Live-culture yogurt has so many health advantages, it appears that every woman should be eating it several times a week starting in young adulthood at the latest.  According to research finding, almost all children and men would also benefit either from being regular consumers or eating yogurt at times of infection, etc.  If milk-based yogurt doesn't work, try soy yogurt.  Everyone should be eating yogurt whenever they must take antibiotics in order to prevent antibiotic diarrhea and yeast infections.  While yogurt was first recommended in the medical research in 1907, recent studies are documenting more and more benefits.  Actually, lactobacillus products similar to yogurt have been popular around the world for centuries, probably due to the ability to decrease infections although this may not have been realized by the consumers themselves.  In fact, the milk of mothers who breast feed is usually infected with lactobacillus.  This inoculates breast-fed infants with healthy and protective bacteria from the very beginnings of life. 

Yogurt definitely reduces the risk of vaginal yeast infections.  It is also rapidly effective in treating both vaginal yeast and bacterial infections with direct instillation of 1-2 teaspoons a day for seven day, most conveniently with a syringe without a needle. Eating yogurt at least several times a week can prevent reinfection.  Actually, available studies suggest that yogurt is a much more successful treatment for the bacterial vaginal infections called vaginosis than are antibiotics.  Both can be used together.  Of course, if the woman has another type of infection, like gonorrhea or chlamydia, antibiotic treatment is definitely needed.  Unfortunately, yogurt doesn't treat trichomonas infections. 

Roughly 10-15% of women have bacterial vaginosis and another 30% intermediate abnormal vaginal flora with only 60% have normal lactobacillus flora.  Yogurt, with its high levels of lactobacilli, very likely reduces tubal infections causing infertility, increases IVF success rates, reduces the risk of women contracting gonorrhea, chlamydia, and even HIV.  It very likely helps prevent pre-term deliveries as well as chorioamnionitis since all of these above conditions have been found to be increased in women with bacterial vaginosis, a condition that is readily cured with yogurt, which helps restore and maintain normal vaginal flora.  Since women, like men, often don't know they are infected with STDs, yogurt very likely also helps decrease the spread of STDs in the population.

Many studies show that live-culture yogurt considerably decreases diarrhea in infants, toddler, children, and adults, including the diarrhea occurring after antibiotic treatments, necrotizing enterocolitis in newborns, and diarrhea in HIV patients, and diarrhea with N-G tube feeding.  Anyone starting antibiotic treatment should eat yogurt every day during the treatment.  Yogurt is also great for individuals with lactose intolerance.  

Several well-controlled studies have shown that yogurt or similar probiotics help ulcerative colitis, and pouchitis.  Since Crohn's disease is very similar, it is likely to benefit it as well.  Yogurt very likely reduces the risk of breast cancer.  Several studies have also documented benefits for atopic dermatitis and eczema in children.

There is less extensive evidence that live-culture yogurt reduces upper respiratory infections, lower respiratory infection, and female urinary track infection.  Single studies report that yogurt or a yogurt-life probiotic decreases allergic symptoms in adults, lowers the risk of bladder cancer, treats acute pancreatitis,  helps rheumatoid arthritis, reduces colic in infants, helps allergic rhinitis, relieves constipation, helps hepatic encephalopathy and aids transplant patients.  Research suggests that it might be helpful for nasal infections and peptic ulcer disease.  It may also reduce the risk of cataracts, childhood lead poisoning, inguinal fungal infections, diaper rash, and sinus infections.

Yogurt has been associated with a modestly increased longevity in three studies looking at the issue.  Its consumption has been claimed to be associated with the increased longevity of people in the country of Georgia in the Caucasus Mountains, but the data is considered unreliable.

Since yogurt is a good way to obtain calcium, it should help osteoporosis and help keep blood pressure down.  While milk products and calcium supplements increase prostate cancer in men, one study found yogurt slightly aided longevity in men.  A cup of "lite" yogurt a day also helped lose weight, fat mass, and inches around the waist in two studies.  American flavored yogurts usually contain 40% of their calories as added sugar.  That's fattening and unhealthy.  Lite yogurt uses aspartame or some other artificial sweetener.  Alternatively, plain yogurt can be eaten as is or sweetened at home by adding chopped-up fruit.

While yogurt might sound like a panacea, it is far from that.  I have not seen anything suggesting that it reduces heart disease or has a measurable impact on stroke.  Of course, I haven't seen anything that shows that it doesn't help these diseases either.  Still, in view of the research, I would recommend everyone, but especially women, eat at least a half cup of "lite" low-sugar or plain yogurt each day.  

Many research studies in probiotics are done using different strains of lactobacilli and other safe bacteria and even safe yeast.  Most yogurts contain one strain of lactobacillus and bifidobacillus as well.  I have seen up to six strains of bacteria used in locally available yogurt, but I haven't seen any study to examine whether this has a better effect.  

Plain fat-free yogurt which is available for about $2.00-$2.60 per quart.  The cheapest I have found was at Super Wal-Mart.  Aldi's has the cheapest flavored lite yogurt available at 34 cents per 8 oz. cup, but only in two flavors.  Super Wal-Mart has four types of its own flavored lite yogurt at 38 cents per 6 oz. cup.  Super Wal-Marts and all other supermarkets have much larger varieties of lite yogurts of various brands available for somewhat higher prices.  

Substituting yogurt for milk does cause the consumer to get less vitamin D, since milk is fortified with vitamins A and D in the U.S., but yogurt is not.  However, if the reader follows my advice found elsewhere on this website and takes a daily multivitamin and a daily vitamin D tablet, the reader will be getting 800 IU/day of vitamin D, or the equivalent of the vitamin D in 8 glasses of fortified milk.  Vitamin A supplementation is of questionable value and any one a day multivitamin will give you more than you need.

A half cup a day of yogurt is probably enough, but someone with serious problems should use at least a cup a day or half cup twice a day.  Vaginal infections can be treated more rapidly by a simple introduction of 5-10 cc (1-2 teaspoon) of yogurt each day for up to seven day.  This can be done with a syringe without a needle or any other convenient method.  

A number of other fermented products are available in the U.S. and other countries.  Soy milk yogurt is available and yogurt bacilli is present in certain cheeses.  While the cheeses may have other health drawbacks, fermented soy milk is probably just as good as cow milk yogurt.  

Obtaining yogurt-like lactobacillus in capsules is possible.  These are for sale at many health food stores, but they are more expensive than yogurt and a small amount of research suggests that they are not as good.  Two out of ten such preparations purchased in health food stores in British Columbia did not have any viable bacteria, five grew no lactobacillus, and on average they had only 10% of the viable bacteria as claimed on the label (Can Fam Physician. 2004 Apr;50:583-7).  Similar disappointing results are reported in South Africa (S Afr Med J. 2004 Feb;94(2):121-4).  Other types of healthy bacteria or yeast are available in capsules, but there is no evidence that these are any better than yogurt.  In fact, in the one study comparing yogurt Lactobacillus to the patented yeast S. boulardii, both helped childhood diarrhea equally well.  Even yogurt can lose some of its bacteria as it gets older, but I haven't been able to find a report that quantifies it.

Unfortunately, as for pharmaceuticals, companies who produce probiotic capsules are more willing to fund research studies, because they stand to make more money.  You can't make a lot of money selling yogurt.

Children Receive Lactobacilli From Breast-Feeding Mothers: In a study of 178 breast-feeding infants and their mother showed that in each case mothers had Lactobacilli gasseri in their breast milk and that children had the identical strains in their mouth and feces. Human milk is a source of lactic acid bacteria for the infant gut. Martin R, Langa S, Reviriego C, Jiminez E, Marin ML, Xaus J, Fernandez L, Rodriguez JM. J Pediatr. 2003 Dec;143(6):754-8

Breast Milk Helps Establish Bifidobacterium: Human milk oligosaccharides are readily fermented in the infant colon where they selectively stimulate the growth of bifidobacteria. Bifidobacteria lower intestinal pH through the production of acetic and lactic acids which may suppress the growth of pathogenic bacteria. Univ. Sidney. Bifidogenic effects of feeding infant formula containing galacto-oligosaccharides in healthy formula-fed infants. Napoli JE, Brand-Miller JC, Conway P. Asia Pac J Clin Nutr. 2003 Nov;12(Suppl):S60

Other Lactobacilli: There are hundreds of lactobacillus species around the world either used to ferment various food products or being strains of natural bacteria. It is widely used around the world for meat preservation and fermentation. Res Microbiol. 2001 Dec;152(10):839-48.  L. plantarum is used for sauerkraut and fermenting alfalfa. Lactobacillus reuteri and L. sanfrancensis are used for sourdough bread. Lactobacillus crispatus and L. jensenii are the most common vaginal flora. Lactococcus lactis., Lactobacillus helveticus, and Lactobacillus reuteri are used for Edam cheese. L. casei is another cheese maker. Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus are used in yogurt in Japan.  Some strains can be harmful, causing dental caries, while yogurt Lactobacilli actually decrease dental caries.

Antibiotics, Sexual Intercourse Tend to Alter Vaginal Flora: In a Univ. of Pittsburgh study of 101 women followed for 8 months, antibiotic use was by far the most powerful factor disturbing the healthy lactobacillus flora.  However, those having intercourse at least once a week did have more of a tendency to have an unfavorable disturbance. Factors associated with acquisition of, or persistent colonization by, vaginal lactobacilli: role of hydrogen peroxide production. Vallor AC, Antonio MA, Hawes SE, Hillier SL. J Infect Dis. 2001 Dec 1;184(11):1431-6. Ed: This study emphasizes the value of a daily yogurt habit. Of course, if the male partner also has a daily yogurt habit, it might make a difference on the bacteria and yeast that he carries. No research has ever looked at this factor.  Also, a Yale study found that the weekly instillation of a teaspoon of plain yogurt directly to the vagina each week helped prevent the recurrence of yeast infections in women with that problem.  The same would appear true of women having altered vaginal flora, although most would not know it unless they had some symptoms.  Approximately 50% of U.S. women have either mixed or pathologic vaginal flora when surveys have been done.

Most Yogurts 10-20 Times as Many Active Colonies as One Capsule: Swiss label lactobacillus capsules claim 6 billion live cultures per capsule. But the first Canadian Broadcasting Corporation (CBC) test showed 1.7 billion. Two weeks later, 460 million were still alive. Udo’s Choice promised, and delivered, more than one billion in the first test. It started at 2.1 billion and ended with 692 million bacteria alive. European studies found the same kind of results. Astro BioBest yogurt started with the most - 794 million live bacterial cultures per gram (175 grams per container or 139 billion per container). But near the end of shelf life, almost two-thirds had died (794 to 260 million per gram or falling from 139 to 50 billion per container). Organic Meadow (100 to 6 million per gram) and Danone (180 to 120 million per gram or 32 to 21 billion per container) stayed above the million mark on each test. Liberty yogurt fared the worst, starting off low at just 118,000 live bacterial cultures per gram — and dropping to just 4,000 after two weeks. CBC News 9/9/03 Ed: Lactobacillus capsules cost $.11 per capsule and up at iHerb.com. Thus, 3 to 5 capsules would be the same price as a container of yogurt. Thus, capsules might be an acceptable alternative to yogurt for those who can’t stand the taste. However, I worry that capsules in some stores might be a lot older than 2 weeks.

Thomas E. Radecki, M.D., J.D.

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