Pre- & Probiotics

What are they?

Fun fact alert!!! There are 10x more bacterial cells in the human body than actual human cells! There are trillions of microbes actually and they’re on the skin, in the mouth, ears, sinuses, and genitals. The bacteria that live in the gut make up what's known as the gut microbiome, and it’s estimated that between 30 and 400 trillion bacteria call the human gut their home. They are critical to health and aid the body in breaking down and digesting food, keeping inflammation in check, manufacturing vitamins, communicating with the body’s immune system, and keeping the bacterial population in balance.

Following birth, the intestinal tracts of babies are actually sterile. Through a vaginal birth, breastfeeding, infant formula consumption, exposure to things in the environment by putting feet and fingers in their mouth, the digestive tract develops it's own unique gut microbiome.

There are lots of species of bacteria in the gut although the most common belong to two different groups: Lactobacillus and Bifidobacterium. When strains of bacteria are isolated from a human host, cultured in a lab, and added to foods, beverages, or dietary supplements, they are known as probiotics.

Therefore, probiotics are the actual live bacteria that can be consumed via foods, beverages, and dietary supplements, which help to populate the gut with good bacteria, or support the gut microbiome in general.

Prebiotics on the other hand are non-digestible components of foods that actually feed, and/or stimulate the growth and activity of the good bacteria in the gut.

It’s important to note that the gut microbiome consists of both bacteria that are healthy and those that are unhealthy. Most of them are symbiotic, meaning both the body and the bacteria have a mutually beneficial relationship. In health, they will continue to coexist without side effects. However, if there is a disturbance in the balance, then dysbiosis will result and one may be more susceptible to unwanted symptoms or disease.

What do they do?

Gut bacterial dysbiosis, brought on by a poor diet, illness, prolonged use of antibiotics or other bacteria-destroying medications, has been linked to the onset of several diseases including inflammatory bowel diseases, obesity, diabetes, liver disease, chronic heart disease, cancers, HIV, and autism, to name a few. So, probiotics, prebiotics and a healthy gut microbiome have a huge role to play in both gut and overall health.

Probiotics stimulate the immune system, help break down foods and toxic foods, synthesize certain vitamins (B & K) and amino acids, and help to maintain the healthy balance of bacteria in the gut.

Complex carbohydrates, like starches and fibers, are not very easily absorbed and travel to the large intestine. It is here that the microbes will work to break these down with their digestive enzymes. This fermentation of indigestible carbohydrates causes short chain fatty acids (SCFA) to be produced, which can be used by the body as a nutrient source. In addition, SCFA may play a role in healthy muscle function and the prevention of chronic disease. It is these indigestible sources of foods that are considered prebiotics.

Where do I get them?

Each person has their own unique network of bacteria that is actually determined by genes, exposure to bacteria as infants, later environmental exposures, and diet.

The gut microbiome as a subject of research and new product development has grown exponentially, along with consumer interest in how to optimize their own gut microbiome. As such, probiotics are big business. Supplements sales of probiotics are expected to exceed $65 billion by next year (2025). The research on probiotic supplementation is conflicting and general opinion suggests rather than take supplements chronically, there may be certain times when acute probiotic supplementation is needed. One such time is in infancy. If a baby is not being breastfed, there are infant formulas that exist with nutrients which can help to populate the infant’s gut with healthy bacteria. Another time is at the other end of life, when the microbiome is not as robust as it was in the younger years. And other situations may require acute supplementation, such as reducing diarrhea following exposure to pathogens or replenishing the bacteria in the gut following a course of antibiotics. Check with your doctor or dietitian as to whether a probiotic supplement would be beneficial.

Keep in mind that probiotics are regulated as dietary supplements and therefore are not regulated by the FDA. Check with your doctor or dietitian to see when you might need to use them and ask for a recommendation on a reputable source.

Other than supplementation, probiotics can be found foods. Fermented foods contain probiotics naturally, which may support the health of the gut microbiome. These types of foods include yogurt, kefir, pickled vegetables, tempeh, kombucha, miso, kimchi, and sauerkraut.

A diet high in fiber can also help to supply the prebiotics that will feed the good bacteria in the body. These are indigestible carbohydrates that will be broken down into SCFA (short chain fatty acids). Prebiotic types of foods include garlic, onions, leeks, asparagus, dandelion greens, Jerusalem artichokes, seaweed, and just turning yellow bananas. Generally speaking, fruits, veggies, whole grains, and beans are sources of prebiotics.

How much is needed?

This is difficult to say as there is no established dietary recommendation. However, a general recommendation is to include pre- and probiotic types of foods in what is eaten daily.

One thing to be aware of is that if prebiotic types of foods are not eaten regularly, it's worth considering introducing them slowly. Adding a lot of them all at once may cause unwanted gas or bloating. Adding them slowly can build up a tolerance to these good gut foods!

How to get them?

Eat fermented foods regularly, below are some ideas:

• Sauerkraut avocado toast

• Kimchi fried rice

• Miso soup

• Plain non-fat yogurt with breakfast, or in a smoothie

• 4 oz of plain kombucha daily

• Add pickled vegetables to your sandwich

• Include onions and garlic in your cooking

• Eat bananas when they’re just starting to turn yellow

• Eat potato and leek soup

• Have roasted asparagus as a side veggie.

References

Harvard T.H. Chan School of Public Health. (n.d.). The Microbiome. The Nutrition Source. Retrieved from https://www.hsph.harvard.edu/nutritionsource/microbiome/

Lolou, V., & Panayiotidis, M. I. (2019). Functional Role of Probiotics and Prebiotics on Skin Health and Disease. Fermentation, 5(2). Retrieved from https://doi.org/10.3390/fermentation5020041

Prebiotics vs. Probiotics: What’s the Difference? (2020, March 25). Cleveland Clinic, Health Essentials. Retrieved from https://health.clevelandclinic.org/prebiotics-vs-probiotics-whats-the-difference/

U.S. Department of Health and Human Services, National Center for Complementary and Integrative Health. (2019). Probiotics: What You Need To Know. Retrieved from https://www.nccih.nih.gov/health/probiotics-what-you-need-to-know