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PROBIOTIC FOOD AND THEIR
FUNCTIONAL ROLE
BY
Pintu choudhary
Master of Technology
( Food Science and Technology)
Indian Institute of Crop Processing Technology
Ministry of Food Processing Industries
Government of India
Thanjavur - 613005
Contents
• Definition
• History
• Characteristics
• Mechanism of action
• Advantages
• Functions
• Probiotic foods
• Multi probiotics
• Side effect of probiotics
• Prebiotics
• Characteristics of probiotics,
• Prebiotic foods
• Symbiotic
Definitions
•World Health Organization:
“live microorganism which, when
administrated adequate amounts, confer health
benefits on hosts”
•A bacterial strain that
• Survive stomach acid and bile
• Adhere in intestinal lining
• Grows and establishes temporary
residence in intestine
• Impart health benefits
Louis Pasteur
(1822 - 1895)
Potential benefits of
Lactobacillus 125 yrs. ago
1905: Concept of Probiotics
Metchikoff Elie
1848-1926
History
• At the start of the 20th
century, Russian noble prize
winner and father of modern immunology, Elie
Metchnikoff, a scientist at the Pasteur institute, was the
first conceptualize “probiotics”.
• In 1907 Metchnikoff proposed that the acid producing
bacteria in fermented milk products could prevent
“fouling” in the large intestine and if consumed regularly,
lead to a longer, healthier life
• In early 1930’s, in Japan, Minoru shirota developed a
fermented milk product called Yakult (probiotic yogurt
like product made by fermenting a mixture of skimmed
milk with a special strain of Lactobacillus casei shirota).
• Probiotic term coined in 1965 by Lilly and Stillwell.
Characteristics of Effective Probiotics
• Able to survive the passage through the digestive
system.
• Able to attach to the intestinal epithelia and colonize.
• Able to maintain good viability.
• Able to utilize the nutrients and substrates in a
normal diet.
• non pathogenic and non toxic.
• Capable of exerting a beneficial effect on the host.
• Stability of desired characteristics during processing,
storage and transportation.
• Anti-inflammatory,antimutagenic,immunostimulatory.
Advantages
• Produce lactic acid- lowers the pH of intestines
and inhibiting bacterial villains such as
Clostridium, Salmonella,Shigella, E. coli, etc.
• Decreases the production of a variety of toxic or
carcinogenic metabolites.
• Aid absorption of minerals, especially calcium,
due to increased intestinal acidity.
• Production of β-D galactosidase enzymes that
break down lactose.
• Produce a wide range of antimicrobial
substances acidophilin and bacitracin etc.
help to control pathogenic bacteria .
• Produce vitamins (especially Vitamin B
and vitamin k
• Act as barriers to prevent harmful bacteria
from colonizing the intestines
Cont.
Mechanism of Action of
Probiotics
Inhibit Potentially Pathogenic Microorganisms
(PPMs)
• Reduction in Intestinal pH
• Production of bacteriocins
• Competitive blocking of adhesion sites
• Competition for nutrients
Mechanism of Action of
Probiotic
Probiotics
(Friendly Bacteria)
Normalise
Intestine
Immunomodulation Metabolic effects
Energy prevention and
recovery
Treatment of peptic
ulcer
Diarrhea
Blood pressure
regulation
Regularity
Reduction of infection
Lactose digestion
Immune function
Lowers cholesterol
(Bile acid de conjugation
&Secretion)
Allergy Prevention
and Recovery
• Experimental evidence indicates that probiotics are
effective in treating atopic eczema in infants.
• It has also been shown that the incidence of allergies in
infants with a high risk of allergy can be halved with the
consumption of certain probiotics by their mothers when
pregnant and by the infant after birth.
• It is thought that consumption of probiotics helps to form
a normally functioning immune system, preventing
allergies(Ouwehand, 2007).
Treatment of Peptic Ulcers
• Helicobacter pylori is a pathogenic bacteria that causes
peptic ulcers and other gastric problems. H. pylori is
normally treated with antibiotics. This treatment is
expensive and has negative side effects.
• The consumption of probiotics with antibiotics is thought
to be the most effective and safest treatment. (Lesbros-
Pantoflickova,Corthésy-Theulaz& Blum, 2007).
Diarrhea
• Evidence indicates that probiotic bacteria in foods can
help prevent and treat diarrhea in children. Rotavirus
infections are a common cause of diarrhea in
children. In clinical trials, infected children who
consumed probiotic fermented milk had lower rates of
diarrhea (Agrawal, 2005) .
• Probiotic treatments have also been used to
effectively treat antibiotic associated diarrhea
(Agrawal, 2005)
Blood Pressure Regulation
• Milk is fermented by bacteria and the protein in
the milk is hydrolyzed into smaller peptides. The
peptides are absorbed in the small intestine.
Consumption of these peptides in milk and
yogurt have been shown in clinical studies to
lower blood pressure in some individuals
(Jauhiainen & Korpela,2007).
Regularity
• The consumption of probiotics reduces the
transit time for the movement of wastes through
the intestines. This results in reduced
constipation and may help prevent colon cancer
(Dannon,2007).
• Prebiotics also decrease transit time through the
intestines because they are a form of fiber
( Dempsters,2007).
Reduction of Infection
• Probiotics and prebiotics have been shown to
reduce infections in sick and postoperative
patients. Because the use of antibiotics reduces
the population of intestinal bacteria, using
probiotics and prebiotics to repopulate the
digestive tract, ensures the presence of a
healthy n of good bacteria to prevent infection
(Agrawal, 2005)
Lactose Digestion
• Individuals with lactose intolerance are missing
important digestive enzyme, lactase. Probiotic
bacteria make the lactase enzyme and
consumption of these bacteria can help lactose
digestion (Stanton,Gardiner,Meehan,Collins,
Fitzgerald, Lynch, & Ross, 2001)
Immune Function
• Consumption of probiotics can enhance natural
immune functions (Agrawal, 2005).
Lowering cholesterol
A range of LAB able to break down bile in
the gut, thus inhibiting its reabsorption
(which enters the blood as cholesterol)
Probiotic strains
Lactobacillus species:
• L. acidophilus
• L. plantarum
• L. casei subspecies rhamnosus
• L. brevis
• L. delbreuckii subspecies bulgaricus
Bifidobacterium species
• B. adolescentis
• B. bifidum
• B. longum
• B. infantis
• B. breve
Other Species of Probiotic
• Streptococcus salivarius ssp. thermophilus
• Lactococcus lactis ssp. lactis
• Lactococcus lactis s ssp. cremoris
• Enterococcus faecium
• Leuconostoc mesenteroides ssp. dextranicum
• Propionibacterium freudenreichii
• Pediococcus acidilactici
• Saccharomyces boulardii
Example of Probiotic Foods
Yogurt
• Usually made from milk (rarely, from cream) inoculated with
Streptococcus thermophilus and either Lactobacillus acidophilus
or Lactobacillus bulgaricus.
• Turkish in origin
• Available in innumerable forms and flavors
1. Low fat chocolate yogurt
2. Drinkable fruit-flavored goat yogurt
3. Neon-colored yogurt in squeeze tubes
Frozen Yogurt
Laloo’s Goat’s Milk Frozen Yogurt,
naturally chock-full of S.
Bulgaricus, L. Acidophilus and Bifidus.
Juice
• First probiotic juice launched in the fall of 2007 by Next Foods.
• Goodbelly, organic fruit juice-based probiotic
beverage , contains L.Plantarum 299v,
has effects on irritable bowel syndrome
• Three initial flavors include Brilliant Blueberry, Peach Mango and
Strawberry Rosehip
Attune Foods : Chocolate &
Granola bars
• Attune makes Wellness Bars in three chocolate varieties and three
yogurt and granola varieties.
• All products contain “more than 5 times the live active cultures in
yogurt, with less sugar.
Kashi Vive Probiotic Digestive
Wellness Cereal
Vive contains one billion CFUs of
Lactobacillus acidophilus per serving.
Yakult Dairy Drink
• Probiotic, cultured dairy beverage
• Has citrus flavor
• Sold in single-shot
containers that contain around
8 billion live and active Lactobacillus
casei shirota cells per bottle
Frozen Yogurt
LaLoo’s Goat’s Milk Frozen Yogurt,
naturally chock-full of S. Thermophilus, L.
Bulgaricus, L. Acidophilus and Bifidus.
Juice
• First probiotic juice launched in the fall of 2007 by Next
Foods.
• Goodbelly, organic fruit juice-based probiotic
beverage , contains L.Plantarum 299v,
has effects on irritable bowel syndrome
• Three initial flavors include Brilliant Blueberry, Peach Mango
and Strawberry Rosehip
Ricera Rice Yogurt
An organic, non-dairy, rice “yogurt” with whole grains
and live, active cultures, including Lactobacillus
bulgaricus, Streptococcus thermophilus, Lactobacillus
acidophilus and Bifidobacterium bifidum.
Multi-Probiotics
Research emerging on potential health benefits of multiple probiotic strains
as a health supplement as opposed to a single strain.
1. Multibionta
Lactobacillus gasseri PA16/8, Bifidobacterium bifidum MF20/5,
Bifidobacterium longum SP07/3
2. Acidophilus Pearls
Lactobacillus acidophilus, Bifidobacterium longum
3. Kyo-Dophilus
Lactobacillus acidophilus, Bifidobacterium bifidum, Bifidobacterium
longum
4. Symprove live activated probiotic
Lactobacillus plantarum, Lactobacillus acidophilus, Lactobacillus Casei,
var. Rhamnosus, Enterococcus faecium, all in active state not freeze-dried
Side Effects of Probiotics
• Rare cases cause bloating, diarrhea, abdominal pain.
• If in excess cause infection that require medical
attentions.
• People having on underlying disease or
compromised immune system cause potential health
problems like skin rash, fever, bloody stools etc.
• Sometimes interact with immunosuppressive drugs
leading to life threating conditions. So people taking
such drugs should avoid it.
Prebiotics
• A prebiotic is a non-digestible component
which beneficially affects the host by
selectively stimulating the growth and/or
activity of one or a limited number of colonic
bacteria, thereby improving the health of the
host .
• Examples : inulin, garlic, onions, chicory root,
Asparagus, whole wheat, rye, barley
Some examples of Prebiotics
Characteristics of Prebiotics
• Should not be hydrolyzed or absorbed in the upper
part of G.I tract.
• Should be a selective substrate for one or a limited
number of potentially bacterial commercial to the
colon culture protagonist.
• Should be able to alter the colonic micro flora
towards a healthier composition or selectively
stimulates the growth and or activity of intestinal
bacteria associated with health and well being.
• Should help increase the absorption of certain
minerals such as calcium and magnesium.
• Favorable effect on the immune system and provide
improved resistance against infection.
Synbiotics
• PROBIOTICS + PREBIOTICS
• Foods containing the combination of probiotics and
prebiotics are referred to as symbiotic.
• Improved survival in upper GIT and more efficient
implantation.
Conclusions
• Probiotic bacteria confer health benefits by
bolstering protective, structural and metabolic
functions in the human body.
• Not all probiotics are equal.
• Disconnect between scientific evidence and
allowable claims.
• Claims should be substantiated with well-
controlled clinical studies.
• Products should be characterized for content
and stability.
Institutes engaged in Probiotic research in
India
• Central Food Technology And Research Institute,
Mysore, India
• National dairy research institute, Karnal,
Haryana, India
• Institute of microbial technology, Chandigarh, India
• National dairy development board, Anand, Gujarat,
India
A habit
that can really benefits
our overall health-
“TAKING PROBIOTICS”
References
• Agrawal, R. (2005). Probiotics: an Emerging Food Supplement with Health
Benefits. Food Biotechnology,
• 19, 227-246.
• Arvanitoyannis, I. S. & Van Houwelingen-Koukaliaroglou, M. (2005).
Functional Foods: A Survey Of
• Health Claims, Pros and Cons, and Current Legislation. Critical Reviews in
Food Science and Nutrition,
• (45), 385-404.
• Dannon. (2007). A lowfat yogurt that helps naturally regulate the digestive
system. Retrieved June 26,
• 2007, from http://www.activia.com/pdf/Act_scientific_summary.pdf?v1
• Dempster’s. (2007). Introducing fibre with a difference, a prebiotic
difference.
• FAO/WHO Working Group. (2002). Guidelines for the Evaluation of
Probiotics in Food. Retrieved May
• 30, 2007, from ftp://ftp.fao.org/es/esn/food/wgreport2.pdf.
Probiotic foods

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Probiotic foods

  • 1. PROBIOTIC FOOD AND THEIR FUNCTIONAL ROLE BY Pintu choudhary Master of Technology ( Food Science and Technology) Indian Institute of Crop Processing Technology Ministry of Food Processing Industries Government of India Thanjavur - 613005
  • 2. Contents • Definition • History • Characteristics • Mechanism of action • Advantages • Functions • Probiotic foods • Multi probiotics • Side effect of probiotics • Prebiotics • Characteristics of probiotics, • Prebiotic foods • Symbiotic
  • 3. Definitions •World Health Organization: “live microorganism which, when administrated adequate amounts, confer health benefits on hosts” •A bacterial strain that • Survive stomach acid and bile • Adhere in intestinal lining • Grows and establishes temporary residence in intestine • Impart health benefits
  • 4. Louis Pasteur (1822 - 1895) Potential benefits of Lactobacillus 125 yrs. ago 1905: Concept of Probiotics Metchikoff Elie 1848-1926
  • 5. History • At the start of the 20th century, Russian noble prize winner and father of modern immunology, Elie Metchnikoff, a scientist at the Pasteur institute, was the first conceptualize “probiotics”. • In 1907 Metchnikoff proposed that the acid producing bacteria in fermented milk products could prevent “fouling” in the large intestine and if consumed regularly, lead to a longer, healthier life • In early 1930’s, in Japan, Minoru shirota developed a fermented milk product called Yakult (probiotic yogurt like product made by fermenting a mixture of skimmed milk with a special strain of Lactobacillus casei shirota). • Probiotic term coined in 1965 by Lilly and Stillwell.
  • 6. Characteristics of Effective Probiotics • Able to survive the passage through the digestive system. • Able to attach to the intestinal epithelia and colonize. • Able to maintain good viability. • Able to utilize the nutrients and substrates in a normal diet. • non pathogenic and non toxic. • Capable of exerting a beneficial effect on the host. • Stability of desired characteristics during processing, storage and transportation. • Anti-inflammatory,antimutagenic,immunostimulatory.
  • 7. Advantages • Produce lactic acid- lowers the pH of intestines and inhibiting bacterial villains such as Clostridium, Salmonella,Shigella, E. coli, etc. • Decreases the production of a variety of toxic or carcinogenic metabolites. • Aid absorption of minerals, especially calcium, due to increased intestinal acidity. • Production of β-D galactosidase enzymes that break down lactose.
  • 8. • Produce a wide range of antimicrobial substances acidophilin and bacitracin etc. help to control pathogenic bacteria . • Produce vitamins (especially Vitamin B and vitamin k • Act as barriers to prevent harmful bacteria from colonizing the intestines Cont.
  • 9. Mechanism of Action of Probiotics Inhibit Potentially Pathogenic Microorganisms (PPMs) • Reduction in Intestinal pH • Production of bacteriocins • Competitive blocking of adhesion sites • Competition for nutrients
  • 10. Mechanism of Action of Probiotic
  • 11. Probiotics (Friendly Bacteria) Normalise Intestine Immunomodulation Metabolic effects Energy prevention and recovery Treatment of peptic ulcer Diarrhea Blood pressure regulation Regularity Reduction of infection Lactose digestion Immune function Lowers cholesterol (Bile acid de conjugation &Secretion)
  • 12. Allergy Prevention and Recovery • Experimental evidence indicates that probiotics are effective in treating atopic eczema in infants. • It has also been shown that the incidence of allergies in infants with a high risk of allergy can be halved with the consumption of certain probiotics by their mothers when pregnant and by the infant after birth. • It is thought that consumption of probiotics helps to form a normally functioning immune system, preventing allergies(Ouwehand, 2007).
  • 13. Treatment of Peptic Ulcers • Helicobacter pylori is a pathogenic bacteria that causes peptic ulcers and other gastric problems. H. pylori is normally treated with antibiotics. This treatment is expensive and has negative side effects. • The consumption of probiotics with antibiotics is thought to be the most effective and safest treatment. (Lesbros- Pantoflickova,Corthésy-Theulaz& Blum, 2007).
  • 14. Diarrhea • Evidence indicates that probiotic bacteria in foods can help prevent and treat diarrhea in children. Rotavirus infections are a common cause of diarrhea in children. In clinical trials, infected children who consumed probiotic fermented milk had lower rates of diarrhea (Agrawal, 2005) . • Probiotic treatments have also been used to effectively treat antibiotic associated diarrhea (Agrawal, 2005)
  • 15. Blood Pressure Regulation • Milk is fermented by bacteria and the protein in the milk is hydrolyzed into smaller peptides. The peptides are absorbed in the small intestine. Consumption of these peptides in milk and yogurt have been shown in clinical studies to lower blood pressure in some individuals (Jauhiainen & Korpela,2007).
  • 16. Regularity • The consumption of probiotics reduces the transit time for the movement of wastes through the intestines. This results in reduced constipation and may help prevent colon cancer (Dannon,2007). • Prebiotics also decrease transit time through the intestines because they are a form of fiber ( Dempsters,2007).
  • 17. Reduction of Infection • Probiotics and prebiotics have been shown to reduce infections in sick and postoperative patients. Because the use of antibiotics reduces the population of intestinal bacteria, using probiotics and prebiotics to repopulate the digestive tract, ensures the presence of a healthy n of good bacteria to prevent infection (Agrawal, 2005)
  • 18. Lactose Digestion • Individuals with lactose intolerance are missing important digestive enzyme, lactase. Probiotic bacteria make the lactase enzyme and consumption of these bacteria can help lactose digestion (Stanton,Gardiner,Meehan,Collins, Fitzgerald, Lynch, & Ross, 2001) Immune Function • Consumption of probiotics can enhance natural immune functions (Agrawal, 2005).
  • 19. Lowering cholesterol A range of LAB able to break down bile in the gut, thus inhibiting its reabsorption (which enters the blood as cholesterol)
  • 20. Probiotic strains Lactobacillus species: • L. acidophilus • L. plantarum • L. casei subspecies rhamnosus • L. brevis • L. delbreuckii subspecies bulgaricus
  • 21. Bifidobacterium species • B. adolescentis • B. bifidum • B. longum • B. infantis • B. breve
  • 22. Other Species of Probiotic • Streptococcus salivarius ssp. thermophilus • Lactococcus lactis ssp. lactis • Lactococcus lactis s ssp. cremoris • Enterococcus faecium • Leuconostoc mesenteroides ssp. dextranicum • Propionibacterium freudenreichii • Pediococcus acidilactici • Saccharomyces boulardii
  • 23. Example of Probiotic Foods Yogurt • Usually made from milk (rarely, from cream) inoculated with Streptococcus thermophilus and either Lactobacillus acidophilus or Lactobacillus bulgaricus. • Turkish in origin • Available in innumerable forms and flavors 1. Low fat chocolate yogurt 2. Drinkable fruit-flavored goat yogurt 3. Neon-colored yogurt in squeeze tubes
  • 24. Frozen Yogurt Laloo’s Goat’s Milk Frozen Yogurt, naturally chock-full of S. Bulgaricus, L. Acidophilus and Bifidus. Juice • First probiotic juice launched in the fall of 2007 by Next Foods. • Goodbelly, organic fruit juice-based probiotic beverage , contains L.Plantarum 299v, has effects on irritable bowel syndrome • Three initial flavors include Brilliant Blueberry, Peach Mango and Strawberry Rosehip
  • 25. Attune Foods : Chocolate & Granola bars • Attune makes Wellness Bars in three chocolate varieties and three yogurt and granola varieties. • All products contain “more than 5 times the live active cultures in yogurt, with less sugar. Kashi Vive Probiotic Digestive Wellness Cereal Vive contains one billion CFUs of Lactobacillus acidophilus per serving.
  • 26. Yakult Dairy Drink • Probiotic, cultured dairy beverage • Has citrus flavor • Sold in single-shot containers that contain around 8 billion live and active Lactobacillus casei shirota cells per bottle
  • 27. Frozen Yogurt LaLoo’s Goat’s Milk Frozen Yogurt, naturally chock-full of S. Thermophilus, L. Bulgaricus, L. Acidophilus and Bifidus. Juice • First probiotic juice launched in the fall of 2007 by Next Foods. • Goodbelly, organic fruit juice-based probiotic beverage , contains L.Plantarum 299v, has effects on irritable bowel syndrome • Three initial flavors include Brilliant Blueberry, Peach Mango and Strawberry Rosehip
  • 28. Ricera Rice Yogurt An organic, non-dairy, rice “yogurt” with whole grains and live, active cultures, including Lactobacillus bulgaricus, Streptococcus thermophilus, Lactobacillus acidophilus and Bifidobacterium bifidum.
  • 29. Multi-Probiotics Research emerging on potential health benefits of multiple probiotic strains as a health supplement as opposed to a single strain. 1. Multibionta Lactobacillus gasseri PA16/8, Bifidobacterium bifidum MF20/5, Bifidobacterium longum SP07/3 2. Acidophilus Pearls Lactobacillus acidophilus, Bifidobacterium longum 3. Kyo-Dophilus Lactobacillus acidophilus, Bifidobacterium bifidum, Bifidobacterium longum 4. Symprove live activated probiotic Lactobacillus plantarum, Lactobacillus acidophilus, Lactobacillus Casei, var. Rhamnosus, Enterococcus faecium, all in active state not freeze-dried
  • 30. Side Effects of Probiotics • Rare cases cause bloating, diarrhea, abdominal pain. • If in excess cause infection that require medical attentions. • People having on underlying disease or compromised immune system cause potential health problems like skin rash, fever, bloody stools etc. • Sometimes interact with immunosuppressive drugs leading to life threating conditions. So people taking such drugs should avoid it.
  • 31. Prebiotics • A prebiotic is a non-digestible component which beneficially affects the host by selectively stimulating the growth and/or activity of one or a limited number of colonic bacteria, thereby improving the health of the host . • Examples : inulin, garlic, onions, chicory root, Asparagus, whole wheat, rye, barley
  • 32. Some examples of Prebiotics
  • 33. Characteristics of Prebiotics • Should not be hydrolyzed or absorbed in the upper part of G.I tract. • Should be a selective substrate for one or a limited number of potentially bacterial commercial to the colon culture protagonist. • Should be able to alter the colonic micro flora towards a healthier composition or selectively stimulates the growth and or activity of intestinal bacteria associated with health and well being. • Should help increase the absorption of certain minerals such as calcium and magnesium. • Favorable effect on the immune system and provide improved resistance against infection.
  • 34. Synbiotics • PROBIOTICS + PREBIOTICS • Foods containing the combination of probiotics and prebiotics are referred to as symbiotic. • Improved survival in upper GIT and more efficient implantation.
  • 35. Conclusions • Probiotic bacteria confer health benefits by bolstering protective, structural and metabolic functions in the human body. • Not all probiotics are equal. • Disconnect between scientific evidence and allowable claims. • Claims should be substantiated with well- controlled clinical studies. • Products should be characterized for content and stability.
  • 36. Institutes engaged in Probiotic research in India • Central Food Technology And Research Institute, Mysore, India • National dairy research institute, Karnal, Haryana, India • Institute of microbial technology, Chandigarh, India • National dairy development board, Anand, Gujarat, India
  • 37. A habit that can really benefits our overall health- “TAKING PROBIOTICS”
  • 38. References • Agrawal, R. (2005). Probiotics: an Emerging Food Supplement with Health Benefits. Food Biotechnology, • 19, 227-246. • Arvanitoyannis, I. S. & Van Houwelingen-Koukaliaroglou, M. (2005). Functional Foods: A Survey Of • Health Claims, Pros and Cons, and Current Legislation. Critical Reviews in Food Science and Nutrition, • (45), 385-404. • Dannon. (2007). A lowfat yogurt that helps naturally regulate the digestive system. Retrieved June 26, • 2007, from http://www.activia.com/pdf/Act_scientific_summary.pdf?v1 • Dempster’s. (2007). Introducing fibre with a difference, a prebiotic difference. • FAO/WHO Working Group. (2002). Guidelines for the Evaluation of Probiotics in Food. Retrieved May • 30, 2007, from ftp://ftp.fao.org/es/esn/food/wgreport2.pdf.

Editor's Notes

  1. In conclusion, the intestinal flora may impact health through a number of protective, structural, and metabolic functions. Although these mechanisms have not been fully characterized, probiotic bacteria are believed to confer health benefits by bolstering these effects. However, it is essential to understand that not all probiotics are created equal, as the benefits of these agents are both strain-specific and dose-specific. Although the range of probiotic products is expanding, making clinical recommendations can be complicated by misinformation as well as the frequent disconnect between scientific evidence and allowable claims on these products. Consumers and health care professionals choosing probiotics should ensure that the health claim(s) regarding the product are substantiated with well-controlled studies and that the product has been adequately characterized for content and stability.