An Introduction to Probiotics

Probiotic supplements are so popular at the moment. As research into gut health improves, we are getting a glimpse of just how important the little creatures that make up our microbiome really are. A happy camp in your gut can improve digestion, help protect against disease and improve immune function.

For most people, good gut health means taking a probiotic supplement. In this post I’m going to tell you a little bit about probiotics and what the first steps should be to improving your gut health.

This is a very simple look at probiotics for anyone who is generally well and healthy. If you have a specific health condition or want to know about supplements for babies and children, let me know and I’ll follow this with a part 2.

What are probiotics?

Probiotics are tiny organisms like bacteria, yeast and fungi that (in high enough doses) have health benefits. They take up residence in our digestive system and make up our microbiome. They help us digest food and even help us produce some vitamins (like B12 and K) and fatty acids and, they keep bad bacteria in check. When the balance between beneficial and bad bacteria is good, we have a healthy gut and are more likely to be at our healthiest.

We see that people with a healthy gut have less digestive issues (like bloating and gas) but also tend to have less allergies, better moods, maintain a healthy weight and are less likely to develop chronic diseases in later life. What we haven’t quite figured out yet though is if taking a tablet (or powder) is effective at creating the perfect healthy gut. Early studies are showing that probiotic supplements help to:

• lower LDL and total cholestoral,
• treat diarrhea and constipation
• help symptoms of Irritable Bowl Syndrom and Inflammatory Bowel Disease
• clear acne and improve skin conditions, and
• reduce the side effects caused by antibitoics (like diarrhoea).

There’s even some evidence to suggest that some probiotics will help babies with colic, childhood eczma and dermatitis, tonsillitis, laryngitis and even tooth decay.

Creating the perfect gut microbiome

Our gut make up is determined by genes, how we were born (cesarean or vaginal birth), our mothers gut microbiome, our diet and lifestyle, history of disease and the environment. These are a lot of variables. Taking a daily probiotic supplement could be a step in the right direction of a healthy gut microbiome. But there are other strategies we need to adopt to making sure their environment is optimal first, like improving your diet and lifestyle more generally. Otherwise it is like adding more fish without cleaning the fish tank first.

Including plenty of prebiotics in your day is a good start. These are parts of plant foods we eat that we can’t break down. The bacteria in our gut break down these plant fibres for us, keeping them fed, happy and multiplying in the process. They also discourage the growth of bad bacteria. High fibre foods, like wholegrains, fruit and vegetables good sources of prebioitics. Onion, leek, garlic, asparagus, wholegrain wheat, artichoke and bananas top the list.

Sources of probiotics

In addition to supplements we can get probiotics from foods too. Such as:

• aged cheese
• sourdough bread
• kefir
• kimchi
• kombucha
• miso
• sauerkraut, and
• yoghurt.

Make sure the fermented vegetables you buy have been lacto-fermented and not pickled in vinegar. The good stuff will be in the fridge section, not shelf-stable. 

Homemade fermented foods have higher levels of probiotics than commercial varieties.  If you prefer to buy yoghurt, make sure it doesn’t have any sugar (or artificial sweeteners) added and that it has had some bacteria strains added. Not all yoghurts tell you how much is added but 100 million CFUs is a good amount. Interestingly, we still aren’t sure how much of these bacteria strains survive the initial digestive processes. So make sure you’re enjoying the other benefits of yoghurt too, like the calcium, protein and taste!

It’s impossible to say exactly how many and what strains are in fermented foods as it varies greatly, especially if they’re home made. The longer they’re fermented, the more strains and CFUs are typically present. So get yourself used to the tang! The benefit of getting probiotics from food is that we get nutrients and fibre as well.

Taking an oral supplement may be a good idea, but we don’t actually have enough evidence to support healthy people taking them for their long term health. Consider it an insurance policy that is unlikely to do you harm. Having said that if you have IBS or IBD though, you must seek advice from your dietitian or physician before taking one. There are specific formulas that have been developed for treating conditions and different digestive complaints.

Not all probiotics are equal

Different strains of bacteria live in different parts of our digestive system and they do different things. What is is so interesting is that everyone’s ideal balance of bacteria is also different. It could be as unique as a finger print. What is the perfect balance for me, might not be as great for you.

Which probiotic supplement to chose (if you chose one at all) is very individual and depends on your needs at the time.

If you’re looking for a good all-rounder then here’s three main things to consider:

Is it a reputable brand? You probably get what you pay for with probiotic supplements. Ask your pharmacist, dietitian or a Registered nutritionist for their recommendation and only buy from a reputable practitioner that has high stock rotation. You don’t want an old bottle that has been stored incorrectly. A probiotic from the supermarket is unlikely to meet the cut.

How potent is it? 50 billion CFUs (colony forming units) is a good start. That’s how many you will get in a dose. They probably won’t all survive the storage or journey to the gut, so the more the better.

How many strains? The more strains the better. These five are the most recommended for general digestive and immune boosting benefits. They are the most likely survive journey through the acidic conditions of our stomach to where they get to work in the gut:

• Lactobacillus acidophilus
• Lactobacillus plantarum
• Bifidobacterium lactis
• Bifidobacterium longum
• Bifidobacterium bifidum

Most brands will also contain a prebiotic (usually inulin). If not, make sure you take it with a high fibre meal made with wholegrains and vegetables.

If you’re generally well and healthy, and you just want a boost then a ‘general’ probiotic may be for you. You’re unlikely to see any benefit before 2-3 months (if the benefit is detectable at all). It doesn’t matter if you choose a shelf stable tablet, a refrigerated capsule or a powder – as long as you store it appropriately and remember to take it consistently. Otherwise you really are just wasting your time and money.

I recommend that anyone who is taking antiobiotics to take a supplement to replace some of the good bacteria that went down with the bad guys. You don’t have to wait until you’ve finished the course, just wait 4 hours between the antibiotic and the probiotic supplement. A high dose with many strains for up to a week after your last antibiotic is ideal, to be followed with a lower “everyday” supplement to get you back on track.

My thoughts on probiotics and gut health

Every study concludes by saying “more research is needed”. So the real truth is, it’s too soon to know for sure. What we do know is that when your gut bacteria is in balance, your body is healthiest. Your immune system is strong, you have better sleep patterns, better mood and good memory.

So here’s what I think we should all do to improve out gut microbiome:

• Talk to your Dr and let them know this is an area of interest for you. Get it on their radar for you.
• Only take antibiotics if they are needed. Antibiotics are commonly over prescribed. If you have an infection, ask for it to be tested so you get the right antibiotic for the job. I 100% support the use of antibiotics when they’re needed.
• Work on improving their living conditions before you move them in!
  • Reduce the amount of added sugar in your diet. Read this for more information on where sugar hides in packaged foods.
  • Reduce the amount of processed and takeaway foods in your diet.
  • Look after the good guys you already have by eating a fibre rich diet that also includes a wide variety of wholegrains, fruit and vegetables.
• THEN consider introducing some good bacteria every day with yoghurt, sourdough, kefir, saurkraut, miso and probiotic supplements to be eat with prebiotics.

I’ve also updated my post How to cure a hangover with some tips on how a probiotic may help! If you’re interested in which probiotic to take for particular conditions, have a look at this roundup of the latest evidence on specific probiotic strains and their benefits (there’s even an app!).