Guests: Dr Nigel Plummer
Presenter: Patrick Reyes
Guest Bio: Dr Nigel Plummer is a world-renowned expert in the field of probiotics with over 20 years of experience. He earned his doctorate in microbial physiology from the University of Surrey, UK. Together with his team of researchers, they have published over 80 original scientific papers, including eight human RCT’s mainly on the microbiome and its manipulation with probiotics.He provides lectures globally to both health professionals and members of the public on all aspects of nutrition and its contribution to health and disease.
Segment overview: Dr Nigel Plummer, a world-renowned expert in the field of probiotics, shares his knowledge gained from his experience of over 20 years in the field. He explains the effects of using probiotics alongside antibiotics.
Health Professional Radio – Use of Probiotics Alongside Antibiotics
Patrick Reyes: Hello and welcome to Health Professional Radio. My name is Patrick Reyes and on today’s show, we have Dr. Nigel Plummer. He is a world-renowned expert in the field of Probiotics and his research team has published over 80 original scientific papers including 8 human RCTs, mainly on the microbiome and its manipulation with probiotics. And he has also given lectures globally to help professionals and members of the public on all aspects of nutrition. Welcome to the show Nigel.
Dr. Nigel Plummer: Thank you very much. Good to be here.
P: Can you tell the audience a little bit more about yourself and what it is that you do?
N: Well I’m a microbiologist, that’s my training. I started off in the pharmaceutical industry actually. I started working for Pfizer but many, many years ago, and now, I developed an interest in probiotics. In fact, Leon, the interest with animal probiotics. I’m looking at preventing the neonatal diarrhea in young pigs and young cows and that was going back nearly 30 years now. And following the development of those probiotics, which actually worked very, very well, we then stepped into the arena of looking to make probiotics for humans. So then covers the long story, we started to develop a research group, we developed our first range of probiotics which at that time, we used human strains, and at that time, that was very innovative. And then, as we’ve gone on, as you said, we’ve now published 80 papers and done 8 or 9 full RCTs now. So yes, it’s a big part of our on-going business, we’re also a manufacturer of probiotics, so fully-integrated from the implementation of the bugs that we select and actually ourselves in our own strains, right through to the production of finish products. So, we’re completely embedded in the source of probiotic industry. And in a sense, that the scientific arena is kind of caught us up in the last 10 years, there has been a huge increase interest in the microbiome and obviously, the publication if you like of a detailed view of the microbiome and definition of the microbiome has spurred a huge amount in the earth interest in this subject. So yes.
P: And what was your motivation or your drive when it came to studying and doing your research on probiotics?
N: Right at the start, as I say, when I was at Pfizer in the pharmaceutical industry, I was working on antibiotics. And indeed, what we’re looking at, on what … antibiotics and looking at the effectiveness of antibiotics in resolving neonatal diarrhea that I’ve mentioned in young pigs and young cows that suffer horribly from very, very bad diarrhea in the first period after birth and over weaning, and can kill up to 20% of young cows and young pigs. And what we were finding was that antibiotics did not really, they had some effects but they certainly didn’t resolve the situation and hence it was apparent at that point that there were other elements lacking if you like from the immune protection that these young animals had. And part of that was the establishment of a protective microbiota and it was that connection really from antibiotics through to probiotics, or the used of it or the application of probiotics as a way of replacing or establishing a microbiota which in that case, wasn’t there. So that was the first connection, and then it became such an interesting area that it just carried on from there.
P: Who would you say is most likely to benefit from your research?
N: Well I think now that there are certain conditions and certain situations where I think there is compelling reasons for the use of probiotics. Let’s list one or two of them, I think now we’ve got to the point where around the use of antibiotics, the use of probiotics as a way of trying to mitigate the very damaging effects that the antibiotics have on the intestinal microbiota. I think that those mitigation effects are now also, positive in such and so consistent that the use of probiotics alongside antibiotics is now I think, it’s such a compelling story. And let me just go into that in a sense. Antibiotics, because most antibiotics are taken orally and we take in Australia for instance, there’s 26 million scripts of antibiotics that are written every year. That’s basically one for every person per year. And antibiotics, all of them really will have a devastating effect on the small intestinal microbiota because most antibiotics, either pass through that microbiota to be absorbed into the bloodstream. And even if it’s a non-absorbable antibiotic, it goes through the small intestine to get to the large intestine. And so antibiotics have a devastating effect on the small intestinal microflora and it’s the small intestinal microflora that we now know is very, very important in terms of the types of attributes that we expect to see from probiotics for instance. So if we look at the manipulation of the immune system, most of the immune system in our gut and hence, in our body lies in the small intestine not in the large intestine. Most of the intestinal effects that we look for in probiotics are centered on the small intestine, things like gastroenteritis, a lot of IBS symptoms for instance, centered in the small intestine rather than the large intestine. And this is where both antibiotics have the negative effect and probiotics have the positive effect. So around antibiotic use, I don’t think that there’s a doubt about the use of probiotics, one other thing that’s really important in that. And that is that there is now clear evidence, one of our clinical trials demonstrated this. Clear evidence that the use of probiotics around an antibiotic decreases the level of antibiotic resistance in the regrowth flora in the gut. Now, basically what I mean by that, the use of probiotics alongside antibiotics is the first positive intervention that we know of that has a possibility of decelerating the progression or resistance to antibiotics. Everything else in terms of our efforts to decelerate progression of antibiotic resistance is based upon, if you like limiting the use of antibiotics. Probiotics also are proactive intervention in potentially decelerating progression of resistance through antibiotics and that’s a huge thing. The second point that I’d like to mention in terms of absolute compelling evidence to the use of probiotics is alongside the birthing process in the neonate. Our first microflora is established literally within the birthing process and because we used antibiotics very much in terms of what … it’s also used as a prophylactic… As a lot of antibiotic used alongside the birthing process overall. And what we know is that the disruption on non-establishment of an optimal microflora during the birthing process, potentially has a long-term implications on our health, such as much high risk of developing allergy, much high risk of developing gastroenteritis, and enterocolitis in infancy, and even higher risk of developing weight gain and obesity in later childhood. Now the use of probiotics at that time around birth so to the mother during pregnancy and to the baby in the first 6 months of life again, is now compelling evidence many, many trials are showing that we can significantly prevent the risk of developing allergy, significantly decrease incidence of gastroenteritis and enterocolitis and so forth. Those two are very, very clear. And really for anybody who has a dysbiosis alongside of things like IBS, anybody who has IBS will really benefit from the use of probiotics. And the other one that’s really coming through now is that probiotics are really good regulator and stimulator, if you want to use that term of our immune systems generally. And so there was a metro analysis published in 2014, showing that the use of probiotics over the winter, decreased coughs and colds in adults and in children. And this is a metro analysis of 20 trials, decreased coughs and colds by 30%. And that’s why about metro analysis for Vitamin C, Zinc, and Echinacea. So probiotics, even for something like coughs and colds seem to offer a much better solution. And some of the things that we traditionally look for that resolution as I say, such as Vitamin C and Zinc. So those are the types of areas now where I think probiotics have profound information, compelling information based on the solid science, and they’ll be more as we move on.
P: Alright. And what would you say is the biggest misconception your clients or users, or the public have about probiotics that you would like to clear up?
N: It’s a very interesting one, the misconception. I think that there are I suppose not so much myths but the things that not truly accurate. One of the things that I would like to clear up for instance is that, having for instance, more strains in a probiotic doesn’t necessarily make the probiotics more effective. We’ve got a coach of collection over 200 strains. We use maybe 10 of those strains from a clinical and a commercial points, because they are very best strains. So it’s much better to have, for that 1 or 2 really effective strains, than let’s say 15 ineffective strains. I understand where the concept comes from and our microbiota is incredibly complex and rich flora, and we understand that. And so there’s almost a natural tendency to say “Okay fine, the more strains that we have, the better it is.” And in a sense, I can understand where that logic comes from, but from a practical point of view, having effective strains is better than having lots of ineffective strains. That’s I think, number one. And the other thing is that, just looking at the numbers of all, what we call commonly former units, so the potency of the product. If you go back 20 years, probiotics were I suppose you’d see probiotics to the level of 1 of 1 billion per serving or 500 million and a high potency probiotic at that point would be 5 billion probiotics. And what we now know is that typically, it’s always the case but generally speaking, the higher potency that you have with a probiotic, up to about 25 to 50 billion, you tend to see more consistent and better effects. So, what I would say is that, what we’re seeing now is that, if you like that the range of potency that we’d like to see, to see physiological and therapeutic effects is in the realm of between 5 and 25 to 30 billion. So we’ve kind of moved up the scale. And my final thing that I would say, in terms of people choosing a probiotic, whether it’s practitioners, whether it’s the general public, then what they should be looking for is that the probiotic has supporting evidence that this in a form of randomized controlled trials that have been published and they should be human trials that demonstrate a significant benefit for the … looking to treat. There’s lots and lots of good probiotics out there, but there’s a lot of probiotics that really haven’t been proven out there as well. So what the practitioner to remember, the general public should be looking for when they’re choosing a probiotic, is choose a probiotic where there is clear significant benefits from published randomized controlled human trials that show a benefit for the condition that the practitioner is looking to treat. That’s the, if you like number one selection criteria that the practitioner should use.
P: I see. Now, is there any future or upcoming lectures that you would like people to know about?
N: In Australia, I’m in Sydney an I’m giving a lecture at the Big Pharmacy Show which is in the Gold Coast. And that’s Saturday, this week. And so yes, anybody can come along to that, that will be great.
P: Alright. Now, before we go ahead and end the segment, let me give a go head and give you one more question. What’s a message you’d like to send to our audience for being part of Health Professional Radio today?
N: A message I’d like to send that in terms of probiotics usage? Okay, I would say that well if we look globally, probiotics are I suppose now are undoubtedly fastest growing category of nutraceuticals in the market place. And the reason for that, is that over the last 10 years, the importance we’ve seen in terms of the microbiome on our physiology and the impact that it has on the different parts of our physiology. And the compelling research that probiotics as manipulators of our microbiome, make it now that the reasoning is clear why there’s such growth, and it’s because probiotics have been shown now to be beneficial and in a number of ways, the other nutrients haven’t been shown to be. And also areas where, also the … medicines, and all pharmaceuticals don’t really have a role to play or a weapon in their armory. Let me give you an example of that, if you take prevention of allergy, and that can be a lifelong benefit, that there isn’t anything in the pharmaceutical armory or in nutritional armory, that has been shown to decrease the incidence of allergy in young infants by 50%. Probiotics have been shown to do that on a consistent phase. I think that’s the message that I want sent out, that basically probiotics are a major category of nutraceuticals now and we’re only just seeing the first generation of probiotics and we’ll see as years to come, second and third generation of probiotics coming through.
P: Alright, well it’s been a pleasure talking to you today Nigel.
N: Thank you very much, it’s been a pleasure.
P: You’re welcome. And you’ve been listening to Health Professional Radio, I’m your host Patrick Reyes and we’ve been in conversation with Dr. Nigel Plummer. A world-renowned expert in the field of Probiotics as we talked about the benefits of probiotics. If you’ve missed our conversation or if you’d like to listen to this interview again, transcripts and audio of this program are available at healthprofessionalradio.com.au and also at hpr.fm, and you can subscribe to this podcast on iTunes.