The importance of a healthy gut has been gaining more attention in healthcare due to the growing body of research emphasizing diseases and conditions affected by the gut microbiota. A dysfunctional gut has been associated with chronic inflammation leading to conditions such as obesity, metabolic syndrome, depression, anxiety, and Alzheimer’s disease. In the functional medicine sphere, I am constantly hearing about the next “7 Day Gut Healing Protocol” or "Bone Broths for Gut Healing". Although, I don’t believe in the false promises of these marketing schemes, I do believe there is truth to supporting and loving our gut bugs. This post only scratches the surface on one of the newest topics in science—the microbiota.
WHAT IS THE ‘MICROBIOTA'?
Our gut, or gastrointestinal tract, is filled with bacteria, collectively called the microbiota. In fact, the total amount of gut bugs is estimated to be more than 10^14 bacterial cells—10 times the number of human cells in our body! Caring for these gut bugs is of utmost importance, because they impact our health in massive ways.
In a recent podcast, I heard Dr. Amy Proal, a PhD. in microbiology, use the following analogy to explain the relationship between our gut bugs and our immune system. I have paraphrased her beautiful explanation here: Imagine a classroom full of students. In this group, there is a mixture of dedicated students and rebellious students—or the “bad" students. The students, good and bad, are similar to our gut bugs, each one with their own agenda. The teacher in the classroom is like our immune system, patrolling the students and keeping everyone on task and in-line. However, things can go haywire when the teacher leaves the classroom. Suddenly, the “bad” students can convince the good students to misbehave too. And eventually the whole classroom is full of disruptive students.
Our gut bugs have their own agenda and without a strong immune system to keep them in check, they can become disruptive, multiply, form alliances, and create havoc.
But we must remember that these gut bugs are beneficial to us too. There wouldn’t be a classroom without students in the first place!
So, how do these gut bugs help us? First, our gut bugs aid in the digestion of food, especially fiber that cannot be broken down by our own digestive enzymes. Secondly, our gut bugs help with the production of vitamins, like B & K, which are crucial for blood clotting and cell metabolism. To add to the list, our gut bacteria metabolize toxins, pollutants, and other xenobiotics, play a role in weight management, and contribute to our overall mood!
SUPPORTING THE STUDENTS & THE TEACHER
Supplementing with prebiotic foods and probiotics can improve the diversity of the gut microbiota significantly. Prebiotics and probiotics benefit the immune system and provide anti-inflammatory effects on the body.
There is an important difference between PREbiotics and PRObiotics.
Prebiotics are non-digestible foods that benefit our whole body by selectively stimulating the growth of one or a small number of bacteria in the colon. When we ingest a prebiotic food, it travels to the colon where it is fermented by certain bacteria, consequently improving the microbiota composition.
The health benefits of prebiotics are associated with the process of fermentation and production of short chain fatty acids (SCFA). Some touted health benefits include energy source for the intestinal lining, inhibition of pathogenic organisms, resilient immune system, and decreased inflammation.
The most commonly available and best researched prebiotics include Fructooligosaccharides (FOS), lactulose, and glactooligosaccharides (GOS). Prebiotics can be taken in supplemental form (be sure to start with small doses at first because it can initially cause adverse GI reactions aka gas, bloating or diarrhea) or prebiotic foods can be eaten. Some food sources of prebiotic compounds include garlic, onion, chicory root, beetroot, human milk, Jerusalem artichokes, and oats.
On the other hand, probiotics are supplements that contain live bacteria that support the existing microflora and can be used to treat a wide variety of conditions depending on the strain of bacteria used.
Essentially, PREbiotics feed the PRObiotics.
Traditionally, probiotics have been used for conditions such as intestinal permeability, dysbiosis, gastrointestinal tract infections, IBD, IBS, lactose intolerance, vaginal candidiasis, and post antibiotics. However, more novel uses of probiotics include endometriosis, hypercholesterolemia, prevention of postpartum obesity, mastitis, and poor immune function. Probiotics work by competing with potentially pathogenic bacteria and fungi in our gastrointestinal tract, interacting with immune cells, providing anti-inflammatory activity, strengthening the intestinal barrier, and producing beneficial compounds in the gut (short chain fatty acids like butyrate).
By working with your practitioner, you can find the correct probiotic strain specific for your clinical problem--this means, do not ingest any probiotic off the shelf or one that someone tells you is really good. Do your research first, or find someone that has done the research for you.
STRAIN MATTERS!!
Because each probiotic strain is unique, you should make sure you know which strain is in each supplement, if that strain is right for YOU and your condition, and if it exhibits efficacy/well-researched.
**If you’d like to learn more about this, check out Probiotic Advisor—a database with science-based evidence regarding each strain.
I hope this post clears some things up for you regarding probiotics and prebiotics and the role of the microbiota in our health. Feel free to comment with any questions, as I’d love to hear from you.
References
Ahrne, S. and M. L. Hagslatt (2011). "Effect of lactobacilli on paracellular permeability in the gut." Nutrients 3(1): 104-117.
Ho, J. K., Chan, G. F., & Li, J. B. (2015). Systemic effects of gut microbiota and its relationship with disease and modulation.BMC Immunology, 1621. doi:10.1186/s12865-015-0083-2
Peluso, I., Romanelli, L., & Palmery, M. (2014). Interactions between prebiotics, probiotics, polyunsaturated fatty acids and polyphenols: diet or supplementation for metabolic syndrome prevention?. International Journal Of Food Sciences And Nutrition, 65(3), 259-267. doi:10.3109/09637486.2014.880670