Health benefits of probiotics: are mixtures more effective than single strains?
- 2.8k Downloads
Most studies on probiotics utilise single strains, sometimes incorporated into yoghurts. There are fewer studies on efficacy of mixtures of probiotic strains. This review examines the evidence that (a) probiotic mixtures are beneficial for a range of health-related outcomes and (b) mixtures are more or less effective than their component strains administered separately.
Mixtures of probiotics had beneficial effects on the end points including irritable bowel syndrome and gut function, diarrhoea, atopic disease, immune function and respiratory tract infections, gut microbiota modulation, inflammatory bowel disease and treatment of Helicobacter pylori infection. However, only 16 studies compared the effect of a mixture with that of its component strains separately, although in 12 cases (75%), the mixture was more effective.
Probiotic mixtures appear to be effective against a wide range of end points. Based on a limited number of studies, multi-strain probiotics appear to show greater efficacy than single strains, including strains that are components of the mixtures themselves. However, whether this is due to synergistic interactions between strains or a consequence of the higher probiotic dose used in some studies is at present unclear.
KeywordsMulti-strain probiotics Health benefits Synergy Probiotic efficacy
This work forms part of a PhD project funded by Probiotics International, Somerset, UK.
- 1.Joint FAO/WHO Expert Consultation on Evaluation of Health and Nutritional Properties of Probiotics in Food Including Powder Milk with Live Lactic Acid Bacteria (2001) Health and nutritional properties of probiotics in food including powder milk with live lactic acid bacteria. Food and Agriculture Organization of the United Nations, World Health OrganizationGoogle Scholar
- 3.Rowland IR, Capurso L, Collins K, Cummings J, Delzenne N, Goulet O, Guarner F, Marteau P, Meier R (2010) Consensus on probiotic science. Gut Microbes 1 (in press)Google Scholar
- 6.Paubert-Braquet M, Xiao-Hu G, Gaudichon C, Hedef N, Serikoff A, Bouley C, Braquet BBP (1995) Enhancement of the host resistance against Salmonella Typhimurium in mice fed a diet of supplemented yogurt or milks fermented with various Lactobacillus Caseu strains. Int J Immunother 11(4):153–161Google Scholar
- 8.Haller D, Antoine JM, Bengmark S, Enck P, Rijkers GT, Lenoir-Wijnkoop I (2010) Guidance for substantiating the evidence for beneficial effects of probiotics: probiotics in chronic inflammatory bowel disease and the functional disorder irritable bowel syndrome. J Nutr 140(3):690S–697SCrossRefGoogle Scholar
- 15.Kajander K, Myllyluoma E, Rajilic-Stojanovic M, Kyronpalo S, Rasmussen M, Jarvenpaa S, Zoetendal EG, de Vos WM, Vapaatalo H, Korpela R (2008) Clinical trial: multispecies probiotic supplementation alleviates the symptoms of irritable bowel syndrome and stabilizes intestinal microbiota. Aliment Pharmacol Ther 27(1):48–57CrossRefGoogle Scholar
- 18.Olivares M, Diaz-Ropero MA, Gomez N, Lara-Villoslada F, Sierra S, Maldonado JA, Martin R, Lopez-Huertas E, Rodriguez JM, Xaus J (2006) Oral administration of two probiotic strains, Lactobacillus gasseri CECT5714 and Lactobacillus coryniformis CECT5711, enhances the intestinal function of healthy adults. Int J Food Microbiol 107(2):104–111CrossRefGoogle Scholar
- 22.Venturi A, Gionchetti P, Rizzello F, Johansson R, Zucconi E, Brigidi P, Matteuzzi D, Campieri M (1999) Impact on the composition of the faecal flora by a new probiotic preparation: preliminary data on maintenance treatment of patients with ulcerative colitis. Aliment Pharmacol Ther 13(8):1103–1108CrossRefGoogle Scholar
- 23.Cui HH, Chen CL, Wang JD, Yang YJ, Cun Y, Wu JB, Liu YH, Dan HL, Jian YT, Chen XQ (2004) Effects of probiotic on intestinal mucosa of patients with ulcerative colitis. World J Gastroenterol 10(10):1521–1525Google Scholar
- 24.Sandborn WJ (1994) Pouchitis following ileal pouch-anal anastomosis: definition, pathogenesis, and treatment. Gastroenterology 107(6):1856–1860Google Scholar
- 31.Cremonini F, Di Caro S, Covino M, Armuzzi A, Gabrielli M, Santarelli L, Nista EC, Cammarota G, Gasbarrini G, Gasbarrini A (2002) Effect of different probiotic preparations on anti-helicobacter pylori therapy-related side effects: a parallel group, triple blind, placebo-controlled study. Am J Gastroenterol 97(11):2744–2749CrossRefGoogle Scholar
- 32.Myllyluoma E, Veijola L, Ahlroos T, Tynkkynen S, Kankuri E, Vapaatalo H, Rautelin H, Korpela R (2005) Probiotic supplementation improves tolerance to Helicobacter pylori eradication therapy—a placebo-controlled, double-blind randomized pilot study. Aliment Pharmacol Ther 21(10):1263–1272CrossRefGoogle Scholar
- 33.Finegold SM (1970) Interaction of antimicrobial therapy and intestinal flora. Am J Clin Nutr 23(11):1466–1471Google Scholar
- 42.Samadi AR, Islam R, Huq MI (1983) Replacement of intravenous therapy by oral rehydration solution in a large treatment centre for diarrhoea with dehydration. Bull World Health Organ 61(3):471–476Google Scholar
- 44.Barone C, Pettinato R, Avola E, Alberti A, Greco D, Failla P, Romano C (2000) Comparison of three probiotics in the treatment of acute diarrhoea in mentally retarded children. Minerva Pediatr 52(3):161–165Google Scholar
- 49.Gotz V, Romankiewicz JA, Moss J, Murray HW (1979) Prophylaxis against ampicillin-associated diarrhoea with a lactobacillus preparation. Am J Hosp Pharm 36(6):754–757Google Scholar
- 51.Plummer S, Weaver MA, Harris JC, Dee P, Hunter J (2004) Clostridium difficile pilot study: effects of probiotic supplementation on the incidence of C. difficile diarrhoea. Int Microbiol 7(1):59–62Google Scholar
- 52.de Vrese M, Winkler P, Rautenberg P, Harder T, Noah C, Laue C, Ott S, Hampe J, Schreiber S, Heller K, Schrezenmeir J (2006) Probiotic bacteria reduced duration and severity but not the incidence of common cold episodes in a double blind, randomized, controlled trial. Vaccine 24(44–46):6670–6674Google Scholar
- 53.Winkler P, de Vrese M, Laue C, Schrezenmeir J (2005) Effect of a dietary supplement containing probiotic bacteria plus vitamins and minerals on common cold infections and cellular immune parameters. Int J Clin Pharmacol Ther 43(7):318–326Google Scholar
- 54.Olivares M, Diaz-Ropero MP, Gomez N, Lara-Villoslada F, Sierra S, Maldonado JA, Martin R, Rodriguez JM, Xaus J (2006) The consumption of two new probiotic strains, Lactobacillus gasseri CECT 5714 and Lactobacillus coryniformis CECT 5711, boosts the immune system of healthy humans. Int Microbiol 9(1):47–52Google Scholar
- 55.Gluck U, Gebbers JO (2003) Ingested probiotics reduce nasal colonization with pathogenic bacteria (Staphylococcus aureus, Streptococcus pneumoniae, and beta-hemolytic streptococci). Am J Clin Nutr 77(2):517–520Google Scholar
- 60.Collado MC, Jalonen L, Meriluoto J, Salminen S (2006) Protection mechanism of probiotic combination against human pathogens: in vitro adhesion to human intestinal mucus. Asia Pac J Clin Nutr 15(4):570–575Google Scholar
- 62.Roselli M, Finamore A, Britti MS, Mengheri E (2006) Probiotic bacteria Bifidobacterium animalis MB5 and Lactobacillus rhamnosus GG protect intestinal Caco-2 cells from the inflammation-associated response induced by enterotoxigenic Escherichia coli K88. Br J Nutr 95(6):1177–1184CrossRefGoogle Scholar
- 65.Apella MC, Gonzalez SN, Nader de Macias ME, Romero N, Oliver G (1992) In vitro studies on the growth of Shigella sonnei by Lactobacillus casei and Lact. acidophilus. J Appl Bacteriol 73(6):480–483Google Scholar
- 67.Ridwan BU, Koning CJ, Besselink MG, Timmerman HM, Brouwer EC, Verhoef J, Gooszen HG, Akkermans LM (2008) Antimicrobial activity of a multispecies probiotic (Ecologic 641) against pathogens isolated from infected pancreatic necrosis. Lett Appl Microbiol 46(1):61–67Google Scholar