Not All Probiotics are Created Equal: How Much is Enough and What About Prebiotics?
"Often, I'm asked, 'How do you recommend people eat?' And I say, 'It's really simple. You can ask yourself a question, 'Did God make this or did man make this?' Did God make a Twinkie? No. Did God make an avocado? Yes." -- Dr. Mark Hyman
(Cleveland, OH) – Medical evidence shows the bacteria in our gut, that is, in our intestines, affects all aspects of our health. The key is trying to stop the things that kill our good bacteria such as antibiotic overuse, sugar, and junk food, then putting the good bacteria in our gut by eating probiotic foods and taking probiotic supplements, and finally, feeding the bacteria their favorite foods in the form of fiber.
The mixture of good and bad bacteria in our intestines is called the gut microbiome. Virginia Commonwealth University researcher Dr. Jasmohan Bajaj says building a better gut involves eating a diet rich in probiotics. These are foods and drinks that contain living, healthy bacteria.
"The things that can help healthy gut microbes are diets that have fermented products," he said, "And by fermented products, I do not mean beer."
Fermented foods are found in the refrigerated areas of the grocery store. For example, Kim-Chi, which is fermented cabbage, also Kombucha, fermented tea, can be found in the produce section. Kefir and yogurt, both high in probiotics, can be found in the dairy section.
Dr. Bajaj recommends plain yogurt. "When we talk about yogurt, you have to be very careful, when you look at the nutritional information, that you do not take yogurt that is so high in sugar that it actually negates the effect of the beneficial microbes in it," he said.
In addition to food, probiotic supplements can also help build levels of good bacteria. According to Johns Hopkins gastroenterologist Dr. Gerard Mullin, author of the book The Gut Balance Revolution, you must choose carefully because all supplements aren't always the real deal.
"If I'm in a store I'd go more towards where there's a refrigerator," he said, "For some people, 10 billion is fine, for others, 30 billion is the sweet spot. Yet if some people are really sick and they need it as a therapeutic rescue, like people with ulcerative colitis who are quite ill," he continued, "Those who took a trillion or more a day of a very highly purified brand called VSL-3, they actually were able to induce remission when they failed heavy doses of medications."
Feed Your Good Bugs
Cleveland Clinic researcher Dr. Gail Cresci said in addition to placing good bacteria in our gut through probiotic foods and supplements, the next step is to make sure they grow.
"I like to think of the gut microbiome," she explained, "You have trillions of pets living inside your intestinal tract. And just like you would feed your cat or your dog, you want to give them good food. You also need to think, when you're eating, you're not just fueling yourself. You're also fueling those little pets living inside you. So you need to feed them what they want to be fed and if you do, then they'll behave properly for you."
The foods our good bacteria like to eat are called prebiotics. May Clinic microbiome expert Dr. Purna Kashyap says prebiotics consist of all types of fiber.
"You take any form of vegetable," he said, "Carrot, onions, all of these have different forms of fiber. And there are different degrees of fiber, and when you consume different vegetables, each of them will have one predominance of fiber versus the other."
He said radishes, jicama, and dandelion greens are particularly good prebiotic foods.
In addition to vegetables, whole fruit contains fiber. Dr. Kashyap says like vegetables strive for a variety of fruit. He cautions some fruit, such as bananas and pineapple, contain high amounts of sugar, while other fruits, such as berries are much lower in sugar.
He points out fruit juice contains no fiber, is therefore not considered a prebiotic and is best avoided.
However, other good sources of fiber include whole grain oatmeal (not instant), psyllium husks, flaxseed, chia seeds and beans.
The Cleveland Clinic's Dr. Mark Hyman, author of the book, Food: What the Heck Should I Eat? says our dietary choices boil down to common sense.
"Often, I'm asked, 'How do you recommend people eat?' And I say, 'It's really simple. You can ask yourself a question, 'Did God make this or did man make this?' Did God make a Twinkie? No. Did God make an avocado? Yes."
Bone broth can also boost gut health.
A Smart Start
Dr. Hyman said in addition to antibiotics and a poor diet, delivering a baby via Caesarian section provides less desirable bacteria to the newborn than a vaginal delivery.
The Mayo Clinic's Dr. Heidi Nelson agrees. She points out one of the best things we can do for our children is start them off with a wide variety of good gut bacteria.
"Really about the age of two to three is where the child's microbiome is more reflective of what you'll see as an adult," she explained, "The primary colonization of the gut microbiota occurs through the delivery process."
Dr. Mullin says the birth canal is loaded with healthy bacteria which are transferred to the baby during birth.
"A factor is whether you're born through the vaginal canal, natural childbirth, and we acquire the maternal flora," he said, "Or a C-section, which has skin microbes, which can be more harmful to us. And it's harder and slower for us to develop the microbiome when you're born by C-section."
Similarly, the time right after birth is critical for the baby's microbiome. Dr. Cresci says breast milk is better for the baby than processed, bottle milk.
"Breast milk actually has probiotics and it has prebiotics in it as well," she said, " And formula companies realize this and try to mimic breast milk as much as possible. And they may have added probiotics and prebiotics. But it's not enough. It's not like the entire composition which you get in breast milk."
A child's microbiome is not only shaped by his or her type of delivery and feeding, but also by the bacteria to which the child is exposed in its environment.
"Our body gets exposed to bacteria and our immune system develops around that and that sets your lifetime immune system up," Dr. Nelson said, "So the more exposure you have early on, the easier it is for you to get exposure to those things later in life and not have a bad reaction to them. Keeping clean is good, but there probably is such a thing as too clean. Where is that fine line? We don't know precisely right now. We all grew up playing in the dirt and it didn't hurt us and it probably kept us healthy and having a strong immune system."
Dr. Nelson points out children raised on farms have the lowest incidence of asthma, while kids raised with pets have the second lowest, and kids raised in more sterile homes have the highest incidence of asthma.
Discover the amazing role your gut health has in regulating your overall health and wellness by clicking on this link to get your free booklet, Build a Better Gut.