Prebiotics and Probiotics. Are the benefits real?
The World Gastroenterology Organisation. 2023 Guidelines
The WGO has just released guidelines on probiotics and prebiotics and their related benefits.
Let's start with the official definitions.
Probiotics are ‘Live microorganisms that when administered in adequate amounts confer a health benefit on the host’
Prebiotics, are ‘A selectively fermented ingredient that results in specific changes in the composition and /or activity of the gastrointestinal (GI) microbiota, thus conferring benefit(s) upon the host health.
Phew… wordy
Prebiotics are split into groups commonly FOS, GOS, Inulin, and Lactulose, and for completeness include breast milk.
Lactulose can be found in treatments for constipation and is is commonly used to support people with liver disease
FOS & Inulin are naturally found in foods such as wheat, onions, bananas, honey, garlic, chicory, Jerusalem artichoke and leeks.
GOS foods include peas, beans, chickpeas, cashews, soy and soya products, green peas, butternut squash, and beetroot.
The fermentation of these foods can cause some people with a low tolerance to FODMAP’s issues such as bloating and pain, partly because they are fermented by gut bacteria. Additionally, while these foods are beneficial to your gut bacteria for those people who are following a low-carbohydrate diet, you will recognise some of these foods as being high in carbohydrates.
As always nutrition needs to be personalised to be of the most benefit
If you can tolerate prebiotic foods the benefits are;
An increase in the number of beneficial bifidobacteria in the colon, inhibiting pathogens and producing vitamins and digestive enzymes.
Increased calcium, iron and magnesium absorption, particularly beneficial if you are pre/post menopause.
Increased faecal weight, helping with symptoms of diarrhoea
Shortening GI transit time, helping with constipation
Lower blood lipid level, great news for those of us with high cholesterol
The benefits of probiotic strains of bacteria are that they may disrupt pathogens, improve the intestinal environment, improve the intestinal barrier, down-regulate inflammation, and up-regulate the immune response to antigens.
By disrupting pathogens we can prevent diarrhoea, particularly when you change your environment, such as when you travel for work or holidays.
Improving the intestinal environment and intestinal barriers can help to lower food intolerance so that you can eat a more varied diet without suffering gut pain and discomfort and other food intolerance symptoms AND it improves nutrient absorption.
Up-regulating your immune response to antigens means that your health is generally more robust and you are able to resist viruses, pathogens and parasites.
What are the clinical uses of probiotics? (where are they most beneficial)
They may shorten the duration of acute diarrhoea in children and adults but need to be administered within 48 hours of symptoms starting to be effective.
Prevention of antibiotic diarrhoea, for people who are NOT immunocompromised.
May be beneficial in reducing the GI side effects of the eradication of an H-Pylori infection.
Improvement in immune response, in particular, seasonal flu and responsiveness to vaccines
Support for people with mild IBD and mild to moderate ulcerated colitis.
May alleviate symptoms of IBS
Reduce crying time in breastfed babies with colic.
Improve symptoms brought on my lactose intolerance
Improvement in nonalcoholic liver disease and blood cholesterol,
The report also suggested that there is evidence that probiotics may be beneficial for
Bacterial vaginosis
Prevention of oral pathogens, leading to gum disease
May reduce the incidence and duration of common upper respiratory tract infections
How do you choose the best product for your symptoms?
The research is complicated and long! Specific strains of bacteria are linked with specific conditions. I wish there was an easy answer, but there are thousands of species and thousands of research papers.
Good quality probiotics can be bought from Boots, Superdrug and Holland and Barrett. The brands I recommend from these shops are Optibac and Pro-ven.
In general, I suggest that you don’t buy the first probiotic or prebiotic that you come across. Think about the symptoms you want to address and buy the products that closely match your symptoms.
For example, Saccharomyces boulardii is associated with the prevention of diarrhoea and improvement in IBS symptoms
If you have more specific symptoms then look at a brand such as Invivo. Invivo conducts its own research and can provide evidence for its products. Be aware that no supplement company is able to give specifics regarding the symptoms their products are designed to support.
For good quality Prebiotics, my favourite brands are again Invivo, and also a new band Advanced-biotics.
I hope this information is useful. This is a HUGE topic, with very exciting research being done. However, probiotics are not suitable for everyone. If you are immunocompromised you should not take a probiotic unless under medical supervision
If you need advice on how to manage your IBS symptoms and which prebiotic or probiotic may be beneficial, then please contact me to book your free 30-minute consultation
Sending nutritional hugs
Jacxx
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