The microbiome

More and more studies are emerging about “the microbiome”.  This is the community of microbes that live inside us.  We have microbiomes on our skin, in our gut, vagina, mouth and nose. Practically any cavity inside us can have microbes inhabiting there.

We have about 10x as many microbes living inside us, or on us, than we have human cells (and we have approximately 75 trillion cells)!  This indicates the idea that we should be scared of microbes or bacteria is a little outdated.

Probiotics

The growing interest in particularly the gut microbiome has led to multiple probiotics coming onto the market.  The supermarkets are filled with “gut friendly” bacteria-laden yoghurt.

Is taking care of that ecosystem inside us as simple as swallowing a probiotic every day or eating some yoghurt?

Well, unfortunately, the answer is no!

Probiotics and fermented foods cannot repopulate your bowel flora – as they only stay in the system temporarily.  It’s the prebiotics that feed the microbes and can ensure the survival & flourishing of the ones we want in our systems.   

What are probiotics?

According to WHO, probiotics are “live organisms which when administered in adequate amounts, confer a health benefit on the host.”  However, the cultures we get in supermarket yoghurts cannot survive the pasteurisation process that those yoghurts go through.

In order for a yoghurt to be considered a probiotic food it must contain live cultures.  Whilst it is true that raw yoghurt can contain live cultures, again these effects are only temporary.

Therefore, using probiotics and fermented foods has to be done alongside eating prebiotic, bacteria-feeding foods or supplements to really be effective.

The most well researched prebiotic supplements are lactulose, fos and gos. However, research around acacia gum and partially hydrolysed guar gum is also emerging.

What are prebiotics? Prebiotic foods include what we call “FODMAPs” which are highly fermentable carbohydrates. These include whole foods like whole grains, nuts, seeds, onions, garlic and brightly coloured organic veggies.

However, these foods and supplements are often poorly tolerated with people with SIBO and IBS. Therefore, working on the IBS is essential so that someone can then work on building their gut microbiome. 

Probiotic quality

We are beginning to see that throwing multiple strain probiotic supplements, is not necessarily an effective strategy.

It’s about getting the right person for the job because different probiotic strains have different therapeutic qualities.  For example, Lactobacillus Rhamnosus GG, has been shown to help cell growth in the intestines and enhance the protection of the gut wall.

Some probiotics act as anti-microbials against pathogenic (disease-causing) micro-organisms and positively affect our immunity. Furthermore, they produce beneficial compounds in the gut, have anti-inflammatory effects, speed up or slow down gut transit time, and even alter our brain chemistry and metabolism!

So, how do you know that you are getting the right probiotic for the job?

Do your research! We’ve all done it, myself included, purchased a supplement because we’ve read somewhere that “probiotics are good”.  But, this is not an effective approach.  

Probiotic dosing

Importantly, dosing is about getting the right amount of intake. Unless research shows lesser doses of a particular probiotic to be effective, the general rule of thumb is that a single strain should contain at least 10 billion CFU to be effective.

Consequently, each strain within multi-strain probiotics should contain at least 10 billion CFU.  Many people don’t think about particular strains or dosages of a probiotic, so it’s a good point to remember.   

Furthermore, we have many different species of bacteria living within us.  Stool testing can show which species we have and diversity is the key. We’ve all heard of lactobacillus and Bifidobacterium, but research is showing that these aren’t the only two species that can have significant impacts upon someone’s health.

Akermansia muciniphila and faecalbacterium prausnitzii, the new kids on the block in terms of research, have been shown to be protective against leaky gut and inflammation and to be good indicators of increased microbial diversity in the gut.

In conclusion, certain prebiotics feed certain species of bacteria, so by knowing what exists within us we can target our food choices more specifically to increase certain populations.   

Fermented foods.

Fermented foods can also help feed the populations in the gut.  They cannot specifically colonise in the way that probiotics can, but they can certainly be used to increase the growth and diversity of beneficial bacteria in our microbiome.

Good choices include raw sauerkraut, raw kimchi, tempeh, miso and kefir.  Heat can destroy the bacteria, so add your choices to your food at the end of cooking instead of heating them up within the food, and ensure that your kimchi and sauerkraut are raw and unpasteurised! 

Finally, each microbiome, whether it be skin, gut, oral or vaginal, is drastically different so we can’t take a one size fits all approach.  Suffice to say that the vaginal microbiome is essential for urinary tract health and reducing fungal or bacterial infections.

The oral microbiome is a whole article in itself!  And our skin microbiome, which is there to provide us with protection, has taken a real bashing from the new age of antibacterial wipes and sprays that plague our supermarket shelves! 

Key takeaways

So, what are the key takeaways? Emerging research is showing how important certain microbes that live on and inside of us are for overall health.

But, eating supermarket yoghurt and taking probiotics with no actual goal in mind with no idea of what each particular strain does and whether it contains a therapeutic dose, is not going to make much of an impact on increasing your microbial diversity.

Stool testing, which can be ordered through a naturopathic nutritionist, will give you a much better idea of the health of your gut microbiome and your overall gut health.

Once armed with that information, your practitioner can help you choose the right probiotics and prebiotics for the job by looking at the research, mixed with some raw unpasteurised fermented foods and by adding onions, garlic and eating around 14 different coloured whole foods a day!     

References 

Aureli, P., A. Fiore, et al. (2010). “National survey outcomes on commercial probiotic food supplements in Italy.” Int. J Food   
Bao, Y., Y. Zhang, et al. (2010). “Screening of potential probiotic properties of Lactobacillus fermentum   
Cao, Y., Shen, J., & Ran, Z. H. (2014). Association between Faecalibacterium prausnitzii Reduction and Inflammatory Bowel Disease: A Meta-Analysis and Systematic Review of the Literature. Gastroenterology research and practice, 2014, 872725.  
Carlson, J., Erickson, J., Lloyd, B., Slavin, J. (2018). ‘Health Effects and Sources of Prebiotic Dietary Fiber.’ Current Developments in Nutrition, Volume 2, Issue 3.    
Hawrelak, J. A. (2013). Probiotics. Textbook of Natural Medicine.  
Hill, C., Guarner, F., Reid, G., Gibson, G. R., Merenstein, D. J., Pot, B., … & Calder, P. C. (2014). Expert consensus document: The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology and Hepatology, 11(8), 506.   
Huebner, J., R. L. Wehling, et al. (2007). “Functional activity of commercial prebiotics.” International Dairy Journal.  
Kristensen, N. B., Bryrup, T., Allin, K. H., Nielsen, T., Hansen, T. H., & Pedersen, O. (2016). Alterations in fecal microbiota composition by probiotic supplementation in healthy adults: a systematic review of randomized controlled trials. Genome medicine, 8(1), 52.   
Miquel, S. et al. (2013). Faecalibacterium prausnitzii and human intestinal health. Current opinion in microbiology, 16(3), 255-261. 
Mohammedsaeed, W., McBain, A. J., Cruickshank, S. M., & O’Neill, C. A. (2014). Lactobacillus rhamnosus GG inhibits the toxic effects of Staphylococcus aureus on epidermal keratinocytes. Applied and environmental microbiology, 80(18), 5773-81.   
Naito, Y., Uchiyama, K., & Takagi, T. (2018). A next-generation beneficial microbe: Akkermansia muciniphila. Journal of clinical biochemistry and nutrition, 63(1), 33-35.   
Patel, S., & Goyal, A. (2012). The current trends and future perspectives of prebiotics research: a review. 3 Biotech, 2(2), 115–125.  
Rao, R. K., & Samak, G. (2013). Protection and Restitution of Gut Barrier by Probiotics: Nutritional and Clinical Implications. Current nutrition and food science, 9(2), 99-107. 
Reid, G. (2006). Probiotics to prevent the need for, and augment the use of, antibiotics. The Canadian journal of infectious diseases & medical microbiology. 17(5), 291-5.
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