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watch with times they are a-changin quote by bob dylan

The Times They Are A-Changin’ With Probiotics

/in featured, ISAPP Science Blog /by Mary Ellen Sanders

December 15, 2017. By Prof. Daniel Merenstein, MD, Department of Family Medicine, Georgetown University Medical Center, Washington DC.

I had a surprising encounter a few weeks ago in the clinic. I was caught off guard, had to take a step back and think about what happened. I recommended to my patient that she take a probiotic with the antibiotic I was prescribing. She said to me, “What is a probiotic?” My response was, “A probiotic,” as if it didn’t require any further explanation. It was nearly incomprehensible to me that she didn’t know what a probiotic was and maybe she just didn’t hear me or just didn’t understand me (I tend to speak too fast). But no, she just didn’t know what one was. I then realized how unusual this encounter was.

Something has been a-changing. It hasn’t been a quick process and I am not sure when it changed, but it did. Even just a few years ago when I recommended supplementing a course of antibiotics with a probiotic, people were generally receptive and had a vague idea about probiotics. However we generally had to talk about what probiotics were and how to use them. Fast forward to today and it appears to me that 95% of people respond, “I already take one.” Much more common than hearing “What’s a probiotic?” is to hear, “Of course, you always have to take a probiotic when taking an antibiotic.”

I am currently recruiting for my 8th probiotic clinical trial (PLAY ON). My team has recruited over 1,400 participants for previous studies. We have a system and a great team, but we are having the most difficult time recruiting for this study. I have thought a lot about why and I think it comes down to the times they are a-changin’. When we started on this research path 12 years ago, our research team and the subjects we recruited were excited about probiotics and their potential. But today the public doesn’t see the potential of probiotics; they know probiotics impact the gastrointestinal tract and should be used when taking antibiotics. Therein lies our challenge: to be in our study a subject has to be willing to take the chance of being in the placebo group. That makes little sense to a public that already knows to take a probiotic when on antibiotics.

My first two NIH studies were funded by the National Center for Complementary and Integrative Health, while my current study is funded by the National Institute of Child Health and Human Development. The shift has occurred from complementary, to mainstream. One need no longer attend a microbiome or probiotic conference to hear talks on probiotics; nearly all clinical conferences will now have probiotic talks. I am confident my team will adjust to these changing times but I think more important is how researchers and clinicians adjust. Probiotics are not alternative options anymore, the evidence base is robust and some indications well-studied. The discussions need to shift from, “You should have probiotics on formulary” to specific recommendations of which probiotics should be used for what indications. Similarly when discussing other disease states in the gut (e.g. necrotizing enterocolitis, infantile colic, and irritable bowel syndrome), it is time to take the next step and discuss specific recommendations. I am sure I will see another patient who has never heard of probiotics, but I’m willing to bet that doesn’t happen for many months. More likely, I expect I will be discussing the efficacy of the products my patients are already taking. That is an important change that docs need to think about.

Come gather ’round people
Wherever you roam
And admit that the waters
Around you have grown
And accept it that soon
You’ll be drenched to the bone.
If your time to you
Is worth savin’
Then you better start swimmin’
Or you’ll sink like a stone
For the times they are a-changin’.

Bob Dylan, Nobel Laureate

The Times They Are A-Changin’

Columbia Records, 1964

fermented foods

Fermented foods, health and ISAPP

/in featured, News /by Mary Ellen Sanders

By Mary Ellen Sanders PhD, Executive Science Officer, ISAPP

It seems that fermented foods have ‘arrived’. Just within the community of ISAPP board members, fermented foods and their importance to health have been a topic of great interest. The idea that adding foods containing live microbes may be sound dietary advice has been reflected in many venues and formats, as seen here:

  • Bob Hutkins:
    • Presented “Health benefits of fermented dairy foods: microbiota and beyond” at 5th YINI Summit (Danone Institute) Fermented Foods and Health: The Intersection of Gut Microbiota and Fermentation Microbes on October 18, 2017.
    • Will convene a discussion group at ISAPP 2018 in Singapore “Taking advantage of fermented foods for health.”
    • Submitted a paper on counts of live microbes in fermented foods “A survey of live microorganisms in fermented foods”
    • Along with lead author Maria Marco and others summarized a discussion group on fermented foods convened at the 2016 meeting of ISAPP in Turku, reflected in this popular Current Opinions in Biotechnology article, Health Benefits of fermented foods: microbiota and beyond.
  • Gregor Reid:
  • Mary Ellen Sanders
  • Seppo Salminen:
  • ISAPP board of directors
    • In 2015, published several comments to the US Dietary Guidelines Advisory Committee, presenting the scientific rational for fermented foods to be part of the US dietary guidelines. See here and here (and for a comment on prebiotic inclusion in dietary guidelines, see here)
    • Oversaw the ISAPP Science Translation committee, which published a consumer-friendly infographic and related materials on Fermented Foods.

ISAPP will continue to work to get this topic recognized by nutrition professionals globally.

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ISAPP Releases Series of Informational Videos on Probiotics and Health

/in featured, News /by Mary Ellen Sanders

October 10, 2017. Probiotics are a hot topic—an online search for information yields millions of hits. But how much of this easily-accessible information is scientifically accurate?

The clinicians and scientists serving on the ISAPP Board of Directors constantly receive questions about what’s true when it comes to probiotics and prebiotics. That’s why ISAPP decided to commission a series of four informational videos on probiotics. These videos were overseen by members of our board of directors without input from industry, but industry provided educational grants for their production.

The four new videos focus on these topics:

  • What is a probiotic?
  • Benefits of probiotics
  • Are all probiotics the same?
  • How to choose a probiotic

Watch for the videos to roll out during the month of October 2017! They’ll appear here on the ISAPP website video page.

With our mission to advance scientific excellence in probiotics and prebiotics, ISAPP is committed to helping consumers access science-based information on probiotics and prebiotics. To stay up to date on ISAPP news, please sign up for our monthly newsletter!