Quick guide 

Extensive clinical documentation exists on the best probiotic strains to use for maintaining the immunity and gastrointestinal health of children and adults. To find the best probiotic on the market for a specific health benefit, here are some key points associated with a good-quality probiotic product.

All probiotics are not created equal

• Clinical results are explicitly connected to a specific probiotic strain. For example, the clinically tested function associated with our Lactobacillus rhamnosus, LGG^® (hereafter referred to by use of the trademark LGG^®) does not extend to the use of a generic Lactobacillus rhamnosus strain as a probiotic.
• Multiple probiotic strains in one product does not necessarily provide a greater number of health benefits. There should be clinical support for health benefits for specific probiotic strain combinations.¹
• The clinical results relating to a probiotic strain pertain to the specific target group tested.²
• The clinical results relate to a probiotic strain pertain to the health area investigated.²

Just the right amount

• Probiotic products contain millions to billions of live bacteria, each of which can form colonies; thus, the level is given as Colony Forming Units (CFU).¹
• A higher CFU number does not mean it is the most effective probiotic.³
• 500 million to 50 billion CFU have been associated with various health benefits.
• Colonization is not a common characteristic of probiotics and is not necessary for health benefits.⁴

Long-term viability for desired results

• Probiotics are live microorganisms and should be alive when ingested.⁵
• The manufacturing date is not as important as the ‘end of shelf life’ date, a product's potential expiration date, on a probiotic product label.¹
• The level present (CFU) at the ‘end of shelf life’ should be within the range of clinical results connected to that specific probiotic strain.¹
• Not all probiotics need to be refrigerated to remain viable; actually, most can be kept at room temperature.³

Safe to consume confidently

• People in good health typically may use the recommended CFU level without concern.³
• Healthcare professionals should be consulted for women who are pregnant, infants, individuals with a compromised immune system, or people with short bowel syndrome.³
• The probiotic should be approved for human consumption by a recognized regulatory or food safety authority:
  
  • US Food and Drug Administration GRAS (Generally Recognized As Safe) notified to the FDA in the US;⁶
  • QPS (Qualified Presumption of Safety) granted by EFSA  in Europe.⁷
    

LGG^® is a registered trademark of Chr. Hansen A/S.

The article is provided for informational purposes regarding probiotics and is not meant to suggest that any substance referenced in the article is intended to diagnose, cure, mitigate, treat, or prevent any disease.

Reference list

1. Jackson SA, et al. Improving End-User Trust in the Quality of Commercial Probiotic Products. Frontiers in Microbiology. 2019;10:739. (PubMed)
2. McFarland LV, et al. Strain-Specificity and Disease-Specificity of Probiotic Efficacy: A Systematic Review and Meta-Analysis. Front Med (Lausanne). 2018;5:124-. (PubMed)
3. World Gastroenterology Organisation. World Gastroenterology Organisation Global Guidelines - Probiotics and prebiotics. 2017. (Link to article)
4. Alander M, et al. Persistence of colonization of human colonic mucosa by a probiotic strain, Lactobacillus rhamnosus GG, after oral consumption. Appl Environ Microbiol. 1999;65(1):351-4. (PubMed)
5. Hill C, et al. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology &Amp; Hepatology. 2014;11:506. (PubMed)
6. Food and Drug Administration. GRAS Notice Inventory > Agency Response Letter. GRAS Notice No GRN 000049. 2002.
7. EFSA Panel on Biological Hazards (BIOHAZ). Statement on the update of the list of QPS-recommended biological agents intentionally added to food or feed as notified to EFSA 3: Suitability of taxonomic units notified to EFSA until September 2015. EFSA Journal. 2015;13:4331.