A Meta-Analysis of Probiotic Efficacy for Gastrointestinal Diseases

Background: Meta-analyses on the effects of probiotics on specific gastrointestinal diseases have generally shown positive effects on disease prevention and treatment; however, the relative efficacy of probiotic use for treatment and prevention across different gastrointestinal diseases, with differing etiology and mechanisms of action, has not been addressed. Methods/Principal Findings: We included randomized controlled trials in humans that used a specified probiotic in the treatment or prevention of Pouchitis, Infectious diarrhea, Irritable Bowel Syndrome, Helicobacter pylori, Clostridium difficile Disease, Antibiotic Associated Diarrhea, Traveler’s Diarrhea, or Necrotizing Enterocolitis. Random effects models were used to evaluate efficacy as pooled relative risks across the eight diseases as well as across probiotic species, single vs. multiple species, patient ages, dosages, and length of treatment. Probiotics had a positive significant effect across all eight gastrointestinal diseases with a relative risk of 0.58 (95 % (CI) 0.51–0.65). Six of the eight diseases: Pouchitis, Infectious diarrhea, Irritable Bowel Syndrome, Helicobacter pylori, Clostridium difficile Disease, and Antibiotic Associated Diarrhea, showed positive significant effects. Traveler’s Diarrhea and Necrotizing Enterocolitis did not show significant effects of probiotcs. Of the 11 species and species mixtures, all showed positive significant effects except for Lactobacillus acidophilus, Lactobacillus plantarum, and Bifidobacterium infantis. Across all diseases and probiotic species, positive significant effects of probiotics were observed for all age groups, single vs. multiple species, and treatment lengths

Systems maps and analytical framework. Mapping food waste drivers across the food supply chain

This report generated 17 systems maps for five contrasting product types that were investigated along their supply chains. The system maps identify: (1) Product specific drivers: drivers specific to the selected food products at a specific stage of the supply chain); (2) Generic drivers: drivers which concern two or more selected products (e.g. labelling errors, limited shelf life etc.); (3) Systemic drivers: drivers that are interlinked with more than one step of the supply chain (e.g. minimum orders, last minute cancellation, lack of data and communication, minimum life on receipt criteria etc.). The cross cutting systemic drivers emphasized supply chain issues, e.g. regarding notably the interactions between the different businesses and unfair trading practices. The systems map approach also shed light on two key factors that impact drivers according to the product specificity: (1) Impacts of food waste drivers highly depend on the level of perishability and microbiological risk of food products. For example, less perishable food products such as frozen and canned products are more likely to be wasted because of product damage, labelling errors and/or equipment breakdown. More perishable and higher risk food products are more likely to be wasted when approaching the “best before” date or because of supply and demand imbalances and poor information sharing along the supply chain. (2) Lack of communication and cooperation is a central drivers of food waste. The impacts of these are higher in more complex products/supply chains where trouble with one ingredient affects the whole product (e.g. prepared meals). Finally, the systems mapping shed light on drivers which were “hiding” behind other drivers. For example, the question of date labelling is a well-known cause of waste for perishable products, but very often there are further drivers behind it (e.g. overstocking in the retail sector)