Probiotics: Do They Really Work?
The Fiscal Times reported that Millennials spend 32 billion dollars annually on complimentary and alternative medicine. And 10% of U.S. Millennials have used probiotics in the past thirty days. Is this investment in your health backed by science? Does the average 30-year-old need to take a daily dose of probiotics in the form of a supplement?
Probiotics: live bacteria/microbe generally regarded as safe in the form of supplements or food products; in appropriate amounts are recognized as beneficial in our gut are Lactobacillus, Bifidobacterium, and Actinobacteria; these bacteria are not native to our guts.
Born Free of Bacteria
Humans are born with a clean, bacteria-free gut. These little bugs are introduced as soon as you are born. The first exposure is at delivery (vaginal versus cesarean), followed by breast milk or baby formula, and then the first foods you were given to eat. This starts your microbiome—the bacterial environment found in your GI tract.
With high stress, especially as a baby or due to a less nutritious diet, your gastrointestinal tract’s lining becomes permeable or leaky. Think about it looking like the holes in Swiss cheese or, better yet, a sponge. Now the microbes that were meant for your gastrointestinal system leak out into your blood, liver, and places that weren’t meant to harbor such bacteria. The gram negative bacteria that spreads is what so many people refer to as the bad bacteria. Think E. coli. bacteria gone wild and causing disharmony in your body.
Poor diet, antibiotics, especially overuse of antibiotic therapy, stress—especially stress when an infant—and even being too clean/germophobic are all reasons to send your gastrointestinal tract into a tail spin. And then you feel the bloat, the gas, and, even worse, battle constipation and/or diarrhea. You go to the doctor or perhaps you read the latest article on irritable bowel syndrome (IBS). The outcome? You start taking probiotics.
Are they Necessary or Not?
Is this the panacea for a healthy bowel? Do you even know what is in your supplement? Is there research to support taking probiotics? Dr. Lisa Malter, director of the Inflammatory Bowel Disease Clinic at Bellevue Hospital, says, “It is almost never necessary to take probiotics.”
She shared that there are very few situations in which probiotics have proven beneficial. One of Dr. Malter’s greatest concerns in recommending a capsule of bacteria is the lack of regulation. Malter says, “Quality control is a big issue as no probiotics require FDA approval.” While it is hip to take probiotics in 2016, the jury is still out!
Like Malter shared, regulation is a huge problem and there is concern over exactly which strain of bacteria is best, not to mention if it is better to use one strain or multiple strains. For example, there is research that suggests some stands of Lactobacillus acidophilus are correlated with weight gain, while Lactobacillus gasseri is associated with weight loss.
The point here is that there are many unanswered questions. Despite the fact that there is a plethora of probiotic supplements on the market, Mayer of the Clinical Journal of Investigation writes that there is only preclinical evidence that these bacteria living in our gut and their metabolites affect digestion, gut linings, stress response, and behavior.
When to Take Probiotics
How do you know what to do? Malter says that if she does recommend probiotics, it would most likely be for a patient with antibiotic associated diarrhea, “c. diff” infection, or in some cases of Irritable Bowel Disease, which is her specialty.
The International Probiotic Associations states on its website that there is scientific evidence to support the benefit of probiotics with certain types of diarrhea, lactose intolerance, food and skin allergies, recurrent ear and bladder infections, and even bad breath. For more information visit the www.international probiotics.org.
Questions Needing Answers
When choosing a probiotic supplement, there are many things to consider. Will the probiotic help your microbiome (environment of bacteria in a specific area of your body)? Is the probiotic known to help your individual circumstance? It remains to be determined if both the microbiome and the individual benefit from probiotic therapy. While certain strains may be beneficial, do you definitely know which strain your body needs? And is it an undergrowth or overgrowth of bacteria that your gut is experiencing?
Many of the above questions remain unanswered but are definitely food for thought. Here are five more questions to get you thinking whether you should probiotic or not.
1. Do I get probiotics in the form of yogurt, kefir, milk, and/or kimchi?
2. Do I have one of the following:
- a. diarrhea
- b. IBS – Irritable Bowel Syndrome
- c. infection with Clostridium difficile
- d. high cholesterol
- e. depression
3. Were you born via vaginal delivery or cesarean? Non-vaginally delivered babies have less exposure to the good bacteria at birth and may be more likely to develop allergies.
4. Does this particular probiotic have evidence supporting its ability to become part of the microbiome within your GI track? In other words, will this probiotic continue to live without constant supplementation?
5. Did the supplement company follow the World Health Organization (WHO) guideline for isolation and application of probiotics?
For the handful of diagnoses and or symptoms that could benefit from probiotics, it is just as important to know which strain is associated with specific benefits.
Which strain is best for you?
To help find more reputable supplement companies, consider a visit to www.ConsumerLabs.com. This is a third-party company that tests a variety of brands for the accuracy and quality of their product. If you have a poor immune system or are critically ill, do not take probiotics. Always consult your medical doctor before taking any probiotic or supplement.
Remember, the Food and Drug Administration does not regulate supplements. While there are only a handful of situations in which probiotics have proven to really work, the microbiome meaning bacteria and the gastrointestinal tract is top priority for researchers. Stay alert for more exciting news on your belly and bacteria.
Laura Cipullo is NYC’s expert Registered Dietitian, Certified Diabetes Educator, Certified Eating Disorder Registered Dietitian, and President of the International Association of Eating Disorder Professionals New York Chapter. Laura is a three-time author, with her most recent book, the Women’s Health Body Clock Diet. This cutting-edge chrononutrition book teaches the reader to reset the twenty-four-hour body clock through six weeks of meal “structures” and using Laura’s Positive Nutrition approach based on science, mindfulness, and compassion.