Cited by 490Probiotics and Fermented FoodsGut microbiota and healthInfant Nutrition and Health

Bifidobacteria and Their Health-Promoting Effects

Open access
Hidalgo-Cantabrana, Claudio, Delgado, Susana, Ruiz, Lorena, Ruas-Madiedo, Patricia, Sánchez, Borja, Margolles, Abelardo·2017·Microbiology Spectrum

Abstract

Bifidobacteria are members of the intestinal microbiota of mammals and other animals, and some strains are able to exert health-promoting effects. The genus Bifidobacterium belongs to the Actinobacteria phylum. Firmicutes , Bacteroidetes , and Actinobacteria constitute the most abundant phyla in the human intestinal microbiota, Firmicutes and Bacteroidetes being predominant in adults, and Actinobacteria in breast-fed infants, where bifidobacteria can reach levels higher than 90% of the total bacterial population. They are among the first microbial colonizers of the intestines of newborns, and play key roles in the development of their physiology, including maturation of the immune system and use of dietary components. Indeed, some nutrients, such as human milk oligosaccharides, are important drivers of bifidobacterial development. Some Bifidobacterium strains are considered probiotic microorganisms because of their beneficial effects, and they have been included as bioactive ingredients in functional foods, mainly dairy products, as well as in food supplements and pharma products, alone, or together with, other microbes or microbial substrates. Well-documented scientific evidence of their activities is currently available for bifidobacteria-containing preparations in some intestinal and extraintestinal pathologies. In this review, we focus on the role of bifidobacteria as members of the human intestinal microbiota and their use as probiotics in the prevention and treatment of disease.

AI snapshot

Written from the paper’s full text.

TL;DR

This review summarizes bifidobacteria as early colonizers of the infant gut and as probiotics, with strain-specific health effects reported in intestinal, extraintestinal, and allergic conditions. It concludes that evidence is promising but often insufficient, strain- and host-dependent, and requires better mechanistic understanding and product labeling.

Key findings

  • Bifidobacteria can exceed 90% of the total bacterial population in breast-fed infants; adult fecal bifidobacterial load is estimated at close to 4%. The genus contains more than 50 species, with more than 50 complete genome sequences available, and a phylogeny based on 48 genomes identified seven phylogenetic groups.
  • Clinical benefits are reported for selected strains and mixtures, including B. animalis subsp. lactis BB-12, B. breve Yakult, B. infantis 35624, and VSL#3, in antibiotic-associated diarrhea, C. difficile-associated diarrhea, IBS, ulcerative colitis, necrotizing enterocolitis, H. pylori infection, colorectal cancer, and allergic disease. A meta-analysis of 23 clinical trials (n = 4,213) found moderate evidence that probiotics are effective in preventing C. difficile-associated diarrhea; VSL#3 given for 10 days yielded an H. pylori eradication rate of 32.5% in adults; fecal microbiota transplantation showed up to 95.9% success for C. difficile infection.
  • Proposed mechanisms include human milk oligosaccharide utilization, organic acid and antibacterial peptide production, quorum-sensing inhibition, immune modulation, exopolysaccharide effects, and cross-feeding with other gut bacteria. Effects are described as strain-dependent and influenced by the target population’s genetic background and gut microbiota composition.
  • In a study of 16 probiotic products, only one matched its bifidobacterial label, highlighting unresolved labeling and strain-identification problems.

Methods

  • Narrative review; no systematic review protocol, search strategy, inclusion criteria, or meta-analytic methods are stated.
  • Synthesizes human clinical trials, meta-analyses, and in vitro/in vivo mechanistic studies; for the disease-effectivity section, the authors state they focus on clinical trials and exclude animal models and in vitro or ex vivo studies.
  • Includes tables listing Bifidobacterium strains reported to show effectivity in human trials and selected meta-analyses/reviews on probiotic products containing bifidobacteria.

Limitations

  • Stated: for many strains there is insufficient scientific evidence to support reported positive effects, and clear biomarkers for bifidobacterial efficacy are not yet identified. Most bifidobacterial strains were tested in combination with other microorganisms or prebiotic carbohydrates, making single-strain probiotic effects difficult to prove.
  • Stated: health benefits appear strain-dependent, notably for immunomodulation, and also depend on the genetic background of the target population; further basic research is needed to clarify molecular mechanisms and define strain-specific effects. Correct identification and labeling of species/strains in foods and supplements remains an unresolved issue.
  • Evident: as a narrative review, it does not systematically appraise study quality or risk of bias, and its tables are described as a selection, so conclusions may reflect selected literature rather than a comprehensive evidence synthesis.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1128/microbiolspec.bad-0010-2016

Cites

170 of 170 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 53 cited sources checked · 0 supported · 0 flagged

  • Premisecitation
    § ABSTRACT

    Bifidobacteria are numerically dominant members of the intestinal microbial communities by the age of 3 to 4 months.

    “Indeed, bifidobacteria are numerically dominant members of the intestinal microbial communities by the age of 3 to 4 months (15, 16).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
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      Not checked in the free run.

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      Not checked in the free run.

  • Premisecitation
    § ABSTRACT

    Bifidobacteria are among the best described gut bacteria with ability to utilize HMOs.

    “Bifidobacteria are among the best described gut bacteria with ability to utilize HMOs.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
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      Not checked in the free run.

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      Not checked in the free run.

  • Interpretationnone given
    § ABSTRACT

    Some Bifidobacterium strains are able to exert health-promoting effects.

    “Bifidobacteria are members of the intestinal microbiota of mammals and other animals, and some strains are able to exert health-promoting effects.”
    Quote in the paperSubstantial claim
  • Premisecitation
    § ABSTRACT

    Bifidobacteria are among the dominant bacterial populations in the gastrointestinal tract of humans.

    “Bifidobacteria are among the dominant bacterial populations in the gastrointestinal tract (GIT) of humans.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
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      Not checked in the free run.

  • Premisecitation
    § ABSTRACT

    Bifidobacterial exopolysaccharides have been proven to be capable of modulating gut microbiota in in vitro fecal batch cultures and in vivo mice trials.

    “Bifidobacterial molecules, such as the exopolysaccharides present in the outer cell-surface layer, have been proven to be capable of modulating gut microbiota in in vitro fecal batch cultures (55) and in vivo mice trials (56), thus providing a molecular basis for gut microbiota-bifidobacteria cross talk.”
    Quote in the paperSubstantial claim0 of 2 sources checked
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      Not checked in the free run.

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      Not checked in the free run.

  • May combine two claims. 10
  • Classified as probably not a substantial claim. 1
  • May combine two claims.

    Premisecitation
    § ABSTRACT

    Numerous studies have demonstrated the capability of prebiotics to promote bifidobacterial presence within the microbiota, correlating with other changes in the overall microbiota composition and metabolism.

    “On the other hand, numerous studies have demonstrated the capability of prebiotics to promote bifidobacterial presence within the microbiota, correlating with other changes in the overall microbiota composition and metabolism.”
    Quote in the paperSubstantial claim0 of 4 sources checked
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      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § ABSTRACT

    In a recent study performed with 16 probiotic products, using DNA-based methods as well as culturing techniques, only one matched its bifidobacterial label; thus, most of them differ from the ingredient list.

    “Indeed, in a recent study performed with 16 probiotic products, using DNA-based methods as well as culturing techniques, only one matched its bifidobacterial label; thus, most of them differ from the ingredient list (101).”
    Quote in the paperSubstantial claim0 of 1 sources checked
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      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § ABSTRACT

    Bifidobacterium is one of the main genera of commensal bacteria present in the human GIT and its presence has been related to health benefits in several studies.

    “Bifidobacterium is one of the main genera of commensal bacteria present in the human GIT and its presence has been related to health benefits in several studies (83).”
    Quote in the paperSubstantial claim0 of 1 sources checked
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      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § ABSTRACT

    The probiotic mixture VSL#3 reduces ulcerative colitis symptoms in adults and induces remission in children.

    “In IBD, the probiotic mixture VSL#3, which contains bifidobacteria of different species, was able to reduce the UC symptoms in adults (144, 145) as well as the remission of the disease in children (84).”
    Quote in the paperSubstantial claim0 of 3 sources checked
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      Not checked in the free run.

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      Not checked in the free run.

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      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § ABSTRACT

    Fecal microbiota transplantation is the best methodology to reduce C. difficile-associated diarrhea and eradicate the pathogen, with up to 95.9% success including recalcitrant and severe cases.

    “Regarding C. difficile infection, the best methodology to reduce the associated diarrhea and to eradicate this pathogen is the fecal microbiota transplantation, which has shown up to 95.9% success, including recalcitrant and severe cases (114).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
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      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § ABSTRACT

    A meta-analysis of clinical trials showed that probiotics could be as effective as pharmacological approaches for H. pylori treatment and were the best treatment in terms of patient tolerance.

    “Li and coworkers (117) published a meta-analysis that compiled the clinical trial studies involving H. pylori treatment, and they showed that the use of probiotics could be as effective as pharmacological approaches. In addition, probiotics were revealed in the same analysis as the best treatment in terms of tolerance for the patient.”
    Quote in the paperSubstantial claim0 of 1 sources checked
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      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation
    § CONCLUSIONS

    The health benefits of bifidobacteria appear to be strain dependent, especially for immunomodulation, and also depend on the genetic background of the target population.

    “It is noteworthy that the health benefits exerted by bifidobacteria seem to be strain dependent, notably at the level of immunomodulation, but they are also dependent on the genetic background of the target population (77).”
    Quote in the paperSubstantial claim0 of 1 sources checked
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      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § ABSTRACT

    WAO guidelines concluded there is currently no evidence that probiotic supplementation reduces allergy incidence in children, but there is likely a net benefit for eczema prevention.

    “These guidelines concluded that currently there is no evidence supporting probiotic supplementation for reducing the risk of allergy incidence in children. However, there is likely to be a net benefit using probiotics for eczema prevention, which requires further clinical trials to increase the sample size and the reliability of the results.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
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      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § ABSTRACT

    Each Bifidobacterium species appeared to elicit different immune effects on the host, noteworthy being the ability of B. bifidum to expand the T-regulatory response, which may be relevant for its use in chronic inflammatory diseases.

    “Each Bifidobacterium species appeared to elicit different immune effects on the host, noteworthy being the ability of B. bifidum to expand the T-regulatory response, which may be relevant for its use in chronic inflammatory diseases (104).”
    Quote in the paperSubstantial claim0 of 1 sources checked
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      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning
    § ABSTRACT

    In many cases, there is insufficient scientific evidence to support the positive effects reported for the strains, since clear biomarkers for bifidobacterial efficacy are, as yet, not identified.

    “In many cases, there is insufficient scientific evidence to support the positive effects reported for the strains, since clear biomarkers for bifidobacterial efficacy are, as yet, not identified (Fig. 1).”
    Quote in the paperSubstantial claim
10 of 10
  • The paper relies on this without support.

    Antibiotic treatments for H. pylori decreased in effectiveness over years of antibiotherapy, leading to antibiotic resistance in H. pylori strains.

    “Although very successful in the beginning, antibiotic treatments decreased in effectiveness after years of antibiotherapy, which resulted in the emergence of antibiotic resistance in H. pylori strains.”
  • The paper relies on this without support.

    Feces from a healthy person likely contain between 1 and 4% bifidobacteria.

    “Because it is likely that the feces from a healthy person contain between 1 and 4% bifidobacteria, it remains to be elucidated whether increasing the number of bifidobacteria by appropriate donor selection, or by targeted enrichment of this population before transplantation, could be useful, not only in CDAD, but also in other diseases through fecal microbiota transplantation.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A. muciniphila can produce secretory IgA and antibacterial peptides by immunological rejection to resist pathogen damage to the intestines, and has anti-inflammatory, barrier-improving properties; it can also regulate intestinal microbial balance, and improve the situation of PD, aging, pediatric autism, MS and ALS.

    “For probiotics strains, A. muciniphila can produce secretory immunoglobulin A (IgA) and antibacterial peptides by immunological rejection to resist pathogen damage to the intestines, and has anti-inflammatory, barrier-improving properties. It can also regulate intestinal microbial balance, and improve the situation of PD, aging, pediatric autism, MS and ALS (Derrien et al. 2017; Hidalgo-Cantabrana”

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Cited chemotherapy patients described as having CRC

    Minor

    The text describes the patients in reference 132 as having colorectal cancer, while that reference is titled as a study of patients undergoing chemotherapy for pediatric malignancies.

  • Different references given for the B. breve BB99 IBS mixture

    Minor

    Table 1 assigns reference 142 to the B. breve BB99 mixture, whereas the text assigns it reference 140. The reference list identifies 142 as a VSL#3 study.

  • Different Bifidobacterium species given for NEC study 147

    Minor

    Table 1 identifies the Bifidobacterium strain associated with reference 147 as B. bifidum NCDO 1453. The text instead says the product in that study contained B. infantis.

  • Different references given for VSL#3 in ulcerative colitis

    Minor

    Table 1 cites references 140 and 141 for reducing ulcerative colitis symptoms, while the text cites 144 and 145. The reference list describes 140 and 141 as publications about irritable bowel syndrome.

  • Mouse trials described by a cited rat study

    Minor

    The text calls the in vivo trials cited as reference 56 mouse trials, but the title of reference 56 says the strains were administered to Wistar rats.

  • Different references given for VSL#3 in children with IBS

    Minor

    Table 1 assigns reference 144 to this result, whereas the text assigns reference 142. The reference list identifies 142 as the study of VSL#3 in children with IBS.

  • IBS review has conflicting reference numbers

    Minor

    Table 2 cites reference 145 for a review about probiotics and the gut microbiota in IBS, but the text identifies that review as reference 143. Reference 145 is listed as a clinical study of ulcerative colitis.

  • Allergy-study strain number differs between table and text

    Minor

    Table 1 names strain NCC2828 for reference 157, whereas both the text and the title of reference 157 name NCC2818.

  • IBS mixture contains fewer Lactobacillus strains than stated

    Minor

    The text says the B. longum 101 mixture contains two Lactobacillus strains, but the corresponding Table 1 entry lists only one Lactobacillus strain; its other listed organisms are Lactococcus lactis and Streptococcus thermophilus.

9 of 9

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Tannock GW. 2010. Analysis of bifidobacterial populations in bowel ecology studies p 1–15. In Mayo B van Sinderen D (ed) Bifidobacteria: Genomics and Molecular Aspects . Caister Academic Press Norfolk England.

Cited by

Sorted by citations

Authors
Hidalgo-Cantabrana, C., Delgado, S., Ruiz, L., Ruas-Madiedo, P., Sánchez, B., & Margolles, A.
Affiliations
  • Consejo Superior de Investigaciones Científicas (ES)
  • Department of Microbiology and Biochemistry of Dairy Products, Dairy Research Institute of Asturias, Spanish National Research Council (IPLA-CSIC), Paseo Río Linares s/n 33300, Villaviciosa, Asturias, Spain
Venue
Microbiology Spectrum
Published
2017-05-19
Volume
5
Issue
3
ISSN
2165-0497 (ISSN-L)
OpenAlex
W2690365708
Cited by
490
References
170
Citations by year
2026: 45 · 2025: 73 · 2024: 98 · 2023: 83 · 2022: 51 · 2021: 51 · 2020: 45 · 2019: 24 · 2018: 15 · 2017: 4 · 2014: 1
FWCI
2.61
Type
journal article
Language
en
Open access
Locations
  • Microbiology Spectrum (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • DIGITAL.CSIC (Spanish National Research Council (CSIC)) (submittedVersion)
Funders
Ministerio de Economía y Competitividad
Topics
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
Keywords
Bifidobacterium, human gut microbiome, probiotics, health-promoting properties, infant gut colonization, human milk oligosaccharides, immune system maturation, functional foods, dairy products, disease prevention and treatment, actinobacteria
MeSH terms
Gastrointestinal Microbiome, Adult, Age Factors, Anti-Bacterial Agents, Bifidobacterium, Dairy Products, Diarrhea, Drug Therapy, Gastrointestinal Diseases, Humans, Infant, Infant, Newborn, Intestines, Colorectal Neoplasms, Inflammatory Bowel Diseases, Clostridioides difficile, Helicobacter pylori, Helicobacter Infections, Probiotics, Enterocolitis, Necrotizing, Gastrointestinal Tract, Irritable Bowel Syndrome, Microbial Interactions

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