The benefits of probiotics need to be understood in the context of the gut microbiome, of which our understanding has grown significantly in recent years. The gut microbiome influences many areas of human health, from innate immunity to appetite and energy metabolism. A healthy and balanced gut is key to ensuring proper digestive functioning and there are various factors which can impact its balance and the diversity of gut flora within the microbiome: antibiotic use, diet, increased consumption of processed foods, physical activity levels and stress, to name a few. 

There has been a rise in debate around the claimed health benefits of various fermented foods used as probiotics, such as yoghurt, kefir, kombucha and sauerkraut. While there may be some benefits to consuming bacteria transported in food or in a freeze-dried state, studies have shown that their ability to effectively change the microbiome is limited, because they are food, and so trigger the digestion process. It’s important that the bacteria consumed arrive in a live and active state, for example freeze-dried probiotics also take some time to be activated and so may not be live by the time they pass through the digestive system. Only if the bacteria in the substrate consumed survive the digestion process of the stomach acid can they go on to reach the gut and thrive to drive a healthy microbiome. 

Optimising the balance within the gut microbiome with, for instance, water-based probiotics containing multi-strain, live and active bacteria, can have a positive impact on overall health. Research findings from University College London’s School of Pharmacy have led to an expansion in understanding the range and quality of probiotics on the market. Namely, we now know more about the most effective formulations for successfully colonising in the gut. Moreover, such products are classified as food supplements and are therefore safe to use.

Probiotics are live microorganisms that when administered in adequate amounts can confer a health benefit. They can be found in foods such as yoghurts but also as food supplements. They can help with the following:

• digestive issues such as bloating, IBS and antibiotic-associated diarrhoea 
• lactose intolerance
• supporting the immune system

There is also new emerging evidence that probiotics can influence the gut-brain axis and improve stress and mood. 

The effects of probiotics depend on the properties of the individual strain(s) present. It is important to understand that not all probiotics are the same. Each probiotic is unique – they all act differently and have different effects. It is important to choose a probiotic that is clinically studied and tailored to the health condition.

Probiotics aren’t suitable as food ingredients for a number of reasons. Firstly, probiotics are usually live bacteria, which don’t work well as food ingredients because you can’t heat them, so they cannot be used in baked or cooked foods. In the presence of heat and moisture they can also grow within and outside the food product, meaning that you can’t control the amount of probiotic in the product which can lead to food spoiling. 

Probiotics work best either in cold chain products like yoghurts, or in capsule form as standalone supplements. Plenty of probiotics do have health benefits, but they are not most effective when used as food ingredients.  

Catherine Farrant, CEO & founder, Ossa Organic

The gut microbiome is made up of around 100 trillion active bacteria, yeasts, fungi, viruses and protozoans, outnumbering our own cells by ten to one. Although there has been a flood of research into the microbiome in recent years, our understanding of its mechanisms and impact on overall health is just the tip of the iceberg. With a plethora of information available about probiotics, sorting the fact from the fiction is imperative. Continued research is essential to explain the effect of supplements and probiotics on the microbiome. 

It’s fundamental that we differentiate between the various products available and their claims. Scientific studies have found that probiotics containing active, multi-strain bacteria – which can arrive in the gut in a live state, survive the stomach’s digestive enzymes because it does not trigger digestion, and thrive there – could potentially be more beneficial than probiotics which do not.

Developing guidance and regulation by healthcare and food standards authorities is a lengthy process, whether within the UK, or more widely across Europe. The issue is that the process involves many different institutions and can be quite confusing and complicated – preventing innovation and advancements in science. It is time to challenge the status quo and think of new ways to regulate that keep up with innovation in science and inform the consumer.  

Providing scientific credibility is the most effective way to prove the real value of live, multi-strain probiotics. Evidence that products have been researched in clinically controlled environments and validated by academia must be considered. This is why at Symprove we are continuing to invest in research to show the science behind how we differ from other products. Currently, there are tight restrictions on food health claims. This must change as innovations are developed and validated.

Health claims on probiotics are already tightly regulated. There are probiotics on the market that are well supported by scientific studies but it is not always easy for a consumer to know which probiotics to choose. I would recommend choosing a reputable company that are experts in probiotics and also seeking advice from a healthcare professional such as a dietician or doctor to advise on which probiotics are backed by scientific evidence.  

In the past, most health claims for prebiotics have been for improvements in general health, which are very hard to measure. In previous decades there have been some dubious claims around these general health benefits, however, since the European Food Standards Agency (EFSA) tightened up its regulation in 2012, no company can make a health claim for a probiotic unless it has been proven and approved by the EFSA. There are currently no probiotics with an EFSA-approved health claim. There is more flexibility on health claims in the United States and China, but in general, companies have to prove their claims through scientifically validated and regulated testing. 

Catherine Farrant, CEO & founder, Ossa Organic

There is no doubt that the probiotics market will continue to grow. This will be coupled with greater research into probiotics, as well as the microbiome – especially in an age of ever increasing health-conscious consumerism. Food products and supplements that can prove or demonstrate their science will overtake, and perhaps even displace, older products that have little or no evidence that they can reach the gut in adequate quantities, or even re-balance the microbiome. Moreover, probiotics which accommodate a greater pool of people and are seen to be more ‘natural’ by, for instance, being gluten-, soya- and dairy-free, and vegan certified will have greater appeal.

The volume of research and news, not only about probiotics, but also food, medicines and exercises that could improve our gut health are likely to grow quickly and widely. Whether food, supplement, or medicine, probiotics will likely become a more permanent feature in our search to become a healthier society. 

The market for foods which are potentially a high source of probiotics faces several significant challenges. Firstly, which probiotic to take can be difficult to determine because of the huge diversity in individual’s gut flora or microbiota. There are many different strains of ‘friendly’ bacteria out there, each of which promises a different benefit and it can be confusing. Secondly, not all probiotics can survive the journey through our stomachs and intestines, again making it difficult to determine their effectiveness. Putting yoghurt and sourdough bread aside, many probiotic foods such as sauerkraut, kimchi, miso, kefir, sour pickles and tempeh may not fit well into the average western diet and can be difficult to get hold of.

We see that many people are interested in fermented foods and the growth in kefir for example. However, these products are poorly studied. We know that there is an appreciation for the convenience of a food supplement, that is easy to take and always available. So we see room for both food and supplements in our daily routines. What we see as an issue is the need for more information for consumers on how to select a probiotic strain whether it’s in a food or in a supplement. 

Probiotics are a targeted approach and each strain is different. Probiotics of human origin are different from those from plants or pigs for example. And we know that mixing multiple bacterial cultures does not guarantee that each will retain its properties or that different cultures will even complement each other. Different cultures behave in different ways and may even have competing effects. So whether its food or supplements, for the future, scientific evidence to back up the strains used will be key. 

Companies are moving away from probiotics which claim to improve general health, and are developing next-generation probiotics which target particular health issues, such as cholesterol. These health claims can be measured using biomarkers, such as cholesterol, and therefore can be scientifically validated and proven by independent human studies - as is the case with our products. There is also some work being done to develop certain probiotics which are heat stable, as well as ones which are acid stable and can be incorporated into fruit juices and other beverages. Despite this, I see most probiotics in the future being used either in cold chain products, or in supplement capsules.

Catherine Farrant, CEO & founder, Ossa Organic

Prebiotics feed the good bacteria in our gut, rather like a fertiliser. There are some foods which are naturally high in prebiotics, such as onions, leeks, Jerusalem artichokes and asparagus. However, we would need to eat large amounts daily for there to be any impact. The benefit of adding a prebiotic supplement to everyday foods we eat and drink, is that only a small amount is required to be effective and they are already part of our diet. 

In contrast to probiotics, prebiotics are ideally suited for use as food ingredients. They are heat stable, so can be used in a far wider range of products. They can be processed like any other ingredient, and don’t have much of a taste, so they don’t disrupt existing food products when they are added as an ingredient. 

Prebiotics are like a fertiliser to help the good gut bacteria grow, limiting the space for the bad bacteria. So, prebiotics effectively offer a ‘home grown’ approach to your gut microbiota. Instead of ingesting strains of bacteria, that may or may not survive the digestion process and may not be naturally occurring in your gut, you are feeding the prebiotic bacteria that you already have. On a regulatory level, no products are allowed to use health claims unless the evidence has been approved by European Food Safety Authority. No probiotics have been granted health claims.  

Being heat stable and easy to process stable they are more suitable than probiotics for use as food ingredients. One key benefit is that they have a far longer shelf-life than live bacteria. For example, a prebiotic that we are developing at OptiBiotix currently has a shelf-life of two years, and we think that we will probably be able to extend that to five years. So, there is much less uncertainty when dealing with prebiotics as food ingredients. In addition, all the same health claims regulations apply to prebiotics, so companies have to substantiate any health claims that they make about their prebiotic products. 

There is exciting work going on looking at the impact of prebiotics on different life stages and also on the gut brain axis as some studies have shown the link between our gut health and mood/mental wellbeing. The beneficial properties of prebiotic ingredients at either end of the population life cycle, kids and the elderly, is likely to propel demand for prebiotic products over the coming years. We will see more products targeted specifically at informed parents, keen to care for their children’s long-term gut health on the back of increasing research into the gut-brain axis. Also, as more people become aware of the impact of the reduction of good bacteria in our gut as we age – the bifidobacteria drop – on things such as immunity, we are likely to see products emerge targeted at the older consumer.

I believe that the creation of prebiotics which target specific health benefits are the future. As with probiotics, the industry is starting to move away from general health claims towards more scientifically validated ones.  [Also,] I think that the majority of prebiotics will be used as food ingredients; perhaps some will be developed for use in a standalone sachet form.