This article is a collaboration of representatives from academia, medicine, and industry who came together at a workshop during the International Scientific Association for Probiotics and Prebiotics (ISAPP) held in Cork, Ireland in October, 2012. The goal of the workshop was to assess evidence on the link between the microbiome and under-nutrition, focusing specifically on probiotic and prebiotic treatments. Participants hoped to answer the question of whether probiotics and prebiotics can improve nutritional status in at-risk groups like children, pregnant women, the elderly, and individuals with with disease-associated malnutrition.

The group came up with four recommendations for clinicians and researchers (presented verbatim below):

(1) The categories of malnourished individuals need to be differentiated

To improve treatment outcomes, subjects should first be categorized based on the cause of malnutrition, additional health-concerns, differences in the gut microbiota, and sociological considerations.

(2) Define a baseline “healthy” gut microbiota for each category

Altered nutrient requirement (for example, in pregnancy and old age) and individual variation may change what constitutes a healthy gut microbiota for the individual.

(3) Perform studies using model systems to test the effectiveness of potential probiotics and prebiotics against these specific categories

These should illustrate how certain microbiota profiles can be altered, as members of different categories may respond differently to the same treatment.

(4) Perform robust well-designed human studies with probiotics and/or prebiotics, with appropriate, defined primary outcomes and sample size

These are critical to show efficacy and understand responder and non-responder outcomes.

Source: Gut Microbes

Sheridan, P, et al. (2014) Can prebiotics and probiotics improve therapeutic outcomes for undernourished individuals? Gut Microbes doi: 10.4161/gmic.27252.