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If probiotics really are useless, is it time to give up on 'good bacteria'?

The Telegraph logo The Telegraph 10/09/2018 Luke Mintz

It's routine practice in France for anyone on an antibiotic to be given probiotics © Getty It's routine practice in France for anyone on an antibiotic to be given probiotics Twenty years ago, few people in Britain had heard of probiotics. Known as “good bacteria”, they are said to restore the bacterial balance in your gut to healthy levels, and have exploded in popularity in the last two decades. Their rise is fuelled by shiny, commercial brands like Yakult, which claims to pack 6.5 billion “good” bacteria into a simple, pocket-sized drink.

As with most fashionable health trends, however, scientists are sceptical. Last week, researchers at the Weizmann Institute of Science became the latest to question the benefits of probiotics, labelling them “quite useless” after testing a home-made probiotic cocktail on 25 healthy volunteers.

In one of the most detailed studies of probiotics to date, the volunteers were asked to take a special cocktail of 11 common strains of good bacteria. After examining stomach samples from each volunteer, the Israeli researchers found that, in half of the cases, the good bacteria had simply passed in one end and out of the other. In the other half, the bacteria lingered briefly before being crowded by out by existing microbes.

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The study will delight the sceptics who have spent years arguing that probiotics are nothing more than a fad. But Professor Tim Spector, who researches Genetic Epidemiology at King’s College, London, is more cautious, and thinks we shouldn’t chuck away our probiotic supplements just yet.

Kefir mil © Provided by Shutterstock Kefir mil Unlike much of the rest of Europe, he says, medics in Britain have always given short shrift to the importance of good bacteria. Whereas a doctor in France will quickly prescribe probiotics to a patient who complains of a cold, most British doctors will hold back.

“It's routine practice in France for anyone on an antibiotic to be given probiotics,” he says. “It's routine practice in Poland for anyone on antibiotics to be given kefir [a cultured, fermented milk drink]. Our doctors would laugh if you said you were going to do that. The UK particularly has no culture of fermented foods. Nobody really understands it, and they’re not trained in it.”

Related: 20 Best Foods for a Healthy Gut (Eat This, Not That!)

In this instance, Prof Spector thinks our scepticism could be misplaced. All the Israeli research does is suggest that our traditional way of thinking about probiotics is flawed, he says. We used to imagine that probiotics “took over” the existing microbes in our gut, allowing the effects to last for much longer than the food is in our system for. Now that theory is totally dead, he says. We now know that you must carry on taking the probiotics if you want to keep the bacteria in your system.

But as long as you keep taking them, he argues, probiotics can work wonders.

“There is plenty of evidence to say that if you're ill, if you have a minor illness [and you take probiotics] you will improve. These include travellers' diarrhea and irritable bowel syndrome, and there's evidence for depression. There's evidence for all kinds of childhood problems, and some food allergies.”

He says studies have pointed to as many as 18 medical conditions that probiotics can alleviate.

He recommends taking “real foods” with natural bacteria, rather than artificial supplements, because they contain a much larger range of bacteria. They include non-frozen cheeses (particularly raw-milk cheeses), natural yoghurts, and kefir.

'There is plenty of evidence to say that if you're ill, if you have a minor illness [and you take probiotics] you will improve.' © Provided by Shutterstock 'There is plenty of evidence to say that if you're ill, if you have a minor illness [and you take probiotics] you will improve.' Jeannette Hyde, a nutritional therapist and author, also believes that natural fermented foods are much better than artificial probiotic supplements.

She says she recently saw one client who had been taking a “very expensive” probiotic pill for nearly three years. When she examined her client’s stool sample, however, she found almost no trace of the good bacteria promised on the label.

But she says it would be wrong to abandon our quest for good bacteria just because a few supplements have been shown not to work. When consumed through real foods, natural bacteria can help, she says, and the results of this week's Israeli study do not change that.

“Just because a special cocktail [scientists] made didn't work, it doesn’t mean that if you've had some really smelly cheese that's been fermented for two years, and the French have been eating for centuries, that it doesn't work. [The study] was so completely abstract from the real world.”

She recommends a varied diet that is high in fibre for those concerned with keeping a healthy gut.

Whatever the research shows, it seems likely that probiotics will only grow in popularity in the coming years. Prof Spector believes British doctors will soon “catch up” with their continental counterparts, and begin to recommend probiotics after a course of antibiotics.

“At the moment, it's still not considered particularly mainstream, despite the evidence,” he says. “But it will happen, and I think it will be driven by the public.”

Watch: 5 Things You Didn't Know About Probiotics (Newsweek)

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