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Probiotics help prevent antibiotic-associated diarrhea

Probiotics help prevent antibiotic-associated diarrhea

Tuesday, May 15, 2012. A review and meta-analysis reported in the May 9, 2012 issue of the Journal of the American Medical Association found a protective effect for orally-administered probiotics against diarrhea that often develops as a response to antibiotic drugs. While antibiotics destroy harmful as well as beneficial bacteria, probiotics consist of beneficial live microorganisms whose presence in the digestive tract can help prevent the overgrowth of unhealthy organisms.

Susanne Hempel, PhD, of the research organization RAND Health in Santa Monica, California and her colleagues reviewed 82 randomized clinical trials of patients receiving antibiotics that compared the effects of a probiotic to no treatment, a placebo, or a different probiotic or probiotic dose. A pooled analysis of 63 of the trials, which included a total of 11,811 participants, concluded that the use of probiotics was associated with a 42 percent lower risk of developing diarrhea as a result of antibiotic use compared to not consuming probiotics. Because many types and blends of probiotics were used in the studies, it was difficult to identify which strains were responsible for the benefits observed, however, pooled analyses limited to trials of Lactobacillus, Saccharomyces and Streptococcus probiotics were associated with risk reductions of 36%, 52% and 49%, respectively.

"We found a clear beneficial effect of probiotics in preventing or treating antibiotic-associated diarrhea," stated study coauthor Sydne J. Newberry, who is a nutritional scientist and a researcher at RAND. "However, more work is needed to determine which types of probiotics work best, which patients are most likely to benefit from probiotics and whether there are any risks in using them."

"The pooled evidence suggests that probiotics are associated with a reduction in antibiotic-associated diarrhea," the authors conclude. "More research is needed to determine which probiotics are associated with the greatest efficacy and for which patients receiving which specific antibiotics."

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Higher vitamin D levels predict improved survival among colorectal cancer patients

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An article published online on January 25, 2012 in Cancer Epidemiology, Biomarkers and Prevention reports an association between higher prediagnostic levels of vitamin D and increased survival among patients with colorectal cancer.

The study evaluated the association between serum vitamin D levels and mortality among 1,202 men and women enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, which recruited over 520,000 participants from 1992 to 1998. Subjects in the current study were diagnosed with colorectal cancer between enrollment and June, 2003. Blood samples obtained upon recruitment were analyzed for serum 25-hydroxyvitamin D [25(OH)D]. Over a mean follow-up period of 73 months, 444 deaths due to colorectal cancer and 97 deaths from other causes occurred.

Men and women whose serum vitamin D levels were among the top 20 percent of participants had a 31 percent lower risk of dying from colorectal cancer and a 33 percent lower risk of mortality from any cause compared to those whose levels were among the lowest 20 percent. Having a high vitamin D level was protective against cancers of both the colon and the rectum. When subjects were analyzed according to calcium intake, a significant protective effect of vitamin D was observed only among those with high dietary calcium.

"If verified in other studies, calcium supplementation in combination with vitamin D may be potentially useful for improved survival in colorectal cancer patients," the authors write. "This large and comprehensive study, based on the EPIC cohort has shown that higher blood vitamin D levels before colorectal cancer diagnosis are associated with reduction in colorectal cancer-specific and overall mortality. Further prognostic studies among cancer patients are needed to determine whether 25(OH)D levels at diagnosis and post-diagnosis correlate with those measured prior to diagnosis, and influence all-cause and disease-specific survival among colorectal cancer patients."

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