Promotional Features

How validated probiotic strains are advancing women’s health in Asia
PROBIOTICAL

Paid for and in partnership with PROBIOTICAL

The following content is provided by an advertiser or created on behalf of an advertiser. It is not written by the NutraIngredients-asia.com editorial team, nor does it necessarily reflect the opinions of NutraIngredients-asia.com.

For more information, please contact us here​.

How validated probiotic strains are advancing women’s health in Asia-Pacific

Last updated on

Women’s health is a growth area in Asia-Pacific. Facing an evolving set of needs across life stages, women are seeking out clinically validated products that can help them naturally meet their health and wellness goals.

The demand is creating opportunities for customized blends of probiotic strains that are tailored to the needs of women at every life stage from adolescence to post-menopause. In recent years, probiotics have moved beyond gut health to target metabolic conditions, skin disorders, and much more.

The scientific progress has shown the specific strains that can benefit women at each life stage. Women in Asia-Pacific are particularly interested in incorporating probiotics into their wellness regimes.

A Euromonitor survey found 37% of women in China choose natural or traditional remedies for women’s health issues, compared to 27% of their counterparts in Europe.1​ Similarly, a higher proportion of women seek alternative medicines in India (29%) than in Europe (12%). Widespread interest in women’s health dietary supplements is driving strong sales, with the market in Asia-Pacific growing 10% in 2023.

Yet, women in Asia-Pacific continue to have unmet health and wellness needs. Here, we look at areas of ongoing unmet need and how companies can use clinically validated strains to create products that meet the demands.

Why nutrition is an opportunity

In India, 53% of women of reproductive age have anemia, indicating iron deficiency.2​ More than half of the cases of anemia are moderate or severe. Iron deficiency is a major issue in South Korea and Japan too, with respectively 13.5% and 19% of women of reproductive age in the countries having anemia. Iron deficiency is a particular concern in pregnant women in South Korea and Japan.3​ Almost one-quarter of pregnant women in Japan have anemia.

Calcium deficiency is another widespread problem.4​ Intake of the mineral is below the internationally recommended level in nearly all Asian countries. In Malaysia, the Philippines, and India people consume less than half the recommended amount of calcium, on average.

The consequences of calcium deficiency vary by life stage, with the increased risk of preeclampsia and maternal morbidity affecting people of reproductive age and the negative effects on bone health being more relevant for older women.5​ Calcium deficiency in seniors is becoming a public health problem as societies age, with studies suggesting Asia will account for half of all osteoporotic hip fractures by 2050.

Studies have linked probiotics to mineral absorption.6​ If probiotics can optimize mineral absorption, the use of the supplements could mitigate the health consequences of deficiencies even if dietary intake of nutrients such as calcium and iron stays the same.

Improved mineral status in healthy women: Clinical evidence

Researchers studied the effect of two probiotic strains – Bifidobacterium lactis​ BS01 and Lactobacillus acidophilus​ LA02 – on mineral balance in a randomized clinical trial.7​ The study randomized 53 healthy young women to receive placebo or the probiotic strains for six weeks.

The concentration of calcium and iron in hair samples increased in women taking the strains, validating their effect on mineral balance. At baseline, 31% of women in the supplement cohort had calcium levels below the reference value. The figure fell to 6% over the course of the trial. Similarly, the proportion of women with iron levels above the reference value rose from 25% to 63%.

Limosilactobacillus reuteri ​Lb26 and Bifidobacterium animalis ​subsp. lactis​ Bb1 internalize high levels of selenium and zinc, respectively, making these sources more bioavailable compared to other sources commonly used in the formulation of supplements dedicated to women.8

How strains affect mood

Psychiatric disorders such as depression and schizophrenia, as well as stress and anxiety, are associated with decreased abundance of Lactobacillus​, Faecalibacterium​ and Bifidobacterium​.9​ Other studies have linked increases in types of bacteria, such as Escherichia coli​, that make lipopolysaccharide (LPS) to the neuroinflammation that is associated with mood disorders.

Anxiety disorders are more prevalent and more disabling in women than in men.10,11​ Anxiety disorders are twice as prevalent in women as in men, reflecting biological, psychological, and social factors. Women are more likely to report insomnia and other sleep disturbances and are twice as likely to experience depression.

Women suffer from mood fluctuations and depressive symptoms at different stages of life, linked to hormonal changes associated with menstrual cycles, pregnancy, postpartum period, and menopause. Premenstrual syndrome and premenstrual dysphoric disorder are examples where mood swings can be particularly pronounced.

When used as part of a blend, probiotics could address the decreased abundance of bacteria such as Lactobacillus​, impaired intestinal permeability and the rises in LPS-producing bacteria seen in people with mood disorders.

Lacticaseibacillus rhamnosus​ LR06 and Lactiplantibacillus plantarum​ LP01 have been studied with Limosilactobacillus fermentum​ LF16 and Bifidobacterium longum​ 04 in a multi-strain probiotic. The blend positively affected epithelial intestinal barrier, ROS production, and cell viability in different cellular axis models. The mix has proven more effective than single strains.

Potential mechanisms of action for the activity of the blend on the gut-microbiota-brain axis include the production of the neurotransmitters serotonin and GABA, counteraction of oxidative stress and inflammation, antipathogenic activity, as and the restoration of membrane integrity. Evidence that the blend may be able to improve mood, anxiety, depressive symptoms, and sleep disorders in women has led researchers to test the blend of strains in humans.

The blend:Clinical evidence

Investigators have confirmed the effect of the blend on mental health in four different randomized placebo-controlled clinical trials, which are supported by seven preclinical studies that compared the activity of the blend to the single strains.

Compared to placebo in different clinical settings, the blend significantly enhanced overall sleep quality and reduced the time it took to fall asleep, improved mood and measures of subclinical/occasional depression, enhanced resilience against mood fluctuations, and notably decreased state and trait anxiety scores. The significant improvements persisted at the six-week analysis and the final post-dosing assessment, with no significant changes seen in the placebo group.

The preclinical and clinical studies showed the blend significantly impacts neurotransmitter production and modulates the immune system, oxidative stress, and low-grade systemic inflammation, with significant changes in the metabolic profiles and gut microbiota in patients who received the probiotic formulation.12–16

Unmet needs in gynecological health

Maintenance of a healthy vaginal microbiome throughout the lifespan has important effects on a woman's life and fertility, notably because the microbial community is the first line of defense against infections in a part of the body involved in 175 million cases of disease a year.17

Bacterial vaginosis, which happens when the vaginal microbiome is disrupted, has a prevalence of 24% in East Asia and Pacific and 29% in South Asia.18​ The figures make bacterial vaginosis the most common cause of vaginal discharge in women of reproductive age.19​ Vulvovaginal candidiasis, a yeast infection, is the second most common cause.20​ Most women will have at least one vulvovaginal candidiasis episode.

Topical and oral treatments are available for the bacterial and yeast conditions but there remains a need for interventions that provide durable relief. Research showing certain strains lower intravaginal pH, creating a barrier against yeast, and restore normal vaginal flora suggests probiotics may be an attractive alternative.

BV, VVC and UTIs: Clinical evidence

Investigators randomized women with bacterial vaginosis to take placebo or Lactobacillus fermentum ​LF15 and L. plantarum​ LP01, formulated in slow-release vaginal tablets.21​ Scores on a bacterial vaginosis test fell below the threshold level in 92% of the women in the probiotic arm. Almost 60% of the women had a score that suggested the restoration of physiological vaginal microbiota after taking the strains.

Another trial assessed the effect of Lactobacillusfermentum​ LF10 and Lactobacillus acidophilus ​LA02 on vulvovaginal candidiasis, the second most common cause of vaginitis after bacterial vaginosis.22​ The subjects applied vaginal tablets. After 28 days, the strains significantly solved Candida yeast symptoms in most of the women. Assessments after two months showed the long-term barrier effect of the product.

A third trial assessed a blend of L. plantarum ​LP01, L. paracasei ​LPC09, S. thermophilus​ ST10, tara gum, cranberry, and D-mannose in women affected by cystitis.23​ Typical symptoms of cystitis, including pain when urinating, were significantly improved.

Partnering to seize the opportunities in women’s health

The potential of Probiotical’s custom blends extend beyond nutrition, mood, and gynecological health. Some strains can address leaky gut syndrome, a cause of increased intestinal permeability that is linked to women’s health conditions such as endometriosis, polycystic ovary syndrome, and premenstrual symptoms.24–26

Other strains cut levels of heavy metals, which affect reproductive health, or act on the gut-skin axis to address acne and beauty from within.27,28​ Postbiotic heat-treated bacteria used for the formulation of cosmetic and personal care products targeting hydration, redness, pathogenic overgrowth and inflammation in the intimate provide further opportunities to manage vaginal symptoms.29

The wide range of conditions linked to gut and vaginal microbiota, plus the fact that women’s health concerns vary by life stage, creates opportunities for a variety of blends capable of addressing different needs from adolescence, through the reproductive years, and into menopause and beyond.

Probiotical enables its partners to meet diverse health needs by developing products that are tailored to the specific requirements of women in different age groups. The products are based on Probiotical strains that produce vitamins, counteract high cholesterol, target increased intestinal permeability and inflammatory processes, provide gender-specific antioxidant activity, detoxify from heavy metals, and target symptoms in the intimate area.30–35​ 

The company can customize the strains and finished product to give customers a formulation that is ready to market. As well as developing products, Probiotical supports its partners with regulatory affairs, market insights, clinical protocol support, and more.

Companies that want to learn more about the women’s health market and Probiotical’s capabilities can visit the company at booth F28 at Vitafoods Asia in Bangkok in September 2024.

References

1.​ Retail Asia. Women’s Health in APAC: Achieving optimal wellness through nutrition.
2.​ World Health Organization. Prevalence of anaemia in women of reproductive age (aged 15-49) (%).
3. ​World Health Organization. Prevalence of anaemia in pregnant women (aged 15-49) (%).
4.​ IOF. Key statistic for Asia.
5.​ Shlisky, J.; Mandlik, R.; Askari, S.; et al. (2022). Calcium deficiency worldwide: prevalence of inadequate intakes and associated health outcomes.​ Annals of the New York Academy of Sciences​, 1512​(1), 10–28.
6.​ Varvara, R-A.; Vodnar, D-C.; Probiotic-driven advancement: Exploring the intricacies of mineral absorption in the human body.​ Food Chemistry: X, Volume 21, 2024.
7. ​Czajeczny, D.; Wójciak, R.; Czajeczny, D.; et al. (2021). Bifidobacterium lactis BS01 and Lactobacillus acidophilus LA02 supplementation may change the mineral balance in healthy young women.​ J. Elem.
8. ​Mogna, L.; Nicola, S.; Pane, M.; et al. (2012). Selenium and zinc internalized by Lactobacillus buchneri Lb26 (DSM 16341) and Bifidobacterium lactis Bb1 (DSM 17850): improved bioavailability using a new biological approach.​ Journal of clinical gastroenterology, 46 Suppl, S41–S45.
9.​ Bharwani, A.; Mian, M. F.; Foster, J. A.; et al. (2016). Structural & functional consequences of chronic psychosocial stress on the microbiome & host.​ Psychoneuroendocrinology, 63, 217–227.
10. ​McLean, C. P.; Asnaani, A.; Litz, B. T.; et al. (2011). Gender differences in anxiety disorders: prevalence, course of illness, comorbidity and burden of illness.​ Journal of psychiatric research, 45(8), 1027–1035.
11. ​Albert P. R. (2015). Why is depression more prevalent in women?.​ Journal of psychiatry & neuroscience : JPN, 40(4), 219–221.
12. ​Di Cesare, F.; Calgaro, M.; Ghini, V.; et al. (2023). Exploring the Effects of Probiotic Treatment on Urinary and Serum Metabolic Profiles in Healthy Individuals.​ Journal of proteome research, 22(12), 3866–3878.
13. ​Kerksick, C. M.; Moon, J. M.; Walden, K. E.; et al. (2024). Multi-strain probiotic improves subjective sleep quality with no impact on body composition, hemodynamics, and physical activity.​ Beneficial microbes, 15(2), 179–194.
14. ​Walden, K. E.; Moon, J. M.; Hagele, A. M.; et al. (2023). A randomized controlled trial to examine the impact of a multi-strain probiotic on self-reported indicators of depression, anxiety, mood, and associated biomarkers.​ Frontiers in nutrition, 10, 1219313.
15. ​Marotta, A., Sarno, E., Del Casale, A., et al. (2019). Effects of Probiotics on Cognitive Reactivity, Mood, and Sleep Quality.​ Frontiers in psychiatry, 10, 164.
16. ​Calgaro, M.; Pandolfo, M.; Salvetti, E.; et al. (2021). Metabarcoding analysis of gut microbiota of healthy individuals reveals impact of probiotic and maltodextrin consumption.​ Beneficial microbes, 12(2), 121–136.
17. ​Abou Chacra, L.; & Fenollar, F. (2021). Exploring the global vaginal microbiome and its impact on human health.​ Microbial pathogenesis, 160, 105172.
18. ​Peebles, K.; Velloza, J.; Balkus, J. E.; et al. (2019). High Global Burden and Costs of Bacterial Vaginosis: A Systematic Review and Meta-Analysis.​ Sexually transmitted diseases, 46(5), 304–311.
19. ​Braunstein, M.; & Selk, A. (2024). Bacterial vaginosis.​ CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 196(21), E728.
20. ​Zeng, X.; Zhang, Y.; Zhang, T.; et al. (2018). Risk Factors of Vulvovaginal Candidiasis among Women of Reproductive Age in Xi'an: A Cross-Sectional Study.​ BioMed research international, 2018, 9703754.
21.​ Vicariotto, F.; Mogna, L.; & Del Piano, M. (2014). Effectiveness of the two microorganisms Lactobacillus fermentum LF15 and Lactobacillus plantarum LP01, formulated in slow-release vaginal tablets, in women affected by bacterial vaginosis: a pilot study.​ Journal of clinical gastroenterology, 48 Suppl 1, S106–S112.
22. ​Vicariotto, F.; Del Piano, M.; Mogna, L.; (2012). Effectiveness of the association of 2 probiotic strains formulated in a slow release vaginal product, in women affected by vulvovaginal candidiasis: a pilot study.​ Journal of clinical gastroenterology, 46 Suppl, S73–S80.
23.​ Vicariotto F. (2014). Effectiveness of an association of a cranberry dry extract, D-mannose, and the two microorganisms Lactobacillus plantarum LP01 and Lactobacillus paracasei LPC09 in women affected by cystitis: a pilot study.​ Journal of clinical gastroenterology, 48 Suppl 1, S96–S101.
24. ​Takeda, T.; Yoshimi, K.; Kai, S.; et al. (2022). Characteristics of the gut microbiota in women with premenstrual symptoms: A cross-sectional study.​ PloS one, 17(5), e0268466.
25. ​Sun, Y.; Gao, S.; Ye, C.; et al. (2023). Gut microbiota dysbiosis in polycystic ovary syndrome: Mechanisms of progression and clinical applications.​ Frontiers in cellular and infection microbiology, 13, 1142041.
26.​ Xholli, A.; Cremonini, F.; Perugi, I.; et al. (2023). Gut Microbiota and Endometriosis: Exploring the Relationship and Therapeutic Implications.​ Pharmaceuticals (Basel, Switzerland), 16(12), 1696.
27. ​Abdel-Megeed R. M. (2021). Probiotics: a Promising Generation of Heavy Metal Detoxification.​ Biological trace element research, 199(6), 2406–2413.
28. ​Sánchez-Pellicer, P.; Navarro-Moratalla, L.; Núñez-Delegido, E.; et al. (2022). Acne, Microbiome, and Probiotics: The Gut-Skin Axis.​ Microorganisms, 10(7), 1303.
29. ​Shen, X.; Xu, L.; Zhang, Z.; et al. (2023). Postbiotic gel relieves clinical symptoms of bacterial vaginitis by regulating the vaginal microbiota.​ Frontiers in cellular and infection microbiology, 13, 1114364.
30. ​Chamignon, C.; Mallaret, G.; Rivière, J.; et al. (2023). Beneficial Effects of Lactobacilli Species on Intestinal Homeostasis in Low-Grade Inflammation and Stress Rodent Models and Their Implication in the Modulation of the Adhesive Junctional Complex.​ Biomolecules, 13(9), 1295.
31.​ Pompei, A.; Cordisco, L.; Amaretti, A.; et al. (2007). Administration of folate-producing bifidobacteria enhances folate status in Wistar rats.​ The Journal of nutrition, 137(12), 2742–2746.
32.​ Amoruso, A.; Deidda, F.; Pane, M.; et al. (2019). A Systematic Evaluation of the Immunomodulatory and Functional Properties of Probiotic Bifidobacterium Breve BR03 (DSM 16604) Lactobacillus plantarum​ LP01 (LMG P-21021).​ J Prob Health​.
33.​ Strozzi, G. P.; & Mogna, L. (2008). Quantification of folic acid in human feces after administration of Bifidobacterium probiotic strains.​ Journal of clinical gastroenterology, 42 Suppl 3 Pt 2, S179–S184.
34. ​Magistrelli, L.; Amoruso, A.; Mogna, L.; et al. (2019). Probiotics May Have Beneficial Effects in Parkinson's Disease: In vitro​ Evidence.​ Frontiers in immunology, 10, 969.
35. ​Monzani, R.; Gagliardi, M.; Clemente, N.; et al. (2022). The Gut-Ex-Vivo System (GEVS) Is a Dynamic and Versatile Tool for the Study of DNBS-Induced IBD in BALB/C and C57BL/6 Mice, Highlighting the Protective Role of Probiotics.​ Biology, 11(11), 1574.