Gregor Reid Talks about the Benefits of Probiotics
Special Topics Interview: June 2010
More recently, you've done some work with the
use of probiotics in HIV/AIDS patients as well as natural food sources
of probiotics in Africa. What sort of impact do you think probiotics
might have on the health of HIV/AIDS patients and people in general in
these regions of the world?
It started with Stephen Lewis, who was the United Nations' special envoy for HIV/AIDS in Africa—he gave a talk at the university. I wasn't there, but a colleague of mine, Bob Gough, was. In addition to being impressed with Stephen's wonderful oratory skills, he inspired Bob to say, "Look, I'm in charge of housing at the university and we have about 6-7,000 first-year students who could become engaged and do something for HIV in Africa."
For whatever reason, he called me and I went to a meeting. It was kind of strange, people from Housing discussing what they could do for Africa.
My feeling was that if you're going to do something like this, it has to be sustainable. You can't be airlifting supplies every week; that doesn't help the country. It has to be something that when you walk away, they can continue on their own.
It also should be something that can affect everybody, something that can be purchased by extremely poor people. Also, with the rates of malnutrition and HIV, many people get diarrhea or some kind of gut problems. So putting all that together, I said, "Well, why don't we make a probiotic yogurt?"
So that was the goal. I donated the strain, Dr. Shari Hekmat devised a yogurt with it, and two student interns went out to Tanzania, Africa, and set up a kitchen by teaching local mothers how to make probiotic yogurt. Western Heads East was born.
Now we have this whole network running on the ground, and I think that's why it's successful. Often, well-intentioned initiatives peter out, because people don't engage grass-root local scientists and politicians and NGO's.
The women are incredibly dedicated. We're talking about an environment where 80% of people share pit toilets and unemployment is like 60%—in many cases survival comes through selling a couple of pieces of corn every day. There are electricity shortages...it's just extremely challenging.
And yet these mothers—some of whom faced violence from male partners upset because they believed their women should stay home and take care of them and their children—out of all these challenges, stuck with it, set up an NGO, and have now helped the concept go to Kenya and soon Rwanda, and hopefully other regions.
They're determined to be a grassroots organization for the poor, and for us, it's been incredible to send out interns (the real heroes and heroines) for several months of internship work. Most of them get malaria or some kind of sickness, and yet they come back so motivated and changed as people.
In terms of the science, it's very difficult to do it because there is only have one ethics review board for the whole country and so it took nine months to get approval for one study. Nobody seems to want to fund this kind of work, maybe because they see it as too low tech. I've had situations where people say, "Pfft! Yogurt! That's not going to help people."
"The term 'probiotics' had been loosely used and had different definitions over the years, but the concept hadn't really been taken seriously until the last 10 years or so"
We have got some data coming in slowly but surely and the results indicate that the probiotic yogurt can reduce diarrhea, improve energy levels, reduce side effects from antiretroviral therapy (these drugs themselves can kill you), and improve nutrition, etc.
We never said we'd cure AIDS; what we're trying to do is help the quality of life, help people with the virus, and I think we're doing that.
Where do you see probiotics going in the next
decade?
If you have a slide of the human body, you could point to any part of it, and you'll find that microbes play a role in health. And so, the sky's the limit, really. Probiotics at present represents somewhat of a crude way of manipulating that flora, but it will become more targeted.
We're dead without our organisms; it's as simple as that. There's not a human being alive who doesn't have microbes. We came from these organisms and so they're integral to everything that we do—they affect every part of us.
For example, in the bloodstream, lactobacilli might help to lower cholesterol. In the brain, recent papers have shown reduced anxiety or pain if you take probiotics. You can go through papers on reduced duration of respiratory infections, bladder cancer—it's really hard to find a part of the body probiotics don't affect. There's already some work showing that probiotics could impact obesity.
Probiotics is one way of restoring beneficial organisms. In the future, we will take specific strains at specific times. For example, I have a neighbor with really, really bad allergies, causing lesions all over his legs and hospitalization a couple of time every summer due to these allergies. We put him in a study where we made a probiotic yogurt and he was in the active arm rather than the placebo.
He had a great summer. He was raving about it: "God what was in this stuff?" He had hardly any issues with allergies at all. So I said to him, "Well, the study is over, but if you take DanActive, it's at least worth trying."
He's been on that for a year and a half now, and I think last summer he may have taken an antiallergy medication once. He totally swears by the yogurt. In his case, I think it's had a massive, massive effect. You can feel better with placebo, but that won't stop the lesions coming out, so I feel it is the product that has helped him.
There are a lot of examples like that, but as a scientist I need to try and find out what works, why it works in some people and not in others.
I just wrote a paper which will come out in Gut Microbes, probably later on in 2010, on responders and nonresponders. It comes from a meeting I hosted as president of ISAPP (International Scientific Association for Probiotics and Prebiotics) in November 2009, in which we explored why some people respond well and others not at all to probiotics and medications.
Part of the reason is the selection criteria for entering the study and part of it is the genetics of how someone responds. So by carefully planning the study and using predictors of who will respond, I think we'll find that we can improve the number of people who respond in future studies.
In the next 20 years you will see many more applications. They might be more complicated, they'll probably be more targeted. More personalized medicine will find its place. So a patient will be able to say "I'm 38, I want to get pregnant," or "I'm menopausal," or whatever..."This I what I want the probiotic for," and so you'll have a range of different strains to choose from based upon your flora, age, health status, etc.
Until very recently, not one of us did anything for our flora. We didn't
take one piece of food and say, "I'm taking this because I want my
beneficial flora to be enhanced." Tomorrow, you just might do
that!
Gregor Reid, Ph.D., MBA, Dr. HS, FCAHS
University of Western Ontario
and
Lawson Health Research Institute
London, Ontario, Canada
GREGOR REID'S CURRENT MOST-CITED PAPER IN ESSENTIAL SCIENCE INDICATORS:
Reid G, et al., "Potential uses of probiotics in clinical practice," Clin. Microbiol. Rev. 16(4): 658-+, October 2003, with 143 cites. Source: Essential Science IndicatorsSM from Clarivate.
KEYWORDS: PROBIOTICS, LACTOBACILLI, BLADDER INFECTIONS, UROGENITAL INFECTIONS, SIGNALING MECHANISMS, GUIDELINES, HIV/AIDS, PROBIOTIC YOGURT, AFRICA, GRASSROOTS ORGANIZATION, QUALITY OF LIFE, DIARRHEA, BENEFICIAL BACTERIA, PERSONALIZED MEDICINE, OBESITY, ALLERGIES, RESPONDERS, NONRESPONDERS.
Photo 1:
Photo 1 description:
Gregor Reid's probiotics team.