have we learned and what’s next? Chaired by Mariya Petrova

Guided by IAC and SFA representatives, the attendees at each workshop will discuss topics of interest and attempt to answer relevant questions in the biotics field. For example:

  • What are the latest developments in the biotic field regarding research, discoveries, and techniques?
  • What problems are we currently facing, and how will we solve them?
  • What are the future opportunities, and how can we progress?

How will this advance innovation in the field?

The Innovation Workshops will provide a platform where IAC representatives and SFA members can benefit from the exchange ideas gained from unique viewpoints expressed. Industry members can hear firsthand about innovative research that students and fellows perform in their labs, while students can gain a deeper understanding of some of the considerations for commercialization and opportunities and barriers in the marketplace. By joining forces, we believe these workshops will form a bridge between industry and young generation scientists and provide valuable insights into to the latest biotic questions.

Through initiatives such as these, ISAPP drives scientific innovation in biotics for the benefit of the entire field.

Popular media, misinformation and ‘biotics’

By Mary Ellen Sanders, PhD, Executive Science Officer, ISAPP

Encountering misinformation is all too easy when seeking understanding of probiotics, prebiotics, synbiotics, and postbiotics (collectively, ‘biotics’). It can be perpetuated both by proponents and detractors. Through this lens, I’m prompted to comment on some high profile pieces making news recently. A Washington Post article Probiotic supplements may do the opposite of boosting your gut health was published on March 28, 2023, by Anahad O’Connor. This author was then interviewed for a CBS video story Studies find that probiotics can harm gut health on March 30, 2023.  Then, a National Geographic article Probiotics, prebiotics, postbiotics. What’s the difference? was published on the same day.

These pieces appropriately acknowledge the availability of evidence linking probiotics to human benefits. Yet the points raised about potential harms from probiotics and a misunderstanding of what ‘biotic’ substances really are deserve comment.

Harms of probiotics

Amid a backdrop of marketing and media messaging lauding the many benefits of probiotics, reporters are understandably drawn to the counter message that ‘probiotics can harm gut health’. Safety must always be rigorously assessed, as encouraged by a 2023 ISAPP paper focused on emerging issues in probiotic safety (see here). However, the claims of harm made – although generated from studies in humans – are not based on clinical endpoints. Instead they are based on either microbiome endpoints (Suez et al. 2018) or on post hoc analysis of biomarker outcomes (Wastyk et al. 2023). The limitations of the Suez et al. 2018 study were discussed in more detail previously (See: Clinical evidence and not microbiota outcomes drive value of probiotics). This paper evaluated the effect of one multi-strain probiotic product and is the only paper I am aware of that shows that probiotics inhibit microbiome recovery after antibiotic treatment. The paucity of supporting evidence for the harm supposedly documented in this paper is not mentioned in the stories. It is noteworthy that in the Wastyk et al. 2023 paper the authors acknowledge that the study did not achieve its primary objectives, and in referring to their post hoc analysis (including the ‘evidence’ for harm), they specifically acknowledge that such analysis is not conclusive evidence:  “We next leveraged aspects of our study design … in a discovery analysis process to reveal trends that could inform possible … hypotheses for future studies.” These studies are best used for generating hypotheses requiring further study.

Another criticism that was leveraged as evidence that probiotics cause harm is that probiotics reduce microbiota diversity. Any probiotic-induced reduction in diversity of fecal microbiota has not been shown to be associated with harm. Further, most studies show no significant overall changes in microbiome composition in response to traditional probiotic administration. However, it should be understood that the value of diversity as a marker of health remains unproven. The evidence is from observational studies and only shows associations, not causality.

 You can’t both object to criticisms based only on microbiome data but then promote probiotics based on it.

As stated, relying on microbiota endpoints to advance the idea that probiotics cause harm is not justified. But I cannot escape the fact that probiotic proponents in part contribute to this thinking. When probiotics are marketed as being able to ‘balance the microbiota’, without clinical data to substantiate a benefit, aren’t they promoting the same limited science?

Adherence to definitions of biotics needed

ISAPP has rigorously considered and offered definitions for probiotics, prebiotics, synbiotics, postbiotics and fermented foods (see here for a summary), which have been presented in highly cited reviews in Nature Reviews Gastroenterology and Hepatology (see here, here, here, here and here). These efforts were undertaken to advance a common understanding of these terms, so that precision can be attained in communications on them.

This objective has been far from realized. Misuse of these terms continues on product labels, in scientific publications, and in popular press communications.

The articles cited above compelled me to offer some take home messages for those responsible for accurately communicating science:

  • “Prebiotics + probiotics = postbiotics”, a heading in the National Geographic article, is completely wrong.

Probiotics are: Live microorganisms that, when administered in adequate amounts, confer a health benefit on the host

Prebiotic is: A substrate that is selectively utilized by host microorganisms conferring a health benefit on the host

Postbiotic is: Preparation of inanimate microorganisms and/or their components that confers a health benefit on the host

  • Fermented foods are not the same as probiotics. Most fermented foods have not been proven to improve health (associative studies have suggested, but in most cases not proven, health benefits), many do not retain live microbes, and most are not made with microbes characterized to the strain level. All these are requirements to meet the definition of a probiotic. See here, here and here for clear discussions of this issue.
  • Fermented foods are not the magic bullet that many portray them as. Yes – for that subset of fermented foods that retain live microbes – they may contribute a diversity of live microbes to the diet. ISAPP has recently researched this area (see recent ISAPP publications here and here). And yes, they are tasty. However, the evidence level for benefits of traditional fermented foods is nowhere near the level for probiotics. Still, healthcare professionals critical of evidence supporting probiotic benefits commonly recommend fermented foods.
  • Postbiotics do not refer to ‘metabolites from probiotics’. See here for why ISAPP focused the definition of postbiotic on inactivated microbes with or without their metabolites.
  • In simplistic language, prebiotics can be viewed as food for beneficial microbes, but, typically, prebiotics target the normal microbes in the gut, not probiotics. See here.

Conclusion

Both the positive and negative effects of probiotics based on microbiome assembly can be misrepresented in the press, by some marketing claims, and sometimes in scientific literature. The field will benefit from communications that acknowledge the limitations of available science. Further, it’s important for clarity in communication that the field coalesces around established definitions and honor the criteria needed to meet those definitions. Additionally, scientists and medical professionals should apply the same scrutiny and critical thinking to fermented foods as they do to probiotics.

ISAPP encourages healthy debate, critical review of new studies and innovative research. Since ISAPP’s mission is focused on promoting the science of these substances, journalists are invited to reach out as needed to ISAPP for an evidence-based perspective on this evolving field (www.ISAPPscience.org).

ISAPP appoints new Executive Director to step into leadership role in April 2023

The board of directors of the International Scientific Association for Probiotics and Prebiotics (ISAPP) is pleased to announce the appointment of ISAPP’s next Executive Director (ED), Marla Cunningham of Brisbane, Australia. Cunningham will assume leadership of the organization April 1, 2023. ISAPP’s current ED, Dr. Mary Ellen Sanders, will stay on as Executive Science Officer until June 30, providing some overlap with Cunningham as she familiarizes herself with this new role.

Cunningham brings 20 years of experience as a scientist and business leader in the probiotic, prebiotic and natural products industry, working across innovation, clinical research, product development and education. She trained as a healthcare practitioner in complementary medicine and has written and presented extensively for clinical audiences on implementation of science in the biotics field. Cunningham has been an industry member of ISAPP for six years in her capacity as Global Research and Innovation Manager at Metagenics, and served as ISAPP’s Senior Industry Advisory Committee Representative to the board of directors for four years. She will work with ISAPP’s existing staff and board of directors to continue fulfilling the mission of the organization.

ISAPP President Dr. Dan Merenstein, who chaired the Executive Director search committee, says, “Among the excellent candidates for the Executive Director role, we determined that Marla was the best fit due to her background and previous work inside ISAPP. She is a dynamic speaker, and is always looking for ways to move ISAPP and the biotic field forward.”

Dr. Sanders says, “Marla has been an engaged member of the ISAPP community for several years and I’m confident she understands and values the unique role of ISAPP in the biotics field. With her strengths in written and oral communications, probiotic and prebiotic science, and liaison with industry, she will keep the organization dynamic and productive as it moves into this new phase.”

Sanders will remain close to the organization and intends to support Cunningham after June as needed.

“ISAPP has been a driving force in this field, fostering scientific collaboration and consensus and building a high calibre network of academic and industry scientists across the globe,” says Cunningham. “I’m excited and grateful to have the opportunity to contribute to this community in this new capacity. I’m looking forward to engaging with the ISAPP board of directors and the broader ISAPP community on the challenges and opportunities we face in the field, and developing strategic priorities to move the science forward together.”

 

Scientist investigating links between diet and immune system receives 2023 ISAPP Early Career Researcher Prize

ISAPP is pleased to announce the winner of the 2023 Glenn Gibson Early Career Researcher Prize: Paul Gill, PhD, Research Fellow at University College London, UK.

Paul’s work investigates links between diet and the immune system – in particular, how short-chain fatty acids (SCFAs) affect immunity in healthy individuals. His research found that fermented foods such as vinegar and kombucha are a rich source of SCFAs, and these may modulate immunity when consumed along with fermentable fibers. He plans to investigate the application of these findings in dietary treatment for inflammatory bowel disease.

Prior to his fellowship at University College London, Paul completed a Bachelor of Biomedical Science and a PhD in the Department of Gastroenterology, both at Monash University in Australia.

Paul Gill was identified by the ISAPP prize committee as having made significant contributions in the biotics field at an early stage in his scientific career. The award is given annually to a researcher who is no more than five years past their terminal degree, with basic or clinical research in the fields of probiotics, prebiotics, synbiotics, postbiotics or fermented foods. Additional criteria include evidence of impact through citizenship, or outreach efforts through social media or other means. He will receive a cash prize and a speaking slot at the ISAPP annual meeting in June, 2023.

New ISAPP Webinar: Fermented Foods and Health — Continuing Education Credit Available for Dietitians

Dietitians – along with many other nutritional professionals – often receive questions about consuming fermented foods for digestive health. But how strong is the evidence that fermented foods can improve digestive health?

ISAPP is pleased to work with Today’s Dietitian to offer a free webinar in which Hannah Holscher, PhD, RD, and Jennifer Burton, MS, RD, LDN will discuss the foundational elements of fermented foods, the role of microbes in fermentation, how they differ from probiotics and prebiotics, and how to incorporate fermented foods into client diets in an evidence-based manner. Participants will come away with a grasp of the scientific evidence that supports fermented food consumption. This activity is accredited by the Academy of Nutrition and Dietetics Commission on Dietetic Registration (CDR) for 1.0 CPEUs for dietitians.

The one-hour virtual event, titled “Fermented Foods and Health — Does Today’s Science Support Yesterday’s Tradition?”, was held April 20th, 2022, at 2:00 pm Eastern Time.

See the webinar recording here.

ISAPP and Today’s Dietitian also collaborated on a self-study activity titled “Evidence-based use of probiotics, prebiotics and fermented foods for digestive health”. This free activity, which provides more detail on the topic that the 1-hour webinar above, was approved by CDR to offer 2.0 CPEUs for dietitians and is available here through November 2023.

ISAPP begins its search for the next executive director

By Mary Ellen Sanders, PhD

When Glenn Gibson, Irene Lenior-Wijnkoop and I first kicked around the idea of an organization for scientists and dedicated to science of probiotics and prebiotics (in 1999), I don’t think any of us would have anticipated that in 2022 that organization would be celebrating its 20th anniversary. But I do think if we could have seen where we’ve come, we would have been pleased.

As I write, my mind is racing over so many highs (dinner at the National Academy of Sciences in DC and lunch at the top of the ski lift in Copper Mountain, Colorado) and lows (broken down and lost buses on the way to our gala event in Berkeley) of our gatherings and the many positive outcomes due to ISAPP bringing excellent industry, academic and government scientists together to discuss how to improve the field.

But my purpose with this blog is to look forward, not back. I want to let the ISAPP community know that ISAPP is searching for a new executive director to take over for me when I retire in June 2023. The position announcement is found here.

Together, we have accomplished a lot in ISAPP’s twenty-year existence: dozens of publications, including five highly-viewed scientific consensus definitions, interactions with U.S. regulators that helped them reduce barriers to human research on probiotics, networking among scientists leading to collaborative research, concise summaries of the ‘biotics’ family of substances and fermented foods in friendly language in our series of infographics and videos, developing continuing education materials, collaborating with scientific organizations on projects of mutual interest, and more. We have built a strong, collegial community, which is leading cutting-edge science on probiotics, prebiotics, synbiotics, postbiotics and fermented foods. These community members have many more goals and ambitions to realize in the years ahead. I am ready to pass the baton to someone who will build on the momentum of the past and extend ISAPP’s global activities. I look forward to what the future brings for our vibrant organization.

ISAPP awards the Glenn Gibson Early Career Research Prize to two diet and gut health researchers

The ISAPP board of directors is pleased to announce that the 2022 Glenn Gibson Early Career Research Prize has been awarded to two promising researchers in the field of probiotics, prebiotics and related substances.

Dr. Martin Laursen, Senior Researcher at the National Food Institute, Technical University of Denmark, has demonstrated excellence in his work on the impact of probiotics and human milk oligosaccharides on infant gut microbiota and health. Dr. Eirini Dimidi, Lecturer at King’s College in London, UK, has carried out meaningful work on probiotics, prebiotics, and fermented foods and their impact on constipation.

The award criteria stipulated that the researchers must be fewer than five years from their terminal degree, and their scope of research must be basic or clinical research disciplines in the fields of probiotics, prebiotics, synbiotics, postbiotics or fermented foods. In addition, the researchers were required to show evidence of a significant research finding and its publication(s), new ideas that advance the field, and / or evidence of impact through citizenship, general outreach, social media or other means.

The prize committee chose the two recipients from among dozens of applicants and identified each of them as having made important contributions to the field at this early stage in their scientific careers. Each winner will receive a cash prize and an opportunity to speak at the ISAPP annual meeting, to be held in Spain in June, 2022.

Stay tuned to learn more about these rising star researchers!

See here for details about the 2022 Glenn Gibson Early Career Research Prize

Hands holding mobile phone

Virtual events continue to fill gaps as in-person meetings are being planned

Prof. Bob Hutkins, PhD, University of Nebraska – Lincoln, USA

For scientists, annual meetings provide coveted opportunities to hear about the latest scientific advances from expert researchers, and they are where students and trainees get to present their research, often for the first time. Of course, meeting and socializing with colleagues, both new and old, during breaks and evening sessions is also an important part of these conferences.

Yet over the past two years, most occasions to meet face-to-face were canceled. Virtual meetings became the new normal and, even though a poor substitute for in-person gatherings, provided opportunities to connect and share emerging science. As we anticipate being together again in person – hopefully for 2022 meetings – take note of three upcoming conferences to fill the gap. Each of these feature meetings are related to the gut microbiome, diet, and health.

(1) In October, the Agriculture and Health Summit: Cultivating Gut Health at the Crossroads of Food & Medicine is a FREE three-day virtual conference that brings together a unique combination of researchers, industry leaders and thought leaders from the biomedical and agricultural sectors for important conversations about the future of human health. The event will provide a rare opportunity for individuals with diverse areas of expertise to discuss opportunities and challenges in creating ‘foods for health’ through the gut microbiome, working toward solutions in nutrition and medicine. More information can be found here. Among the presenters are ISAPP Executive Science Officer, Mary Ellen Sanders, and board members, Dan Merenstein and Bob Hutkins.

 

(2) Then in November, a Nature-sponsored online conference called Reshaping the Microbiome through Nutrition will be held. According to the website, “this conference will bring together researchers working on the microbiome and nutrition to discuss how our microbiota use and transform dietary components, and how these nutrients and their products influence host health throughout life, including effects on development and infectious and chronic diseases. A central theme of the meeting will be how diet and dietary supplements could be harnessed to manipulate the microbiome with the aim of maintaining health and treating disease”More information is found here.

(3) Another meeting in November is organized across ten centers/institutes at the NIH and the Office of Dietary Supplements and the Office of Nutrition Research. This two-day conference November 5 and 8, titled Precision Probiotic Therapies—Challenges and Opportunities, features a Keynote address by Prof. Jeff Gordon, from the Washington University School of Medicine. ISAPP president Prof. Dan Merenstein, Georgetown University School of Medicine, is also presenting. To register for this FREE meeting, see here.

 

In this current era, interest in how diet (including probiotics, prebiotics, and fermented foods) influences the microbiome and affects human and animal health has never been greater, as is evident by these and other similarly-themed conferences.

ISAPP is planning its next annual by-invitation meeting, to be held in person.

 

ISAPP welcomes Anisha Wijeyesekera, PhD, as new board member

As of the June, 2021 virtual annual meeting, the ISAPP board of directors is pleased to welcome a new member-at-large: Anisha Wijeyesekera, PhD – Lecturer in Human Microbiome, Diet & Health in the Food Microbial Sciences Unit, Department of Food & Nutritional Sciences, University of Reading, UK. Wijeyesekera is an early career researcher with expertise in metabolic profiling for functional assessment of the gut microbiota, particularly in response to prebiotics and probiotics. Her research focus rounds out the board members’ collective leadership in the fields of probiotics, prebiotics, synbiotics, fermented foods and postbiotics.

Wijeyesekera’s research focuses on applying an integrated systems biology approach, exploiting analytical technologies to characterise molecular phenotypes and better understand the impact of genes, lifestyle and environmental factors (including diet and the microbiome) on human health. The ultimate goal of her research is to use this information to tailor nutritional or other interventions (such as prebiotics and probiotics) to improve health outcomes. She has applied these technologies in a range of human studies from examining the metabolome and microbiome in developing infants, to identifying metabolic signatures associated with infant disease outcomes and nutritional interventions, as well as mining metabolite patterns associated with diet and ageing.

In addition to this expertise, Wijeyesekera brings to the ISAPP board extensive experience communicating with stakeholders including the general public, schoolchildren, patients as well as world-leading researchers. She has made important links with researchers worldwide, leading to new initiatives and research collaborations. For example, she helped move the Yoba for Life probiotic programme forward, by winning grant funding to conduct a pilot study in Ugandan school children to assess the impact of probiotic dietary intervention on metabolic and microbial profile. (In this blog post, read more about how the programme encourages locally produced probiotic yogurt.)

Wijeyesekera received a BSc (Hons) in Biomedical Sciences from the University of Durham, an MSc in Bioinformatics from the University of Exeter and a PhD in Chemistry from Imperial College London. Following postdoctoral research, she worked as a Research Manager in the Division of Computational and Systems Medicine at Imperial College London, UK before joining the Food Microbial Sciences Unit at the University of Reading, UK in 2016.

 

ISAPP’s Inaugural Early Career Researcher Prize Awarded to Two Rising Star Probiotic Scientists

This year, ISAPP established a prize for early career researchers with the goal of recognizing individuals who contribute substantial research findings in the fields of probiotics, prebiotics, synbiotics, postbiotics and fermented foods. The criteria for this award included evidence of impact through citizenship, general outreach and citations, as well as a dissertation with novel contributions that advance the field.

The ISAPP board is pleased to announce the winners of the inaugural Early Career Researcher prize for 2021: Irina Spacova, University of Antwerp, Belgium, and Car Reen Kok, University of Nebraska – Lincoln, USA. The winners each receive a cash award and the opportunity to speak at a future in-person ISAPP meeting.

Irina Spacova, co-recipient of the ISAPP 2021 Early Career Researcher Prize

Irina earned her joint PhD degree in Bioscience Engineering from KU Leuven and the University of Antwerp, Belgium, in 2018. In Irina’s words, “My passion is unraveling the potential of locally applied probiotics against viral and other respiratory diseases.” Her study of topically applied probiotics may lead to an effective, innovative probiotic delivery system, providing a means to expand probiotics to new body sites and novel health endpoints.

 

Car Reen Kok, co-recipient of the ISAPP 2021 Early Career Researcher Prize

Car Reen’s education includes a BSc in biochemistry and MS in Food Science, both from the University of Nebraska-Lincoln, where she now is working on her PhD. Her research focuses on untangling factors leading to responsiveness or non-responsiveness to prebiotic interventions through metagenomics readouts. This line of research has great potential to personalize prebiotics, thereby increasing their effectiveness.

Prof. Glenn Gibson brought the idea for this award to his fellow ISAPP board members and led its establishment. Mary Ellen, ISAPP’s Executive Science Officer, says: “During a brainstorming session with the board, Glenn proposed that ISAPP start an annual award given to early career researchers to recognize their accomplishments in the probiotic, prebiotic and related fields. He compiled all the details and chaired the first selection committee – in short, he made it happen. This really shows who Glenn is – someone who always wants to encourage and reward others for a job well done.”

Glenn Gibson’s term on the ISAPP board comes to an end in June, 2021. In his honor, henceforth, the name of this annual prize will be the Glenn Gibson Early Career Researcher Prize.

The 2022 competition will open on December 1, 2021, with a deadline of February 28, 2022. Please visit the Students’ section of the ISAPP website after the opening date for more details.

 

ISAPP thanks Prof. Glenn Gibson as he retires from the organization’s board of directors

By Mary Ellen Sanders, PhD, ISAPP Executive Science Officer

Glenn Gibson – co-founder and backbone of ISAPP for over 20 years – has retired from the ISAPP board of directors.

In 1999, Glenn, Irene Lenoir-Wijnkoop and I conceived of ISAPP as a scientific ‘home’ for the multidisciplinary scientists involved in probiotic and prebiotic research. In 2002, ISAPP was incorporated as a non-profit, public service organization.

Colin Hill and Glenn Gibson

Through all the years, Glenn supported ISAPP beyond measure. His scientific acumen led to many insightful ideas for discussion groups and scientific speakers. He brought ISAPP and probiotic / prebiotic science to the attention of UK political strategists. He hosted meetings, chaired panels, authored publications, provided steady guidance and leadership, and helped keep the board focused on the mission at hand. He also promptly answered my interminable shower of emails for 20+ years. Highlights of his service include:

  • Co-founded ISAPP in 1999
  • Served as Vice President, President and Past President
  • Hosted ISAPP’s 2003 meeting in Henley, UK and 2007 in London, UK
  • Chaired 12 discussion groups
  • Chaired 2 ISAPP consensus panels, on probiotics (2013) and prebiotics (2016)
  • Co-authored 18 ISAPP publications (https://isappscience.org/publications/)
  • Chaired the innovative Springboard session at the Antwerp meeting (2019)
  • And so much more!

Glenn Gibson, Gregor Reid, Mary Ellen Sanders

What is more difficult to catalogue is how thoroughly enjoyable Glenn was to work with over the years. He did so much with an air of ease and joy, making it fun for everyone around him.

Glenn also masterfully decoupled ego from accomplishments. A person less dedicated to this principle would have reminded us ‘early and often’ (as they say) of his scientific stature in the field. Glenn remained approachable despite being one of the ‘greats’ – he started the field of prebiotics, a term addressed in over 9000 papers (close to 200 being his), and coined ‘synbiotics’, a term with 1700 papers currently published. I marvel at how many researchers and companies these two ideas have kept busy over the past 30 years. He developed a validated in vitro gut model, enabling mechanistic studies of the effects of dietary ingredients on gut microbiota, while conducting over 50 human studies, showing his commitment to move the science into the human so we can understand how it can make a difference in people’s lives. Yet still, his penchant was always to give others the credit, the limelight, the microphone, the opportunities.

His incredible stature in the field could have led him to dedicate his precious time to organizations much better established than ISAPP. But to the benefit of all of us, he was ISAPP’s greatest champion. His commitment radiated out to many academic experts who thought hey, if Glenn is in, I’ll be in, too, and to many industry scientists who simply relished the opportunity to network and collaborate with him under the ‘ISAPP umbrella’.

Gabriel Vinderola and Glenn Gibson, Singapore, 2018

Glenn believes that the right thing to do now is let ISAPP move into its next phase as he retires from board membership. I’ll be following his example in 3 years. Meanwhile, my challenge is to figure out how to find opportunities to keep him connected to the busy and dynamic ISAPP community.

As Glenn steps away, ISAPP would like to honor him by naming the Early Career Researcher Prize, which Glenn initiated, after him. The 2022 edition of the prize will be called the Glenn Gibson Early Career Researcher Prize. It’s a small gesture, as it’s impossible to thank Glenn sufficiently for all he has done for the ISAPP community. But we know he will continue to inspire the next generation of probiotic and prebiotic researchers! As his dedicated colleagues and friends, we wish him all the best as he brings his formidable talents to bear on other projects in the months and years ahead.

Enjoy this candid interview with Glenn.

 

The Human Mycobiome: An ISAPP mini-symposium

ISAPP announces an open registration mini-symposium on the human mycobiome.

Although the contribution of the intestinal microbiome in human physiology is well-studied, the specific role of intestinal fungi, the gut mycobiome, is not well understood. Yet they may play an important role in shaping host development and health. For example, the evidence that fungi are involved in development of chronic inflammatory diseases is building. Further, a healthy gut microbiome is likely a major line of defense against the detrimental spread of fungi from the intestinal environment to other parts of the body, or unwanted establishment of fungi in the gut itself. This mini-symposium features six short lectures that will explore different aspects of the human mycobiome, including research, clinical and industry perspectives.

Mini-symposium schedule, July 1, 2021

10:00-10:05 AM EDT Welcome. Eamonn Quigley/Mary Ellen Sanders ISAPP
10:05-10:25 Overview of the human mycobiome. Pauline Scanlan University College Cork, Ireland
10:25-10:45

 

Characterizing gut mycobiota from healthy adults: conventional vs vegetarian diets. Heather Hallen-Adams University of Nebraska – Lincoln
10:45-11:05 Gut mycobiota in immunity and IBD. Iliyan D Iliev Cornell University, Ithaca, NY
11:05-11:25 Mycobiome of infants in a type-1 diabetes prospective cohort.  Joseph Petrosino Baylor College of Medicine

Houston, TX

11:25-11:35 A clinician’s perspective on gut fungi. Eamonn Quigley Houston Methodist,

Weill Cornell Medical College, TX

11:35-11:40 Importance of the mycobiome: industry perspective. Frank Schuren TNO, Microbiology & Systems Biology, The Netherlands
11:40-noon Q&A

The webinar was held on July 1, 2021 — see the recording here:

ISAPP publishes continuing education course for dietitians

For dietitians, it’s often difficult to find practical, up-to-date resources with a scientific perspective on probiotics, prebiotics, synbiotics and fermented foods. ISAPP is pleased to announce a new resource to fill this need – a Special Continuing Education Supplement in Today’s Dietitian titled, “Evidence-based use of probiotics, prebiotics and fermented foods for digestive health”. This free continuing education course also includes infographic summaries, links to supplementary information, and even some favourite recipes. US dietitians can earn 2.0 CPEUs for completing this self-study activity.

The resource was written by dietitian and assistant professor Dr. Hannah D. Holscher, along with two ISAPP board members, Prof. Robert Hutkins, a fermented foods and prebiotics expert, and Dr. Mary Ellen Sanders, a probiotic expert.

“We hope this course will give dietitians an overview of the evidence that exists for probiotics, prebiotics, synbiotics and fermented foods, and help explain some of the practical nuances around incorporating them into their practice,” says Sanders. “In addition, we believe that this course will be a scientifically accurate overview that can counter prevalent misinformation. It can serve as a useful resource for diverse array of professionals active in this field.”

Find the supplement here.

In Memoriam: Todd Klaenhammer

By Mary Ellen Sanders and Colin Hill

We all suffered a devastating loss this past Saturday with the death of Prof. Todd Klaenhammer, aged 69.

Todd was a larger-than-life figure in the scientific field of genetics of lactic acid bacteria. Todd’s 38-year career started at the age of 26, when he joined North Carolina State University as an assistant professor in 1978. His research and teaching awards are too numerous to count, as the phrase goes, but of special note was his election in 2001 to the U.S. National Academy of Sciences. Later he also received the O. Max Gardner award, given to one researcher in the North Carolina University system “who has made the greatest contribution to the welfare of the human race.”

Gregor Reid, Todd Klaenhammer, Colin Hill and Paul Ross in Tromso, Norway.

For those of us fortunate enough to work closely with him, it was a privilege to witness his mind at work, making those leaps in understanding in real time as he furiously forged ahead of the data while designing strategies to test his theories. He saw the potential for probiotics when few others were interested. He led the field in phage resistance, in bacteriocin research, and in basic lactic acid bacterial genetics. When many preferred to study the more genetically accessible lactococci he went with the much more recalcitrant lactobacilli. The discoveries he made were all the more notable because he always maintained a relatively small laboratory group, not moving to the large team-based approaches that are more common today. He was a fierce competitor, but was warm and generous when his friends and rivals made scientific advances. His willingness to take on challenges was truly inspirational, and his scientific intellect was the rock-solid foundation for everything he achieved in a legendary career.

As a founding board member for ISAPP, serving on the board from 2002 to 2016, Todd helped shape ISAPP’s development. He had a great influence on ISAPP leadership, nudging Prof. Colin Hill to serve as president and nominating Prof. Sarah Lebeer to the board. He, along with Prof. Jeff Gordon, organized the National Academy of Sciences Sackler Symposium “Microbes & Health” in conjunction with the 2009 ISAPP annual meeting at the Beckman Center in Irvine CA. Later, one of ISAPP’s finest moments was the gala dinner during the 2015 ISAPP meeting in Washington DC, which Todd hosted at the National Academy of Sciences Great Hall.

Colin Hill, Todd Klaenhammer, Dymphna Hill and Mary Ellen Sanders at dinner after the 2012 ISAPP annual meeting in Cork, Ireland.

Todd seemed especially happy when he was able to help young scientists succeed in science. His “work hard, play hard” ethic and his fierce dedication made positions in his lab coveted. Competition for a space in his lab became steeper as the years went by. The best and the brightest students and postdocs found their way to his lab over the years, and he was extremely proud of all that those in his lab accomplished.

Todd always welcomed the opportunity to connect with his many colleagues and friends. He was rarely without a story to share – watching his Ford Bronco start to sink into the lake with his cherished golden retriever paddling in the back was a favorite. The listening throng always radiated congeniality. He could work a crowd.

Saying goodbye to Todd will be hard for so many of us across the globe. We will miss his good humor, his friendship, his constant encouragement of others to excel, and his hustle to make sure they did.

Rest in peace, Todd. We will try to continue to make you proud.

Mary Ellen Sanders was a graduate student in the Klaenhnammer lab from 1978-1983. Colin Hill was a postdoc in the Klaenhammer lab from 1988-1990.

Todd Klaenhammer (second from left) with other participants in the 2010 ISAPP meeting in Barcelona.

Read more about Todd Klaenhammer’s life and career:

The Passing of Todd Klaenhammer. Annual Review of Food Science and Technology

Beloved Dairy Researcher Klaenhammer Dies

OBITUARY. Todd Robert Klaenhammer

Biography of Todd R. Klaenhammer

A Lasting Legacy: Probiotics Pioneer Todd Klaenhammer Retires

New endowments created honoring Klaenhammer’s legacy in probiotics research

From the Japan Society of Lactic Acid Bacteria: Memory of Prof. Todd R. Klaenhammer (Prof. Todd R. Klaenhammerを偲ぶ), Dr. Mariko Shimizu-Kadota and A legend of LAB is gone (Todd R. Klaenhammer先生を偲んで), Dr. Akinobu Kajikawa. Japan Society of Lactic Acid Bacteria Journal.

ISAPP board members look back in time to respond to Benjamin Franklin’s suggestion on how to improve “natural discharges of wind from our bodies”

Benjamin Franklin, born in 1706, was a multi-talented politician and scientist best known for his discoveries related to electricity. Historians say he was scientifically pragmatic—aiming not just to advance theories, but to solve the most vexing problems of the day.

In 1780, when Franklin read about the intellectual contests being held by The Royal Academy of Brussels (today known as the Royal Flemish Academy of Belgium for Science and the Arts – KVAB), he took it upon himself to write an amusing letter that contained a suggestion for an important scientific challenge: “To discover some Drug wholesome & not disagreable, to be mix’d with our common Food, or Sauces, that shall render the natural Discharges of Wind from our Bodies, not only inoffensive, but agreable as Perfumes.”

Over two centuries later, the organization was prompted for a reply. Writer Brian Van Hooker wrote to the KVAB: ‘I am a writer at MEL Magazine and I am working on a piece about a letter that Benjamin Franklin sent to your organization’s predecessor, the Royal Academy of Brussels, 240 years ago. The letter was entitled “Fart Proudly,” and I’m reaching out to see if anyone at your organization might like to issue a reply to Mr. Franklin’s letter’.

Since ISAPP board member Prof. Sarah Lebeer (University of Antwerp, Belgium) is a KVAB Belgian Young Academy alumna with microbiome knowledge, Bert Seghers from the Academy asked her to help draft a reply. However, since the gut microbiome is not her main area of expertise, she consulted her fellow ISAPP board members. For example, Bob Hutkins, author of a popular ISAPP blog post on intestinal gas, immediately sent her a paper entitled Identification of gases responsible for the odour of human flatus and evaluation of a device purported to reduce this odour with the comment: “The next time a graduate student complains about their project, refer them to this paper and the 5th paragraph of the methods”—a paragraph that describes how scientists in the experiment were tasked with rating the odor of flatus and differentiating between the different smells of sulphur-containing gases.

But it was the answer of Prof. Glenn Gibson (University of Reading, UK) that was incorporated into the ‘formal’ reply to Franklin’s suggestion. “Your suggested topic on improving flatulence odour is amusing, but indeed also very relevant. An outstanding answer to the contest as you formulate it would be ground-breaking,” wrote Profs. Lebeer and Gibson. They noted that gases in the intestine are mainly released by the bacteria living there—but especially the sulphate reducing bacteria contribute to the “traditional” smell due to their production of noxious H2S —and that advances in probiotic and prebiotic science could one day lead to reduced (and “nicer smelling”) gas production by switching hydrogen gas production to methane or even acetate and away from H2S.

Brian Van Hooker summarized: “In other words, Mr. Franklin, they’re working on it and, perhaps sometime within the next 240 years, your dream of non-smelly farts might just come true.”

The KVAB response to Benjamin Franklin concluded: “Your letter is a ripple through time. It may not surprise you that scientific questions can have effects across decades and even centuries. This idea remains the tacit hope of many scientists working together for the progress of humanity. We have not yet invented a reverse time machine, but we send our answer along with your question forward in time, hoping that it may inspire future scientists as your question inspired us.”

Read the MEL Magazine article here.

Read more about gut microbiota & intestinal gas here.

ISAPP ha estado trabajando en colaboración con la Sociedad de Enterocolitis Necrotizante

La Asociación Científica Internacional para Probióticos y Prebióticos (ISAPP, por sus siglas en inglés), ha estado trabajando en colaboración con la Sociedad de Enterocolitis Necrotizante (NEC Society) en el desarrollo de una infografía sobre el rol de los probióticos en la prevención de la Enterocolitis Necrotizante (ECN).

La ECN es una enfermedad intestinal que puede poner en peligro la vida principalmente en bebés prematuros. Esta enfermedad produce un proceso inflamatorio que puede provocar daños en el tejido intestinal e incluso la muerte.

La leche materna de la madre del bebé es la forma más importante de ayudar a disminuir el riesgo de ECN. La leche pasteurizada de madres donantes es la segunda mejor opción. Adicionalmente, suministrar probióticos a bebés prematuros, junto con la leche materna, puede reducir el riesgo de ECN.

Los probióticos son microorganismos vivos que, cuando se administran en cantidades adecuadas, confieren un beneficio para la salud del huésped.

Los padres con hijos con riesgo de desarrollar ECN pueden consultar a los responsables de la Unidad de Cuidados Intensivos, sobre la posibilidad de utilizar probióticos para contribuir a prevenir el desarrollo de ECN.

ISAPP ha preparado una infografía en español con mayor información sobre este tema, la cual se puede encontrar aquí.

‘Probiotic’ on food labels in Europe: Spain adopts a pioneering initiative

By Silvia Bañares, PhD in commercial law, attorney Barcelona Bar Association, Spain; and Miguel Gueimonde, Departamento de Microbiología y Bioquímica de Productos Lácteos, IPLA-CSIC, Villaviciosa, Asturias, Spain. 

The word ‘probiotic’ has been absent from food products in most countries in Europe for years. Authorities there concluded that the word is an implied health claim, which is a reasonable position based on the probiotic definition: live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. The argument proceeds: since there are no health claims approved for probiotics by the European Union, the word is not allowed on food labels. However, the logic fails since in 2010 ESFA actually did approve a health claim for probiotics – although they didn’t use the term ‘probiotic’. This claim was for yogurt cultures improving lactose digestion. But nonetheless, restrictions on using the word ‘probiotic’ have endured.

Recently, akin to positions taken by Italy (here and here) and ostensibly the Czech Republic (as stated here), Spanish authorities have determined that the term ‘probiotic’ may be used.

In October 2020 the Spanish Health Authority (AESAN) delivered a new decision related to the use of the term “probiotic” in foodstuffs. According to it:

“until  a uniform criterion is generated on the part of the Member States of the European Union, it is considered that it could be accepted that the term probiotic/s  on the label of foodstuffs, both of national manufacturing as well as from other countries of the European Union. In all cases, these products must meet the safety requirements. However, it should be noted that the use of this term cannot be accompanied by any health claim, unless expressly authorized under the Regulation of the European Union  -Regulation EC 1924/2006[1], [2]

This new decision completely differs from the previous one (February 2020), which forbade the use of “probiotic/s” term in food products. Surprisingly, both documents are extremely similar in their reasoning.

However, the new Guidance contains some points that might be relevant for the future:

  • First, there is a clear statement related to the EU Commission Guidance of 2007 [3]; such Guidance had always been invoked as the rationale in order to forbid the term probiotic in foodstuffs, since according to it, the reference to “probiotic/s implies a health benefit”[4]. But the AESAN communication points out for first time that such Guidance is not binding since it has no legal force.
  • Secondly it recognizes the lack of harmonization at the EU level regarding the “probiotic” term:

 “From the discussions that have been held within the European Commission’s group of experts on nutritional and health claims, it is found that there are different interpretations by State Members regarding the use of the term “probiotic”, which, in turn, implies a non-harmonized situation in the European Union market”[5].

  • Third, there is a clear reference to mutual recognition principle; that is to say, any product legally marketed and sold in any EU country might be, in its turn, marketed in any other European Union Member State. For instance, any foodstuff labelled as “probiotic” in Italy might be legally sold in Spain as far as it fulfils the aforementioned criterion in its country of origin. The AESAN communication recognized such fact, pointing out that:

“In this sense, infant formulas and follow-on formulas are marketed which, as a voluntary added ingredient, contain different live microorganisms. The presence of these live microorganisms is indicated on the product label in the ingredient list. In the field of food supplements, it has been found that there are a large number of food supplements on the market, which include the term “probiotic/s”. These products come from different EU countries, where they are allowed to be marketed under this name and, therefore, they could not be prevented from being marketed in Spain, in application of the “principle of mutual recognition” established in the European Union Treaty”[6].

This statement is clearly aligned with Regulation EU 2019/515 [7] (related to mutual recognition principle) and a recent Commission Regulation (Implementing Regulation 2020/1668), which develops the previous one [8]. According to these dispositions, any competent authority suspending market access should notify the legitimate public interest grounds for such suspension. Therefore, Spain would find quite difficult to reject a foodstuff labelled as “probiotic” in another EU country when it is legally sold as such. Hence, it can be said that Spain has adopted a pioneering initiative that maybe could be followed by other EU Member States.

Italy and the Czech Republic have allowed use of the term ‘probiotic’ on foods – perhaps simply because they considered it to be the right thing to do – but they did not make the convincing legal argument made by Spanish authorities. The rationale presented by Spain could likely be easily adopted by other EU countries as well. Perhaps the Spanish initiative will motivate the EU Commission and EFSA to reach a consensus about this word.

Two decades ago, with a rapidly growing list of probiotic-containing products reaching the market worldwide, there was increasing concern by consumers about how to distinguish among the different probiotic strains available and how to know which products have evidence for different health benefits. This, together with the interest of scientist and industry for clear rules and fair competence, prompted the EU Commission to regulate the area and the Regulation EC n° 1924/2006 on nutrition and health claims made on foods was developed. In its preamble this Regulation states, “to ensure a high level of protection for consumers and to facilitate their choice, products put on the market must be safe and adequately labelled” and recognises that  “general principles applicable to all claims made on foods should be established in order to ensure a high level of consumer protection, give the consumer the necessary information to make choices in full knowledge of the facts, as well as creating equal conditions of competition for the food”.  Therefore, consumer protection and facilitating informed purchase choices was in the forefront of the Regulation, in an attempt to satisfy the concerns and demands that consumers had leveraged.

Subsequent interpretation of the Regulation EC n° 1924/2006 led to the conclusion that the term “probiotic” was a health claim and, as a consequence, should not be used in product labelling. Different countries, such as Italy or the Czech Republic, reacted to this by developing national regulations allowing the probiotic food labelling. Now Spain, on the basis of mutual recognition principle, accepts its use as well.

However, this new situation makes relevant again the challenges that consumers had identified two decades ago:  how to differentiate among the different available probiotic products and make an informed, purposeful purchase. This unsolved issue should now be addressed. In this context, we advocate for the development of easy-to-use guidelines targeted to regular consumers, not to clinicians or scientists, to provide consumers with the necessary tools to make their choice.

Related article: Spanish agency approves use of term ‘probiotic’ on food and supplements

References:

[1] https://www.aesan.gob.es/AECOSAN/web/seguridad_alimentaria/subdetalle/probioticos.htm

[2] Translation by the authors

[3] https://ec.europa.eu/food/sites/food/files/safety/docs/labelling_nutrition_claim_reg-2006-124_guidance_en.pdf

[4] Guidance on the implementation of Regulation n° 1924/2006 on nutrition and health claims made on foods conclusions of the Standing Committee on the Food Chain and Animal Health /14/12/2007

[5] Translation by the authors

[6] Translation by the authors

[7] Commission Implementing Regulation (EU) 2020/1668 of 10 November 2020 specifying the details and functionalities of the information and communication system to be used for the purposes of Regulation (EU) 2019/515 of the European Parliament and of the Council on the mutual recognition of goods lawfully marketed in another Member State.

[8] Regulation (EU) 2019/515 of the European Parliament and of the Council of 19 march 2019 on the mutual recognition of goods lawfully marketed in another Member State and repealing regulation (EC) nº 764/2008

ISAPP collaborates with NEC Society to help parents understand the role of probiotics in reducing the risk of necrotizing enterocolitis

By Dr. Mary Ellen Sanders, PhD, ISAPP Executive Science Officer

To date, over 50 clinical trials on probiotics and necrotizing enterocolitis have been published. Medical organizations have considered the trials completed to date and have provided guidance (ESPHGAN) and recommendations (American Gastroenterological Association) for implementing probiotics in clinical practice.

As important as the science on this issue are the perspectives from parents of babies who have suffered from NEC or are at risk of developing the disease. Such parents consistently point to the need for credible and balanced educational materials about this condition. Recently, ISAPP has been fortunate to work with the NEC Society to develop materials that will help inform parents.

See the new ISAPP infographic Probiotics and Necrotizing Enterocolitis: What Parents Should Know.

Disponible también en español. Информация также доступна на русском языке.

Also, a recent ISAPP blog Probiotics to Prevent Necrotizing Enterocolitis: Moving to Evidence-Based Use by Dr. Ravi Patel MD, a neonatologist on the NEC Society’s Scientific Advisory Council, summarizes the state of the science supporting this use, including both controlled efficacy trials and post-implementation surveys.

The NEC Society is a nonprofit organization – the only US group dedicated to NEC – with the stated mission of “building a world without necrotizing enterocolitis (NEC) through research, advocacy, and education.” They advocate for families affected by NEC by bringing together critical stakeholders to improve understanding, prevention, and treatment for NEC. Jennifer Canvasser founded the NEC Society in 2014 after her son, Micah, died from complications of NEC just before his first birthday. Micah was born at 27-week’s gestation, placing him at increased risk of NEC. Despite Micah’s risk factors and his parents asking the care team to consider offering Micah probiotics, he was not treated with probiotics. Although it is impossible to know if probiotics could have changed Micah’s course, his parents feel that more could have been done to better protect Micah from the devastation of NEC. Micah’s photo is featured in the new infographic co-created by ISAPP and the NEC Society.

“It is vital for healthcare providers to support NICU parents in understanding the protective and risk factors associated with NEC,” Canvasser shared. “Parents are the most important members of their baby’s care team. For parents to effectively engage and contribute, they need to be supported in accessing and understanding important information related to their child’s health. This new resource on probiotics and NEC will help to ensure that NICU parents are informed and feel encouraged to ask questions so they can best advocate for their child.”

The NEC Society intends to use the new infographic as a resource available to NICU parents and providers. It will be downloadable from the websites of both the NEC Society and ISAPP, and it will be shared via both social media platforms. Once in-person events are possible again, print versions will be made available. ISAPP will also work with the NEC Society’s Scientific Advisory Council to explore how we can further disseminate this resource to NICUs.

Read more about the efforts of the NEC Society here:

Head of the Herd: Jennifer Canvasser, Founder and Director, Necrotizing Enterocolitis (NEC) Society

Family Reflections: harnessing the power of families to improve NEC outcomes

10 Things All Parents of NICU Babies Need to Know

9 Things You Need to Know About Necrotizing Enterocolitis