ARE YOU USING PROBIOTICS CORRECTLY?

Last week, as you may recall, I wrote about prebiotics, those behind-the-scenes digestive health assistants that serve to nurture probiotics, their more widely celebrated colleagues. Known to help increase bowel regularity while decreasing gas and bloating, probiotics are making their way onto more and more top-10 health lists so it’s not so surprising to find them tucked into all manner of foods and beverages, with labels slapped on touting their health benefits.

However, the formula for using probiotics to optimize your health is somewhat more nuanced than merely spooning up a daily serving of yogurt! That’s okay -- giving you the "story behind the story" is exactly what Daily Health News is here to do. So read on to learn the real secret to putting probiotics to work for you.

PROBIOTICS GO MAINSTREAM

Probiotics are definitely getting more respect. A friend told me that her doctor gave her the name of a probiotic supplement when he handed her an antibiotic prescription, telling her to take them to replenish the valuable intestinal bacteria that the antibiotics would suppress. Probiotics have made their way into the hospital world, too -- they’re given to patients to help prevent deadly intestinal diseases that have resulted from antibiotic-resistant superbugs... researchers are studying their use for premature babies... and a few doctors even are urging consideration of a new hand-hygiene protocol that involves dipping caregivers’ hands into probiotic solutions after scrubbing in order to recolonize the skin with good bacteria.

Maybe those doctors are also telling patients to buy probiotic-fortified foods at the supermarket -- and there’s nothing wrong with doing so. But Leo Galland, MD, director of the Foundation for Integrated Medicine in New York City, wants us to understand that we won’t achieve any meaningful benefits by relying on these probiotic-fortified food sources alone.

WHY WE NEED SUPPLEMENTS

Dr. Galland explained that acid naturally present in most probiotic-containing foods suppresses these helpful bacteria, at least partially -- so it’s impossible to know how many cultures survive and are of benefit. He believes that supplements are a better route since they reliably deliver a beneficial number of probiotic organisms.

However, he pointed out that specific types of probiotics can be used to address specific health concerns. This is another argument for supplements instead of probiotic-fortified foods and another reason why it’s important to work with a doctor (a naturopathic physician or a gastroenterologist experienced in working with prebiotics and probiotics) who can ascertain what’s best for you, how much you should take and at what times of day.

Dr. Galland told me that he tends to prescribe specific types of probiotics in certain situations. For example...

For people with no particular health concerns, Dr. Galland might suggest 20 billion Colony Forming Units (CFUs) of combined lactobacillus and bifidobacterium "as a good general preventative for intestinal and respiratory tract infections."

For people taking antibiotics, Saccharomyces boulardii (S. boulardii, brand name Florastor) usually is the best choice (though actually this particular probiotic is not a bacteria but a yeast). It’s also helpful in boosting effectiveness of Flagyl (metronidazole) and is used to treatClostridium difficile colitis and antibiotic-associated colitis, as well as other bacterial and nonbacterial intestinal infections. Note: Dr. Galland said that S. boulardii should be taken only for the duration of antibiotic or Flagyl treatment, after which he switches his patients to a bacteria-based probiotic.

For patients having abdominal surgery, Dr. Galland prescribesLactobacillus plantarum for a few weeks before and after surgery, since research shows that it helps reduce postoperative infections. Other studies demonstrate that lactobacillus probiotics can help to reduce frequency of diarrhea and abdominal pain in cancer patients as well.

For gas and bloating, Dr. Galland said that certain soil-based organisms (called "SBOs" -- for instance, one kind is Bacillus laterosporus) can be helpful. These probiotics aren’t normally found in the human digestive system and they won’t take up permanent residence, so patients who find them beneficial may want to continue taking them daily even after their symptoms have subsided, he added.

WHAT’S BEST FOR YOU?

As with prebiotics, Dr. Galland said that it may take some trial and error to identify which probiotics are helpful in achieving the desired results without upsetting your system. He has found Lactobacillus plantarum beneficial for many of his patients, but it isn’t always the right choice. Dr. Galland told me that experienced doctors often use sophisticated stool test results to identify the types of bacteria already in a patient’s system, since this information can help determine the best course of pre- and probiotic therapy, along with other natural supplements that will yield good results.

If you want to try adding probiotics to your personal health regimen, talk to a doctor with expertise in this area and expect to start slowly and watch closely to see what works best. (You’ll know it’s working if it helps diminish digestive difficulties, such as gas, indigestion and irregular bowel movements.) This may mean that you end up trying several different types of probiotics before you find what helps your system function best. Stick with it though, since these beneficial bacteria have the potential to transform your health for the better.

Can Bad Bugs Make You Fat?

June 27, 2010 12:00 AM by Mehmet C. Oz, MD, and Michael F. Roizen, MD |

Are bacteria to blame for your elastic-waist jeans and poolside muumuu? Did microbes make you devour double bowls of triple-fudge ice cream last night?

It only sounds like a horror movie. A growing stack of research suggests that the mysterious, microscopic "zoo" in your digestive system plays a role in how slim -- or pudgy -- you are. But don't even think about trying to figure out which of the countless "probiotic" pills out there might get you into smaller jeans. We've got a saner bug-control plan.

The human body hosts trillions of tiny critters, most of whom hang out in your intestines. Most are beneficial bugs called probiotics. They break down food, help you absorb certain nutrients, keep your immune system firing on all cylinders, and fend off invaders that can cause a nasty case of the runs. They can even protect against stomach ulcers and urinary tract infections and ease irritable bowel syndrome. Can they help fight allergies, too? Find out.

But here's the thing: There's now surprising evidence that the wrong gut bugs could make you fat. In one study, obese people were three times more likely than lean folks to have a virus called Ad-36 in their digestive tracts -- a bug known to make chickens fatter. Also, some intestinal bacteria seem to trigger bigger appetites and a tendency to store more calories as fat. Researchers even think "fat bugs" might plump you up by pulling more calories from the food you eat.

Happily, there's also a bit of evidence that good bugs might help you slim down in some circumstances. Among extremely overweight people who had weight loss surgery, those who took a probiotic supplement lost weight faster. And women who took a probiotic during pregnancy had less body fat overall -- and less dangerous belly fat -- after giving birth than pregnant women who didn't take probiotics, even though they all followed the same diet.

A whole industry has grown up around probiotic supplements, including probiotic-enhanced foods and "prebiotics," types of fiber that promote the growth of good bugs. Some products are good. Others are still in question. For example, we don't yet know enough about the healthiest mix of microbes for weight loss. What we do know: Good bugs are good for your body. So it's worth taking these steps to keep 'em happy and working hard inside you:

Feed them their favorite foods. It's way easier to cultivate the good bacteria you already have than to import replacements. To encourage your good bugs to be fruitful and prosper, feed them special prebiotic fibers called inulin and oligosaccharides (don't try saying either three times fast). And where do you get these yummy fibers? Pretty simple: bananas, asparagus, onions, and garlic; also, dandelion greens, Jerusalem artichokes, and jicama. All are top sources of good prebiotic fibers. Apples may help, too, because they contain pectin, another beneficial prebiotic fiber. And there are some prebiotics in barley, berries, tomatoes, honey, flaxseeds, and beans, too.

Take a probiotic. While you can get probiotics in food pretty easily by consistently eating low-fat yogurt with live active cultures, popping a probiotic supplement is more reliable. One of us (Dr. Mike) recommends taking one regularly if you're healthy -- it's part of his 360-5 wellness program at the Cleveland Clinic. The trick is to find formulas that can survive your stomach's digestive fluids. Dr. Mike likes brands that contain Bacillus coagulans because its outer shell is so tough that it can survive even (burp) the gnarliest mix of stomach acids. Two brands that have it: Sustenex and Digestive Advantage. Alternatively, he recommends probiotics that are actually activated by your gut's digestive juices, such as Culturelle. If it helps keep you slim and healthy, that's quite a trade-off.