Updated: Mar 30, 2020
As a gut health naturopath and nutritionist my days are filled with people wanting to understand probiotics in relation to their (gut) health. You may already appreciate there is more to choosing the right probiotic than what meets the eye. To help you understand the world of probiotics here is some key things you need to understand.
1. What is a probiotic?
Over history, probiotics have been defined in a few different ways. The current definition, comes from the International Scientific Association for Probiotics and Prebiotics and define probiotics as “live microorganisms that, when administered in adequate amounts, confer a health benefit to the host"(1).
2. What does their long name mean?
That long unpronounceable name on the back of your probiotic bottle actually means something and is so important when it comes to choosing the right strain for your health. Let's use the example of Lactobacillus plantarum 299v.
Genus describes the first name of a bacterium (e.g. Lactobacillus). The genus is quite general and refers to a grouping of organisms based on similarity of qualities, such as physical characteristics, metabolic end-products and metabolic requirements.
Species is a bacterium’s second name (e.g. plantarum). It is a much more narrow classification based on shared common features that distinguish them from other species with that genus.
Strain is an even more specific classification that distributes members of the same species into subgroups based on one or more properties that these bacteria have that are distinct from other members of the species (e.g. 299v)(2).
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3. How important is the probiotic strain?
In short, SO important.
Each bacterial species contains a huge number specific strains, each differing in their properties. Some strains are weak or strong in their resilience against the journey through the upper gastrointestinal tract (GIT), some interact with your immune system and some inhibit pathogenic (bad/unwanted) bacteria.
When you are choosing a probiotic and it has labelled using only genus and species, for example Lactobacillus plantarum, but hasn't mentioned the strain such as 299v, this is problematic. Just because one strain of bacteria in a given species has a proven action or characteristic, it does not mean that another strain will too, even if they are closely related.
Strains of bacteria within the same species can have significantly different actions, properties and characteristics (1,3). For example, clinical trials found the following when studying Irritable Bowel Syndrome (IBS) and probiotics:
Lactobacillus plantarum 299v has been shown to effectively reduce IBS symptoms (4) (Bonus tip: this strain can be found in the product IBS Support by Ethical Nutrients).
Lactobacillus plantarum MF1298 was found to actually worsen IBS symptoms (5)
Want more information? Check out this blog addressing the 5 biggest myths about probiotics.
4. How do probiotics work?
As you will appreciate, over the last few years the research into gut health, probiotics and gut bacteria has increased enormously. To date research has confirmed that probiotics, depending on specific strains and species ingested can provide the following benefits (2):
Immune modulation (support a healthy immune response)
Modification of GIT transit (slow or speed up transit time)
Reduced visceral hypersensitivity (pain and discomfort commonly associated with IBS)
Antagonism against potential pathogens (help fight against 'bad' bugs)
Induction of GIT mucin secretion (protective secretion along gut wall)
Enhanced GIT IgA secretion (an important immune marker)
Directly attaching to rotaviruses (helps fight against viruses)
GIT, breastmilk and vaginal microbiota modification (help change the species found in these areas)
Production of beneficial compounds (e.g., short chain fatty acids)
Alteration of the vaginal, intestinal and colonic milieu (the environment)
Strengthening of the intestinal barrier/wall
Repair of the intestinal barrier (helpful in healing a leaky gut)
Metabolism of cholesterol in the GIT
5. Are fermented foods considered probiotics?
Based on current interpretations of the probiotic definition, it technically excludes traditional (wild) ferments like sauerkraut, kimchi, yoghurt and kefir. These are considered food sources of “live and active cultures”, but not probiotics (1).
The reason for their exclusion is that fermented foods are of undefined microbial content, meaning the bacterial species, strains and number can differ with each batch. Additionally, the strains within may also lack specific therapeutic qualities i.e. no health benefit for the person eating it. It is due to these variabilities that traditional fermented foods (wild ferments) cannot be relied upon for specific therapeutic effects in the same way that probiotic preparations containing well-defined strains, with well-characterised clinical effects, in precise doses can (6).
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6. Do you need to take a probiotic?
If you have a condition or symptom you want addressed, it is important to choose the correct and specific probiotic strain that has clinically proven therapeutic efficacy, to ensure you are receiving the desired therapeutic effect. It should also be noted that a probiotic strain that works in one condition will not necessarily be effective for other conditions (7), so something that works for Crohn's Disease may not work for Ulcerative Colitis, despite both being classified as Irritable Bowel Diseases.
If you are wanting a probiotic for general gut health support with no symptom or condition in mind, there is less pressure to choose the right strain/s, and a multi-strain probiotic may be suffice.
Fermented foods in its many forms is also something I would recommend. Fermented foods that have been stored correctly are considered safe and can provide general health benefits. By consuming fermented foods regularly you can help increase the overall bacterial diversity in your gut, which has been linked to a lower incidence of disease (8).
As an important side note. If you have or suspect you are experiencing histamine sensitivity issues, read this article before implementing fermented foods and/or probiotics.
As you can see there is a lot to consider when choosing the right probiotic for your health. Finding your perfect probiotic can be difficult as it requires sifting through the evidence, knowing what products contains the specific strains, some of which may only be available in practitioner products or are not available in Australia yet and then understanding what dose to prescribe.
If this all seems like a bit too much, it may be time to get some individualised help and assistance in this probiotic process. Reach out and book your initial consultation TODAY!