Actimel

Actimel

Launched in Europe in 1994, Actimel (also known as DanActive in the United States and Canada) is a 'probiotic' yoghurt-type drink produced by the French company Danone. It is sold in 100ml bottles, typically as an 8, 6 or 4 pack, but more recently as a 12 or 16 pack. The main claimed benefit of Actimel is the strengthening of the body's natural defences through the use of patented bacterial culture called Lactobacillus casei DN-114001, marketed as Lactobacillus casei Defensis or Immunitas(s) and more recently as L. casei Danone. Each bottle is claimed to contain 10 billion of these bacteria.[1] In addition Actimel contains the traditional yoghurt cultures Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus salivarius subsp. thermophilus.

After the introduction of Yakult in Europe in 1993 several other companies including Danone responded releasing their own L. casei based products. Since 1994, L. casei based yogurts have become a common product in West European supermarkets.

Actimel earned over €1400 million (US$1.8 billion) in retail sales in 2006 [2] and can be found in more than 20 European countries as well as in South America and the Middle East. Actimel was released as DanActive in the United States on a limited regional basis in 2004 (flavours Strawberry, Vanilla, and Blueberry) then was given a nationwide launch in 2007 (adding the flavour Cranberry/Raspberry).

Contents

Ingredients

Standard Actimel (excludes variations such as Actimel Light) contains:

Scientific basis

The main claimed benefits are referenced to several scientific studies listed by the manufacturer on various of its websites,[3] . The list of scientific papers differs on each country's website.[4][5][6]

Claimed benefits range from reducing the incidence of diarrhea[7][8][9] and rhinitis reduction for young children [10], to improvement of the immune function in adults[11]) and seniors [12][13]and reduction of duration of winter infections for elderly.[14]

Some clinical studies suggest potential effects for children such as eradication of H. pylori when combined with antibiotics[15] or restoration of activity of fecal enzymes in children after surgery.[16]

A recent study published by the British Medical Journal[17] suggests that the product could help to avoid antibiotic–associated diarrhea and limit Clostridium difficile infections in elderly patients.

Research is ongoing to determine the effectiveness, or otherwise, of this product in reducing the occurrence of common illnesses in children attending daycare centers in the US.[18] This clinical trial has been registered clinicaltrials.gov [19] (as is now often required for peer-reviewed publication, in order to decrease the likelihood of null results being unreported), but results are not published as yet.

Debates surrounding health claims on probiotic foods

See also Health claims on food labels.

On January 23, 2008, a proposed class action was filed in California, accusing Danone Co. Inc. of false advertising in their marketing of yogurt containing probiotic bacteria (Danactive & Activia), alleging that the claimed health benefits have never been proven.[20] The company has denied this accusation.[21]

Foodwatch claims that Danone "makes a mountain out of a molehill" in suggesting that Actimel protects from cold and boosts health. Foodwatch believes that the company sells a commodity product as a niche product using branding.[22]

The Advertising Standards Authority (ASA) is an independent regulator for advertisements, sales promotion and direct marketing in the UK. According to Spiegel Online one TV spot from Actimel was blocked by the ASA in 2006 and one in 2008.[23] In the first case the ASA upheld a complaint that the advert misleadingly implied that children given Actimel would be prevented from catching bacterial infections.[24] Meanwhile in the second case complaints about the use of the phrase "Actimel is scientifically proven and you can see that proof for yourself on our website" were upheld as only summaries of, or references to, these studies were present on the website and the full content was not available.[25] A TV advert which stated that Actimel was "scientifically-proven to help support your kids' defences" was banned by the Advertising Standards Authority.[26]

Alexa Meyer, from the Department of Nutritional Sciences, University of Vienna, Austria, comparing probiotic drinks and normal yoghurt, found no significant difference in the effect of Actimel and normal yogurt with living bacteria. The nutritional researcher recommends to get enough sleep, wash hands often and eat a daily bowl of yoghurt. She says this would activate more active germ-fighting white blood cells, enhancing the immune system, probably due to the presence of Lactobacillus bulgaricus, from any normal yogurt, which is half the price of Actimel.[27]

The equivalence of yoghurts is supported by Berthold Koletzko from the University of Munich, Metabolic Diseases and Nutrition, Munich, Germany in case of diarrhoea advises parents to give their children yogurt with living bacteria. It does not necessarily need to be Actimel, but may also be other yogurts. A measurable health benefit linked to the presence of live Streptococcus thermophilus and Lactobacillus delbrueckii sp. Bulgaricus was reported by Koletzko and colleagues 2005 yoghurt. In this review Koletzko and colleagues say that it was clearly demonstrated that yoghurt containing viable bacteria improves lactose digestion and eliminates symptoms of lactose intolerance, and clearly fulfil the current concept of probiotics.[28]

The net "all-cause" effects of yoghurts have also been questioned; its September 6, 2009 issue, Nature featured an article by Didier Raoult who claimed that "probiotic-enriched" yogurt beverages may have contributed to the increase in obesity over the past 20 years.[29]

Within the 27 countries of the European Union, a new health claims regulation was put in place by the European Commission as of July 1, 2007,[30] under which companies who wish to make claims about the nutritional & functional benefits of a product must support the claims with scientific evidence.[31] In Canada, a similar regulation is currently in the works at Health Canada,[32] as it plans to update its assessment framework to make the system clearer and the claims more credible.[33]

Nutrition facts

Danone Actimel plain 0% actually contains 3.3 g of sugar, original plain contains 10.5 g of sugar, multifruit contains 12.0 g of sugar for every serving (100 g). None of those concentrations is higher than the level defined as “HIGH” by the UK Food Standards Agency (described for concentrations of sugar above 15 g per 100 g).[34] As a comparison, Coca-Cola and orange juices are also in the range of 10 g of sugar per 100 g, but with a serving size usually higher than 250 ml the total sugar quantity is much higher.

Through nutrient profiling guidelines, current health claim regulations in the European Union may forbid the use of health claim on food products that are nutritionally unbalanced, but dairy products and probiotic drinks are likely to be considered favourably because their health benefits outweigh the fact they are high in one of the designated 'unhealthy' ingredients.[35]

References

  1. ^ a b DanActive: Help strengthen your body's defenses
  2. ^ Danone Actimel: Innovation Builds a Probiotic Mega-Brand
  3. ^ How does Actimel help to boost your immune system | Scientific evidence | For Children
  4. ^ http://www.actimelusa.com/8044-Lactobacillus%20Casei%20Clin%20study_a.pdf
  5. ^ Actimel Ayuda a tus Defensas
  6. ^ Danone-et-Vous-Vos-Marques-Actimel
  7. ^ Pedone CA, Arnaud CC, Postaire ER, Bouley CF, Reinert P (November 2000). "Multicentric study of the effect of milk fermented by Lactobacillus casei on the incidence of diarrhoea". Int J Clin Pract 54 (9): 568–71. PMID 11220983. 
  8. ^ Pedone CA, Bernabeu AO, Postaire ER, Bouley CF, Reinert P (Apr-May 1999). "The effect of supplementation with milk fermented by Lactobacillus casei (strain DN-114 001) on acute diarrhoea in children attending day care centres". Int J Clin Pract 53 (3): 568–71. PMID 10665128. 
  9. ^ Agarwal KN, Bhasin SK (December 2002). "Feasibility studies to control acute diarrhoea in children by feeding fermented milk preparations Actimel and Indian Dahi". Eur J Clin Nutr 56 (4): 56–9. doi:10.1038/sj.ejcn.1601664. PMID 12556949. 
  10. ^ Giovannini M, Agostoni C, Riva E, Salvini F, Ruscitto A, Zuccotti GV, Radaelli G; Felicita Study Group (August 2007). "A randomized prospective double blind controlled trial on effects of long-term consumption of fermented milk containing Lactobacillus casei in pre-school children with allergic asthma and/or rhinitis". Pediatr Res 62 (2): 215–20. doi:10.1203/PDR.0b013e3180a76d94. PMID 17597643. 
  11. ^ Marcos A, Wärnberg J, Nova E, Gómez S, Alvarez A, Alvarez R, Mateos JA, Cobo JM (December 2004). "The effect of milk fermented by yogurt cultures plus Lactobacillus casei DN-114001 on the immune response of subjects under academic examination stress". Eur J Nutr 43 (6): 381–9. doi:10.1007/s00394-004-0517-8. PMID 15309418. 
  12. ^ Parra MD, Martínez de Morentin BE, Cobo JM, Mateos A, Martínez JA (June 2004). "Daily ingestion of fermented milk containing Lactobacillus casei DN114001 improves innate-defense capacity in healthy middle-aged people". J Physiol Biochem 60 (2): 85–91. doi:10.1007/BF03168444. PMID 15457926. 
  13. ^ Parra MD, Martínez de Morentin BE, Cobo JM, Mateos A, Martínez JA (2004). "Monocyte function in healthy middle-aged people receiving fermented milk containing Lactobacillus casei". J Nutr Health Aging 8 (4): 208–11. PMID 15316583. 
  14. ^ Turchet P, Laurenzano M, Auboiron S, Antoine JM (2003). "Effect of fermented milk containing the probiotic Lactobacillus casei DN-114001 on winter infections in free-living elderly subjects: a randomised, controlled pilot study". J Nutr Health Aging 7 (2): 75–7. PMID 12679825. 
  15. ^ Sýkora J, Valecková K, Amlerová J, Siala K, Dedek P, Watkins S, Varvarovská J, Stozický F, Pazdiora P, Schwarz J (September 2005). "Effects of a specially designed fermented milk product containing probiotic Lactobacillus casei DN-114 001 and the eradication of H. pylori in children: a prospective randomized double-blind study". J Clin Gastroenterol 39 (8): 692–8. doi:10.1097/01.mcg.0000173855.77191.44. PMID 16082279. 
  16. ^ Pawłowska J, Klewicka E, Czubkowski P, Motyl I, Jankowska I, Libudzisz Z, Teisseyre M, Gliwicz D, Cukrowska B (December 2007). "Effect of Lactobacillus casei DN-114001 application on the activity of fecal enzymes in children after liver transplantation". Transplant Proc 39 (10): 3219–21. doi:10.1016/j.transproceed.2007.03.101. PMID 18089357. 
  17. ^ Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial - Hickson et al., 10.1136/bmj.39231.599815.55 - BMJ
  18. ^ Decreasing Rates of Illness in Kids (DRINK) - Full Text View - ClinicalTrials.gov
  19. ^ Home - ClinicalTrials.gov
  20. ^ CTV.ca | Dannon sued over probiotic yogurt claims
  21. ^ "Dannon Refutes Class Action Lawsuit Alleging Misleading Claims". Reuters. 2008-01-24. http://www.reuters.com/article/pressRelease/idUS242897+24-Jan-2008+BW20080124. 
  22. ^ Foodwatch: Abgespeist: Actimel von Danone. Activer Etikettenschwindel. 17.12.2008. danone_actimel_compactinfo_20081217 http://www.abgespeist.de/actimel/index_ger.html
  23. ^ Amann, Susanne: Marketing-Erfolg. Mit Joghurt Millionen scheffeln. Spiegel Online 22.12.2008 http://www.spiegel.de/wirtschaft/0,1518,druck-597184,00.html
  24. ^ ASA adjudication 1st November 2006 http://www.asa.org.uk/asa/adjudications/Public/TF_ADJ_41911.htm
  25. ^ ASA adjudication 12th March 2008 http://www.asa.org.uk/asa/adjudications/Public/TF_ADJ_44120.htm
  26. ^ BBC 'Healthy' yoghurt advert banned 13 October 2009
  27. ^ Meyer AL, Micksche M, Herbacek I, Elmadfa I.: Daily intake of probiotic as well as conventional yogurt has a stimulating effect on cellular immunity in young healthy women. Ann Nutr Metab. 2006;50(3):282-9. Epub 2006 Feb 23. http://www.ncbi.nlm.nih.gov/pubmed/16508257
  28. ^ Guarner, F.; Perdigon, G.; Corthier, G.; Salminen, S.; Koletzko, B.; Morelli, L.: Should yoghurt cultures be considered probiotic? Br J Nutr. 2005 Jun;93(6):783-6. Review. http://www.ncbi.nlm.nih.gov/pubmed/16022746
  29. ^ Probiotics and obesity: a link? : Abstract : Nature Reviews Microbiology
  30. ^ EFSA releases first health claims guidelines
  31. ^ Health claims deadline passes
  32. ^ Managing Health Claims for Foods in Canada: Towards a Modernized Framework
  33. ^ Canada seeks opinion on health claims review
  34. ^ Good food and healthy diet - Live Well - NHS Choices
  35. ^ European nutrient profiling may exempt key food groups

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