Home Ingredients Lactobacillus paracasei CNCM I-1518 (L. casei DN-114 001, Actimel)

Lactobacillus paracasei CNCM I-1518 (L. casei DN-114 001, Actimel)

Lacticaseibacillus paracasei subsp. paracasei CNCM I-1518 (formerly Lactobacillus casei DN-114 001)
Evidence Level
Limited
8 Clinical Trials
6 Documented Benefits
2/5 Evidence Score

Lactobacillus paracasei CNCM I-1518, now named Lacticaseibacillus paracasei subsp. paracasei and long published as Lactobacillus casei DN-114 001, is the Danone strain sold as L. casei Danone® in Actimel fermented milk drinks, called DanActive in a US trial, which also carry the yogurt cultures S. thermophilus and L. bulgaricus. In a 638-child trial against a placebo drink, common infections were 19% less frequent, one of two main outcomes, while trials in 599 Russian children, 1,072 older adults and 1,000 shift workers missed their main infection counts, with shorter illnesses or fewer people ill as secondary findings. Antibody responses to flu vaccination rose more in adults over 70. Most trials were run or funded by Danone. A 100 g bottle of Actimel Original carries 9.4 grams of sugar. Results apply to this strain only.

Studied Dose 100 to 200 g or mL a day of the fermented milk drink as one or two bottles, with at least 10^10 CFU per 100 g in a recent trial and 10^8 CFU per gram or mL in older ones, taken daily for 3 weeks to 3 months.
Active Compound Live Lacticaseibacillus paracasei subsp. paracasei CNCM I-1518 (L. casei DN-114 001), sold as L. casei Danone® in Actimel® fermented milk drinks (called DanActive® in a 2010 US trial) by Danone, together with the yogurt cultures Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus. Only drinks are listed; no capsule form was found.

Benefits

Parent-reported illness rates in children at daycare and school

In 638 children aged 3 to 6 drinking one bottle a day for 90 days, common infections were 19% less frequent than on a placebo drink, one of two main outcomes, at a margin (P = 0.046) that a correction for two main outcomes would not pass, mainly from stomach and bowel infections; illness-related behavior change did not differ. In 599 children in Russia, two bottles a day did not lower the main infection count.

Supported by Trial 1

Length of illness episodes in older adults

In 1,072 older adults drinking 200 g a day for 3 months, the main outcome, the number of common infections, did not differ from a non-fermented control, but episodes were shorter on average (6.5 vs 8 days). A 360-person, 3-week pilot also found no change in how often infections occurred, with shorter illnesses (7.0 vs 8.7 days).

Supported by Trial 3, Trial 5

Illness counts in shift workers

In 1,000 healthy shift workers drinking 200 g a day for 3 months, the main outcome, the total number of common infections, did not differ from control. Fewer people on the drink had at least one infection (43% vs 51%), and a later added analysis found fewer infections overall. These secondary findings were not the trial's main test.

Supported by Trial 4, Trial 2

Vaccine antibody response in adults over 70

In two controlled trials in 86 and 222 healthy adults over 70, drinking Actimel twice a day for 7 or 13 weeks, with flu vaccination after 4 weeks, raised antibody titers to the vaccine strains more than a non-fermented control drink. Antibody titers are markers; the trials did not test whether fewer people became ill.

Supported by Trial 6

Bowel regularity in hospital patients taking antibiotics

In 135 older hospital patients taking antibiotics, a 100 g drink twice a day during the course and for a week after fewer had antibiotic-associated loose stools (12% vs 34% on a sterile milkshake placebo). A later hip fracture study against past patients found no reduction, and EFSA judged the evidence insufficient for a related claim.

Supported by Trial 7

Stool health in toddlers compared with plain yogurt

In 928 healthy children aged 6 to 24 months given 100 g a day of milk fermented with the strain and yogurt cultures, fewer had episodes of acute loose stools than children given standard yogurt (15.9% vs 22%). The trial was run from Danone's research center, and the abstract does not name a primary outcome.

Supported by Trial 2, Trial 5

Mechanism of action

1

Survival through the human gut

In a human sampling study, up to 51.2% of the strain swallowed in fermented milk survived to the ileum and up to 28.4% to the feces, and in older adults L. casei counts in stool rose during intake. Survival shows the strain reaches the gut alive; it is not itself a health benefit.

2

Immune cell and antibody markers

In shift workers, natural killer cell counts and activity rose during infections on the drink, and in students under exam stress, lymphocyte and CD56 cell counts held steadier than on plain milk while anxiety and cortisol did not differ. Vaccine antibody titers rose more in adults over 70. These are markers, not illness outcomes.

3

Close genetic match to the Yakult strain (lab work)

Genome sequencing of strains taken from Actimel and Yakult bottles found them nearly identical, differing by 29 single-letter changes and one small insertion, which the authors read as a recent common ancestor. Each strain's trials were still run on its own product, so results are reported separately.

Clinical trials

1
Children in Daycare and School: 90-Day DRINK Trial vs Placebo Drink
PubMed

Double-blind, cluster-randomized, placebo-controlled trial; one strawberry DanActive drink a day (L. casei DN-114 001 at 1 x 10^8 CFU/g plus S. thermophilus and L. bulgaricus) or a sweetened, flavored non-fermented acidified dairy drink with no live cultures for 90 days (Merenstein et al. 2010, Eur J Clin Nutr).

638 children aged 3 to 6 attending daycare or school in the Washington, DC area (314 active, 324 placebo).

Of two parent-reported primary outcomes, common infection incidence was 19% lower on the drink (incidence rate ratio 0.81, 95% CI 0.65 to 0.99, P = 0.046), mainly from gastrointestinal infections, while change of behavior because of illness did not differ. With two primary outcomes, P = 0.046 would not pass a Bonferroni cutoff of 0.025, the threshold the authors used for subgroup comparisons. Randomization was by household. Lower respiratory infections did not differ. Both drinks had 19 g of added sugars per 200 mL. Funded by The Dannon Company, and three authors were Dannon employees.

2
Children at Russian Day-Care Centers: 3-Month Trial (primary outcome not met)
PubMed

Multicenter, double-blind, randomized, placebo-controlled trial; two 100 g bottles a day of Actimel (at least 10^10 CFU CNCM I-1518 per 100 g plus yogurt cultures) or a matched non-fermented acidified dairy drink for 3 months plus 1 month of follow-up (Prodeus et al. 2016, J Pediatr Gastroenterol Nutr).

599 children aged 3 to 6 at 12 day-care centers in Russia (300 active, 299 control).

The primary outcome, common infection incidence during intake, did not differ (98 vs 93), and the authors note overall incidence was unexpectedly low. Duration, severity, sick leave and quality of life did not differ. Rhinopharyngitis, a secondary count over the whole study, was lower (81 vs 100, P = 0.017). Danone Research sponsored and funded the trial (NCT01200173), and one author was a Danone Research employee.

3
Older Adults: 3-Month Trial vs Non-Fermented Control (primary outcome not met)
PubMed

Multicenter, double-blind, controlled trial; 200 g a day of the fermented dairy product with L. casei DN-114 001 or a non-fermented control dairy product for 3 months plus 1 month of follow-up (Guillemard et al. 2010, Br J Nutr).

1,072 free-living older adults, median age 76 (537 active, 535 control).

The primary outcome, the cumulative number of common infections, did not differ, nor did severity, fever, medication use, immune blood measures or quality of life. Average episode duration was shorter (6.5 vs 8 days, P = 0.008), as was cumulative duration (7 vs 8 days, P = 0.009). The first author is from Danone Research.

4
Shift Workers: 3-Month Trial (primary outcome not met)
PubMed

Single-center, randomized, double-blind, controlled trial; 200 g a day of the fermented dairy product with L. casei DN-114 001 or a control product for 3 months plus 1 month of follow-up (Guillemard et al. 2010, J Am Coll Nutr).

1,000 healthy shift workers (500 per group).

The primary outcome, the cumulative number of common infections, did not differ. A post hoc categorical analysis found fewer (OR 0.75, P = 0.017), and fewer people had at least one infection (43% vs 51%, P = 0.005). Natural killer cell counts and activity rose during infections, a marker. The first author is from Danone Research.

5
Older Adults: 3-Week Winter Pilot (no change in infection rates)
PubMed

Randomized, controlled pilot study; milk fermented with yogurt cultures and L. casei DN-114 001 for 3 weeks, or control; a Danone-funded review describes it as open-label at 200 mL a day with a no-product control group (Turchet et al. 2003, J Nutr Health Aging).

360 free-living older adults (180 per group).

The incidence of winter infections did not differ. Illnesses were shorter on the fermented milk (7.0 vs 8.7 days, P = 0.024), and maximal temperature was slightly lower (38.3 vs 38.5 C). The abstract does not state funding.

6
Adults Over 70: Flu Vaccine Antibody Trials vs Control Drink
PubMed

Two randomized, multicenter, double-blind, controlled trials; Actimel (L. casei DN-114 001 plus yogurt cultures) or a non-fermented control dairy product twice daily for 7 weeks (pilot) or 13 weeks (confirmatory), with flu vaccination after 4 weeks (Boge et al. 2009, Vaccine).

86 (pilot) and 222 (confirmatory) healthy adults over 70 in France.

Antibody titers to the vaccine strains rose more on Actimel; in the confirmatory study, the B strain titer rise was larger at 3, 6 and 9 weeks (p = 0.020), with similar results for H3N2 and H1N1. These are antibody markers; illness was not the outcome. The abstract does not state funding.

7
Hospital Patients on Antibiotics: Placebo Milkshake Trial
PubMed

Randomized, double-blind, placebo-controlled trial; a 100 g Actimel drink (L. casei DN-114 001 at 1 x 10^8 CFU/mL, S. thermophilus, L. bulgaricus) or a sterile long-life milkshake twice a day during an antibiotic course and for one week after (Hickson et al. 2007, BMJ).

135 hospital patients in London, mean age 74, taking antibiotics; 113 were analyzed for the primary outcome.

Antibiotic-associated diarrhea, the primary outcome, occurred in 7 of 57 (12%) vs 19 of 56 (34%) on placebo (P = 0.007), and C. difficile diarrhea in 0 vs 9 of 53. Funding included Danone Vitapole, and three authors had Danone-funded convention travel. A later non-randomized hospital study found no reduction, and EFSA did not accept a related claim.

8
Young Military Recruits: Probiotic vs Plain Yogurt (no difference)
PubMed

Randomized trial; a yogurt containing L. casei or a non-probiotic yogurt; a Danone-funded review identifies the product as the CNCM I-1518 drink at 100 mL a day for 8 weeks and describes the trial as single-blind (Pereg et al. 2005, Am J Infect Control).

541 young male military recruits in Israel (502 analyzed).

Diarrhea incidence was 12.2% on the probiotic vs 16.1% on control (P = 0.207), and duration did not differ (3.0 vs 2.6 days). The authors called this a nonsignificant trend. The abstract does not state funding.

Side effects and drug interactions

Common Potential side effects

The fermented drink was described as safe and well tolerated in trials in 1,072 older adults and 1,000 shift workers, and in 638 children, 18 on the drink and 22 on placebo had at least one adverse event.
A 100 g bottle of Actimel Original lists 66 calories and 9.4 grams of sugar, according to Actimel UK; the drink in the US children's trial had 19 grams of added sugars per 200 mL.
The drinks are made from milk, so they are not suitable for people with milk allergy.
Mild digestive changes such as gas can occur when starting a probiotic.
Severely immunocompromised or critically ill people should check with a doctor before taking live probiotics.
Most trials described here were run, funded or supplied by Danone, so independent confirmation is limited.
Check the label: results for CNCM I-1518 do not carry over to other L. paracasei or L. casei products.

Important Drug interactions

Antibiotics: in 135 hospital patients, a drink taken twice daily through the antibiotic course and for a week after lowered antibiotic-associated diarrhea versus placebo, but a later non-randomized hospital study found no reduction and EFSA judged the evidence insufficient; no cited study tested dose timing.
Flu vaccine: in adults over 70, antibody responses to vaccination rose more on the drink than on a control drink; no harm to vaccine response was reported.
Immunosuppressants or other medicines that weaken the immune system: talk with your doctor before taking live probiotics.
No other drug interactions were studied in the trials cited here.

Frequently asked questions about Lactobacillus paracasei CNCM I-1518 (L. casei DN-114 001, Actimel)

Is L. casei Danone in Actimel the same as L. casei DN-114 001?

Yes. Actimel UK states that L. casei Danone is the trademark name for the strain deposited as CNCM I-1518, also called L. casei DN-114 001. Its species is now named Lacticaseibacillus paracasei subsp. paracasei. The drink also contains the yogurt cultures S. thermophilus and L. bulgaricus.

Does Actimel support the immune system?

Results are split. A 638-child US trial found 19% fewer common infections than on a placebo drink on one of its two main outcomes, a margin that would not pass a correction for testing two, but trials in 599 Russian children, 1,072 older adults and 1,000 shift workers did not lower their main infection counts, though some found shorter illnesses. Most trials were Danone funded. See a doctor for a high fever, trouble breathing or symptoms that last.

How much was used in studies, and is there a capsule form?

Trials used 100 to 200 g or mL of the fermented milk drink a day, as one or two bottles, for 3 weeks to 3 months; a recent one listed at least 10 billion CFU per 100 g. Actimel UK states 10 billion L. casei cultures per bottle in its FAQ and 20 billion on its home page and Original product page. No capsule supplement of this strain was found.

How much sugar is in a bottle of Actimel?

Actimel UK lists 9.4 grams of sugar and 66 calories in a 100 g bottle of Actimel Original, and sells a 0% fat, no added sugar range. One or two bottles a day, as used in trials, counts toward daily added sugar intake.

What is Lactobacillus paracasei CNCM I-1518?

Lactobacillus paracasei CNCM I-1518, now named Lacticaseibacillus paracasei subsp. paracasei and long published as Lactobacillus casei DN-114 001, is the Danone strain sold as L. casei Danone® in Actimel fermented milk drinks, called DanActive in a US trial, which also carry the yogurt cultures S. thermophilus and L.

What is Lactobacillus paracasei CNCM I-1518 used for?

NutraSmarts does not list Lactobacillus paracasei CNCM I-1518 under a health category. What the research covers: In 638 children aged 3 to 6 drinking one bottle a day for 90 days, common infections were 19% less frequent than on a placebo drink, one of two main outcomes, at a margin (P = 0.

Is Lactobacillus paracasei CNCM I-1518 safe, and does it have side effects?

Side effects and cautions reported for Lactobacillus paracasei CNCM I-1518 include: The fermented drink was described as safe and well tolerated in trials in 1,072 older adults and 1,000 shift workers, and in 638 children, 18 on the drink and 22 on placebo had at least one adverse event. A 100 g bottle of Actimel Original lists 66 calories and 9. It may also interact with some medications. Lactobacillus paracasei CNCM I-1518 is not right for everyone, so check with a healthcare provider first if you are pregnant or breastfeeding, have a medical condition, or take prescription medication.

Does Lactobacillus paracasei CNCM I-1518 interact with any medications?

Possible interactions include: Antibiotics: in 135 hospital patients, a drink taken twice daily through the antibiotic course and for a week after lowered antibiotic-associated diarrhea versus placebo, but a later non-randomized hospital study found no reduction and EFSA judged the evidence insufficient; no ci… If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Lactobacillus paracasei CNCM I-1518?

NutraSmarts rates the evidence for Lactobacillus paracasei CNCM I-1518 as Limited (2 out of 5). It is backed by 8 study summaries and 16 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(16 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Merenstein D, Murphy M, Fokar A, Hernandez RK, Park H, Nsouli H, Sanders ME, Davis BA, Niborski V, Tondu F, Shara NM. Use of a fermented dairy probiotic drink containing Lactobacillus casei (DN-114 001) to decrease the rate of illness in kids: the DRINK study. A patient-oriented, double-blind, cluster-randomized, placebo-controlled, clinical trial. Eur J Clin Nutr. 2010;64(7):669-77. doi: 10.1038/ejcn.2010.65.PubMedUsed to support: Double-blind, cluster-randomized, placebo-controlled trial (DRINK study) in 638 children aged 3 to 6 in daycare or school in the Washington, DC area, given one strawberry DanActive drink (L. casei DN-114 001/CNCM I-1518 at 1 x 10^8 CFU/g at end of shelf life, plus S. thermophilus and L. bulgaricus) or a sweetened, flavored non-fermented acidified dairy placebo drink daily for 90 days. Of two parent-reported primary outcomes, common infectious disease incidence was 19% lower (incidence rate ratio 0.81, 95% CI 0.65 to 0.99, P = 0.046), driven mainly by gastrointestinal infections; change of behavior because of illness did not differ. Both drinks had 19 g of added sugars per 200 mL. Investigator-initiated, funded by The Dannon Company; three authors were Dannon employees.
  2. Prodeus A, Niborski V, Schrezenmeir J, Gorelov A, Shcherbina A, Rumyantsev A. Fermented Milk Consumption and Common Infections in Children Attending Day-Care Centers: A Randomized Trial. J Pediatr Gastroenterol Nutr. 2016;63(5):534-543. doi: 10.1097/MPG.0000000000001248.PubMedUsed to support: Multicenter, double-blind, randomized, placebo-controlled trial in 599 children aged 3 to 6 at 12 Russian day-care centers, given two 100 g bottles a day of Actimel (at least 10^10 CFU of L. casei CNCM I-1518 per 100 g, plus yogurt cultures) or a sweetened, flavored non-fermented acidified dairy drink for 3 months. The primary outcome, common infectious disease incidence during product intake, did not differ (98 vs 93); overall incidence was unexpectedly low. Rhinopharyngitis was lower over the whole study period (81 vs 100, RR 0.82, P = 0.017). The trial was sponsored and funded by Danone Research (registered as NCT01200173), and one author was a Danone Research employee.
  3. Guillemard E, Tondu F, Lacoin F, Schrezenmeir J. Consumption of a fermented dairy product containing the probiotic Lactobacillus casei DN-114001 reduces the duration of respiratory infections in the elderly in a randomised controlled trial. Br J Nutr. 2010;103(1):58-68. doi: 10.1017/S0007114509991395.PubMedUsed to support: Multicenter, double-blind, controlled trial in 1,072 free-living older adults (median age 76) given 200 g a day of the fermented dairy product with L. casei DN-114 001 or a non-fermented control dairy product for 3 months plus 1 month of follow-up. The primary outcome, cumulative number of common infectious diseases, did not differ, nor did severity, fever, medication use or immune blood measures. Average episode duration (6.5 vs 8 days, P = 0.008) and cumulative duration were lower, as were upper respiratory infection durations. The first author is from Danone Research.
  4. Guillemard E, Tanguy J, Flavigny A, de la Motte S, Schrezenmeir J. Effects of consumption of a fermented dairy product containing the probiotic Lactobacillus casei DN-114 001 on common respiratory and gastrointestinal infections in shift workers in a randomized controlled trial. J Am Coll Nutr. 2010;29(5):455-68. doi: 10.1080/07315724.2010.10719882.PubMedUsed to support: Single-center, randomized, double-blind, controlled trial in 1,000 healthy shift workers given 200 g a day of the fermented dairy product with L. casei DN-114 001 or a control product for 3 months plus 1 month of follow-up. The primary outcome, cumulative number of common infectious diseases, did not differ; a post hoc categorical analysis found fewer (OR 0.75, P = 0.017), and fewer people had at least one infection (43% vs 51%, P = 0.005). NK cell counts and activity rose during infections. The first author is from Danone Research.
  5. Turchet P, Laurenzano M, Auboiron S, Antoine JM. Effect of fermented milk containing the probiotic Lactobacillus casei DN-114001 on winter infections in free-living elderly subjects: a randomised, controlled pilot study. J Nutr Health Aging. 2003;7(2):75-7.PubMedUsed to support: Controlled pilot study in 360 free-living older adults given milk fermented with yogurt cultures and L. casei DN-114 001 for 3 weeks, or control. The incidence of winter infections did not differ; duration of all illnesses was shorter (7.0 vs 8.7 days, P = 0.024), and maximal temperature was slightly lower. The abstract does not state the comparator, dose or funding; a Danone-funded review describes the study as open-label, at 200 mL a day, with a no-product control group, in Italy.
  6. Boge T, Rémigy M, Vaudaine S, Tanguy J, Bourdet-Sicard R, van der Werf S. A probiotic fermented dairy drink improves antibody response to influenza vaccination in the elderly in two randomised controlled trials. Vaccine. 2009;27(41):5677-84. doi: 10.1016/j.vaccine.2009.06.094.PubMedUsed to support: Two randomized, multicenter, double-blind, controlled trials in healthy adults over 70 (86 in a pilot, 222 in a confirmatory study) drinking Actimel (L. casei DN-114 001 plus yogurt cultures) or a non-fermented control dairy product twice daily for 7 or 13 weeks, with flu vaccination after 4 weeks. Antibody titers to the vaccine strains rose more on Actimel (B strain, p = 0.020 in the confirmatory study). These are antibody markers, not illness outcomes. The abstract does not state funding.
  7. Hickson M, D'Souza AL, Muthu N, Rogers TR, Want S, Rajkumar C, Bulpitt CJ. Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial. BMJ. 2007;335(7610):80. doi: 10.1136/bmj.39231.599815.55.PubMedUsed to support: Randomized, double-blind, placebo-controlled trial in 135 hospital patients (mean age 74) taking antibiotics, given a 100 g Actimel drink (L. casei DN-114 001, S. thermophilus, L. bulgaricus) or a sterile long-life milkshake twice daily during the antibiotic course and for one week after. Antibiotic-associated diarrhea, the primary outcome, occurred in 12% vs 34% (P = 0.007). The full text names the product and strain and lists Danone Vitapole among the funders; three authors had received Danone funding to attend Danone conventions. Hospital patients on antibiotics; context only.
  8. Pereg D, Kimhi O, Tirosh A, Orr N, Kayouf R, Lishner M. The effect of fermented yogurt on the prevention of diarrhea in a healthy adult population. Am J Infect Control. 2005;33(2):122-5. doi: 10.1016/j.ajic.2004.11.001.PubMedUsed to support: Randomized trial in 541 young male military recruits given a yogurt containing L. casei or a non-probiotic yogurt; 502 were analyzed. Diarrhea incidence was 12.2% vs 16.1% (P = 0.207) and duration did not differ. The abstract does not name the strain; a Danone-funded systematic review identifies the product as the CNCM I-1518 drink at 100 mL a day for 8 weeks.
  9. Poon T, Juana J, Noori D, Jeansen S, Pierucci-Lagha A, Musa-Veloso K. Effects of a Fermented Dairy Drink Containing Lacticaseibacillus paracasei subsp. paracasei CNCM I-1518 (Lactobacillus casei CNCM I-1518) and the Standard Yogurt Cultures on the Incidence, Duration, and Severity of Common Infectious Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2020;12(11):3443. doi: 10.3390/nu12113443.PubMedUsed to support: Systematic review and meta-analysis of nine randomized trials from eight publications of the fermented dairy drink with CNCM I-1518 and yogurt cultures in generally healthy children and adults. Odds of at least one common infection were lower (OR 0.81, 95% CI 0.66 to 0.98), with no significant effect on duration or severity. Funded by Danone Nutricia Research; two authors were Danone employees and the others work for a consultancy contracted by Danone. Identifies the Pereg trial product and dose.
  10. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). Scientific Opinion on the substantiation of a health claim related to fermented milk containing Lactobacillus casei DN-114 001 plus yoghurt symbiosis (Actimel®), and reduction of Clostridium difficile toxins in the gut of patients receiving antibiotics and reduced risk of acute diarrhoea in patients receiving antibiotics pursuant to Article 14 of Regulation (EC) No 1924/2006. EFSA J. 2010;8(12):1903. doi: 10.2903/j.efsa.2010.1903.PubMedUsed to support: EFSA scientific opinion (2010) on a Danone application for a claim that Actimel (L. casei DN-114 001 plus yogurt cultures) reduces C. difficile toxins and the risk of diarrhea in people taking antibiotics. The Panel concluded that a cause and effect relationship had not been established, noting that the one supportive human trial had considerable limitations.
  11. Oozeer R, Leplingard A, Mater DD, Mogenet A, Michelin R, Seksek I, Marteau P, Doré J, Bresson JL, Corthier G. Survival of Lactobacillus casei in the human digestive tract after consumption of fermented milk. Appl Environ Microbiol. 2006;72(8):5615-7. doi: 10.1128/AEM.00722-06.PubMedUsed to support: Human study of ileal and fecal survival of L. casei DN-114 001 consumed in fermented milk: survival rates were up to 51.2% in the ileum and 28.4% in the feces. Shows gut transit survival; no health outcome.
  12. Douillard FP, Kant R, Ritari J, Paulin L, Palva A, de Vos WM. Comparative genome analysis of Lactobacillus casei strains isolated from Actimel and Yakult products reveals marked similarities and points to a common origin. Microb Biotechnol. 2013;6(5):576-87. doi: 10.1111/1751-7915.12062.PubMedUsed to support: Genome sequencing of L. casei strains isolated from Actimel and Yakult products: the two genomes were nearly identical, differing by one insertion-deletion and 29 single-nucleotide changes, which the authors read as a very recent common ancestor. Laboratory study; no human outcomes.
  13. Marcos A, Wärnberg J, Nova E, Gómez S, Alvarez A, Alvarez R, Mateos JA, Cobo JM. The effect of milk fermented by yogurt cultures plus Lactobacillus casei DN-114001 on the immune response of subjects under academic examination stress. Eur J Nutr. 2004;43(6):381-9. doi: 10.1007/s00394-004-0517-8.PubMedUsed to support: Trial in university students during exam stress: two 100 mL portions a day of Actimel (L. casei DN-114 001 plus yogurt cultures) or a daily glass of semi-skimmed milk for 6 weeks. Anxiety rose similarly in both groups, and serum cortisol did not differ (P = 0.062); total lymphocyte and CD56 cell counts held steadier on Actimel. Markers only.
  14. Pedone CA, Arnaud CC, Postaire ER, Bouley CF, Reinert P. Multicentric study of the effect of milk fermented by Lactobacillus casei on the incidence of diarrhoea. Int J Clin Pract. 2000;54(9):568-71.PubMedUsed to support: Multicenter, randomized, double-blind trial in 928 healthy children aged 6 to 24 months given 100 g a day of milk fermented by yogurt cultures and L. casei DN-114 001 (10^8 CFU/mL) or standard yogurt. Diarrhea incidence was 15.9% vs 22% (p = 0.03). The authors were at the Center International de Recherche Daniel Carasso, Danone's research center; the abstract does not name a primary outcome.
  15. Mallina R, Craik J, Briffa N, Ahluwalia V, Clarke J, Cobb AG. Probiotic containing Lactobacillus casei, Lactobacillus bulgaricus, and Streptococcus thermophiles (ACTIMEL) for the prevention of Clostridium difficile associated diarrhoea in the elderly with proximal femur fractures. J Infect Public Health. 2018;11(1):85-88. doi: 10.1016/j.jiph.2017.04.001.PubMedUsed to support: Study in 105 older patients with hip fractures needing antibiotics who were given Actimel until 3 days after the last antibiotic dose, compared with historical controls: C. difficile diarrhea was not significantly reduced (OR 0.9, 95% CI 0.27 to 2.91). Not randomized. Hospital patients on antibiotics; context only.
  16. Nutricia Limited (Danone), Actimel UK. Actimel FAQ and Actimel Original product page Actimel UK website (not PubMed-indexed). 2026;Accessed November 2026..SourceUsed to support: Company website, not PubMed-indexed. The FAQ states that L. casei Danone is the trademark name for Lactobacillus casei CNCM I-1518, also called L. casei DN 114 001, and that Actimel has 10 billion L. casei cultures (the home page and the Original product page say 20 billion). The Original product page (actimel.co.uk/yogurt-drink/original-range/original) lists a 100 g serving with 66 kcal and 9.4 g sugars, ingredients yogurt (milk), sugar, milk minerals concentrate, L. casei Danone and vitamins D and B6, and an immune claim based on vitamins D and B6. Only drinks are listed.