Good Bugs: How to Choose a Probiotic

It’s all about the microbiome!  The approximately 100 trillion bacteria and other microbe that inhabit your body is collectively known as your microbiome. It is estimated that our cells are outnumbered 3:1 by microbes.  This delicate balance between different strains of microbes has been shown to contribute to our immune system and overall health. Research is showing we don’t have just one genome or DNA sequence, but also the genes of our microbiome present a second genome.  The interaction of these genomes determines health.

Microbiota Research

Much attention has been placed on microbes as a promising way to improve and treat different conditions in the future of medicine.  In 2007, the Human Microbiome Project (HMP) was launched looking at the roles of different microbes in health and disease.  In recent years, interest in fecal microbiota transplantation (FMT) has grown, in which fecal bacteria (yes poop!) from a healthy  individual is transplanted into a recipient.  Introducing healthy flora  restores the colonic microflora, and has been an effective treatment for  C. Difficile, a difficult to treat infection,

Probiotics and Health Benefits

Interest in probiotics has surged in recent years. While research is ongoing and emerging on the benefits of probiotics, there is already strong evidence for it’s use for gastrointestinal issues including antibiotic associated diarrhea, IBS, inflammatory bowel disease, as well as respiratory health and urogenital issues.  As a dietitian, I believe in food first.  Proper macro and micronutrients should always be the foundation of your diet.  That said, many times supplements will help get you to the desired outcome faster.  For example, it would take the equivalent of 37 tubs of yogurt to provide the same amount of probiotics in one pill! The International Association of Prebiotics and Probiotics (ISAPP) defines probiotics as “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host”, and have stated that most probiotics on the market do not meet this definition.

Here are four things to look for in a quality probiotic:

1. 1. 1. Make sure the strain is identified. Many products list only the genus and species, such as Lactobacillus (genus) acidophilus (species).  Look for labels that also list strain Lactobacillus Acidophilus NCFM (strain). The strain is linked to the specific function of the particular microbe. For instance, the 299v strain of L. Plantarum  has been studied for lower bowel inflammation.  A good analogy is to think of a guard dog versus a poodle…same genus and species, but two very different dogs.
      2. Look for probiotics that are guaranteed at expiration. Probiotics can be guaranteed at manufacture or guaranteed at expiration.  When a probiotic is “guaranteed at manufacture”, that means once it leaves the warehouse, the company cannot ensure the quality.  Because levels of probiotics can decrease over time, probiotics guaranteed at time of manufacture may not be as potent after it is manufactured. When a probiotic is guaranteed at expiration, it means the company has taken the necessary quality steps to ensure the microbes will be viable and in the amount on the label at expiration.
      3. Match the amount of CFUs to the amount in the research. Probiotic counts are measured in CFUs, or colony forming units, and can range from several million to several trillion CFUs per dose.  Does the amount of CFUs match the research on the strain in the probiotic? More is not always better. Remember it is all about the proper balance of trillions of microbes.  A better approach is to take the probiotic strain in the amount that was researched for the health outcome or condition you are addressing.
      4. More is not always better.  As with the amount of CFUs, this holds true for the amount of strains in a probiotic. In the last several years, there has been a surge of multi-strain probiotics entering the market.  While this can be good when synergistic strains that have been studied together are introduced, there can be downfalls. Some strains can inhibit others, and are not optimal when taken together. Also, multiple strains are sometimes put together to imply a better product, but many of the strains are not in doses high enough to be effective to keep the cost of the supplement down.

Having a healthy gut microbiome is extremely important.  Taking the right probiotic may help you target specific health conditions and improve overall wellness.