Understanding Probiotics

Some forms of intestinal bacteria are actually good for you

It’s spring, and gardeners are gearing up to protect their plants against all manner of pests, from groundhogs to bugs. Gardening enthusiasts worth their salt know that there are good bugs and bad bugs, however. If an old-time western were filmed starring the creatures that inhabit a typical New Hampshire veggie patch, pollinating bees would wear white hats while slugs and voracious hornworms, capable of munching and destroying entire plants faster than you can say photosynthesis, would be cast as villains.

Similarly, good bugs and bad bugs live in our gut. As clean as we like to think we are, each of us is home to a tremendous amount of bacteria. We typically have more than 400 varieties of these microscopic critters thriving within the hotbed of activity that is our digestive system. The white-hatted bugs, or bacteria, in our gut aid digestion and protect against disease, while the bad bacteria contribute to disease and a host of ills.

And just as some gardeners sprinkle various additives in their garden to boost the health of their plants, some doctors and dietitians today recommend that people use probiotics to aid digestive health.

The term “probiotics” refers to the beneficial bacteria inside our digestive tract. Probiotics are part of a checks-and-balances system that helps keep gastrointestinal matters running smoothly. They protect us against “bad,” pathogenic bacteria, says Liz Whalen, RD, LD, dietitian manager at St. Joseph Hospital in Nashua. As research studies show that low levels of probiotics can lead to health trouble, there is growing interest in using food or supplements to boost probiotic levels in the microfloral mix of organisms within the gut.

“Probiotic bacteria perform a lot of different functions,” says Vincent Aguirre, MD, PhD, a gastroenterologist at Elliot Gastroenterology in Manchester. Probiotics support the immune system, help digest and ferment food, augment the protective-barrier function that the intestine normally provides, and possibly influence a number of other related aspects of gastrointestinal health, from easing indigestion to improving bowel quality and regularity, Aguirre says. Some strains of probiotic bacteria have even been associated with obesity, body composition and carbohydrate processing in diabetics. Probiotics have been used medicinally for hundreds of years, Aguirre says, but there’s been a flurry of research lately into the role that intestinal bacteria plays and how it affects body functioning.

Research does support enhancing probiotic levels at least in individuals who face certain medical conditions and situations, including antibiotic use, hospitalization, advanced age, diabetes, infectious diarrhea, traveler’s diarrhea, and irritable bowel syndrome. “The idea is that if you’ve been exposed to harmful bacteria, through antibiotic use or some other reason, you can restore a natural balance through the use of supplemental probiotics,” Aguirre says.

But when it comes to probiotic supplements, it’s a clear case of buyer beware. “[Supplements] are not FDA-regulated or approved for any particular medical end-use,” Aguirre says, even though pharmaceutical companies market probiotics as supplements for specific conditions.

Although it is known that particular strains of probiotics can help patients who suffer from specific diseases and medical situations, it’s not always currently known which probiotics work best in which instances, Aguirre says. Ongoing research aims to solve this mystery so that specific beneficial bacteria can be used to target specific problems, from shoring up the immune system to enhancing the barrier function of the intestine or targeting obesity.

For now, some doctors recommend taking supplements that provide the specific probiotic strain that has been proven to help a particular condition, and in the dose that has been proven to work. Probiotic pills for sale on the Internet often contain a mix of strains, however, and taking the proven dose can add up to an expense of hundreds of dollars per month, Aguirre says. The supplements are not typically covered by insurance.

So, unless you have a medical condition that has been shown to benefit from probiotics, in which case your doctor might prescribe probiotic supplements, your best bet as a healthy individual who wants to maintain peace among his or her intestinal flora is to eat probiotic-rich foods such as yogurt, aged cheese, sourdough bread, sauerkraut, kefir, tempeh and miso soup. Yogurt is an especially popular choice for augmenting probiotic levels. Look for one that lists live or active cultures among its ingredients, which means the manufacturer claims that the product has high probiotic content. Just keep in mind that probiotics don’t always survive the pasteurization process, so in some instances, probiotics in food are killed while the product is being prepared, says Aguirre.

“This is an area that’s not highly regulated,” warns Aguirre, who does advise some of his patients to eat certain yogurts. “There is minimal regulation as to what these manufacturers can advertise.”

Aside from yogurts and dairy products, not many foods are likely to have substantial quantities of probiotics, he says, but even just heeding the tried-and-true axiom of eating a balanced diet will help support good probiotic balance.   

Chew on this

If you want to keep up your levels of “good” intestinal bacteria but don’t want to take supplements and dislike the taste of probiotic dietary sources such as yogurt, there is another way to enhance your probiotic level: by boosting the prebiotics in your body. Prebiotics occur naturally in some of the food we eat and become food themselves for probiotics, so maintaining a high level of prebiotics will create a welcoming environment for probiotics.

Prebiotics and probiotics “work hand in hand” to benefit digestive tract health, says Liz Whalen, RD, LD, Dietitian Manager at St. Joseph Hospital in Nashua. Prebiotics exist in foods that are high in fiber, Whalen says, such as fruits, vegetables and whole grains.

If you have a specific health problem or condition that you’re aiming to fix, meet with a medical expert who will know whether you should take supplements. “Meeting with a doctor or a dietitian will steer you to the specific strain [of bacteria] that will help you achieve your goals,” Whalen says.

But if you’re generally healthy and “follow a dietary model of ‘everything in moderation,’ then you’re probably fine” with your current balanced diet and needn’t worry about augmenting prebiotic or probiotic levels, Whalen says.

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