Fact-Checking: Probiotics, Immunity & Coronavirus
12 Mar 2020
In the wake of COVID-19, there has been a sharp increase in enquiries about immunity boosting ingredients, particularly our probiotics.
Do probiotics really help with immunity? Could they potentially prevent or cure the virus?
CN-Healthcare interviewed Dr James Dekker, Fonterra’s senior scientist with 20+ years of research into probiotics, immune system health & overall wellbeing, to get the facts.
Can probiotics prevent Coronavirus?
COVID-19 is a novel virus not seen in humans before. This means that health professionals are still in the process of learning how Coronavirus behaves, the mechanisms by which it is transmitted and how it interacts with the human immune system. Due to COVID-19's novelty, it is extremely unlikely that anyone could confidently comment on the ability of any treatment (probiotics included) to prevent this strain of the virus, as this would require robust clinical evidence to be substantiated. Current treatments simply address the symptoms of coronavirus (e.g. fever, cough etc.) which can be typical of seasonal flu or general respiratory illness. So, we don’t really have a definite answer to your question.
However, Fonterra can speak to how the immune system generally functions, and what aspects of immunity our probiotic strains (HN001TM & HN019TM) can support based on the clinical evidence available at this stage. Our probiotics can support general immunity, rather than targeting the prevention of a specific disease in the wider population.
Probiotics can be used to support general immunity, rather than targeting prevention of a specific disease in the wider population.
Dr. James Dekker | Senior Research Scientist | Fonterra
Can probiotics can prevent inflammatory storms in patients with COVID-19?
While some probiotic strains (including HN001TM & HN019TM) have shown to exhibit anti-inflammatory effects, “inflammatory storms” represent severe and acute medical events, and the impact on such states (if any) by probiotics is unknown.
Consumer concerns about immunity are understandably heightened at this time, with many people turning to potential treatments or preventative measures they believe will protect them. However, we would re-iterate the advice of many governments and health organizations i.e. Coronavirus is an emerging disease meaning there is currently no robust scientific evidence to suggest there are any treatments to specifically prevent or cure it.
What kind of people need probiotics?
Probiotics are usually targeted to the general consumer, either to promote health or for mild to moderate conditions amenable to nutritional intervention. We have seen some evidence that probiotics could be particularly useful for supporting those with sub-optimal immunity – for instance, older individuals.
Probiotics are also commonly recommended for people who have recently taken antibiotics, which disrupts the natural balance of ‘good’ and ‘bad’ bacteria in the gut. This imbalance is called dysbiosis.
Dysbiosis can also be caused by stress, exposure to toxins, disease, excessive exercise, poor diet and age, so people with these factors may also benefit.
Additionally, people at either end of life typically have a reduced diversity of gut bacteria. Since increased diversity of gut bacteria is associated with better health outcomes, infants or the elderly may also benefit more from probiotic consumption.
What are the health benefits of taking probiotics?
It is widely recognized that probiotics are good for digestive health and immunity, with some evidence in other areas such as mental health or weight management. However, it is very important to note, that probiotics are not a cure-all.
Consumers need to be aware there are many different types of probiotics. Each probiotic strain will provide a different set of benefits. Just because Probiotic 'X' does something, there is no guarantee that Probiotic 'Y' will do the same.
Consumers should check which probiotic strains they are getting when making purchase decisions. Probiotics names are made up of genus, species and strain. These are a little bit like a first, middle & last name e.g. Lacticaseibacillus rhamnosus HN001
When it comes to the ability of NZMP strains to reduce infection risk or influence inflammation, our research shows evidence that:
BifidoB HN019TM (Bifidobacterium animalis subspecies lactis HN019):
- May reduce the risk of respiratory tract infections in infants. However, the immune system of an infant is different from that of an adult, so there is no guarantee that the same benefit will be seen in an older age group.
- Improves immune biomarkers, indicators of good immune function associated with protection from pathogens.
- May improve protection against diarrhea-causing infections.
- May reduce gum infections.
- May support reduction of inflammation associated with infection or chronic inflammatory states.
There are many different types of probiotics. Each probiotic strain will provide a different set of benefits.
Dr. James Dekker | Senior Research Scientist| Fonterra
LactoB HN001TM (Lacticaseibacillus rhamnosus HN001):
- May reduce inflammation associated with raised cytokine IL-6 levels. IL-6 is a protein involved in regulating immune responses and is used as a marker (or flag) or an immune response.
- Improves immune biomarkers, indicators of good immune function associated with protection from pathogens.
- Can reduce the levels of some types of harmful micro-organisms in the gut.
- May improve gut barrier function – gut barrier integrity is important as a first-line immune defence and can be affected by several threats including infection.
- Enhances immunity against certain types of pathogens that can attack the female reproductive system.
NZMP Probiotic strains have also been shown to be safe and well-tolerated across a range of age groups, including infants, pregnant women and the elderly. Additionally, there are various other benefits related to gut health (which can impact overall immunity), conditions associated with the gut (for example, irritable bowel syndrome), allergy and nutrient absorption.
How should consumers choose probiotics?
Understanding the science behind probiotics can be a complex business. Ideally, your doctor should provide medical advice on the strain, dosage and duration of treatment based on your needs.
But here are some pointers:
- Pick by Health Benefit: as previously mentioned, probiotics are not a magic solution to cure all ailments! Not all probiotics will provide the same benefits. Choose a probiotic that has been shown by sound scientific evidence to specifically address your specific health condition.
- Human Clinical Evidence: check that the probiotic strain has been researched in humans, not just animals. This is because health benefits seen in animals don't necessarily translate to humans. Animal studies are typically done for 2 reasons to 1) establish a treatment is safe, before moving to human clinical trials; 2) because they are faster and cheaper. The human clinical research should ideally be peer-reviewed and published in a reputable academic journal. This means that other scientists have critiqued the research to ensure it is robust.
- Dosage: The amount of probiotics in a product will be labelled as a Colony Forming Units (CFU) per serve. A probiotic strain needs to be at a CFU equal or higher than the dose used in successful human clinical studies to provide you with a health benefit. Note that a higher CFU doesn't necessarily mean extra health benefits.
Look for products that guarantee CFU throughout shelf life [otherwise]... you may not achieve the health benefit you are looking for.
- Shelf life: look for products that guarantee CFU throughout the shelf life. This is because the probiotics can begin to die in the timeframe between the product being manufactured and being consumed by the end-user. If the probiotics are dead, or the dose is below the recommended level, you may not achieve the health benefit you are looking for. This means you should avoid products with disclaims like "X CFU per serve at the time of manufacture" as this often means the product has not been tested to guarantee that the CFU stated on the pack truly reflects the minimum number of probiotics still alive by the product's use-by/expiry date.
- Storage: Some probiotics will need special storage conditions to remain alive. Check the storage instructions on the product. If the store you are buying from is not adhering to these instructions then the probiotics may not be alive e.g. if the packaging states “keep refrigerated” but the product is being sold at room temperature at the store, then don’t buy it.
- Avoid probiotic products that need to be heated before consumption: Most probiotics will be killed with heat. This might mean opting for shelf stable probiotic products, or those that need to be refrigerated. To provide health benefits, probiotics must reach your gut alive.
Does milk contain probiotics?
Standard dairy milk does not usually contain probiotics.
In almost all cases, milk available commercially has been pasteurized (i.e. has undergone heat treatment) to kill harmful bacteria. This process would also kill probiotic bacteria, which need to be alive to provide a health benefit. However, some manufacturers may add probiotics to milk drinks (e.g. flavoured milks), or powdered milk formulas after heat processing/treatment.
While NZMP's probiotics can be delivered in milk, they were identified and isolated from cultures used in cheese and yoghurt production.
When is the best time to take probiotics?
Probiotics can be taken at any time of day.
The most important requirement is to consistently take your probiotic supplement of choice. This is because regular consumption is required to maintain a certain probiotic's level in your gut, in order to realise the desired health benefit. If you stop taking a probiotic, then your gut bacteria will normally return to the same state they were in prior to supplementation within a couple of weeks. The benefits of the probiotic will usually subside as well, although some types of probiotics have been selected specifically because they linger in the gut.
This article was originally posted in Chinese on CN-Healthcare on March 6th 2020 by Zhao Guangna, and has been republished with permission
* In April 2020 the Lactobacillus genus was reclassified, resulting in a name change of our probiotic from Lactobacillus rhamnosus HN001 to Lacticaseibacillus rhamnosus HN001. There is no change to the abbreviated scientific notation L.rhamnosus HN001. Additional information can be found here.
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Dr James Dekker
Senior Research Scientist | Fonterra
James Dekker started his career as a medical researcher studying immunology, molecular biology and genetics, with stints at the Australian National University in Canberra and the John Radcliffe Hospital in Oxford, England. He returned to New Zealand in the early ’90s, and for the last 20 years has been researching probiotics and their health benefits. During this time he has been instrumental in shaping Fonterra’s clinical research in the probiotics space and has been the author of numerous peer reviewed articles.