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    Probiotics and Prebiotics – What They Mean To Your Health

    Dr. Mark Graves, Internal Medicine Internal Medicine, Deaconess Clinic Downtown 12/10/2019

    Probiotics and prebiotics—these are some health and nutrition “buzz words” right now.  But do you know what they mean, and how pre-and-probiotics may affect your health?

    This is a topic I’m excited about because it is a newer field in medicine and there are exciting developments that are affecting virtually every specialty. The topic of pre/probiotics is scientifically-interesting to me, but it’s also a topic that can help you—in very practical ways—improve your health.

    Understanding Gut Bacteria
    I want to start by explaining how much we have learned about the process of digestion—and the role of bacteria—in even the past decade or so.

    For most of history, we believed that digestion was a process of eating food, and then it was processed and digested by enzymes in the stomach and small intestine. Once it moved into the large intestine, it was there until a bowel movement, and that was about it. We knew bacteria lived in the gut, but didn’t know it had a significant role in overall body systems and health.

    Now we know that there’s a significant relationship between the gut bacteria and the chemicals and hormones that they release. These chemicals and hormones affect each of our body systems—including our brain!

    Each of us has a different mix of bacteria in our gut. Many are good bacteria, most of them are neutral, and there are a few that, if they grow extensively, can really cause problems--big problems.

    The challenge, then, is to encourage the growth of good bacteria while minimizing the bad.

    Sometimes a first step is to actually place the good bacteria there in the first place by taking probiotics. However, there is a challenge with “getting them where they need to go.”

    Let’s think about this like you would a lawn. You want to encourage the growth of lush, green grass, and you want the weeds to go away. You have to make the lawn hospitable to grass, while discouraging the growth of weeds. You also need to “fill in” with additional grass seed in spots where it’s thin. Your gut is the lawn, bacteria is both grass and weeds, and we need to figure out how to plant more grass and discourage the weeds.
    Choosing Oral Probiotics
    There are some bacteria that have been clearly identified as being good bacteria for certain conditions. Depending on which illness or condition you have and want to treat, taking a specific/targeted bacteria is important.

    Probiotics for Digestion
    If you have digestion problems, such as irritable bowel syndrome, frequent diarrhea or chronic constipation, abdominal pain/cramping, and more, I have found a probiotic blend that is recommended by my gastroenterologist colleagues here at Deaconess. It is called Align probiotic supplement. It’s a blend that supports digestive health and maintains digestive balance, and is found in many drug stores. This product contains b.infantis 35624, which is associated with digestive health.

    Probiotics for Neurologic Health
    For neurologic problems, there is a recent study in “Frontiers in Aging Neuroscience” called “Effect of Probiotic Supplementation on Cognitive Function and Metabolic Status in Alzheimer’s Disease: A Randomized, Double-Blind and Controlled Trial.”

    In this study, scientists showed that patients with Alzheimer’s disease had a 20% improvement in their memory score when they used 4 specific probiotics for 3 months. These strains include:

    • Lactobacillus acidophilus
    • L. casei
    • L. fermentum
    • Bifidobacterium bifidum

    This dosage was appropriate 400 billion bacteria per species (yes, that’s a big dose).

    This mix and dosage is difficult to find. One of my patients did some extensive work to find these probiotics for a family member. He found this particular mix available at Elbert’s here in Evansville, and Adele’s Naturally has also let us know that they carry this mix. Other retailers may carry it as well.
    Probiotic Coatings, Storage and Other Tips
    If an oral probiotic pill/capsule is not designed with thick enough coating, this is what happens: You take the pill, and stomach acid or small intestine enzymes break down the coating and kill the bacteria before it ever gets where it needs to go: the large intestine.

    So one of the most important things to look for is a product with a heavy-walled or “enteric coating” that allows the bacteria to make it into the gut before the capsule dissolves.

    If you have a probiotic and open it and stir it into some applesauce….sorry, it’s not going to work.

    I encourage people to buy probiotics from places where the storage and temperature have been tracked and controlled. Probiotics are living bacteria, and if not protected from temperature swings, the potency will change. Each bottle will indicate how many units at the time of manufacture. That number inevitably goes down over time.

    Also, it’s ideal to visit a local health food store. The staff is trained to help you, and they’ll be knowledgeable about new information. They’re also likely to have product that has been kept at a stable temperature since manufacture.

    Prebiotics are foods are those that encourage the growth of good bacteria and discourage the growth of bad bacteria. The right food also functions as the transmitter of those hormones and chemicals I mentioned earlier.

    Fiber is very much a prebiotic. This list of foods includes the types of fiber that, when digested, promote healthy body function.

    • Asparagus
    • Bananas
    • Onions
    • Garlic
    • Cabbage
    • Beans
    • Legumes
    • Bran
    • Leeks
    • Root vegetables (sweet potatoes, beets, carrots, turnips)
    • Apples

    All of these can help your body be healthier, but also are more hospitable to growth of good bacteria in the gut.

    I am sometimes asked about fermented foods as probiotics themselves (rather than just being prebiotics). I admit I’m not extremely knowledgeable about fermented foods for this purpose, but I have read some positive information and think there is value in adding them to a healthy diet.

    In summary
    For maintaining overall health, keep some basic principles in mind:

    • More strains is better—several varieties of bacteria.
    • Higher numbers are better—the higher the number, the more benefit.
    • Since this is something that can benefit for a lifetime, you want to look for a product that will work that you can also afford.
    • Find a product that mentions an enteric coating, so all the bacteria isn’t killed by the digestion process before getting to the large intestine.
    • Eat a diet rich in fruits, vegetables and whole grains to help good bacteria grow.
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