Dr. Neal on probiotic supplements and what probiotics are.
My wife was watching some Golden Girls reruns on TV the other day.
“Why?” you may wonder.
It brings back fond memories. When she was a kid, her parents would allow her to stay up late on Saturday nights and watch the show. She says she would usually fall asleep in front of the television set before the show ended and now, she can finally watch them in their entirety – and understand the jokes. But, anyhoo, while she was watching there just happened to be a commercial for a probiotic supplement that promised to help “keep you regular.”
What are Probiotics?
We have lots of good bacteria found in the gut–we’re talking LOTS of them–it is estimated that each person has anywhere from 10-100 trillion of these good bacteria in our intestines. And remember, these are good bacteria; they help keep us healthy.
Probiotics are live bacteria that support the health of our microbiome. In fact, it is believed the term “probiotic” comes from the combination of 2 Greek words which translate to “for life,” And, yes, foods like yogurt, Kefir and Yakult contain lots of probiotics. Because probiotics are composed of strains of bacteria, you’ll find the names of these strains come from Latin.
Strains of Probiotics
Depending on the food source, the probiotic strains found in that food may differ.
Probiotics are often found in dairy products, although other food sources can be a source of probiotics as well. These foods include fruits, vegetables and soy. Yogurt and other cultured or fermented dairy products are the most commonly consumed foods containing probiotics.
The majority of probiotic strains available in the marketplace contain species of Lactobacillus and Bifidobacterium. Again, these are most often found in dairy products.
But which strains are found in what products? And, do these strains have different health effects? I’ll begin with the former.
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Which Probiotic Strains are in Common Products?
Yakult, a dairy-based probiotic drink, is made of fermented milk and contains L. casei shirota.
Contrast this with the strains found in Danon’s Activia yogurt, which contains B. animalis DN173010.
The Nestle company also has its own probiotic yogurt-like beverage which also contains B. animalis, but of the lactis subspecies.
Greek yogurt and traditional yogurts both contain Lactobacillus acidophilus.
Cottage cheese contains similar strains – usually both Lactobacillus acidophilus and Bifidobacterium.
When it comes to refrigerated yogurts, the National Yogurt Association (NYA) — yes, it’s a real thing — created a seal that can be found on the packaging indicating when a product contains live and active cultures. Food manufacturers earn this seal when they demonstrate that their products contain at least 100 million cultures per gram for their refrigerated products, specifically. Frozen yogurts have different criteria altogether. For products that don’t contain this seal, look for a list of specific live and active probiotic strains on the packaging.
Are Probiotic Health Claims Really True?
The trouble is we don’t really know how helpful these foods are when it comes to actually increasing the number of good bacteria in your gut. This is because these foods have to first pass through the stomach before they get to the intestine. The stomach is a pretty harsh environment for most things. It’s possible that many of those good bacteria are destroyed before they get to the intestines, where they can thrive. As always, I have to rely on actual studies to find out whether probiotics are helpful. Luckily, there are plenty of those!
Based on the data I have seen, there are some probiotics that are showing promise for helping reduce the symptoms of certain conditions. For example, there are some that may help reduce the symptoms of Irritable Bowel Syndrome (IBS), like diarrhea and cramping.
What about other conditions where the symptoms don’t seem directly connected to the gut, like the common cold?
Some studies have found that supplementing with certain strains of probiotics may reduce the likelihood of getting a cold or, if you do get sick, reduce how long the cold will last. Supplementing with 2 strains of Lactobacillus–Lactobacillus plantarum and Lactobacillus paracase–seem to be the most helpful.
There are also some data that support the use of S. salivarius in reducing risk of viral or bacteria-causing throat infections. As far as these throat infection studies go, researchers have only looked at children so we don’t know if we’d see the same results in adults.
Do Probiotic Supplements Help with Weight Loss?
With regards to probiotic supplementation and weight loss, we need more and better designed studies to understand what’s going on. Many of the studies are sponsored by companies that may have a financial stake in the findings, like the Nestle company for example. These companies will create formulations of these products and then give money to researchers to try them out. That can quickly pose a conflict of interest, pressuring the researcher to find a positive result.
Probiotics & Other Conditions
Researchers have also studied strains of probiotics on cholesterol and even anxiety and depression. For lowering “bad” or LDL cholesterol levels in the blood, a combination of Lactobacillus acidophilus and Bifidobacterium lactis may help. But don’t expect it to dramatically lower these bad cholesterol levels–if it does help, it may only lead to a modest lowering.
When it comes to anxiety and depression, an association between gut health and these conditions has been established. Researchers have started to examine whether improving gut health can also improve anxiety and depression. The research is promising, but what’s not so clear is which probiotic strains appear to help. Right now, there appear to be 2 strains that may help: Bifidobacterium longum and Lactobacillus helveticus.
Conclusion on Probiotics
In summary, there are many probiotic strains out there. Here are the ones that I’ve mentioned so far:
- Lactobacillus plantarum and Lactobacillus paracasei – potentially prevent colds
- S. salivarius – may help prevent throat infections in children (we need more studies with adult participants)
- Lactobacillus acidophilus and Bifidobacterium lactis in combination – possibly help lower “bad” LDL cholesterol levels
- Bifidobacterium longum and Lactobacillus helveticus – may help with anxiety and depression
With regards to proper storage of these probiotics, some require refrigeration whereas others may be stable at room temperature. It really depends on the brand and the probiotic strains. Carefully read the packaging to find out how best to store the probiotic. And, as always, if you decide to begin supplementing (with anything really), speak to your primary healthcare provider first.
Remember that probiotics are found naturally in foods, too.
There are some that would want to stay away from commercially-prepared probiotics (basically probiotic supplements). According to the National Institutes of Health, most healthy adults can consume probiotic supplements. But, this is assuming that the product is made of quality ingredients, is free of impurities, and is stored properly.
The most commonly reported side effect is gas. But for some people, serious side effects have been reported. Those that are seriously ill, like those suffering from cancer or are receiving chemotherapy or radiation, those with weakened immune systems, anyone who has recently undergone surgery, and young infants may want to avoid supplementing with probiotics. And since many of the food sources of probiotics are found in milk-based products, if you have a milk allergy or are lactose intolerant, be careful.
As always, if you decide to begin supplementing (with anything, really), speak to your primary healthcare provider first.