Bifidobacteria: benefits, dosage, contraindications

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Bifidobacteria are lactic acid bacteria that are considered probiotics. Probiotics are many and diverse live bacteria naturally present in our bodies and that have numerous physiological benefits. Bifidobacteria are a type of rod-shaped, Gram-positive bacteria that produce lactic acid and acetic acid and are natural inhabitants of the human gastrointestinal tract. They normally colonize the human colon. Bifidobacteria belong to a group of bacteria called lactic acid bacteria. Lactic acid bacteria, which also include lactobacillus species, are also found in fermented foods such as yogurt and cheese. Bifidobacteria, particularly Bifidobacterium bifidum, make up the predominant intestinal flora of breast-fed infants. Bifidobacteria are also present in the adult colon, but are less predominant. Most researchers agree that the effectiveness of bifidobacteria and other probiotics for any indication depends on their ability to colonize a tissue site. To do this, bifidobacteria preparations must contain living, viable organisms. For oral preparations, the bacteria must also remain viable after passage through the intestine. Bifidobacterium longum is particularly resistant to gastric acid. They must also be able to adhere to the intestinal epithelium. The effectiveness of bifidobacterial strains may vary because of differences in their ability to adhere to epithelial cells. Complex sugars, such as fructo-oligosaccharides, inulin and oligofructose, are selectively fermented by bifidobacteria in the colon and increase the numbers of indigenous bifidobacteria. Adding oligosaccharides to bifidobacteria also appears to enhance bifidobacterial activity. However, there is no trial confirming the clinical benefit of combining bifidobacteria with complex sugars. In general, these probiotic strains help to maintain the balance of the oral, intestinal and vaginal flora. They are consumed for the prevention and treatment of different forms of diarrhea such as those related to antibiotic use, those associated with rotavirus, or those resulting from radiotherapy for cervical cancer. They may also help strengthen immunity while protecting the digestive system against certain bacterial infections. Furthermore, it has been reported that strains such as Bifidobacterium bifidum have been reported to significantly reduce upper respiratory tract infections. Interestingly, some strains of this bacterium are effective at preventing colonization of the gastric mucosa by pathogens such as Helicobacter pylori. The latter is well known for causing chronic infections and predisposing to gastric cancer.

Other name(s) 

Bifidobacterium adolescentis, Bifidobacterium animalis, Bifidobacterium bifidum, Bifidobacterium breve, Bifidobacterium longum.

Scientific name(s)

Bifidobacterium

Family or group: 

Probiotics

Active ingredients:

Bifidobacterium bifidum

Bifidobacterium infantis

Bifidobacterium longum

Bifidobacterium lactis


Indications

Scoring methodology

EFSA approval.

Several randomized, double-blind, controlled clinical trials (> 2), including a significant number of patients (>100), with consistently positive conclusions for the indication.
Several randomized, double-blind, controlled clinical trials (> 2), including a significant number of patients (>100), with positive conclusions for the indication.
One or more randomized studies, or several cohorts or epidemiological studies, with positive conclusions for the indication.
Clinical studies exist but are uncontrolled, with conclusions that may be positive or conflicting.
No clinical studies to date that can demonstrate the indication.


Constipation
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Several strains of bifidobacteria have been evaluated for constipation. The strongest evidence is for strains of Bifidobacterium animalis subsp. lactis. A meta-analysis of clinical research shows that taking these strains increases stool frequency by about 1.5 bowel movements per week in adults with functional constipation. Clinical research in adults with chronic constipation also shows that taking a multi-strain probiotic containing Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus lactis, Bifidobacterium bifidum, Bifidobacterium longum and Bifidobacterium infantis twice daily for 7 days increases the number of weekly bowel movements by about 2 compared with placebo.

Posologie

posologieOrally

posologie1 - 100 IU

populationAdults


Synergies


Irritable bowel syndrome
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According to studies, bifidobacteria (notably Bifidobacterium infantis and Bifidobacterium lactis) may improve patients' condition by easing symptoms such as the intensity and frequency of abdominal pain, flatulence and bloating, and by regulating bowel transit. nnSome research has evaluated bifidobacteria in combination with other probiotic species. A clinical study shows that a specific probiotic combination containing strains of lactobacilli, bifidobacteria and streptococci (VSL#3, sold under the name VIVOMIXX) reduces bloating in patients with diarrhea-predominant IBS.nnClinical research has focused on specific products such as Duolac Care containing B. lactis, Bifidobacterium breve, Lactobacillus acidophilus, Lactiplantibacillus plantarum, Lacticaseibacillus rhamnosus and Streptococcus thermophilus twice daily for 4 weeks. The results show that this combination can relieve symptoms in 72% of patients suffering from irritable bowel syndrome. nnAnother clinical study conducted in patients with diarrhea-predominant IBS shows that taking a specific probiotic (NordBiotic) containing B. lactis BL040, B. breve BB010, Bifidobacterium longum BL020, Bifidobacterium bifidum BF030, Lacticaseibacillus rhamnosus LR110, Lacticaseibacillus paracasei LPC100, L. acidophilus LA120, Lacticaseibacillus casei LC130, L. plantarum LP140, and Streptococcus thermophilus ST250 at a dose of 2.5 billion CFU twice daily for 8 weeks improves overall symptom severity, as well as the severity and frequency of pain, and quality of life compared with placebo. nn

Posologie

posologieOral administration

posologie0.1 - 1 IU

duration4 - weeks

populationAdults, Women, Children


Synergies

Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles.
Clinical trial: Lactobacillus plantarum 299v (DSM 9843) improves symptoms of irritable bowel syndrome
I.31, a new combination of probiotics, improves irritable bowel syndrome-related quality of life
Efficacy of double-coated probiotics for irritable bowel syndrome: a randomized double-blind controlled trial
Clinical trial: the effects of a fermented milk product containing Bifidobacterium lactis DN-173 010 on abdominal distension and gastrointestinal transit in irritable bowel syndrome with constipation
The Effectiveness and Safety of Multi-Strain Probiotic Preparation in Patients with Diarrhea-Predominant Irritable Bowel Syndrome: A Randomized Controlled Study
Irritable bowel syndrome symptom severity improves equally with probiotic and placebo
Efficacy of synbiotic, probiotic, and prebiotic treatments for irritable bowel syndrome in children: A randomized controlled trial.
Multistrain probiotic preparation significantly reduces symptoms of irritable bowel syndrome in a double-blind placebo-controlled study
Efficacy and Safety of Probiotics in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis
Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome.
Randomized clinical trial: Bifidobacterium bifidum MIMBb75 significantly alleviates irritable bowel syndrome and improves quality of life--a double-blind, placebo-controlled study

Respiratory infections
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Most clinical research shows that taking bifidobacteria can reduce the risk of respiratory infections in otherwise healthy patients, but the effect varies depending on the bifidobacteria species. Below is a closer look at some studies. One clinical study shows that daily intake of 3 billion colony-forming units (CFU) of Bifidobacterium bifidum R0071 for 6 weeks reduces the number of cold or flu episodes by about 35% in students. Clinical research in children aged 2 to 6 years shows that taking Bifidobacterium longum B536, 5 billion CFU daily, for 10 months modestly reduces symptoms and the frequency of respiratory illnesses compared with placebo. Another clinical study conducted in infants aged 6 to 12 months shows that taking B. lactis HN019 at one million CFU per gram of infant formula for 12 weeks reduces the incidence of confirmed and parent-reported upper respiratory tract infections compared with formula without added probiotics. However, taking Bifidobacterium longum subsp. infantis R0033 does not appear to be beneficial.

Posologie

posologieOral administration

posologie3 - 3 IU

duration6 - weeks

populationAdults, Children


Synergies

Alterations of intestinal flora and the effects of probiotics in children with recurrent respiratory tract infection
Effect of Lactobacillus rhamnosus LGG® and Bifidobacterium animalis ssp. lactis BB-12® on health-related quality of life in college students affected by upper respiratory infections
Bifidobacterium bifidum R0071 results in a greater proportion of healthy days and a lower percentage of academically stressed students reporting a day of cold/flu: a randomized, double-blind, placebo-controlled study.
Bifidobacterium animalis subsp. lactis BB-12 in reducing the risk of infections in early childhood
Adjuvant treatment with a symbiotic in patients with inflammatory non-allergic rhinitis
Evaluation of the immune benefits of two probiotic strains Bifidobacterium animalis ssp. lactis, BB-12® and Lactobacillus paracasei ssp. paracasei, L. casei 431® in an influenza vaccination model: a randomized, double-blind, placebo-controlled study
Use of a probiotic mixture containing Bifidobacterium animalis subsp. lactis BB-12 and Enterococcus faecium L3 as prophylaxis to reduce the incidence of acute gastroenteritis and upper respiratory tract infections in children
Comparison of two probiotics in follow-on formula: Bifidobacterium animalis subsp. lactis HN019 reduced upper respiratory tract infections in Chinese infants
Probiotics with vitamin C for the prevention of upper respiratory tract symptoms in children aged 3-10 years: randomized controlled trial
Probiotic Bifidobacterium lactis Probio-M8 treated and prevented acute RTI, reduced antibiotic use and hospital stay in hospitalized young children: a randomized, double-blind, placebo-controlled study
Probiotics and vitamin C for the prevention of respiratory tract infections in children attending preschool: a randomized controlled pilot study
Probiotic Supplements Beneficially Affect Tryptophan-Kynurenine Metabolism and Reduce the Incidence of Upper Respiratory Tract Infections in Trained Athletes: A Randomized, Double-Blinded, Placebo-Controlled Trial
Bifidobacterium longum BB536 alleviated upper respiratory illnesses and modulated gut microbiota profiles in Malaysian pre-school children

Diarrhea
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Diarrhea can be caused by infections (viruses, parasites, bacteria), including acute diarrhea (gastroenteritis) and traveler's diarrhea caused by E. coli. According to studies, consumption of mixtures of lactobacilli and bifidobacteria can prevent and/or treat (reduce the duration of) these diarrheas. Preliminary clinical research shows that administration of the Bifidobacterium BB-12 strain alone or with Streptococcus thermophilus, or administration of Bifidobacterium bifidum plus Streptococcus thermophilus as part of an infant formula, helps reduce the incidence of diarrhea and rotavirus shedding in infants. Other clinical research shows that administration of a probiotic formula containing Bifidobacterium longum BORI and Lactobacillus acidophilus AD031 to infants with rotavirus infection reduces the duration of diarrhea compared to placebo.

Posologie

posologieOral

posologie1 IU

populationAdults, Children


Synergies


Ulcerative colitis
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Bifidobacteria combined with lactobacilli help facilitate the treatment of ulcerative colitis. They increase the disease remission rate. The best evidence of benefit is a specific multi-species probiotic containing lactobacilli, bifidobacteria, and streptococci (VIVOMIXX , formerly VSL#3). A review of the clinical research shows that taking this product in addition to standard treatment for ulcerative colitis can nearly double remission rates in adults and children with ulcerative colitis compared with standard treatment alone.

Posologie

posologieOral

posologie0.9 - 1.8 IU

populationChildren, Adults


Synergies


Gestational diabetes
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Most research shows that bifidobacteria combined with lactobacilli are beneficial for women with gestational diabetes. A meta-analysis of clinical research in women with gestational diabetes shows that taking Lactobacillus and Bifidobacterium improves glycemic markers such as fasting blood glucose and insulin sensitivity compared with placebo. Daily intake of a capsule containing lyophilized strains of Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidum at a rate of 2 billion CFU per gram for 6 weeks decreases fasting blood glucose by 5.3 to 9.2 mg/dL and reduces insulin resistance and insulin levels compared with placebo. Limited research suggests that bifidobacteria in combination with lactobacilli are not beneficial for PREVENTING gestational diabetes. A clinical trial conducted in overweight and obese women at 16 or 20 weeks' gestation shows that taking Lactobacillus rhamnosus (LGG) and Bifidobacterium animalis subspecies lactis (BB-12) at doses greater than 1 billion CFU per day until 28 weeks' gestation does not reduce gestational diabetes compared with placebo.

Posologie

posologieOrally

posologie6 IU

duration6 - weeks

populationPregnant women


Synergies


Gastritis
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A meta-analysis shows that the use of bifidobacteria and lactobacilli in combination with treatment against H. pylori increases the eradication rate by at least twofold. They also reduce treatment-related side effects. Soluble factors from the Bifidobacterium breve strain are able, in vitro, to modulate the inflammatory response by decreasing the secretion of pro-inflammatory cytokines by intestinal epithelial cells. This strain therefore helps relieve inflammation in the intestine.

Posologie

posologieOrally

posologie5 - 5 IU

duration1 - week

populationAdults


Synergies


Dermatoses
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Studies have shown the beneficial effects of probiotics, including bifidobacteria, on dermatoses. These effects are related to the immunomodulatory and anti-inflammatory properties of bifidobacteria.nnStudies show that taking Bifidobacterium lactis reduces the severity of eczema and the levels of serum markers of inflammation. nnAnother clinical study conducted in patients with psoriasis shows that taking a probiotic mixture for 8 weeks improves the overall symptoms of the disease.nnThe total daily dose was 2.6 billion colony-forming units (CFU) of B. lactis, Bifidobacterium bifidum, Bifidobacterium longum and Lactobacillus acidophilus.nn

Posologie

posologieOral administration

posologie30 - 80 IU

populationChildren, Adults


Synergies


Hypercholesterolemia
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In a preliminary study, the consumption of fermented milk containing Bifidobacterium longum and Lactobacillus acidophilus helped reduce cholesterol levels, notably by lowering LDL levels. nnOverall, it has been reported that supplementation with the strain Lactobacillus plantarum Q180 exerts a favorable effect on postprandial lipid metabolism in healthy subjects. In fact, a significant reduction in LDL cholesterol levels and Apo B100 was observed. Similarly, blood triglyceride levels were also decreased.nnThis probiotic strain, which regulates the microbiota, could constitute a functional ingredient for maintaining a healthy lipid profile.nn

Posologie

posologieOral administration

duration4 - weeks

populationAdults, Women


Synergies


Acne
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A preliminary study suggests that consumption of lactobacilli and bifidobacteria reduces redness and inflammation associated with, or unrelated to, acne. An oral probiotic treatment reduces serum IL-10 levels in subjects with acne. The probiotic strains could therefore regulate the immune and inflammatory response in these subjects. A bacteriocin extracted from the strain Lactococcus sp. HY 449 inhibits the growth of several pathogenic microorganisms involved in skin inflammation and acne without causing allergic reactions or skin irritation.

Posologie

posologieOrally

posologie30 - 60 IU

duration12 weeks

populationAdolescents, Adults


Synergies


Crohn's disease
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Only a limited number of studies have reported a role for probiotics in the remission of Crohn's disease. The VIVOMIXX or VSL#3 formulation, containing a high concentration of eight strains of lactic bacteria — Bifidobacterium breve, B. longum, B. infantis, Lactobacillus acidophilus, L. plantarum, L. casei, L. bulgaricus, and Streptococcus thermophilus — in a trial of 40 patients randomized to 3 months of rifaximin followed by 9 months of VSL#3 or 12 months of mesalamine (an anti-inflammatory used to treat certain inflammatory diseases of the colon and intestine [IBD]) also reported prevention of relapses with probiotic treatment. However, a Cochrane systematic review did not support a role for probiotics in Crohn's disease based on the available evidence. Most studies included relatively small numbers of participants with different treatment protocols, probiotic strains, and outcome measures, making comparisons difficult.

Posologie

posologieOral

posologie0.9 - 1.8 IU

populationAdults


Synergies


Metabolic syndrome
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It is well established that the gut microbiota is involved in the development of metabolic diseases. Indeed, it has been observed that obese and diabetic patients have an altered microbiota compared with that of healthy subjects. This is referred to as intestinal dysbiosis. In particular, an increase in Firmicutes (harmful bacteria) has been noted in the human gut microbiota. In several mouse models, it has been observed that a high-fat diet leads to a less diverse microbiota, richer in Firmicutes and poorer in beneficial bacteria. Under these conditions, consumption of probiotics could contribute to the treatment of metabolic diseases such as obesity, type 2 diabetes, and non-alcoholic fatty liver disease (NASH or "fatty liver disease"). In patients with type 2 diabetes, regular probiotic intake improves glycemic control and reduces body weight and inflammation. Often used alone, the simultaneous administration of multiple probiotic strains with complementary modes of action could also potentiate their effects. Different probiotic strain species may act synergistically with various effects on host metabolism: - Lipid absorption - Sugar digestion - Regulation of inflammation (reduction of pro-inflammatory cytokines such as TNF-α and IL-6 with Bifidobacterium lactis) - Beneficial production of short-chain fatty acids

Posologie

posologieOrally

posologie1 IU

populationAdults


Synergies


Allergic rhinitis
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A double-blind, randomized study shows that taking one capsule containing 1.2 billion CFU of L. gasseri KS-13, 0.15 billion CFU of B. bifidum G9-1 and 0.15 billion CFU of B. longum MM-2, for a total of 1.5 billion CFU per capsule, has beneficial effects for healthy adults with self-identified seasonal allergiesnnThis probiotic combination improved rhinoconjunctivitis-specific quality of life during the allergy season in these healthy individuals who reported seasonal allergies.nn

Posologie

posologieOrally

posologie0.15 IU

duration8 weeks

populationAdults


Synergies


Properties


Gastroprotective

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Bifidobacteria improve and contribute to digestion while facilitating overall transit. Bifidobacteria are also of interest for the prevention of ulcers and gastrointestinal inflammation. In animal research, B. lactis strains improve the integrity of tight junctions and protect against mucosal permeability induced by nonsteroidal anti-inflammatory drugs (NSAIDs).

Usages associés

Constipation, Diarrhea, Gastritis

Antibacterial

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Bifidobacteria are symbiotic bacteria that provide a natural barrier against bacterial infections in the intestine. They produce antibacterial molecules (peptides called bacteriocins) that help fight certain pathogenic bacteria.

Usages associés

Irritable bowel syndrome, Diarrhea, Gastritis, Acne, Gastritis, Helicobacter pylori infection

Immunomodulatory

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Bifidobacteria are a natural barrier against infections and have a nonspecific immune-modulating action through the stimulation of macrophages and lymphocytes.

Usages associés

Respiratory infections, Constipation, Irritable bowel syndrome, Diarrhea, Gastritis, Ulcerative colitis, Dermatoses, Gastritis, Crohn's disease, Metabolic syndrome, Acne, Allergic rhinitis, Helicobacter pylori infection

Anti-inflammatory

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Through their immunomodulatory actions, bifidobacteria, alone or in combination with lactobacilli, help fight inflammation. More specifically, a randomized, double-blind, placebo-controlled study was conducted on 32 healthy elderly subjects over three weeks; taking a probiotic blend twice daily (Lactobacillus gasseri KS-13, Bifidobacterium longum MM2, B. bifidum G9-1) demonstrated these properties. The researchers evaluated the effect of this supplementation on several parameters: circulating CD4+ lymphocyte levels, cytokine production, and the shift of the gut microbiota toward a healthy bacterial population. Interestingly, taking this high-concentration probiotic formulation maintained CD4+ lymphocytes and decreased the profile of inflammatory cytokines. The hypothesis put forward by the researchers is a normalization of the microbial communities, which more closely resembled those reported in younger healthy populations.

Usages associés

Metabolic syndrome, Gastritis, Crohn's disease, Respiratory infections, Dermatoses, Ulcerative colitis, Irritable bowel syndrome

Anticancer

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Bifidobacteria have shown anticancer effects, particularly against colon cancer cells. In one study, it was demonstrated that the secretions of different Bifidobacterium species significantly decreased the survival rates of colon cancer cells compared with control groups. This anticancer activity is attributed to the modulation of the expression of pro-apoptotic and anti-apoptotic genes. As a reminder, apoptosis is programmed cell death. A more recent study examined the role of bifidobacteria in cancer immunotherapy. It suggests that these bacteria can influence the immune system by modulating the activity of dendritic cells, which are crucial for the adaptive immune response. Thus, bifidobacteria can enhance the immune system's recognition and elimination of cancer cells. This interaction between bifidobacteria and the immune system is promising as an adjuvant to cancer immunotherapy.


Antioxidant

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The intake of lactobacilli and bifidobacteria reduces oxidative stress in pregnant women by increasing insulin sensitivity and antioxidant enzymes.


Hypolipidemic

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A mixture of probiotics (Lactobacillus and Bifidobacterium) reduces LDL cholesterol levels in patients with hypercholesterolemia. The probable mechanism of action involves the interaction of bifidobacteria with bile salt metabolism, notably through the deconjugation of bile acids and their increased excretion, which leads to a reduction in serum cholesterol.

Usages associés

Metabolic syndrome, Hypercholesterolemia

Hypoglycemic agent

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A mixture of probiotics (Lactobacillus and Bifidobacterium) may improve insulin levels and glycated hemoglobin (HbA1c) in diabetic patients. A meta-analysis examined the effectiveness of probiotics for glycemic control in adults with impaired glycemic regulation, including prediabetes and type 2 diabetes. It included 28 randomized controlled trials with 1,947 participants. The results show that probiotics significantly reduce fasting blood glucose in the short term and the long term. There is also a reduction in HbA1c among participants taking probiotics, although these results are not statistically significant. Probiotics may improve pancreatic beta-cell function, thereby increasing insulin production and lowering blood glucose. They may also improve insulin sensitivity in peripheral tissues. In addition, probiotics positively influence gut health and microbiota composition, which can indirectly affect glucose metabolism.

Usages associés

Metabolic syndrome, Gestational diabetes


Safe dosage

Child from 1 up to 18 years:

Bifidobacteria have been used safely in children, including those under 2 years of age, for periods of up to 12 months. A specific probiotic combination containing strains of Lactobacillus, Bifidobacterium, and Streptococcus has been used safely for one year in children aged 1 to 16 years. Another combined probiotic containing Lactobacillus acidophilus and Bifidobacterium animalis has been used safely for up to 6 months in children aged 3 to 5 years. An additional probiotic combination containing Lactobacillus acidophilus and Bifidobacterium bifidum has been used safely for up to 3 months in children aged 8 to 13 years. For dosing, refer to the manufacturer's instructions.

Pregnant woman :

Products containing Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium bifidum, Bifidobacterium longum, and Lacticaseibacillus rhamnosus have been used safely for 6 weeks starting from the 24th to the 28th week of gestation. Reliable information available on other strains of bifidobacteria is insufficient.

Adults 18 years and older :

Bifidobacteria have been used safely in clinical trials lasting up to one year. For dosing, refer to the manufacturer's instructions.


Interactions

Médicaments

Antibiotics: moderate interaction

The use of antibiotics could reduce the effects of bifidobacteria. Separate by at least two hours.


Precautions

Breastfeeding woman : use with caution

There is not enough reliable information on the use of Bifidobacteria during breastfeeding.

Immunodeficiency : use with caution

Bifidobacteria preparations may cause pathogenic colonization in immunocompromised patients. Although this has not occurred specifically with bifidobacteria, there have been rare cases involving other probiotic species such as Lactobacillus. Pathogenic colonization appears more likely to occur in severely immunocompromised patients. Use with caution in these conditions.