Previously here, we discussed the importance of the microbiome in gastrointestinal (GI) health. Many patients being treated for allergic issues using sublingual immunotherapy have associated GI issues that can be helped with adjunct therapy using probiotics. With so many people affected by digestive disorders, it’s important to review how to ensure your microbiome is supported so you and your family can have lasting health.
Gastrointestinal health, or gut health, is an important factor for many health conditions. Our digestive system, which extends from the mouth to the anus, is the largest organ of the body. It contains over twenty feet of surface area which digests and absorbs the nutrients from our food and beverages, while also providing a protective barrier from foreign objects and harmful microorganisms. The microbiome, which contains the largest portion of the body’s microbes, is housed in the intestines. When these microbes are balanced, they contribute to our general health and well-being.
When our microbiata becomes imbalanced due to antibiotic use, eating a poor diet, or adverse effects from our environment, dysbiosis occurs. Dysbiosis is an imbalance of the beneficial versus unfavorable gut microbes. These disparities create an environment which is potentially more susceptible to a diseased state. Fortunately we can support gut health by using supplements or foods containing probiotics, prebiotics, or synbiotics. Today we delve into the topic of probiotics.
Probiotics are defined by the Food and Agriculture Organization of the United Nations and The World Health Organization (FAO/WHO) as, “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.” In simple terms, they are the beneficial bacteria that support gut health. For a food or product to be considered a probiotic, it must contain live microorganisms and have a documented health effect or benefit to the individual. Probiotics can found in foods, supplements, drugs, and infant formula.
How do I pick a probiotic?
Probiotic supplements are readily available to purchase at pharmacies, grocery stores, and online. When purchasing a probiotic supplement, the label should state the genus, species, and strain of each specific probiotic found in the supplement. Lactobacillus rhamnosus GG is one example. Lactobacillus is the genus, rhamnosus is the species, and GG is the strain.
The label should also specify the number of live microorganisms per serving as well as the amount of live microorganisms at the expiration or end of shelf date. Avoid products that state the amount of live microorganisms at the time of manufacture, as this will not give you a clear picture of actual dosing at time of purchase since the product will lose potency over time. Probiotics are measured in colony forming units, or CFUs. The storage guidelines, as well as the contact information of the manufacturer, should also be listed on the supplement label.
Health benefits are strain-specific. In other words, not all probiotics are created equal. Each individual probiotic strain has a different research-based level of recommended CFUs per dose, which is indicated when promoting a probiotic for use for a digestive or other health disorder.
Research on probiotics continues to evolve
Not all of the different strains sold in food or supplement form have research backing up their benefits; thus they would not be considered probiotics. Two of the most common probiotics found in supplements include lactobacillus and bifidobacteria. Bifidobacteria is found in the greatest quantity in the human gut when compared to other types of bacteria which reside in the digestive system, and is thus one of the most researched bacteria for gut health. Probiotics also include yeasts such as saccharomyces.
Some of probiotic’s researched health benefits include maintaining gastrointestinal health by supporting the digestive system. Probiotics are indicated for antibiotic-associated diarrhea, irritable bowel syndrome, ulcerative colitis, vaginal health, and constipation to name a few.
Probiotics are generally considered safe. Side effects may include mild digestive upset such as gas or bloating. If side effects occur, consider decreasing the dose. Use with caution in premature infants and immunocompromised individuals.
Probiotics in foods
Probiotics in foods can be naturally occurring or added, but not all food containing beneficial bacteria are considered a probiotic. When searching for a probiotic food, labels typically do not give you as thorough of a picture as supplements do. Probiotic species may be listed, but the specific probiotic strain may be excluded along with the amount of CFUs. Foods containing probiotics typically do not contain adequate amounts of probiotics for a specific perceived health effect. These products may not be defined as a probiotic due to their lack of defining characteristics we reviewed above.
Foods containing beneficial bacteria may still have some health benefits that support our overall general well-being. Some common foods with beneficial bacteria include yogurts, kefir and fermented foods such as kombucha tea, tempeh, kimchi and sauerkraut. Look for labels that state, “live and active cultures,” to ensure you are consuming foods containing these beneficial microbes.
To find a specific probiotic geared toward your health concern, check out the website usprobioticguide.com. You can also download an app via their website.
Probiotics are just one part of the allergy and gut health puzzle. We will continue to investigate gut health by exploring prebiotics.
- Lee YY, Liong MT, Goh KL. Probiotics and Prebiotics for Gut Health: The Essentials. WGO Handbook on Diet and The Gut. 2016;46-49.
- Pandey KR, Naik SR, Vakil BV. Probiotics, prebiotics and synbiotics-a review. J Food Sci Technol. 2015;52:7577-7587.
- California Dairy Research Foundation. Probiotic Guidelines, Then and Now. February 2017. Available at: https://cdrf.org/probiotic-guidelines-now/. Accessed May 26, 2017.
- Sanders ME. How Do We Know When Something Called “Probiotic” Is Really a Probiotic? A Guideline for Consumers and Health Care Professionals. Functional Food Reviews 2009;1:3-12.