Probiotics in dietary guidelines and clinical recommendations outside the European Union

Table 1 Occurrence of yoghurt and/or probiotics as relevant issues in different food-based dietary guidelines

Country	Organization	Document	Yoghurt recommendation	Probiotic recommendation
New Zealand	Ministry of Health	Part 1: New Zealand Food and Nutrition Guidelines[24]	Milk and milk products, including yogurt. Provide energy, protein, fats (mostly saturated), vitamins (riboflavin, B12, A) and minerals (calcium, iodine, phosphorus, zinc). They are important for children and young people to ensure optimal bone health. Reduced or low fat particularly, milk and milk products are the best choices because these foods include less saturated fat, and often more protein and calcium than high-fat alternatives	Not mentioned
Canada	Agriculture and Agri-Food Canada; Health Canada	Probiotics- understanding them will lead to greater use[25]; Canada's Food Guide[26]	Yoghurt (as lower fat milk alternative; milk per se as source of Vitamin D)	Approved by Health Canada as Functional Food with Added Probiotics[27]: Activia® with Bifidobacterium (animalis) lactis DN-173 010; DanActive® with Lactobacillus casei DN-114 001; Yoptimal® and iÖGO ProbioTM with Bifidobacterium lactis BB-12 and Lactobacillus acidophilus LA-5)
United States	United States Department of Agriculture	Dietary Guidelines for Americans, 2010[28]	All milks, including yogurts, frozen yogurts and cheeses. Most choices should be fat-free or low fat. Milk and milk products contribute many nutrients, such as calcium, vitamin D (for products fortified with vita-min D), and potassium, to the diet. Moderate evidence shows that intake of milk and milk products is linked to improved bone health, especially in children and adolescents. Moderate evidence also indicates that intake of milk and milk products is associated with a reduced risk of cardiovascular disease and type 2 diabetes and with lower blood pressure in adults. Choosing fat-free or low-fat milk and milk products provides the same nutrients with less solid fat, and thus, fewer calories. In addition, selecting more milk group intake as fat-free or low-fat fluid milk or yogurt rather than as cheese can increase intake of potassium, vitamin A, and vitamin D and decrease intake of sodium, cholesterol, and saturated fatty acids	Not mentioned
India	National Institute of Nutrition	Dietary Guidelines for Indians[29]	Recommended as curd	Not mentioned
Australia	The Department of Health and Ageing; The Australian Nutrition Foundation;	The Australian Guide to Healthy Eating[30] Australian Dietary Guidelines[31]	Milks, including buttermilk, yoghurt (all yoghurts including reduced fat or full cream-without added sugar), soy yoghurt (calcium fortified), and cheese Milk, cheese and yoghurt provide calcium in a readily absorbable and convenient form. They have various health benefits and are a good source of many nutrients, including calcium, protein, iodine, vitamin A, vitamin D, riboflavin, vitamin B12 and zinc. Avoiding dairy foods and not making suitable alternative choices, such as the ones recommended in this food group, can affect your long-term health	Not mentioned
Brazil	The Ministry of Health	The Food Guide[32]	Milk is an important source of vitamin B2 and main source of calcium in the feed; dairy products such as yoghurt and cottage cheese have the same profile	Not mentioned
China	The Ministry of Health	China's Dietary Guidelines (2007)[33], Chinese Dietary Guidelines[34]	Yogurt, as source of calcium	Not mentioned
Israel	Ministry of Health	The Food Pyramid[35]	Yogurt as source of calcium in the group of protein-rich foods	Not mentioned
Japan	Health and Agriculture ministries	The Food Guide[36]	Yoghurt as a source of calcium	Not mentioned
Mexico	Department of Nutrition and Health Promotion	The Plate of Good Eating[37]	Recommended	Not mentioned
Thailand	Ministry of Public Health[38]		Mentioned in general along with milk	A list of approved microorganisms for food use provided, but no recommendation made.
Turkey	Ministry of Health	Basic Food Groups[39]	Yogurt, cheeses contain important nutrients: proteins, calcium, phosphorus, vitamin B2 (riboflavin) and vitamin B12; eating yogurt and drinking ayran (buttermilk) help in treatment of diarrhea	Not mentioned

All the reviewed countries (except India, which recommends curd) suggest yoghurt in their dietary guidelines. For the time being Canada is the only country mentioning probiotics.