The event this year was hot on marketing and consumer perception information, had focus sessions on the microbiome in the first 1000 days of life (including during pregnancy!), sports performance and the development of biotherapeutics.
Groundbreaking innovations were presented in second generation probiotics, new simplified-metagenomics tools, new communication models and new techniques to offer researchers ever more precision.
This document aims to sum-up the main information from these 3 exciting days.
- Consumer understanding and engagement
Maria Gustafsson from the communication agency Eat Well Global gave insights on consumers perception and interest in gut health. 55% of the interrogated American population were aware of the gut microbiome but 74% didn’t know what it does. There is huge interest but lack of knowledge, which is also traceable to their sources of information: TV, family and friends and the internet are the top 3. Consumers lack of information given by healthcare professionals.
Important to know: 57% of the interrogated consumers are ready to pay up to 10% more for a product with probiotics!
The main consumers today are women millennials, who think about health, have a social mission, but are also on-the-go and need products easy to bring along.
Maria’s data was supported by a further study on 4000 consumers from 4 European countries, reported by Diane K. Ray from the Natural Marketing Institute. She showed that the majority of probiotic users are both in the EU (44%) and in the US (34%) in the “well-being” category, that is to say proactive people for whom healthy eating is a priority and who spread the word. They are followed directly by the so-called “magic bullets” (23% of probiotic consumers in EU, 28% in US), characterized by lower commitments, looking for quick and easy solutions.
Interestingly, the top 5 consumer motivators for the choice of probiotics are the following:
1. Unquestionable safety
2. Scientific/clinical proof that it works (make it simple but give reasons to believe)
3. From natural sources
4. Easy to digest/easy on the stomach
5. Knowing the source of ingredients or even detail the processes of production
The main influencers for their decision are the physician, the pharmacist, healthcare websites, package labels and dietitians/nutritionists, in this order.
On marketing still, Ewa Hudson now from Illumina and Lucas Morea from Hyperbiotics both highlighted the influence of the digital revolution in sales nowadays: web reviews are increasingly important and the focus on online advertisement and responding to customers and reviews made Hyperbiotics the number one probiotic food supplement selling online within 5 years. Lucas’ advice: “Tech is the New Order. Don’t compete. Partner.”
Ewa Hudson gave an update on the leading categories: digestion and immunity continue to come first, followed by a strikingly growing woman health (including urinary tract infection), cardiovascular health, oral health, maternal & infant, skin health and of course, gut-brain. Ewa insists on the importance of a cut-down of each category by specific functionality and as much personalization/customization as possible: the wider the range the more opportunity brands have to respond to their customer’s issues.
- The microbiome in the first 1000 days
Researcher Lindsay Hall opened the first focus workshop on the first 1000 days. She reminded us about the typical fecal microbiome of the newborn: vaginally, breastfed babies carry about 80% Bifidobacteria, while formula-fed infants have only about 5-10%. Bifidobacteria beneficially impact gut architecture (including the establishment of a healthy microbiome in the future) and antibody response, setting up a healthy immune environment for youth and later life.
Digging to even before birth, during pregnancy: David McIntyre, Imperial College, exposed work relating to the vaginal microbiome during gestation with a specific focus on the risk of preterm birth (PTB, the primary cause of infant death globally, and half of PTB cases are associated with infection ascending from the vagina). Women at risk of PTB were recruited and had their vaginal microbiome sequenced. The result? When the microbiome was dominated by L. crispatus or L. gasseri, they had a longer cervix and an outcome of less PTB.
McIntyre explained that when Preterm Prelabour Rupture of the Fetal Membrane (PPROM) happens, it increases the microbial load so the procedure is erythromycin treatment to keep infection and inflammation under control. He dropped a bomb when he demonstrated that before the antibiotic treatment, two thirds of women had a healthy vaginal microbiome, while after the treatment they were only one sixth to one third. This underscores that the antibiotic dose is able to wipe out the protective Lactobacilliwhile it is not strong enough to kill the pathogens. In addition, L. crispatus dominated women already protect their neonates from sepsis: he asks why couldn’t we use microbiome data to direct the therapy to women that may actually benefit from it.
Anna Happel, the winner of the scientific frontiers, presented data consistent with McIntyre, demonstrating that L. crispatus is the best adapted for vaginal pH, able to lower it to the physiological levels, to oppose the growth of P. bivia and showing the best anti-inflammatory properties.
Still in pregnancy but switching to the gut microbiome, Omry Koren from Bar-Ilan university talked about the physiological dysbiosis occurring towards the end of pregnancy, probably as the mothers get ready to harvest more energy from food and supply HMOs to their offspring.
- Sports performance and the microbiome engagement
Irish researcher Wiley Barton exposed the differences between athletes’ microbiomes and those of control people. Athletes bear a more diverse gut microbiome as measured by Shannon index, and their functions are shifted towards decreased vitamin biosynthesis, higher energy metabolism, upregulation of cofactor biosynthesis and of both carbohydrate degradation and biosynthesis. It is still unclear which part of this shift is explained by the training itself, and which part by the athletes’ protein rich diet.
The highlight of the sports performance session was Jonathan Scheiman, CEO of FitBiomics, when he showed that marathon athletes have a peak, during the marathon, of a bug that breaks down lactic acid and converts it into anti-inflammatory SCFA propionate! The potential for two benefits in one pathway is thrilling! Ultra-marathoners, he says, have higher lactate degrading pathways.
- Innovation and trailblazer session
Groundbreaking ideas came out in the trailblazer session firstly with Kristofer Cook, CEO of Carbiotix, who presented their services about to launch: a second-generation, simplified metagenic monitoring, if one can describe it in these words. The idea is to send a scrub of toilet paper monthly to the company that sends back, instead of a full report hardly interpretable, a one-figure indicator of microbiome health he called Fiber-Loving Bacteria Index. Arguing that most adults suffer from a fiber gap, the personalization angle comes through the fact that they then send back along with the results a customized amount of prebiotic fiber, adapted to each result. All that for a ridiculously cheap price. “It will become irresponsible not to get tested”, Cook bluntly states. The consumer only needs to trust blindly the value of the indicator, since the company won’t share the algorithm behind its calculation or even the type of analysis done on the fecal sample.
Céline Druart from A-Mansia presented research on one of the most famous potential second-generation probiotics, Akkermansia muciniphila. In humans, the levels of Akkermansia muciniphila are decreased in people with obesity, hypertension, diabetes, IBD and autism, and its amount predicts the response to a low-caloric diet. The start-up has now confirmed safety of the novel strain in humans and overcome some industrial challenges allowing for the production of a quantity needed to start a clinical trial. Definitely looking forward to seeing the results, and the product on the market, ETA 2020!
In terms of technologies, although not in the same session, one can’t omit to mention the great presentation from Jos Boekhorst, Senior Scientist Bioinformatics, Microbiomics group, NIZO, who presented a capsule (IntelliCap®) able to sample gut contents anywhere. In particular it allowed NIZO to compare the ileum microbiome to the fecal microbiome in people under a low carb, high protein diet vs. a low protein high carb diet. The differences identified were major between the taxa present at ileal level and at the end of the colon. This opens the door to a whole new, more precise research.
Finally, not only isolated actors from the industry but the IPA and academic research come together in favor of flow cytometry (FCM) as a more precise and universal enumeration method than plate count. Martin Wilkinson from the University of Limerick, Ireland argues that the “plate-and-wait” doesn’t provide information on the bacterial physiology or activity, contrary to FCM, which provides near-immediate results, easily in triplicate. The comparison between the two methods is possible when they refer to a fresh sample in which most cells are viable (ie. culturable), and not when products such as ripening cheeses include a lot of dead or damaged cells. Indeed flow cytometry, unlike plate count, is able to identify vital (live) cells through their membrane potential, redox potential or intracellular enzyme activity, even if they are not able to grow and form colonies. Henceforth only the regulators are awaited to pronounce themselves on definitions of viability and vitality to be taken account by the industry in the quality control and methods.
- From bugs to drugs
In this session we heard about the therapeutic potential of some strains or microbiome targeting therapies in ulcerative colitis, cancer (Francisco Guarner, consultant of gastroenterology, and Johanna Maukonen, Global Health and Nutrition leader in Dupont), major depression (Caroline Wallace, research assistant in Providence Care Hospital, Canada) and other sectors.
With over 350 participants, Probiota broke a new record of attendance, demonstrating the rise in interest from diversified sectors. Brands came up in the discussions, and it is always one of the top networking events worldwide bringing together the academy and the industry. Next Probiota event: 6-7 June in Miami! In the meantime don’t miss next month Pharmabiotics Global in Paris if you are working in the Live Biotherapeutic Products, or Microbiome Congress in Rotterdam, a little more research-focused than Probiota.