Gut health can be a complicated topic that requires the perfect balance of multiple factors to achieve. We spoke to Andrea Burton, a Technical Advisor at ADM Protexin, about everything you need to know about digestive wellness and the role probiotic supplements play.
Andrea Burton
Technical Advisor, ADM Protexin
What is the importance of gut health and what are some common misconceptions?
Interestingly, the digestive system is external to the body; it is only when particles pass through the digestive lining that they enter into the body. Therefore, the gut has an extremely important role to play in keeping the body healthy and it can only do this efficiently and effectively if the gut itself is healthy. It acts as our first line of defense by blocking out harmful toxins, bacteria, and viruses while also absorbing the nutrients from our diet to feed every cell of our body. And with over 70 percent of our immune cells residing in the lining of the gut, gut health is of huge importance.
A major factor in digestive health is the trillions of micro-organisms (known as the microbiota, which includes not only bacteria, but also viruses, fungi, and protozoa) which reside in the human gastrointestinal tract. Dysbiosis (either a qualitative or quantitative change in the gut microbial community) is commonly observed in many gut-related conditions. There is a strong association between reduced diversity and poor digestive health, which indicates that a species-rich gut ecosystem is more robust against environmental influences. Microbial diversity is therefore generally seen as a good indicator of a “healthy gut.”
There can be numerous reasons why the digestive system is not working optimally; including poor diet (too much sugar and not enough fiber), lifestyle (lack of exercise and sleep), stress levels, food intolerances, genetics, the environment we live in, and certain medication.
One common misconception in the area of gut health is that probiotics colonise the gut, but they are in fact considered transient in nature. They exert beneficial effects as they move through the intestines — such as changing the pH, supporting the immune system, and improving the health of the gut lining — before being excreted in the stools after a few days to weeks. This helps to create an environment more favorable for the body’s own resident bacteria.
Another misconception is that short-term doses are better than regular daily supplementation. Regular low-level exposure to beneficial bacteria through daily supplementation closely mimics how we would have traditionally been exposed to bacteria in nature, when historically we would have been living and working outside more and in closer proximity to animals. The microbiome can also change rapidly (significant changes have been shown to occur in as little as 24 hours), so it’s important to keep levels topped up. Therefore, regular intake through supplementation or traditionally fermented foods may be beneficial, depending on individual diet and lifestyle factors.
Can you give a brief explanation of probiotics and their importance with regards to gut health?
Probiotics are live microorganisms which, when administered in adequate amounts, confer a health benefit on the host.
An altered gut microbiome (dysbiosis) can affect many biological processes, increasing the risk of disease. There is a large body of evidence showing positive effects for the use of live bacteria supplements in a range of health conditions. Research indicates that dysbiosis can potentially trigger the development and/or progression of immune and inflammatory related illnesses. Probiotic supplements have been shown to interact with both the innate immune system (the one we are born with) and the acquired immune system (the one we acquire over time as we come into contact with microorganisms from the environment). Research also shows that probiotics may have a regulatory role, having the ability to activate immune cells that release anti-inflammatory compounds and suppress potentially pathogenic (disease-causing) microorganisms in the gut. In addition, probiotics support good digestive function by helping to increase absorption of many immune-supportive nutrients from food.
How can probiotic supplements promote gut health?
The benefits seen from taking a probiotic supplement will vary from person to person based on a number of factors such as why they are taking the product (e.g. for preventative wellness or to address a symptom or manage a condition), the level of dysbiosis they have in their gut, their underlying health, and other dietary and lifestyle factors.
Particular benefits that probiotic supplements may offer are:
- The inhibition of pathogens (disease-causing microbes) through competitive exclusion, altering the colonic environment and directly through bacteriocin activity.
- Supporting the gut barrier function (preventing a “leaky gut”).
- Providing extra nutrition by assisting in food digestion and the synthesis of nutrients (such as B vitamins, vitamin K, and short-chain fatty acids).
- Supporting the function of the immune system (70 percent of which resides in the gut).
- There is also increasing evidence that modulating the gut-brain axis using probiotic supplements may also be a useful therapeutic tool in the management of anxiety and depression.
Should you discuss with a doctor before taking probiotic supplements? If so, what are some important questions to ask?
If you are taking any medications, have any medical conditions, are pregnant, or are breastfeeding, always consult your doctor before taking any dietary supplements. Although there are currently no known contraindications between probiotics and pharmaceutical medications, some probiotic products contain other ingredients such as vitamins and minerals which may interact with medications, so it is always wise to ask your doctor about any potential interactions.
Are there different types of probiotic supplements? Could you give a brief breakdown of different types and products?
There are a wide range of different probiotic products available, with various species, strains, and strengths, as well as different ways for them to be taken (capsules, drinks, gummies, and nutrition bars). The beneficial effects of different bacteria are strain-specific. Therefore, which strains are most appropriate will depend on an individual’s circumstances and the reasons they are looking to supplement. Multi-strain products have been found to be more effective at inhibiting pathogens than their component strains administered separately, and as different strains exert their effects in different parts of the gastrointestinal tract, multi-strain products may be of benefit in a wider range of digestive conditions.
One such multi-strain formula (Bio-Kult Original) was recently used in the largest double-blind randomized controlled trial of live bacteria supplements in IBS-diarrhea type patients ever conducted. The study in 400 people found that bacterial supplementation significantly improved overall symptom severity in IBS patients and was well tolerated. Abdominal pain and frequency reduced by an average of 69 percent, and 34 percent of participants were completely symptom-free at the end of the four-month trial. Significantly though, as well as relieving IBS-D symptoms, beneficial bacteria was also shown to markedly improve all aspects of quality of life. This includes psychological issues such as anxiety about health, depression, lack of enjoyment of life, and feelings of having to avoid stressful situations.
Alongside probiotics, there are numerous digestive aids on the market which may be beneficial. Examples include anti-microbial agents, designed to eradicate pathogenic overgrowth; prebiotics to feed beneficial species of bacteria in the gut; digestive enzymes; betaine hydrochloride (the building blocks for stomach acid); bitters and bile supplements, designed to help us better digest our food; and nutrients to support the health of the gut lining. Investigating the underlying imbalances and then selecting appropriate supplements for the specific issues at hand is likely to be most beneficial and cost-effective for clients, rather than a scatter-gun approach.
Who should take a probiotic supplement, and how do you know which type is right for you?
As mentioned previously, the beneficial effects of different bacteria are strain-specific, and therefore which strains are most appropriate will depend on an individual’s circumstances and the reasons they are looking to supplement. As we have seen, a number of factors can compromise the balance of bacteria and other microorganisms in our guts. For example, microbiome composition can be rapidly altered by exposure to antibiotics, with potential knock-on effects on health through the selection of resistant opportunistic pathogens that can cause acute disease. It is therefore advisable to take a live bacteria supplement alongside antibiotics (at least two hours apart) and for a few weeks afterwards to help support the gut and potentially reduce the risk of antibiotic associated diarrhea and C. difficile infections.
Similarly, infection, stress, travel, or a period of unhealthy nutrition or lifestyle can all affect the composition of our gut bacteria. Therefore, anyone who has recently been ill; is in a period of high stress; is travelling abroad; or who doesn’t eat a diet high in fermented food, fruit, vegetables, and fiber should consider supplementation. There is also increasing evidence that modulating the gut-brain axis using live bacteria supplements could be a novel therapeutic solution for anxiety and depression.
Are there times when it would not be advised to take a probiotic supplement?
Probiotics are generally very safe and well-tolerated. However there are a few instances where individuals should be cautious. For example, those who are immunocompromised, have acute pancreatitis, or are taking a blood thinner medication such as warfarin should be cautious. Remember that if you are unsure about taking probiotic supplements, speak with your doctor.
Is there anything else you would like to add on this subject?
The degree of health benefits provided by probiotic supplements vary in their ability to a) deliver viable, functional bacteria in large enough numbers, (b) provide protection against the harsh effects of the gastric environment and intestinal bile, and (c) survive formulation processes. Therefore, CFU counts (colony forming units), should be stated at the date of expiry of a product’s shelf-life (not at manufacture). In addition, delivery mechanisms, such as protective coatings applied to the bacteria themselves, should be used to ensure that viable bacteria reach the intestines. There is often a misconception that refrigerated products are superior. However, with the development of new technology such as lyophilisation (freeze-drying) and cryo-protection, shelf-stable products are now able to match refrigerated products for quality while providing consistency as to the viability until the end of the shelf life.