WHAT YOU NEED TO KNOW BEFORE TAKING A PROBIOTIC



WHAT ARE PROBIOTICS?

Probiotics are the happy bugs that live in our gut, predominately in our large intestine.


By definition they are 'live microorganisms which when administered in adequate amounts confer a health benefit on the host" (1).


Now in English, when we eat live microbes, we have to consume them in large enough quantities, commercially known as colony forming units (CFU), and have been scientifically proven to be beneficial for our health. Probiotics are are grouped according to their genus, species and strain eg. Lactobacillus (genus), Lactobacillus acidophilus (species) and Lactobacillus acidophilus ABC (strain), with each strain having a different or no effect. The most commonly researched microbes are from the genus Bifidobacterium, Lactobacillus and Saccharomyces (1).


WHAT DO THEY DO?

There is a huge gap between what we know and what we don't know. What we do know is probiotics have 2 main functions in our gut, support a healthy immune and digestive system (1). They improve our health by helping breakdown foods we may not be able to on our own (eg. lactose-the sugars found in milk), they produce and help absorb vitamins and short chain fatty acids (SCFA), improve the balance of good and bad bacteria and, communicate with host cells through chemical signalling (2, 3). This all leads to reduced inflammation, a healthier environment in our large intestine and stronger immune system. Particular effects on the body may be strain or species specific, scientists are still working on this, so watch this space! It is also important to note, we don't know if probiotics we eat survive the journey to AND colonise our large intestine. Like I have said, there is so much we don't know, but it is an exciting area that we are constantly learning about. There are promising benefits which extend beyond the gut to heart, kidney, brain and vaginal health (3)!


WHERE CAN I GET THEM?

Probiotics can be found naturally in foods or in a commercial supplement form. Most people automatically think of fermented foods as probiotics but this is not true. Food processing techniques such as baking a loaf of sourdough can destroy the microbes therefore, not meeting the definition of 'live microorganisms'.

Additionally, some fermented foods contain live microbes but don't meet the official definition of probiotics because there isn't clinical human studies providing a health benefit. This doesn't mean they aren't good for you, just means they may not have had enough research into it yet.


DO I NEED TO TAKE A SUPPLEMENT EACH DAY?

No. There are a few situations where taking a probiotic supplement has been proven to be beneficial.


If you are travelling and get travellers diahorrea, you have just completed a course of antibiotics or have a poor diet (1). They may be helpful in the treatment and management of IBS, inflammatory bowel disease, allergies, constipation, diarrhoea, h.pylori infections, colic, lactose malabsorption, non-alcoholic fatty liver disease and more (1, 3). Our gut microbiome is like our own fingerprint, no one has the same as you -crazy right?!


As always, it's better to eat nutrients in the food than supplement form to get the benefits of other nutrients (e.g. calcium in fermented dairy, vitamin C in sauerkraut).


WHAT SHOULD I BE LOOKING FOR?

If you want to take a supplement, you need to make sure you are taking the correct strain and dosage of microbes to match your desired outcome. Supplements are not as tightly regulated as medications, so the quality of probiotics may not match the incredible health claims on the packaging, plus they can be expensive! If you are already healthy and eat a diet high in fermentable fibre (soluble and resistant starch), wholegrain, fermentable foods, fruits and vegetables, probiotic supplements are probably a waste of your hard earn money which you can use for something else.



QUICK TIPS ON WHAT TO LOOK FOR:


1. Check the CFU is stated at the end of shelf life, not time of manufacturing as they can die over the shelf life of the product. The dose is generally strain specific, but as a guide, look for 1-10 billion CFU per serve or dose (dependent on how you consume it) (3).

2. Choose foods which state specific genus, species and preferably strains of Lactobacillus, Bifidobacterium or Saccharomyces (3). These are the main three which have been studied which we KNOW are beneficial for our health...'vegan cultures' isn't being transparent with consumers and a big hint it may not be beneficial of your health.

3. Don't choose a food just because it 'contains live bacteria' look at what else the food includes, and do your own research....a kombucha that is high in sugar doesn't mean it is good for you.

4. Microbes are sensitive little critters, choose refrigerated products or products that protect them from the harsh environment of our digestive system. Storage instructions should be stated on the packaging (3).



IMPORTANT REMINDER

Think of probiotics as plants in a garden, and prebiotics as the sunlight and water to help them grow and flourish. So make sure you are feed your microbes (probiotics) fermentable fibres (prebiotics) to ensure they thrive, so you thrive!


If you found this helpful or know someone who would, please forward or share. Education and knowledge is key!


This is a really tricky area, however if you think you need to take a probiotic, speak to your GP or digestive dietitian. As always, I am happy to help and have a chat, or can point you in the direction of someone else who can.


Thank you for taking the time to read this,

Sarah


Do you have some digestive problems? CLICK HERE TO BOOK AN APPOINTMENT


(1) https://www.nature.com/articles/nrgastro.2014.66?foxtrotcallback=true

(2) https://4cau4jsaler1zglkq3wnmje1-wpengine.netdna-ssl.com/wp-content/uploads/2016/08/Probiotics_0119.png

(3) http://www.worldgastroenterology.org/guidelines/global-guidelines/probiotics-and-prebiotics/probiotics-and-prebiotics-english



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