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Probiotics Part 2: Choosing an Effective Source

Posted by September 15th, 2014 in Wellness

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In our last post, we looked at what probiotics are, and how research has shown them to be beneficial to your health. Now that you know they’re helpful, you’re probably wondering how you can get more of these “good bacteria.” Keep reading to learn what to look for in foods and supplements, so you can know what will really work before you head to the grocery market or health food store.
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How effective are the probiotics in yogurt?
One of the reasons probiotics have become such a buzzword is because of the recent craze for Greek yogurt. Probiotics in food are nothing new though; bacteria that produce lactic acid have been used in food fermentation for centuries. All kinds of yogurt (not just Greek) as well as fermented milk drinks like kefir contain probiotics. Yogurt and kefir contain lactobacillus cultures. Even though these are living microorganisms, these foods aren’t really considered probiotics (functional food products would be more accurate). Dr. Tang finds that many do not provide adequate levels of probiotics — for a food to be classified as a probiotic, it needs to contain enough viable bacteria to show significant benefit.
Some yogurts (like Activia) are fortified with additional bacteria, allowing them to be classified as probiotics. Studies that have looked at this kind of product showed that these did not actually change the overall bacterial composition of the gut, though they did alter gene expression patterns that relate to carbohydrate metabolism. While they did make a difference while patients were consuming the yogurt, the effects only lasted as long as they continued to regularly eat the yogurt.
Why don’t the effects last? One of the issues is that the lactobacillus found foods like yogurt and kefir has a very difficult time surviving the acidity found in the stomach — you need to consume a tremendous number of microorganisms to ensure that a decent percentage will make it through this journey. Second, these foods usually only have one type of lactobacillus species. For probiotics to make a difference, it’s important to have multiple strains since each variety has predilection for only a certain part of the intestinal tract. To get results from probiotics, the entire intestinal tract needs to be addressed. Last, Dr. Tang notes that many patients knowingly (or sometimes unknowingly) have sensitivities to dairy products or are lactose intolerant, which means yogurts are not appropriate choices for these patients.
How can you read a label to tell if a probiotic will work?
Though we hear a lot about probiotics in food, they are also available in supplement form as tablets, capsules, and powders. The efficacy of probiotic supplements depends on their ability to survive and thrive in the gut, which is why some are microencapsulated or enteric coated. For the “good bacteria” to colonize your gut, you have to ingest living, viable organisms on a regular basis so that an effective concentration is maintained. The difficulty of maintaining live bacteria through the manufacturing process (not to mention on the shelf in stores) means that the quantity, quality, and purity of the probiotics can vary among products. These supplements aren’t FDA regulated, so that means that you’ve got to do some legwork to ensure you’re getting the best probiotics.
Since efficacy can vary by person even with proven strains, look for supplements that contain multiple strains. In fact, Dr. Tang recommends looking for a product that contains up to 14 strains, which gives you the best chance to colonize your gut with the different types of good bacteria.
There’s not a strong consensus on the minimum number of microorganisms that need to be ingested in order to reap the benefits of probiotics. A rule of thumb though is that a supplement should contain billions of microorganisms to increase the likelihood that they’ll be able to successfully colonize your gut. If you do want to look for yogurt rather than a supplement, it should be sealed and explicitly labeled as containing “live and active cultures.” For it to be potentially effective, it must contain at least 100 million viable bacteria per gram at the time of manufacture (like we said, it takes a very large number to ensure that at least some survive the voyage!).
In order to further boost the probiotics’ chances of survival — and your chances of reaping the most benefit — it’s important that you follow the manufacturer’s recommendations for how the supplements should be stored. Many probiotic supplements need to be refrigerated, or at least kept away from direct heat. That’s also something to consider when you’re shopping — if the store isn’t taking proper care of the probiotics, they’re doomed before you even purchase them. Be sure to double-check expiration dates, too.
Are there certain probiotics I should look for?
It’s important to look for supplements that include probiotics that have been evaluated in research and proven to be effective. One of the most familiar species of “good bacteria” is lactobacillus. More than 100 species of lactobacillus have been identified, and they are often used to ferment foods like yogurt (think “lacto,” like milk). Lactobacillus rhamnosus GG (LGG, sold as Culturelle), lactobacillus planetarium, lactobacillus reuteri, lactobacillus casei, and lactobacillus acidophilus are some of the more well-known species lactobacilli.
Lactobacillus is not normally present in the gut (those that live there naturally are called “indigenous bacteria”). Instead, this is a “transient bacteria,” meaning that lactobacillus is only present if it is consumed or otherwise taken in. It has been found that vegetarians and people who eat a more plant-based diet have higher colonization rates of certain lactobacillus species. On the other hand, researchers found that approximately 25 percent of people consuming a “traditional” Western diet (heavy on the meat and carbs) had no lactobacillus in their guts.
What’s so great about these little bugs? Well, lactobacillus bacteria produce lactic acid and other enzymes, helping to digest and metabolize both proteins and carbohydrates. They synthesize B vitamins and Vitamin K, break down bile salts, and bolster your immune system. They also can help fight off bad bacteria such as E.Coli, pseudomonas, staphylococcus aureus, salmonella, shigella, candida, and Helicobacter pylori. Lactobacilli work hard to help you stay healthy!
Another common species of good bacteria that you can look for is bifidobacterium, which is composed of 30 different strains. These are indigenous bacteria that normally colonize the gut early in life, constituting 95 percent of the gut population in healthy, breast-fed infants. Bifidobacterium normally colonize the large intestine, but their levels tend to decline as we age. They are also highly susceptible to antibiotics and environmental toxins, which can devastate their populations. Bifidobacterium help your body to metabolize lactose, synthesize B vitamins, ferment indigestible carbohydrates, and produce beneficial short-chain fatty acids. By producing these compounds, they stimulate your immune system, helping to inhibit pathogens and keep you healthy. Bifidobacterium have been shown to relieve constipation, lessen the effects of inflammatory bowel disease, reduce intestinal permeability, and lower cholesterol levels. The types B.bifidum, B. breve, and B.lactis all exhibit protective effects against acute diarrhea, too.
Last but not least, the yeast Saccharomyces boulardii makes enzymes that help break down certain bacteria toxins and prevent the binding of “bad bacteria.” S. boulardii can also reduce intestinal inflammation and alleviate “leaky gut” syndrome, a condition where the natural protective intestinal barrier weakens.
Understanding the gut continues to be a promising frontier in medical research, and it has been speculated that as we better get to know how probiotics work they will be able to combat diseases and improve our wellness. If you’re wondering whether probiotics could help improve your digestive health, why not come in for a consultation with Dr. Tang? Call us today at 408-740-5320.
Creative Commons Creative Commons Attribution 2.0 Generic License   photo:  BobMical

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