Updated: Oct 9, 2018
Many people ask us what supplements they should add for optimal health, and prebiotics and probiotics are definitely among the most important supplements (or foods) that most of us need more of. Many people incorrectly assume that they don't need supplements, and that it's possible to meet nutrition needs solely from their diet, and that a few vegetables and some yogurt has gut health covered. The problem with this assumption is that the modern diet is severely deficient in prebiotic fiber, and the probiotic food sources most people rely on are poor therapeutic options like yogurt.
What's the Difference?
Firstly probiotics are food for your gut, and consist of therapeutic doses of live beneficial bacteria. Prebiotics are foods that cannot be digested by humans, but rather are digested by the bacteria in our gut. Think of probiotics as seeds, and prebiotics as fertiliser. Studies have found that although probiotics are brilliantly beneficial, they do not cause significant changes in the quantity or number of species of gut bacteria. Conversely prebiotics do help to increase both the amount of bacteria, and the type of bacteria.
Prebiotics increase the species of bacteria living in the gut
Probiotics help regulate the type of species in the gut
Many modern diets lack adequate fiber
Our ancestors ate an average of 100g of fiber per day, compared to a measly 10-15g per day in modern diets. Fiber is essential for a healthy gut and digestive process. In the gut, fiber helps reduce intestinal permeability (leaky gut), increases colon acidity to promote beneficial bacteria colonisation, and increases the production of Short Chain Fatty Acids (SCFA) which fuel the gut lining. High fiber intake is associated with better heart health, increased immunity, enhanced detoxification, reduced inflammation, insulin sensitivity and therefore more stable blood sugar.
Fermentable fibers provide bulk in the stool, and are not digested by us, but rather serve as food for our microbiome, the trillions of bacteria in our colon. As our gut bacteria act upon the fiber in our colon, they convert fiber into SCFA like butyrate, propionate and acetate which are primary sources of energy for the gut lining cells. Butyrate (also found in butter) is associated with many health benefits like increased gut lining integrity, and is often used in supplementation
Unfortunately one of the biggest challenges in promoting gut health, is that many people need higher fiber intake to support healthy gut flora, but struggle to tolerate it. When increasing fermentable fiber is imperative to do so slowly to reduce symptoms like bloating, constipation and gas! Prebiotic rich foods include dandelion greens, leafy green vegetables, onions, leeks, garlic, avocado, cooked and cooled potatoes, green bananas.
Types of Fiber
There are 3 main types: soluble, non-starch polysaccharides, resistant starch. It's best to eat a variety of these. Soluble fiber is best tolerated by patients with gut issues as it ends creates a gel-like substance that soothes the gut lining. Examples: Partially hydrolzed guar gum, glucomannan, acacia, modified citris pectin, psyillium
Non starch polysaccharides are primarily FODMAPs so they’re the most likely to cause gas, bloating, and GI distress. Larch arabinogalactan and Beta-glucan elso assist in regulating and stimulating the immune system. Galactooligosaccharides (GOS), tend to be best tolerated and produce the least amount of gas Examples: Larch arabinogalactan, Beta-glucan, Inulin & Oligosaccharide (FOS), GOS
Finally resistant starch is probably the most famous of the fibers in the health community. It's a type of starch that’s not digested in the small intestine or stomach, and reaches the colon intact, thus resisting digestion. It’s not broken down into glucose, so it doesn’t effect blood sugar. Resistant starch stimulates the growth of beneficial species like Bifidobacteria and Lactobacillus bacteria and helps promote insulin sensitivity and better sleep. Examples: cooked and cooled Potatoes, green banana, rice, (only RS when cooled down after cooking)
Bread and cereal companies are always advertising their high fiber content which helps us to be more 'regular', but grain fiber isn't particularly beneficial for several reasons. Grain fiber is primarily insoluble and doesn't get fermented significant by gut bacteria, and thus isn't the best choice for prebiotic fiber. According to Chris Kresser evidence suggests it’s potentially harmful because it’s abrasive quality damages intestinal wall and inflames the gut. Gluten and grains are well associated with increased inflammation, intolerance and increased intestinal permeability, not just in celiac patients. Read more here
Probiotics mean ‘For Life’ and are beneficial organisms that help improve the environment of our digestive tract. Probiotics work by transiently, only as long as you’re using them to help create a favorable environment for beneficial bacteria. We can get probiotics from supplements and the foods we eat, particularly from fermented foods, and fresh foods grown in soil with a healthy bacterial ecology. For some people, consuming fermented foods (which are rich in probiotic bacteria) will be enough to restore and maintain healthy gut flora. Those with a compromised microbiome and gut pathology will often need supplemental assistance.
Probiotics have 3 main functions:
1. Protective: probiotics help displace pathogens by occupying space in the gut
2. Structural barrier fortification: Probiotics help reinforce a healthy defense over the gut lining
3. Metabolic: Probiotics metabolise dietary carcinogens, synthesise vitamins, ferment non digestible dietary residue and epithelial mucus, ion absorption, salvage energy.
Fermented foods provide massive amounts of lactic acid bacteria like Lactobacillus, Bifidobacteria and Streptococcus. A cup of kefir contains approximately 2.35 trillion colony-forming units, most probiotic supplements only have a few billion. Key examples include Kimchi, Saurkraut, Kefir, or Kombucha. We are accustomed to getting our nutrients and bacteria from food, so fermented products are potentially more bioavailable. In addition bacteria on fermented foods may be able to better survive stomach acid, and increase the bioavailability of key vitamins and minerals.
Aside from enhancing gut health, fermented foods help to reduce lipid levels, increase antioxidant potential, lower blood pressure and reduce inflammatory molecules. The best thing about fermented foods is they are cheaper than therapeutic probiotic supplements, and an easy and tasty addition to meals.
Choosing a Good Probiotic Supplement
To choose a good probiotic firstly you need to make sure it has a high potency count of bacteria so that it's a therapeutic dose with a concentration higher than what is found in the gut. Lactobaccilus and bifidobacterium are the most common supplements sold, but potentially not the best option for many people. In some cases they strains can cause further gut distress and reinforce pathogenic bacteria in the gut. These 2 strains should be the most abundant in the human gut, and it's speculated that by taking them in therapeutic doses, it's hard to make a difference as numbers in the gut should already be higher. In our practice we have had better results supplementing with 4 different types of probiotics. Soil based organisms (SBO's), Bacillus spore probiotics, Lactobacillus Plantarum and Saccharomyces Boullardi yeast(SB.)
Soil Based Organisms
These are species of microflora found in the soil that humans have been exposed to throughout our evolution. Modern agriculture and industrial food handling have compromised soil quality, and sterilised food production to eradicate bacteria. As mentioned above, SBO’s are found in the gut in lower numbers than more commonly used probiotics like lactobacillius and bifidobacteria, and are thus easier to influence via supplementation. Soil-based organisms tend to be safer and better tolerated by most clients, and have been shown to be effective for IBS, diarrhea, constipation, and other digestive conditions like SIBO, all of which are commonly made worse by other probiotic strains. SBO's are most popular in our practice!
Saccharomyces Boulardii (SB)
This yeast is a probiotic, that eats other non-beneficial yeasts. If you take antibiotics, it’s a good idea to supplement with SB. SB won’t be killed by antibiotics, and therefore can help keep pathogenic bacteria at bay. It’s also been shown to reduce Candida, assist Crohn’s disease, SIBO, speed up recovery from heart surgery or congestive heart failure. It’s even shown to reduce ‘low-grade inflammation, and fat mass in obese and type 2 diabetic db/db mice.’
Bacillus Spore probiotics (Spores are designed to colonise)
Bacillus Spores regulate immune activation in your gut by proliferating lymphocytes in the peyers patch, a key area for monitoring bacterial species and immune function. Bacillus spores help improve immune response (both innate and adaptive), help prevent growth of pathogenic bacteria, produce high levels of arotenoids which are key antioxidants, as well as produce key enzymes that help digestion alleviate bloating, cramping and discomfort.
This is another favourite supplement of ours for repairing intestinal permeability or 'leaky gut.' It's commonly found in sauerkraut and is particularly good for reducing gut distress and symptoms like gas, bloating, constipation, and has inflammation reducing and cognitive enhancing properties.
A good brand
Choosing a good brand is essential and most chemist or supermarket brands leave a lot to be desired!
It must be able to survive the acidic environment of the stomach and capable of colonizing
The probiotic strain should be normal inhabitants of the human gut.
must be supplemented in concentrations higher than what is found in the gut.
ensure the bacteria potency is guaranteed through to the expiration date
Opt for a gluten, dairy and soy free probiotic without any additives,
possibly combined with a prebiotic to help culture the probiotic in the gut.
The more strains, the better as a diverse gut ecology is a good indicator of health.
The modern diet and lifestyle makes it challenging to have a healthy gut due to poor nutrient quality of foods, highly processed diets, stress, toxin exposure, medications and so much more. Supplementation will never combat poor nutrition and lifestyle choices, so when aiming to enhance your gut health, it's important to take an integrated approach to remove gut hurting habits and promote gut building habits.
When adding probiotics, prebiotics and fermented foods, it’s CRUCIAL to start at a very low dose and build up slowly over time! As the good bacteria combat the bad, die off reactions release toxins that can cause gas, bloating, changes in stool frequency, skin rashes, etc. Once adapted, aim for one to two tablespoons of fermented vegetables with each meal, plus a small cup of kombucha, or kefir per day. Fiber in particular will often cause gut distress when it's added, and if symptoms persist after a few days on a subtle beginning dose, then it's worth investigating things further with a functional medicine practitioner. Likewise if you have problems with gut related symptoms and tolerating the above foods or supplements, it's likely something is off with your gut health and you may need to run some functional testing. Reach out if that's the case and we'll do out best to assist you.
Our Preferred Brands
Soil Based: Prescript Assist (we stock)
Bacillus Spore: Poliquin Megabiotic
Saccharomyces Boullardii yeast: SB Poliquin
Lactobaccilus Plantarum: Jarrow Ideal Bowel Support