2. What led to your interest in the human microbiome and probiotics? 

Dr Andrew Bruce stimulated me to examine the beneficial lactobacilli in the urogenital tract and together we decided to test whether supplementation could prevent infections. That was long before any real interest in the microbiome or probiotics. We were pioneers for sure.  We always felt that there was something very important about the beneficial organisms and the decision was to try and replenish them, which essentially is what is now known as probiotics. That started in 1982, long before Lederberg came up with the definition for the microbiome.

3. You have published several scientific research papers (over 540 to be more precise) and have been described as ‘a Canadian and international pioneer’ when it comes to your research, but are there any projects that you feel were the most instrumental in the development of your career?  

Firstly, the studies on administering lactobacilli to humans, for sure. We initially gave the lactobacilli intra-vaginally because we thought that would be the best way to replenish the indigenous strains and counter the uropathogens that colonized there then ascended into the bladder.  However, this approach constituted drug therapy which would have taken us down a very expensive development route. So, we decided to try and administer the lactobacilli orally in the hope that they ascended from the rectum to the perineum then vagina the same way uropathogens did. In 1992, we filed a patent on the concept. We weren’t expecting the lactobacilli to reach the urogenital tract in high numbers, but the approach seemed to work and was confirmed by researchers in Italy. We further showed that the orally administered probiotic lactobacilli could reduce the risk of bacterial vaginosis and allow replenishment of the patient’s own lactobacilli. This was quite significant at the time. 

Secondly my efforts to bring probiotics to poor people in East Africa in 2004. I was asked how we could help the HIV and AIDS epidemic in Africa, to which I said “why don’t you give them the ability to make probiotic yoghurt, because yoghurt can help with immunity, prevention of diarrhoea and malnutrition – all the things that were being suffered by HIV/AIDS patients”.  Through a student-led program here and Tanzanian women’s group we set up a kitchen and from that it grew into what we have today. 

4. You were influential in the establishment of the Western Heads East (WHE) programme, a collaboration that created probiotic yoghurt social enterprises in Sub-Saharan Africa, and you are currently involved in the ‘Fermented Food for Life’ project. Could you share with us a bit more about the background and aims of these projects? We’d also love to hear about any current findings and any further plans for these projects. 

The initial aim was to improve the well-being of people with HIV/AIDS and to empower women to establish microenterprises. In addition, we wanted to give Canadian students experience working in development world settings. 

The AIDS epidemic was a disaster for women because mostly men got sick and so they couldn’t work which meant the women had to go out and work whilst also caring for their children and partner. Many of these women didn’t own their houses and weren’t empowered, so a number of them decided to try and set up small businesses. They get together and make patties from dough and sell them on the street. By teaching them how to make probiotic yoghurt, they were able to create a revenue stream and become leaders in their community. It took a while, of course, and initially some of the men objected to it as they wanted their wives to take care of them and not other people, but once they started bringing in good food and some revenue the men were very supportive. 

WHE and Yoba-for-Life continue to do important work in the region of Tanzania, Uganda and Kenya, with many local people engaged in sustainable projects. A sachet created by Yoba-for-life contains 1 gram of two bacterial strains and costs around US $0.50, allowing production of up to 100 litres of probiotic yogurt or fermented millet, cereal, juices and other foods. 

Another benefit to the probiotic yoghurt was the ability of the lactobacilli to bind to aflatoxins. These toxic compounds in peanuts and corn killed hundreds of children in Kenya in 2003 through acute poisoning. The idea we pursued was if someone is going to eat corn contaminated by the fungus, if they eat probiotic yoghurt at the same time perhaps the lactobacilli could bind to the aflatoxin and not get absorbed into the system. We did a small study that supported this hypothesis, and since then Yoba-for-life researchers have shown that aflatoxin levels can be reduced to almost zero. Thus, even contaminated corn could be fermented by the probiotic organisms. 

This project of ‘Fermented Food for Life’ has the potential to be implemented within poorer communities in developed countries. The low cost of the sachets makes it feasible for people in poor communities to make their own probiotic fermented foods. Many people cannot afford $1.50 yoghurt sold in supermarkets, but they could afford the ones produced using this technology. 

Bill Gates recently said that probiotics will be critical to fight malnutrition. It was a very encouraging message but ironic, since his Foundation had turned down our project to reach a million people so we had to get funding from Canada. Hopefully, his advisors will see that he doesn’t need to wait for some futuristic probiotic – there is one here right now that could do it. 

5. To date, the European Food Safety Authority (EFSA) have not approved any health claims on probiotic food products across the European Union (EU). Furthermore, within the EU the use of the term probiotic is not permitted for food products because it in itself is considered a health claim. What are your thoughts on this? 

We could spend the whole article on this. The scientific community took a far too passive and diplomatic stance instead of demonstrating outside the homes of committee members and the politicians who designed their mandate. 

People are now aware that probiotics can have beneficial effects and be good for you so why would you deny the public the information they need to buy a product? Secondly, there are clearly studies to show that probiotics have tangible health effects, however, it feels as though nothing will ever be good enough for EFSA to approve a probiotic health claim. If you look at Canada, we have probiotics on the market with informative health claims. Are we a developing country compared to the UK or France? No! It is incomprehensible the extent to which bureaucracy has taken over this area. 

There are so many products on the market that have never seen a human study in their life and contain strains that have no proper documentation. They should therefore not be called a probiotic.  

Governments and granting agencies need to fund more human studies. Currently it’s almost essential that grant awardees must do mouse work supposedly to investigate mechanisms of action. It is hard to believe given how mice are nothing like humans! Rather, grant applicants should be funded if they are doing studies on humans not mice, unless the product being tested has a major safety risk.  

6. There is currently no official definition for the term ‘fermented food’, and people often confuse them as being probiotics.  Do you think there will be an agreed definition in the future?  

There is definitely a need for clarification and that is why a recent consensus meeting was held in London through the International Scientific Association for Probiotics and Prebiotics (ISAPP) to define fermented food. This should be published in the new year. 

It is good to see for the increased interest in fermented foods and I tried to have Health Canada recommend consumption of one fermented food per day for their new Food Guide. Sadly, despite the evidence, they ignored me and worse still did not even acknowledge the existence of the human microbiome!  It has been problematic that some companies are not being more informative to consumers if they are selling a fermented food that has been pasteurized. This would not be expected to convey the same benefits as one with live microbes in it. Also, too many of them are stating that their product contains ‘probiotic’, when this is not true. For a fermented food to contain a probiotic, the strain needs to be properly documented at the very least. 

7. Nowadays there are many gut health books out there claiming to provide the perfect diet to getting a healthy gut. What are your thoughts on these? How can we combat any incorrect messages about gut health and probiotics that are being put out there / being published? 

Most, if not all, of these that I’ve seen are not worth reading. The authors have no clue what a probiotic is, they don’t understand the microbiome, and make wild assumptions or generalisations about what has been proven in humans. 

I tend not the read these sorts of books. There are a few books out there for example ‘Dirt is good’ by Jack Gilbert and Rob Knight that can be a nice read, but I don’t agree with telling people to send their faeces samples off for testing, as nobody knows what a healthy microbiome looks like. I think it’s currently not informative and even a waste of money. 

Many consumers now look to the internet or social media and highly marketed ‘gurus’ for their health issues. What they mostly get is either what they want to hear, what sounds cool, or what is worth trying if you pay the gurus or their sponsors lots of money. 

The way forward is to try and educate more and more people about what is real, proven and worthy compared to what is fake news or garbage.  

8. Throughout your education and career, you have traveled to over 60 worldwide destinations and currently reside in Canada, but what is something that you miss the most about your homeland of Scotland?

The Isle of Cumbrae on a sunny day. It is a magical place with the highest point overlooking the River Clyde and Scottish islands. 

I miss being able to see my mother and brother’s family more often, as well as attending Aberdeen Football Club games. 

9. If you could give one tip to aspiring students what would it be?

It’s about the climb. Some people may appear to rise to the ‘top’ with ease. It’s often because their mentors have their ‘backs’ rather than miraculous things they do themselves. I think hard work and imagining the end goal or product that will actually help people (in the case of students in healthcare areas) or contribute to the planet (for other students), will keep you on track, even when the world seems to ignore you or dismiss your ideas. If everyone does the best they can do, then that’s all that can be asked. It’s about what you can do - not what others say you can’t. 

19/02/20