A game of health claims consequences

In 2009, we published a review on the health effects of probiotics. Although there are gaps in the evidence, a number of peer-reviewed trials have demonstrated strain-specific benefits in a variety of clinical situations, such as antibiotic-associated and C. Difficile diarrhoea, ulcerative colitis and possibly irritable bowel syndrome. In addition, health professionals increasingly recommend probiotics as a precautionary measure for those taking antibiotics.

But decisions at European level may limit the information available to those wishing to take probiotics. The term 'probiotic' is considered to be, at the very least, a non-specific health claim, as referred to in Article 10 (3) of the nutrition and health claims regulation.

Although there are gaps in the evidence, a number of peer-reviewed trials have demonstrated strain-specific benefits in a variety of clinical situations, such as antibiotic-associated and C. Difficile diarrhoea, ulcerative colitis and possibly irritable bowel syndrome. In addition, health professionals increasingly recommend probiotics as a precautionary measure for those taking antibiotics.

Once the Commission's list of approved claims is published, statements such as 'contains probiotics' will only be lawful if accompanied by an authorised Article 13 or 14 opinion on the bacterial strains. However, the focus of the authorisation procedure for health claims has been the general (healthy) population and this is presumably one of the reasons why no positive opinions for probiotic-containing products have been approved.

A universally accepted definition of probiotics was published in 2001 by the World Health Organisation. Probiotics are: 'live microorganisms which, when administered in adequate amounts confer a health benefit'. A number of scientists with established international reputations in this field of science have expressed their concerns about the current position through the collection of signatures on www.gut-health.eu.

The situation in Europe is in contrast to that in the US and Japan, where health claims procedures have recognised the health effects of probiotics. As a result, in these countries, products that contain probiotics are signposted for those who wish or are advised to consume them.

Professor Judy Buttriss is director general of the British Nutrition Foundation.