Published in Therapeutic Advances in Gastroenterology, the human trial review showed that PFM, which contained the bacterial strain Bifidobacterium lactis CNCM I-2494 along with four strains of lactic acid bacteria, was associated with beneficial effects on gut function, immunity and metabolic regulation.
It has also been shown that PFM consumption can influence the gut–brain axis by controlling the brain activity as well as the gut microbiome composition in healthy people.
Functional foods favoured
Here, the review took into account three randomised controlled trials consisting of 598 participants that compared PFM with a control dairy product for at least 4 weeks.
The PFM had to contain B. lactis CNCM-I2494 and four specific species of lactic acid bacteria (Lactobacillus bulgaricus strains CNCM I-1632 and CNCM I-1519, Streptococcus thermophilus strain CNCM I-1630, and Lactococcus lactis ssp. lactis strain CNCM I-1631).
Eligible study participants had to be aged 18 and over and recruited from the general population. The participants all exhibited signs of gastrointestinal discomfort at the start of the study.
The team found consuming PFM was associated with a significant improvement in overall gastrointestinal comfort compared with the control product, having been assigned a number needed to treat (NNT) of 10.24.
PFM was also superior to the control in reducing digestive symptoms, as measured using a composite score.
“Probiotics have a modulatory effect on the gut microbiota and therefore should not be expected to have the rapid and dramatic effects that are observed with pharmaceutical agents,” the study team commented.
“The addition of a probiotic food to the daily regimen of healthy adults experiencing mild gastrointestinal discomfort is readily achieved and, based on the findings reported here, is likely to actually offer them significant benefit.”
What is an NNT?
The number needed to treat (NNT) is a measure used to describe the effectiveness of a health-care therapy. Typically this treatment applies to pharmaceutical medication.
More specifically, the NNT value is the number of patients that need to be treated in order for one to benefit compared with a study’s control.
As a comparison, the NNT value of rifaximin used to treat irritable bowel syndrome (IBS) is 10.2.
NNT values for probiotics in IBS have ranged from 7–8 and around eight for antibiotic-associated diarrhoea.
Minimal side effects
The findings point to PFM as an effective approach in resolving mild gastrointestinal symptoms.
Individuals with gastrointestinal discomfort often follow restrictive diets (e.g. a gluten free diet or low FODMAP diet) in order to minimise symptoms.
However, in contrast with probiotics, these diets may have detrimental effects on nutritional status and may also negatively change gut microbiota make up.
“Importantly, this study also demonstrates that this PFM is not likely to cause an exacerbation of symptoms,” the study added. “The safety profile is such that the probiotic approach is a reasonable one, without the necessity for medical advice.”
In 2015 the European Food Safety Agency (EFSA) issued updated guidance on health claims that considered reduced gastrointestinal discomfort was a potentially beneficial physiological effect and could be the basis of a probiotic or prebiotic health claim. But no application among 300+ submitted for prebiotics and probiotics has yet won a positive opinion from EFSA's 20-strong NDA health claim assessment panel since it issued its first opinion in 2008.
Source: Therapeutic Advances in Gastroenterology
Published online ahead of print: DOI: 10.1177/1756283X16670075
“Systematic review and meta-analysis: the effects of fermented milk with Bifidobacterium lactis CNCM I-2494 and lactic acid bacteria on gastrointestinal discomfort in the general adult population.”
Authors: Julie Glanville et al
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