Yogurt — Probiotic Strains

Table of Contents

1. The FDA Standard of Identity (21 CFR 131.200)
2. The Two Starter Cultures — Symbiosis and Fermentation Roles
3. Probiotic Adjunct Strains (L. rhamnosus GG, L. casei Shirota, Bifidobacterium, L. reuteri)
4. The ISAPP Definition of a Probiotic
5. Surviving Gastric Transit — What Reaches the Gut
6. CFU Counts on Labels and Through Shelf Life
7. Strain-Specific Evidence (LGG, B. animalis DN-173 010, L. casei Shirota, L. reuteri)
8. Heat-Treated Yogurt and the Live-Culture Question
9. Doses Used in Trials of Named Strains
10. Cautions (Bacteremia, Pancreatitis Trial, Short-Bowel Syndrome)
11. Key Research Papers
12. Connections
13. Featured Videos

The FDA Standard of Identity (21 CFR 131.200)

The legal definition of “yogurt” in the United States is the FDA standard of identity at 21 CFR 131.200, in its current form from a 2021 final rule (86 FR 31137, June 11, 2021). It describes yogurt as the food produced by culturing cream, milk, partially skimmed milk or skim milk (alone or in combination) with a characterizing bacterial culture that contains the lactic acid-producing bacteria Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus. The dairy ingredients must be pasteurized or ultra-pasteurized before the culture is added, and the finished product must have a pH of 4.6 or lower within 24 hours after filling. Cultures in addition to the characterizing culture are listed as optional ingredients, alongside sweeteners, flavorings, color additives, stabilizers, emulsifiers, preservatives and added vitamins A and D.

The standard sets yogurt at not less than 3.25 percent milkfat and not less than 8.25 percent milk solids not fat. A yogurt with between 2.44 and 3.25 percent milkfat must state its milkfat percentage next to the word “yogurt”; below 2.44 percent milkfat, the product is treated as a modified food under a separate section (21 CFR 130.10).

The standard allows yogurt to be treated after culturing to inactivate viable microorganisms and extend shelf life; such a product must carry the phrase “does not contain live and active cultures”. A yogurt may carry the phrase “contains live and active cultures” if it contains at least 10⁷ colony-forming units per gram (CFU/g) at the time of manufacture, with a reasonable expectation of 10⁶ CFU/g through the manufacturer’s assigned shelf life (21 CFR 131.200).

Internationally, the Codex Alimentarius describes yogurt as made with a combination of S. thermophilus and L. delbrueckii subsp. bulgaricus (Marco 2021), and a review of food fermentations notes that in several countries the name yogurt is allowed only for products made with cultures containing both (Sieuwerts 2008).

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The Two Starter Cultures — Symbiosis and Fermentation Roles

Each of the two starter species can ferment milk on its own, but both grow and produce acid faster in mixed culture than alone — a mutual benefit described as protocooperation or mutualism. A 2008 review of food-fermentation microbiology describes the exchange (Sieuwerts 2008):

• Streptococcus thermophilus grows first — with few exceptions, its strains lack extracellular proteases, so it starts on the free amino acids and small peptides already in milk; during this phase there is almost no growth of L. bulgaricus. Most S. thermophilus strains require only histidine, and their growth can be enhanced by methionine, proline, glutamic acid and valine.
• Lactobacillus delbrueckii subsp. bulgaricus supplies peptides — as S. thermophilus growth slows, L. bulgaricus grows and its cell-wall protease (PrtB) breaks the caseins into small peptides. These peptides also serve as an amino-acid source for a second growth phase of S. thermophilus.
• S. thermophilus supplies growth factors — it provides L. bulgaricus with formic acid, pyruvic acid, folic acid and carbon dioxide (released from the urea present in milk).
• Texture — acidification coagulates the milk proteins, and the bacteria, mainly S. thermophilus, produce exopolysaccharides (EPS) that form a matrix with the milk proteins, giving yogurt its structure.
• Aroma — diacetyl, acetaldehyde and acetoin are among the key aroma compounds of yogurt; a 2020 study measured their odour thresholds in a yogurt matrix and found that the three act synergistically (Tian 2020).

Some strains of each species also produce bacteriocins that can inhibit the other (Sieuwerts 2008).

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Probiotic Adjunct Strains (L. rhamnosus GG, L. casei Shirota, Bifidobacterium, L. reuteri)

Many yogurts and yogurt-based drinks contain added probiotic strains, which do not necessarily contribute to the fermentation (Sieuwerts 2008); depending on region, these “probiotic” or “bio” yogurts now account for much of the yogurt market (Savaiano 2021). The added strains on this page are those with trials summarised below:

• Lactobacillus rhamnosus GG (LGG) — a strain of human origin (Goldin 1992) and the first Lactobacillus strain to be patented, in 1989, on the basis of its ability to survive and grow at gastric-acid pH and in bile and to adhere to intestinal cells (Capurso 2019). An account of its discovery was published by Gorbach in 1996.
• Lactobacillus casei strain Shirota — tested in a fermented milk drink in randomized trials in office workers and in residents of an aged-care facility (Shida 2017; Nagata 2016).
• Bifidobacterium animalis strain DN-173 010 — tested in a fermented milk in a colonic-transit trial in healthy women (Marteau 2002).
• Lactobacillus reuteri DSM 17938 — tested in infants with colic (Sung 2018); this is not a yogurt trial.
• Lactobacillus acidophilus — in a 1984 study, sweet (unfermented) milk with added L. acidophilus NCFM did not improve lactose digestion in lactase-deficient people, whereas yogurt did (Savaiano 1984, as described in Savaiano 2021).

Probiotic effects are generally treated as strain-specific: a meta-analysis of LGG begins from the premise that “the effects of probiotics are strain specific” and that the clinical effects of each strain need to be evaluated separately (Szajewska 2015, LGG). The ISAPP expert panel also judged that some general benefits can be ascribed to strains of well-studied species as a group (Hill 2014; see the next section).

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The ISAPP Definition of a Probiotic

In 2014 an expert panel convened by the International Scientific Association for Probiotics and Prebiotics (ISAPP) reaffirmed the FAO/WHO definition of a probiotic as relevant and sufficiently accommodating (Hill et al., Nature Reviews Gastroenterology & Hepatology):

“Live microorganisms which when administered in adequate amounts confer a health benefit on the host.”

Points from the consensus statement and its 2021 companion on fermented foods:

1. Live — “Dead microbes, microbial products, microbial components do not come under the probiotic classification” (Hill 2014).
2. Evidence of benefit — evidence of a health benefit is required, at either a strain-specific or a group level depending on the nature of the benefit. The panel judged that certain effects can be ascribed to strains of well-studied species delivered at a functional dose, and cited Health Canada’s acceptance of named Bifidobacterium and Lactobacillus species, delivered in food at 1 × 10⁹ CFU per serving, for non-strain-specific claims (Hill 2014).
3. “Live and active cultures” versus “probiotic” — for foods containing live microbes as a diverse, undefined community, the panel found it was not always possible to separate the contribution of the microbes from that of the food matrix; it judged that such microbes fall short of the criteria for “probiotics” and that these foods are best described as “containing live and active cultures” (Hill 2014). The 2021 ISAPP consensus on fermented foods restated that fermented foods are not equivalent to probiotic foods, and described “foods made by fermentation” as acceptable wording for pasteurized fermented foods without live microbes (Marco 2021).

On the yogurt starter cultures themselves, Hill 2014 records that the 2001 FAO/WHO expert consultation said traditional starters are not to be considered probiotics because they lack the ability to proliferate in the intestine, while the 2002 FAO/WHO guidelines recognised probiotic status for the traditional yogurt cultures because they improve lactose tolerance in people who maldigest lactose — a benefit since endorsed by the European Food Safety Authority (EFSA). A 2005 review reached the same conclusion: human studies show that yogurt containing viable S. thermophilus and L. bulgaricus improves lactose digestion and eliminates symptoms of lactose intolerance, so these cultures fulfil the concept of probiotics (Guarner 2005).

EFSA’s 2010 scientific opinion on live yogurt cultures and improved lactose digestion (EFSA 2010) underlies an approved EU claim for live cultures in yogurt or fermented milk to aid lactose digestion (Savaiano 2021). EFSA accepted characterisation at the species rather than the strain level because the mechanism — microbial production of the enzyme β-galactosidase (lactase) — is understood (Hill 2014; Marco 2021). By contrast, health-claim applications for probiotics evaluated by EFSA had, up to 2013, almost completely yielded negative results, and later applications were also rejected (Dronkers 2018); a 2021 review states that no probiotic claim for foods had been granted by EFSA (Marlicz 2021).

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Surviving Gastric Transit — What Reaches the Gut

• Fermented-food bacteria in general — multiple human studies have shown that microorganisms in fermented foods can survive gastric transit and reach the colon, and many of the lactic acid bacteria that dominate these foods are acid- and bile-tolerant (Marco 2021).
• The two yogurt species — when 20 healthy volunteers ate commercial yogurt, L. bulgaricus and S. thermophilus were found in their faeces, suggesting that both can survive transit through the gastrointestinal tract (Elli 2006). A 2021 systematic review nonetheless described survival of the two yogurt species beyond the upper gastrointestinal tract as less clear (Savaiano 2021).
• LGG — fed to 76 volunteers, LGG was recovered in the faeces of all who received it in fermented milk or whey and of 86% who received a frozen concentrate, and it was also present in volunteers taking ampicillin. After feeding stopped, it persisted in the faeces of 87% of volunteers four days later and 33% seven days later (Goldin 1992).

Fermented-food lactic acid bacteria can transiently make up between 0.1% and 1% of the bacteria in the large intestine. They are unlikely to maintain long-term residence, though some are metabolically active in the gut; the ISAPP panel noted that such interactions would be augmented by repeated daily consumption (Marco 2021).

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CFU Counts on Labels and Through Shelf Life

Counts of live bacteria are given in colony-forming units (CFU). Figures from the sources on this page:

• US “contains live and active cultures” statement — at least 10⁷ CFU/g at the time of manufacture, with a reasonable expectation of 10⁶ CFU/g through the assigned shelf life (21 CFR 131.200).
• Other regions — in most regions the microbes in yogurt must be alive and abundant, at least 10⁷ CFU/g (Savaiano 2021).
• Added probiotic strains — for fermented milks and yogurts containing probiotic strains, between 5 and 8 log CFU per gram of product at the moment of consumption is typically considered acceptable, according to a 2008 review (Sieuwerts 2008).
• Canada — Health Canada accepts named Bifidobacterium and Lactobacillus species as probiotics for non-strain-specific claims when delivered at 1 × 10⁹ CFU per serving (Hill 2014).

The doses used in trials of named strains are listed with each trial in the next sections.

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Strain-Specific Evidence (LGG, B. animalis DN-173 010, L. casei Shirota, L. reuteri)

• LGG and antibiotic-associated diarrhoea — a 2015 meta-analysis of 12 randomized trials (1,499 participants) found that LGG reduced the risk of antibiotic-associated diarrhoea from 22.4% to 12.3% (relative risk 0.49; low quality of evidence). Analysed separately, the reduction was significant in children (five trials, 445 participants) but not in adults (six trials, 863 participants), except in a subset receiving antibiotics for Helicobacter pylori eradication (Szajewska 2015, LGG).
• LGG and acute gastroenteritis in children — in a trial at 10 US paediatric emergency departments, 971 children aged 3 months to 4 years received LGG at 1 × 10¹⁰ CFU twice daily for 5 days or placebo. Moderate-to-severe gastroenteritis within 14 days occurred in 11.8% with LGG and 12.6% with placebo, and there were no significant differences in duration of diarrhoea or vomiting, day-care absenteeism or household transmission (Schnadower 2018).
• Probiotics as a group and antibiotic-associated diarrhoea — a 2012 meta-analysis pooling 63 randomized trials (11,811 participants) found probiotics associated with less antibiotic-associated diarrhoea (relative risk 0.58; number needed to treat 13). Most trials used Lactobacillus-based products, strains were poorly documented, and the evidence was insufficient to tell whether the effect varied by population, antibiotic or probiotic preparation (Hempel 2012). An earlier meta-analysis of 34 trials reported a 52% reduction in antibiotic-associated diarrhoea, and found that the protective effect did not vary significantly among the strains tested, which included Saccharomyces boulardii, LGG, L. acidophilus and L. bulgaricus (Sazawal 2006).
• Probiotics and C. difficile-associated diarrhoea — the 2017 Cochrane review (31 trials, 8,672 participants) found an incidence of 1.5% with probiotics versus 4.0% in controls (relative risk 0.40; moderate certainty); in a post hoc analysis the benefit appeared only in trials whose participants had a baseline risk above 5% (Goldenberg 2017). Its 2025 update (38 trials, 13,179 participants) found 1.6% versus 3.2% (relative risk 0.50; low certainty), one case prevented for every 65 people taking probiotics, and a reduction in antibiotic-associated diarrhoea (relative risk 0.67; low certainty); it noted author affiliation with or funding from probiotic companies in 28 of the 47 included studies (Esmaeilinezhad 2025).
• Saccharomyces boulardii — this probiotic yeast (not a yogurt organism) lowered the risk of antibiotic-associated diarrhoea from 18.7% to 8.5% in a meta-analysis of 21 randomized trials (4,780 participants); its reduction of C. difficile-associated diarrhoea was significant in children but not in adults (Szajewska 2015, S. boulardii).
• After a course of antibiotics — in mice and people, a multi-strain probiotic given after antibiotics markedly delayed, and left persistently incomplete, the return of the person’s own stool and gut-lining microbiome compared with spontaneous recovery, while a transplant of each person’s own stored stool restored it within days (Suez 2018).
• Bifidobacterium animalis DN-173 010 — in a double-blind crossover study, 36 healthy women ate three 125 g cups a day of a fermented milk containing the strain or a control without bifidobacteria, each for 10 days. Total and sigmoid colonic transit times were significantly shorter with the strain; faecal weight, pH, bacterial mass and bile acids were not significantly affected (Marteau 2002).
• Lactobacillus casei strain Shirota — in 96 male office workers aged 30–49, a fermented milk containing 1.0 × 10¹¹ viable cells once daily for 12 winter weeks was followed by a lower incidence of upper respiratory tract infections than control milk (22.4% vs 53.2%); all authors were employed by the strain’s manufacturer (Shida 2017). In an aged-care facility, residents given the fermented milk once daily for 6 months (36 per group) had a significantly lower incidence of fever and improved bowel movements compared with a placebo beverage (Nagata 2016).
• Lactobacillus reuteri DSM 17938 — an individual-participant meta-analysis of four double-blind trials (345 infants with colic) found less crying and/or fussing with the probiotic (adjusted mean difference −25.4 minutes at day 21). The effect was large in breastfed infants and not significant in formula-fed infants (Sung 2018).
• High-dose multi-strain mixture in pouchitis — in 36 patients with recurrent or refractory pouchitis whose remission had been induced with antibiotics, 6 g once daily of a high-dose multi-strain probiotic maintained remission at one year in 17 of 20 (85%), versus 1 of 16 (6%) on placebo (Mimura 2004). This is a medical preparation, not a yogurt.
• Irritable bowel syndrome — the 2021 American College of Gastroenterology guideline suggests against probiotics for global IBS symptoms (conditional recommendation, very low level of evidence), and the 2020 American Gastroenterological Association guideline recommends probiotics in IBS only in the context of a clinical trial; neither recommended a strain (Marlicz 2021; Su 2020).

Small intestinal bacterial overgrowth is covered on the SIBO page; the trials above did not report results for people with SIBO.

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Heat-Treated Yogurt and the Live-Culture Question

Under the US standard, yogurt may be treated after culturing to inactivate viable microorganisms and extend its shelf life. The product keeps the name “yogurt”, but the label must then carry the phrase “does not contain live and active cultures” in letters at least half the height of the name (21 CFR 131.200). The ISAPP fermented-foods panel described “foods made by fermentation” as acceptable wording for pasteurized fermented foods without live microbes (Marco 2021).

In a 1984 breath-hydrogen study of nine lactase-deficient people, yogurt enhanced lactose digestion, and pasteurizing the yogurt eliminated that effect: pasteurization reduced the yogurt’s lactase activity 10-fold and its cell counts 100-fold. Even so, all subjects fed pasteurized yogurt were symptom-free, whereas eight of nine had gastrointestinal distress after cultured milk (buttermilk), although the amount of lactose malabsorbed was similar (Savaiano 1984). A 2021 systematic review describes another study in which, among flavored and frozen yogurts, ice cream and ice milks, only fresh yogurt significantly improved lactose digestion (Savaiano 2021).

The same review describes two trials in which both pasteurized and non-pasteurized yogurt, eaten for 12 weeks, lowered total cholesterol (by 5% and 10%, respectively), suggesting that a milk component may have contributed (Savaiano 2021).

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Doses Used in Trials of Named Strains

Each trial tested one preparation at one dose and schedule. As reported in the trial abstracts:

• LGG, children with acute gastroenteritis — 1 × 10¹⁰ CFU twice daily for 5 days; no difference from placebo (Schnadower 2018).
• B. animalis DN-173 010, healthy women — three 125 g cups a day of a fermented milk for 10 days; shorter total and sigmoid colonic transit (Marteau 2002). The abstract does not give a CFU count.
• L. casei strain Shirota, office workers — a fermented milk with 1.0 × 10¹¹ viable cells once daily for 12 weeks; fewer upper respiratory tract infections (Shida 2017).
• L. casei strain Shirota, aged-care residents — a fermented milk once daily for 6 months; lower incidence of fever (Nagata 2016). The abstract does not give a CFU count.
• High-dose multi-strain mixture, pouchitis — 6 g once daily for one year; remission maintained in 85% versus 6% (Mimura 2004).
• Multispecies probiotic, predicted severe acute pancreatitis — given enterally twice daily for 28 days; no reduction in infections and higher mortality (Besselink 2008; see Cautions).
• Pooled analyses — the LGG and C. difficile meta-analyses combined trials of different doses and their abstracts give no single dose; the 2017 Cochrane review found similar results for lower versus higher doses (Szajewska 2015, LGG; Goldenberg 2017).

Strained and unstrained yogurt are compared on the Greek vs Regular page.

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Cautions (Bacteremia, Pancreatitis Trial, Short-Bowel Syndrome)

• Lactobacillus bacteremia — Lactobacillus bacteremia is rare. In a review of 89 Finnish cases, the strain was identical to the probiotic LGG in 11; 82% of the patients had severe or fatal underlying illness, and the predisposing factors were immunosuppression, prior prolonged hospitalization and prior surgery. Mortality was 26% at one month and 48% at one year, and severe underlying disease was the significant predictor of death (Salminen 2004). The Cochrane reviews’ conclusions on the short-term safety of probiotics apply to people who are not immunocompromised or severely debilitated (Goldenberg 2017; Esmaeilinezhad 2025).
• Severe acute pancreatitis — the PROPATRIA signal — the 2008 PROPATRIA trial (Besselink et al., Lancet) tested a multi-strain probiotic in 298 patients with predicted severe acute pancreatitis. It did not reduce infectious complications (30% vs 28% on placebo) and found increased mortality in the probiotic arm (24 deaths, 16%, vs 9, 6%, on placebo); nine patients in the probiotic group developed bowel ischaemia, eight of them fatally, against none in the placebo group. The trial’s authors concluded that probiotic prophylaxis should not be administered in this category of patients. In 2010 The Lancet published an expression of concern about the trial report (PMID: 20226971); the PubMed record of the notice gives no reason. It followed a 2009 report by Dutch health inspectorates on how the trial was conducted (PMID: 20051171), and the investigators replied that best practices at the time were followed (PMID: 20362327). The trial gave the preparation enterally to hospitalized patients.
• Lactobacillus endocarditis — a 2024 review of 82 published cases of infective endocarditis caused by Lactobacillus species found a prosthetic valve in 16% of patients and prior probiotic use in 17.3%; overall mortality was 17.1%, and prosthetic-valve infection and presentation with shock were independently associated with death (Ioannou 2024).
• D-lactic acidosis (short-bowel syndrome) — D-lactic acidosis, with confusion, slurred speech and gait disturbance, has been documented in case reports of 98 people with short-bowel syndrome (Bianchetti 2018). A review of five randomized trials in 544 healthy infants found no clinically relevant adverse effects of D-lactic acid-producing probiotics or fermented formulas; the only known paediatric cases occurred in short-bowel syndrome or, historically, with acidified infant formulas (Łukasik 2018).
• Biogenic amines — histamine, tyramine and other biogenic amines are formed by some lactic acid bacteria during fermentation of cheese, meats, vegetables, soybeans and wine; without host detoxification they can cause effects such as migraines. Decarboxylase-negative starter cultures are one strategy used to reduce their formation (Marco 2021).

Decisions about probiotic products during serious illness belong with a clinician.

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Key Research Papers

1. Hill C et al. (2014). Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology & Hepatology — PubMed PMID: 24912386
2. Gorbach SL (1996). The discovery of Lactobacillus GG. Nutrition Today 31(Suppl 1):5S — doi:10.1097/00017285-199611001-00002
3. Goldenberg JZ et al. (2017). Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. Cochrane Database of Systematic Reviews — PubMed PMID: 29257353 (updated in 2025: see Esmaeilinezhad et al. 2025 below)
4. Schnadower D et al. (2018). Lactobacillus rhamnosus GG versus placebo for acute gastroenteritis in children. NEJM — PubMed PMID: 30462938
5. Besselink MGH et al. (2008). Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial (PROPATRIA). The Lancet — PubMed PMID: 18279948 — Expression of concern (Lancet 2010: PubMed PMID: 20226971)
6. Marteau P et al. (2002). Bifidobacterium animalis strain DN-173 010 shortens the colonic transit time in healthy women. Alimentary Pharmacology & Therapeutics — PubMed PMID: 11876714
7. EFSA Panel on Dietetic Products, Nutrition and Allergies (2010). Scientific Opinion on the substantiation of health claims related to live yoghurt cultures and improved lactose digestion (ID 1143, 2976) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal 8(10):1763 — doi:10.2903/j.efsa.2010.1763
8. Sanders ME et al. (2019). Probiotics and prebiotics in intestinal health and disease: from biology to the clinic. Nature Reviews Gastroenterology & Hepatology — PubMed PMID: 31296969
9. Szajewska H, Kolodziej M (2015). Systematic review with meta-analysis: Lactobacillus rhamnosus GG in the prevention of antibiotic-associated diarrhoea in children and adults. Alimentary Pharmacology & Therapeutics — PubMed PMID: 26365389
10. Mimura T et al. (2004). Once daily high dose probiotic therapy [product name omitted] for maintaining remission in recurrent or refractory pouchitis. Gut — PubMed PMID: 14684584
11. Sazawal S et al. (2006). Efficacy of probiotics in prevention of acute diarrhoea: a meta-analysis of masked, randomised, placebo-controlled trials. Lancet Infectious Diseases — PubMed PMID: 16728323
12. Suez J et al. (2018). Post-antibiotic gut mucosal microbiome reconstitution is impaired by probiotics and improved by autologous FMT. Cell — PubMed PMID: 30193113
13. Esmaeilinezhad Z, Ghosh NR, Walsh CM, et al. (2025). Probiotics for the prevention of Clostridioides difficile-associated diarrhea in adults and children. Cochrane Database of Systematic Reviews 9:CD006095 — PubMed PMID: 40931979
14. Hempel S, Newberry SJ, Maher AR, et al. (2012). Probiotics for the prevention and treatment of antibiotic-associated diarrhea: a systematic review and meta-analysis. JAMA 307(18):1959-69 — PubMed PMID: 22570464
15. Szajewska H, Kołodziej M (2015). Systematic review with meta-analysis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Alimentary Pharmacology & Therapeutics 42(7):793-801 — PubMed PMID: 26216624
16. Marco ML, Sanders ME, Gänzle M, et al. (2021). The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on fermented foods. Nature Reviews Gastroenterology & Hepatology 18(3):196-208 — PubMed PMID: 33398112
17. Guarner F, Perdigon G, Corthier G, Salminen S, Koletzko B, Morelli L (2005). Should yoghurt cultures be considered probiotic? British Journal of Nutrition 93(6):783-6 — PubMed PMID: 16022746
18. Savaiano DA, Hutkins RW (2021). Yogurt, cultured fermented milk, and health: a systematic review. Nutrition Reviews 79(5):599-614 — PubMed PMID: 32447398
19. Savaiano DA, AbouElAnouar A, Smith DE, Levitt MD (1984). Lactose malabsorption from yogurt, pasteurized yogurt, sweet acidophilus milk, and cultured milk in lactase-deficient individuals. American Journal of Clinical Nutrition 40(6):1219-23 — PubMed PMID: 6439026
20. Elli M, Callegari ML, Ferrari S, et al. (2006). Survival of yogurt bacteria in the human gut. Applied and Environmental Microbiology 72(7):5113-7 — PubMed PMID: 16820518
21. Goldin BR, Gorbach SL, Saxelin M, Barakat S, Gualtieri L, Salminen S (1992). Survival of Lactobacillus species (strain GG) in human gastrointestinal tract. Digestive Diseases and Sciences 37(1):121-8 — PubMed PMID: 1728516
22. Capurso L (2019). Thirty years of Lactobacillus rhamnosus GG: a review. Journal of Clinical Gastroenterology 53(Suppl 1):S1-S41 — PubMed PMID: 30741841
23. Sieuwerts S, de Bok FA, Hugenholtz J, van Hylckama Vlieg JE (2008). Unraveling microbial interactions in food fermentations: from classical to genomics approaches. Applied and Environmental Microbiology 74(16):4997-5007 — PubMed PMID: 18567682
24. Tian H, Yu B, Yu H, Chen C (2020). Evaluation of the synergistic olfactory effects of diacetyl, acetaldehyde, and acetoin in a yogurt matrix using odor threshold, aroma intensity, and electronic nose analyses. Journal of Dairy Science 103(9):7957-7967 — PubMed PMID: 32684481
25. Shida K, Sato T, Iizuka R, et al. (2017). Daily intake of fermented milk with Lactobacillus casei strain Shirota reduces the incidence and duration of upper respiratory tract infections in healthy middle-aged office workers. European Journal of Nutrition 56(1):45-53 — PubMed PMID: 26419583
26. Nagata S, Asahara T, Wang C, et al. (2016). The effectiveness of Lactobacillus beverages in controlling infections among the residents of an aged care facility: a randomized placebo-controlled double-blind trial. Annals of Nutrition and Metabolism 68(1):51-9 — PubMed PMID: 26599038
27. Sung V, D’Amico F, Cabana MD, et al. (2018). Lactobacillus reuteri to treat infant colic: a meta-analysis. Pediatrics 141(1):e20171811 — PubMed PMID: 29279326
28. Su GL, Ko CW, Bercik P, et al. (2020). AGA clinical practice guidelines on the role of probiotics in the management of gastrointestinal disorders. Gastroenterology 159(2):697-705 — PubMed PMID: 32531291
29. Marlicz W, Skonieczna-Żydecka K, Krynicka P, Łoniewski I, Rydzewska G (2021). Probiotics in irritable bowel syndrome – is the quest for the right strain over? Rapid review of existing guidelines and recommendations. Przegląd Gastroenterologiczny 16(4):369-382 — PubMed PMID: 34976247
30. Dronkers TMG, Krist L, Van Overveld FJ, Rijkers GT (2018). The ascent of the blessed: regulatory issues on health effects and health claims for probiotics in Europe and the rest of the world. Beneficial Microbes 9(5):717-723 — PubMed PMID: 29798707
31. Salminen MK, Rautelin H, Tynkkynen S, et al. (2004). Lactobacillus bacteremia, clinical significance, and patient outcome, with special focus on probiotic L. rhamnosus GG. Clinical Infectious Diseases 38(1):62-9 — PubMed PMID: 14679449
32. Ioannou P, Ziogou A, Giannakodimos I, et al. (2024). Infective endocarditis by Lactobacillus species – a narrative review. Antibiotics (Basel) 13(1):53 — PubMed PMID: 38247612
33. Bianchetti DGAM, Amelio GS, Lava SAG, et al. (2018). D-lactic acidosis in humans: systematic literature review. Pediatric Nephrology 33(4):673-681 — PubMed PMID: 29218437
34. Łukasik J, Salminen S, Szajewska H (2018). Rapid review shows that probiotics and fermented infant formulas do not cause d-lactic acidosis in healthy children. Acta Paediatrica 107(8):1322-1326 — PubMed PMID: 29603358
35. U.S. Food and Drug Administration. 21 CFR 131.200 — Yogurt (standard of identity; 86 FR 31137, June 11, 2021, as amended) — eCFR: 21 CFR 131.200

PubMed Topic Searches

1. PubMed: LGG clinical trials
2. PubMed: B. animalis subsp. lactis trials
3. PubMed: Strain-specific probiotic effects
4. PubMed: Gastric survival of yogurt cultures
5. PubMed: ISAPP probiotic definition

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Connections

• All Food
• Yogurt Overview
• Yogurt Benefits Hub
• Greek vs Regular
• Lactose Tolerance
• Bone Density and Calcium
• Probiotics
• SIBO
• Crohn's Disease
• Ulcerative Colitis
• Irritable Bowel Syndrome (IBS)
• Immune Boosting
• Milk
• Garlic (Prebiotic Inulin)
• Onions (Prebiotic)
• History
• Nutrients

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