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Knowledge, Use and Perceptions of Probiotics and Prebiotics in Hospitalized Patients Melanie Betz 1, Anne Uzueta 2, Heather Rasmussen 1, Mary Gregoire 1, Cassie Vanderwall 1, Gretchen Witowich 1 1 Clinical Nutrition, Rush University Medical Center, Chicago, IL 60612, 2 Clinical Nutrition, Advocate Christ Medical Center, Oak Lawn, IL 60453 Introduction o The digestive tract of humans is the habitat for trillions of microbes that significantly affect host physiology and health, and modification of the gut microbiota through dietary means has been shown to beneficially impact human health and disease. o Probiotics and prebiotics are dietary compounds that have shown the ability to modify gut microbiota. o A probiotic is a live microorganism that, when administered in adequate amounts, confers a health benefit on the host. o A prebiotic is a fiber that beneficially affects the host by selectively stimulating the growth of bacteria in the gut. o Recent research has focused on the efficacy of probiotics and prebiotics for different health conditions. Despite the increase in research as well as the market for probiotics and prebiotics in recent years, little is known about the current use, knowledge and perceptions of these products in hospitalized patients. Objectives o To gain a better understanding of knowledge, use and perceptions of hospital patients are taking probiotic and prebiotic products. o To compare differences in use and perceptions of probiotics and prebiotics based on patient demographics. Methods o This study used a descriptive, cross-sectional survey method to verbally administer questionnaires to 200 hospitalized patients at Rush University Medical Center and Advocate Christ Medical Center in Chicago, Illinois (67% response rate). o The questionnaire contained three sections: demographic, past medical history and probiotic and prebiotic questions. o Patients completed a cognitive screen and consented before the questionnaire was administered. Results were electronically recorded using Survey Monkey TM. Results o The sample was 58% female and 56% Caucasian with a mean age of 56 years and 46% completing ≤12 years of education. o 73% of the sample was familiar with the concept probiotic compared to 52% familiar with the prebiotic concept after probiotic and prebiotic definitions were read. o The most common health conditions believed to be benefitted by probiotics and prebiotics were digestion/gut health (85% for probiotics and prebiotics), constipation (80% and 74%), diarrhea (75% and 71%) and immune health (68% and 72%). o Most common reasons to consume probiotics were to try them (36.2%) and digestion/gut health (33.3%). Diarrhea, immune health and digestion/gut health were most improved by probiotic consumption; diarrhea and overweight or obesity were least improved. o Most common reasons to consume prebiotics were to try them (43%), for overweight or obesity (29%) and digestion/gut health (17%). Health conditions not on the handout, digestion/gut health and immune health were most improved by prebiotic consumption; diarrhea and general health were least improved. o 34% believed probiotics improved their health “quite a bit” or “very much,” similar to 33% for prebiotics. o TV/radio (57% for probiotics and 37% for prebiotics) and family/friends (46% and 51%) had the largest impact on both probiotic and prebiotic product consumption. Dietitians impacted 10% of probiotic and 21% of prebiotic consumption. o 90% of patients responded with “not at all” or “a little” to the statement “probiotics are harmful”. 95% responded with these choices to “prebiotics are harmful.” Figure 2. Patient Mean Responses to Probiotic and Prebiotic Perception Questions Responses based on 5-point scale (1=Not at all, 2=A little, 3=Somewhat, 4=Quite a bit, 5=Very much) Conclusion This study demonstrated that patients at two large, urban medical centers are mostly unfamiliar with probiotics and prebiotics. Probiotics are better recognized by inpatients compared to prebiotics. Many patients are consuming products containing probiotics and prebiotics. Inpatients are consuming probiotics mostly for gastrointestinal reasons and prebiotics to help reduce overweight and obesity followed by gastrointestinal health. Patient education is necessary to ensure that both probiotics and prebiotics are being consumed safely and for health conditions supported by research. Table1. Medical center patient probiotic and prebiotic product consumption Probioticsn%a%a Prebioticsn%b%b Consumption practice Ever consumed probiotics c 10552.5 Ever consumed prebiotics d 7638.0 Currently consuming8341.0 Currently consuming6231.0 Product Yogurt11372.0 Kashi Go Lean Crunch TM 3226.2 Activia TM YoPlus TM Yoplait yogurt 93 16 59.2 10.3 Skinny Cow TM ice cream3226.2 sandwiches GoodBelly ® yogurt42.5 Ensure ® with FOS2016.4 Lowell TM Polish yogurt10.6 Luna bar ® 1915.6 Dairy drink DanActive TM dairy drink 31 16 19.7 10.2 South Beach Diet ® bars Other 16 2 13.2 1.6 Kefir127.7 Breakstone’s ® LiveActive10.8 Activia TM dairy drink10.6 cottage cheese Other (unspecified)10.6 Pill117.0 Florajen ® 10.6 Florastor ® 10.6 Other (pills95.8 unspecified) Cereals2222 1.3 Vive TM Kashi a Percent total based on 157 responses b Percent total based on 122 responses c Significantly more females were consuming probiotics d Significant difference found based on education; highest education group had the highest percent consumption of prebiotics RUSH UNIVERSITY MEDICAL CENTER Figure 3. Health Conditions Believed Benefitted by Pro/Prebiotics Figure 1. Percentage of Patients Familiar with Probiotic Term (left) and Prebiotic Term (right). Figure 2. Percentage of Patients Able to Correctly Define Probiotic (left) and Prebiotic (right).