Updated: May 26, 2020
Gut health and probiotics are a topic that I often get asked about. It’s a complicated subject as we are currently saturated with different information regarding nutrition, wellness and our health.
Gut health and probiotics are a topic that I often get asked about. It’s a complicated subject as we are currently saturated with different information regarding nutrition, wellness and our health. With new research and products constantly being put in our line of sight by marketers, influencers, even our trusted healthcare practitioners, it can be overwhelming to find the option or the answer you trust is best for your individual needs. It can even be overwhelming for me as a trusted registered dietitian sifting through the vast research current available on the topic of probiotics!
This blog post contains evidence-based facts to give you insight in the world of probiotics. I’ll help you understand what to look for when choosing the right probiotic, to determine whether or not you even need to be taking probiotics, and to learn what potential benefits probiotics may offer you.
Always consult with your doctor or dietitian before taking any supplements. A gastroenterologist and GI dietitian can help you determine whether or not probiotics are necessary in your routine if you are suffering from gastrointestinal symptoms.
Should I be taking a probiotic?
Although research shows that the consumption of probiotics is not necessarily harmful, it may not always be necessary.
You may want to take a probiotic if:
You have no GI symptom and are taking antibiotics for something else. And if you're a woman
You have chronic yeast infections
After finishing antibiotics. But you can eat yogurt while taking antibiotics.
If you have a compromised immune system (80% of immune cells live in gut)
Do NOT take a probiotic if you have GI symptoms but unsure of cause (in middle of screened for diagnosis) you do not want to alter results/cause symptoms
What exactly are probiotics?
Probiotics are live bacteria that can provide many health benefits such as restoring the balance of bacteria in the body by keeping the harmful microbes in check. When the microbiome becomes unbalanced it can cause digestive issues. Probiotics may contain some antimicrobial compounds, stimulate an immune response such as the secretion of immunoglobulin-A (IgA), and compete with pathogens for nutrients by colonizing in the gut to help negate the growth of the pathogenic bacteria₂. Not all probiotics contain these mechanisms of action, but if you are looking for highly efficient probiotic, you’ll want them to have these functions.
What are essential characteristics to look for in a probiotic?
You want the probiotic supplement that you choose to survive in your upper gastrointestinal tract (GIT) all the way into your colon. In order for a probiotic to survive through the mouth, stomach, and small intestines, you want the strain to have gastric acid and bile salt stability. Some probiotics might say they contain 15 billion CFU (which stands for “colony-forming units”) on the label, but if the majority of those units do not last past the stomach, those large numbers aren’t doing much to benefit your health. In order to improve survival from the acidity in the stomach, some manufacturers use enteric coatings on their capsules, which can help with strains that demonstrate low tolerance to gastric acid₁. *Note: consult your doctor before taking a probiotic (or any medication or supplement) with enteric coatings if you have short bowel syndrome.* You want a probiotic to have scientific substantiation - that is, clinical trials and scientific research that validate its health effects. If the company did not take the time to perform research on their product to ensure its efficacy and are not willing to share that research with the consumer, it is unlikely their probiotic is anything but a complete waste of your money. Some companies will include the species of probiotics their product contains, but if you’re looking for a probiotic to help treat a certain condition, you should look for the strain in the supplement as well, since different probiotic strains will have different actions. E.g. through research, Lactobacillus rhamnosus GG was found to prevent viral gastroenteritis₃. While Lactobacillus rhamnosus GR-1 has shown to decrease the incidence of urinary tract infection (UTI) in women who suffer from recurrent UTIs₃. Different strains of probiotics have varying effectiveness in the body.
What about dosing of a probiotic?
Clinical trials have shown between 107 to 1011 CFUs per day is a strong dose to be listed on a probiotic; however, the number of CFUs in your probiotic really depends on the strength of the strains included in the probiotic and their ability to survive through the upper GIT₂.
8 Foods with probiotics
Yogurt is one of the best sources of probiotics. It is made from milk that has been fermented by friendly bacteria, mainly lactic acid bacteria and bifidobacterial. However, keep in mind that not all yogurt contains live probiotics. In some cases, the live bacteria have been killed during processing. For this reason, make sure to choose yogurt with active or live cultures. Also, make sure to always read the label on yogurt before you buy it. Even if it is labeled low-fat or fat-free, it may still be loaded with high amounts of added sugars.
Kefir is a fermented probiotic milk drink. It is made by adding kefir grains to cow's or goat's milk. It is cultures of lactic acid bacteria and yeast that look a bit like cauliflower and contains several major strains of friendly bacteria and yeast, making it a diverse and potent probiotic.
Sauerkraut is finely shredded cabbage that has been fermented by lactic acid bacteria. It is one of the oldest traditional foods and is popular in many countries, especially in Europe.
Tempeh is a fermented soybean product. It forms a firm patty whose flavor is described as nutty, earthy or similar to a mushroom. It is often used as a meat substitute in vegan / vegetarian dishes.
Kimchi is a fermented, spicy Korean side dish. Cabbage is usually the main ingredient, but it can also be made from other vegetables. Kimchi is flavored with a mix of seasonings, such as red chili pepper flakes, garlic, ginger, scallion and salt. Kimchi contains the lactic acid bacteria Lactobacillus kimchii, as well as other lactic acid bacteria that may benefit digestive health.
Miso is a Japanese seasoning. It is traditionally made by fermenting soybeans with salt and a type of fungus called koji. Miso can also be made by mixing soybeans with other ingredients, such as barley, rice and rye.
Kombucha is a fermented black or green tea drink. This popular tea is fermented by a friendly colony of bacteria and yeast.
Pickles are cucumbers that have been pickled in a solution of salt and water. They are left to ferment for some time, using their own naturally present lactic acid bacteria. This process makes them sour. Keep in mind that pickles also tend to be high in sodium. It is important to note that pickles made with vinegar do not contain live probiotics.