Extracted from National Kidney Foundation website.

As a chronic kidney disease (CKD) patient, you may have considered the use of herbal products to assist you with various health concerns. This fact sheet will give you some information to enable you to make decisions regarding your use of herbs.

Use of herbal supplements may be unsafe for CKD patients, since your body is not able to clear waste products like a healthy person. There are some facts about herbs that every CKD patient should know:

• Very few herbs have been studied in CKD patients. What may be safe for healthy persons may not be safe for someone with CKD, and in fact, could be dangerous. Therefore, you need to be very cautious about your use of these products.
• The government does not regulate herbal supplements, so the exact content of these products is unknown.
• Without regulation, there are no requirements for testing, so the purity, safety and effectiveness of the products are unknown.
• Herbal preparations are subject to contamination (may contain toxic heavy metals such as lead or mercury).
• Products may contain minerals harmful to CKD patients, for example: potassium.

Some herbs that may serve as diuretics may also cause “kidney irritation” or damage. These include bucha leaves and juniper berries. Uva Ursi and parsley capsules may have negative side effects as well.

Many herbs can interact with prescription drugs. A few examples are St. Johns Wort, echinacea, ginkgo, garlic, ginseng, ginger, and blue cohosh. Transplant patients are especially at risk, as any interaction between herbs and medications could potentially put them at risk for rejection or losing the kidney. It is important to ask your doctor and/or pharmacist about any herbs or medicines you want to take to avoid potential problems.

Herbs that may be toxic to the kidneys
Artemisia absinthium (wormwood plant)	Periwinkle
Autumn crocus	Sassafras
Chuifong tuokuwan (Black Pearl)	Tung shueh
Horse chestnut	Vandelia cordifolia

Herbs that may be harmful in chronic kidney disease
Alfalfa	Buckthorn	Ginger	Nettle	Vervain
Aloe	Capsicum	Ginseng	Noni juice
Bayberry	Cascara	Horsetail	Panax
Blue Cohosh	Coltsfoot	Licorice	Rhubarb
Broom	Dandelion	Mate	Senna

Herbs known to be unsafe for all people
Chapparal	Pennyroyal
Comfrey	Pokeroot
Ephedra (Ma Huang)	Sassafras
Lobelia	Senna
Mandrake	Yohimbe

These lists are not necessarily complete. More information regarding the use of herbs will become available over time. You are encouraged to proceed with caution with all herbal preparations and use them only under the direction of your medical team.

With all of these cautions, perhaps you are wondering if use of any herbs is a good idea. The use of common herbs, in normal amounts, when cooking is just fine and typically recommended to enhance the flavor of foods on a low-sodium diet.

So, before you take any herbal supplement, we recommend:

• Checking with your doctor, dietitian, pharmacist and/or product manufacturer regarding safety, dosage, duration of use, interactions with prescription drugs, etc.
• Use only standardized herbal extracts made by reputable companies.
• Never take more than the recommended dosage, or longer than recommended.
• Do not use herbal remedies for serious illness.
• Do not use herbs if considering pregnancy.

Remember … natural does not mean safe, especially for CKD patients. Be smart and ask questions before using any herbal products.

Kibow has a recently published a paper on CMRO.

By Lorraine Heller, 25-Jun-2009

Taken from: http://www.nutraingredients-usa.com/content/view/print/251906

Probiotics are picking up in the US market as consumers become more aware of their role in maintaining digestive health, says Datamonitor.

Based on statistics broken down from one of its recent reports, Datamonitor said that a major driver behind increased consumer awareness has been the success of marketing campaigns for products such as Activia and Yakult.

"US Consumers are now more knowledgeable regarding the relationship between fiber and digestive health and are seeking out more ways of safeguarding their health with functional foods," said Mark Whalley, consumer markets analyst at Datamonitor.

Growing acceptance

The group’s comments, part of a geographical break down from a recent report on the global probiotics market, suggest that US consumers are becoming increasingly accepting of the concept of ‘friendly’ bacteria as awareness increases.

In 2008, Datamonitor valued the US market for probiotics at $1,526.7m, up from $952.1m in 2003.

Although the market is growing fast, it still remains well behind Europe, where probiotics have had more time to edge their way into consumer minds and guts.

Indeed, just last year a national survey carried out in the US by Opinion Research Corporation revealed that only 15 percent of American adults were familiar with the healthy bacteria. Some 85 percent of respondents knew “little to nothing” about probiotics.

A similar survey commissioned last year by LiveActive from Kraft Foods found that nearly two-thirds of Americans (63 percent) said they are “not at all familiar” with probiotics and only 13 percent of those who were familiar with them could define them accurately.

“Recognition of probiotics still has some way to go. However, it seems that the more consumers use these kinds of products in everyday life, the more they believe in the benefits,” Whalley told NutraIngredients-USA.com.

Trust

According to Datamonitor’s statistics, from a report published in February this year – Opportunities in Digestive and Immunity Health: Consumer Attitudes and Behaviors – only a minority of consumers remain skeptical about probiotic product claims.

A Datamonitor consumer survey conducted last year revealed that only 14 percent of Americans found probiotic product claims to be untrustworthy.

“This is not surprising given the fact that digestive health has only recently become a mainstream issue in the United States,” said Datamonitor.

Around 38 percent of consumers trusted foods and beverages which make digestive health claims, while 47 percent were undecided.

Females were more likely to trust these products than males (41 percent compared to 36 percent), which could be expected given the fact that females suffer from digestive health problems more than males.

Digestive health is ‘mainstream’

In 2008, nearly 59.9 million Americans complained of heartburn, and this figure expected to rise to almost 73 million by 2013, amounting to nearly a quarter of the population.

According to Datamonitor, this increased awareness “is only the beginning of the digestive health movement.”

“In Asia Pacific countries such as Japan, the idea of drinking a daily Yakult is a far more normal and accepted part of life. As time goes on, the same culture is expected to develop across Europe and North America.”

"The real success of these products has been the way in which consumers have adopted them for a 'daily dosing' routine," said Whalley.

Taken from: http://www.nutraingredients-usa.com/Industry/Probiotic-foods-going-medical

Public interest in probiotic foods and beverages has never been stronger and will continue to surge aided by medical fraternity interest, according to a recent Dannon and Yakult-funded meeting of international scientists and medical professionals.

Speaking at the 37th American Academy of Physician Assistants gathering in San Diego, California, attendees heard talks on the role of probiotics in foods as well as medical treatments.

The Physician Assistants from the fields of gastroenterology, nutrition, microbiology and pediatrics learnt how probiotic formulations that include foods can be applied in medical fields and how public interest continues to surge.

“Physician Assistants are increasingly asked to explain how probiotics like those in cultured dairy products and other foods or supplements can benefit the gastrointestinal tract, immunity, and health throughout the lifespan,” the organizers said.

Probiotic mechanisms

Dr. W Allan Walker, director of the Division of Nutrition at Harvard Medical School, explained some of the ways in which probiotic organisms can affect health, and focused on their ability to benefit early child development.

"In infants, gut bacteria are acquired up until about 2 years of age,” he said. “'Good' bacteria consumed during this time can therefore promote the right type of bacterial colonization and can lead to enhanced immunity”

It was noted that probiotics have been proven effective in the treatment of gastrointestinal disorders, respiratory infections and allergic conditions.

Mary Ellen Sanders, PhD, from the International Scientific Association for Probiotics and Prebiotics added to the discussion. "Bacteria colonizing our bodies are numerous and vital,” she highlighted.

“They outnumber our own cells 10-fold and are known to play critical roles in immune system development, maturation of intestinal cells and providing important metabolic functions that we can't do for ourselves. Probiotics can enhance these normal, beneficial activities of our colonizing microbes and have been shown to promote health in a variety of ways.”

Other speakers included Yehuda Ringel, MD, of the University of North Carolina at Chapel Hill, and Martin Floch, MD, from the Yale University School of Medicine, who explored clinical applications for probiotics.

Yakult and Danone, the parent of Dannon, jointly established the Global Probiotics Council in 2004 to further probiotic research and advance public awareness.

From: http://abcnews.go.com/Health/wireStory?id=7542074

By Anthony J. Brown, MD

NEW YORK (Reuters Health) - Pregnant women who take probiotic supplements starting in the first trimester are less likely to develop central obesity after they've given birth, according to a new study.

Central obesity was defined as a body mass index of 30 or higher or a waist circumference greater than 80 centimeters, about 31-1/2 inches.

At 1 year after giving birth, 25 percent of women given probiotics along with dietary counseling had central obesity based on that definition, compared with 43 percent of women given diet advice alone.

The findings were reported Thursday at the European Congress on Obesity being held in Amsterdam, the Netherlands.

"This is the first study showing that probiotics-supplemented diet during pregnancy and breastfeeding influences the adiposity of women over the 12-month postpartum period," Kirsi Laitinen, from the University of Turku, Finland, told Reuters Health.

The results stem from a study of 256 pregnant women who were given either probiotic capsules plus dietary advice, or placebo capsules plus dietary advice, or placebo capsules and no dietary advice. The probiotic capsules, which contained Lactobacillus and Bifidobacterium, were continued for up to 6 months after delivery until the women had stopped exclusive breastfeeding.

The percentages of women with central obesity at 1 year were 25 percent, 43 percent, and 40 percent in the probiotic, dietary advice-only, and no-probiotic/advice groups, respectively. The corresponding average body fat percentages were 28 percent, 29 percent, and 30 percent.

Laitinen noted that one limitation of the study was "the lack of baseline measurement of waist circumference, which was not possible to conduct in pregnant women."

Modification of normal bacterial in the intestines probiotics "together with a balanced diet may offer a reasonably economic, practical, safe and potentially successful method to be used with other lifestyle-related factors in controlling obesity," the researcher said -- while acknowledging that further studies are needed to verify these findings.

In the United States, most probiotic products are either foods or dietary supplements. A few probiotics are marketed as medical foods. Although fermented dairy products such as yogurt and kefir are typically associated with delivery of "beneficial cultures", the types of foods claiming to deliver probiotics has expanded to include granola and candy bars, frozen yogurt, cereal, juice and cookies. Whether or not any given product, even ones that claim to contain "probiotics", actually deliver adequate amounts of efficacious probiotic strains cannot be ascertained from just looking at the product. In general, consumers need to contact the manufacturer to determine what studies have been conducted on their specific product as formulated and what health benefits should be expected.

In food products, the probiotics used are primarily species of Lactobacillus or Bifidobacterium, or Streptococcus thermophilus.

In the United States, yogurt is required to be produced by the fermentation by Lactobacillus bulgaricus and Streptococcus thermophilus. However, post-fermentation heat treatment of yogurt, which kills all live cultures, is allowed. To help consumers distinguish between yogurts that contain live active cultures and those that do not, the National Yogurt Association established a "Live Active Culture" seal. The seal is available for use by any yogurt manufacturer on packaging and requires refrigerated yogurt to contain 10⁸ viable lactic acid bacteria per gram at the time of manufacture. The seal also can be used on frozen yogurts containing 10⁷ viable lactic acid bacteria per gram at time of manufacture. However, these counts do not differentiate probiotic bacteria from starter culture bacteria (L. bulgaricus and S. thermophilus), and therefore the seal is not useful in determining if adequate levels of added probiotic bacteria are present in a yogurt. In other words, the standard refers to a total number of live cultures and levels of each microbe present do not have to individually meet the standard. The NYA is also currently petitioning the United States government to have the standard of identity of yogurt changed to require that the starter cultures be viable in the finished yogurt.

The dietary supplement market for probiotic cultures seems to be a more diverse and more active market than probiotics for dairy. The supplement market contains many different product formats and contents, including capsules, liquids, tablets and even food-like formats. If properly prepared and stored, probiotic bacteria can remain viable in dried form and reach the intestine alive when consumed. A diverse array of bacterial genera and species are represented in these products, including many different lactobacilli, bifidobacteria and less commonly, Enterococcus, Bacillus, Escherichia coli and yeast. Dietary supplement products are purchased primarily in health food stores or natural foods grocery stores.

Probiotics are defined as live, naturally occruing microorganisms which when administered or ingested in sufficient amount confer a positive health benefit on the host.

For example, for the probiotic bacterium, Bifidobacterium Longum (KB31), the genus is Bifidobacterium, the species is Longum and the strain is KB . Sometimes the company develops a marketing name for this strain and in this case, it is KB31.

Most probiotic products contain bacteria from the genera Lactobacillus or Bifidobacterium, although other genera, including Escherichia, Enterococcus, Bacillus and Saccharomyces (a yeast) have been marketed as probiotics.

For our product, Kibow Biotics, there are 3 probiotic strains with a total of 30 million CFUs (Colony Forming Units).