What are Spore-Based Organisms and are they Better than Human-Derived Probiotics?

Spore-based organisms are not new, as some believe.  They have been around since the 1930's, and were debunked in 1939.  Yet they have made a resurgence as of late, probably because in the nutritional industry companies are aggressively trying to carve out a niche for themselves, attempting to promote things that are "new" and "unique," but really are anything but. 

“Spore-based” organisms are being misclassified by some manufacturers as probiotics, although this designation is a deviation from the International Scientific Association of Prebiotics and Probiotics (ISAPP).  According to the ISAPP, to be classified as a probiotic, bacterial strains must be human in origin. Therefore, spores would not fit that definition, as spores are soil-based.

"...Bacillus coagulans is a ubiquitous soil bacterium that grows at 50-55 °C [122-133 °F]..." Stand Genomic Sci. 2011 Dec 31;5(3):331-40. Rhee et al.

Therefore, soil-based organisms are not typically considered “normal” GI residents. The suggestion of use is often to the hygiene-theory of disease, as it is now being suggested that humans are now “too clean,” and exposure to these various soil organisms may prime the immune system. This is a theory that may not be commonly accepted in conventional medicine or even in holistic medicine circles, however, because it lacks scientific validation. 

The strains used in high quality probiotics are generally human-microflora – those genus, species, and strains found natively in the human gut.  Some probiotics may also offer other strains that are found in dairy and/or fermented plants foods (sauerkraut, as example). 

Strains are given their designation once the genome is mapped. Spore organisms have not been subjected to DNA mapping.  We also know there is a massive body of research on the various specific human strains. In theory, spores as probiotics might have some benefit, and there are research articles available, but thus far the research looks very scant compared to the mammoth amount of data regarding human-based organisms.  But an important point to consider is that none of the few studies that exist on spores show anything new or better than what standard human-based probiotics have been shown to provide.  Thus, the marketing on spore probiotics does not appear to match the research.  As has been said, "what glitters isn't always gold."  

The only unique characteristic of spore-based organisms is their purported (not proven) improved survivability, which is less unique in terms of clinical properties.  It is suggested that there is greater survival through the GI tract, as they are in their “inactive” spore state when swallowed and supposedly activated during digestion. However, if this survivability proves valid, some have concerns along these lines as to the safety and potential growth of pathogens as a result of lack of transit.  

Regarding survivability in the digestive process, survivability of the more hardy strains of probiotic organisms is not the primary concern anyway.  Think about it.  When a person eats kefir or any other cultured food, do the organisms survive digestion and colonize?  Most of the time, yes, and they are not even encapsulated!  This is just another example of companies trying to create a "need" that doesn't really exist and has never been demonstrated in the literature. 

Recall the definition of probiotics: “Proven clinical efficacy when taken orally.” Human-based probiotics have this track record of clinical efficacy, safety, and reems of research.  

When in doubt, therefore, it would be advisable to go with the proven track record and research.

In summary, there are two very important considerations.

First, what is the true definition of a probiotic according to the ISAPP?  For one, genus, species, and strain must be listed on the bottle.  

Secondly, and perhaps more importantly, they have to have proven clinical efficacy in humans when taken orally. 

So then, other than supposed unique survivability, what does the literature show regarding these spore-species – in humans – that may not be found with more ‘traditional’ human-microflora?  Well, nothing.

In keeping with the standards of scientific research and strains that are accepted as safe and effective, do spore-based strains like lactobacillus sporogenes enjoy this kind of data?  No. According to the article, Lactobacillus sporogenes is Not a Lactobacillus Probiotic, "No independent panel of experts has evaluated the safety of B. Coagulans for human consumption."¹  

Furthermore, Lactobacillus Sporogenes is not even a legitimately recognized strain and is actually a misclassification, as stated above.

 

 Let’s close the discussion by quoting again from the same article:

 

"Unlike [true] probiotic species of lactobacilli, members of the genus Bacillus are not considered normal members of the intestinal flora... Published literature supporting the role of Bacillus coagulans in enhancing human health is sparse, especially as compared to literature published on Lactobacillus use as probiotics. To continue to persist using this taxonomically incorrect name leads to speculation about the advantages of willingly mislabeling a product. It is likely that companies hope to benefit from association with the large aggregate of published literature and history of use on the safety and health benefits of the genus Lactobacillus... The perpetuation of intentional mislabeling in the long run will serve to erode consumer confidence and undermine the credibility of the probiotic industry." 

 

Reference:

“Lactobacillus sporogenes” Is Not a Lactobacillus Probiotic, – Mary Ellen Sanders Dairy and Food Culture Technologies Littleton, Colo; Lorenzo Morelli Instituto di Microbiologia UCSC Piacenza, Italy; Scott Bush Rhodia Inc. Madison, Wis.

 

 

Weight Control, Glucose Sensitivity, and the other Benefits of B. Lactis B420

As the research on probiotics continues to mushroom, some very compelling applications are being shown that would not have previously been attributed to the microbiome.  

Along those lines, then, there's some very interesting research surrounding a new probiotic strain called, Bifidobacterium Lactis B420.  

Now, before we examine the research on this strain, let's first note that medical science is beginning to make a connection between body weight and gut microbiota.  This was first discovered by accident with fecal implant patients.  Doctors began to notice that recipients of fecal implants would take on the characteristics of the donor in terms of body composition.  So a study was done on mice to try to reproduce this, and indeed they found the same thing in the laboratory.  A fecal sample was taken from an obese person and implanted into a mouse, and the mouse gained weight. 

So enter, then, the research on B. Lactis B420. 

Before we look at the research specific to body weight, let’s first look at the various other benefits of this impressive strain on other health paramters.

Experimental research has indicated that:

• B420 increased tight junction integrity of epithelial cells, and therefore protected gut epithelial cells from the harmful effects of pathogenic microbes.
• B420 protected against NSAID-induced GI side effects in a rat model by reducing an NSAID-induced inrease in stomach permeability
• B420 reduced mucosal dysbiosis, bacterial translocation, expression of major pro-inflammatory cytokines in various tissues, and improved glucose metabolism in mice fed a high fat diet (HFD).
• In HFD-fed mice, B420 modulated gut microbiota and improved glucose intolerance.  Further, the combination prevented the impairment of intestinal immunity due to metabolic abnormalities induded by the HFD.
• In a mouse model of diabetes, B420 enhanced concentrations of ileum GLP-1, a protein involved in both insulin secretion and satiety signaling.
• In an obese mouse model, increases in body weight and fat mass in mice fed with HFD for 12 weeks were significantly reduced if the mice were co-administered B420.  
• In a diabetes mouse model, mice receiving both HFD and B420 had decreased fat mass compared with mice receiving only HFD.  B420 also improved glucose metabolism in this mouse model.

So this is already a very impressive list of benefits even without the benefits of weight control.  But now let’s turn our attention to that aspect, which is human data.

The goal here was to determine if the B420 could make a change in the incremental body weight that many people experience over time as they age.  The untreated group of overweight individuals gained 3.1% of bodyweight in six months.  The overweight group receiving 10 billion units per day of the B420 probiotic strain, however, did not gain any extra body weight in that same period of time, and they observed no dietary or lifestyle changes.  All they did was add the probiotic.  The probiotic group also showed a slight decrease in waist circumference of 2.4%, AND they ate less, showing improved satiety with the use of the probiotic strain. 

Another very positive benefit was the improvement in short chain fatty acids over that period of time, a huge benefit to gut health. 

Now, as we know, many people tend to gain weight as they age, some a little, and some a lot.  It’s too early to tell if the B420 can legitimately be called a weight LOSS probiotic, but it can certainly be called a weight CONTROL probiotic.  With that in mind, remember that those in the study didn’t change anything about their lifestyles.  So it could be, perhaps, that if this probiotic strain was added to a weight loss plan, it may amplify the effects of the other weight loss efforts….maybe.  Again, there’s not enough information to go on yet to verify that statement, but I think it’s a fairly good assumption that this could be the case. 

I’ll close by saying that weight gain with age is multi-factorial, and can be attributed to shifts in hormones and other factors.  However, we cannot and should not rule out the changes in the microbiome that occur with age as well.  And weight issues aside, there are enough other benefits with this remarkable strain that it should be considered for use with leaky gut and autoimmune patients, those with gut dysbiosis, and even glucose and insulin intolerance. 

References available upon request

The Emerging Understanding of Probiotics and Colonization

Recently I was asked a good question by a doctor about oral probiotic supplements and whether they survive transit in the GI, particularly very acidic stomachs, and whether or not there are studies confirming colonization of various probiotics strains.  Since this question represents the more widespread thought process of probiotics -- a thought process that is becoming antiquated -- I thought I would pass the answer on.

To answer this question, let's consider the strain studied in weight control.  The genus, species, and strain are: B. Lactis B420.  B420 is not a human-strain. It was first identified in dairy. However, as fermented dairy foods are common in human diets, B420 can be grown from a stool sample from non-supplemented humans (proof of survival in GI transit). Also, in the current study, B420 was cultured from stool samples of the treatment arms as proof of survival in GI transit. So is this same culturing required for all human-strain probiotics? Not really. If they are human-strains, how did they get there in the first place? Orally, through foods, through the gut. Non-protected, no 'encapsulation' was needed naturally. And one would assume that this is the case even with very low pH (high acidity), since probiotics from fermented foods appear to still colonize the guts of people in all pH ranges.  (i.e. People with very high acid stomachs with a pH of, say, 1 or 2, do not have sterile GI tracts.  They are still colonized with all kinds of bugs.)

Regarding survivability of stomach acid, then, what is well understood is that the stomach is acidic pretty much all the time (while food may actually act as an acid buffer), and that human-strain probiotics should 'naturally' be able to survive GI transit (i.e. how did they get their in the first place?).

Now, here's the biggie: Colonization. 

It used to be thought that the rationale for use of oral probiotics was to repopulate the gut. That is out of date. The current understanding of probiotics is strain-specific activity. In other words, residency in the gut microbiota seemed to be the marker of a strain's hardiness/survivability in times past.  But not anymore. The modern understanding is that oral probiotics are not about colonization.  Oral probiotics are about their transient effects, helping to make the neighborhood a better place. A healthy gut is a diverse one, made up of hundreds, even thousands of species. How can one create diversity through oral probiotics of one, two, or even eight strains? It likely cannot be accomplished with so few strains.  The oral probiotic stays for a little while, does its job, and then leaves.  Job done.  

Part of the definition of oral probiotics​ is proven efficacy in humans proven by reams of research, which, by the way, is why you want the genus, species, AND strain -- all three -- identified so that you can correlate the strain with the research.  Said another way, according to sources like the International Scientific Association of Prebiotics and Probiotics, a TRUE probiotic must have two things in particular in order to be legitimately called a probiotic: 1) genus, species, and strain identified, and 2) they must have proven oral benefit - including survival through the GI tract. If a product simply says on the label, for example, lactobacillus acidophilus, but no strain, then you cannot connect it to specific research, and thus, you don't know if it survives digestion or not, and you don't know what, if any, benefit it has in humans.  A product without the strain identified can probably rightly be called a bacteria, but NOT a probiotic.  If the strain is not identified on the label it is absolutely impossible to make any claim of being orally effective. 

Typically, part of the evaluation of a probiotic is observation of its traits (phenotype). The probiotic strain is tested for acid and bile tolerance. If tolerant, this is recorded. Once understood it is no longer necessary to test each generation of this proven strain trait. What is necessary is to test the DNA to ensure that each generation is the same as previous (genotype). 

The third factor to GI survival is the use of human microflora. As stated above, these species/strains ‘natively’ survive passage through the GI tract,​ as this is their normal abode. Once again, how do the hundreds of species of good flora get to the gut in the first place? Nearly a​ll orally. Ninety-percent of the bacteria that enters the body does so through the mouth. ​The genus/species of bacteria that live in our gut survive and thrive,​ as they are inherently adapted to do. 

As an example, consider the genus and species of one common probiotic family, ​Lactobacillus acidophilus.The latter term, acidophilus, is​ from the Latin, and refers to ​"acid-​loving."​
  

So, in short, yes, most probiotics survive digestion (some strains much better than others), even in very acidic stomachs.  And yes, part of the research in identifying a true probiotic is its effectiveness in humans. But again, colonization is not the true marker of a probiotic's effectiveness: strain-specific activity is.  And that is another reason why the genus, species, and strain listed on the bottle is so important.

In closing, I should add that some companies choose to list the strain in their promotional literature, but not on the bottles.  This, too, is a quality issue because by not listing it on the label of each bottle, companies don't have to prove that the strains are in THAT bottle or lot.  Companies who do random batch assays and then list the strains in their promotional literature are not proving anything in regards to all the different batches and bottles.  If a company lists the strains on the bottle, however, they have bound themselves to being able to provide documentation of the presence of those strains in that bottle and batch.

Natural Interventions for Strep B

I'm about to be a grandpa!  

And my daughter, Hannah, who is due in two short weeks, has recently been diagnosed with Strep B, and her Ob-Gyn wants to put her on antibiotics during labor, which is the typical procedure.  Of course, wanting to avoid the antibiotic route, I started doing some studying on the subject, and here's what I found.  Hopefully this will be of interest to all my holistic-minded readers.

What is Strep B?

Group Beta Streptococcus (GBS), otherwise known as Strep B, is a colonization that affects many people and around 1/4 to 1/3 of women in the third trimester of pregnancy. Many people carry this bacteria in their digestive systems with no problem, but it can cause complications in newborns of mothers who are colonized.  In some rare cases babies have actually died when exposed to high levels of GBS during labor.  

Mothers are often tested for Group B Strep in the third trimester of pregnancy and, if they are positive, are usually given Penicillin or other antibiotics during labor.  While antibiotics might indeed be necessary if the bacteria cannot be eradicated, antibiotics, of course, carry their own risks for newborns and mothers alike, such as a higher risk of candida.  

When a baby is born its GI is sterile, and the microbiota must be colonized by the mother when the baby passes through the birth canal and when mother holds the child.  This colonization process is important to ward off the chances of digestive and immune issues later in life.  

For example, C-section babies, who bypass the birth canal and are therefore not colonized by the mother sufficiently, have a 75% higher risk of developing autoimmune disease later in life because the early biodiversity of the intestinal tract is negatively effected. (See, Cesarean Delivery May Affect the Early Biodiversity of Intestinal Bacteria, Journal of Nutrition.)

For reasons of proper colonization, then, it is important to either try to eradicate the GBS bacteria before labor, or be sure to aggressively colonize mother and baby with probiotics after the birth if antibiotics become necessary.  

Thankfully, there are natural ways to deal with GBS that can yield very good results.

The following suggestions do not represent documented research, but is compiled from anecdotal evidence, and is not intended to be medical advice.

Natural Remedies for GBS

Again, let me state emphatically that GBS does have the potential to be serious and shouldn’t be ignored. But just as emphatically I will state again that antibiotics carry their own risks and can be problematic as well. 

The good news is, at least in some cases, GBS can be avoided with natural remedies.

Probiotics

As GBS occurs naturally in the digestive tract for some people, it is important to treat the intestinal tract as a whole instead of simply focusing on the vaginal area. A probiotic-rich diet is beneficial for overall health, and may also be beneficial in eradicating GBS.  A probiotic-rich diet can be accomplished both dietarily and by taking probiotic supplements, preferably both.

Eating a probiotic-rich diet including things like Kombucha, Water Kefir, Yogurt, Sauerkraut and other fermented foods to help create a healthy gut environment, and taking aggressive amounts of probiotic supplements orally and vaginally may cause the colonization to occur much faster.  

Taking oral probiotics does work for bacterial vaginosis, depending on the strains used, but it takes some take to migrate to the vaginal area -- two weeks in some cases.  Using the capsules as suppositories will colonize the vagina immediately. Two strains in particular, Lactobacillus rhamnosus GR-1 and Lactobacillus reuters RC-14, have been studied extensively in bacterial vaginosis and possess anti-fungal and bacteriocin-like compounds, and even produce hydrogen peroxide.  In short, these are powerful antimicrobial probiotic strains that can ward off numerous different kinds of urogenital issues, including, perhaps, GBS, although GBS has not been specifically studied with respect to these strains as of yet.  There are, however, over 175 scientific publications on these strains for bacterial vaginosis and yeast vaginitis, and other colonization studies by oral and vaginal application showing impressive results. 

A List of Antimicrobials that can be Complementary 

• High potency garlic supplements (2-3 caps between meals) or raw garlic cloves daily.
• Coconut Oil for its naturally antiviral properties.
• Plain organic yogurt vaginally to help balance bacteria. May add the GR-1 and RC-14 probiotic supplement to the mix, and or other strains if desired.
• Taking high potency vitamin C daily.
• Using a Chlorhexidine rinse vaginally before and during labor. (This is the usual protocol.) This might considered a last resort, as the emerging evidence about the bacterial transfer during labor brings this practice into question.
• Raw apple cider vinegar consumed orally daily and using it as a diluted rinse.

The above protocol is what has been working out there according to midwives.  Some anecdotal evidence I found suggests that GBS can be eradicated in 2 weeks using this protocol.  

The jury is still out for me, so I will let you know what ends up happening with my daughter.   

Natural Immune Support, Part 2

Here’s something that not a lot of people know:

Between 60 and 70% of the body’s immune defenses are concentrated in an area of the gut known as the Gut Associated Lymphoid Tissue (GALT). (By the way, 70% of the body’s serotonin is made in the gut, too!).

It is imperative, therefore, that the gut flora – the good bacteria that colonizes the intestines – be intact. Good bacteria like lactobacillus acidophilus, B. Lactis, and others, are not only good for helping with digestion, but they are also important for the assimilation of nutrients from food, supporting hormone balance, neurostransmitter balance, and yes, even the immune system.

But maintaining the life of these healthful bacteria is more of a daunting task in today’s world than ever before. Dietary insults like the sugar, caffeine, alcohol, and highly processed foods can diminish these important organisms. Likewise, antibiotics in the pill form and from the ones hidden in commercial meats are a death blow to our bacteria friends. Antibiotics (meaning, “anti-life”), are designed to annihilate all forms of bacteria, good and bad. What is often left over after a round of antibiotics are the resistant bad guys who then gladly take up residency where the good guys once were. And that can eventually wreak havoc on the health of the GI, the immune system, hormone balance, and one's mood!

Thankfully, we can replace much of these friendly organisms with supplemental “probiotics” (meaning, “pro-life”).

While the list of probiotic organisms is a long one, there are a few that research has shown are the best choices in enhancing immunity.

Firstly, the probiotic strain Bifidobacterium lactis HN019 has shown remarkable immune-enhancing qualities.

In a 2001 study on the elderly reported in the American Journal of Clinical Nutrition, thirty healthy elderly volunteers (age range: 63–84 y; median: 69 y) participated in a 3-stage dietary supplementation trial lasting 9 wk. During stage 1 (run-in), subjects consumed low-fat milk (200 mL twice daily for 3 wk) as a base-diet control. During stage 2 (intervention), they consumed milk supplemented with B. lactis HN019 in a typical dose (5 [1] 1010 organisms/d) or a low dose (5 [1] 109 organisms/d) for 3 wk. During stage 3 (washout), they consumed low-fat milk for 3 wk. Changes in the relative proportions of leukocyte subsets and ex vivo leukocyte phagocytic and tumor-cell-killing activity were determined longitudinally by assaying peripheral blood samples.

Increases in the proportions of total, helper (CD4+), and activated (CD25+) T lymphocytes and natural killer cells were measured in the subjects’ blood after consumption of B. lactis HN019. The ex vivo phagocytic capacity of mononuclear and polymorphonuclear phagocytes and the tumoricidal activity of natural killer cells were also elevated after B. lactis HN019 consumption. The greatest changes in immunity were found in subjects who had poor pretreatment immune responses. In general, the 2 doses of B. lactis HN019 had similar effectiveness.
Am J Clin Nutr 2001;74:833–9

Likewise, the Lactobacillus Rhamnosis HN001 and the Saccharomyces Boulardii strains have shown similar immune-enhacing benefits. In fact, L. Rhamnosis HN001 was shown to lead to “an increased ability to fight infectious diseases” in subjects who were already healthy. J Am Coll Nutr. 2001 Apr;20(2 Suppl):149-56. In other words, the addition of L. Rhamnosis HN001 made a strong immune system even stronger.

A Cold and Flu Prevention Protocol
During this time of year, a basic foundational regime for prevention of colds and flu would be to take the vitamin C complex (see my last post), and include 1 capsule of the L. Rhamnosis/B. Lactis, S. Boulardii formula on an empty stomach. This formula is the newest probiotic designed specifically for immunity. It contains 5.5 billion live organisms of S. Boulardii, 3 billion B. Lactis HN0019, and 1 billion L. Rhamnosis HN001 per capsule. For acute infections, one could go up to 6 per day.

Not Limited to Colds and Flu Alone
This new probiotic formula is what saved me from a bout with “Montazuma’s Revenge” when I was in Mexico last year. Laying on my bed in the fetal position for about six hours, a friend came to the rescue with his last capsule. In a half hour I was up and around and feeling great again. GI infections are a great application of this powerful probiotic combination as well.