My obsession with probiotics dates back to when I first moved to India and started experiencing the fantastic flavours that my taste buds loved but overwhelmed my Western stomach. However, as I grew accustomed to the food and learned more about nutrition, I became less reliant on probiotics to support my gut health and instead began to practice gut-healthy eating practices.
Personal experience aside, there is a considerable debate in gut health: whether or not we need to supplement our gut microbiome (a fancy term for the bacteria living and thriving in our digestive systems). Research on gut health is an emerging field of study, and despite it being fascinating (and sometimes mindblowing) and it's safe to say that we don't have all the answers yet.
Nutrition coaches, like myself, were steadfast in prescribing probiotic supplements to everyone who would stop for a moment to learn about this exciting new world. Improving our gut health could decrease inflammation, improve our moods, elevate our cognition, and perhaps even clear up our troubled skin. We boasted about how our mighty guts could fight off infection - seeing as we eat multiple times a day and eating and drinking are sure-fire ways to ingest pathogens - 70% of our immunity is found in our guts.
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However, over time, I realized that as our gut is intricate and complex, adding a simple probiotic into its daily function wasn't a cure-all. You could be forgiven if you also thought so; perhaps we over-sold the role of probiotics in our enthusiasm. And although our gut health does play a vital role in our overall health, believing that we can influence our entire body's health by simply ingesting a pill or drink is a bit short-sighted.
But that doesn't render probiotics obsolete. Probiotics do have a role in our diets, just different from what you think.
First, let's start with a definition of a probiotic. The universal definition of probiotics is "live microorganisms, which when administered in adequate amounts, confer a health benefit to the host." The host. It sounds like an alien movie. If you think ingesting a capsule full of living organisms is weird, our entire gut is already full of them. According to Harvard Health, over 100 trillion bacteria live in our digestive system. The journal Therapeutic Advances in Gastroenterology tells us over 1,000 different species in the gut microbiome. Researchers are beginning to realize that each species has a different role and function, which is quite impressive.
Furthermore, no two people will have the same microbiome. A person's compilation of gut bacteria is uniquely personal – even twins won't have identical samples. So, when we talk about a healthy gut microbiome, we must understand first that no one solution will work for everyone.
That is also confusion when choosing a probiotic. There is a lactobacillus, Bifidobacterium, saccharomyces, and bacillus, to name a few. How do you know what bacteria your body needs replenishing versus the role that bacteria will perform in the body? A paper entitled Probiotics: Mixed Messages published by the Canadian Family Physician aptly says, "Thus, for practising physicians, probiotic choices tend to be subjective, extrapolated, imaginative, based on availability, or based on suggestions of the company providing the probiotic." There is no standard practice, and probiotics are often a suggestion and self-administered - to what effect?
But we can say that a healthy microbiome has the largest variety of bacteria. The more different strains of bacteria, the more roles they can play in your body, and the better your health will be. These bacteria can reduce inflammation, regulate hunger and satiety cues, and help our bodies respond to stress. Diets high in processed foods and low in fibrous fruits and vegetables tend to have lower microbiome diversity, which is why eating your veggies is essential!
Your body can be home to harmful gut bacteria and good, and there is a war between them (a battle of good versus evil is happening in your intestines right now!)
Our natural reaction is to support the "good" bacteria, to be the winning team, so our first thought is to send down reinforcements to bolster their efforts. It's a noble cause; however, in some cases, it may be futile. On top of everyone's different microbiome, we can't be sure if the probiotics we ingested were correctly stored and even successfully made it "down the hatch." Even if probiotics managed to make their way their our digestion, they may not even stick around and take up residence. Instead, evacuate along with our faeces.
So does that make a probiotic worthless? Not necessarily.
There are some pretty good reasons to take probiotics.
We live in a world that reveres modern medicine, and sometimes these medicines can alter our microbiome. The word "antibiotic" should be a clue as to how they can impact our guts - wiping out swaths of good and bad bacteria is collateral damage in the pursuit of fighting infection. For someone taking a course of antibiotics, taking a probiotic alongside it may be the best decision.
Furthermore, infectious diarrhoea, irritable bowel syndrome (IBS), or someone suffering from ulcerative colitis or h.pylori may also benefit from a probiotic supplement.
However, if you want to take a probiotic "just in case" and for "general health" or other claims such as mood improvement and fat loss, your money is better off being spent elsewhere.
Here is how you can improve your probability of having a healthy microbiome
1. Eat lots of fruit and vegetables: These foods are high in fibre, which good bacteria love to eat.
2. Limit processed foods: Relying on fast foods can limit our gut microbiome diversity.
3. Only take antibiotics when required
4. Be active: Activity supports a healthy immune system
5. Get outdoors: Exposure to nature and animals will help increase your gut microbiota diversity.
6. Eat foods rich in probiotics. Examples are fermented dairy products such as yoghurt, curd, buttermilk, kefir, bacterially fermented cheeses, and sour cream. Foods such as kimchi and sauerkraut are also rich in probiotics.
Jen Thomas is a Chennai-based weight loss coach