Actimel

Actimel (also known as DanActive in the United States and Canada) is a 'probiotic' yogurt-type drink produced by the French company Danone. It is sold in 100ml bottles, typically as an 8, 6 or 4 pack, but more recently as a 12 or 16 pack. The main claimed benefit of Actimel is the strengthening of the body's natural defences through the use of patented bacterial culture called Lactobacillus casei DN-114001, marketed as Lactobacillus casei Defensis or Immunitas(s) and more recently as L. casei Danone. Each bottle is claimed to contain 10 billion of these bacteria.^[1] In addition Actimel contains the traditional yogurt cultures Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus salivarius subsp. thermophilus.

After the introduction of Yakult in Europe in 1993 several other companies including Danone responded releasing their own L. casei based products. Since 1994, L. casei based yogurts have become a common product in West European supermarkets.

Actimel earned over €1400 million (US$1.8 billion) in retail sales in 2006 ^[2] and can be found in more than 20 European countries as well as in South America and the Middle East. Actimel was released as DanActive in the United States on a limited regional basis in 2004 (flavours Strawberry, Vanilla, and Blueberry) then was given a nationwide launch in 2007 (adding the flavour Cranberry/Raspberry).

Ingredients

Standard Actimel (excludes variations such as Actimel Light) contains:

• Milk (fresh/powdered)
• Sugar (sucrose)
• Live Lactobacillus casei DN-114001 probiotic strain, 10 000 million per 100 mL bottle^[1]
• Live yogurt cultures

Flavours

There are seventeen flavours of Actimel, these are: Apricot, Blackcurrant, Blueberry, Coconut, Kiwi, Multifruit, Orange, Original, Passionfruit & Mango, Strawberry, Strawberry & Banana, Vanilla, Fat Free: Original, Peach & Mango and Raspberry.

In the United Kingdom, there is also a limited edition flavour: Honey & Lemon.

Scientific basis

The main claimed benefits are referenced to several scientific studies listed by the manufacturer on various of its websites.^[3] The list of scientific papers differs on each country's website.^[4][5][6]

Claimed benefits range from reducing the incidence of diarrhea^[7][8][9] and rhinitis reduction for young children,^[10] to improvement of the immune function in adults^[11] and seniors ^[12][13] and reduction of duration of winter infections for elderly.^[14]

Some clinical studies suggest potential effects for children such as eradication of H. pylori when combined with antibiotics^[15] or restoration of activity of fecal enzymes in children after surgery.^[16]

A recent study published by the British Medical Journal^[17] suggests that the product could help avoid antibiotic–associated diarrhoea and limit Clostridium difficile infections in elderly patients.

Research is ongoing to determine the effectiveness, or otherwise, of this product in reducing the occurrence of common illnesses in children attending daycare centers in the US.^[18] This clinical trial has been registered at ClinicalTrials.gov^[19] (as is now often required for peer-reviewed publication, in order to decrease the likelihood of null results being unreported), but results are not published as yet.

Debates surrounding health claims on probiotic foods

On January 23, 2008, a proposed class action was filed in California, accusing Danone Co. Inc. of false advertising in their marketing of yogurt containing probiotic bacteria (Danactive & Activia), alleging that the claimed health benefits have never been proven.^[20] The company has denied this accusation.^[21]

Foodwatch claims that Danone "makes a mountain out of a molehill" in suggesting that Actimel protects from cold and boosts health. Foodwatch believes that the company sells a commodity product as a niche product using branding.^[22]

The Advertising Standards Authority (ASA) is an independent regulator for advertisements, sales promotion and direct marketing in the UK. According to Spiegel Online one TV spot from Actimel was blocked by the ASA in 2006 and one in 2008.^[23] In the first case the ASA upheld a complaint that the advert misleadingly implied that children given Actimel would be prevented from catching bacterial infections.^[24] Meanwhile in the second case complaints about the use of the phrase "Actimel is scientifically proven and you can see that proof for yourself on our website" were upheld as only summaries of, or references to, these studies were present on the website and the full content was not available.^[25] A TV advert which stated that Actimel was "scientifically-proven to help support your kids' defences" was banned by the Advertising Standards Authority.^[26]

Alexa Meyer, from the Department of Nutritional Sciences, University of Vienna, Austria, comparing probiotic drinks and normal yogurt, found no significant difference in the effect of Actimel and normal yogurt with living bacteria. The nutritional researcher recommends to get enough sleep, wash hands often and eat a daily bowl of yogurt. She says this would activate more active germ-fighting white blood cells, enhancing the immune system, probably due to the presence of Lactobacillus bulgaricus, from any normal yogurt, which is half the price of Actimel.^[27]

The equivalence of yogurts is supported by Berthold Koletzko from the University of Munich, Metabolic Diseases and Nutrition, Munich, Germany in case of diarrhoea advises parents to give their children yogurt with living bacteria. It does not necessarily need to be Actimel, but may also be other yogurts. A measurable health benefit linked to the presence of live Streptococcus thermophilus and Lactobacillus delbrueckii sp. Bulgaricus in yogurt was reported by Koletzko and colleagues in 2005. In this review Koletzko and colleagues say that it was clearly demonstrated that yogurt containing viable bacteria improves lactose digestion and eliminates symptoms of lactose intolerance, and clearly fulfil the current concept of probiotics.^[28]

The net "all-cause" effects of yogurts have also been questioned; its September 6, 2009 issue, Nature featured an article by Didier Raoult who claimed that "probiotic-enriched" yogurt beverages may have contributed to the increase in obesity over the past 20 years.^[29]

Within the 27 countries of the European Union, a new health claims regulation was put in place by the European Commission as of July 1, 2007,^[30] under which companies who wish to make claims about the nutritional & functional benefits of a product must support the claims with scientific evidence.^[31] In Canada, a similar regulation is currently in the works at Health Canada,^[32] as it plans to update its assessment framework to make the system clearer and the claims more credible.^[33]

Nutrition facts

Danone Actimel plain 0% contains 3.3 g of sugar, original plain contains 10.5 g of sugar, multifruit contains 12.0 g of sugar for every serving (100 g). None of those concentrations is higher than the level defined as "HIGH" by the UK Food Standards Agency (described for concentrations of sugar above 15 g per 100 g).^[34] As a comparison, Coca-Cola and orange juices are also in the range of 10 g of sugar per 100 g, but with a serving size usually higher than 250 ml the total sugar quantity is much higher.

Through nutrient profiling guidelines, current health claim regulations in the European Union may forbid the use of health claim on food products that are nutritionally unbalanced, but dairy products and probiotic drinks are likely to be considered favourably because their health benefits outweigh the fact they are high in one of the designated 'unhealthy' ingredients.^[35]

References

External links

• Actimel website
• Actimel website in the UK
• DanActive - Actimel in the US
• Danone - The manufacturers of Actimel
• Dannon - Dannon in the US