Online information in Spanish on probiotics, yoghurt, kefir, kombucha, fibre and prebiotics: an analysis of the quality of information and the certainty of the evidence supporting health claims.

OBJECTIVE: To examine the certainty of the evidence supporting health claims about probiotics, yoghurt, kefir, kombucha, fibre and prebiotics, and to assess the quality of online information in Spanish. DESIGN: Content analysis. METHODS: We compiled a data set of 114 web pages by searching six popular search phrases in Spanish relating to probiotics, yoghurt, kefir, kombucha, fibre and prebiotics on Google.es and coded them for typology and health claims. We examined the certainty of the evidence for health claims from systematic reviews. Information quality was assessed according to 10 criteria, where a web page: mentions scientific publications and reports their conclusions; quantifies relative and absolute effects; acknowledges some limitations; discusses certainty of evidence; reports the potential harms, alternatives and costs; and does not argue based on personal experiences. RESULTS: Gastrointestinal health (86.0%), general health (57.9%), cardiovascular health (53.5%) and immune system health (50.9%) were the most widely mentioned topics. Half of claims (52.6%, 70/133) were supported by evidence from systematic reviews. Probiotics had the highest number of claims supported by evidence and kombucha the lowest. The highest certainty was found for antibiotic-associated diarrhoea, necrotising enterocolitis and otitis (moderate) in probiotics and yoghurt, infectious diarrhoea and hepatic encephalopathy (moderate) in prebiotics, and cardiovascular health (high to moderate) and colorectal cancer (moderate) in fibre. On a scale of 0-10, the median information quality score for all web pages was 3. Only 18.4% reported study conclusions, 7.9% quantified the effects, 28.9% acknowledged some limitations in the research and 42.1% reported potential harms. CONCLUSIONS: Most online health claims for dietary interventions intended for improving health through the gut microbiome are supported by low or very low certainty of evidence. Online information does not align with the evidence and is incomplete or unbalanced.

Microbiome research in general and business newspapers: How many microbiome articles are published and which study designs make the news the most?

The microbiome is a matter of interest for science, consumers and business. Our objective is to quantify that interest in academic journals and newspapers, both quantitatively and by study design. We calculated the number of articles on the microbiome from the total number of biomedicine articles featured in both PubMed and Spanish science news agency SINC, from 2008 to 2018. We used the Factiva database to identify news stories on microbiome papers in three general newspapers (The New York Times, The Times and El País) and three business newspapers (The Wall Street Journal, the Financial Times and Expansión), from 2007 to 2019. Then, we compared news stories with microbiome papers in PubMed, while also analyzing the frequencies of five study design types, both in the newspapers and in the papers themselves. Microbiome papers represented 0.8% of biomedicine papers in PubMed from 2008 to 2018 (increasing from 0.4% to 1.4%), while microbiome news published by SINC represented 1.6% of total biomedical news stories during the same period (increasing from 0.2% to 2.2%). The number of news stories on microbiome papers correlated with the number of microbiome papers (0.91, p < 0.001) featured in general newspapers, but not in business ones. News stories on microbiome papers represented 78.9% and 42.7% of all microbiome articles in general and business newspapers, respectively. Both media outlet types tended to over-report observational studies in humans while under-reporting environmental studies, while the representation of systematic reviews of randomized controlled trials, randomized controlled trials and animal/laboratory studies was similar when comparing newspapers and PubMed. The microbiome is receiving increasing attention in academic journals and newspapers. News stories on the microbiome in general and business newspapers are mostly based on research findings and are more interested in observational studies in humans and less in environmental studies compared to PubMed.

Online Information of Vaccines: Information Quality, Not Only Privacy, Is an Ethical Responsibility of Search Engines.

The fact that Internet companies may record our personal data and track our online behavior for commercial or political purpose has emphasized aspects related to online privacy. This has also led to the development of search engines that promise no tracking and privacy. Search engines also have a major role in spreading low-quality health information such as that of anti-vaccine websites. This study investigates the relationship between search engines' approach to privacy and the scientific quality of the information they return. We analyzed the first 30 webpages returned searching "vaccines autism" in English, Spanish, Italian, and French. The results show that not only "alternative" search engines (Duckduckgo, Ecosia, Qwant, Swisscows, and Mojeek) but also other commercial engines (Bing, Yahoo) often return more anti-vaccine pages (10-53%) than Google.com (0%). Some localized versions of Google, however, returned more anti-vaccine webpages (up to 10%) than Google.com. Health information returned by search engines has an impact on public health and, specifically, in the acceptance of vaccines. The issue of information quality when seeking information for making health-related decisions also impact the ethical aspect represented by the right to an informed consent. Our study suggests that designing a search engine that is privacy savvy and avoids issues with filter bubbles that can result from user-tracking is necessary but insufficient; instead, mechanisms should be developed to test search engines from the perspective of information quality (particularly for health-related webpages) before they can be deemed trustworthy providers of public health information.

[Role of probiotics in obesity management]. / El papel de los probióticos en el manejo de la obesidad.

Obesity is a major public health issue as it is related to several chronic disorders, including type-2 diabetes, high blood pressure, dyslipemia, cardiovascular diseases and cancer, among others. Novel research shows that the gut microbiota is involved in obesity and metabolic disorders, revealing that obese animal and human subjects have alterations in the composition of the gut microbiota compared to their lean counterparts. Moreover, it has been observed in germ-free mice that transplantation of the microbiota of either obese or lean mice influences body weight, suggesting that the gut ecosystem is a relevant target for weight management. Certain strains of probiotics may regulate body weight by influencing the host's metabolic, neuroendocrine and immune functions. Taken together, our knowledge about the influence of gut microbiota on obesity is progressing. Therefore, modulation of its composition through probiotics may provide new opportunities to manage overweight and obesity.

La obesidad es un importante problema de salud pública, ya que está relacionada con varias enfermedades crónicas, incluyendo diabetes tipo 2, hipertensión arterial, dislipemia, enfermedades cardiovasculares y cáncer, entre otras. La microbiota intestinal se considera uno de los nuevos factores que participan en la obesidad y los trastornos metabólicos. Animales y seres humanos obesos tienen alteraciones en la composición de la microbiota intestinal en comparación con sus homólogos delgados. Además, se ha observado en ratones libres de gérmenes que el trasplante de la microbiota procedente de ratones bien obesos o delgados influye en el peso corporal, lo que sugiere que el ecosistema intestinal juega un papel importante en el control ponderal. Asimismo, determinadas cepas de probióticos podrían regular el peso corporal al influir en las funciones metabólicas, neuroendocrinas e inmunológicas del hospedador. Con todo ello, nuestro conocimiento sobre la influencia que la microbiota intestinal tiene sobre la obesidad va avanzando, por lo que cabe considerar que la modulación de su composición mediante probióticos podría ofrecer una nueva vía para el tratamiento del sobrepeso y la obesidad.

El papel de los probióticos en el manejo de la obesidad / Role of probiotics in obesity management

La obesidad es un importante problema de salud pública, ya que está relacionada con varias enfermedades crónicas, incluyendo diabetes tipo 2, hipertensión arterial, dislipemia, enfermedades cardiovasculares y cáncer, entre otras. La microbiota intestinal se considera uno de los nuevos factores que participan en la obesidad y los trastornos metabólicos. Animales y seres humanos obesos tienen alteraciones en la composición de la microbiota intestinal en comparación con sus homólogos delgados. Además, se ha observado en ratones libres de gérmenes que el trasplante de la microbiota procedente de ratones bien obesos o delgados influye en el peso corporal, lo que sugiere que el ecosistema intestinal juega un papel importante en el control ponderal. Asimismo, determinadas cepas de probióticos podrían regular el peso corporal al influir en las funciones metabólicas, neuroendocrinas e inmunológicas del hospedador. Con todo ello, nuestro conocimiento sobre la influencia que la microbiota intestinal tiene sobre la obesidad va avanzando, por lo que cabe considerar que la modulación de su composición mediante probióticos podría ofrecer una nueva vía para el tratamiento del sobrepeso y la obesidad (AU)

Obesity is a major public health issue as it is related to several chronic disorders, including type-2 diabetes, high blood pressure, dyslipemia, cardiovascular diseases and cancer, among others. Novel research shows that the gut microbiota is involved in obesity and metabolic disorders, revealing that obese animal and human subjects have alterations in the composition of the gut microbiota compared to their lean counterparts. Moreover, it has been observed in germ-free mice that transplantation of the microbiota of either obese or lean mice influences body weight, suggesting that the gut ecosystem is a relevant target for weight management. Certain strains of probiotics may regulate body weight by influencing the host’s metabolic, neuroendocrine and immune functions. Taken together, our knowledge about the influence of gut microbiota on obesity is progressing. Therefore, modulation of its composition through probiotics may provide new opportunities to manage overweight and obesity (AU)