By Andrew Larson, MD, FACS, FASMBS
Here at Clean Cuisine and with my own patient population I have seen an increasing interest in prebiotics and probiotics both as standalone supplements and to be consumed in functional foods such as kefir, miso, tempeh, sauerkraut and garlic.
But, do prebiotics and probiotics live up to the hype? Yes is the short answer. In fact, I recently came across an academic review article delineating several benefits for prebiotics and probiotics in children’s health in a highly respected medical journal1 and I am more convinced than ever that prebiotics and probiotics are an exciting area of preventive medicine for adults and kids alike.
What are Probiotics? What do Probiotics Do?
Probiotics are “friendly” bacteria that keep you healthy. Probiotics are living good bacteria that stay alive in your intestine after being consumed. These microscopic organisms work hard to alter the overall intestinal environment to a favorable one by crowding out bad bacteria such as viruses that might otherwise dominate and harm health. Even though they are bacteria, probiotics actually help protect your body from infection. Probiotics can stimulate and work with your immune system to improve your health and prevent, or even treat, certain diseases.
Probiotics help with digestion and nutrient absorption. Probiotics enable essential health-promoting nutrients to be absorbed that otherwise would not have been able to cross the intestinal wall into the circulatory system. In fact, the depletion of “friendly” probiotics can lead to nutrient depletion and consequently inferior health; if your body can’t utilize the nutrient-dense foods you eat it’s just as bad as not consuming them in the first place. The regular consumption of probiotics will help your body to properly digest, process and utilize the food you eat. Probiotic consumption also increases the bioavailability of minerals, especially calcium.
Probiotics help detoxify and cleanse your body. Probiotics have been shown to support liver function and detoxification. These “friendly” bacteria filter toxins in the gut before they get into the bloodstream. The presence of probiotics speeds up the transfer time of toxic waste in your colon, thus preventing toxins from staying in your body and being reabsorbed in your bloodstream.
The Science Behind Probiotics & How a Probiotic Rx Might Help You
The strongest evidence for probiotic benefits exists for the prevention and treatment of diarrheal illnesses. For example, one comprehensive review study2 reveals that the probiotic S. boulardii can reduce antibiotic associated diarrhea by more than fifty percent. To prevent antibiotic associated diarrhea probiotics should be taken as soon as one starts taking the antibiotic for best results; nevertheless, even after diarrhea has already set in probiotics have been shown to cure it more quickly.
Probiotics are also effective at treating infectious diarrhea caused by viruses or bacteria that is unrelated to antibiotics use. Probiotics are effective at preventing and treating traveler’s diarrhea and problems caused by the bacteria h. pylori, a major cause of gastritis and stomach ulcers. Probiotics are also effective at maintaining remission of disease in persons with ulcerative colitis. Other gastrointestinal conditions thought to be helped include c. difficile colitis, a deadly disease caused by antibiotic use, Crohn’s disease, and irritable bowel syndrome.
Probiotics seem to have benefit as regards to dental conditions, including gingivitis and the development of dental disease.
The consumption of probiotics is even linked to an improvement in halitosis (bad breath.)
Probiotics have proven benefits for infants and young children. There is good research to show probiotics cut dramatically, by about 50%, the risk of an infant or young child developing eczema, allergic rhinitis (nasal allergies), or asthma. Probiotics have also been proven to treat, and often cure, allergic dermatitis (skin disease) in children.
Probiotics can help prevent infections. In adults tantalizing research indicates probiotics can prevent infections of the ears, nose, and throat, and the urinary and respiratory systems.
There may be benefits in preventing cancers of the colon (3) and bladder and even helping with the management of diabetes and rheumatoid arthritis.
Potentially Promising Weight Loss Benefits of Probiotics
As a bariatric (weight loss) surgeon I am always intrigued with new research that might help my patients lose weight. Some preliminary studies at Washington University (4, 5) in St. Louis have revealed certain “unfriendly” gut bacteria are exceptionally adapt at extracting calories from food, thereby doubling fat accumulation. Lead investigator Dr. Jeffrey Gordon theorized that “…differences in our gut microbial ecology may determine how many calories we are able to extract and absorb from our diet and deposit in our fat cells.”
In other words, depending upon intestinal bacteria levels, you might not necessarily extract the same number of calories after eating your bowl of pasta as your friend does after eating hers, which may help explain why some people seem to be able to eat more than others without gaining weight. As of now I cannot say there is definite proof that just by adding probiotics you lose weight, but it is theoretically possible that adding more “friendly” bacteria just may help you shed pounds. And there is no downside to doing so.
What are Prebiotics?
Prebiotics are non-digestible carbohydrates such as “fructo-oligosaccharides,” “inulin,” “galacto-oligosaccharides” that many probiotic bacteria consume for food. If you eat more prebiotics you will likely have more good “friendly” bacteria in your intestine.
What are the Proven Benefits of Prebiotics?
Non-digestible carbohydrate prebiotics have been studied extensively and have been shown to reduce asthma and eczema in children and, just like probiotics, they are helpful in reducing problems with diarrhea in persons of all ages. According to the Mayo Clinic prebiotics found in a wide variety of fruits, unrefined whole grains, and vegetables can also help normalize bowel function and support a healthy immune system in general. Prebiotics have been shown to hold significant promise for reducing the risk of developing colorectal cancer(6), a disease in my surgical practice that I operate for on a weekly basis.
The Bottom Line on Prebiotics and Probiotics
Unfortunately, numerous factors can disrupt the balance between “good” and “bad” bacteria, and therefore interfere with your body’s natural ability to heal and detoxify itself. Helping to restore intestinal integrity, probiotics work round the clock to balance the “good” and “bad” bacteria within the GI tract, which can easily be upset by chlorinated water, poor elimination of waste, stress, oral contraceptives, a diet rich in refined foods and poor digestion. Antibiotics can also wreak havoc on the gut flora. I always tell my patients and family members that they should take antibiotics as infrequently as possible and if they do need to take them then it is important to simultaneously supplement with a high quality probiotic.
Choosing a High Quality Probiotic Supplement
In addition to eating foods containing prebiotics and probiotics, I encourage my patients to supplement with probiotics on a regular basis as a good way to maintain the normal gut ecology and reduce toxins produced by imbalances in gut bacteria.
When looking for a probiotic supplement it is important to realize not all probiotics are equal from a quality or bioavailability standpoint (meaning your body doesn’t always absorb the probiotics that the label claims it has.) Many mass market probiotic supplements contain a limited number of good bacteria and are manufactured in such a way that the good bacteria cannot necessarily survive –such as being exposed to heat and light–or contain fillers and added sugars that interfere with their bioavailability. It is important not only to choose a supplement that is high quality, but also one that has a broad spectrum of strains.
Our own Clean Cuisine probiotics brand containing a broad spectrum of strains of highly bioavailable-friendly bacteria that have been clinically documented for their effectiveness (such as Lactobacillus and Bifidobacterium). Providing a dairy free, high-potency 25 billion hypoallergenic blend of 12 certified probiotic species, Clean Cuisine’s Probiotics offer broad coverage to support a healthy balance of microflora across the entire gastrointestinal tract.
In addition to the Clean Cuisine brand I also tell my patients about Dr. Ohhira’s premium broad-spectrum probiotic supplement brand containing 12 strains of friendly bacteria, including E. faecalis TH. Dr. Ohhira’s award-winning brand was developed by Japanese microbiologist Dr. Iichiroh Ohhira, PhD, and, to my knowledge, is the only manufacturer that relies on a natural fermentation process using ancient Japanese traditions. I am sure there are other good probiotic supplements on the market but Dr. Ohhira’s is definitely a superior choice.
Probiotics and prebiotics are also available naturally in food.
Look for a complete list of healthful Clean Cuisine foods containing prebiotics and probiotics HERE.
P.S: Be sure to ask any questions you may have in the comment section below!
REFERENCES
1. Thomas, DW, Greer FR, and Committee on Nutrition; Section on Gastroenterology, Hepatology, and Nutrition “Clinical Report—Probiotics and Prebiotics in Pediatrics” Pediatrics, vol. 126, no. 6, Dec 2010
2. McFarland LV, “Systematic review and meta-analysis of Saccharomyces boulardii in adult patients” World J Gastroenterol. 2010 May 14;16(18):2202-22
3. Wollowski, I. G., et. al. “Protective Role of Probiotics and Prebiotics in Colon Cancer,” American Journal of Clinical Nutrition 73, no. 2 (2001): 451S-5S.
4. Turnbaugh PJ, et al. “An obesity-associated gut microbiome with increased capacity for energy harvest.” Nature, Dec. 21, 2006.
5. Ley RE, Turnbaugh PJ, Klein S, Gordon JI. “Human gut microbes associated with obesity.” Nature, Dec. 21, 2006.
6. Geier MS, et. al. “Probiotics, Prebiotics and Synbiotics: a role in chemoprevention for colorectal cancer?” Cancer Biol Ther. 2006 Oct;5(10):1265-9
Thanks Andy. This is very informative. I am going to forward it on to my daughter! Pam
oh good! glad you liked it Pam. I’ll let Andy know. We were on vacation in CA (amazing trip!) back to work and reality now though 😉
I’ve tried getting an answer to this question before, but so far no luck. I prefer to get my probiotics through foods. Often, I see articles about probiotics than mention for instance, sauerkraut. However, they fail to mention that the only sauerkraut that is beneficial is one that is naturally fermented, WITHOUT heat. I believe that heat of some amount and duration will destroy the beneficial bacteria. I also see recipes for miso and yogurt that involve cooking. (beyond the brief stir into a hot bowl of broth that a true miso soup would involve) Can you confirm that the beneficial bacteria are only viable and beneficial in their raw state? Or, am I mistaken? People need to understand this.
Hi Nancy, here is a link to another article, which answers all of your (excellent) questions in depth: http://cleancuisine.com/foods-prebiotics-and-probiotics/
Dr. Andy,
Clean Cuisine shared your article timely. My daughter has been having problems absorbing iron and has consistently low ferritin and huge hair loss.
I would like her to try pre and pro biotics since she has had gut problems since infancy and hpylori as a young girl, she is now 18. Do you recommend pre and pro biotics daily? If so what doses? Also, would the doses be the same for someone approaching their 50’s such as myself?
I highly recommend she try probiotics. Our own product contains 25 billion plus colony forming units (more is typically better) from 12 strains of bacteria (more is typically better). Whole Foods or a health food store will likely offer a few brands that meet these criteria. They should be taken daily. Though the probiotics last longer refrigerated they will tolerate a reasonable amount of time (few days) at room temperature. Read the labeling to know how many pills are needed for one dose (ours is one pill). Prebiotics can be obtained from food (there is a link in our post to an article discussing prebiotic foods) or you can take a “fructooligosaccharide” supplement daily, again read the label for dose. Inulin is another easy to find prebiotic product that can be supplemented with. I don’t see any reason to change the dose based on one’s age as these are natural substances with no “drug” effects to worry about.
Where can i purchase your probiotics?
There are links to our probiotics and am/pm clean cuisine supplements “sell and info page” throughout our site but if you want the direct link it is “www.cleancuisinesupplements.com” The probiotics are $39.95 for a 60 day supply. Thanks for your interest
Dr. Larson,
That was a great article and very informative. You have my records and know the ordeals I have suffered. I have practiced the things you and Ivy discuss and see a huge difference in the way I feel. Living the total clean life is challenging, but like the reply above, I too want to get probiotics through food.
My cheat days have become further and further apart, Thanks to you and Ivy’s posts and supportive friends.
I’m looking for a pro/prebiotic containing Saccharomyces boulardii. On this page it lists your product contains bacteria “(such as Lactobacillus, Bifdobacterium and Saccharomyces” but I do not see it listed on the supplement facts
thanks.
Sorry for the confusion. Saccharomyces sp. are proven to have benefit but they are not in our name brand product or the dr ohhira product. Garden of Life makes a product called Primal Defense Ultra Ultimate Probiotic Formula that does…we have now edited the post to avoid confusion….thank you
I’m looking for a product containing S. boulardii. On this page you state your product contains “such as Lactobacillus, Bifdobacterium and Saccharomyces” but it is not listed on the Supplement Facts Label. Thanks for info.
What brand(s) do you recommend for children? i.e. in a chewable form. I have been giving my children Pedia Lax Probiotic Yums, but would like your opinion on whether this is a good option or if there is a better option. Thank you!
Hi Tricia, I just looked up Pedia Lax and looks like it only contains one strain, which is not optimal. I think Garden of Life RAW Probiotics for Kids is a good one and so are the packs Dr. Mercola sells (you can learn more about his products here: http://probiotics.mercola.com/probiotics-powder.html ) —both contain multiple strands and both are high quality. Hope this helps?
Thank you Ivy! I will look for the Garden of Life brand at PCC. While we’re on the topic of supplements for kids, what do you recommend for a multivitamin? My kids currently take Solaray Children’s Chewable Vitamins & Minerals, which were recommended to me at the health supplement store. Would you say that a multivitamin, probiotic and fruit/veggie supplement (Fruit Plus+ Chewables) is enough for kids?
Thanks!
Tricia
Hi Tricia! Oh how funny, I was just answering comments and recommended Garden of Life for a different article and just now realizing you are the same Tricia 😉 Anyway, as for the kids, yes, I think a good multi, probiotic and phytonutrient booster are very important. The only additional thing I would suggest is a pharmaceutical grade fish oil with both EPA/ DHA—this is really important for SO many reasons. Nordic Naturals is one of my favorite brands and it is distributed nationwide. Oh! And I not sure how old your kids are, but I have recently been giving my son (who is now 13 years old) Mega Foods “Alpha Teen” as a multi-vitamin—I just recently discovered this brand and it really is a very good supplement. Hope this helps!?
Is it necessary to switch probiotic brands occasionally? I have been taking your brand for over 2 years and been doing great with my gut, but for some reason it has been giving me trouble lately–with pain and constipation.
That’s a GREAT question Olivia. And yes, I would definitely recommend rotating around a bit. We actually just recently learned the importance of this in the last few months. Dr. Ohhira makes a great one HERE AND this one by Garden of Life is also excellent. Please let me know if you try one of the others and keep me posted on how things go. Hope this helps?
To Ivy and Andy,
On the page with your “50 Clean Eating Tips”, I noticed a couple of mistakes.
That page does not have its own comment section, so I thought I’d mention the corrections here instead.
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Number 46 — “One of our favorite all-purpose wheat-free flours that we have found we can replace with any recipe that calls for wheat is sprouted spelt flour”
Spelt flour is not a “wheat-free flour” — spelt is definitely a type of wheat.
[From its Wikipedia entry: “Spelt…is a species of wheat.”]
Therefore, for those people who *must* avoid wheat or gluten, spelt is not safe to eat. (Not even the sprouted form.)
The people who already know that they must not eat wheat or gluten for medical reasons will probably already know that spelt is a type of wheat,
but their well-meaning friends, neighbors, and co-workers may not know that, and if such acquaintances see on an authoritative internet resource like this one an announcement that spelt is “wheat-free”, they might put spelt in food that they serve to a person who must totally avoid wheat/gluten and promise them that it’s “wheat-free” when it is not, which could lead to severe reactions.
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Number 20 — “Plenty (Chronicle Books) by Yotam Ottolengh is a great one to start with!”
Just a small thing – there is an “i” at the end of his last name.
Hi Reena,
Thank you for your comment. Yes, you are absolutely right that many people might not realize that spelt is not gluten free. However, spelt is an ancient form of wheat and doesn’t have as much gluten as modern wheat. Many people, even those who are gluten sensitive, are actually able to tolerate spelt even if they can’t tolerate wheat. Modern wheat has been progressively hybridized over several generations to improve yield, to increase gluten (which improves bread quality) and for various other reasons. After WWII, as part of the Green Revolution, scientists made some significant changes to heritage wheat that resulted in increased yields and higher gluten content. I believe these changes, along with the fact that a lot of modern wheat has glyphosate residue is one of the reasons so many people have wheat sensitivity today (you can read more about this in my blog post here: http://cleancuisine.com/biodynamic-farming/ ) Spelt doesn’t have the issues associated with modern wheat. Having said that, if someone has celiac disease then they absolutely should not have spelt.
And thank you for the correction to tip # 20 =) !!
Is there any specific time to take these probiotics for best results?
Hi Akki,
That’s a GREAT question! I actually didn’t know the answer but I just looked it up and found a
a 2011 study showed that probiotics taken within 30 minutes of a meal survived in significantly higher numbers than probiotics given more than 30 minutes after a meal. The study also showed that more bacteria survived when taken with food that contained a little fat, than when they were taken with water or apple juice. So I would say taking them with a meal (it doesn’t matter whether it is breakfast, lunch or dinner though) would be your best bet! Hope this helps?
That’s good to know that probiotics will make there be more friendly bacteria in your intestine. My son is rather sickly and is always having stomach problems. It seems like getting some sort of children’s probiotic for him would be a really good idea.
Amanda, yes! I would definitely get him started on a broad strain of probiotics (even if it an adult version split in half—it can be hard to find a good kid brand)