Probiotics: Supplements, foods & benefits

What are probiotics?

Probiotics are the live bacteria or yeasts that provide benefit to our health, contributing particularly to the normal functioning and balancing of the intestinal microflora, but also of the urinary system.

The most common probiotics found in the human microbiome belong to the Lactobacillus and Bifidobacterium families.

What do they do?

There are several mechanisms of probiotics action, which may vary depending on the type and amount administered. The most important are:

• They produce acids that lower the gut pH, preventing the growth of pathogenic microorganisms.
• They produce substances (e.g. bacteriocins), toxic against various pathogens.
• They prevent the adhesion of pathogens (e.g. E.coli) to the endothelium of the urinary and gastrointestinal tract.
• They increase the body’s immune response, stimulating the phagocytic activity of lymphocytes and macrophages.

Probiotic benefits

Although there are many different strains, probiotics have the following main benefits for our health:

• Balancing the gut microbiome
• Better treatment of gastrointestinal symptoms
• Assimilation of nutrients
• Vitamin production (eg B12 in the gut)
• Improving psychology
• Strengthening the immune system

More specifically, they can help with the following health conditions:

1. Diarrhea

Probiotics are the first line of treatment for antibiotic-induced diarrhea. They restore the intestinal flora and are most often administered prophylactically at least 2 hours after antibiotic treatment. In addition, they also help to treat diarrhea from other causes.

2. Constipation

Post-analyses from 2014 and 2017 confirm that probiotics, specifically Bifidobacterium lactis, contribute to the treatment of even chronic constipation.

3.Bloating

One of the main actions of probiotics is to treat bloating. Guidelines issued by the American College of Gastroenterology in 2021 recommend taking probiotics to treat irritable bowel symptoms, specifically bloating.

4. Improving psychology

Both animal and human studies confirm that probiotic supplements can improve certain mental disorders, such as anxiety and depression.

5. Urinary tract health

In many women, urinary tract infections as well as vaginal infections are common. Microbes find fertile ground when the microflora in the area is disturbed. Thus, pathogens such as Candida or E.coli overgrow.

Taking probiotics helps to restore the vaginal microflora and to better deal with the above conditions.

6. Skin diseases

Taking probiotics can improve the progression of certain skin conditions such as:

• the eczema
• psoriasis
• even acne

Nowadays, there are even skin-cosmetic products with probiotics, for external application, which aim to regulate the skin’s microbiome.

7. Infant colic

Although the exact cause of colic is not known, studies have shown that giving probiotics to infants who suffer from colic can immediately and without side effects improve your baby’s persistent crying.

8. Oral health

Periodontal diseases result from infections and inflammations of the gums and bones that surround and support the teeth.

A 2016 review of 12 studies (452 participants) evaluated probiotics for periodontal disease and found evidence that they could be a useful addition to treatment by reducing disease-causing bacteria and improving clinical signs of disease.

Probiotics for oral health are usually found in lozenge form, so they work directly on the affected area.

9. Elderly health

It is known that in the elderly there is a decrease in “friendly” bacteria in the gut, specifically Bifidobacteria, with a parallel increase in “hostile” bacteria and subsequent health problems. For this reason, it is most often recommended that they take fortified probiotics, in addition to their diet.

10. Vitamin production

Probiotics are also important for the production of some vitamins in the gut, such as vitamin K and most of the B vitamins (eg B12, B1, B2, B5, biotin, folic acid, etc.). In fact, they are particularly important for the production of vitamin B12 in strict vegetarians (vegans), since they cannot get it from animal sources!

Probiotic foods

There are many foods rich in probiotics and they contribute particularly to gut health. The ones that stand out are:

1. Yoghurt

Probably the most popular probiotic food is “live” probiotic yogurt or Greek yogurt made from cow, goat or sheep milk.

Yogurt, in most cases, can be ranked at the top of the probiotic foods if it comes from grass-fed animals and is unpasteurized. Look for the words “yogurt culture” in the ingredients, as many yogurt desserts are nowadays popular.

2. Kefir

It is a probiotic fermented milk drink. Kefir contains many important strains of friendly bacteria and yeast, making it a diverse and powerful probiotic source.

3. Sauerkraut

Sauerkraut is chopped, fermented cabbage that is very popular in many European countries. In addition to probiotics, it is rich in:

• lutein
• zeaxanthin
• Vitamin C
• Vitamin K
• iron
• potassium

4. Pickles

These are pickled gherkins, which are left to ferment for a period of time, using their own natural lactic acid bacteria. It is an excellent source of “friendly” bacteria and Vitamin K.

Except for sauerkraut and pickles, all pickled vegetables contain probiotics.

5. Buttermilk

It is a fermented dairy product. Buttermilk is low in fat and calories, but contains several essential vitamins and minerals.

6. Fermented soy products

Fermented soy products are very common in Asian cuisines. Such are:

• the natto
• the Miso
• the Tempeh

7. Olives

Brine-cured olives are an excellent source of probiotics (similar to pickles).

Just make sure olives don’t contain sodium benzoate, a food additive that can negate many of the benefit-promoting properties of this probiotic food.

Which one should I choose?

Many probiotic preparations with different compositions are commercially available.

In the table below you can find which bacteria (strains) have been found after studies to have benefits in various symptoms and health conditions.

What is the best time to take probiotics?

Indeed, many wonder if it is better to take the probiotic before or after eating.

Although there are no clear guidelines, a general rule states that probiotics with lactobacillus or bifidobacteria strains are best taken about half an hour before a meal, while saccharomyces boulardii can be taken at any time.

In addition, when it comes to live microorganisms, be sure to take the product away from hot drinks to avoid their destruction.

It is preferable to follow the manufacturer’s instructions on how to take it, which suggests the optimal way, depending always on the technology of the pharmaceutical form that has been used.

How long to take probiotics?

Most of the time, probiotics are recommended to be taken daily for a period of 2 weeks to 2 months in a row, in order to restore the normal flora in the intestinal tract.

In any case, depending on the situation, a different download interval is also recommended. For example, in the treatment of diarrhea due to taking antibiotics, the flora returns in about 3 days, while in the case of irritable bowel, taking them is recommended even for months in a row.

In conclusion, it is good to get the opinion of your treating physician or pharmacist for the duration of their reception.

Side effects

Probiotics are generally safe and well tolerated. In cases of overdose, bloating or even diarrhea may be observed.

When not take probiotics

Although probiotics are generally considered safe preparations, with no notable side effects and interactions, their intake should be avoided by:

• immunocompromised individuals
• critically ill patients
• people with intestinal obstructions
• premature infants
• patients with very low immunity

In these cases, people would do well to get medical approval before using them.