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Children’s Health

Children’s Health Issues

Protect Your Pregnancy With Probiotics

Children’s Health, Women’s Health / By

Pregnancy is a joyous time in a woman’s life. It is important during this time for women to take care of their bodies; and, adding probiotics may help.

A recent study of pregnant women over the course of six years has found a correlation between probiotics consumption and a decreased risk of late pregnancy complications. Of the more than 33,000 pregnant Norwegian women studied, those that consumed probiotics were 20% less likely to contract late-pregnancy diseases like pre-eclampsia. Pre-eclampsia causes high-blood pressure and protein-filled urine after a woman’s 20th week of pregnancy and, if left untreated, can escalate into eclampsia, a rare but fatal disease.

While researchers factored in other pregnancy-related risks, such as a family history of pre-eclampsia, obesity and high-blood pressure, women consuming probiotics during the time of their pregnancy still showed a lowered chance of contracting pre-eclampsia. Although science has not conclusively found a way to fully prevent pre-eclampsia, consuming probiotics, like EndoMune Advanced, and regular pre-natal doctor visits may help.

Protect Your Pregnancy With Probiotics Read More »

How to get rid of diarrhea

Children’s Health, Digestive Health, Women’s Health / By

Taking probiotics may be helpful in preventing diarrhea, but a review of more than 63 studies by the Cochrane Library suggests that it can help to get rid of diarrhea quicker.

This review of nearly 8,000 patients — including 56 focused on infants and young children — concluded the use of probiotics shortened the course of diarrhea by a day, and reduced the duration of diarrhea lasting more than four days by 59 percent.

Also, probiotics decreased the chances of spreading the diarrhea infection and relieved discomfort.

Lactobacillus acidophilus and Bifidobacterium bifidum — both critical strains of beneficial bacteria contained in EndoMune Advanced Probiotic and EndoMune Kids, –were among the strains of probiotic bacteria used in the studies.

Researchers found no difference between the strains of probiotic bacteria used as all the strains proved to be safe and beneficial to the study participants.

“A striking finding of this review is that most trials reported that probiotics reduced diarrhea,” said lead researcher Stephen Allen of the School of Medicine at Swansea University, UK, according to a press release. “The beneficial effect was consistent and significant across many different types of trials.”

Be wary of standard diarrhea treatments

Unfortunately, three of the more popular ways to treat diarrhea — taking an antibiotic or an over-the-counter medication or eating specific foods — may not be as safe or reliable and create more health complications you’ll want to avoid, especially if your child is at risk.

For example, some health experts advise taking antibiotics, but only if bacteria or parasites trigger diarrhea. Yet, antibiotics can cause great harm not only by disrupting the healthy balance of bacteria in your gut but by promoting the spread of antibiotic-resistant superbugs like C. diff infections.

Also, taking an over-the-counter drug like loperamide (Imodium) or bismuth-subsalicylate (Pepto Bismol) only treats diarrhea, but not the underlying cause of the problem. Plus, you should be very careful if your child has the flu or chickenpox that you don’t treat him/her with medicines that contain bismuth-subsalicylate due to their link to Reye syndrome, a rare but very serious disease.

Plus, the verdict is very much mixed about the value of following the BRAT diet (bananas, rice, applesauce and toast), particularly for children because it doesn’t contain enough nutrients to help their guts recover from diarrhea.

However, taking a probiotic is one of most effective ways, not only to shorten the duration of diarrhea, but to give your body a healthy boost to its natural defenses to prevent it altogether.

The real trick about probiotics: There’s a huge difference between taking a probiotic containing single or multiple strains of beneficial bacteria.

A growing number of studies have shown taking a multi-species probiotic like EndoMune — containing 10 strains beneficial bacteria plus a prebiotic– are effective in treating a host problems in addition to diarrhea, including IBS, respiratory tract infections and immune functioning. More information about traveler’s diarrhea can be found here.

 

How to get rid of diarrhea Read More »

Probiotics and Flu Season

Children’s Health, Disease / By

The temperature is dipping and you all know what that means – cold and flu season is upon us. No one wants to end up stuck in bed for a week with uncomfortable, draining flu symptoms. Happily, there are a few basic things you can do to prevent the onset of the flu:

  • Get the flu vaccine
  • Wash your hands religiously
  • Avoid crowds
  • Do not sneeze or cough into your hands
  • Drink lots of fluid
  • Eat lots of fruits and vegetables
  • Exercise regularly
  • Get at least 7 hours of sleep, per night

These recommendations are the typical prescription for prevention from most practiced care providers. However, there’s one more key step that could make the difference for you this flu season: taking a probiotic.

The Proof Is in the Research

Published health studies such as Probiotics Effects on Cold and Influenza-like Symptom Incidence and Duration in Children1 from the medical journal Pediatrics, demonstrate the validity of probiotics as a preventative health supplement.

For example, this particular study divided healthy children, ages 3-5, into three separate groups:

  • Those receiving a placebo (104 participants)
  • Those receiving a probiotic containing Lactobacillus acidophilus (110 participants)
  • Those receiving a probiotic containing Lactobacillus acidophilus & Bifidobacterium lactis (112 participants)

For the purposes of the study, each child received their supplement daily, for 6 months, under close cold and flu symptom scrutiny.

At the end of the study researches found that, when compared to the placebo groups, the other two participant groups had reduced flu-like symptoms, antibiotic use and days missed from school – a huge relief to parents and physicians alike.

 

What The Research Means for You

Studies in adults2, similar to the Pediatrics study, have been performed and the results indicate similar findings, particularly in cases of upper respiratory infections.

Scientific outcomes infer that this occurs because oral probiotic supplements can stimulate the immune system in the gastrointestinal tract. Once this occurs, the GI tract typically begins producing more immune cells. Those cells can then stop cold and flu inflammation before it becomes severe and attack viruses as they invade the lining of the respiratory tract3,4,5,6. Thus, the body eradicates viruses before they settle.

 

Take Home Message

Results like these highlight the importance of taking a daily, oral probiotic supplement during flu season – particularly one containing the potent bacteria strain combination of lactobacilli and bifidobacteria in a serving size of 10 billion colonies or more.

Try a probiotic, like EndoMune Advanced Probiotic or EndoMune Kids Advanced Probiotic for your little ones, that meets these standards to help counter disastrous flu symptoms this autumn and winter.

1 Probiotic effects on cold and influenza-like symptom incidence and duration in children.Leyer GJ, Li S, Mubasher ME, Reifer C, Ouwehand AC; Pediatrics. 2009 Aug;124(2):e172-9. Epub 2009 Jul 27

2 Probiotics for the prevention of respiratory tract infections: a systematic review.Vouloumanou EK, Makris GC, Karageorgopoulos DE, Falagas ME; Int J Antimicrob Agents. 2009 Sep;34(3):197.e1-10. Epub 2009 Jan 28.
Probiotics in intestinal and non-intestinal infectious diseases–clinical evidence.
Hatakka K, Saxelin M; Curr Pharm Des. 2008;14(14):1351-67. Review.

3 Probiotic bacteria reduced duration and severity but not the incidence of common cold episodes in a double blind, randomized, controlled trial.de Vrese M, Winkler P, Rautenberg P, Harder T, Noah C, Laue C, Ott S, Hampe J, Schreiber S, Heller K, Schrezenmeir J; Vaccine. 2006 Nov 10;24(44-46):6670-4. Epub 2006 Jun 6.

4  Probiotics in intestinal and non-intestinal infectious diseases–clinical evidence. Hatakka K, Saxelin M; Curr Pharm Des. 2008;14(14):1351-67. Review.

5 Molecular and cellular basis of microflora-host interactions.Winkler P, Ghadimi D, Schrezenmeir J, Kraehenbuhl JP; J Nutr. 2007 Mar;137(3 Suppl 2):756S-72S. Review.

6 Probiotic and prebiotic influence beyond the intestinal tract. Lenoir-Wijnkoop I, Sanders ME, Cabana MD, Caglar E, Corthier G, Rayes N, Sherman PM, Timmerman HM, Vaneechoutte M, Van Loo J, Wolvers DA; Nutr Rev. 2007 Nov;65(11):469-89. Review

Probiotics and Flu Season Read More »

Probiotics for Pediatric Antibotic-Associated Diarrhea

Children’s Health / By

Welcome to February, readers!

February – the season for love, chocolate and valentines – is also, unfortunately, the season for colds and flu. Your littlest valentines will be especially susceptible to the bad weather bugs during the February freezes. The seasonal sniffles may not only impact your child’s sinuses and energy, but also their bathroom habits and regularity. This month’s newsletter will discuss how the use of probiotics can prevent your child from getting diarrhea when they are prescibed an antibiotic to cure a respiratory infection.

The Curious Case Of The Two Kiddie Colds

While your child may require an antibiotic to quickly and completely cure their cold or infection, prescribed medications often carry unintended negative consequences. Most of the antibiotics pediatricians prescribe to children can cause diarrhea – specifically AAD or Antibiotic Associated Diarrhea.

Consider these two cases:

    1. Peter, a 4-year old preschooler, caught a cold from his classmates. He developed a cough, sore throat and 102º fever. His mom gave him an over the counter children’s cold remedy, but over the next 2 days young Peter developed a productive cough. Worried and upset, Peter’s mother took him to his pediatrician who prescribed an antibiotic to treat his bronchitis. Peter began to get better but was then stricken by a terrible case of diarrhea that left him weak and dehydrated. His mother rushed him to the ER where he was diagnosed with antibiotic associated diarrhea. Peter was hospitalized, received an IV’s and eventually became well enough to return home.

 

  1. Brian, an 8-month old, contracted a fever while at his daycare center and became fussy. His mother took him to the ER where he was diagnosed with an ear infection. The doctor prescribed an antibiotic and recommended a second medicine – a probiotic to be taken two hours after the first medication. Brian’s infection healed, and he never developed diarrhea.

A Serious Side Effect of Antibiotics

More than 100 trillion bacteria live in our intestines and play an important role in intestinal digestion and immunity. Generally, 85-90% of the bacteria are beneficial and keep bad bacteria at bay. However, while antibiotics effectively resolve the bacterial infections like Peter and Brian experienced, the antibiotics also risk causing diarrhea by destroying the good bacteria and upsetting the healthy balance of the bacterial flora. Studies have found that up to 50% of children who receive antibiotics for ear infections will develop AAD1.

A Proof Is In The Probiotics

The November 2011 issue of the Cochrane Database System Review revealed new evidence supporting using probiotics to prevent pediatric antibiotic-associated diarrhea2.

Sixteen studies tested 3,432 children from 2-weeks old to 17-years. The children received a variety of probiotics co-administered with antibiotics for the prevention of AAD.

Final analysis revealed that AAD was reduced by 50% in the group receiving probiotics versus the group receiving a placebo. Even more, the greater the probiotic colony count, the lesser the incidence of AAD – 63% less in fact.

The study’s authors also noted that the probiotic group experienced no significant, unusual side effects due to the probiotics, other than a reduction of AAD.

Take Home Message

If your child requires an antibiotic to recover from a late winter cold, consider administering a probiotic like EndoMune Jr., which contains a 10 billion colony count in each serving. Administer this probiotic two hours after administering the antibiotic to protect the bacteria cultures and effectively protect your child from AAD.

Eat healthy, exercise, take EndoMune and live well!
Best Wishes,
Dr. Hoberman

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Healthy Benefits of Probiotics for Children

Children’s Health, Healthy Aging / By

As we start the New Year with resolutions for living healthy, I want to share with you an article(1) that assesses the healthy benefits of probiotics for children.

The December issue of Pediatrics included a report, “Clinical Report – Probiotics and Prebiotics in Pediatrics,” prepared by the Committee on Nutrition, a component of the American Academy of Pediatrics – an organization comprised of 60,000 pediatricians.

The purpose of the report was to provide guidance to pediatric health care providers on the usefulness and benefits of probiotics and prebiotics for children. In doing so, the committee:

  1. Reviewed published clinical studies that provided children with probiotics or prebiotics to prevent or treat a variety of health issues, and
  2. Analyzed the quality of the reports and determined whether there was enough evidence to recommend the use of probiotics for the specific disorders.

In the last five years there has been an explosion of clinical studies using probiotics. Most of the studies have proven efficacy or general positive benefits, leading to an increase in the recommendation of probiotics by mainstream medicine.

Committee on Nutrition: Probiotic Recommendations

After thoroughly reviewing and assessing previous studies, the American Academy of Pediatrics’ committee suggested probiotics and/or prebiotics may have a positive impact on the following conditions.

#1: Acute Infectious Diarrhea
The committee reviewed studies to determine if probiotics could prevent episodes of acute infectious diarrhea that occur in child care centers. Based on available studies, the committee did not recommend routine use of probiotics to prevent acute infectious diarrhea but did acknowledge there may be special circumstances that probiotics are beneficial.

#2: Viral Gastroenteritis
Trials of using probiotics to treat children with acute infectious diarrhea found that probiotics shortened the illness in children with viral gastroenteritis by one day. The conclusion stated “there is evidence to support the use of probiotics early in the course of childhood acute infectious diarrhea.”

#3: Antibiotic-Associated Diarrhea
Review of trials using probiotics to prevent antibiotic-associated diarrhea found that probiotics were beneficial. Antibiotics can decrease the healthy intestinal bacteria population and allow the unhealthy bacteria to overgrow and cause diarrhea. The conclusion was that probiotics can be used to reduce the incidence of antibiotic-associated diarrhea.

The committee reviewed numerous clinical trials that used probiotics to treat and prevent other pediatric medical disorders. While some of these studies found specific benefits, the general recommendation was that further studies were necessary to prove efficacy for the following conditions:

  • Irritable Bowel Syndrome
  • Infantile Colic
  • Ulcerative Colitis
  • Eczema

Prebiotics and Allergy Reduction

The committee also reviewed medical trials using prebiotics. Prebiotics refer to a special class of fiber in our diet that acts as “food” for the healthy bacteria, Lactobacillus and Bifidobacterium. These bacteria use the prebiotic as a source of nourishment for their growth and activity.

Studies of adding prebiotics to infant diets found reduced incidence of allergies. The conclusion of the committee was that “confirmatory studies of the benefits of prebiotics….are needed before recommendations cam be made…”

Safe and Promising Supplements

The committee also commented on the safety of both probiotic and prebiotic supplement. They stated “to date, these products seem to be safe for healthy infants and children.” Caution should be used in giving probiotics to children with compromised immune function.

The committee was generally positive about the use of probiotics in children. But, it was being very responsible in not making general recommendations. Although there are positive studies for the clinical use of probiotics, the committee wants to see more studies to confirm the benefits. Further confirmatory studies are being accomplished to prove the clinical health benefits. We await the next updated report.

In the meantime, if your child is suffering with one of the disorders mentioned above, it seems reasonable to consider a therapeutic trial with a probiotic like EndoMune – a safe supplement that contains both probiotics and a prebiotic.

Wishing you and your loved ones a very healthy 2011.

Eat healthy, exercise and stay well.
Dr. Hoberman

References:

(1) Probiotics and prebiotics in pediatrics. Thomas DW, Greer FR; American Academy of Pediatrics Committee on Nutrition; American Academy of Pediatrics Section on Gastroenterology, Hepatology, and Nutrition. Pediatrics. 2010 Dec;126(6):1217-31.

Healthy Benefits of Probiotics for Children Read More »

Healthy Bugs Prevent Depression and Gut Distress

Children’s Health, Drug interactions / By

This month I am discussing some new, exciting research on the effect of probiotics on the gut-brain axis(1). Before proceeding, I think it is best to explain the relationship between the intestines and the brain.

We have all experienced the effect of this axis. Most of us have been in a situation where we become very anxious about an upcoming event – making a presentation, taking an exam – and, as a result, developed a terrible gut pain or “knot.”

As quickly as the pain surfaced, it similarly eases when the stressful event resolves. When this happens, we don’t develop an ulcer or any other structural intestinal problem. So what physically happened to cause this pain?

The brain releases chemicals that travel through the blood stream (or nerves) to the gut.  The major nerves between the brain and intestines are called the vagus and the sympathetic nerves. The “knot” commonly experienced during stressful events is a result of the nerve endings releasing chemicals that cause spasms of the intestines and activation of the intestinal pain fibers.

Now, let’s get really geeky to explain how this happens in more detail. The gut-brain axis consists of:

(1) Vagus and sympathetic nerves that send messages to:

  • Stimulate or inhibit stomach and intestinal secretions
  • Increase or decrease stomach and intestinal motility
  • Enhance or decrease appetite
  • Transmit pain sensation from the gut to the brain
  • Alter our mood …positively or negatively

2) Hormones secreted by the brain and gut that stimulate or suppress the hunger and satiety centers in the brain affecting dietary intake. It is very common for people to attribute weight loss to stress. Their appetite seems to have just “disappeared.”

What really happened was that the emotional stress sent hormones and nerve signals to the intestines causing the following:

  1. Disruption of the healthy intestinal balance of the bacteria.
  2. Multiplication of the unhealthy bacteria, causing intestinal inflammation.
  3. Release of chemicals by the inflamed intestines, stimulating the satiety center in the brain – resulting in loss of appetite.
  4. Once the stress is resolved, both the healthy bacteria and appetite will return.

Be Happy…Take a Probiotic!

With this brief background, we will explore more clearly how intestinal bacteria can be impacted by stress and how probiotic bacteria can improve our mood. It is a two way street.

A research article published this month in the prestigious medical journal Proceedings of the National Academy of the Sciences discusses how probiotic bacteria may lessen anxiety and depression and help to maintain a positive attitude(3).

The point of the study was to determine how bacteria dwelling in the gut can effect the brain, and thereby influence mood and behavior. Since there are special neurotransmitters in the brain that impact mood, the researchers sought to evaluate whether these receptors could be modified by probiotics.

The researchers split their rodent subjects into two groups. One lot was fed a special broth containing Lactobacillus rhamnosus. The other group was fed an ordinary diet not fortified with microbes.

The mice were subjected to a battery of tests that measured their emotional state. The results indicated that the mice fed Lactobacillus performed more activities in a maze which indicated confidence and less anxiety. They were able swim in a container farther indicating a more positive mood.

Direct measurements of the animals’ brains supported the behavioral results. Levels of cortisone, a stress hormone, were significantly lower in the bacteria-fed mice than they were in the control group.

In addition, the number of neurotransmitter receptors was higher in the mood altering portion of the brain. Stimulation of these receptors results in sensations of relaxation and euphoria.

Finally, to prove that the vagus nerve is responsible for transmitting signals from the gut to the brain, the study was done again. But in the second study, the vagus nerve was severed in both groups of mice. The results of the repeat study revealed that the behavior in the two groups of mice was the same. The probiotic fed mice didn’t demonstrate the same activities which had been associated with confidence, less anxiety and a more positive mood. The damaged vagus nerve couldn’t transmit the benefits of the probiotics to the brain.

At this point you may say “well that is very interesting but we are not mice.  Are there studies in humans that also show similar results?”

A recent study in the British Journal of Nutrition(4) assessed whether a daily dose of a Lactobacillus and Bifidobacterium probiotic taken for 30 days could influence the psychological impact of everyday life events in normal human volunteers.

By using standardized psychological tests, the scores of the probiotic treated group had lower values for depression, anger-hostility and physical complaints.

The authors concluded that the beneficial effects of the probitotics may be explained by competitive exclusion of harmful gut bacteria and a decrease in inflammatory signals via the vagus nerve to the brain!

Take Home Message

If you are feeling a little “blue” or just want to feel positive about life, consider taking a beneficial probiotic like EndoMune. The best part of these studies is that there were no adverse effects of probiotics – no need for a black box!

Read about the latest research on the gut-brain axis in 2025 on this blog.

References

(1) Gut-brain axis. Romijn JA, Corssmit EP, Havekes LM, Pijl H. Curr Opin Clin Nutr Metab Care. 2008 Jul;11(4):518-21.

(2) The new link between gut-brain axis and neuropsychiatric disorders. Fetissov SO, Déchelotte P.Curr Opin Clin Nutr Metab Care. 2011 Sep;14(5):477-82.

(3) Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Bravo JA, Forsythe P, Chew MV, Escaravage E, Savignac HM, Dinan TG, Bienenstock J, Cryan JF.Proc Natl Acad Sci U S A. 2011 Sep 20;108(38):16050-5.

(4) Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects. Messaoudi M, Lalonde R, Violle N, Javelot H, Desor D, Nejdi A, Bisson JF, Rougeot C, Pichelin M, Cazaubiel M, Cazaubiel JM. Br J Nutr. 2011 Mar;105(5):755-64.

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New Study Reveals Danger of Sack Lunches

Children’s Health, Mental Health / By

It is back to school time. While you are out shopping for school clothes and supplies, I want to encourage you to consider adding EndoMune to your shopping list.

Over the years I have written a number of newsletters that discuss the benefit of probiotics for children. Topics have included: lessening the risk of infectious diarrhea, preventing cold and flu symptoms and avoiding antibiotic related diarrhea.

This month I want to discuss a new reason for giving your child a daily probiotic: foodborne illnesses.

An interesting study(1) was published this month in the respected medical journal, Pediatrics. The study discussed the risk of foodborne illnesses in sack lunches prepared at home for preschool children going to day care centers. The researchers wanted to determine the temperature of the perishable foods during the morning hours prior to lunchtime.

What Causes Foodborne Illnesses?

Before diving into the findings of the article, I would like to make some general comments about how contaminated foods cause intestinal infections that lead to symptoms of nausea, vomiting, diarrhea, fever and abdominal pain.

Most foodborne infections are undiagnosed and unreported, although the Centers for Disease Control and Prevention estimates that every year about 76 million people in the United States become ill from contaminated foods. Of these people, about 5,000 die(2).

Almost half of the reported foodborne illnesses occur in children, with the majority occurring in children under age 15 years. Frightening, right?

Children are at high risk for foodborne illness for several reasons: immature immune system, reduced stomach acid to kill harmful bacteria, and low body weight – which means a lower dose of pathogen is required to cause injury(3).

There are three important factors when considering food safety: (1) type of food, (2) stored temperature, and (3) time exposed to unsafe temperature.

Bacteria that cause foodborne illnesses like Salmonella and E. coli grow rapidly in certain types of foods. Meat, poultry, fish, dairy products and cut fruits and vegetables are most likely to carry these bacteria.

If the bacteria are present when the food is prepared, then refrigerating the food to below 40°F prevents the bacteria from multiplying and causing an infection. Additionally, cooking foods to a temperature greater 165°F will kill any bacteria in food.  Once cooked, the hot foods need to stay at a safe temperature of greater than 140° F prior to serving or refrigerated to less than 40°F for storing.

When perishable foods like chicken salad or bologna sandwiches are left in the “danger” temperature zone of 40°F to 140°F for greater than two hours, the harmful bacteria rapidly multiply. When this happens, the foods must be discarded due to risk of contamination by bacteria and toxins, which can cause mild to life threatening intestinal infections.

Pediatrics Study: Sack Lunches at Risk of Bacteria Proliferation

This brings us back to the study. The objective was to measure the temperature of the foods in preschool-aged children’s sack lunches. Using non-contact temperature guns, the researchers tested 705 lunches that contained a total of 1,361 perishable foods. The temperature was measured 90 minutes before lunchtime.

The results were astounding: Only 22 or 1.6% of the 1361 perishable food items were in a safe temperature zone.  Overall, 97.4% of meats, 99% of dairy, and 98.5% of vegetables were in the danger zone.

The researchers found that the use of thermally insulated bags with ice packs only marginally improved the number of perishable foods in the safe temperature zone.

So what is a parent to do?

Here are some recommendations:

  • Wash hands and use clean cutting boards and knives.
  • Use safe foods like peanut butter (if allowed), raw, cooked or dry fruit and raw vegetables.
  • Consider making a meat sandwich of turkey or roast beef the night before and putting in the freezer using bags designed for freezing. It will take 3 to 3.5 hours for the sandwich to thaw.
  • Soups, stews and chili make a hearty lunch. To use them in a packed lunch, heat to boiling and put in a sterilized thermos bottle.

Finally, I recommend giving your child a high quality probiotic like EndoMune Kids.

Studies have shown that probiotics are able to defend the human intestinal tract against harmful bacteria. The probiotic bacteria stimulate the immune response, prevent pathogens from adhering to the intestinal lining cells and produce antibacterial proteins(4).

There has been increasing evidence in the last 10 years for the benefit of probiotics in preventing and treating acute diarrhea in children. A number of studies have found that giving probiotics versus a placebo to children in day care facility can statistically lessen the risk of having an episode of diarrhea(6,7).

Take Home Message

Given the results of the study on food temperature in school lunch bags, I would think it would be a good idea to give EndoMune Jr to lessen the risk of experiencing a bout of foodborne gastroenteritis.

Eat healthy, exercise and live well!
Dr. Hoberman

References

(1) Temperature of Foods Sent by Parents of Preschool-aged Children. Almansour FD, Sweitzer SJ, Magness AA.
(2) Food-related illness and death in the United States.Mead, P., L. Slutsker, V Ddietz et al.Emerg Infect Dis, Sept-Oct 1999, 56(No. 53).
(3) Children and microbial foodborne illness.Buzbym H>C. Food Revuewm 2001l 24(2):32-7.
(4) Use of probiotics in children with acute diarrhea. Szajewska H, Mrukowicz JZ. Paediatr Drugs. 2005;7(2):111-22
(5) Probiotics for treatment of acute diarrhoea in children: randomised clinical trial of five different preparations. Canani RB, Cirillo P, Terrin G, Cesarano L, Spagnuolo MI, De Vincenzo A, Albano F, Passariello A, De Marco G, Manguso F, Guarino A. BMJ. 2007 Aug 18;335(7615):340
(6) Efficacy of probiotics in prevention of acute diarrhoea: a meta-analysis of masked, randomised, placebo-controlled trials. Sazawal S, Hiremath G, Dhingra U, Malik P, Deb S, Black RE. Lancet Infect Dis. 2006 Jun;6(6):374-82
(7) Probiotics for children with diarrhea: an update. Guandalini S.J Clin Gastroenterol. 2008 Jul;42 Suppl 2:S53-7

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Probiotics in the News

Children’s Health, Drug interactions / By

I receive daily emails from a number of sources about new developments in medicine, particularly in the areas of gastroenterology and probiotics.

There are two interesting articles I would like to briefly discuss this month:

  • Benefits of Lactobacillus probiotic bacteria against gas-producing E. Coli found in colicky infants(1)
  • Probiotics for prevention of antibiotic-associated diarrhea and Clostridium difficile-associated disease in hospitalized adults(3)


Benefits of Probiotic Bacteria for Colicky Infants

The first report details the research that has been underway to determine how probiotics can lessen the problem of “Infantile Colic.” This is a condition in which a healthy baby shows periods of intense, unexplained fussing/crying lasting more than 3 hours a day, for more than 3 days a week over a duration of three or more continuous weeks. Parents have sleepless nights and stressful days trying to calm their baby. The pediatricians used to recommend trying simethicone drops, which works no better than tap water.

The exact cause of infantile colic is unknown, but a number of reports have associated colic to changes in the bacterial balance in a baby’s intestine.

A study published in the journal Pediatrics in 2007(2) reported on the benefits of taking a probiotic. In the study, 83 colicky babies were divided into two groups: 41 were given a Lactobacillus probiotic and 42 babies received simethicone. The results were astounding:

After one week, babies treated with the probiotic had close to 20% less crying time

  • By 4 weeks, probiotic treated babies had 74% less crying
  • Overall, there was a 95% positive response to the Lactobacillus probiotic drops in colicky infants.

To better understand how probiotics lessen infantile colic, this study was performed to evaluated the interaction between Lactobacillus probiotics and gas-forming coliforms that were isolated from stools of colicky infants. The results showed that several strains of Lactobacillus produced antibiotics against six different species of gas-forming coliforms.

The authors concluded:

  1. There was a greater presence of of coliform bacteria in colicky infants, and
  2. Certain Lactobacillus probiotic bacteria can improve colicky symptoms by reducing the ability of coliform bacteria to colonize the gut.


Probiotics for Prevention of Antibiotic-Associated Diarrhea, C. Difficile

This report published in the American Academy of Nurse Practioners reviewed all the relevant studies on probiotic efficacy for preventing diarrhea and colitis due to taking antibiotics.

I have written several newsletters on how antibiotics can upset the healthy balance of the intestinal bacteria, resulting in mild diarrhea or life-threatening clostridia difficile colitis. There are a 100 trillion bacteria in the gastrointestinal tract. Generally, 85% or more are healthy beneficial bacteria that help in digestion and immunity.

Antibiotics prescribed for an infection like sinusitis or bronchitis can destroy the healthy intestinal bacteria and result in problems with diarrhea. A particular bacteria called Clostridia difficile can multiply when the healthy bacteria are destroyed.

C difficile produces toxins that cause a severe colitis. Unfortunately, this bacteria is becoming more common in hospitals and other health care facilities. As a result, the risk of developing colitis and diarrhea has increased. In 2006, it was reported that patients with C difficile colitis stayed in the hospital 3.6 days longer and the additional hospital costs averaged $3,669 per patient day.(4) A conservative estimate of the cost of this disease in the United States was $3.2 billion annually.(5)

This report was to determine if giving probiotics to patients receiving antibiotics would lessen the risk of developing antibiotic-associated diarrhea and C difficile-associated disease.

The meta-analysis found that the administration of probiotics led to a statistically significant relative risk reduction. Compared to patients given a placebo, the patients receiving probiotics had a:

  • 44% reduction for antibiotic-associated diarrhea
  • 71% reduction for C difficile-associated disease

The authors concluded that administering probiotics concurrently with antibiotics in hospitalized patients could potentially lessen the healthcare spending, morbidity and mortality due to the gastrointestinal complications related to the use of antibiotics.

Articles like these two indicate the amount of research that is going on to determine the health benefits of probiotics. Since I started researching the importance of the healthy intestinal bacteria and probiotics in 2005, the amount of new scientific information published annually is amazing.

(1) Antagonistic effect of Lactobacillus strains against gas-producing coliforms isolated from colicky infants.Savino F, Cordisco L, Tarasco V, Locatelli E, Di Gioia D, Oggero R, Matteuzzi D. BMC Microbiol. 2011 Jun 30;11(1):157.

(2)Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study. Savino F, Pelle E, Palumeri E, Oggero R, Miniero R. Pediatrics. 2007 Jan;119(1):e124-30.

(3) Probiotics for prevention of antibiotic-associated diarrhea and Clostridium difficile-associated disease in hospitalized adults-A meta-analysis.Avadhani A, Miley H.J Am Acad Nurse Pract. 2011 Jun;23(6):269-74

(4) Health care costs and mortality associated with nosocomial diarrhea due to Clostridium difficile.Kyne L, Hamel MB, Polavaram R, Kelly CP. Clin Infect Dis. 2002 Feb 1;34(3):346-53. Epub 2001 Dec 17.

(5) Strategies to prevent clostridium difficile infections in acute care hospitals. Dubberke ER, Gerding DN, Classen D, Arias KM, Podgorny K, Anderson DJ, Burstin H, Calfee DP, Coffin SE, Fraser V, Griffin FA, Gross P, Kaye KS, Klompas M, Lo E, Marschall J, Mermel LA, Nicolle L, Pegues DA, Perl TM, Saint S, Salgado CD, Weinstein RA, Wise R, Yokoe DS. Infect Control Hosp Epidemiol. 2008 Oct;29 Suppl 1:S81-92

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Probiotics May Decrease Allergies

Children’s Health, Healthy Aging / By

The increased sterilization and pasteurization of foods has led to a decrease in the amount of bacteria to which we are exposed. There is a potential this has led to the increase in allergies which today’s children are experiencing.

A Finnish team of researchers conducted a study with pregnant women; some received a probiotic while others received a placebo. From eight months pregnancy to delivery, these women took a daily dose of probiotics or its placebo counterpart.

The children were examined by pediatricians at 3, 6 and 24 months of age. The conclusion was that:

To read the article in its entirety, visit: http://www.newscientist.com/article/dn13778

  • Key proteins associated with tissue inflammation were 50% higher on average in the blood of probiotic-treated infants than in the blood of placebo-treated infants. Inflammation is thought to stimulate the immune system, and so reduce allergic reaction.
  • Probiotic children were 30% less likely than their untreated counterparts to develop an itchy skin condition known as atopic eczema, which is often an early manifestation of allergies.

While more research is needed, it seems plausible that probiotics may be a key ingredient to decreasing the likelihood of your child developing allergies.

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Probiotics and the Prevention of Food Allergies

Children’s Health, Diet, Healthy Aging / By

Most of us are familiar with the term “food allergy.” Case in point, children with an allergy to peanuts can experience allergic reactions ranging from hives to coma, or even death. Sensitized children must have medication with them at all times to immediately treat reactions.

Strict avoidance of peanuts is their sole option to stay well. Schools have tried to create awareness for students and their parents to avoid bringing foods like peanut butter to school if there is a child with a peanut allergy.

In the last two weeks, there have been a number of news reports on the dramatic increase in food allergies experienced by children.

In the June issue of the medical journal Pediatrics(1), a study found that about eight percent of children under the age of 18 (almost 6 million) suffer from one or more food allergies. These numbers are twice as high as reported by the CDC in 2007, which reported a rate just below four percent. Additionally, the severity of the episodes has increased.

The lead author of the June study, Dr. Ruchi Gupta, reported that “based on our data, about one in 13 children has a food allergy. We are seeing a lot more cases in schools than we used to see. It does seem that food allergy is on the rise.” In addition, Dr. Gupta noted, “What’s more, nearly two out of every five affected children suffer from a severe food allergy. For these children, accidental ingestion of an allergenic food may lead to difficulty breathing, a sharp drop in blood pressure, and even death.”

With the growing severity of food allergies, how can probiotics help? There are some very interesting studies that suggest probiotics may lessen the risk of food allergies in children.

To get a better understanding of this topic, this newsletter will discuss:

  • What is a “food allergy”
  • What is the cause
  • How to diagnose a food allergy
  • How is a food allergy treated
  • Can probiotics help lessen the risk of developing a food allergy

What is food allergy?

Food allergy is a term used to describe an adverse immune response to a protein in some foods.

When we are born, our intestinal immune cells have to constantly survey what is being ingested. The immune cells determine if they have to mount a protective reaction to a potentially harmful virus, bacteria, parasite or toxin.

Sometimes, the immune cells react to harmless proteins in our food and produce antibodies that can result in allergic reactions like hives, eczema, asthma, rhinitis and gastrointestinal symptoms of cramps, nausea, vomiting and diarrhea.

The most serious reaction is called anaphylaxis, which causes severe breathing difficulty and a major drop in the blood pressure. Oxygen, epinephrine injections and IV fluids can be lifesaving.

Anaphylactic reactions due to food allergies account for 30,000 episodes annually and possibly 200 deaths each year.(2)

The CDC estimates that eight types of foods are responsible for 90 percent of all food allergies in children: milk, eggs, peanuts, tree nuts, fish, shellfish, soy and wheat.

What is the cause of a food allergy?

The exact cause of food allergies is not known. However, there have been several proposed explanations why food allergies occur and have been on the increase over the last 20-30 years.

Factors thought to contribute to food allergies include genetic predisposition and the introduction of foods too early in infancy.

The other major factor is the “Hygiene Theory”.(3) This theory is based on the idea that in the Western developed countries the exposure to harmful bacteria, parasites, viruses and other toxins has decreased due to our efforts at keeping everything sanitized. As a result, our immune system has more time to spend mounting a reaction to harmless proteins in our diet and other allergens like pollens.

Epidemiologic studies have found that the prevalence of allergies is highest in developed countries.

Over the last 30 years there has been a two-to-three fold increase in childhood allergies in developed countries when compared to those less developed.(4)

There have been a number of reports that have found children growing up on a farm have less allergies.(4) Playing with animals and in the dirt may actually be healthy.

How to diagnose food allergies?

A child might have a food allergy, if he/she has recurrent swelling of lips and face, hives, eczema, wheezing, stuffy nose, abdominal pain, diarrhea.

The best method for diagnosing food allergy is to be evaluated by an allergist. The allergist will review the patient’s history and the symptoms or reactions that have been noted after food ingestion. If the allergist feels the symptoms or reactions are consistent with food allergy, special tests can be performed.

Skin testing can aid in detecting the antibody(IgE) to the suspected food protein.

Blood tests can measure IgE antibodies

Sometimes it is necessary to perform a food challenge while being observed by the physician

How is a food allergy treated?

The only proven therapy is food elimination. All patients at risk for anaphylaxis must be trained to identify early symptoms and be prepared to use an auto-injectable epinephrine pen.

Can Probiotics lessen the risk of developing a food allergy?

To understand how probiotics may lessen the risk of food allergies requires a little primer on how the immune system in the intestines works.

Seventy percent of our immune system is in the intestines. Since the intestines serve as our window to our environment, it is important that the intestines monitor our exposure to harmful infections and toxins.

The lymphocytes (immune cells) in the intestines are of several types:

Th1 helps to fight infections due to bacteria and viruses

Th2 responds to infections caused by parasites

If an infant is not exposed to infectious bacteria and viruses, then Th1 will be less active, causing a shift in the balance of activity in favor of the Th2 lymphocytes, producing antibodies to parasites and also to harmless allergens.

Recently, another lymphocyte called a regulatory cell (Treg) has been identified(5). This lymphocyte can regulate the activity of both Th1 and Th2 lymphocytes.

Probiotics can modulate the immune response by acting on the Treg cells. Studies have shown that probiotics can decrease or down regulate the activity of the Th2 cells and lessen the immune reaction against proteins in foods. (6,7) The term “oral tolerance” is used to describe the process when the immune cells don’t mount a reaction.

Mice raised in a germ-free environment do not develop oral tolerance to food protein.(8) But when a mixture of oral probiotics were given to the mice, the IgE antibodies were not produced.

Since 1997, probiotics have been used in the management of food allergy. Infants with eczema due to cow’s milk had improvement when given a probiotic in their formula.(8)

In another study, either probiotics or a placebo were given to mothers during the last 4 weeks of their pregnancy. Their newborn infants were breast fed and given a probiotic supplement or a placebo for 6 months. The children who were exposed to probiotics had a 50% reduction in allergies compared to the placebo group.(9)

Not all clinical studies have shown that probiotics are able to lessen allergic diseases in children.(10) The good news is that the probiotics seem very safe. No serious adverse effects have been reported in the clinical studies.

There is no question that probiotics can influence the intestinal immune system to lessen allergic responses. Some of the future challenges include determining the most effective:

  • Probiotic strains
  • Combination of bacterial species and strains
  • Dose of bacteria in a serving size
  • Timing of introducing the probiotic to the infant/child
  • Duration of probiotic therapy

Take Home Message

If you don’t live on a farm or your child doesn’t include dirt in their diet, you might consider giving your child a probiotic. For women who are allergy prone, taking a probiotic like EndoMune may help prevent eczema in their offspring. In addition, giving EndoMune Kids to your child during infancy may help to lessen the risk of developing allergies. It is always recommended that you talk with your doctor before taking new medications and supplements.

Eat healthy, exercise and live well!

Dr. Hoberman

(1) The Prevalence, Severity, and Distribution of Childhood Food Allergy in the United States.Gupta RS, Springston EE, Warrier MR, Smith B, Kumar R, Pongracic J, Holl JL.Pediatrics. 2011 Jun 20

(2) Epidemiology of anaphylaxis in Olmsted County: A population-based study. Yocum MW, Butterfield JH,Klein JS, Volcheck GW, Schroeder DR, Silverstein MD.Yocum MW,Butterfield JH, Klein JS, Volcheck GW, Schroeder DR, Silverstein MD.

(3) The hygiene theory: fact or fiction? Sheikh A, Strachan DP.Curr Opin Otolaryngol Head Neck Surg. 2004Jun;12(3):232-6. Review.

(4) Exposure to environmental microorganisms and childhood asthma. Ege MJ, Mayer M, Normand AC, Genuneit J, Cookson WO, Braun-Fahrländer C, Heederik D, Piarroux R, von Mutius E; GABRIELA Transregio 22 Study Group. N Engl J Med. 2011 Feb 24;364(8):701-9.

(5) Hygiene theory and allergy and asthma prevention. Liu AH.Paediatr Perinat Epidemiol. 2007 Nov;21 Suppl 3

(6) Probiotics, prebiotics, and synbiotics: impact on the gut immune system and allergic reactions.Gourbeyre P, Denery S, Bodinier M. J Leukoc Biol. 2011 May;89(5):685-95.

(7) Food allergy and probiotics in childhood. del Giudice MM, Leonardi S, Maiello N, Brunese FP. J Clin Gastroenterol. 2010 Sep;44 Suppl 1:S22-5.

(8) Probiotics: a novel approach in the management of food allergy.Majamaa H, Isolauri E.J Allergy Clin Immunol. 1997 Feb;99(2):179-85

(9) Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial.Kalliomäki M, Salminen S, Poussa T, Arvilommi H, Isolauri E. Lancet. 2003 May 31;361

(10) Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial.Abrahamsson TR, Jakobsson T, Böttcher MF, Fredrikson M, Jenmalm MC, Björkstén B, Oldaeus G.J Allergy Clin Immunol. 2007 May;119(5)

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