Probiotics are beneficial for many reasons. These posts explore the 6W’s – what, where, who, why, when, and which – about taking probiotics. Part 1 looks at what they are, where to find them  and who should take them. This part reviews why we need them, when we should be taking probiotics, and which (supplement or food) to take.

Why should we be taking probiotics?

There are many ways we benefit from probiotics. They aid with digestion of lactose (milk sugar) and proteins, balance the intestinal pH, regulate the movement of food throughout the gut, reduce intestinal inflammation, protect our teeth and gums, manufacture vitamins and increase the absorption of minerals, break down bacterial toxins, protect and modulate autoimmune diseases, support healthy blood pressure, break down and rebuild hormones, and promote healthy metabolism and weight. These are the known ways but the medical community has barely scratched the surface of understanding the intricate relationship between us and our gut microbiome.  Not all strains do the same things and some are specific for specific issues. Here are some ailments that have been studied to have a benefit from probiotics, and the specific strains that have proven beneficial:

• decreasing diarrhea-S. boulardii, L. Rhamnosus, multi-species strains
• enhance immune function-L. casei, L. rhamnosus, L. plantarum, L. bulgaricus, L. acidophilus, B. bifidum, B. breve
• support the digestive system-L. bulgaricus, L. plantarum, L. casei, L. rhamnosus
• enhance the availability of minerals for absorption-Lactic-acid producing bacteria of the Lactobacillus genus
• produce vitamins-Lactic acid-producing bacteria of the Lactobacillus genus
• reduce cholesterol-L. casei, L. acidophilus, B. bifidum, B. breve, S. thermophilus
• manage bowel inflammatory diseases-B. longum, L. casei, L. plantarum, L. acidophilus, L. bulgaricus, B. longum, B. breve, B. infantis, S. thermophilus (this combination is also known as VSL#3)
• improve food allergies-L. rhamnosus, L. bulgaricus, S thermophilus, L. casei
• fight against cancer, specifically in the colon-lactic acid-producing bacteria of the Lactobacillus genus
• heavy metal detoxification-L. rhamnosus binds to cadmium and lead for removal
• improve oral health-L. rhamnosus, L. paracasei, B. longum, L salivarius

When is the best time to take probiotics?

The challenge with taking probitoic supplements is that it is a live microbe (whether it’s a bacteria or yeast) that has to survive until it makes it into the intestines where it will contribute to the microbiome. The gastrointestinal tract can be a tough place for survival, specifically stomach acid. This acid is 1-2 on the pH scale, meaning it is so strong it would burn a hole through the hood of your car if it were spilled onto it (not that I could ever envision a time when that would happen, but you get the idea). For bacteria to survive this environment it has to be appropriately protected (as demonstrated in this study) so it can get into the small or more likely the large intestines alive and do it’s work. So that poses the question, when should I take my probiotics to make sure they are effective? Before a meal? With a meal? On an empty stomach?

There are many factors that can affect the viability of probiotics, such as the particular strain of microbe, the macronutrients content surrounding the microbe (it looks like fat may be a protector), and the timing of the meal. In addition, if taken as a supplement the enteric coating used to protect the live microbes also plays a role in the viability of the bacteria or yeast. Research shows, survival of common strains of Lactobacillus, Bifidobacteria, and Sacchromyces are best when given with a meal or 30 minutes before a meal. It doesn’t matter which meal, just take them with food.

Which types of probiotics – food or supplements – are best?

Probiotics can be taken through a supplement capsule or powder, or we can get probiotic microbes through fermented or cultured foods.

In the supplement form, they are “dosed” by colony forming units, or CFUs. A typical dose is anywhere from 1-25 billion CFUs for maintenance, and at least 50 billion CFUs after taking a round of antibiotics. Under healthcare observation they can be therapeutically dosed as high as 200 billion CFUs for various ailments.

Probiotic foods are defined as “food containing live microorganisms which enhance health by improving the balance of microflora in the gut.” There are many types of probiotic-rich foods including:

• milk products-various cheeses, cottage cheese, yogurt, buttermilk, kefir, raw whey, lassi
• fermented vegetables-sauerkraut, kimchi, brine cured-olives and pickles, other cultured veggies
• other foods include microbrewed beer, chocolate, coconut kefir, kombucha, miso, traditional saurdough bread

There is no one right answer for which is best to take. It appears that natural probiotic-rich foods tend to instinctually protect microbes, allowing them to get past stomach acid. When making the decision of supplement  vs. food your goal for taking probiotics should be considered. For maintaining a health GI tract food may be a better place to get them, but if you are trying to target a specific ailment with a specific probiotic, a well designed supplement may be best to assure you are getting the particular strain you want.

No matter which way you go, starting slow and steady wins the race. Starting with too much may cause some GI distress such as gas, bloating, sometimes diarrhea, or abdominal discomfort. If that happens, decrease the amount you are taking and gradually increase.

There is sooo much information about probiotics. While there are lots of unanswered questions, the medical community is learning more and more at a rapid pace. The Probiotic Advisor is a great place to get unbiased, up-to-date research and information about specific brands. While we are continuing to learn more and more about the harmony and dysbiosis of the gut microbes, one thing is for certain…keeping the microbial balance of the gut happy proves to be a good move for overall health.

Do you take probiotics? If so, which is your preference – food or supplement?