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 Indian J. Dairy Sci. 68(3), 2015

REVIEW ARTICLE

Indian perspective for probiotics: A review

Shailendra Raghuwanshi, Swati Misra and P.S. Bisen

Received : 10 March 2014 / Accepted : 20 March 2014

Abstract In short span, probiotics (a greek word "for Keywords : Probiotics, health benefits, awareness, India
life") have become an integral part of the complex world as
biologics, pharmaceuticals, food and nutritional supplements
due to their potential of providing health benefits. These Introduction
acts as food supplements as well as preventive or curative
drug which contains live non pathogenic bacteria. It is mainly The importance of probiotics is known across civilizations
the bacteria and metabolites produced by them which impart and strata of societies over centuries in the form of practice
these probiotics their health promoting properties. In recent of consuming preserved foods obtained through the process
years, there has been a growing awareness among Indian of fermentation. Since ages, traditional fermentation processes,
consumers about the importance of nutrition, health, and using locally available ingredients, which may be of plant or
quality of food they eat. Consumers are attaching more animal origin, are converted into edible products by the
significance to healthy diet than physical activities. They are physiological activities of microorganisms (Steinkraus 1996).
switching towards health supplements which could have The traditional fermented foods are mainly obtained from dairy
deleterious effect. In modern day lifestyle, the market has products viz. yoghurt, dahi, kefir, cheese (after long storage),
witnessed an increase in sale of health products amongst fermented vegetable or from vegetable juices and from non
the health conscious consumers globally creating new health fermented fruit and berry juices. Indigenous fermented foods
food categories. At present, the probiotics is at nascent have been prepared and consumed for thousands of years,
stage and awareness as food supplement is limited to urban and are strongly linked to culture and tradition. Amongst
areas. The knowledge about their use and technology to Asian countries, the most prominent ones which consumes
prepare them in a convenient form for domestic use have to probiotics are Japan, Korea, Indonesia, India, Nepal, Sri Lanka.
be imparted in the Indian rural areas as an affordable product The Japanese consumes it in the form of Nato and Miso, a
mainly within the lower income group people. Regular use of fermented soybean used as a condiment, while, in Indonesia,
probiotics could improve the quality of life and reduces the it is known as Tempeh and Koreans consumes spicy fermented
dependence on drugs and medical expenses. This review condiment made from various vegetables mainly napa cabbage,
keeping in mind the Indian scenario aims to evaluate the Kimchi. In India, idli, dosa, dhokla, khaman are certain popular
health benefits of probiotics in food and pharmaceutical traditional fermented foods which are consumed throughout
sectors, the existing knowledge in rural population and the India, particularly in southern and western parts of India. At
current Indian market for probiotics. certain times, sour buttermilk or yeast is added in order to
enhance fermentation. Leuconostoc mesenteroides,
Streptococcus faecalis and Pediococcus cerevisiae are the
significant microorganisms involved in the fermentation process
(Purushothaman et al. 1977). In eastern Himalayan regions of
Shailendra Raghuwanshi (
), Swati Misra and P.S. Bisen Darjeeling hills and Sikkim, Kinema, a product of fermented
Department of Biotechnology, Tropilite Food Pvt. Ltd., Davar Campus, soybean is consumed. Bacillus subtilis is the predominant
Tansen Road Industrial Estate, Gwalior, Madhya Pradesh -474002, India
Department of Biochemical Engineering & Biotechnology, Indian Institute microorganism in kinema. Enterococcus faecium, Candida
of Technology, Indian Institute of Technology Delhi, Hauz Khas, New parapsilosis and Geotrichum candidum are also involved. In
Delhi-110 016, India certain parts of India, fermented rice (prepared by addition of
water to cooked rice followed by overnight incubation and
Shailendra Raghuwanshi
Davars Tropilite Food Pvt. Ltd., then water was drained off) was mixed with buttermilk and salt
Davar Campus, Tansen Road Industrial Estate, Gwalior, for direct consumption. The jalebies and kanji are mainly
Madhya Pradesh -474002, India Tel no: +91-751-4056-381 consumed by northern India. Amongst the dairy products,
E-mail: shailendraraghu@gmail.com dahi, rabdi, paneer, shrikhand, misti dahi and chhurpi, are

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Indian J. Dairy Sci. 68(3), 2015

used in northern, western, eastern and Himalayan region of emphasis in the Indian context. The paper also addresses the
India, respectively. Indigenous people of eastern Himalayan Indian consumer's psychology for probiotic products, targeted
regions of Darjeeling hills and Sikkim use the fermented customers and statistics of the consumption of dairy products
bamboo shoot product called mesu as pickle and base of in India. The present study also reviews the health benefits
curry. Khalpi is a traditional cucumber pickle used in the and the impact of probiotics on human health and diseases
Himalayan region of India. These fermented products are supported by clinical evidences. Besides this, potential
consumed unknowingly as, probiotic food or drink, by local strategies for increasing probiotic market in India, current
people from ages due to enormous health benefits associated scientific research on indigenous strains of probiotic bacteria
with them and has now been realized. The organisms that are and futuristic approach for probiotics in terms of research and
best studied and generally regarded as probiotics are species development are also discussed in the light of current literature.
of the bacteria Bifidobacterium, Lactobacillus, and At the end, authors concluded that probiotic has shown a lot
Streptococcus, and also including yeast such as of potential in aiding number of diseases and in the existing
Saccharomyces boulardii (Vanderhoof 2000; Wescombe et al. situation, excellent growth opportunities are stored for both
009). domestic as well as for foreign companies to venture their
capital in the probiotic industry.
In today's modern world, due to urbanization and change in
dietary habits and lifestyle pattern has itself forced the health Probiotics
conscious consumers to search for an alternative treatment
regime for various ailments caused by lifestyle related diseases. The term probiotic means 'pro-life' or 'for life' in Greek.
In this direction, probiotics and probiotic based food Probiotics are live microorganisms which are present naturally
supplementation have drawn interest of consumers. The in our surroundings, our skin, digestive tract, nasal tract,
consumption of probiotics exerts myriad of beneficial effects urinary tract, genital area, mouth, etc., Not all bacteria are
which is evidenced by rigorous scientific evaluation. Promotes harmful, some bacteria are not only beneficial but are needed
proper digestion, a strong immune system, restores gut for some of our body functions.
microbiota, improves barrier function of gut epithelium, modifies
inflammatory response, aids in treating diarrhea originated As per to the existing rules and regulations of each country;
due to traveling or during antibiotic course or upsetness of probiotics is not considered under a single category rather it
gastrointestinal tract, prevents ulceration caused due to is subcategorized under different categories according to their
helicobacter pylori (Kumar et al. 2012; Parvez et al. 2006), intended usage. It is either categorized as probiotic drugs,
and aids in assimilation of nutrients from our food and probiotic food (e.g., foods, food ingredients, and dietary
supplements, in particular B vitamins and omega-3 fatty acids. supplements), probiotics for animal use and genetically
These health benefits initiated the research to support the modified probiotics. In India, probiotic foods come under the
concept that there are clinical health benefits to ingest these functional foods category. Functional foods are defined as
micro-organisms (Guarner and Schaafsma, 1998). It is a major products that are similar in appearance to conventional foods
focus of attention of scientists across the world due to their and are consumed as part of a normal diet and have
promising health benefits and their applications offers an demonstrated physiological benefits, and/or have the potential
innovative approach for development of novel probiotic to reduce the risk of chronic disease beyond nutritive function,
formulations. i.e. they contain bioactive compounds. The Indian Council of
Medical Research and Department of Biotechnology have
The article reviews the reports available on probiotics, formulated guidelines for probiotics being marketed as foods.
illustrates how probiotics functions in human ecosystems, These guidelines specify the criteria that need to be borne
and outlines the global market scenario of probiotics with when launching a probiotic food in the country (Ganguly et

Table 1 Probiotics subcategories in different categories (Arora et al. 2013)

S.No. Country Category
1 Denmark/Sweden/Finland Food Supplements
2 Canada Natural health products
3 Italy Dietary food
4 European countries/Belgium/Germany Biotherapeutic agents
5 Japan/India/China/Malaysia Functional food
6 USA Dietary supplements/ Drugs/ Live
Biotherapeutic agents/ Medical food

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 Indian J. Dairy Sci. 68(3), 2015

al. 2011). Probiotics subcategories in different categories the commercial exploitation of probiotics for health benefits
country vs category (Table 1) was credited to the Japanese scientist Shirota who could
successfully isolate and used L. casei Shirota in order to
How do probiotics function in body? consume the widely consumed probiotic product under the
brand name of 'yakult' (Shida and Nomoto 2013). This probiotic
 Inhibits growth or reduces the activity of bad bacteria drink is safe to use and is backed by preclinical and clinical
in intestine by colonizing the gut studies showing health benefits. Currently, there are numerous
products of various origins and forms containing different
 Having antimicrobial activity and aids in increasing our microorganisms which are available in the market. The term
immunity by making our body more resistant to diseases and "probiotics" was initially coined by Lilly and Stilwell in 1965
infections. and is defined as the substance being secreted by one
 Improves the secretion of digestive enzymes and helps in organism which stimulates the growth of another (Lilly and
proper digestion. Stillwell 1965). This definition was modified over the years to
keep with the pace of the existing knowledge on probiotics.
 Increases the production of lactic acid and regulates pH
balance in intestine and other parts of body. The most widely accepted definition for probiotics was given
by FAO/WHO (2001) for probiotics is that for any strain/
 Promotes acidic pH which facilitates the absorption of product to be classified as a probiotic it must be or must
protein and minerals like calcium, copper, magnesium, iron contain live microorganisms in specific number (generally
and manganese. numbering one billion) which are resistant to gastric acid,
 Having anti-inflammatory properties bile and pancreatic juices and reach the target site (small
intestine/large intestine) in numbers sufficient enough to elicit
 It could ferment fructo-oligosaccharides which thereby a beneficial effect. It should be scientifically validated through
results in reduced pH balance. This increases acidity in gut well controlled clinical trials (FAO 2001).
thereby enabling better absorption of calcium and allow it to
get into blood stream. Global probiotic market
The probiotics market is a lucrative market from the perspective
Historical background of probiotics of functional food suppliers and manufacturers. According to
one of the market report source from Transparency Market
The first probiotic was fermented milk for human consumption. Research (2013) titled "Probiotics Market (Dietary Supplements,
Since vedic times, the role of fermented milk in human diet Animal Feed, Foods & Beverages) - Global Industry Analysis,
was realized. But, the scientific interest in this area was Market Size, Share, Trends, Analysis, Growth and Forecast,
initially recognized by Metchnikoff in the early 1900s. 2012 - 2018, which mentions that the global probiotic demand
According to his hypothesis, the long life of Bulgarian was $27.9 billion (2011) and is expected to reach $44.9 billion
peasants was attributed to their consumption of large in 2018 at a CAGR of 6.8%. The global demand for probiotics
quantities of 'sour milk' containing Lactobacillus bulgaricus. is dominated by Asia-Pacific and Europe, while, Asia-pacific
He believed that the beneficial effect was due to the ability is expected to be the prominent player in near future with an
of probiotics to replace the already existing harmful expected CAGR of 7.0% from 2013 to 2018. In Asia-Pacific,
microorganisms that are present in the gut. Later in 1930's, China and Japan dominates the market revenue for probiotics,
using the Metchnikoff's concept for probiotic microorganisms, with India and other regions also showing significant growth.

Table 2 : The commercially used live cells as probiotics by different companies

Strain Country Company
Lactobacillus rhamnosus GG Finland Valio Dairy, Helsinki
Lactobacillus johnsonii Lal Switzerland Nestle, Lausanne
Lactobacillus casei Shirota Japan Yakult, Tokyo
Lactobacillus acidophilus USA Rhodia, Madison
Lactobacillus casei DN 014001 France Danone
Lactobacillus delbruekii Japan Meiji Milk Products, Tokyo
Saccharomyces boulardii USA Biocodex, Seattle
Bifidobacterium longum BB536 Japan Morinaga Milk Industry
Source: Raja and Arunachalam (2011)

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Indian J. Dairy Sci. 68(3), 2015

While, in Europe, Germany and U.K. are the most attractive in offering probiotic food products in the Indian market
markets, with an expected CAGR of over 6% each from 2013 includes Mother Dairy, Amul, Danone Yakult, Nestle, Tablets
to 2018. The probiotic foods and beverage are the dominant India, Dr Reddy Laboratories, Unique Biotech, Zeus Biotech,
segments among probiotics and is estimated to reach $37.9 etc.
billion in 2018; followed by this, the market for dietary
supplements and animal feed are also witnessing significant Mother Dairy has the dominant position in the Indian probiotic
growth. Dairy products are the largest application market for functional food and beverage market, followed by Amul. These
probiotic foods and are estimated to reach USD 32.2 billion companies are contributing lot to probiotics dairy products
in 2018. The new segment under animal feed has emerged and due to urban population's acceptance to these products
which is estimated to cross USD 3 billion (2018). are helping to increase companies focus to produce more and
more probiotic products.
It is expected that pricing issues, culture cultivation and lack
of standardization of product specifications are expected to In this segment, Amul pioneered to introduce Prolife Probiotic
have an inhibitory effect on market growth. The commercially Ice Cream, Sugar Free Prolife Probiotic Ice Cream, followed by
used live cells as probiotics by different companies are Prolife Lassi (as sachets and in plastic cups) in 2007. In 2011,
mentioned in Table-2. it introduced Flaavyo Fruit Yoghurt, which includes fruit-based
flavors like Mango, Strawberry, Pineapple, and Vanilla, and
Current market of probiotics in India also Mishti Doi (Sweet Curd) and in 2014, it has launched
Flaavyo Frozen Yoghurt.
In the present scenario, India accounts for less than 1% of
the total world's market under probiotics segment. Currently, In this league, in 2007, Yakult Danone India Pvt Ltd (YDIPL),
most of the probiotics products available are predominantly a 50:50 joint venture company between Japan's Yakult Honsha
dahi (Indian yogurt) and a few probiotic beverages such as and The French- Danone Group, has offered yakult, a
flavored milk, fermented and unfermented milk and butter milk. fermented milk drink which contains more than 6.5 billion
But, the market has expanded beyond these most common beneficial bacteria (Lactobacillus casei strain Shirota) in a 65
probiotic products and the new entrants are juices, smoothies, ml bottle priced at Rs 10 and is available in the pack of 5.
cereal, nutrition bars and infant/toddler formula. In India, the These bacteria reach our intestine alive and impart various
per capita consumption of the packaged, store-purchased health benefits. Initially, yakult was available only in Delhi
variety is 300 grams, and this too is heavily skewed toward and thereafter it was launched nationally in a phased manner.
urban India (~1 kg), and is near-zero in rural India. At present,
80% of the total packaged Dahi is constituted by Amul, Mother While, mother dairy has introduced Pro Activ Dahi and drink
Dairy, Nestlé and Britannia due to their distribution networks with a starting price of Rs. 10 and declared that their products
and product penetration. While, rest of the 20% is made up contains dietary fiber. The company expanded the range with
by strong regional players like Karnataka Cooperative Milk the introduction of a fermented milk beverage called Nutrifit
Producers Federation, Parag Milk & Milk Products, Himalaya in two flavors, mango and strawberry. They have a wide
International, Tirumala Milk Products, The Nilgiri Dairy Farm, distribution network in Delhi and Mumbai, Saurashtra and
and VRS Foods. With time, the international entrants such as Hyderabad.
Danone, Fonterra, etc are making their presence felt. In future,
the market is going to be more competitive with the entry of Nestle brings out a probiotic dahi called Actiplus dahi.
major business houses such as Reliance, ITC and CavinKare According to the company, every 100g serve of the dahi has
(data source technopak data, 2014). The yogurt market is over 100 crore probiotics, which help the digestive system if
valued at an estimated INR 1000 crore, or ~USD 182 million, consumed daily. Tablets India, on the other hand, has
comprising organized, packaged yogurt and its varieties, established itself as a major brand in Probiotic drug and
packaged drinks, etc., and also the frozen yogurt service dietary supplement market.
market. This is expected to grow at a CAGR of 20-25% with
the expectation that it will double itself in the next three years Danone launched its creamy stirred yogurt in 2011 to target
(2017). the health-conscious population in India, in three flavors -
plain sweet, strawberry, and pineapple, at outlets in Delhi/
(www.technopak.com) NCR, Mumbai, Pune, Hyderabad, and Bangalore.

According to the reports of Research and Market (2014), In this direction, Britannia after a huge success of their
India's probiotic market is projected to grow at a CAGR of product, Daily Fresh Dahi have entered with a pioneered
around 19% till 2019. Functional dairy products with probiotics product in this segment by launching flavored yogurt in three
are promising in the Indian market, as major players engaged flavors, mango, vanilla and strawberry fortified with 5 active

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 Indian J. Dairy Sci. 68(3), 2015

nutrients, viz,, iron, iodine, calcium, zinc and vitamin A. This have a confusing entity that what make these products
product is available in Mumbai, Delhi, and Bangalore. different from traditional foods .

The market for products containing probiotics is expected to The product's acceptability depends on many factors for
grow as Indians become more aware of natural, healthy selecting, consuming and reusing it and it's not only the
ingredients in foods. The probiotics were launched in India in sensory characteristics of food which determines its
2007 and at present the Indian probiotic industry is valued acceptance. The other factors include the claims and features
more than $10 million. In current scenario, the Indian market's of the product, such as health benefits and the knowledge of
contribution to the world's demand for probiotics, however, is the functional ingredients present in the product (Jaeger, 2006).
less than one per cent in terms of turnover. The Indian probiotic In the past few years, more and more consumers are getting
industry is miniscule and at a very burgeoning stage. Currently, health conscious, this change in consumers behavior is
it stands at about Rs 50 crore and is growing at 20 per cent." indicated by the growing interest in consuming "healthier"
Major pharmaceuticals companies have become active and are foods (Vidigal et al. 2011). Amongst the new and exciting
trying to formulate newer drugs and products, and packaged concepts related to the foods whose health claims have been
products like probiotic-based nutritional supplements with disclosed in recent years, probiotic foods are highlighted.
special needs such as lactation, pregnancy, immunodeficiency Probiotics are living microorganisms which when administered
etc and products especially for pediatric and geriatric patients. in adequate amounts confer health benefits to the host (FAO/
In this aspect, some probiotic based pharmaceutical WHO 2002). At present, there is limited information available
formulations are Sporolac, ViBact, Darolac, Biglac, Bifilac etc. with consumer regarding the benefits of probiotic foods. The
Currently, probiotics are often used as animal feed supplements main target of the food industry should be to understand the
for cattle, poultry and piggery. This requirement is also met consumer's thoughts, beliefs, feelings and behavior so as to
by importing probiotics from other countries. The most hold a good percent share in market by obtaining positive
commonly found commercial probiotic drinks for human attitude and consequent acceptance of their product by the
consumption are found in the form of probiotic drinks, ice consumers.
creams and frozen desserts. The latest and recent addition to
the list of probiotics in India is ViBact (which is made up of Customer segmentation for usage of probiotics
genetically modified Bacillus mesentricus), which acts as an
alternate to B-complex capsules (Sonal et al. 2008). Probiotic India with an increasing awareness and need for preventive
products are gaining acceptance mostly in metros and in medicine is also witnessing the entry of a surge of probiotic
some Tier 1 cities. The Indian market is big, but difficult to foods which are rapidly finding their way onto the market
reach since cold storage and cold distribution chain are shelves (Hajela et al. 2010). The existing probiotic market in
underdeveloped in India, especially in the rural areas. Realizing India majorly comprises of three segments, urban chain mainly
these drawbacks, yakult has taken an initiative in this direction, the elite and middle class population having tendency to self
and has already announced to target tier II cities in their next medicate aids in the growth of probiotic industry. Besides
phase. The strongest sale of Yakult is recorded from Delhi/ this, young adults and people with special needs such as
NCR. In the future, it is important to increase the awareness pregnancy, lactation, immunodeficiency, pediatric patients and
of the country people and to educate them about the lifestyle diseases such as diabetes, obesity, anaemia etc spend
probiotics' benefits. on probiotics. An increase in disposable income of Indian
population is another driving force which acts in favour of
Consumer Psychology probiotic industry. The population statistics clearly reveal that
of the 121 crore Indians, 83.3 crore live in rural areas while
At present there is a slow growth in terms of sales of probiotic 37.7 crore stay in urban areas, said the Census of India's 2011
products, this could be attributed to the cultural differences Provisional Population Totals of Rural-Urban Distribution in
between the western world and India. Many people believe the country, released by Union Home Secretary RK Singh
that "probiotic yogurt" is simply a marketing tool used by (articles.economictimes.indiatimes.com). This data shows that
dairy and yogurt companies. In India, dahi is a part of the nearly 70% of the country's population lives in rural areas.
daily diet and could be prepared easily at home due to optimal Till date, only 30% of the population has an easy access to
environmental conditions, while in many western countries, the probiotic products. The most common problems rural India
curd is a specialty and is bought from supermarkets so faces are poor sanitary conditions and limited health facilities
consumers in western countries considered it as revolution in terms of unavailability of modern medicine. Due to improper
and actively look forward for a newer and better version of hygienic conditions, there is a concomitant outbreak of
curd/yogurt for maintaining a balanced gut flora towards intestinal diseases. In this direction, there is a need to develop
optimal health compared to Indian consumers who believe a simple and accessible method to improve the quality of
that it is not resourceful to spend more for such products and these economically challenged people. At present, difficulty is

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Indian J. Dairy Sci. 68(3), 2015

faced for the distribution of fermented dairy products in rural

India due to unreliable cold distribution chain. The solution
could only be to provide people with lyophilized or spray
dried bacterial strains. At present, there are technological
challenges to prepare an affordable and an effective bacterial
strain (starter of fermentation) which is of no interest for the
industry.

The trend for dairy product consumption in India is high,

since majority of population is vegetarian-based (around 500
million or ~41% of the total population) (http://
www.vegetarians.co.nz), and dairy products are the sole source
of proteins to fulfill the deficiency caused due to absence of
meat in diet. The per capita consumption of dairy products
in rural areas (~36%). In certain individuals and in many
aged people, the level of endogenous enzyme declines and
causes lactose intolerance and the condition manifests with
clinical symptoms such as bloating, flatulence, nausea, Figure 1: Market share of milk and milk products in FY
abdominal pain and diarrhea. In this respect, probiotic strains 13 in terms of total sales value
may decrease the symptoms of lactose intolerance by Source: NDDB and Ministry of animal husbandry
producing their own secreted β-galactosidase or by
consumption of lactose during the fermentation.
pH to provide a hostile environment for pathogens and yeasts,
According to the Indian statistical report, more than 50% of improves nutrient absorption/assimilation from food and
India's population is below the age of 25 and over 65% is digestion, stimulates and balances the immune system,
below 35. India's youth either in urban or in rural India prevents vaginal and urinary tract infections, prevents and
represents a huge market opportunity for any new health and treats side effects of antibiotic therapy, aids in digestion of
wellness product. At present, the Indian youth have hectic lactose and dairy products by reducing lactose intolerance,
working lifestyles and shift in food habits from homemade helps in the regulation of bowel movements, reduces the
food to readymade processed food which creates an toxic load of liver, inhibits the growth of bacteria which
opportunity for probiotic manufacturers. produces nitrates in bowel, since production of nitrates could
in certain cases causes cancer, prevents the overgrowth of
Dairy product consumption in India disease causing microbes such as Candida, E. coli,
Helicobacter pylori and Salmonella, reduces the incidences
As per NDDB, the Indian dairy industry is all set to of yeast infections, virginities and candidacies, calms down
experience high growth rates in the next eight years with the colon irritation following surgery, supports healthy skin
demand likely to reach 200 million tonnes by 2022 from 132 in youth primary bacteria in infants, which helps them to
million tonnes in 2013. Presently, only 20% of the milk grow and develop their immune system, therapeutic for upper
production comes from the organized sector comprising co- respiratory complaints, act as remedy for bad breath (halitosis),
operatives and private dairies. increased ability to synthesize vitamin B, manufactures vitamin
B complex, increases the ability to absorb calcium, reduces
The paramount factors driving the growth in the dairy sector the occurrence of bladder cancer, prevents and manages atopic
include rising disposable incomes, advent of nuclear families dermatitis (eczema) in children.
and fast/instant food gaining ground in India. Other factors
such as structural changes in food habits, expansion of fast Clinical evidences supporting health claims for probiotics
food chains and popularity of pizzas and pastas aided the
usage of milk variants of mozzarella cheese, processed cheese a) Lactose intolerance: Individual's suffering from this
and flavored milk etc. Market share of milk and milk products condition lack the enzyme lactase and is unable to digest
in FY 13 in terms of total sales value (Fig.1) lactose sugar present in dairy products. In this respect, yogurt
promises to be an alternative to milk (Kolars et al. 1984). In
Health benefits of probiotics a study, researchers observed that lactose intolerant subjects
consuming 18 gram of lactose in the form of yogurt could
The probiotics have shown to beneficially affect the host by digest and absorb lactose efficiently than those who receive
improving its intestinal microbial balance through lowering of

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 Indian J. Dairy Sci. 68(3), 2015

same amount of lactose from milk. Besides this, improved d) Prevents urinary tract infections: In immune compromised
lactose tolerance in yogurt group also led to less diarrhea and as well as those with antibiotic treated hosts, the natural
other gastro intestinal symptoms. Through this study, protective biofilm of bacteria and surface walls is lost through
researchers concluded that probiotics in yogurt helps in the disruption. For a normal bacterial flora, host defense is ensured
release of β-galactosidase, an enzyme involved in lactose through a balance between non pathogenic commensals and
breakdown/digestion (Rosado 1996). pathogenic bacteria. In case of HIV+ patients colonization of
lactobacillus in urogenital tract is diminished and this
b) Aids in calcium absorption: Studies have shown that milk correlates with the shedding of HIV into the urogenital tract
contains abundant amount of calcium apart from other dietary (Sha et al. 2005). Besides this, disruption of natural flora
sources. The individuals suffering from lactose intolerance renders patients with many more severe infections.
may develop osteoporosis due to decreased consumption of
milk in diet. In such cases, if probiotics (curd, yogurt or In one of the study, wherein Reid and coworkers reported the
fermented milk) are fed to lactose intolerant individuals, milk use of probiotics for restoring host supportive bacterial flora
lactose is hydrolyzed by probiotic strains and thereby favors (Reid et al. 2004).
calcium absorption (Vandenplas and Benniga 2009).
There are two main scientific concepts associated with
c) Antibiotic associated diarrhea: In one of the post by Nicole probiotics, a) competitive theory, wherein live microbes
Cunningham (2014) in Puraforce Remedies, mentioned that administered orally or applied onto genital area overgrow the
there are two sides of the biotic coin, on one side antibiotics pathogenic flora and thereby restores the environment resistant
and then there are probiotics. If antibiotics are consumed for to infections. In this case, the live microbe produces certain
any reason then in order to counter act their effects, probiotics metabolites which are bactericidal or bacteriostatic to
'friendly bacteria' have to be consumed to fight illness and pathogenic flora in same host (Antonio and Hillier 2003). b)
diseases so that chances to consume antibiotics is reduced Second theory is based on the modulation of the immune
to a certain extent. Antibiotics could not differentiate between system wherein live cells influences the production of
good and bad bacteria. In turn both organisms are killed and immunoglobulins and thus altering the body's immune defense.
due to the suppression of good bacteria, immune system as They also contribute certain specific immune response against
well as digestion suffers. Armuzzi and coworkers in two pathogenic bacteria (Humen et al. 2005).
different studies involving 60 and 120 adult patients reported
that subjects who simultaneously received Lactobacillus GG In one of the case study, twelve subjects with neurogenic
alongwith antibiotics used for the elimination of Helicobacter bladders had E. coli HU2117 coated catheters inserted for 28
pylori, had significantly lower chances of experiencing nausea days. The urinary tract infection reduced to 0.15 cases per
and diarrhea versus placebo. Besides this, Marchand and 100 patient-days compared to 2.72 cases per 100 patient-days
Vandenplas reported that there are atleast three published (Trautner et al. 2007).
studies wherein S. boulardii have shown the ability to reduce
antibiotic associated diarrhea. Certain researchers observed e) Prevents anaemia: Balamurugan and coworkers (2010)
that a number of bacterial probiotics were used for treating reported that anaemic women had lesser number of
antibiotic associated diarrhea and to a certain extent; the Lactobacillus as compared to normal women. The main reason
treatment was not successful (Marchand and Vandenplas, for this could be that lactobacilli increase the expression of
2000). It could be inferred that certain probiotic cultures have iron transporters in the caecum due to production of propionic
the greater ability to treat one disease compared to others acid, a short chain fatty acid (Balamurugan et al. 2010).
present in the probiotic product. Reports clearly reveal that
one out of every four individual experiences antibiotic f) Prevents type-2 diabetes: Musso and coworkers reported
associated diarrhea (Doron et al. 2008). In this context, that the intestinal microbiota in type 2 diabetic patients have
scientists at Indiana University School of Medicine investigated significantly reduced proportions of phylum Firmicutes and
whether probiotics in yogurt prevent this ailment. A study class Clostridia in the diabetic group compared to the control
was conducted with 202 subjects being hospitalized and group (Musso et al. 2010).
receiving oral or intravenous antibiotics. Subjects were
randomly selected for 8 ounces of yogurt and with no yogurt g) Obesity associated problems: Number of studies has
for a period of eight days. During this time period, frequency demonstrated that probiotics present in yogurt has obesity
of diarrhea was assessed. Results showed 24% reduction in fighting potential. Johnson and coworkers while working with
the occurrence of diarrhea in yogurt fed group as against mice studied the anti obesity effects of probiotic yogurt and
control (no yogurt fed) group wherein only 12% reduction observed that mice fed on moderate fat diet was when
was observed (Beniwal et al. 2003). supplemented with yogurt powder had significant weight loss

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compared to control (no yogurt fed). The weight loss was cardiovascular support. In one of the report, wherein more
attributed to an increased lipid levels in faeces of yogurt than 1000 women aged 70 or more were fed with probiotic
supplemented group thereby suggest that yogurt helps in yogurt had shown a higher levels of HDL cholesterol with a
reducing fat absorption in small intestine (Johnson et al. significantly lower carotid artery thickness compared to those
2007). individuals not fed with yogurt (Ivey et al. 2011).

Similar study was conducted with human's at University of In another similar case study, researchers when fed the subject
Tennessee in order to determine that yogurt consumption with 10.5 ounces of full fat yogurt for a period of 21 weeks
causes weight loss. In their study, randomly 34 obese subjects showed an increase in HDL cholesterol level (~12 mg/dL)
were selected and 18 ounces of fat free yogurt was given for without any change in LDL levels. The reports also suggested
12 weeks. At the end of the study, the yogurt group that an altered LDL/HDL cholesterol ratio by 23% was
experienced an average weight loss of 14 pounds and could observed when fed with probiotic yogurt (Kiessling et al.
retain 31% more muscle mass with 81% loss of more abdominal 2002).
fat which was reflected in a reduction of over 1.5 inches from
waist. While, the control group lost 0.23 inches from abdominal j) Fights dental problems: The bacterial growth in mouth
region with a weight loss of 11 pounds. This study also could lead to inflammation and damage to gums and bones
reflects that loss of visceral fat is associated with a reduced that support the teeth. The condition is known as periodontal
risk for cardiovascular disease and type II diabetes (Hamdy disease or gum disease. This is associated with stroke and
et al. 2006). In a study, it was observed that a higher heart disease (Pihlstrom et al. 2005).
concentration of Faecalibacterium prauznitzii found in obese
children is one of the reason for obesity (Balamurugan et al. Ingestion of probiotics in any form, like in foodstuffs (cheese,
2010). While, an altered ratio of Firmicutes and Bacteroidetes yogurt, fermented milk, fruit juice, or chewing gum) or as a
could also be one of the reason (Eckburg et al. 2005). constituent of tablets and capsules, has been shown to afford
a health promoting effect on oral tissues, such as reducing
h) Combating cancer: Certain evidences have shown that the incidence of dental caries, improved management of
incorporation of yogurt in diet could protect against several periodontitis, abridged halitosis and oral candidal infections
types of cancer such as colon, bladder and breast. Pala and (Darwaze 2011). In another study, Japanese researchers
coworkers conducted a study which consists of 45,000 men reported that a daily intake of atleast 2 ounces of yogurt was
and women for a period of 12 years. Results showed that linked with a decreased risk of developing deep probing
subject fed with yogurt reduces colon cancer risk upto 35% depth by 60% and clinical attachment loss by 50%, both
(Pala et al. 2011). periodontal disease parameters (Shimazaki et al. 2008).

While, a Swedish group of Larsson and coworkers conducted In a study conducted by Saraf and coworkers (2010), their
a study on 80,000 men and women for a period of 9 years group observed that there is still inadequate knowledge and
wherein their findings have shown 38% reduction in bladder awareness about probiotic products being available in the
cancer in the group fed with yogurt compared to the control market. Certain literature reports have shown that in India,
group (Larsson et al. 2008). In one of the study, Veer and the most common probiotic products used are Sporolac, is
coworkers observed that intake of fermented dairy products manufactured using sporolactobacilli and is the only bacteria
reduces 37% chances of breast cancer (Veer et al. 1989). used with some of the antibiotic preparations mainly to prevent
antibiotic induced diarrhea especially for pediatric patients,
i) Reduces cardiovascular diseases: There are certain literature Saccharomyces boulardii and yogurt (containing two strains,
reports which showed that yogurt offers a powerful i.e., L.bulgaricus and L. thermophilus). Lactobacillus solution

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 Indian J. Dairy Sci. 68(3), 2015

is an example of a probiotic that is usually given to pediatric a price of 10 Rs. in a pack of five. This is reasonable for the
patients. Bacillus mesentericus (genetically modified) acts as health conscious consumers and for those who are aware of
an alternative to B-complex capsules (Saraf et al. 2010). the importance of functional foods like probiotics. Yakult India
Microbiota and Probiotic Science Foundation convened a
Generally, lactic acid bacteria are considered to be detrimental symposium on "Probiotics in Prevention of Life Style
to dental health as they ferment sugars and lowers down the Disorders" on Dec'2012 which brought together an
pH. When these bacteria are consumed in milk products, the interdisciplinary group of health care professionals to spread
buffering capacity of milk influences acidity. Besides this, the healthcare information/ health benefits of probiotics in
presence of calcium and other constituents also helps in treatment of diseases or any new scientific developments
protecting tooth surface and inhibits the adherence of dental related to probiotics.
pathogens. Capurso, a Russian scientist reported that
bifidobacterium species reduces gingival and periodontal While, Amul launched the probiotic variants of the popular
inflammation. products already present in the market to increase awareness
but marketing initiative taken by manufacturers is inadequate
Future strategies for increasing probiotic market in India which restrain the category to reach its full potential. In store
promotions would bring greater focus on the category.
Since, probiotics contains billions of live cells so adequate
number of cold chain and storage facilities at their retail outlet The retail service outlets of these popular dairy brands are
should be introduced, initiative in marketing skills, increasing using modern trade institutions like colleges, schools, office
awareness campaigns by the brands and price reduction in canteens, airports, five star hotels, and independent kiosks,
probiotic products should be undertaken. apart from traditional spaces such as malls, high streets, and
popular markets, for tapping their target consumer group.
The marketing strategy should consist of 4P's, i.e., product,
price, place and promotion. The product should be fairly In this context, last but not least, different probiotic
reliable what the label mentions, it should be cost effective so manufacturers should come together and develop strategic
that the health benefits of the product could reach to large relationships in order to synergize their strengths and thus
section of the society in different geographical regions. The overcome any individual company's weaknesses to fulfill the
retail and distribution outlets should be there in maximum increasing demand for probiotics.
cities for availability of the product so that the cost of the
cold storied vehicles used for transportation could be reduced Research on indigenous strains of probiotic bacteria
and compensated with the cost price of the product. The
promotional strategies could be used through following means: The progressive move was made by the indigenous dairy
industries with the launch of probiotics in India in 2007 even
" Social media, blogs, email, newsletters, web banners, though the current market of probiotics is miniscule compared
pay per click ads, direct mails to the competitive western world; but the domestic factors
favors the growth of probiotics to a great extent. The Indian
" Radio, television, billboards, print ads research on probiotics was pioneered by Dr. R.N. Sinha and
his students during 1987 and 1993 (Dr. J.R.K. Prasad and Dr.
" Public relations, conferences, media Chand Ram) which was further carried over by a Ph.D. student
in 1994 and thesis submitted to NDRI, in 1997. Simultaneously,
" Sponsored seminars related to targeted work the work was further extended by Dr. (Mrs) P.R. Sinha
(Principal Scientist, Animal Biochem, NDRI, Karnal). Similar
At present, the sales of probiotic product, Yakult is higher as work was also initiated by Dr. C.D. Khedkar, SMC College,
they adopted direct marketing strategies apart from print ads Anand Agriculture University wherein the development of
and TVC's in order to raise the popularity of their products probiotic fermented dairy foods and DVS Probiotics was carried
amongst the consumers. In direct marketing strategy, the over by Dr. Chand Ram, Scientist, NDRI, Bangalore and NDRI,
consumers can order the product through home delivery. In Karnal. Their group is working on anticancerous and preventive
this manner, Yakult has a DM (Direct Marketing) team of healthcare probiotics and synbiotics. One of the research
ladies known as Yakult ladies who visits home and thereby group led by emeritus scientist, Virender K. Batish and their
educates the homemakers about the product and answers the colleague, Ms. Sunita Grover at National Dairy Research
doubts and queries raised by consumers. This ensures that Institute (NDRI), Karnal carried out a project on "Development
the product is being bought regularly by the consumers. of molecular techniques for identification and typing of
Besides this, Yakult is also available in supermarkets. The indigenous probiotic culture". This project was financially
brand has worked out on pricing strategy and sold 65 ml at supported by the Department of Biotechnology, New Delhi

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Indian J. Dairy Sci. 68(3), 2015

and National Centre for Cell Science, Pune. They have a or research groups who are working on indigenous probiotics
repository of 120 different types of bacteria and two of their is commercialization. For any product to be commercialized,
strains have shown an immense potential, i.e., Lactobacillus the biosafety tests have to be performed on animals and
plantarum 91(Lp91) and Lactobacillus fermentum 1(Lf1). The thereafter to conduct the tests in a third party lab in order
research group have defined that Lp91 is a promising strain to verify the claims so as to get the accreditation. For these
as probiotic since it carries immense health importance majorly tests, certain labs ask for a huge amount for Rs. 12 lakh to
for obese, heart disease patients by lowering the cholesterol perform single test which makes it difficult to commercialize
level upto 21% (research conducted on animals). After your process. In this a silver lining could be seen by these
obtaining promising results from Lp91 strain on animal model, researchers as the bigger indigenous dairy industries are
they are ready to conduct human trials. While, research studies ready to support their research to conduct biosafety trials.
carried on animal model using the other potential strain Lf1,
it was observed that Lf1 is effective against colitis in mice. It has also been observed and reported by print media that
In this direction, Dr. V.K. Kansal is working on the development all the top players in dairy industry are using bacteria of
of probiotic Dahi for immune system modulation, cholesterol foreign origin. Despite the presence of many indigenous
lowering and anticarcinogenic attributes. This project was strains that Indian researchers have been working on for long
funded by Department of Biotechnology, New Delhi, India. In time.
Sept' 2014, Dr. A.K. Srivastava, Director National Dairy
Research Institute signed MoU with the CEO of Sarvotham In this direction, Tropilite Food Pvt. Ltd, has taken a lead by
Care Ltd. a leading Hyderabad based nutraceutical company developing a simple, cost effective and time saving process
for the commercialization of their two indigenous probiotic for curd/yogurt starter culture production through submerged
strains. fermentation in a continuous manner. The freeze dried powder
developed from indigenous culture, could act as nutritional
The other research groups who are conducting studies on supplement and had shown an edge over already existing
Indian probiotic microbes are Anand Agricultural University starter cultures in terms of retaining traditional Indian flavor,
in Gujarat and Christian Medical College (CMC) in Vellore, having nutraceutical benefits which could replace the existing
Tamil Nadu. From the past two decades, the research group dietary supplements and doesn't contain harmful
led by Dr. Prajapati, department of dairy microbiology at phytoestrogenes. The product has already been launched
Anand Agricultural University is evaluating the potential of under the brand name "BioFlex-ST500" in Dec' 2014. The
Lactobacillus helveticus and Lactobacillus rhamnosus bacteria product is available in 1g sachet which could prepare a
for different health aspects. In one of the study, reviewed by probiotic curd using 20 L of lukewarm milk. This process was
Kechagia et al. (2013) wherein for antibiotic associated developed under the project which was financially supported
diarrhea, L. rhamnosus and S. boulardii was administered. by DSIR. This is the first Indian company to venture into the
Their group could standardize several type of dahi (curd), mass production of the indigenous starter culture in
lassi (sweet butter milk) and butter milk which contains these preparation of yogurt /curd and fermented drinks. Since, well
probiotic bacteria. In this direction, Department of known dairy industries are manufacturing probiotic products
Biotechnology, Govt. of India, sanctioned a project to test using imported starter cultures.
the role of these probiotic microbes of Lactobacillus genus
that can protect the lining of small intestine in mice receiving Futuristic approach for probiotics in terms of Research and
radiation. The outcomes of the study were later published in Development
the online edition of Gut. A second project was sponsored by
Department of Biotechnology of the Union Ministry of Science At present, the sales of probiotics is limited to metropolitan
and Technology, for further study the health aspects of cities and to some tier I cities; since in smaller cities electricity
probiotics, and to test the role of these microbes in improving and cold storage/refrigeration is the critical problem. In order
immunity. This study involved clinical trials in people between to combat these problems scientists have taken a lead in this
the age group of 65-75. Dr. Prajapati is hopeful that one of direction to make the product reach to larger section of the
his bacteria is to be licensed to a company and product will society mainly in rural areas wherein 70% of the Indian
be launched in a year or so in the market. While, at CMC, population resides. In this segment, research and development
Dr. B.S. Ramakrishna, Department of Gastroenterology, studied is largely focused on improving the stability and usability of
various bacteria of Lactobacillus genus isolated from dairy probiotics. Newer technologies such as microencapsulation
animals of India. Their studies are at nascent stage and have been addressed to enhance shelf life and usability of
believe that next 5- 10 years will be required for his microbes probiotics. Besides this, newer potential strains which could
to be ready for the market. withstand high and low temperature, or frequent temperature
fluctuations and could be used in high pressure applications
At present, the biggest hurdle lies in front of these scientists have been screened and identified.

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 Indian J. Dairy Sci. 68(3), 2015

According to the reports of Frost and Sullivan analyst, the analysis in a pilot study of vaginal colonization. J Clin Microbiol 41:1881-
growth of probiotic cultures fortified food in India is bright 7
Armuzzi A, Cremonini F, Bartolozzi F, et al. (2001) The effect of oral
since; Asians believe that these products are indispensable in administration of Lactobacillus GG on antibiotic-associated
nature for proper health and wellness. In this respect, scientists gastrointestinal side effects during Helicobacter pylori eradication
need to develop customized probiotic strains for specific therapy. Aliment Pharmacol Ther 15:163-9.
applications to promote growth. Armuzzi A, Cremonini F, Ojetti V (2001) Effect of Lactobacillus GG
supplementation on antibiotic-associated gastrointestinal side effects
during Helicobacter pylori eradication therapy: a pilot study. Digestion
Raja and Arunachalam (2011) reviewed that at present the 63:1-7
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standardization and need for validating product claims, lack of Guidelines for Probiotics in USA, India and Malaysia: A Critical Review.
Int J Biotechnol Wellness Ind. 2: 51-64
awareness from the lower middle class population in urban Balamurugan R, Mary RR, Chittaranjan S, Jancy H, Shobana Devi R,
areas and rural masses which hinders the expansion plans of Ramakrishna BS (2010) Low levels of faecal lactobacilli in women with
the dairy companies, Marketing and distribution challenges iron deficiency anaemia in south India. Br J Nutr 104:931-4 [PubMed:
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Beniwal RS, Arena VC, Thomas L (2003) A randomized trial of yogurt for
which requires specific case studies and temperaments. prevention of antibiotic associated diarrhea. Dig Dis Sci 48(10):207782.
Launching the products with Indian consumer interests in Darwazeh A (2011) Probiotics and oral disease: An Update. Smile Dent J
mind and forming a team of Indian sales experts by the 6:6-8
companies will reduce this challenge in a very effective way. Doron SI, Hibberd PL, Gorbach SL (2008) Probiotics for prevention of
antibiotic associated diarrhea. J Clin Gastroenterol 42:5863
Eckburg PB, Bik EM, Bernstein CN, Purdom E, Dethlefsen L, Sargent M, et
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a rapid pace due to globalization and increase in health Expert Consultation on Evaluation of health and nutritional properties
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Ganguly NK, Bhattacharya SK, Sesikeran B, Nair GB, Ramakrishna BS,
industry has undergone a paradigm shift from manufacturing Sachdev HP. (2011) Collabaorators. Indian Council of Medical Research
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fundamental factors like uninterrupted supply of raw materials, 38
qualified man power, congenial investment climate are paving Hajela N, Nair GB, Ganguly NK (2010) Are probiotics a feasible intervention
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Indian market. Consumers should understand that anything in 2:10
Hamdy O, Porramatikul S, AlOzairi E (2006) Metabolic obesity: the paradox
excess is not always good though probiotic has shown a lot between visceral and subcutaneous fat. Curr Diabetes Rev. 2(4):36773
of potential in aiding number of illness and conditions. In the Humen MA, De Antoni GL, Benyacoub J, Costas ME, Cardozo MI,
past few decades, lot of research has been carried out in this Kozubsky L, et al . (2005) Lactobacillus johnsonii La1 antagonizes
direction but no concrete conclusion could be drawn till date Giardia intestinalis in vivo. Infect Immun 73:1265-9
Ivey KL, Lewis JR, Hodgson JM (2011) Association between yogurt, milk,
and have to still wait more as research is going on in this cheese consumption and common carotid artery intima-media thickness
direction. Till then, consumers should understand the concept, and cardiovascular disease risk factors in elderly women. Am J Clin Nutr
"probiotic rather than medicine". Besides this, in the existing 94(1):2349
situation, excellent growth opportunities are stored for both Jaeger SR (2006) Non-sensory factors in sensory science research. Food
Qual Prefer 17(1-2): 132- 144
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capital in the probiotic industry and to make a mark for the Effect of dairy supplementation on body composition and insulin
betterment of the society. resistance in mice. Nutr 23(1112):83643
Kechagia M, Basoulis D, Konstantopoulou S, Dimitriadi D, Gyftopoulou
Acknowledgements K, Skarmoutsou N, Fakiri E M (2013) Health Benefits of Probiotics:
A Review ISRN Nutrition Article ID 481651, 1-7
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SSR would like to acknowledge Department of Science and fermented dairy products over 6 months increases HDL cholesterol.
Industrial Research (DSIR), New Delhi for the financial Eur J Clin Nutr 56(9):843-9
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