Working Toward Evidence-Based Use of Probiotics

Researchers who understand the current state of evidence for probiotics to manage some health conditions are sometimes frustrated with the slow pace of incorporation of probiotic interventions into medical practice. Although evidence for some indications is limited based on quality or quantity of research, many agree that there are several indications with enough evidence to justify use. However, healthcare provides do not have a trusted, convenient source of information to answer the questions they most care about: what specific probiotic products are safe, who will they benefit, to what extent, and can product labels be trusted to be accurate and communicate all necessary information. And they need this information from a trusted source.

Addressing the gap between research and translation into practice was the topic of a panel of experts convened in February 2019 by the British Nutrition Foundation, which summarized the findings in a new paper. Their key conclusions include the following.

  1. The evidence base for probiotics is predominantly in disease management, not health promotion. Communications with healthcare providers (HPCs) will need to reflect this.
  2. An effective communication strategy with HPCs will require a ‘topline’ message approach, which concisely provides facts on the quality and quantity of evidence linked to particular benefits.
  3. In addition to evidence levels, communications should provide brand, product name, probiotic strains, usage information (dose, storage, target group, etc.), and side effects/contraindications. Further, the information should reflect totality of evidence (quality, consistency).
  4. Communications should have an electronic format, such as an online toolkit or ‘app,’ that uses a simple scoring system allowing for rapid appraisal of available evidence.
  5. Currently, the field lacks “comprehensible, accessible and actionable” information prepared by a trusted authoritative body.
  6. Suggested next steps were to establish both an oversight advisory committee and a working group to make progress toward development and dissemination of such resources for the UK.

The paper made note of useful resources currently available from ISAPP, British Dietetics Association, and Clinical Guide to Probiotics (Canada and USA), but commented that available materials are not comprehensive.

Yakult, Danone and DuPont provided an unrestricted grant to cover costs to conduct this panel, but the British Nutrition Foundation had full control of the agenda, conduct and reporting of the panel.


Additional reading:

Probiotics: Money Well-Spent For Some Indications – ISAPP blog

Probiotics in the Year 2018 – ISAPP blog

Guides for Use of Probiotics in the Clinic – Some Recent ISAPP Initiatives – ISAPP blog

Probiotics for Human Use – Nutrition Bulletin Review on evidence for probiotic health benefuts

Translating probiotic science into practice – Nutrition Bulletin Panel Report discussed herein

Improving End-User Trust in the Quality of Commercial Probiotic Products – Addresses issues on improving quality manufacture of commercial probiotic products