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Deaths from friendly bugs

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riker2 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote riker2 Quote  Post ReplyReply Direct Link To This Post Topic: Deaths from friendly bugs
    Posted: 20 Mar 2010 at 3:30pm
Seen article that 25 have died in Holland from eating probiotics. Telegraph. Whats this about?
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MrCage View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MrCage Quote  Post ReplyReply Direct Link To This Post Posted: 20 Mar 2010 at 3:30pm
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/01/25/nyoghurt125.xml


Researchers at the University Medical Centre in Utrecht disclosed that 24 people had died between 2004 and 2007 during a study on whether probiotics affected inflammation of the pancreas in 296 people.

An unknown number of those who died could still be alive if they had not been given the probiotics, said the UMCU. Researchers warned that "extremely ill" people should avoid consumer probiotic products.

Yakult says the drink is "a food and not a medicine".

A spokesman said: "Yakult has been consumed for more than 70 years by millions of people. The drink contains Lactobacillus casei, a probiotic with an extremely long history of safe consumption.

"This study is not related to Yakult or any Yakult products. These severely sick patients received the bacteria directly into the intestine via a tube, which differs from the conventional oral consumption of probiotics," said the spokesman

The Dutch Food and Consumer Product Safety Authority is awaiting a report by the Healthcare Inspectorate before deciding whether to launch its own inquiry.

Doctors in Holland have been told not to give probiotics to patients with organ failure, those in intensive care or being fed through a drip.
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michael View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote michael Quote  Post ReplyReply Direct Link To This Post Posted: 20 Mar 2010 at 3:30pm
Mr Cage is correct in attributing the report to the Telegraph. It is too early to form any views about what has happened except to express sympathy to those who have been bereaved. Pancreatitis the disease that was being studied is particularly unpleasant with a high mortality rate. Also the patients in the trial were classified as critically ill. The article on probiotics on this site does indicate some of the risks associated with ingestion of these organisms including problems of acidosis due to D-lactate production in the gut from the use L acidophilius in patients who have had particular types of intestinal surgery. We will have to Wait until the report on what has happened to learn if there are any new concerns regarding the use of probiotics.

It would appear that 296 people took part in trials funded by the Dutch government at 15 Dutch hospitals. Nine patients (6%) in the control group died compared with 24 (16%) in the group which were treated with probiotics (
http://www.dutchnews.nl/news/archives/2008/01/clinical_trials_result_in_24_d.php) .

For further information please see
http://www.radionetherlands.nl/currentaffairs/080123-probiotics-trial-dutch, this overview of the trial also includes a link to an interview with Hein Goozen, head of surgery at the University Medical Centre in Utrecht where the study was undertaken.

When more substantive information becomes available I will update the article on probiotics.

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riker2 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote riker2 Quote  Post ReplyReply Direct Link To This Post Posted: 20 Mar 2010 at 3:30pm
Thnks. Looks as probiotics came from Winclove, a Dutch company. Bugs included enterococci.

How come they used enterocooci. Though they were dangerous.
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MrCage View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MrCage Quote  Post ReplyReply Direct Link To This Post Posted: 20 Mar 2010 at 3:31pm
Some additional probiotic news. Will be intersting to follow this story and the impact on sales/promotion.

Dannon is being sued for probiotic claims.

http://www.reuters.com/article/healthNews/idUSN237176420080124?feedType=RSS&feedName=healthNews
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michael View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote michael Quote  Post ReplyReply Direct Link To This Post Posted: 20 Mar 2010 at 3:31pm
Strain effects are all important in microbiology and biotechnology hence continued use of usually very well characterised enterococci as probiotics. The potential problems with this group however could create some PR problems in situations where something goes wrong-even if they were not the source of the problem.

Thanks to Mr Cage for the article from Reuters. It will be interesting to see what happens in the US courts. If Dannon looses the action it is likely to affect yoghurt manufacturers in the UK and Europe; some of whom make claims but may have little idea of what is in their products. Because there are not enough graduate food scientists and technologists let alone people with appropriate post graduate qualifications, companies generally rely on culture suppliers, who in Europe are good, for advice on product promotion. There is some risk in this practise.
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michael View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote michael Quote  Post ReplyReply Direct Link To This Post Posted: 20 Mar 2010 at 3:31pm
I note from Flex News that Dannon intend to refute the lawsuit against misleading claims made for their probiotic yoghurt sold in the US- see http://www.flex-news-food.com/console/PageViewer.aspx?page=13794&str=Probiotic%20Probiotics .
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MrCage View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MrCage Quote  Post ReplyReply Direct Link To This Post Posted: 20 Mar 2010 at 3:31pm
On a related note, most of the clinical work on PROBIOTIC survivability has been conducted on fermented milk/yogurt type products. It will be interesting to see if those that have promoted cheese with probiotics have supporting clinical work on the product they are promoting. Although in my opinion bacterial survivability may be improved with a higher fat product; the lack of data may cause some gray hairs for some.
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michael View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote michael Quote  Post ReplyReply Direct Link To This Post Posted: 20 Mar 2010 at 3:32pm
Interesting point. I have seen data for the survival of BB12 in Cheddar cheese, this is a bifidobacterium. While this did not grow it appeared to survive for some months with only a slow loss of viability. Interestingly addition of BB12, a Chr. Hansen's culture, appeared to improve flavour. I have not seen any clinical data for probiotics in cheese that could be used for health claims; this does not mean that there is no data! Perhaps not published at present?
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MrCage View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MrCage Quote  Post ReplyReply Direct Link To This Post Posted: 20 Mar 2010 at 3:32pm
I spoke too soon, I did some hunting around and found some work on cheese.


Helps promote regularity in 2 weeks*

*A clinical study shows results in 2 weeks

Study Design
A randomized, double-blind, placebo-controlled proprietary clinical trial was recently conducted (2007) in 92 healthy American adults with “normal but slow” bowel movement frequency. Subjects were randomized to one of two treatments: 1 daily serving (21 g) of natural cheese with no probiotic culture (control; n=4) or 1 daily serving (21 g) of natural cheese with an added probiotic culture (a minimum of 109 cfu n=44). They consumed the intervention product or control product for 28 days and recorded daily bowel habits (e.g., frequency of defecation, stool consistency and form). No changes in physical activity, diet, or body weight occurred during the study. Compliance was assessed to be excellent.

Results
A modest, but significant, improvement (increase) in bowel movement frequency was noted with probiotic cheese at 2 weeks (but not at 4 weeks).
A modest, but significant, improvement (increase) in a composite measure of bowel function was noted with probiotic cheese at 2 weeks (but not at 4 weeks). This composite measure value is the product of the average bowel movement frequency for the first 14 days and the average stool consistency for the first 14 days, hence a higher value reflects more frequent bowel movements of softer, moister, smoother stools.
Consumers, clinicians, and regulators recognize the importance of stool consistency & frequency, including constipation or irregularity, as a measure of normal and abnormal bowel function.

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joannestewart View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote joannestewart Quote  Post ReplyReply Direct Link To This Post Posted: 20 Mar 2010 at 3:32pm
had a terrible side effect from probiotics... or at least I think that is what has caused it. Wondering if anyone else has had simular experiences. went to the er with very high bp for me 184/92 ,nausa, bloated horrible. pain on the top of my abdomen, and pressure on the top as well. also had briuising on the top of my abdomen. many tests and hours later ................. found a gall stone but had that for years and could not explain the bloating. if anyone has had a simular experience please let me know
thanks
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michael View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote michael Quote  Post ReplyReply Direct Link To This Post Posted: 20 Mar 2010 at 3:33pm
You clearly have had a very unpleasant experience and I hope that you are now a lot better?

I have not heard of a response of the magnitude described by you following consumption of probiotics. However I am aware that some strains of Lactobacillus casei can produce gas from citrate and could give rise to slight bloating under particular conditions. Some probiotic preparations also contain prebiotics-basically complex fiber and the intestinal flora in some individuals can ferment these causing gas. I also note that you are not absolutely certain that it was probiotics that caused your problem.

If you send me a private message detailing the probiotic product you consumed, the quantity you consumed and whether you had recently eaten dairy products contain lactose e.g. ice cream I will respond to you. Any chance that you are lactose intolerant? Please also check the label and indicate whether it contained a prebiotic e.g. FOS.

DO NOT POST ANY MANUFACTURERS INFO ON THIS FORUM!
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michael View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote michael Quote  Post ReplyReply Direct Link To This Post Posted: 20 Mar 2010 at 3:33pm
I am currently working on an update to the probiotics article at http://www.dairyscience.info/probiotics.htm . The last major update to this article was published in February 2008, since then there have been a number of significant developments. These include the failure of some major European dairy companies to obtain ratification by the EFSA of health claims for probiotic products, the deaths of patients on a probiotic trial in the Netherlands, evidence that perhaps some bacteria designated as probiotics may have the potential to aggravate allergies in neonates. However, there has been other more positive research indicating that particular strains of bacteria, in particular lactic acid bacteria, do have the potential to enhance immunity, reduce allergy, and to alleviate distant site infection. This work has very clearly shown that dairy companies and others have a responsibility to use only well characterised strains that have been shown to have probiotic effects in medical trials. Interesting Reid (2007) has stated "A potential major problem for probiotics is the misuse of the term. This can arise from products being poorly manufactured, or being referred to as probiotic without any relevant documentation. The net effect, deleterious to the overall field of probiotics, might be that such products are found to be ineffective, when in fact they were not even probiotic in the first place." Interestingly there is now a growing consensus that there is a world-wide, critical shortage of well qualified food scientists and technologists in commercial food manufacturing. These developments will be taken into consideration in the update which will be available in 2009.
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johnston_01 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote johnston_01 Quote  Post ReplyReply Direct Link To This Post Posted: 20 Mar 2010 at 3:33pm
Any recent development re above?
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michael View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote michael Quote  Post ReplyReply Direct Link To This Post Posted: 20 Mar 2010 at 3:33pm
I plan to update the article on probiotics over the next few months. There have been quite a few positive developments particularly in the area of allergy e.g. recent work has reported a reduction in the incidence of infant eczema by 58 per by feeding 1,000,000,000 colony forming units of a mixture containing Bifidobacterium bifidum W23, Bifidobacterium lactis W52, and Lactococcus lactis W58. This work was done in the Netherlands by Niers et al. (2009).
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