Assessment of Probiotic Use and Knowledge in the Sacramento Region
Mimi Nguyen, BS1, Krista K. Ferge, BS2, Alexandra R. Vaughn, BS1,3, Waqas Burney, MBBS1, Lay Heng Teng, Adrianne Pan4, Victoria Nguyen4, Raja K. Sivamani, MD, MS, CAT1,2*
1. Department of Dermatology, University of California – Davis, Sacramento, CA; 2. Department of Biological Sciences, California State University Sacramento ; 3. Drexel
University College of Medicine, Philadelphia, PA; 4. University of California – Davis, Sacramento, CA
INTRODUCTION
METHODS
Probiotics are live microorganisms that, when administered orally,
modulate the gut microbiome and physiological activity and may
improve overall health (1). As evidence continues to establish the
importance of the gut microbiome in health and disease states, many
people seek to improve gut health through the consumption of
probiotic foods and supplements. Several studies have been
conducted assessing the clinical uses of Lactobacillus acidophilis,
Lactobacillus rhamnosus, and Bifidobacterium bifidum for
gastrointestinal and skin health (2-5). There is some evidence
available supporting the use of certain probiotics for gastrointestinal
illnesses, such as inflammatory bowel disease, irritable bowel
syndrome, and diarrhea, but results of clinical trials have been
inconsistent (2).
Participants
The survey was reviewed and determined to be exempt by the
University of California, Davis (UCD) Institutional Review Board.
Participants were recruited from the UCD Dermatology Clinic, as well
as members of the community at approved locations within a 100mile radius, as they exited the clinic or other public location. Those
who were under 18 years of age, or could not understand and speak
English were excluded from participating.
With the increasing popularity of probiotic supplementation, it is
important for both consumers and healthcare providers to be aware
of their compositions (6). Chin-Lee et al. conducted a small-scale
study in a community-based health care setting and found that 65.2%
of patients reported being familiar with probiotics and 29.9%
reported having previously used probiotics. Of those who have used
probiotics, 38.8% were unable to identify a bacterial strain present in
the supplement (7). Considering various bacterial strains could have
markedly different effects, it becomes important to assess patient
knowledge about probiotics, and their motivation for taking them.
The purpose of this study is to determine which probiotic strains are
commercially available, and to characterize probiotic use among the
general population. The goal of this study was to analyze survey
results from participants in the Sacramento community to determine
trends in probiotic use. The results of this study will aid in patient
counseling by providing a better understanding of the motivation
behind ingesting probiotics.
OBJECTIVES
Study Design
Survey
Participation of subjects who met inclusion and exclusion criteria was
anonymous and voluntary, and subjects were not compensated for
their time. The online survey consisted of 11 questions assessing
probiotic knowledge and use, and 2 demographic questions inquiring
about education level and ethnicity. Individuals who had previously
taken probiotic supplements were directed to 9 additional questions,
while those who had never taken probiotic supplements were
directed to 2 additional questions. For questions evaluating the
importance of various factors in the purchase of probiotic
supplements, subjects were asked to rate each factor on a scale of 03, 0 being not important, and 3 being extremely important. All
subjects were directed to the 2 demographic questions regardless of
previous probiotic use.
Data Collection of Commercially Available Probiotics
Probiotic data was collected from various stores within 100 miles of
the Sacramento region. All capsules, powders, and drinks labeled as a
“probiotic” that included bacterial strains on the nutrition fact labels
were included in the data set. Duplicates from each store were not
included. The research team collected data on the store, brand,
price, refrigeration status, advertised use, dose of strains, and the
specific bacterial strains included in the supplement. All species
included in the nutrition facts were recorded. Advertised use was
determined based on what was written on the packaging, with more
than one use possible.
RESULTS
Top 10 Bacterial Strains Found in Supplements
Location
# of Surveys Collected
UC Davis Dermatology Clinic
194
Local schools (UC Davis, UC Davis School of Medicine, CSU
Sacramento, and Sierra College)
A secondary objective was to determine brands, dosages, prices,
advertised benefits, and refrigeration status of commercially
available probiotics in the Sacramento region.
Statistical Analysis
Chi-squared test was performed to compare categorical survey
responses. Kruskal-wallis test was used to compare intergroup ratings
of importance, followed by post hoc testing using Dunn’s test.
Education level was divided into “some college and below” and
“bachelor’s degree and above.”
100
Health food stores such as Trader Joes, Sprouts, and the Davis Food
Co-Op
102
Total
396
Overall Results:
What species (Mark all that
Bacillus
apply)?
Do you take probiotics?
3,38%
Bifidobacterium
Yes
61%
15,54%
55,41%
•
Saccharomyces
36,49%
I don’t know
Other (please
specify)
6,08%
4,73%
•
How important is the probiotic strain when purchasing
probiotics?
41.22%
I don’t know
•
37.83%
Important
11.49%
Slightly Important
0
10
20
30
40
50
60
70
By Location:
Do you take probiotics?
Clinic
What is the dosage of the
probiotic?
63
131
Clinic
Schools
35
65
58
0%
20%
40%
Yes
80%
17
Schools
45
6
24
Health food stores
44
60%
100%
26
0%
20%
40%
Can recall
No
30
60%
80%
100%
Cannot recall
By Education:
What species (Mark all that
apply)?
Do you take probiotics?
Bachelor's and Higher
Lactobacillus acidophilus
68.5%
115
Lactobacillus rhamnosus
53.0%
89
Bifidobacterium longum
44.6%
75
Bifidobacterium lactis
38.7%
65
Bifidobacterium bifidum
36.3%
61
Lactobacillus plantarum
42.9%
72
Lactobacillus casei
40.5%
68
Lactobacillus paracasei
27.4%
46
Bifidobacterium breve
26.2%
44
Lactobacillus salivarius
28.0%
47
Although probiotic use is prevalent among the Sacramento community,
most people are unfamiliar with the composition of their supplement.
Our data supports previous results indicating that education and
health-consciousness are predictive factors of probiotic use and
knowledge, demonstrating a fundamental difference between
populations that take supplements, and those that do not.
Analysis of probiotics sold in stores show that there is an
overwhelmingly large variation in the characteristics of these
supplements, which means every person could be taking something
very different, while at the same time, all hoping for the same end
result—improved gut function.
Larger studies are needed to determine proper composition, doses, and
uses, to guide consumers in making more educated health-care
decisions.
REFERENCES
9.46%
Not important
n
CONCLUSIONS
•
Streptococcus
39%
No
%
16,22%
Lactobacillus
Health food stores
The primary objective was to determine incentives for taking
probiotics and knowledge about probiotic composition of consumers
in the Sacramento region.
Commercially Available Probiotic Supplements:
94
107
Bachelor's and Higher
50
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6.Vanderhoof JA, Young R. Probiotics in the United States. Clin Infect Dis.
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44
ACKNOWLEDGEMENTS
Some college and Below
49
126
Some college and Below
0%
20%
Yes
40%
No
60%
80%
13
100%
0%
Can recall
RESEARCH POSTER PRESENTATION DESIGN © 2012
www.PosterPresentations.com
36
20% 40% 60% 80% 100%
Cannot recall
Thank you to the UC Davis Dermatology Clinic, Davis Food Co-Op, Trader
Joes, and Sprouts, for allowing us to survey at their location. Thank you to
the UC Davis CTST Biostatistics team for your guidance in performing the
statistical analysis.