How to make the most of probiotics

We know probiotics are good for gut health and beyond, but what we take, and when, can make a difference. Dietitian Katrina Pace explains.

Growing the ‘right’ balance of bacteria is good for our health and one of the things we can do to help rebalance our gut bacteria is to take foods or supplements that contain good bacteria.

Over recent years, research has emerged showing people with certain health conditions grow different bacteria in their body to people without those conditions. Certain bacteria are involved in producing inflammatory chemicals, energy, immune effects and neurotransmitters. In recent articles, we’ve looked into how these bacteria are involved in allergies, depression and anxiety, weight control, autoimmune conditions and immunity.

What are probiotics?

The official definition of probiotic is ‘live microorganisms that, when administered in adequate amounts, confer a health benefit on the host’. But looking on the back of a bottle of probiotics, you’d be forgiven for thinking you need to learn Latin to read the label. You’ll see names such as Lactobacillus acidophilus, Lactobacillus reuteri and Bifidobacterium breve. It’s another language. Understanding a bit more about these names could be the missing piece of the jigsaw puzzle to make the most of these useful bacteria.

How probiotics work

Just as we have antibiotics that work against different types of ‘bad’ bacteria, there is a range of ‘good’ bacteria probiotics that can help treat certain conditions. However, working out which probiotic bacteria to take for which condition isn’t that simple.

Research investigating the effects of different probiotics on different conditions can be hard to interpret as, often, a probiotic containing several different bacteria is used. Different doses and manufacturing processes may also affect the outcomes of research. Which individual strain of probiotic was used can also affect results. And finding the strains resistant to bile and stomach acidity is important, so the bacteria are protected and arrive in the bowels, where they do their work, still alive.

Different probiotic bacteria also work in different ways. Some kill or stop pathogens, some destroy harmful toxins, some protect immune cells, others prevent pathogens attaching to the host and some affect the immune system.

Bacteria basics

The two most common bacteria types found in supplements are Lactobacillus and Bifidobacterium. Lactobacillus group bacteria are one of the first groups of bacteria that colonise our bodies during birth. At about six months of age, along comes the Bifidobacterium group and, together, the two groups create an important balance within the bacteria and yeast that colonise our bodies. Lactobacillus is a group of anaerobic (doesn’t need air to live) bacteria often found in the gastrointestinal tract, vagina and mouth. There are over 180 different types of lactobacilli, which have been used in treating antibiotic-related diarrhoea, anxiety and depression and urinary tract infections. It’s one of the most common types of bacteria found in yoghurt because there’s a ready supply of lactose (milk sugar) – one of its favourite foods.

Bifidobacteria are also anaerobic. Bifidobacterium love eating (fermenting) oligosaccharides (a type of carbohydrate), including those found in milk and plants. Different species and/or strains of bifidobacteria may provide a range of beneficial health effects, including keeping gut bacteria in order and protecting the gut mucosal barrier.

What’s in your probiotic

Here’s a bit more about some of the common probiotic strains found in supplements:

Lactobacillus acidophilus

What it’s used for

Makes B vitamins, folic acid, pyridoxine and vitamin K. Used for treatment of antibiotic-related diarrhoea

Lactobacillus plantarum

What it’s used for

Helps protect the lining of the digestive system. Involved in the production of neurotransmitters

Lactobacillus reuteri

What it’s used for

Protects the body against some harmful bacteria by producing an antimicrobial substance

Bifidobacterium breve

What it’s used for

Maintaining a healthy digestive system. Enhances the immune system

Bifidobacterium longum

What it’s used for

Maintaining a healthy digestive system. May have a role in cholesterol removal

Bifidobacterium animalis/lactis

What it’s used for

Influences transit speed in the colon and reduces inflammation in the gut.

Where to find probiotics

• Capsules or powders at pharmacies added to foods such as yoghurt or drinks added to certain skin and hair products
• Live yoghurt
• Naturally fermented foods, such as kefir, kombucha and sauerkraut, traditionally fermented cheeses, sourdough breads and meats.

If you’re thinking of taking a probiotic, the evidence is fairly conclusive these probiotics work for these conditions:

Antibiotic-associated diarrhoea

Prevention
Choose a probiotic with Saccharomyces boulardii, Lactobacillus acidophilus, Lactobacillus casei or Lactobacillus rhamnosus.

Travellers’ diarrhoea

Prevention
Saccharomyces boulardii
Irritable bowel syndrome (IbS)
Bifidobacterium infantis,
Lactobacillus phantarum,
Lactobacillus rhamnosus GG,
Bifidobacterium breve

Research is still coming in, but it looks like these probiotics may help these conditions:

Weight
Lactobacillus (including gasseri and rhamnosus), Bifidobacterium lactis (more research needed)

Anxiety and depression
Bifidobacterium longum, Lactobacillus helveticus, Lactobacillus plantarum

Blood glucose
Lactobacillus acidophilus

Other tips for choosing a probiotic

• Often research seems to suggest that choosing a capsule or powder with several different probiotic bacteria may be more effective than single bacterium.
• Dose does matter. Choose probiotics with a higher CFu (colony forming unit).
• Some of the newer probiotic supplements don’t need to be kept in the fridge – always check the label.
• Including naturally fermented foods in your daily diet is a tasty way of getting probiotic bacteria.
• There are probiotic supplements that contain bacteria specific to helping conditions such as iBS, mood and candida infections.