#7: The 5 Things You Need To Know Before Taking Probiotics

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In the last few years, there has been a huge craze for probiotics!

• 4M US residents reported having taken probiotic supplements in the last 30 days (National Health Interview Survey, 2012).
• The demand for probiotic-rich foods is still rising and prices are rising daily!

 

There are so many fascinating links between our gut and the rest of our body's health - no wonder you want to reap all the benefits a probiotic could give you! But is this craze justified by the scientific evidence? What are probiotics and what are their benefits? Let’s find out!

1. What probiotics are! 

Probiotics are live microorganisms, mainly bacteria but also yeast. Although people often think bacteria are harmful “germs”, we have a lot more beneficial bacteria than harmful bacteria. Overall, there are more than 100 trillion bacteria in and on our bodies. And many of the probiotics we eat are the same bacteria varieties that we already have in our guts.

Probiotics are defined as live microorganisms, which when administered in adequate amounts, confer a health benefit on the host.

There are approximately 7000-9000 different varieties (species and strains) of microorganisms, e.g. Lactobacillus and Bifidobacterium. Since they are so varied between strains but also within strains, probiotics act through a multitude of mechanisms.

One type of Lactobacillus can prevent illness while another one does not.

Therefore, they have wide-ranging effects on human health and disease;

- Some help protect your gut from harmful microorganisms

- Some improve your digestion and gut function

- Some influence your body’s immune function by destroying harmful disease-causing cells

- Some produce vitamins and enzymes in your large intestine (the end of your gut)

- Some provide other health benefits too! 

 

2. The proven health benefits of probiotics

Many articles will entice you with the 8 health benefits of probiotics or 11 life-changing facts about probiotics and 5 reasons why you should be taking probiotics! But don’t be fooled; the science is a little more complex than that!

The pretty new research (within the last 20 years) shows incredible links between the quality (variety, quantity, and diversity) of our microbiome (i.e. the whole ecosystem of bacteria and yeast in your gut) and diseases such as depression, anxiety, type 2 diabetes, and obesity! However, we do not know whether the dysregulation of the microbiome is causing the disease or the disease causing the microbiome dysregulation. 

Today, probiotics are proven to be effective to treat and prevent only a few specific diseases:

In short;

》Taking probiotics before, during, and after pregnancy may help reduce the risk of the child developing atopic dermatitis, the most common form or eczema. As an adult, the evidence does not support the recommendation of probiotics to treat dermatitis!   

 

You may already have taken probiotics when your doctor prescribed you anti-biotics (i.e. medication to kill bacteria in our bodies). Antibiotics are not so great at supporting our gut health because they can destroy the diversity (which is a good thing!) of your gut microbiome and they can lead to your gut microbiome losing its function to metabolize nutrients (which in turn leads to diarrhea). And the use of antibiotics can also lead to diarrhea… not so sexy, I know! 

Numerous meta-analyses (i.e. the best scientific evidence we have) indicate that taking a few specific probiotic species and strains may reduce the risk of antibiotic-associated diarrhea by 51%. However, this beneficial effect depends on the type of antibiotic used, the strain of probiotic used, the age of the patient, and the overall patient care. 

》Taking probiotics at the beginning of the antibiotic treatment may be considered. Always check with a general practitioner what is best for your specific case!

 

Irritable Bowel Syndrome (IBS) is more and more common. It is a functional disorder of the gut, which manifests itself by recurrent abdominal discomfort or pain, bloating, and changes in stool form or frequency.

Although we don’t yet fully understand the causes of IBS completely, a growing body of evidence supports the potential role of our gut microbiome. But IBS has also been linked to stress (which may also indirectly impact our gut microbiome?)! 

People suffering from IBS often have an abundant presence of pro-inflammatory bacterial species and a reduction of healthy bacterial species. Their gut microbiome dysregulation may, therefore, be one cause of the inflammation and pain experienced by IBS patients. 

In this case, probiotic products containing Lactobacillus and Bifidobacterium can then potentially restore some missing microbial functionality and help manage IBS symptoms.

The theory and mechanisms are promising, but yet again – as so often in science – the true application is not as magical as we would hope! Most IBS patients have found a positive, but the only modest, beneficial effect of taking probiotic products. This effect also depends on the IBS symptom that was measure and the probiotic strain used. 

》If it helps your gut, digestion, and makes you feel good, you can keep taking them!

 

Research over the last decade has brought light on a whole new perspective on the causes of obesity.

Our gut microbiota plays an important role in nutrient and energy metabolism from food. Animal studies suggest that the bacteria in our gut not only impact the use of energy from our diet, but also the energy expenditure and storage within the host (aka the animals!).

Sounds amazing, right? Let’s not get carried away… we do not know yet whether these effects translate to humans.

》The results of human studies that assessed the effect of probiotics on obesity have not been consistent so far. Many factors come into play; the dose, strain, and duration of probiotic intake, and the age, sex, and baseline weight of the patient. 

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3. Whether probiotics help with weight loss!

 

The short answer is no… While some studies have found some reduced body fat and waist circumference in people with obesity upon taking probiotics, many studies have not found any benefit.

 

What we do know is that the gut microbiome is dysregulated in overweight people and when gaining weight. The cause and effect relationship is not fully understood yet: Is the microbiome dysregulated because of weight gain, or does a microbiome imbalance cause weight gain?

 

4. If there is any risk to taking probiotic supplements.

 

It depends... Given the huge consumption of probiotics around the world, the number of infections that come from currently marketed probiotics is negligible. Side effects are minor; i.e. gas or bloating. If however, you experience any side effects, you need to get checked by a general practitioner.  

It could have risks if your immune function is compromised!

》Currently, there is no recommendation for or against probiotic use by healthy people!

You are already a probiotic fanatic?

If you love your probiotic supplements and you get that feeling of doing something great for your health – keep taking them, they will not cause any harm! If, however, you are only taking them because you think you should, let me help you out – you don’t! 

New to probiotics?

• Always ask your doctor for advice about which probiotic to choose, what dose to take, and how long to use the product.
• Check labels for the expiration date, a CFU (CFU stands for the colony-forming units, which is how many bacteria can divide and form colonies) of more than 5Billion and they should be "enteric-coated"
• Don't disregard a proven treatment for the symptom or disease you are experiencing for an unproven one - aka probiotics! 

 

5. What the best probiotic foods are!

 

While we don't need to take probiotic supplements when healthy, it is important to feed our healthy gut bacteria and help support our gut health with a healthy, varied, and balanced diet! Probiotic-rich foods can be a great way to sneak in those health-supporting microorganisms...

All fermented foods contain microorganisms. For the making of yogurts, kefir, and tempeh, for example, probiotics are added to the “raw” ingredients (here; milk and soya). However, that does not mean that these foods all provide health benefits!

Be aware that some probiotic cultures are already destroyed by heat during the process of manufacture. In this case, as with sourdough bread and most pickles, you do not get the health benefits that you might intend!

On another note, some probiotic strains are destroyed by the acid within your stomach and the first part of your gut, meaning that the health properties to the gut are not even going to reach your large intestine (where the probiotics act)!

 

The health benefits of probiotics found in kimchi, apple cider vinegar, cheese, kombucha, miso, and sauerkraut have not been studied extensively. Be reassured, you can still enjoy those foods, but let’s avoid putting unsolicited health claims behind them!

 And other unfermented foods, such as some cereals and juices, can contain microorganisms. Whether they have probiotic properties depends on the strain types and amount they contain. 

 

Yogurt is your best bet! It is available everywhere and since it is the one probiotic-rich food that has extensively been studied, it has proven health benefits!

The number and type of bacteria species can vary depending on the yogurt brand. The probiotic content of yogurt products can range from 90 billion to 500 billion CFU per serving. (CFU stands for the colony-forming units, which is how many bacteria can divide and form colonies.) Look for the words "live and active cultures" on the label.

Yogurt is pretty easy to add to your diet. Have it for breakfast or as a midday snack. You can also substitute yogurt in almost any baking recipe and use it for the creaminess effect in smoothies. Yogurt is a great basis for sauces, salad dressings, or marinades.

  

Resources:

• National Institute of Health, Office of Dietary Supplements https://ods.od.nih.gov/factsheets/Probiotics-HealthProfessional/#disc
• Parvez, S., Malik, K. A., Ah Kang, S., & Kim, H. Y. (2006). Probiotics and their fermented food products are beneficial for health. Journal of applied microbiology, 100(6), 1171–1185. https://doi.org/10.1111/j.1365-2672.2006.02963.x

 

 

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