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Probiotics

Lactobacillus reuteri featured article

Introduction

Lactobacillus reuteri is a bacterium found in the digestive tracts of mammals, including humans, and in fermented foods. It is a member of the genus Lactobacillus, which comprises most of the bacteria that live on and in the human body. Lactic acid-producing bacteria, such as those in the Lactobacillus genus, are commonly used in probiotic supplements. Furthermore, some online resources provide step-by-step instructions for at-home bulk production of yogurt with L. reuteri enrichment. (see also: 1, 2, 3).

**L. reuteri has recently gained popularity due to emerging evidence (of varying quality) that suggests supplemental L. reuteri may...

Episodes

Posted on February 21st 2022 (over 3 years)

In this clip, Dr. Eran Elinav discusses the intestinal barrier's important role in absorbing nutrients while keeping out pathogens.

Posted on February 5th 2022 (over 3 years)

Dr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.

Posted on June 5th 2021 (about 4 years)

Dr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.

Topic Pages

  • Depression

    Probiotics are hypothesized to attenuate depressive symptoms by modulating gut microbiota metabolites, dampening systemic inflammation, and altering CNS neurotransmission.

  • Lactobacillus reuteri

    Lactobacillus reuteri is a probiotic bacterium that produces reuterin, adheres to epithelium, and modulates Toll-like receptor–mediated immunity.

News & Publications

  • Mild cognitive impairment is often a precursor to Alzheimer’s disease, marking the initial stages of cognitive decline that precede more severe dementia. Evidence suggests lifestyle factors mediate the progression of mild cognitive impairment. A recent study found that intensive lifestyle modification improves cognitive and functional performance and slows disease progression in older adults with mild cognitive impairment.

    Researchers conducted a randomized controlled trial involving 49 participants aged 45-90 with mild cognitive impairment or early dementia due to Alzheimer’s disease. Half of the participants received the usual care, while the other half received a 20-week intensive lifestyle intervention. The researchers assessed the participants' cognitive and functional performance and measured plasma biomarkers associated with Alzheimer’s before and after the intervention.

    They found that participants in the intervention group showed considerable improvements in cognition and function compared to the control group. In addition, Aβ42/40 ratios increased in the intervention group but decreased in the control group.

    The Aβ42/40 ratio is a measure of the relative levels of two forms of amyloid-beta protein (Aβ42 and Aβ40) in the blood or cerebrospinal fluid. It is a biomarker used to assess the presence and progression of Alzheimer’s disease. Lower ratios typically indicate higher levels of brain amyloid-beta plaques, a hallmark of the disease. An increase in the Aβ42/40 ratio, as observed in the intervention group, suggests a potential reversal or slowing of amyloid-beta plaque accumulation, indicating an improvement in disease pathology.

    These findings suggest that intensive lifestyle modification has profound effects on Alzheimer’s disease progression in older adults with mild cognitive impairment. FoundMyFitness has a wealth of information about the various components used in this intensive protocol, which included:

  • The gut microbiome is crucial for maintaining normal brain processes, and disruptions in gut health can impair cognitive function. Sleep deprivation also impairs cognitive function, but some evidence suggests that probiotics mitigate these effects. A recent study in mice found that probiotics alleviated sleep-deprivation-induced cognitive impairments.

    Researchers fed sleep-deprived mice a probiotic containing Bifidobacterium breve and subjected them to memory and behavioral tests. They also analyzed changes in the animals' gut microbial composition and the presence of crucial microbial metabolites in the gut and serum.

    They found that Bifidobacterium breve improved the sleep-deprived animals' performance in the novel object recognition test – an assessment of recognition memory. The probiotic also altered their gut microbial composition toward a more favorable profile and increased levels of isovaleric acid and gamma-aminobutyric acid (also known as GABA), metabolites involved in melatonin production and circadian rhythm regulation, respectively.

    Bifidobacterium breve is a probiotic bacterium commonly found in the human gut, with particularly large numbers found in young, breastfed infants. It is known for its beneficial effects on digestive health and immune function, and it has been studied for its potential to alleviate various conditions, including gut disorders and Alzheimer’s disease

    These findings suggest that Bifidobacterium breve mitigates sleep-deprivation-induced cognitive impairments and circadian rhythm disturbances in mice. They also highlight a potential role for gut microbial manipulation in treating insomnia and other sleep disorders. Learn more about the relationship between the gut microbiome and sleep in this clip featuring Dr. Matt Walker.

  • Probiotics attenuate inflammation-associated sickness behaviors.

    The gut-brain axis, a bidirectional signaling pathway between the gastrointestinal tract and the nervous system, plays critical roles in human health. Key elements of this pathway are the tens of trillions of microbes that comprise the intestinal microbiota. Findings from a 2015 study suggest that probiotics attenuate inflammation-associated sickness behaviors.

    Probiotics are typically defined as live microorganisms that, when consumed in sufficient amounts, confer a health benefit on the consumer. They contain a variety of microorganisms, but Lactobacillus and Bifidobacterium bacteria are among the most common. Probiotics can be found in yogurt, kefir, kimchi, and other fermented foods and are widely available as dietary supplements.

    Sickness behaviors are adaptive behavioral changes that occur during infection or chronic inflammatory disorders and may include lethargy, depressed mood, appetite loss, sleepiness, pain, or confusion. Evidence suggests that tumor necrosis factor-alpha (TNF-alpha), a pro-inflammatory cytokine produced by immune cells, activates microglia (the brain’s resident immune cells) and recruits white blood cells to the brain, driving the development of inflammation-associated sickness behaviors.

    The investigators used a model of liver inflammation in mice to study the effects of a probiotic on inflammation-associated sickness behavior. Mice with this form of liver inflammation typically have high levels of pro-inflammatory cytokines and exhibit distinct sickness behaviors. They fed the mice either a probiotic or a placebo and then they studied the animals' behavior. They also measured TNF-alpha levels in the animals' blood and the number of activated immune cells in the animals' brains.

    They found that although the probiotic did not reduce the severity of liver inflammation in the mice, it did reduce sickness behaviors better than the placebo. Mice that received the probiotics also had lower TNF-alpha levels and fewer activated immune cells in their brains compared to mice that received a placebo.

    These findings suggest that probiotics attenuate inflammation-associated sickness behaviors in mice, likely via modulation of the gut-brain axis. Learn about factors to consider when choosing a probiotic supplement in this clip featuring Dr. Jed Fahey.

  • Morning sickness affects up to 85 percent of pregnant women and is caused by hormonal changes during early pregnancy. Vitamin B6, antihistamines, and some prescription medications are used to treat nausea and vomiting during pregnancy; however, additional treatments that address hormonal imbalances are needed. Findings of a new report show that probiotics reduced nausea and vomiting and improved quality of life in pregnant women.

    Levels of hormones such as estrogen and progesterone fluctuate throughout pregnancy altering the composition of the gut microbiota and gastrointestinal function. Gut microbes metabolize food, supplements, and medications and produce compounds such as short-chain fatty acids and bile acids, which are absorbed into the bloodstream and facilitate communication between the microbiota and host. Previous research has demonstrated that probiotics reduce nausea and vomiting; however, research in pregnant women is lacking.

    The investigators recruited 32 female participants who were in their first trimester of pregnancy with no high-risk conditions and had reported symptoms of nausea and vomiting. Participants completed two cycles of Nature’s Bounty brand probiotics (containing 10 billion live cultures of Lactobacillus bacteria) consisting of six days of daily probiotics and two days without probiotics. Participants answered daily questionnaires about gastrointestinal symptoms and provided fecal samples in order to sequence bacterial DNA and measure bacterial metabolites.

    Probiotic supplementation reduced the severity of nausea and vomiting, but did not significantly alter the concentration of fecal metabolites, except for alpha-tocopherol, a form of vitamin E. Probiotic supplementation also had little effect on the composition of the gut microbiota, except for a progressive reduction in the concentration of Akkermansia bacteria. When measuring copies of important bacterial genes, the researchers found that probiotics increased the expression of a gene required to produce the enzyme bile salt hydrolase more than fivefold. Participants with high levels of fecal alpha-tocopherol, low levels of fecal Akkermansia, and/or high copy numbers of the bile salt hydrolase gene were less likely to report vomiting throughout the study.

    The authors interpret these findings to suggest that probiotics enhanced the production of free bile acids in the intestines, facilitating intestinal mobility and metabolism and reducing painful gastrointestinal symptoms.

  • The gut microbiota is composed of the community of bacteria, archaea, fungi, and viruses that live in the human intestine. Dietary components influence the composition and activity of the microbiota. For example, foods high in dietary fiber, such as whole grains and beans, and fermented foods, such as yogurt and sauerkraut, support an abundant and diverse gut microbiota, which is associated with lower disease risk. Authors of a report released this week investigated the effects of high-fiber and fermented foods on the gut microbiota and immune system.

    The authors recruited 36 healthy adult participants (average age, 52 years) who consumed little dietary fiber (fewer than 20 grams of fiber per day) and only one serving of fermented foods or less per day. They instructed half of the participants to add 20 grams or more of fiber per day to their baseline consumption. They instructed the other half of participants to consume six servings or more of fermented foods per day. Participants in both groups consumed their assigned diets for 10 weeks and recorded their food and beverage intake to assess adherence to study instructions. Participants also provided blood samples for the assessment of inflammation and fecal samples for the characterization of the gut microbiome at numerous time points throughout the study.

    A high-fiber diet did not reduce inflammation, but did alter the composition of the microbiota, increasing the abundance of bacteria known to metabolize dietary fibers, such as the genus Lachnospira. Higher fiber consumption also promoted greater secretion of enzymes associated with fiber metabolism and increased abundance of fiber metabolites, such as short chain fatty acids. A high-fermented food diet steadily increased microbiota diversity over time and decreased multiple markers of inflammation, including interleukin (IL)-6, IL-10, and IL-12b, among others.

    These results suggest that probiotics from fermented foods increase microbiota diversity and decrease inflammation. The authors noted that the lack of immunological response in participants consuming the high fiber diet may have been due to the short duration of the intervention.

  • One downside w/ probiotics. “Bacteroides fragilis metabolises exopolysaccharides produced by bifidobacteria” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946188/

    and fragilis fuels colon cancer https://www.nytimes.com/2018/02/01/health/colon-cancer-bacteria.html?ref=todayspaper

    “Patients with familial adenomatous polyposis harbor colonic biofilms containing tumorigenic bacteria” http://science.sciencemag.org/content/359/6375/592

    the same fragilis is antibiotic resistant Antimicrobial resistance in the Bacteroides fragilis group in faecal samples from patients receiving broad-spectrum antibiotics. https://www.ncbi.nlm.nih.gov/pubmed/28445776

    the same fragilis may or may not cause symptoms Dientamoeba fragilis colonization is not associated with gastrointestinal symptoms in children at primary care level. https://www.ncbi.nlm.nih.gov/pubmed/27784723

    Dientamoeba fragilis: A Family Cluster of Disease Associated With Marked Peripheral Eosinophilia https://academic.oup.com/cid/article/57/6/845/329548

    This is one of the best articles highlighting this microbe ( w/ some contrary evidence from northern Europe). “Dientamoeba fragilis, the Neglected Trichomonad of the Human Bowel” https://cmr.asm.org/content/29/3/553

  • Full Title: Probiotic Bifidobacterium strains and galactooligosaccharides improve intestinal barrier function in obese adults but show no synergism when used together as synbiotics

    Background: One way to improve both the ecological performance and functionality of probiotic bacteria is by combining them with a prebiotic in the form of a synbiotic. However, the degree to which such synbiotic formulations improve probiotic strain functionality in humans has not been tested systematically. Our goal was to use a randomized, double-blind, placebo-controlled, parallel-arm clinical trial in obese humans to compare the ecological and physiological impact of the prebiotic galactooligosaccharides (GOS) and the probiotic strains Bifidobacterium adolescentis IVS-1 (autochthonous and selected via in vivo selection) and Bifidobacterium lactis BB-12 (commercial probiotic allochthonous to the human gut) when used on their own or as synbiotic combinations. After 3 weeks of consumption, strain-specific quantitative real-time PCR and 16S rRNA gene sequencing were performed on fecal samples to assess changes in the microbiota. Intestinal permeability was determined by measuring sugar recovery in urine by GC after consumption of a sugar mixture. Serum-based endotoxin exposure was also assessed.

    Results: IVS-1 reached significantly higher cell numbers in fecal samples than BB-12 (P < 0.01) and, remarkably, its administration induced an increase in total bifidobacteria that was comparable to that of GOS. Although GOS showed a clear bifidogenic effect on the resident gut microbiota, both probiotic strains showed only a non-significant trend of higher fecal cell numbers when administered with GOS. Post-aspirin sucralose:lactulose ratios were reduced in groups IVS-1 (P = 0.050), IVS-1 + GOS (P = 0.022), and GOS (P = 0.010), while sucralose excretion was reduced with BB-12 (P = 0.002) and GOS (P = 0.020), indicating improvements in colonic permeability but no synergistic effects. No changes in markers of endotoxemia were observed.

    Conclusion: This study demonstrated that “autochthony” of the probiotic strain has a larger effect on ecological performance than the provision of a prebiotic substrate, likely due to competitive interactions with members of the resident microbiota. Although the synbiotic combinations tested in this study did not demonstrate functional synergism, our findings clearly showed that the pro- and prebiotic components by themselves improved markers of colonic permeability, providing a rational for their use in pathologies with an underlying leakiness of the gut.

    Keywords: Synbiotic, Probiotic, Prebiotic, Obesity, Gut barrier function, Autochthonous, Allochthonous, Galactooligosaccharide, Bifidobacteria, Bifidobacterium

  • A pilot study finds people with multiple sclerosis (and healthy controls) increased several species of beneficial gut bacteria and induced an anti-inflammatory immune response after supplementation with a strong, high CFU probiotic for 3 months.

    Multiple sclerosis patients also displayed a decrease in a type of immune cell called myeloid-derived dendritic cells which play a role in suppressing immune cells that prevent autoimmunity (called T-regulatory cells). Larger studies are needed to replicate these findings as well as investigate whether the probiotic supplementation has any effect on clinical symptoms.

    To my knowledge, there are exactly three brands that have this type of formulation of high CFU probiotic that seems to have a strong and growing body of clinical, published evidence: • VSL#3 (the original formulation) • Visbiome (a newer brand used in this study that is supposed to be substantially similar) • Vivomixx (European branded Visbiome)

  • Nursing mothers that supplemented with the probiotic Lactobacillus reuteriis for 3 weeks were twice as likely as a placebo to reduce crying by 50% in colicky babies who are exclusively breastfed.

    This new study is in line with another recent study that also showed mothers who supplemented with the probiotic Visbiome during late pregnancy and, while nursing, lowered inflammatory biomarkers in the breastmilk and improved symptoms of colic in their newborns as a downstream effect of that.

    I am actually taking 1 sachet of Visbiome (no affiliation) a day while I’m breastfeeding. One sachet contains 450 billion live probiotic bacteria (6 different strains). It’s important to realize that store-bought probiotics have almost certainly been impacted by the deteriorating effects of the supply chain that it took to get them on the shelf in the store… and even if that weren’t the case, usually they have only a VERY small fraction of the dose that clinical strength probiotics like Visbiome and VSL#3.

    Visbiome study link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5133065/

  • 30% of infants gut bacteria may come from the mother’s breast milk and another 10% has been traced to the skin around the mother’s nipple. There is a specific type of prebiotic found exclusively in breastmilk called human milk oligosaccharides that have been shown to set up the early infant microbiome. The bacteria around the skin of the nipple also appears to be important for seeding the infant microbiome. While this study did not examine health consequences of breastfeeding, other studies have found that it is important for immune system development and may protect against obesity.

    To learn more about the role of breastfeeding in setting up the infant microbiome and more generally about how to have a healthy microbiome during adulthood listen to (or watch) my podcast (video/audio) with microbiome experts Drs. Justin and Erica Sonnenburg. YouTube: https://youtu.be/gOZcbNw7sng iTunes: https://itunes.apple.com/us/podcast/sonnenburgs-on-how-gut-microbiota-interacts-our-bodies/id818198322?i=1000351247766&mt=2

  • The probiotics also lowered triglycerides, VLDL, and markers of insulin resistance. There was no cognitive improvement in the placebo group.

    The participants took 2 billion Bifidobacterium bacteria per day, which is a pretty small quantity of probiotics. It is likely that the probiotics are working through multiple mechanisms such as lowering inflammation and increasing neurotransmitters. Other studies have shown that gut bacteria are able to modulate the levels of GABA, norepinephrine, serotonin, dopamine, and acetylcholine through the gut-brain axis.

    I spoke with the gut experts, Drs. Justin and Erica Sonnenburg, about the importance of the gut microbiome in human health and the various foods (ie. fermentable fiber and other prebiotics) that provide our gut bacteria with the food they need to thrive. Here is the interview (also available on iTunes and Sticher): https://www.youtube.com/watch?v=gOZcbNw7sng