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Probiotics 101
(Our friend the bacteria)

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1 Probiotics 101
1.1.1 Introduction 
1.1.2 What are Probiotics? 
1.1.4 What are Prebiotics? 
1.1.5 Probiotic rich foods  
1.1.6 Probiotic bacteria types 
2 Probiotic Health uses 
3 What do Scientists Say? 
4 Issues of quality 
4.1.1 Manufacturing Quality 
5 Summary 
6 Resources 
7 References 

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Probiotics 101

1.1.1 Introduction

Fermented and cultured probiotic foods


like yogurt, kefir or raw sauerkraut,
when consumed in sufficient quantities
may have beneficial effects on human
health from improved digestion to
cancer prevention.

People have been consuming probiotics


since ancient times. One of the most
potent and common bacterium is L.
acidophilus which appears to act as a
natural antibiotic helping us fight
pathogens in our environment.
Probiotics are sensitive creatures easily
killed by stress in our bodies, our highly
acidic modern diets and unhealthy
lifestyle.

Colon + ‘friendly’ bacteria (or ‘good’ yeast) = Happy humans

• Probiotics must say live or active


cultures on the package to be of any
use.
• Most frozen yogurts or yogurt-coated
candies do not contain living or active
cultures and therefore convey no
probiotic benefit and may be sugar-
loaded time bombs – sugar feeds the
mean, nasty yeasts (like
Candida)…but that’s another article.


 
  
  

1.1.2 What are Probiotics?

1.1.2.1 Probiotics are alive and living all over, in and around you.

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skin, in the gut, and other
1.1.3 The world is full of orifices that will go
microorganisms including unmentioned in this article.
bacteria. Our bodies are Some bacteria eat parts of
simply loaded with bacteria food we can’t digest, like
and yeasts and viruses. In cellulose. Others help
fact, our bodies contain more generate vitamin K for us.
DNA from bacteria, yeasts and Probiotics are a bit delicate.
viruses than from our own They need to be cared for or
‘human’ DNA – tons more. You the colonies die out. That’s
might even say we are more why most experts suggest
bacterial than we are human. consuming foods or
We need the non-human living supplements that contain
DNA of probiotics to continue living cultures and soluble
living; how’s that for a creep- fibers (see, “What are
out? Probiotics are literally prebiotics?” on page 5)
living all over us, in and on the

1.1.3.1 Probiotics are friendly bacteria and yeasts vital to several bodily systems

You heard correctly; probiotics are alive! Deep in the primordial


digestive tube that is your intestine (and includes your colon).
Microscopic critters are playing scrabble in your digestive tract.
Probiotics are generally defined by the World Health
Organization as tiny living organisms (bacteria, viruses and
yeasts) that “when administered in adequate amounts, confer a
benefit upon the host”11 – by the way, you are the host.

Probiotics can be transported in your food or survive tucked


away in pills, powders, tablets or other supplement form. The
bacteria wondering, “What did we do to deserve getting locked
up inside this sterile little gel cap for goodness knows how
long?”

Probiotics are good for treating and preventing certain illnesses


and for supporting general wellness, however, (disclaimer)
according the National Center for Complementary and
Alternative Medicine (NCCAM):

• Probiotics are still not wholly understood and more studies


need to be done
• Know your critter: beneficial effects differ from one species or
strain of probiotics to another
• Over 100 companies market probiotic supplements; ideally,
check with individual manufacturers to see if their product is
tied to solid research
• Tell your health care providers when you are supplementing
regularly with probiotics

 An Introduction to Probiotics, National Center for Complimentary and Alternative Medicine, National Institutes of Health, Department of Health and Human Services, January
2007, revised August 2009; definition attributed to the World Health Organization and the Food and Agriculture Organization of the United States

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Probiotics are thought to support:

 Proper development of the immune system


 Protection against disease causing microorganisms
 Digestion and absorption of food and nutrients
 Hormone regulation

1.1.3.2 Probiotics are naturally fermented and cultured

Living At this time, the amount and types of


probiotics cultures needed to ‘convey benefit’ are
(meaning for not regulated by standard. The National
life) include Yogurt Association does have a
naturally voluntary standard signified by a logo
fermented foods and cultured milk placed on products containing an
products – e.g., yogurt, kefir, even estimated 10 million grams per culture,
naturally fermented sauerkraut. though the certification is not a
guarantee of what you get in the
A word of warning: by the most common package you buy.
definition, living cultures must be
present in a sufficient amount to convey Rule of thumb: Trust your own body’s
benefit. response to decide how much
supplementation works for you.
Living cultures + ENOUGH* cultures =
Benefit (*enough has yet to be officially Hint: Eat enough prebiotic-containing
defined) plants in conjunction with probiotics to
boost effectiveness.

1.1.3.3 Probiotics (and increasingly prebiotics) are big business

the optimum ‘dose’ of ‘supplement’


required. Scientists are also studying
which species and subspecies are most
effective to support health. Current
standards rank content in grams per
culture and in species or variety of
culture. In general, all this stuff begins to
sound a lot like an old Latin plant book.
So let’s not get too hung up on
measurement. Simply, we don’t know
Probiotics are gaining popularity and everything we need to know yet, though
Americans spend some $500 million a there’s plenty of evidence showing
year on them; that’s nearly triple the probiotics are safe and healthy food
amount of a decade ago. With the large sources. “USDA Certified Organic” and
amount of money at stake, it’s not ‘live cultures’ or ‘active cultures’ are
surprising that scientists have begun to good labels to look for on packaging.
get funding to study and to determine

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1.1.4 What are Prebiotics?

Prebiotics are snacks for probiotics. Prebiotics are non-digestible food ingredients like
the carbohydrate fiber inulin or FOS (fructooligosaccharides) that serve as snack food
for hungry colonies of probiotic species – prebiotics help probiotics survive the acidic
upper GI tract. Inulin occurs naturally in a whole host of edible plants – most notably,
chicory. Other sources of prebiotics include: onions, leeks, fruit, soybeans, sweet
potatoes, asparagus and some whole grains. Prebiotics fuel the growth or activity of our
‘good’ friends, the probiotic.

Probiotic + Prebiotic = Synbiotic (sin-bio-tic)

Similar to symbiotic (sim-bio-tic) – which means a mutually beneficial arrangement –


synbiotic refers specifically to the beneficial effects of mixing of both pro- and pre-biotics
together. Yogurt contains both inulin and active culture producing a better result in
tandem than alone.

Example: Inulin + active cultures = symbiotic


Yogurt (inulin + active cultures) = symbiotic
Culture food + live cultures = healthier colonies of live cultures

Warning: new snack formulations are adding inulin to almost everything. There is a lack
of good research out there as to whether these highly concentrated inulin ‘additives’ are
a good idea. Therefore, stick to traditional foods from all natural sources wherever
possible. Also, be cautious of ‘new’ or ‘concentrated’ probiotics ‘engineered’ by food
companies – corporations want to create bio-engineered products they can trademark
that may not be fully studied for safety. Stick to traditional bacterial and yeast varieties.

1.1.5 Probiotic rich foods

Best of all is probably to make your own yogurt, kefir or sauerkraut. Remember heat-
treating after culturing means it’s a dead product. Also, watch out for name brands with
heavy sugar content and those that are heat treated after culturing.

Yogurt chemical) sourdough bread


Raw sauerkraut and other raw pickled Miso
vegetables including kim chee and Tempeh
pickles Pulses, seeds and grains
Naturally fermented and unfermented Dong quai
milk including buttermilk Young coconut water
Unpasteurized dairy (a controversial Fermented soy (natto)
product due to Kombucha beverage
pasteurization Kefir (a yogurt-like drink)
laws)
Natural (not

Probiotic foods and supplements may have been present


originally or added during preparation. Most probiotics are
bacteria similar to those naturally found in people’s guts,
especially in those of breastfed infants (who have natural

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protection against many diseases).

1.1.6 Probiotic bacteria types

Because there are so many companies advertising such a wide variety of probiotics, it’s
a good idea to do some product research.

1.1.6.1 Probiotic Family Tree: Bacteria species and subspecies

Most often, the bacteria come from two groups, Lactobacillus or Bifidobacterium. Within
each group, there are different species (for example, Lactobacillus acidophilus and
Bifidobacterium bifidus), and within each species, different strains (or varieties).

1.1.6.2 Probiotics ‘different’ cousin

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Some probiotics are yeast, such as Saccharomyces boulardii, which are different from
bacteria.

2 Probiotic Health uses

Probiotics are considered to be chock full of potential health benefits. Some people use
probiotics to offset side effects from antibiotics, including gas, cramping or diarrhea.
Lactose intolerant? Some people report that probiotics can aid in dairy digestion.

Friendly bacteria are vital to:

 Proper development of the immune system


 Protection against disease causing microorganisms
 Digestion and absorption of food and nutrients

2.1.1.1 Every body has its own unique mix of bio-bugs.

Each person’s mix of bacteria varies. You are wholly unique. The goal is to keep
everything in balance. Don’t overfeed the bad bugs. Don’t underfeed the good bugs.

2.1.1.1.1 The biological balancing act

Think of your body as a giant container filled with the makings of a yogurt smoothie; your
body, like everyone else’s, is made with its own special house blend recipe. The
healthier your diet and lifestyle, the more likely you’ll be well balanced and delicious.

Remember:

- Interactions between a person microorganisms.


and his or her own bodily - All of these unique bacterial (and
microorganisms are unique to yeast and viral) interactions are
them. crucial to that body’s health and
- Interactions between wellbeing; the same applies to
microorganisms are unique to your body.
those colonies of - It’s a balancing act.

Warning: There is no USDA minimum requirement for probiotics. It is not clear how to
determine the right ratio or mix of healthy ‘flora and fauna’ (plants and critters) in our
bodies. As we’ve discussed, you carry a different mix of probiotics than your neighbor
does, or his neighbor does, and so on and so on.

2.1.1.1.2 Listen to your own body to decide supplementation needs.

The current ‘rule of thumb’ – Raw, live, active cultures

Say “yes” to enzyme-rich lacto-fermented foods with words like biodynamic, raw, active
or live cultures on the labels; just say “no” to extra sugar, anything with fructose corn
syrup or corn starch, and say “no way” to heat processed, pasteurized, canned,
preserved – those things just mean dead.

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 Listen to your own body and what regenerate.
it’s telling you.  Also, avoid ‘active culture’
 Your body will probably let you products that contain high sugar
know if you’ve gotten the right content or that include fructose
‘dose’ of probiotics or if extra corn syrups, corn starch or
servings are needed – motto, ‘a artificial ingredients – as those
little every day, goes a long way.’ aren’t very ideal choices.
 Look for a mix of different types (a  Avoid choices that say heat
variety of species) of acidophilus treated after culturing
in your probiotic cocktail.  You must choose ONLY ‘RAW’
 USDA Certified Organic is a good sauerkraut, most often found in
symbol to look for on packaging. health food stores, as grocery
 Never buy yogurt without active or store brands are heat-treated and
live cultures listed on label – no longer offer any ‘biodynamic’
dead, lifeless yogurt doesn’t benefit.

2.1.1.2 This bacterial “balancing act” – Good bugs vs. bad bugs

Bad bugs and antibiotics can kill good bugs.

1. Antibiotics can kill the nice, friendly 2. “Unfriendly” microorganisms such as


bacteria colonies homesteading in the disease-causing bacteria, yeasts, fungi,
gut. Many health professionals suggest and parasites can also upset the
supplementing with healthy bacteria balance of healthy colonies in the body.
supplements when taking antibiotics.

Good bugs may also be able to kills bad bugs.

Researchers are exploring the possibility that probiotics might act to prevent bad bugs in
the first place or at least may suppress bad bug growth and activity. The preventative
power of probiotics may be helpful with conditions such as:

• Infectious diarrhea inflammation


• Irritable bowel syndrome • Tooth decay and periodontal
• Inflammatory bowel disease (e.g., disease
ulcerative colitis and Crohn’s • Vaginal infections
disease) • Stomach and respiratory
• Infection with Helicobacter pylori infections acquired in daycare or
(H. pylori), a bacterium that other group settings
causes most ulcers and many • Skin infection
types of chronic stomach

Good bugs appear to boost immune system defense.

• It’s a fact that there are cells in the you alter a person’s intestinal
digestive tract connected with the tract, thereby theoretically
immune system. boosting the immune system’s
• Introduce probiotic bacteria and defenses.

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3 What do Scientists Say?

“Scientific understanding of probiotics potential, including treating and preventing illness


are moving ahead.” An Introduction to Probiotics, NCCAM, Aug. 2008

According to an NCCAM report, co-funded by the National Center for by the American
Society for Microbiology, there is encouraging evidence for effective probiotic
formulations:

 To treat diarrhea, especially for diarrhea from rotavirus


 To prevent and treat urinary tract or female genital tract infections
 To treat irritable bowel syndrome
 To reduce recurrence of bladder cancer
 To reduce duration of intestinal infections from Clostridium difficile bacterium
 To prevent and treat pouchitis, a condition that can follow surgery to remove the
colon
 To prevent and manage atopic dermatitis (eczema) in children
 The conference panel suggests that more research (especially in the form of
large, carefully designed clinical trials) is needed in order to draw firm conclusions

The key and exciting question: What is going on at the molecular level with the bacteria
and how do they interact with the body to prevent and treat diseases?

4 Issues of quality

4.1.1 Manufacturing Quality

Beware the manufactured food product that can’t occur ‘naturally’

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With more consumers investing in probiotics come more companies trying to cash in on
a good thing. The concerns, say scientists and holistic practitioners are: what happens
when probiotic bacteria are treated or altered in a manufacturing process? What
happens when probiotics are added to non-traditional foods? What if some food
manufacter puts probiotics in donuts or sodas? Would those weird combinations affect
the happy bugs’ ability to survive, grow and/or deliver a therapeutic effect. The same can
be said about recent efforts by companies to put non-soluble fiber inulin into every food
product they can get their hands on – that’s a topic of hot debate – might be a bad idea.

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4.1.1.1 Dosage Effects Quality

The best ways to administer probiotics for therapeutic


purposes, as well as the best doses and schedules is still
open to debate.

- Probiotics offer the potential to aid with the problem of


antibiotic-resistant bacteria in the gut – antibiotic-resistance is
#1 health concern according to a 2009 Pew Foundation report, “Who’s Hogging our
Antibiotics?”
- Probiotics offer the hope of preventing the spread of unfriendly bacteria bacterial
through skin or mucous membranes as can occur in cases of burns, shock, trauma or
suppressed immunity.

4.1.1.2 Side Effects and Risks

Live microorganisms have been in use for thousands of years without causing illness in
people and were used by the ancients as medicine. Still, modern scientists caution that
we still don’t fully understand safety and function of microorganisms in the body.
Theoretical questions exist about safety for the young, elderly and people with
compromised immune systems. Consult your physician in cases where immunity is
impaired. However, be aware that most physicians are not well trained in nutrition. In the
end, food is food and choices come down to good judgment and careful observation. If
you continue to have trouble with dairy foods after trying yogurt or kefir, then switch to a
non-dairy source of probiotic such as sauerkraut or kombucha.

Probiotic side effects, if they occur, tend to be mild and digestive (such as gas or
bloating). More serious effects have been seen in some people. Probiotics might
theoretically cause infections that need to be treated with antibiotics, especially in people
with underlying health conditions. They could also cause unhealthy metabolic activities,
too much stimulation of the immune system, or gene transfer (insertion of genetic
material into a cell). Probiotic products taken by mouth as a dietary supplement are
manufactured and regulated as foods, not drugs.

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5 Summary

If you are thinking about using a probiotic product to treat a medical condition, consult a
health care provider familiar with nutrition and complementary and alternative medicine
(CAM). No CAM therapy should be used in place of conventional medical care or to
delay seeking that care. Effects from one species or strain of probiotics do not
necessarily hold true for others, or even for different preparations of the same species or
strain.

If you use a probiotic product and experience an effect that concerns you, contact your
health care provider. You can locate research reports in peer-reviewed journals on
probiotics’ effectiveness and safety through the resources PubMed and CAM on
PubMed.

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6 Resources

The Environmental Resource Illness Resource:


http://www.ei-resource.org/treatment-options/treatment-information/probiotics-and-
prebiotics/
Body Ecology (diet book and products for people struggling with yeast and other health
issues – proponents of certain raw and natural products with probiotics)
http://bodyecology.com/

National Dairy Council:


http://www.nationaldairycouncil.org/NationalDairyCouncil/Health/Digest/dcd76-
1Page3.htm
 
http://www.kitchengardeners.org/sauerkraut.html


    
  


     

      
   


International Probiotic Conference: http://www.probiotic-conference.net/organization

National Center for Complementary and Alternative Medicine


http://nccam.nih.gov/health/probiotics/

7 References

Sources are primarily recent reviews on the general topic of probiotics in the peer-
reviewed
medical and scientific literature in English in the PubMed database, selected evidence-
based
databases, and Federal Government sources.
1994-2004 U.S. specialty/other supplement sales. Nutrition Business Journal. 2005.
Accessed at http://www.nutritionbusiness.com
on December 7, 2006.
Alvarez-Olmos MI, Oberhelman RA. Probiotic agents and infectious diseases: a modern
perspective on a traditional
therapy. Clinical Infectious Diseases. 2001;32(11):1567-1576.
Bifidobacteria. Natural Medicines Comprehensive Database Web site. Accessed at
http://www.naturaldatabase.com on
December 7, 2006.
Bifidus. Thomson MICROMEDEX AltMedDex System Web site. Accessed at
http://www.micromedex.com on December 7, 2006.
Cabana MD, Shane AL, Chao C, et al. Probiotics in primary care pediatrics. Clinical
Pediatrics. 2006;45(5):405-410.
Doron S, Gorbach SL. Probiotics: their role in the treatment and prevention of disease.
Expert Review of Anti-Infective
Therapy. 2006;4(2):261-275.

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Ezendam J, van Loveren H. Probiotics: immunomodulation and evaluation of safety and
efficacy. Nutrition Reviews.
2006;64(1):1-14.
Food and Agriculture Organization (FAO) of the United Nations and World Health
Organization (WHO). Guidelines for the
Evaluation of Probiotics in Food. Report of a Joint FAO/WHO Working Group on Drafting
Guidelines for the Evaluation of Probiotics
in Food. Accessed at
http://www.who.int/foodsafety/fs_management/en/probiotic_guidelines.pdf on December
7, 2006.
Gill HS, Guarner F. Probiotics and human health: a clinical perspective. Postgraduate
Medical Journal. 2004;80(947):516-526.
Hammerman C, Bin-Nun A, Kaplan M. Safety of probiotics: comparison of two popular
strains. BMJ.
2006;333(7576):1006-1008.
Huebner ES, Surawicz CM. Probiotics in the prevention and treatment of gastrointestinal
infections. Gastroenterology
Clinics of North America. 2006;35(2):355-365.
Lactobacillus. Natural Medicines Comprehensive Database Web site. Accessed at
http://www.naturaldatabase.com on
December 7, 2006.
Lactobacillus. Thomson MICROMEDEX AltMedDex System Web site. Accessed at
http://www.micromedex.com on
December 7, 2006.
Probiotics: Bottom Line Monograph. Natural Standard Database Web site. Accessed at
http://www.naturalstandard.com on
December 7, 2006.
Reid G, Hammond JA. Probiotics: some evidence of their effectiveness. Canadian
Family Physician. 2005;51:1487-1493.
Salminen SJ, Gueimonde M, Isolauri E. Probiotics that modify disease risk. Journal of
Nutrition. 2005;135(5):1294-1298.
Vanderhoof JA, Young RJ. Current and potential uses of probiotics. Annals of Allergy,
Asthma, & Immunology.
2004;93(5 suppl 3):S33-S37.
Walker R, Buckley M. Probiotic Microbes: The Scientific Basis. Report of an American
Society for Microbiology colloquium;
November 5-7, 2005; Baltimore, Maryland. American Society for Microbiology Web site.
Accessed at
http://www.asm.org/academy/index.asp?bid=43351 on December 7, 2006.
July 30, 2009; www.usprobiotics.org
 
      

http://www.saveantibiotics.org/

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