probiotic
This study was aimed at investigating how Spanish media reinforce a positive image of dietary supplements in the treatment of children, potentially leading to harmful health attitudes and behaviors.
The researchers conducted a quantitative content analysis of 912 news articles published between 2015 and 2021 in Spanish media outlets discussing dietary supplements for children. They used a frequency analysis and a proportion comparison to analyze variables such as the reach of news, tone of news, mentions of health professional consultation, association with natural products, media specialization, intertextuality, and headline mentions.
The study found a 60% increase in publications discussing dietary supplements for children during the study period. The content analysis indicates that these articles predominantly present dietary supplements in a positive light, often without robust scientific evidence. Furthermore, many do not emphasize the need for medical consultation, which may contribute to unsupervised consumption of supplements, particularly among minors. This highlights the critical importance of professional guidance when considering dietary supplements for children. Additionally, the frequent emphasis on the “natural” attributes of these products raises concerns regarding consumer perceptions and potential safety risks.
The authors concluded that their study reveals a problem regarding the portrayal of dietary supplements for children in Spanish media. The overly optimistic image, lack of scientific basis, and failure to recommend medical supervision may contribute to unsupervised consumption among minors, risking their health due to misinformed decisions influenced by media portrayal.
I would add that this problem exists not just for children and not just in Spain. It has long been noted to put consumers of all ages and from all countries at risk. The authors kindly cite our own study from 2006 that concluded: “UK national newspapers frequently publish articles on CATs for cancer. Much of this information seems to be uncritical with a potential for misleading patients.”
Even several years before that, my late friend Thomas Weimayr and I published this study in the BMJ:
The media strongly influences the public’s view of medical matters.1 Thus, we sought to determine the frequency and tone of reporting on medical topics in daily newspapers in the United Kingdom and Germany. The following eight newspapers were scanned for medical articles on eight randomly chosen working days in the summer of 1999: the Times, the Independent, the Daily Telegraph, and the Guardian in the United Kingdom, and Frankfurter Allgemeine Zeitung, Süddeutsche Zeitung, Frankfurter Rundschau, and Die Welt in Germany. All articles relating to medical topics were extracted and categorised according to subject, length, and tone of article (critical, positive, or neutral).
A total of 256 newspaper articles were evaluated. The results of our analysis are summarised in the table. We identified 80 articles in the German newspapers and 176 in the British; thus, British newspapers seem to report on medical topics more than twice as often as German broadsheets. Articles in German papers are on average considerably longer and take a positive attitude more often than British ones. Drug treatment was the medical topic most frequently discussed in both countries (51 articles (64%) in German newspapers and 97 (55%) in British). Surgery was the second most commonly discussed medical topic in the UK newspapers (32 articles; 18%). In Germany professional politics was the second most commonly discussed topic (11 articles; 14%); this category included articles about the standing of the medical profession, health care, and social and economic systems—that is, issues not strictly about treating patients.
Because our particular interest is in complementary medicine, we also calculated the number of articles on this subject. We identified four articles in the German newspapers and 26 in the UK newspapers. In the United Kingdom the tone of these articles was unanimously positive (100%) whereas most (3; 75%) of the German articles on complementary medicine were critical.
This analysis is, of course, limited by its small sample size, the short observation period, and the subjectivity of some of the end points. Yet it does suggest that, compared with German newspapers, British newspapers report more frequently on medical matters and generally have a more critical attitude (table). German newspapers frequently discuss medical professional politics, a subject that is almost totally absent from newspapers in the United Kingdom.
The proportion of articles about complementary medicine seems to be considerably larger in the United Kingdom (15% v 5%), and, in contrast to articles on medical matters in general, reporting on complementary medicine in the United Kingdom is overwhelmingly positive. In view of the fact that both healthcare professionals and the general public gain their knowledge of complementary medicine predominantly from the media, these findings may be important.2,3
25 years later, the call on journalists to behave more responsibly when reporting about so-called alternative medicine (SCAM) is as loud and clear as it is neglected and ignored.
As we all know, the FDA cannot require that dietary supplements be proven effective before they are sold. Yet, Robert F. Kennedy Jr. once said the FDA is exhibiting an “aggressive suppression” of vitamins, dietary supplements, and other substances and that he will end the federal agency’s “war on public health”.
With Kennedy now in the driver’s seat, the supplement industry expects to make bolder health claims for its products and to get the government, private insurers, and flexible spending accounts to pay for supplements, essentially putting them on an equal footing with FDA-approved pharmaceuticals.
The day Kennedy was sworn in as secretary of Health and Human Services, Trump issued a “Make America Healthy Again” agenda instructing health regulatory agencies to “ensure the availability of expanded treatment options and the flexibility for health insurance coverage to provide benefits that support beneficial lifestyle changes and disease prevention.” Kennedy added that dietary supplements are one key to good health. Supplement makers now want programs like health savings accounts, Medicare, and even benefits from the Supplemental Nutrition Assistance Program, or SNAP, to pay for vitamins, fish oil, protein powders, herbal remedies and probiotics.
In speeches and in a pamphlet called “The MAHA Mandate,” Emord and alliance founder Robert Verkerk said Kennedy would free companies to make greater claims for their products’ alleged benefits. Emord said his group was preparing to sue the FDA to prevent it from restricting non-pharmaceutical products.
With their ‘Mandate’ Emord and Verkerk want “to shift the healthcare paradigm towards one that restores the health of the American people through a holistic and individual-centered approach that works with, rather than against, nature”.
But do they ever question whether:
- vitamins do anything at all to people who eat a normal diet?
- fish oil is effective and safe for which conditions?
- protein powders have any effects beyond eating a steak?
- herbal remedies generate more good than harm?
- probiotics work for which conditions?
The short answer is no. To me, it seems that the MAHA are as uninterested in the evidence regarding efficacy and safety (quite possible they know how flimsy it is) as they are keen on the promotion of quackery.
Constipation is characterized by persistent difficulty in defecating. It is a common disorder in the community particularly affecting the elderly and those with intellectual disabilities and neuropsychiatric disorders. It can also be caused by numerous medications including analgesic, antidepressant, antihypertensive and anticholinergic agents. It may be asymptomatic or it may produce abdominal pain/cramps, bloating, nausea and anorexia progressing to urinary incontinence and fecal impaction, or paradoxical diarrhea due to overflow.
This review demonstrated that constipation may also kill you. A wide range of mechanisms associated with constipation may result in death including:
- bowel obstruction,
- stercoral colitis with ulceration,
- perforation and peritonitis,
- respiratory compromise,
- abdominal compartment syndrome,
- venous thrombosis with pulmonary thromboembolism.
Moreover, constipation may exacerbate pre-existing diseases and treatments such as laxative and enemas may be lethal. The autopsy examination of a case with constipation and megacolon should take into account all of the pre-existing conditions, as well as the possibility of underlying disorders such as Hirschprung disease. Review of the decedent’s medical and drug history and level of supportive care will be important. Toxicological evaluations may be useful.
____________________
Constipation is defined as having fewer than three bowel movements per week or experiencing difficulty in passing stool. The condition is common and often difficult to treat. WebMD recommends diet and lifestyle changes, such as:
- Drink an extra two to four glasses of water a day, unless your doctor tells you to limit fluids for another reason.
- Try warm liquids, especially in the morning.
- Add fruits and vegetables to your diet.
- Eat prunes and bran cereal.
- Exercise most days of the week. When you move your body, the muscles in your intestines are more active, too.
- Don’t ignore the urge to poop. Listen to your body when it’s telling you it’s time to go.
- Eat foods with probiotics such as yogurt and kefir.
- Skip processed meats, fried foods, and refined carbs such as white bread, pasta, and potatoes. You can eat lean meats such as poultry and low-fat dairy products.
- Keep a food diary and make a note of any foods that constipate you.
- Adjust how you sit on the toilet. Raising your feet, leaning back, or squatting may make it easier to poop.
- Take an over-the-counter fiber supplement (Metamucil®, MiraLAX®, Citrucel® or Benefiber®). Start with a small amount at first.
- Avoid reading or using your phone or other devices while you’re trying to move your bowels.
- Drink less alcohol and caffeinated drinks, which can make you dehydrated.
- Talk to your doctor about bowel training. It can help train your body to pass stool shortly after breakfast every morning.
- Don’t rush when going to the bathroom. Give yourself time to relax, which can help your digestive muscles relax.
- Talk to your doctor about any medications that could be causing your constipation.
___________________
Because conventional options are often not as successful as hoped, many sufferers turn to so-called alternative medicine (SCAM). But is SCAM really a solution?
A recent review found that “acupuncture or electroacupuncture and herbal medicine are effective in treating
constipation, whereas findings on massage and moxibustion are inconclusive.” Our own assessment [‘Oxford Handbook…’ (2008)] of the evidence disagrees and rated as follows:
- Beneficial: Psyllium
- Likely to be beneficial: abdominal massage, biofeedback, fibre
- Unknown effectiveness: acupuncture, aloe vera, ayurvedic medicine, meditation, Padma Lax, probiotics, herbal tea.
Whichever way we turn it, constipation is a more serious condition than many of us think, and neither conventional healthcare nor SCAM are convincingly successful in helping those who suffer from it.
Probiotics are live microorganisms promoted claimed to provide health benefits when consumed, generally by improving or restoring the gut microbiota. Prebiotics are compounds in food that foster growth or activity of beneficial microorganisms such as bacteria and fungi. Both are sold as dietary supplements, and there is hardly a human disease or symptom for which these supplements are not said to be effective.
One such claim is that the ingestion of prebiotics during pregnancy and lactation has immunomodulatory benefits for the developing fetal and infant immune system and provide a potential dietary strategy to reduce the risk of allergic diseases.
This study sought to determine whether maternal supplementation with dietary prebiotics reduces the risk of allergic outcomes in infants with hereditary risk.
A double-blind randomized controlled trial was conducted in which pregnant women were allocated to consume prebiotics (14.2 g daily of galacto-oligosaccharides and fructo-oligosaccharides in the ratio 9:1) or placebo (8.7 g daily of maltodextrin) powder. The treatment lasted from less than 21 weeks’ gestation until 6 months postnatal during lactation. All eligible women had infants with a first-degree relative with a history of medically diagnosed allergic disease. The primary outcome was medically diagnosed infant eczema by age 1 year, and secondary outcomes included allergen sensitization, food allergy, and recurrent wheeze by age 1 year.
A total of 652 women were randomized between June 2016 and November 2021 (329 in the prebiotics group and 323 in the placebo group). There was no significant difference between groups in the percentage of infants with medically diagnosed eczema by age 1 year (prebiotics 31.5% [103 of 327 infants] vs placebo 32.6% [105 of 322 infants]; adjusted relative risk, 0.98; 95% CI, 0.77-1.23; P = .84). Secondary outcomes and safety measures also did not significantly differ between groups.
The authors concluded that they found little evidence that maternal prebiotics supplementation during pregnancy and lactation reduces the risk of medically diagnosed infant eczema by age 1 year in infants who are at hereditary risk of allergic disease.
It is rare that we come across a well-planned, well-conducted and well-reported study of pro/prebiotics. When we do, it often casts doubts on the numerous claims made for these products.
Here we have such a study.
I congratulate the Australian authors for conducting it.
Previous randomized controlled trials (RCTs) suggested that gut microbiota-based therapies may be effective in treating autoimmune diseases, but a systematic summary is lacking. This systematic review was aimed at filling the gap.
The literature searches identified total of 80 RCTs. They related to 14 types of autoimmune disease:
- celiac sprue,
- SLE,
- lupus nephritis (LN),
- RA,
- juvenile idiopathic arthritis (JIA),
- spondyloarthritis,
- psoriasis,
- fibromyalgia syndrome,
- MS,
- systemic sclerosis,
- type 1 diabetes mellitus (T1DM),
- oral lichen planus (OLP),
- Crohn’s disease,
- ulcerative colitis.
The results showed that gut microbiota-based therapies may improve the symptoms and/or inflammatory factor of:
- celiac sprue,
- SLE,
- LN,
- JIA,
- psoriasis,
- PSS,
- MS,
- systemic sclerosis,
- Crohn’s disease,
- ulcerative colitis.
However, gut microbiota-based therapies may not improve the symptoms and/or inflammatory factor of spondyloarthritis and RA. Gut microbiota-based therapies may relieve the pain of fibromyalgia syndrome, but the effect on fibromyalgia impact questionnaire score is not significant. Gut microbiota-based therapies may improve HbA1c in T1DM, but its effect on total insulin requirement does not seem to be significant. Probiotics did not seem to increase the incidence of adverse events.
The authors concluded that gut microbiota-based therapies may improve several autoimmune diseases (celiac sprue, SLE and LN, JIA, psoriasis, fibromyalgia syndrome, PSS, MS, T1DM, Crohn’s disease, and ulcerative colitis).
This sounds promissing, perhaps even a bit too good to be true?
To answer this question, It seems important to look at the quality of the primary studies:
- Twenty-nine RCTs failed to describe the random sequence generation methods.
- Seventeen RCTs were not blinded and their results contained subjective indicators.
- Seven RCTs were rated as high risk of bias.
And what about other caveats?
- The effect sizes vary but are often small.
- There is much heterogeneity.
- For some of the conditions there are only very few trials
- There is no uniform, plausible mode of action.
In summary, while these findings are no doubt interesting, I recommend taking them with a pinch of salt.
Kourtney Kardashian believes that vaginal health is an important but not sufficiently talked about part of women’s well-being. So, why not make a bit of money on the subject? A recent article explains in more detail:
The reality TV star recently launched a vitamin sweet called Lemme Purr to boost the health of your vagina. On her Instagram channel, she says these gummies use pineapple, vitamin C, and probiotics to target vaginal health and pH levels that “support freshness and taste”.
Kourtney continues with the selling words “Give your vagina the sweet treat it deserves (and turn it into a sweet treat)”. One of the claims she makes is that the vitamin sweet supports a healthy vaginal microflora. As a researcher specialising in the role of vaginal microflora for women’s health, I was curious and wanted to find out which active ingredients this claim is based on.
Lemme Purr contains pineapple extract (probably for its taste), vitamin C (not really needed if you have a balanced diet), and a clinically tested probiotic (Bacillus coagulans). According to the product description, the probiotic has been shown in clinical studies to support vaginal health, freshness, and odour. This surprised me – I should know about these studies and effects as this is my primary research field.
A healthy vaginal microflora is composed of lactobacilli that keep the pH low and protect us from infections. My colleagues and I never identified Bacillus coagulans as being important for the health of vaginas, even though we have analysed thousands of samples during recent years. From other research groups and our own results, we know that Lactobacillus crispatus is the species that is associated with vaginal health and female fertility.
As I may have missed something important, I immediately checked what has been published on that probiotic in scientific journals. I found one systematic review and meta-analysis (a type of analysis where many individual studies are taken together) that mentions Bacillus coagulans. Apparently, it may improve stool frequency and symptoms of constipation, although the authors conclude that more research is needed.
On the topic of women’s vaginal health, I could only find a single study. There, 70 women with vaginal discomfort reported symptom relief after direct vaginal administration of the probiotic. There is nothing published on the oral administration of the probiotic that could support the claims made by Kourtney.
__________________________
I was not entirely sure where women are supposed to put Kourtney’s gummies. So, I watched a video where Kourtney applies one of these items herself. I am very pleased to report that, in the video, she put one in her mouth!
After this relief, I ran a few Medline searches to get an impression of what the evidence tells us. In contrast to the author of the above article, I found plenty of literature on the subject and quite a few clinical trials. So, maybe Kourtney is on to something?
Somehow, I doubt it. I did not find a study with her product. Call me a skeptic, but I do get the feeling after looking at Kourtney’s website that she is much more interested in money than vaginal health.
