Prebiotics and Probiotics

Sue Hubbard, M.D.

Marketing Claims Don't Match Research Findings So Far

There's has been a lot of discussion lately (in both medical and lay literature) surrounding the use of prebiotics and probiotics. The first question patients and parents often ask is, what's the difference between the two?

Prebiotics are non-digestible nutrients found in foods such as legumes, fruits and whole grains. They're also found in breast milk. Prebiotics have also been called "fermentable fiber." Once ingested, prebiotics may be used as an energy source for the good bacteria that live in the intestines.

Probiotics are beneficial live bacteria that you actually ingest. These bacteria then pass from the stomach into the intestine to promote "gut health." There are currently hundreds of different probiotics being marketed.

The research on the value of using prebiotics and probiotics has been ongoing, but there are actually very few randomized, double blind, controlled studies to document that pre- and probiotics provide any true benefit to treat many of the diseases they're marketed to treat.

There are several areas where probiotics have been shown to be beneficial. By beginning probiotics early in the course of a viral "tummy infection" in children, the length of diarrhea may be reduced by one day. Probiotics have also been shown to be moderately effective in helping prevent antibiotic associated diarrhea, but not for treatment of that diarrhea.

There are also studies that are looking at giving very low birth weight premies probiotics to help prevent a serious intestinal infection called necrotizing enterocolitis. To date, there seems to be evidence to support this and there are currently more ongoing studies.

Studies are also being done to look at the use of probiotics as an adjunct to the treatment of irritable bowel syndrome, infantile colic, and chronic ulcerative colitis as well as to possibly prevent eczema. While preliminary results are "encouraging," there's not enough evidence to date to support their widespread use.

Prebiotics and probiotics are now often found in dietary supplements, as well as in yogurts, drink mixes and meal replacement bars. It's important to read the label to see if these products are making claims that are not proven, such as, "protects from common colds" or "good bacteria helps heal body." Many of the statements seem too good to be true!

Until further studies are done, there's no evidence that these products will harm otherwise healthy children, but at the same time there's not a lot of data to recommend them. They should never be used in children who are immuno-compromised, or who have indwelling catheters, as they may cause infection.

Dr. Sue Hubbard is a nationally known pediatrician and co-host of "The Kid's Doctor" radio show.

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