Probiotics have become one of those nutrition and health buzzwords in recent years. This isn’t surprising seeing as the research into this area is growing rapidly with many exciting discoveries being made about their role in our health. It seems like everyone is jumping on the probiotic bandwagon, from restaurants offering kombucha on their menu to skincare brands using probiotics in their formulations, as well as a wide range of probiotic formulations being available on the market.
Are they actually worth the hype though?
First Up - What Are Probiotics?
Probiotics are live microorganisms, including bacteria and yeast which may pass on health benefits to the consumer. Probiotics are very varied - There are literally hundreds of different probiotics which are further classified by their strain and species.
How Do They Differ From Prebiotics?
It can be pretty easy to mix up probiotics and prebiotics! Prebiotics are indigestible fibres which pass through our gut, acting as food for our gut bacteria. Prebiotics are found in foods such as onions, leeks, garlic, oats and wheat bran. Prebiotic supplements such as fructooligosaccharides and inulin are now also available and are sometimes added into probiotic supplements.
What Benefits Are There To Probiotic Supplementation?
Probiotics and gut health are an emerging area of nutrition research. The research into the beneficial effect of probiotics is promising, but it’s one of those areas that we still in many ways know so little about.
However, there is strong evidence supporting the use of probiotics in certain situations and for certain populations. We believe that supplement recommendations should never be blanket recommendations, and that they should always be individualised. There are certain groups of people who may benefit in particular from probiotic supplements.
1. Prevention of Antibiotic-Associated Diarrhoea
There is good quality evidence to support the use of antibiotics to prevent antibiotic-associated diarrhoea as well as clostridium difficile (C.Diff) infections. This benefit has been seen in both adults and children. The probiotic should be taken for the course of the antibiotics, but it’s best to take them a few hours apart to make sure the probiotic isn’t destroyed by the antibiotic. The most researched strains for this purpose are saccharomyces boulardii and lactobacillus rhamnosus GG.
2. Prevention of Traveller’s Diarrhoea
People travelling to foreign countries might benefit from probiotic supplementation. Saccharomyces boulardii or a mixture of lactobacillus acidophilus and bifidobacterium bifidum have also been seen to reduce the risk of traveller’s diarrhoea. These are usually taken for 2-7 days before travelling, then every day while you are travelling.
3. Management of Irritable Bowel Disease
Irritable Bowel Disease (IBS) affects at least 10-20% of people worldwide. Many people with IBS report symptoms such as bloating, excessive gas, reflux, urgency to go to the bathroom, constipation and diarrhoea. Stomach pain is another common symptom of IBS, being reported in over 80% of sufferers. A probiotic supplement containing strains from the lactobacillus, bifidobacterium and saccharomyces genus might be helpful in managing symptoms. A supplement should be trialled for four weeks to see if any benefit is observed.
4. Management of Inflammatory Bowel Disease
Inflammatory Bowel Disease incudes Crohn’s Disease and Ulcerative Colitis. These conditions are characterised by inflammation and disturbance of the gut microbiome. A probiotic supplement containing strains such as saccharomyces boulardii and VSL#3 may help reduce the number of relapses. There is stronger evidence for their use in ulcerative colitis than there is in Crohn’s disease.
5. Treatment of Vaginal Thrush
Probiotics used as an additional therapy to antifungal drugs has been shown to enhance their effect and improve the rate of clinical cure. This benefit was also observed with possible reduced rates of relapse within one month. Different trials used different strains of probiotics such as lactobacillus acidophilus, saccharomyces boulardii, streptococcus thermophiles and lactobacillus casei.
6. Mental Health
Probiotics may also play a role into mental health, although this is an area in which more research is needed. It has been suggested that probiotics play a role in the bidirectional communication between the gut and brain through the gut-brain axis. It’s thought that there are specific strains which may play a role in the reduction of depression, such as bifidobacterium infantis and lactobacillus rhamnosus.
Is a supplement key to good gut health?
A supplement will rarely if ever fix everything. Gut health is a varied and complex area. As seen above, there are benefits to supplementation, but it’s not the only important factor for optimising gut health. There are also so many other factors which influence the balance of beneficial to harmful bacteria in our gut. These include diet, exercise, early life exposures such as method of birth (vaginal versus caesarean section delivery) and method of feeding (breast versus bottle feeding), age, medications, stress and illness can all affect our gut microbiome.
In fact, The American Gut Project, a study that looked at the diet and lifestyle factors that affect the gut microbiome, found that people who ate 30+ different plant foods a week had a far more diverse microbiome than those who ate 10 or less plant foods. This means that one of the best things you can for for your gut health is to include a wide range of different fruits, vegetables, legumes, nuts, seeds and grains in your diet.
How Can I Include Probiotics In My Diet?
There are many benefits to including probiotic rich foods in your diet. These good bacteria may help fight off other bacteria, fungi and viruses that can cause infection. A lack of good bacteria has been shown to be a key reason that individuals pick up infections. This isn’t surprising, seeing as over 70% of your immune system is found in your gut.
Probiotic containing foods include live yoghurt, kefir, raw sauerkraut, raw kimchi, kombucha, tempeh and miso. While the evidence is still unclear as to whether probiotics in some sources like kombucha survive stomach acid and reach the digestive tract alive, it’s still worth including them in your diet for increased nutrient diversity. The evidence for bacteria in live yoghurt reaching the digestive tract is more promising. There can be up to 1 billion bacteria per spoon of live yoghurt! However, it’s worth noting that for probiotics to actually be present in yoghurts, the product needs to specify which strain of live probiotic that it contains. This can be found in the ingredients list.
You can also choose to take a probiotic supplement. It’s worth noting that different strains are researched for different things, so make sure to choose one with researched strains.
It’s also really important to include prebiotic rich foods in your diet to help feed your gut bacteria. Choose foods like garlic, onions, chicory, asparagus, leeks and artichokes – Yes, it always comes back to eating your veggies!