Inside Scoop: Here are your answers to…What are probiotics? Are they safe? Do they do anything good? How do I choose which to buy? And should I take probiotics every day?

This post was submitted by Paul Jenkins, MSc in Applied Chemistry and founder of DNA Lean.

What do sauerkraut, yoghurt, pickles, buttermilk, kefir, kimchi and other cultured vegetables have in common? Certainly, not their provenance. However, if you had the chance to enjoy a taste of each, you probably know what I mean. There is something that we tend to think is shared between these foods, which is why we have the inclination to group and associate them under the same class even though they’re not quite identical. Let me help you out.

Vinegary. Pungent. Sour. Sulphur-like; to avoid even less appetizing alternatives in case you’re eating or you’re on your way to having some right now.

All of these words describe each of the natural food products we most commonly devour that are highest in probiotics. And they’re all incredibly strong. Tormund strong – although I haven’t tasted giant’s milk just yet. Heavy duty stuff, if they’re properly made, that is. So intense that kefir triggered my gag reflex more than once. Still, I sometimes enjoy a sharp, cool mug with a side of freshly-baked rye bread. Human nature is complicated that way.

So what are probiotics, really? Are they safe? Do they do anything good, and, if so, how? More importantly, how do we choose which to buy? And should we take probiotics every day? Let’s try to answer these questions with the help of the little research that has been done so far.

For (a healthy) life     

Etymologically speaking, the name of probiotics is a composite between a Latin preposition “pro-” and a Greek adjective “biotikos” (transliterated, don’t judge), so that the resulting word essentially means “for life”.

It’s as if both of the languages were necessary to make such a bold claim. These products are collections of yeasts and live bacteria known to have beneficial effects on our bodies. You might think that bacteria are inherently bad, but, as we speak, there are beneficial microbes living both within your gut and on your skin.

What do they do? These valuable microorganisms are working to protect you from external threats, keep you healthy, aid in the digestion and absorption of various food stuffs, including protein and amino acids as well as produce vitamins from the foods you ingest. They’re pro-life in the most authentic, unadulterated way possible because life is hell without them. The major problem we’re confronted with nowadays is that the global medical community does not fully endorse the use of probiotics due to lack of sufficient research regarding commercially available products.

Both in the U.S. and in the U.K. probiotics are sold as food supplements, rather than medicine. While this may not strike you as controversial, claims related to foods require less testing than in the case of drugs, which is to say the assertions made by their manufacturers don’t necessarily need to be true from a legal standpoint. Because of this subpar regulation of probiotics, nobody can ever be sure whether what the label says is factual, whether there are enough microbes to actually trigger an effect, or if they will survive to reach your gut in the first place.

So, how can they be healthy? As you’ll see, extant literature indicates certain bacteria are constructive towards keeping us in good shape. Whether what you buy actually contains them is another question. Tricky, isn’t it.

CFU: Is Bigger Better?

Short answer: no.

Long answer: speaking as a nutrition specialist with a degree in Chemistry, increasing the CFU (colony-forming) count is a relatively cheap marketing ploy to try and convince people that one product is better than another. Basically, the CFU represents the approximate amount of bacteria you’re supposed to get with each serving. There is such great variety in the probiotics currently available on the market that servings of different products can vary from millions up to 100 billion.

There are three important facts you should take away from this section:

1) effective CFU doses can be anywhere from 10 million to 1 billion+,

2) multi-strain products are generally better than single-strain ones,

3) and adequate levels of vitamin D will improve their widespread beneficial impact.

Although many supplement companies suggest that a higher CFU is better, remember that they are not legally bound to the veracity of their statements, not in the way pharmaceutical companies are. Recently, supplement companies even started to commission studies on their products, which, although a step forward, is still not ideal. A good source of information would be a third-party investigation that tries to replicate the results of these in-house examinations. However, if the serving happens to contain under the minimum amount of approximately 10 million, it’s likely (according to macro statistics) that the dosage won’t achieve the desired effects.

There are other factors to consider as well. For one, due to improper storage conditions, some of the colonies can easily die, as they might be sensitive to temperature, humidity and light variations. Secondly, not all microbes will reach your actual gut, as some of them might be annihilated by the highly acidic environments of the stomach and upper intestine.

Try to choose a product that addresses such issues, point by point (e.g. guaranteed CFU number at expiry). It may not be the flashiest or the one that convinces you straight away with various selling techniques, but it will certainly be better.

Why Probiotics Are Good

When used appropriately, probiotics can help and/or treat acute diarrhoea, antibiotic-associated diarrhoea (AAD), necrotizing enterocolitis (NEC), chronic inflammatory bowel disease (IBD), Crohn’s disease, ulcerative colitis, and more. NEC, for instance, is a major cause of mortality in premature, underweight infants. Although there is a scarcity of well-founded research to rigorously account for the beneficial effects of probiotic usage, along with recommended doses and their impact, the literature that is currently available is promising, to say the least. Moreover, the evidence points towards the fact that more health conditions are associated with an unbalanced gut microbiota than we previously thought to be the case.

Gut microbes play a role in the development of obesity, i.e. lower microbe diversity is frequent in obese people, in our body’s ability to extract vital nutrients and substances from foods, as well as in our overall health. Since our good germs act as modulators for several immune functions, we absolutely need to take care of them in the same way and with the same fervour we look to defend against bad ones. They can help protect us against a variety of bacterial, gastrointestinal, and respiratory ailments, such as the common cold, several types of infections, and malnutrition. However, as with most good things, there are some risks associated with probiotic dietary supplements and you need to be fully aware of them before making any decisions.

Consult your (family/general practitioner) doctor before taking something that can have such a widespread impact on your health. Feel free to apply this advice to any health-related question you might have, but most especially to probiotics and other, related supplements. Lastly, do not, under any circumstance, believe outrageous health claims on products. Many of them have been retracted following lawsuits and allegations of misrepresentation, both in the U.K. and in the U.S.

The Bad and the Terrifying

Unfortunately, the lack of sufficient rigorous health investigations surrounding the positive impact of probiotics is only outmatched by the rarity of studies focusing on their side-effects. The latter include diseases such as endocarditis, bacteremia, negative metabolic effects on the GI tract and, most notably, the risk of antibiotic resistance. Essentially, you might be training your immune system to be unresponsive to vital, 21st century medication. This is worrying, especially for an industry that was worth over $35 billion in 2015 and is expected to exceed $66 billion by 2024.

Despite claims of the opposite, several commercially available dietary supplements containing probiotics were shown to be resistant to strains of broad spectrum antibiotics (such as ciprofloxacin, streptomycin, gentamicin, and more) that are currently used by doctors to treat a host of contagions. Among the latter you can include bone and joint infections, urinary tract infections, tuberculosis, pneumonia, meningitis, sepsis, the plague, and much, much more. Currently, there’s little to no evidence as to whether some or which of these resistances (if any) will be transferred to our genes via interactions of these microbes in our gut.

There is a dire need of more information in terms of which commercially available strains are likely to confer resistance to what classes of antibiotics and in what conditions this process can take place. I remain apprehensive about all marketed probiotics until such knowledge becomes a standard and, for your own safety, you should too.

Should I Take Probiotics Every Day?

As a nutrition specialist and coach, I would only advise taking probiotics in the form of supplements under the careful, close scrutiny of a medical doctor. We’re not meant to be taking them every day unless prescribed by a professional. Their substantial benefits and the noteworthy role they play in our overall health was proven beyond a reasonable doubt. However, tempering with such a fragile and complex ecosystem such as the gut microbiome ought not to be played by ear – on the contrary. This is all the more important as many commercially-available strains were proven to be antibiotic resistant, a feature which we know can be transferred to other microorganisms they interact with.

You can, however, try to keep your gut organisms healthy. What this means is, first of all, taking antibiotics only under prescription and medical supervision. These drugs are bacteria killers by nature. They kill the bad guys, but also the good ones. Aside from this, you can have a healthy, varied diet that includes as few processed products as possible and a balanced in-take of macronutrients from diverse, whole-food sources.

Fermented foods, such as the ones that I’ve mentioned in the beginning of this article, are a great source of natural probiotics. Lastly, protecting your good bacteria also means abstaining from alcohol abuse (not in general, just in excess, thankfully) and drug in-take, as well as maintaining proper levels of personal hygiene.

Paul Jenkins

Paul Jenkins is the founder of DNA Lean, an innovative line of sports supplements designed to provide the average gym-goer right up to the professional athlete good, honest, and research-backed supplementation for optimal performance and hormonal health.

Paul has almost 20 years’ experience in sports nutrition and coaching. Although he studied an MSc in Applied Chemistry, he firmly believes that food is medicine and that natural ingredients from plants and herbs can better work in harmony with the human body to improve performance, rather than resorting to pharmaceutical drugs.