New research sells digestive health products

Walk the aisles of any natural products store and you’ll likely find a plethora of “gut health” products aimed at quelling gas, bloating, diarrhea and abdominal pain. But could such products also clear up acne, mollify depression, ease pain and kidney problems, and help people lose weight? Currently, the science is young, and lawsuit-weary manufacturers are remaining cautious about what they claim, yet mounting evidence suggests that unhealthy innards can, indeed, wreak havoc far beyond the bowels.

“The digestive system is key to everything,” says Elizabeth Lipski, PhD, a clinical nutritionist and author of Digestive Wellness: How to Strengthen the Immune System and Prevent Disease Through Healthy Digestion (McGraw Hill, 2011). “If it’s compromised for any reason, we can’t get nutrients in or waste out, and nothing works right.”

Lipski points out that roughly 70 percent of our immune cells and antibodies reside in the gut, and 90 percent of the mood-influencing brain chemical serotonin originates there. In addition, the digestive system is home to “about 4 pounds of bacteria, which, when in balance, make B-complex vitamins and vitamin K, protect us from infection, help combat toxins and keep us healthy,” Lipski says. “The gut microbiome is where most of the genes that tell our body how to run reside.”

For centuries, Ayurvedic and traditional Chinese medicine have recognized that good digestion is the root of all health, but only recently has this notion moved West. In 2007, the National Institutes of Health launched the Human Microbiome Project, a five-year effort to better understand how resident gut microorganisms influence various body systems. Meanwhile, university researchers and biotech companies are conducting trials and exploring broader applications of products aimed at quieting bowel troubles. “Science-wise, we aren’t entirely there yet, but that doesn’t mean companies aren’t working madly on it,” says Mary Ellen Sanders, PhD, a Centennial, Colo.-based food microbiologist and probiotics consultant. “We’ll see major development in this area in coming years.”

The good news for retailers? As this science develops, so will opportunities for digestive health product sales.

Heal the gut, heal the skin?

Just how could a sour bowel lead to acne, sore joints or fatigue? The mechanisms are myriad and complex, but many experts suspect that an overgrowth of harmful bacteria and a compromised intestinal lining are often to blame.

“If you are not having a bowel movement on a regular basis, your plumbing gets backed up and you can end up with an overgrowth of bacteria in your small intestine,” explains Tracey Beaulne, ND, a Toronto-based naturopath who focuses on addressing skin problems via the gut.

Studies show that small-intestine bacterial overgrowth—or SIBO—can impair nutrient absorption, starving the skin and organs and contributing to syndromes such as fibromyalgia and chronic fatigue. A 2008 study of 173 participants found that SIBO is nine times more prevalent in people with acne rosacea than in those without skin problems. Furthermore, the researchers found that treating acne with antimicrobials induced an “almost complete regression of lesions.”

Lipski adds that when the shield of friendly bacteria that lines the intestinal tract is compromised (via poor diet or medications, for example), it can, like a garden hose full of holes, allow harmful bacteria, toxins and food particles to pass into the bloodstream, setting off a system-wide inflammatory response, complete with skin woes.

Another culprit is food allergies. “Let’s say dairy doesn’t agree with you, but you keep eating it anyway—the gut responds with that same inflammatory response,” Beaulne says.

Thus far, the evidence supporting probiotics for skin health is lean but promising. One recent study of 56 people with acne showed that repopulating the gut with good bacteria, via daily consumption of a lactoferrin-enriched, fermented dairy beverage, decreased lesions significantly over 12 weeks. Several other studies have shown that supplementation with probiotics—particularly Lactobacillus rhamnosus GG—during pregnancy can prevent or alleviate eczema in children.

Only a few companies are currently marketing gut health products for the skin. For example, Nestlé recently launched Innéov Solaire with Skin Probiotic in Europe. Still, practitioners are already connecting the dots.

“If someone comes in with terrible skin and constipation or bloating, I prescribe probiotics, omega-3 fatty acids [which also address inflammation in the gut] and, if necessary, antimicrobials—like oil of oregano and grapefruit seed extract,” to address bacterial overgrowth, Beaulne says.

Weight and pain management, immunity and more

The gut-health links don’t end with skin and mood. Kibow Biotech, a probiotics manufacturer in Newtown Square, Pa., recently released a kidney support supplement that enlists the bacteria Streptococcus thermophilus, Lactobacillus acidophilus and Bifidobacterium longum to gobble excess toxins in the bloodstream and give the kidneys a rest.

Numerous companies, including Chicago-based Sunstar Americas (maker of PerioBalance) and Tampa, Fla.-based Oragenics (maker of EvoraPlus), now offer specific strains of probiotics aimed at preventing cavities and freshening breath.

Probiotics for vaginal health are gaining shelf space as well, thanks to studies showing that Lactobacillus rhamnosus GR1 (found in Los Angeles–based Jarrow Formulas’ Fem-Dophilus and elsewhere) can prevent female urinary tract and vaginal infections.

And Ganeden Biotech, the Mayfield Heights, Ohio-based manufacturer behind the popular GanedenBC30 patented probiotic strain, is currently exploring new applications. “We are doing some interesting work looking at athletes, cardiovascular health and inflammation,” says Mike Bush, vice president of business development. “We are also looking at probiotics in the cosmetics industry, and we’ve published a study showing they can improve flexibility and reduce inflammation among people with arthritis.”

Other new research suggests gut bacteria can influence how efficiently we break down food—predisposing us to diabetes and obesity—and the way our pain receptors behave. One study, published in the journal Nature, found that oral administration of certain Lactobacillus strains prompted a pain-numbing effect “similar to the effects of morphine” in the intestinal tract.

As for evidence of overall immunity-boosting, a July 2009 study of 326 children published in the journal Pediatrics showed that those who took Danisco’s Howaru Protect probiotic formula (a blend of Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07) twice daily for six months reduced fever incidence by 73 percent, coughing incidence by 62 percent and runny nose incidence by 59 percent compared to a placebo. The kids who took the probiotics also missed fewer days of school and used fewer antibiotics.

The gut-mood connection

Researchers have long known that people who ail from irritable bowel syndrome are more likely to be depressed and anxious, but many figured sufferers felt blue because their stomachs were upset. The answer, it turns out, may be much more complicated.

“Our bowel is a strong metabolic organ that produces many molecules that affect our brain,” says Premysl Bercik, MD, a researcher with the Hamilton, Ontario, Canada-based Farncombe Family Digestive Health Institute at McMaster University.

In a study published this year in the journal Gastroenterology, Bercik found that by manipulating the bacteria in the guts of mice (via antimicrobials), his team could turn a timid and reclusive mouse into a bold explorer and boost the production of brain-derived neurotropic factor, a protein that, when lacking, has been associated with depression. When the bacteria were changed back, so were the mice.

In another animal study, researchers gave probiotics to mice that had bacterial infections in their colons and exhibited anxiety-like behavior. Even though the probiotics didn’t quell the inflammation (which many assumed was causing the anxiety), the mice calmed down. “[The probiotics] basically acted like a medication for anxiety—changing the biochemistry in the brain,” Bercik says.

Stanford University School of Medicine researchers reported in May that lab rats exposed to stomach irritation early in life were more likely to display depressed and anxious behaviors later on. Meanwhile, other small, industry-sponsored trials have shown that administering probiotic drinks and prebiotic fiber supplements to normalize gut flora can boost mood and ease anxiety in humans.

Bercik isn’t ready to make that leap, however. Instead, his institute has launched a new human trial to gauge the impact of probiotic supplements on mental health. “There is a light at the end of the tunnel, but we are only at the very beginning of it,” he says.

Retailers can help shoppers weigh their gut health options

How can retailers best help shoppers as the science evolves? “They can play a big role in educating their customers to the fact that if they are taking in nutrients but not absorbing them in their gut, they’re going to be sick long term,” says Brenda Watson, a Florida-based nutritionist and author who recommends a regimen of fiber, omega-3s, probiotic supplements and digestive enzymes to promote overall health for her clients.

Sanders believes retailers should ask more questions and know their product options. “Find out why a customer is interested in a gut health product, and if he tells you something specific, find the product that has been tested for that use and recommend it,” she says.

And if the study hasn’t been done yet? Just wait a few months.