The familiar phrase “you are what you eat” should really be changed to “you are what you are able to digest”. So you may be eating right, but is it being put to good use? Over the last 20+ years, our knowledge of the crucial role that gut flora play in our everyday lives has multiplied almost as fast as bacteria. Nowadays we are being bombarded with so much information about probiotics and the microbiome of the gut, it is almost overwhelming. But fear not, I will help you digest (pun intended) the current data so that you can make an informed decision about what is best for you.
All probiotics are NOT created equal. Just as we all have different fingerprints, we all have different gut flora. So a one-size-fits-all approach to probiotics just doesn’t work. Your doctor may say, “just eat some yogurt and that’s all you need”. This may or may not serve you well. The strains of bacteria in most commercial yogurts have not been proven to be beneficial. Just one capsule of a good probiotic can contain the same amount of bacteria in 37 cups of yogurt.
Let’s backtrack here for a bit. Our lower gastrointestinal tract or “gut” for short, is a highly sophisticated apparatus that is about 25 feet long (small intestines plus large intestines) responsible for converting the food we eat into absorbable essential nutrients while eliminating waste products. While we may have learned about the structure and function of the digestive system in high school Biology class, little was known or taught about the 100-150 trillion organisms than reside with in it. Yes, you read that correctly, there are 10 times more bacteria living inside our gut than there are cells in our body! Each individual has a different concoction of the thousands of known species and over 70,000 strains identified thus far. So really, we are just beings that harbor 5-6 pounds of bacteria in a nice warm, cushy environment. They are just doing us a favor by helping us digest our food and producing key vitamins to sustain life. They support 70% of our immune system, since they have a vested interest in us staying alive. According to the brilliant scientists that conducted the Human Microbiome Project, we are the human “supraorganism” and the microbiome (referring to our bacterial inhabitants) is a virtual organ within an organ. We cannot live without them and vice versa.
So you can decide if you want to be friends or enemies with your gut guests. Their composition and function (or dysfunction) is up to you: what you choose to eat, your lifestyle, your stress and your previous medical history. It all started at birth. The species and strains of your gut bacteria depend upon so many factors: vaginal delivery vs. C-section, breastfed vs. formula fed, your mother’s flora and her overall health, early exposure to antibiotics or not, previous illnesses, travel, the list goes on and on. There are a myriad of factors that can lead to an unhealthy gut and consequently many diseases including indigestion, irritable bowel syndrome, inflammatory bowel disease, diverticulitis, GI cancer, other chronic inflammation, and even type II diabetes and obesity.
So, say you’d like to be better friends with your gut bacteria, what should you do? The definition of a probiotic according to the World Health Organization is something that contains “live micro-organisms which, when administered in adequate amounts, confer a health benefit on the host”. As I stated earlier, not all probiotics are created equal and each individual may benefit from different species and strains. First of all, a capsule of dead bacteria is of no use; you are just wasting your money. The probiotic you choose to purchase must survive the manufacturing and shipping process. Heat kills the bacteria so any product that is not properly refrigerated is questionable. Once ingested, they must be able to survive the acidity of the stomach and be resistant to the effects of digestive enzymes and bile so they can reach their final destination, your intestines. There is enough research out there now to prove that the benefits of probiotics are strain-specific with strains derived from humans being the most desirable. Right now, the FDA does not require that the specific strain be printed out on the label. There is also no guarantee that the number of colony forming units (CFU’s) specified on the product label are 100% viable by the date of expiration. This is why it is crucial for you to do your homework and purchase a properly stored and shipped product from a reliable company. This is where a knowledgeable healthcare professional can help guide you.
The science of probiotics is becoming so sophisticated that the concept of “precision probiotics” is now emerging. New research supports the idea that once an individual’s “core gut microbiome” becomes disrupted, disease is born. Some labs are even conducting DNA profiles of stool. You may be thinking that this is starting to sound complicated and expensive; well, it doesn’t have to be. For most healthy people, just getting on the right track is easy. Two of the most beneficial species to the human gut are Lactobacillus Acidophilus NCFM and Bifidobacterium lactis B107. These strains along with a few others should comprise the “core” of any good probiotic product you purchase. Diversity in strains that are scientifically proven to promote gut health is becoming more clinically important. Additional strains may be beneficial to target an individual’s needs such as irritable bowel syndrome, inflammatory bowel disease, gluten sensitivity/“leaky gut”, frequent urinary tract infections, traveler’s diarrhea, etc. The types and amounts of beneficial bacteria present in healthy babies, children, and adults differ greatly; logically, there are different products available for each. There are also probiotics tailored to help you fight off the common cold, experience less diarrhea when on antibiotics, and recolonize and restore the good GI tract flora after an insult such as a course of antibiotics or the stomach flu.