What Are Probiotics?

There are about 39 to 300 trillion bacteria inhabiting your body, but don’t be alarmed. These bacteria are either harmless or beneficial to your health. Most of these bacteria reside in your gut. Which bacterial species are present in the gut would have a significant impact on your health. If you nurture the correct bacterial species you are likely to experience the following benefits:

• Better digestion
• Weight loss
• Enhanced immunity
• Reduced likelihood of developing certain diseases
• Healthier skin

This is where probiotics come in. They are live bacteria or yeasts that are good for you, especially for your gut. To have the correct bacterial balance in your gut, you must consume foods, usually fermented foods, or supplements that contain probiotics. Once they grow and colonize your gut, you will experience the aforementioned benefits. This is the reason why probiotics are also called “good bacteria” for they are usually bacterial in nature and facilitate processes that are beneficial to the human body.

You should not confuse “good bacteria” with pathogenic bacteria. Depending on the bacterial species, a bacterium could either be beneficial to your body or could cause disease or infection. The good bacteria is the former while pathogenic bacteria are the latter.

A bacterial species can be considered as a probiotic bacteria if they possess the following characteristics:

• Can be isolated from specimens that came from a human
• Can survive being ingested and would reach the intestines
• Offers benefits that are supported by scientific research once consumed
• Safe to consume

Probiotics vs Prebiotics

Prebiotics should not be confused with probiotics. Prebiotics are nondigestible food components that are utilized by a specific good bacteria as their food source. When a person ingests this prebiotics, they selectively encourage the growth and or activity of a specific good bacteria. Probiotics, on the other hand, are the live beneficial microorganisms that are to be ingested.

There is a close relationship between probiotics and prebiotics. According to a research paper published in Ecology of Food and Nutrition, the probiotic lactobacillus would be able to grow in greater numbers in the gut if they are given the prebiotic inulin. So when a person consumes lactobacilli containing food like yoghurt, followed by an inulin rich food like banana, not only will they introduce more beneficial lactobacilli in their gut, they would also encourage their growth by giving them inulin. Thus, it is highly recommended that a prebiotic food is taken along with a probiotic food.

What Do Probiotics Do?

As mentioned earlier, there exists a complex community of microorganisms within your gut called the gut flora, gut microbiota, or gut microbiome. Bacteria is the most abundant microorganism in your gut flora. These bacteria aid in the production of vitamin K, and some B vitamins. Aside from that, these bacteria convert dietary fibres into short-chain fats like butyrate, propionate, and acetate which are vital for your gut wall health and are capable of improving immune response.

Another action of probiotics would be to compete with spaces against pathogenic bacteria. When the good bacteria would colonize a certain area in your gut, any pathogenic bacteria that may enter your gut wouldn’t be able to establish a colony in that location.

Aside from that, probiotics may also help improve digestion, aid in the processing and production of vitamins, improve immune response, produce beneficial substances, and aid in the breakdown of certain foods and medications.

The gut microbiome is sensitive to our diet. This means that what we eat dictates whether we are cultivating a balanced gut microbiome or an unbalanced one, and several studies have shown that an unbalanced gut microbiome may lead to a number of diseases.

Signs Probiotics Are Working

The best way to know whether or not the probiotics that you are taking are working would be to look out for their health benefits. So what are the benefits of probiotics?

1. You Lose Weight Easily

Although more studies are needed, there is a strong connection between gut microbes and a person’s body weight. In a research paper published in The British Journal of Nutrition, it was demonstrated that those who consumed probiotics experienced a reduction in their belly fat by up to 8.5% over 12 weeks. In this study, 210 individuals with excess belly fat consumed Lactobacillus gasseri daily. Their belly fat was measured through computed tomography before they started consuming probiotics and 12 weeks after they ate probiotics daily. Their belly fat was reduced by up to 8.5% after 12 weeks but when they stopped consuming probiotics on a daily basis, they gained their belly fat after 4 weeks.

This may have to do with the fact that there might be a connection between a person’s gut microbiome and their weight. Some researchers believe that if you have the correct gut microbiome, you are less likely to become overweight. They go into further detail and mention that the right microbiome can change your food preferences in such a way that encourages healthy food choices.

Despite these findings, there are still a lot of unknowns regarding probiotics’ weight loss effect. The following are still unclear:

• Which probiotic strain is the best for weight loss.
• The dosage and duration of probiotic treatment.
• The expected long-term effects of probiotic treatment.
• How factors like age, gender, health conditions, and lifestyle would affect the efficacy of probiotic treatment.

Thus, researchers suggest that those who are seeking weight loss by using probiotics would do so by pairing it with a healthy diet and regular exercise.

2. You Feel Improvements in Your Gut

The primary benefit of probiotics is improved gut health which means several gastrointestinal conditions would be alleviated.

a) Constipation

A study published in the American Journal of Clinical Nutrition in 2014, reviewed 14 studies that investigated the effects of probiotics on constipation. Results of this review showed that probiotics, especially Bifidobacterium lactis, can alleviate symptoms of constipation. Other studies relating to the effects of probiotics on constipation were conducted thereafter. In 2017, one review took 9 studies that tackled the effects of probiotics on constipation in elderly individuals. Majority of the studies used the probiotic Bifidobacterium longum. Researchers of these studies also endorsed the anti-constipation effect of probiotics.

b) Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome is a common digestive disorder wherein the person affected would experience symptoms such as gas, bloating, constipation, and diarrhoea, to name a few. Several studies have shown that probiotics may help treat Irritable Bowel Syndrome. A 2018 scientific review published in Aliment Pharmacol involving 53 studies and a total of 5,545 participants supports the idea that probiotics may be able to help treat IBS. However, a 2019 scientific review published in Nutrients volume 11 showed mixed results. Both studies also mentioned some areas where further studies are required like which type of IBS would respond to the probiotic treatment, which probiotic, or probiotic mixtures, is the best for IBS, and at what dosage and duration of probiotic treatment would work best.

c) Antibiotic-Associated Diarrhea

Antibiotic-associated diarrhoea is a type of diarrhoea that appears as a consequence of using broad-spectrum antibiotics. These types of antibiotics kill whatever bacteria are present in the body, be it good or bad. When this happens, the gut of the affected individual would become vulnerable to diarrhoea-causing pathogens. Since consumption of probiotics would re-introduce good bacteria into a person’s gut, then theoretically they would be the best option to treat antibiotic-associated diarrhoea. Several studies have determined this to be the case. In a 2017 review involving 17 studies and a total of 3631 participants, researchers mentioned that giving probiotics to patients along with their antibiotics resulted in a 50% decrease in the likelihood of acquiring antibiotic-associated diarrhoea. However, the effects of probiotics on antibiotic-associated diarrhoea seems to vary depending on a person’s age as revealed by a 2016 study. To be specific, the risk of acquiring antibiotic-associated diarrhoea is not reduced in older individuals, ages 65 years and above. The 2016 study wasn’t able to review studies with participants that are younger than 18 years old. However, a 2015 study did just that. According to this study, there is moderate-quality evidence that supports the idea that probiotics can prevent antibiotic-associated diarrhoea in children.

d) Clostridium Difficile Infection

Similar to antibiotic-associated diarrhoea, Clostridium difficile infections can occur as a result of using broad-spectrum antibiotics. When all types of bacteria are eliminated in the gut, including the beneficial one, pathogenic bacteria can easily invade the gut and cause diseases. Although people who aren’t taking antibiotics could still acquire Clostridium difficile infections, it is more common in people who do. Since Clostridium difficile is similar to antibiotic-associated diarrhoea, and probiotics can prevent antibiotic-associated diarrhoea, then probiotics can be used to prevent or treat Clostridium difficile infections. This is the idea that a 2017 study sought to analyze. Researchers of this study concluded that the use of probiotics may be able to reduce the risk of Clostridium difficile infection. However, this study did not offer any data regarding the probiotics’ dosage and the duration of the treatment.

e) Inflammatory Bowel Disease

Inflammation is a natural bodily mechanism that is utilized to fight off infections and other types of insults. However, inflammation can go out of control and may cause damage to the human body. Inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease are conditions wherein inflammation has gone out of control. Symptoms of ulcerative colitis and Crohn’s disease include abdominal pain, diarrhoea, loss of appetite, weight loss, and fever. This disease varies greatly from person to person, there are cases wherein the symptoms are severe and even life-threatening.

Interestingly, probiotics have varied effects on the different kinds of inflammatory bowel diseases. It was demonstrated in a review that was published in Clinical and Experimental Gastroenterology volume 7 that probiotics are beneficial for treating ulcerative colitis. However, the same review demonstrated that probiotics are not beneficial for treating Crohn’s disease.

f) Traveller’s Diarrhoea

Traveller’s diarrhoea is named as such because it is a kind of diarrhoea that would usually happen when someone travels and eats local foods or drinks water that is contaminated. This type of diarrhoea isn’t usually serious. However, it can be quite unpleasant.

It has been suggested that probiotics can help prevent traveller’s diarrhoea. However, the International Society of Travel Medicine stated in their 2017 guideline that there’s not enough data to say for certain that prebiotics can, in fact, prevent or treat traveller’s diarrhoea. The following year, a review evaluating 11 studies with a total of 5,143 participants revealed that probiotics may be helpful for the prevention of traveller’s diarrhoea. However, more high-quality studies are needed before probiotics would be endorsed for treating traveller’s diarrhoea.

g) Helicobacter Pylori

Helicobacter pylori is a serious infection of the stomach that may lead to ulcers and even stomach cancer. Some studies suggest that probiotics show great potential in treating Helicobacter pylori infections. However, more studies are needed to optimize the usage of probiotics against Helicobacter infections. Optimization can be done by determining which probiotic species would work best against helicobacter infections, and determining the optimum dosage and duration of probiotic treatment.

3. Your Dental Health Would Improve

Through unknown mechanisms, probiotics seem to help improve dental health and there are studies that would support this claim. Researchers determined that probiotics may be helpful in preventing dental caries in infants and young children, as demonstrated by a review which was published in the American Journal of Dentistry.

Probiotics may be helpful in the prevention of Periodontal or Gum Disease as well. Infections and inflammation of the gums and bone that surround and support the teeth are what is referred to as Periodontal disease. This disease can be so severe at times that the gums are pulled away from the teeth and bone is lost. Since gums and bones are the things that support the teeth, without them the teeth may begin to fall out.

Fortunately, a 2016 study revealed that probiotics can reduce the population of gum-disease-causing bacteria. However, further studies are needed as the study did not provide any information regarding which probiotic species to use.

4. Reduction and Prevention of Allergies

One benefit of probiotics is the improvement of immune function. Allergies can be thought of as an overreaction of your immune system. This means that probiotics may be able to help reduce the occurrence of allergies.

Allergic rhinitis or hay fever is characterized by the swelling of the insides of the nose as a result of allergen inhalation. These allergic reactions can be quite uncomfortable. According to a review published in the International Forum of Allergy and Rhinology, probiotics might be able to alleviate symptoms of allergic rhinitis. However, the review wasn’t able to determine which probiotic to use, the probiotic dosage, and the duration of treatment.

A 2015 review offered different results. In this review, 17 studies that investigated the use of probiotics during pregnancy, and the subsequent provision of the same probiotics to the infant, were assessed. The review concluded that a mixture of various probiotics when given to a pregnant mother and her baby can significantly reduce the risk of developing atopic dermatitis.

5. Other Health Benefits

a) Acne

Researchers discovered that probiotics when taken, orally or used topically, might be able to have an effect on acne. Although this is the case, the American Academy of Dermatology stated that there isn’t enough evidence for them to recommend probiotics as a treatment for acne.

Besides acne, there is some evidence that probiotics can have a positive effect on eczema and rosacea, and improve overall skin health.

b) Hepatic Encephalopathy

The liver is one of the main detoxifying organs in our body. When the liver is severely damaged, it wouldn’t be able to carry out its detox function properly and would lead to toxin buildup. When the toxins would build up in the bloodstream and reach the brain, the toxins may impair brain function leading to a condition called hepatic encephalopathy.

Probiotics may be able to help with the treatment of this disease. In 2017 a group of researchers reviewed 21 studies that investigated the effects of probiotics on hepatic encephalopathy. They concluded that probiotics may have effects that are beneficial for encephalopathy. However, they also stated that more high-quality studies are needed as the current studies on the topic are of low quality.

c) Upper Respiratory Infections

People taking probiotics may experience fewer and shorter upper respiratory infections. This is what a 2015 scientific review of studies that investigated the effects of probiotics on upper respiratory infections revealed. However, further studies are needed as most of the studies in the review were poorly conducted.

d) Inflammation and Immune Function

As mentioned earlier, probiotics can improve immune function which enables the body to fight off infections better. Aside from that, the body would be able to efficiently regulate immune processes such as inflammation.

e) Depression and Anxiety

There are ongoing studies on the bidirectional link between the central nervous system and the enteric nervous system called the gut-brain axis. Some of these studies touted that probiotics may be able to reduce symptoms of anxiety and depression in people with clinical depression.

f) Blood Cholesterol

A systematic review conducted by the Tianjin University of Traditional Chinese Medicine concluded that probiotics may be able to reduce total cholesterol and Low-Density Lipoprotein levels.

g) Blood Pressure

Probiotics may be able to lower blood pressure at a modest degree, this is the conclusion that a systematic review, which was published on Hypertension volume 64, arrived at.

Probiotics’ Effect On Some Conditions In Infants

1. Infant Colic

Researchers are still trying to understand what causes colic. However, there is some evidence that this condition is caused by imbalances in the gut microbiome. Theoretically, this makes probiotics one of the best solutions to colic since they can help balance the gut microbiome by introducing good bacteria in it. Several studies investigated the benefits of probiotics for infants with colic. In 2018, the Medical University of Warsaw conducted a scientific review on some of these studies and demonstrated that probiotics can treat colic in breastfed infants.

2. Necrotizing Enterocolitis

Necrotizing enterocolitis is a serious and sometimes fatal condition that involves injury or damage to the intestinal tract of premature infants. The exact cause of this disease is still unknown. However, what is known is that intestinal tissue death is its main symptom. There are several theories as to its cause, one of them has to do with an imbalance in the gut microbiome. Similar to infant colic, theoretically, probiotics would be beneficial for the treatment of necrotizing enterocolitis as it brings balance in the gut microbiome. Aside from that, probiotics are able to create short-chain fats that can help in the repair of damaged intestinal tissue.

In a 2017 scientific review, which was published in Acta Paediatrica, it was shown that probiotics aided in the prevention of necrotizing enterocolitis in very low-birth-weight infants. However, researchers noted that not all studies showed the same positive result. This may have to do with the fact that Lactobacillus and Bifidobacterium probiotics seemed to produce the best results, and that some of these studies did not use any of those probiotics.

3. Sepsis

There are several groups that are at a high risk of sepsis, premature infants are particularly high risk. Sepsis occurs when the human body has an extreme response to an infection. Due to this extreme response, several major organs may not work properly. As such, sepsis is a serious and life-threatening condition. Fortunately, probiotics can reduce the risk of sepsis in premature infants, according to a study that was published in Pediatrics volume 137.

What Are Probiotic Foods

Probiotic foods are simply foods that contain good bacteria such as Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, Escherichia, and Bacillus. Food supplements that contain the aforementioned bacteria are also considered probiotic foods.

1. Yoghurt

Yoghurt is made from fermented milk. The fermentation process is carried out by good bacteria mostly lactic acid bacteria and bifidobacteria. Yoghurt is considered a probiotic food because the good bacteria will remain in the fermented milk.

The fermentation process of yoghurt converts the lactose present in the milk to lactic acid. This means that on a case to case basis, those who have lactose intolerance may be able to tolerate yoghurt.

Whenever you would purchase yoghurt, do some thorough research first, for there are some yoghurt brands that do not contain live probiotics. Some of these yoghurt brands would kill off the good bacteria somewhere in the production process. Always choose yoghurt that contains live cultures. Also, read the label carefully. Stay away from low-fat or fat-free yoghurt, most of the time they have high amounts of added sugar.

2. Kefir

Kefir is a probiotic drink. Basically, it is cow’s or goat’s milk that contains kefir grains which are actually cultures of lactic acid bacteria and yeast that looks similar to cauliflower. Although yoghurt is more popular than kefir, this probiotic drink may be superior to yoghurt because of the fact that it contains several major strains of good bacteria and yeast. Similar to yoghurt, a good number of lactose-intolerant individuals can tolerate kefir.

3. Sauerkraut

Sauerkraut is a German word that literally translates to sour cabbage. Basically, sauerkraut is sour finely shredded cabbage that has been fermented by lactic acid bacteria. It has a sour, salty taste and a perfect side dish for meat dishes. It could also be used as toppings for sausages. Only purchase unpasteurized sauerkraut as pasteurization can kill the good bacteria present in it.

4. Tempeh

When you ferment soybeans using the mould Rhizopus, you get tempeh. By now you may have noticed that all of these foods are fermented. That’s because the process of fermentation encourages the growth of the probiotic microorganism. In tempeh’s case, the fermentation process improves the nutritional value of the soybeans as it destroys the plant compound known as phytic acid. This plant compound is found in abundance in soybeans and can inhibit iron and zinc absorption. Aside from that, the fermentation process encourages the mould Rhizopus to produce vitamin B12 which is a vitamin that is not present in soybeans. Tempeh is a great meat substitute, it has a nutty, earthy taste that is similar to mushrooms.

5. Kimchi

Kimchi is a spicy Korean side dish. It is more of an umbrella term for fermented vegetables. However, cabbage is the most common ingredient of kimchi. This dish features strong flavours because of its heavy usage of seasonings such as red chilli pepper flakes, garlic, ginger, scallion, and salt. The fermentation process of kimchi encourages the growth of several lactic acid bacteria species including a species that is exclusive to kimchi, the Lactobacillus kimchii.

What is the best probiotic to take?

There are several probiotics available in the market, to answer the question of what is the best probiotic to take, you must identify your purpose for taking these probiotics first.

1. For Relief from Constipation

When your bowel movements are hard, difficult to pass, and infrequent, you may have constipation. This is a common condition, everyone experiences constipation once in a while. However, there are people who are chronically constipated. Fortunately, probiotics can help alleviate constipation and among all of the probiotic microorganisms, Bacillus lactis is the best one for constipation relief.

2. For Diarrhea Treatment

When you have bowel movements that are loose-to-liquid three consecutive times in a single day then you have diarrhoea. Most of the time diarrhoea is nothing serious. However, there are individuals who have to suffer from diarrhoea chronically. There are also cases wherein diarrhoea is caused by food poisoning and gastroenteritis. The probiotics Lactobacillus rhamnosus, Lactobacillus acidophilus, and Lactobacillus bulgaricus, are the best for diarrhoea, whatever the cause of the diarrhoea might be. However, for diarrhoea that is brought about by Irritable Bowel Syndrome, B. coagulans, S. boulardii and a combination of several Lactobacillus and Bifidobacterium strains are the best probiotics to use.

3. For Irritable Bowel Syndrome

There are several symptoms of irritable bowel syndrome. Abnormal stool consistency or frequency, bloating, gas, nausea, and lower abdominal pain are just some of its symptoms. As mentioned earlier, B. coagulans, S. boulardii and a combination of several Lactobacillus and Bifidobacterium strains are best for diarrhoea that is caused by Irritable Bowel Syndrome. For constipation-predominant IBS, S. cerevisiae is the best probiotic to use. However, this probiotic doesn’t have any effect on the other symptoms of IBS.

There are instances where combining various probiotics would offer a different effect as to when they are given individually. Combining Lactobacillus, Bifidobacterium and Streptococcus strains in a single probiotic dose would only alleviate pain and bloating in patients with diarrhoea-predominant IBS but would not affect the other symptoms.

4. For Weight Loss

The following probiotics are the best ones to consume if you are looking to shed off some excess fats:

• Lactobacillus gasseri,
• Lactobacillus rhamnosus
• and the combination of Lactobacillus rhamnosus and Bifidobacterium lactis.

The mere act of consuming these probiotics can increase fat loss by up to 8.5%. They also limit calorie absorption which leads to caloric deficits and ultimately weight loss.

5. For Brain Health

Probiotics are capable of fermenting dietary fibres and convert them to short-chain fatty acids that provide nourishment to the gut and even improve brain function. Probiotics such as Bifidobacterium longum, Bifidobacterium breve, Bifidobacterium infantis, Lactobacillus helveticus and Lactobacillus rhamnosus, are the best probiotics to consume for the purpose of improving brain function. Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidum have been touted as the best probiotics for treating depression.

6. For Heart Health

Bacterial strains such as Lactobacillus acidophilus, Bifidobacterium longum and Lactobacillus reuteri are capable of lowering a person’s total cholesterol and bad cholesterol while increasing their good cholesterol levels. The reduction in total cholesterol and bad cholesterol levels is a favourable occurrence as they can block blood vessels and cause the heart to become overworked. The increase in good cholesterol levels is a favourable outcome as well, for this type of cholesterol removes cholesterol from the bloodstream.

7. For the Immunity

For better immune function, consumption of the following probiotics is recommended:

• Lactobacillus GG
• Lactobacillus crispatus
• Lactobacillus gasseri
• Bifidobacterium bifidum
• Bifidobacterium longum

Not only did these probiotic bacteria improve immune defence against diseases such as upper respiratory tract infections and urinary tract infections, but they also improved immune response regulation which is made evident by the reduction of occurrence and severity of inflammatory diseases.

8. For General Health

The short-chain fatty acids that are produced by the probiotic bacteria have various positive effects on several organs of the body. Among the probiotic bacteria, Bifidobacterium bifidum is superior when it comes to the fatty acids that they produce because they are the best when it comes to improving health in general.

Conclusion

Probiotics are live microorganisms that when ingested would reside in our gut. Once they inhabit our gut they can convert prebiotic dietary fibres into beneficial fatty acids. They also make it difficult for pathogenic microorganisms from getting a foothold in our gut. The primary health benefit that comes from consuming probiotics is improved gut health. However, it may also offer several health benefits besides that.

Probiotics can be obtained through the consumption of probiotic foods or probiotic supplements. Currently, the most popular probiotic foods include the following; yoghurt, kefir, sauerkraut, tempeh, and kimchi. Almost all of these probiotic foods are fermented, for the fermentation process is important for the growth of the probiotic microorganism.

Probiotics offer a wide range of health benefits but some specific species, strains, or combinations work best for specific purposes like how Bifidobacterium bifidum is best for improving health in general.