Probiotics

By Patrick Holford

Don’t underestimate the power of your bacteria. Inside our bodies are twenty times more bacteria than living cells and the role they play in keeping you healthy is no less important. Having the right bacteria is vital for healthy digestion, keeping your immune system strong and consequently for fighting infections.
However, not all bacteria are good for you. There are harmful or pathogenicbacteria that can either cause infection directly, or produce toxic substances that contribute to inflammation or cancer, particularly of the digestive tract. The good guys, principally two families of bacteria called the Lactobacillus and Bifodobacteria, to a large extent keep the bad guys under control. What you eat, and supplement makes a big difference to the balance of bacteria inside you and consequently your health. The ingesting of beneficial bacteria, known as probiotics, have a number of proven benefits.
The value of probiotics was first brought to light in 1907 by Metchnikoff, a Nobel laureate working at the Pasteur Institute in Paris, who was impressed by the robust health and longevity of Bulgarian peasants who were in the habit of drinking fermented milk. In the 1930s Dr Minoru in Japan isolated a strain of lactobacillus bacteria now used in the yoghurt drink Yakult, and, by the 1990s an estimated 20 million people in Asia were consuming probiotics. Interestingly, the addition of probiotics into animal feed has increased fivefold in the last ten years because this has proven to increase the animal’s growth and reduce signs of stress. This potential benefit has yet to be studied in humans.

Fighting Infections Naturally

Infectious agents are all around us. Whether or not you succumb is not only determined by your exposure, but also by your balance of bacteria. The reason for this is that beneficial bacteria both consume the nutrients that would otherwise feed the bad guys and also block receptor sites that harmful bacteria have to latch onto to cause an infection, for example by entering the blood stream. However, the main way probiotics protect you is because they produce substances, such as lactic acid and hydrogen peroxide, that stop harmful bacteria from growing. These are nature’s antibiotics. They not only keep less desirable residents, such as E coli or Enterobacteria at bay, they also make it very hard for bugs such as Staphylococci (responsible for many sore throats), Salmonella and Campylobacter, which cause most cases of food poisoning, to survive. Worldwide, more than a million people die from food poisoning each year. In the UK alone there are around 60,000 reported cases of food poisoning a year, although the real numbers are probably ten times this.
Probiotics don‘t just give pathogenic bacteria a hard time, they positively boost your immune system. Six research studies have specifically found that different strains of beneficial bacteria improve the fighting power of the immune system. This means that probiotics are also important in the treatment of cancer and allergies, as well as infections caused by viruses, parasites and yeasts such as Candida albicans, which is responsible for thrush. One research study published in the Annals of Internal Medicine in 1992 gave women prone to thrush a live yoghurt containing Lactobacilli for six months or no yoghurt. After six months those on yoghurt were asked to switch to no yoghurt, and vice versa. Most on no yoghurt dropped out of the study, while those on their daily yoghurt refused to switch after six months. They had experienced a substantial reduction in the number and severity of yeast infections. Even more effective is the use of suppositories to deliver probiotics directly into the vagina. Probiotics have also proven helpful in treating recurrent bladder infections, sinusitis and tonsillitis.

Improving Digestion

Probiotics are your digestive tract’s best friend for a number of reasons. First, they help to digest your food. Both proteins and fats can be broken down into amino acids and fatty acids by Lactobacilli bacteria. The sugar in milk, lactose, is also broken down into glucose and galactose. This is especially helpful for those who are lactose-intolerant, lacking the digestive enzyme lactase which would normally do this. They also improve the absorption of calcium and other minerals, manufacture vitamins, primarily vitamin K, B12 and folic acid, relieve constipation and are important healers in a wide variety of digestive disorders. Among these are Crohn’s disease, ulcerative colitis, diarrhoea and irritable bowel syndrome. In one study from Poland on irritable bowel syndrome 100 patients were either given Lactobacilli, a placebo or anti-spasmodic drugs. Three quarters of those taking Lactobacilli had significant improvement, compared to 27% taking the drug and 0% taking the placebo. Twenty-two patients who had no relief on the drug were then given probiotics plus the drug. 77% reported improvement. Clearly probiotics was much more effective than anti-spasmodic drugs. It has been estimated that about half of all people diagnosed with irritable bowel syndrome have abnormal bacteria balance and therefore are likely to benefit from probiotics.
Inflammatory bowel disorders such as Crohn’s and colitis have also been proven to respond favourably to probiotics. Lactobacillus salivarius, a particular strain of lactobacilli, has proven particularly effective for colitis sufferers. One of the ways that probiotics may help is by promoting healing and repair of the digestive tract. When the digestive tract is inflamed, perhaps due to these diseases, infection of irritation by alcohol, painkillers or antibiotics, it can become abnormally permeable, which is a major cause of developing food allergies and detoxification problems. This sequence of events can also cause other inflammatory diseases such as arthritis which has also been shown to benefit from probiotics. The digestive tract can be restored to health by short chain fatty acids (SCFAs) that are naturally produced by Lactobacilli, Bifidobacteria and Eubacteria. (Eubacteria are generally not used as probiotics because supplementation makes little difference to their numbers in the gut.) The most proven benefit of probiotics is in cases of diarrhoea, especially those brought on by bacterial infections. In most cases, provided the right strain of bacteria at the right strength is used, probiotics can halve recovery time from a bout of diarrhoea. Hence, probiotics are an exotic traveller’s best friend. If you suffer from food allergies the chances are probiotics will help you too. Many food reactions may not be solely due to food allergy but also due to thefeeding of unfriendly bacteria which then produce substances that activate the immune system in the gut. Probiotics have been shown to help reduce inflammatory reactions in food allergies by lessening the response in the gut to allergenic foods.

Probiotics - Who benefits?

There is a good case for recommending probiotics, either in fermented foods or supplements, every single day to promote health and prevent disease. It certainly worked for the Bulgarians. The case is even stronger for the eldery since the amount of colonic bacteria decreases with age. The same is probably true for those under continuous stress. In animal studies probiotics have been shown to help reduce the symptoms of stress when animals are transported - so if you’re a stressed out commuter they may help you too! If any of the following apply to you probiotics are likely to help.

When You Most Need Probiotics

During an infection, especially sore throats,
Candida or bladder infections
Food poisoning, traveller’s diarrhoea or irritable bowel syndrome
Inflammatory bowel problems eg Crohn’s or colitis
Cancer, especially of the stomach or bowel
Constipation or any digestive disturbance including indigestion
After a course of antibiotics
After surgery
At times of prolonged stress

Choosing the best probiotic foods and supplements

Many cultures have observed the health promoting effects of fermented foods and include them as a regular part of their diet. These foods include: yoghurt, cottage cheese, kefir (from dairy produce) sauerkraut, pickles (from vegetables) miso, tofu, natto, tempeh, tamari, shoyu, soya yoghurt (from soya) wine (from grapes) sourdough bread (from wheat or rye)
However, most of these foods don’ t contain strains of Lactobacillus or Bifidobacteria that can colonise in the digestive tract. Yoghurt and other fermented dairy products often contain Lactobacillus thermophilus or bulgaricus.
These bacteria will hang around for a week or so doing good work. They, like the other beneficial bacteria, can make vitamins as well as turning lactose, the main sugar in milk, into lactic acid. This makes the digestive tract slightly more acidic which inhibits disease-causing microbes. Including these foods in your diet is a good way to promote healthy intestinal flora, however it is not as powerful as supplementing those strains of bacteria that can easily colonise the digestive tract. These resident strains are shown below. The most effective probiotic supplements provide these strains, often in combination.

Resident and Transient Bacteria Strains

ADULTS RESIDENT

L.acidophilus
L.salivarius
B. infantis
B. bifidum
B. brevis
B. longum

PASSING THROUGH

L.bulgaricus
L.casei
L.sporogenes
S. thermophilus

Key B = Bifidus L = Lactobacillus S = Streptococcus
Another way to boost the healthy bacteria inside you is to eat foods that feed them. The best food for your health-promoting bacteria is something called fructo-oligo-saccharides, or FOS for short, which is sometimes known as a prebiotic. Bananas are especially rich in these, as are barley, fruit, garlic, Jerusalem artichoke, onions, soybeans and wheat. One study found that eating banana powder thickened the stomach lining, as opposed to aspirin which thins the stomach lining.
The best probiotic supplements also contain FOS for the bacteria to feed off, promoting their rapid multiplication. FOS can also be supplemented on its own and has been shown to help promote more of the good guys and less of the bad guys, as well as relieving constipation.
Overall, eating a plant-based diet, high in fruits and vegetables, which are naturally high in fibre and FOS, is much more likely to encourage healthy bacteria. On the other hand, a high meat diet which, apart from being the primary source of gastrointestinal infections, is more likely to introduce toxic breakdown products as well as slowing down gastrointestinal transit time.

Are your probiotics getting through?

Even if you supplement the right probiotics, in food, powders or capsules, the next question is to what extent they make it through your stomach to the small and large intestine. The vast majority of gut bacteria reside in the colon. About 100 trillion to be precise, which is more than all the people on this planet. Stomach acid kills off a lot of bacteria, but certainly not all. There are four ways you can help more get through:
Supplement at least 100 million viable organisms
Supplement with FOS
Supplement away from food
Enteric coated supplements
Spore-form Lactobacillus supplements Supplementing enough bacteria is the starting point. You probably need 100 million to a billion viable bacteria to start with. Supplements are made by culturing bacteria then freezedrying them. If this is done properly probiotic supplements are stable for many months, if not years and do not need to be kept in the fridge. When you swallow them and they come in contact with moisture, they come back to life. If the supplement contains FOS this will promote rapid multiplication, so you may not need so many to start with. The same is true for microencapsulated or enterically coated supplements, which should be taken with food, otherwise take away from meals to minimise their destruction from gastric acid in the stomach.
Lactobacilli and Bacillus coagulans, formely known as Lactobacillus sporogenes, are particularly resistant to stomach acid and are therefore a good choice as a supplement. This type of Bacillus is especially effective at producing lactic acid, which is the primary way in which probiotics fight infection. Although not resident, Bacillus coagulans hangs around for a week or so doing good work. If you are taking probiotics therapeutically, for example to reinoculate the digestive tract after antibiotics or as part of an anti-infection strategy, for example to kill off Candidiasis, you may need three times the amount needed for general health promotion. These higher levels of probiotics and prebiotics such as FOS do sometimes result in increased flatulence, at least in the short-term. This is not necessarily a bad sign. Sometimes, as less desirable organisms die off, symptoms get worse before they get better.
In summary, here are a few steps you can take to promote healthy intestinal flora:
Eat a more plant-based diet
Eat fermented foods such as yoghurt, cottage cheese, miso, shoyu, sauerkraut, sourdough bread, especially those cultured with Lactobacillus or Bifodobacteria.
Take a probiotic supplement containing beneficial strains of bacteria as well as FOS.


For more information on keeping your digestive tract healthy, read ‘Improve Your Digestion’ and ‘New Optimum Nutrition Bible’ www.patrickholford.com