What Are Probiotics?
As defined by the World Health Organization, "Probiotics are live micro-organisms which when administered in adequate amounts confer a health benefit on the host."
But what does that mean?
Micro-organisms include bacteria, yeast and fungi and there are many trillions of them around, on and in us. In fact, did you know that your body has more bacteria living in and on it than human cells? Some of these bacteria can cause disease, others can be of benefit to your health and others are just there, not causing harm or good.
In order for a micro-organism to be called a "probiotic" there must be clinical evidence that if you use it in the amount recommended it has the ability to result in a health benefit. For example, even though there are more than 150 strains of Lactobacillus bacteria, only those that have been clinically shown to be of benefit for certain health conditions are probiotic.
What form do probiotics come in?
Probiotics can be purchased in different types of supplement forms including capsules, lozenges, liquids and chewing gum and can also be found in some foods and drinks that have been supplemented with them.
Are fermented foods and drinks naturally probiotic?
Fermented foods (such as sauerkraut, kimchi and tempeh) and drinks (such as kombucha and kefir) naturally have live micro-organisms in them and are considered by many to be a healthy addition to one's diet. They are commonly referred to as "probiotic." However, for any food or drink to be considered to have probiotic properties, it must contain proven probiotic strains that are present in adequate amounts. A good example of a fermented food that is also a probiotic food is yogurt that has been supplemented with probiotic strains.
So although many fermented foods and drinks contain live micro-oganisms, only those that that meet the criteria under the definition of probiotic can be labeled or considered a probiotic food or drink.
Benefits of probiotics
Probiotics promote a healthy balance of gut bacteria and have been linked to a number of health benefits. Some examples of research-backed findings include probiotics that have the ability to prevent and/or treat diarrhea and other digestive disorders, as well as reduce the severity of some allergy-driven disorders, such as eczema. Some may also help to boost the immune system.
It's important to understand that there are many species and types of probiotics and only certain probiotics may help with certain ailments; in other words, it's not a one-size fits all scenario.
AEProbia is an excellent online resource that shows what probiotics are available in Canada and their specific intended conditions.
The OPSiP Study Probiotics
The probiotics used for the OPSiP study have been carefully selected based on their potential ability to impact GBS bacteria.
OPSiP study participants will be taking two capsules plus one lozenge per day. The probiotic capsules will contain Lactobacillus rhamnosus GR-1, Lactobacillus reuteri RC-14 and the probiotic lozenge will contain Streptococcus salivarius K12. Half of participants will receive the probiotics while the other half will receive placebos. *Placebos have no active or medicinal ingredient in them and so in this case there would be no probiotic in them.
L. rhamnosus GR-1 and L. reuteri RC-14, when taken by mouth, have been shown to settle in the digestive tract (gut) and in the vagina. If the right amount is taken then they may replace some disease-causing bacteria and reduce the chance of certain infections, such as vaginal yeast infections.
Studies in pregnant women have also shown that these lactobacillus probiotics may have the ability to reduce or stop GBS bacteria from settling in the vagina.
Streptococcus salivarius K12 has been widely and safely used in both chewing gum and lozenge form to reduce strep throat infections (Strep A) in both adults and children. The focus of this particular probiotic has been on mouth and throat health, however, studies done in laboratories have shown that S. salivarius K12 has the ability to both stop the growth of and kill GBS bacteria.
Are probiotics safe to take in pregnancy?
Probiotics are considered safe and their use may result in positive health benefits; however, a study utilising these three specific species of probiotics together has not been done in relation to GBS in pregnancy. The College of Family Physicians of Canada has concluded that probiotics are generally considered safe and are well tolerated in pregnancy. The most common negative side effect of probiotics is flatulence (increased gas), which usually resolves with continued use of the probiotic.
Some studies have shown that in people who are severely immune-compromised there may be risk of less than 1 in 1 million of the probiotics themselves causing an infection. Even though the risk is very minimal, if you are immune-compromised (for example, you are a cancer patient or you are on immune therapy treatment) then you would not be eligible for this study. For eligibility criteria click here.
Health Canada has approved each of the three probiotics that will be used in this trial for use in the general population, including adults and children. Health Canada approval was also received specifically for this study.
The lactobacillus probiotics have been used many times in studies involving pregnant individuals. The S. salivarius probiotic has been widely and safely used for decades to reduce strep throat infections (Strep A) in both adults and children. Although it has not had the same degree of testing specifically with pregnant individuals, a small study in New Zealand with pregnant individuals did not find any concerns for either the women or their babies.
The probiotics and their placebos have been donated to the OPSiP study by Chr. Hansen, Denmark and Blis Technologies, New Zealand and are manufactured using Good Manufacturing Practices (GMP).