The Hype About Probiotics

Are you familiar with the term “echo chamber”? Amongst other things, it’s a media concept that describes how the internet works. Instead of expanding our awareness and experience of the world, it can limit it. The belief systems or “lens” we inadvertently apply in our social media engagements and google browsing, is amplified and reflected back to us. We only see what we already believe to be true. As the internet giants adapt to keep us engaged, our society becomes more polarized, with more extreme political views, and violence. Healthcare is not immune to this effect.

A recent Israeli study on probiotics, published a few weeks ago in the journal Cell, is one example. CBC and dozens of other media outlets concluded that probiotics could be harmful if taken after a round of antibiotics. The principle author of the study is quoted by ScienceDaily.com: “People have thrown a lot of support to probiotics, even though the literature underlying our understanding of them is very controversial…” I’m aware that the research is in its infancy – but a controversy? But I suppose it did capture our attention.

If you make the effort to pay for access to the original study, you might be surprised to discover that the data, acquired from only 8 people, simply discovered that taking a particular probiotic preparation after consuming strong antibiotics, resulted in a very slow return or change to the person’s pre-antibiotic microbiome state. The media has popularized this finding as “harmful”. If a Scientist made this conclusion based on the data, they would be judged by their peers as making unfounded and naïve assumptions. [1] We don’t hold our media to this level of integrity, unfortunately.[i],[ii]

These media stories that circulate on the internet and in people’s facebook feeds, create unnecessary conflict that further polarizes our beliefs about appropriate healthcare. For example, if you believe that all pharmaceuticals are “bad”, your internet browsing and facebook feed will reinforce your ideas about big pharma and push you to further criticize your family doctor. If you believe that natural health products are risky and unproven, your experience here too, will be supported. And as the large media conglomerates share hyped-up and judgmental information from both perspectives, our community’s capacity for bridging the gap and developing high-quality, accessible, integrative healthcare, is inadvertently inhibited.

Being “media literate”, in which we take the time to evaluate information presented and explore its biases, is more important than ever. In the case of probiotic literature, please keep in mind that despite the hundreds of studies published globally each month, our scientific understanding of the microbiome is still very much in its infancy. The human microbiome is a big deal, a paradigm shift in medicine, but understanding how to apply this information to achieve health requires patience, a holistic perspective, and more (not less) collaboration among health professionals.

“Be as careful of the books you read, as of the company you keep, for your habits and character will be as much influenced by the former as the latter.” Paxton Hood

 

[1] A more critical and academic review of the data reveals the nuances in the study results. For example, we can’t assume that returning a participants’ microbiome to its original state (and in a matter of weeks no less), is ideal. We can’t account for the diet and lifestyle impact of these participants on their recovery, (which we know has a distinct impact). What the study actually teaches us, is that we have much to learn about what an ideal microbiome looks like, how to best measure this, and how probiotics impact this. These results support conclusions from previous studies that probiotic strains have a transient metabolic impact on the body, such as by immune modulation or detoxification (i.e. they don’t need to colonize the gut to have an effect). And most of all, these results must be understood in the context of results from hundreds of studies published on the microbiome each month, and hundreds more published on the benefits of probiotics after antibiotic use.

 

[i] Dumas-Mallet E, Smith A, Boraud T, Gonon F (2017) Poor replication validity of biomedical association studies reported by newspapers. PLoS ONE 12(2): e0172650. https://doi.org/10.1371/journal.pone.0172650

[ii] Selvaraj S, Borkar DS, Prasad V (2014) Media Coverage of Medical Journals: Do the Best Articles Make the News? PLoS ONE 9(1): e85355. https://doi.org/10.1371/journal.pone.0085355