Two dangerous diseases in newborns, necrotizing enterocolitis (NEC) and neonatal sepsis, may meet their match with well-designed probiotic supplements. Both of these conditions are common in premature babies and are most dangerous in low birth weight and very low birth weight infants. Research has confirmed that when a pregnant mother takes high-quality probiotics during pregnancy, her baby is significantly less likely to develop either NEC or sepsis, particularly when the baby is breastfed after birth (and mom is still taking the supplements) and/or when probiotics are added to formula. A probiotic supplement with multiple strains seems to be the most effective in these cases.
Officials in the E.U., where supplements are more heavily regulated than in the U.S., haven't authorized the use of the word probiotic to back any health claim. The only approved use related to microorganisms is "live yogurt cultures and improved lactose digestion." It can all feel like, well, a punch to the gut. So we asked scientists at the forefront of probiotic research to help us separate fact from hype, and pros...from cons. Here's what you need to know.
If you want to get to the root causes of what goes on inside your gut, look at what you’re putting at the end of your fork. If you consume a milkshake, hamburger, and French fries, you turn on genes that promote inflammation in your gut and your body. On the other hand, if you eat 2 cups of steamed broccoli, you will turn on anticancer and anti-inflammatory gene pathways. The foods you eat control your state of health, and the gut is the gateway to the rest of the body. Identifying and eliminating foods that rob your body of energy becomes a central focus in my program. Gluten, eggs, dairy, soy, most legumes, corn, and sugar (and, for some of you, nightshades) are inflammatory and make you and your gut sick. When my patients eliminate these problem foods for at least 28 days, they feel better, lose weight, and heal their gut. 

What about prebiotics vs probiotics? Prebiotics are the food fibers that go through the gut unchanged and are then used by good colon bacteria as a food source for their own growth. Everyone already has most of these good bacteria present, but often in small quantities. Prebiotics are used to stimulate their growth. Simply stated, you already grow your own probiotics within your colon. You do not rely on them to make the passage through the stomach acid — acid that can destroy many probiotic bacteria. That’s why taking a probiotic supplement or adding probiotic foods to your diet does not always help your digestive system. You can eat as many probiotic bacteria as you want, but if they don’t survive the trip to the colon, your effort will be fruitless.
No matter how many superfoods you eat, your body won’t be able to benefit from them if your gut environment isn’t teeming with healthy bacteria. You see, enzymes and digestive bacteria help to break down the food you eat into molecules that make their way into your bloodstream to nourish your body. Inadequate or unbalanced microbial populations in the gut can derail this process and can even lead to malabsorption of critical nutrients. 
Naturally fermented pickles, the type in which vinegar is not used in the pickling process, are rich sources of good bacteria. Sea salt and water are used in a fermentation process that results in the growth of good bacteria. Make sure vinegar was not used in the pickling process as pickles made in this way will not be rich in bacteria that boosts healthy gut flora. Beneficial bugs in fermented foods like pickles boost gut health and encourage a diverse microbiome. Eating foods that are rich in probiotic bacteria such as pickles retards the growth of harmful bacteria and it boosts the body's defenses against infection.
Even for healthy people, there are uncertainties about the safety of probiotics. Because many research studies on probiotics haven’t looked closely at safety, there isn’t enough information right now to answer some safety questions. Most of our knowledge about safety comes from studies of Lactobacillus and Bifidobacterium; less is known about other probiotics. Information on the long-term safety of probiotics is limited, and safety may differ from one type of probiotic to another. For example, even though a National Center for Complementary and Integrative Health (NCCIH)-funded study showed that a particular kind of Lactobacillus appears safe in healthy adults age 65 and older, this does not mean that all probiotics would necessarily be safe for people in this age group.

Helicobacter pylori (H. pylori) is a bacteria that causes chronic inflammation (gastritis) of the inner lining of the stomach, and also is the most common cause of ulcers worldwide. About 50% of people in the world carries or is infected with H. pylori. Common symptoms of H. pylori infection are occasional abdominal discomfort, bloating, belching or burping, and nausea and vomiting. H. pylori infection is difficult to eradicate, and treatment is with two or more antibiotics.
Although many manufacturers will make claims regarding the benefit of probiotics for all sorts of disorders, there is not always research to back up those claims. It can be difficult to conduct quality research on probiotics due to the wide variety of strains available. And many studies show mixed results. However, given that, there is some research support for the use of probiotics for the following health conditions:
If you are thinking about taking a probiotic or prebiotic and are unsure where to start or what to take, ask for help from a specialist. There are so many products available on the market it can be difficult to decide which to choose. The evidence is very much linked to the supplement so whether it’s a powder, tablet or drink you’re looking for, choosing the right one should depend on the symptoms you’re experiencing. 

Inflammatory bowel disease (IBD) treatment with antibiotics is fraught by variable efficacy. Recent discovery of genetic polymorphisms (NOD2/CARD15) in CD which play a role in bacterial peptidoglycan recognition [Inohara et al. 2003; Kobayashi et al. 2005], may be responsive to alterations in enteric flora and thus be important in the pathogenesis and maintenance of IBD [Sartor, 2004].
To factor strain-specific benefits into our efficacy score, we referenced the information in these guides. Products were rewarded for containing strains on these lists. Additionally, measured levels of each strain were compared to what is thought to be effective based on these guides, and scores were scaled accordingly. In cases where products did not list strain-specific amounts, or their listed strains were not included in these guides, total measured CFUs were compared to a general effectiveness threshold of 1 billion CFUs cited by research published in the American Journal of Clinical Nutrition11.
Despite the uncertainty, foods enriched with probiotics and probiotic supplements are increasingly popular in the U.S. Finding probiotic supplements in grocery and health food stores is easy. For example, you may already know that yogurt contains probiotic bacteria such as lactobacillus and bifidobacteria. Many clinical studies suggest these bacteria relieve symptoms related to lactose intolerance.
The right resident strains - quite a few probiotics on the market contain things like active yeasts or soil based organisms. While these ingredients may be helpful to some, if you want to optimize your gut health, you need to look for strains that are resident to the human gut like those from the Lactobacillus, Bifidobacterium, and Streptococcus families.
Also, it’s important to understand that probiotics are not a new idea. Throughout history, cultures have thrived on probiotics found in fermented foods and cultured foods, which were invented for food preservation long before the refrigerator. The process of fermentation has been lost in recent years, as it is no longer needed to preserve foods, meaning that we now lose out on those vital probiotics benefits.
If you’re looking for a great probiotic you can take every day to target everything from gut to skin health, the Culturelle Daily Probiotic is our top choice. Each capsule has 10 billion active cultures of 100 percent Lactobacillus GG, a probiotic that helps curb gas, bloating, and upset stomach, and works to boost your immune system. Each capsule has the probiotic equivalent of 10 cups of yogurt and is dairy-free, sugar-free, and gluten-free. This container comes with 30 pills to be taken just once a day (most recommend taking it at night, especially when you’re just starting on probiotics).
Probiotics can help protect against common gynecological conditions such as bacterial vaginosis, candidiasis, and urinary tract infections, says Jennifer McDaniel, MS, RDN, CSSD, a dietitian in St. Louis, MO. “Bacteria can pass through our digestive system into the vagina, so we have the opportunity to consume probiotics that can benefit our vaginal health. L. rhamnosus GR-1 and L. reuteri RC-14 are evidenced-based probiotic strains for women’s urogenital health. Not only do they disrupt the infection of a range of unhealthy bacteria and yeast in the vagina, they offer benefits to the vagina and reduce the risk of problems such as bladder infections.” Fem Dophilus, made by Jarrow Formulas, has the critical strains and the company adheres to the highest production standards, she says.
Unlike MegaFood, the Renew Life label’s cold-storage recommendation is printed so small we nearly missed it (and it didn’t ship with a cold pack). If a probiotic requires refrigeration, be vigilant when buying it — the retailer that stores it or the company that ships it should keep it refrigerated until it gets to you. Otherwise, some of its potency might diminish in storage or transit.
Sure, why the hell not? Lebwohl says: "Essentially a yeast infection is an overgrowth of a kind of fungus. In theory, a probiotic could potentially have an effect of the microbiome of the vagina, though proof of its effectiveness hasn’t really been established.” No harm in giving it a try as long as you don't succumb to the temptation to put yogurt in your vagina.
Prebiotics do contribute to a happy, symptom-free gut in the sense that they serve as fuel for the good microbes that help keep the digestive process humming. So while on their own they don’t do much, you absolutely need prebiotics for gut microbiome support and healthy digestion. Natural foods are by far the best source — supplements aren’t necessary if you’re eating a healthy, balanced, and veggie-rich diet.
Gas (intestinal gas) means different things to different people. Everyone has gas and eliminates it by belching, burping, or farting (flatulence). Bloating or abdominal distension is a subjective feeling that the stomach is larger or fuller than normal. Belching or burping occurs when gas is expelled from the stomach out through the mouth. Flatulence or farting occurs when intestinal gas is passed from the anus.
Even with antibiotic-associated diarrhea, which has the best evidence, "you could have seven people take the same probiotic and only have one report a definite difference," says gastroenterologist Matthew Ciorba, M.D., a medical professor who studies human gut microbiota at Washington University School of Medicine in St. Louis. That's because each person's microbial makeup is as unique as a fingerprint, influenced by age, genetics, and gender. For example, animal research from the University of Texas at Austin found the microbes living in the guts of males and females react differently to the same diet. Scientists are now studying ways to harness a person's own microbes to treat illnesses, rather than going for a mass approach.

Some literature gives the word a full Greek etymology,[66][67] but it appears to be a composite of the Latin preposition pro, meaning 'for', and the Greek adjective βιωτικός (biōtikos), meaning 'fit for life, lively',[68] the latter deriving from the noun βίος (bios), meaning 'life'.[69] The term contrasts etymologically with the term antibiotic, although it is not a complete antonym. The related term prebiotic comes from the Latin prae, meaning 'before', and refers to a substance that is not digested, but rather may be fermented to promote the growth of beneficial intestinal microorganisms.[70]


Medications (especially antibiotics), stress, diet and other factors can alter the ratio of good to bad bacteria in your gut, causing infection and disease. This happens more often than you might think: antibiotics are one of the most prescribed medications in Canada and the US (and often prescribed unnecessarily… but that’s another story) (3;4). They’re important and effective in killing infection-causing bacteria, but they often end up killing a lot of good bacteria, upsetting that important balance and giving dangerous Clostridium difficile bacteria a chance to cause severe diarrhea and other bowel diseases, sometimes with fatal results (5).

With Prebiotin, you can easily add prebiotic fiber to your diet without worrying about eating huge amounts of troublesome foods or hunting down hard-to-find ingredients. You also won’t have to worry about loading up on high-calorie foods that can negatively affect any effort to lose weight. Combining Prebiotin prebiotic fiber with a diet enriched with probiotic foods can only help your effort to positively influence the bacterial balance in your lower gut.


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^ Cuello-Garcia CA, Brożek JL, Fiocchi A, Pawankar R, Yepes-Nuñez JJ, Terracciano L, Gandhi S, Agarwal A, Zhang Y, Schünemann HJ (2015). "Probiotics for the prevention of allergy: A systematic review and meta-analysis of randomized controlled trials". J. Allergy Clin. Immunol. (Systematic review & meta-analysis). 136 (4): 952–61. doi:10.1016/j.jaci.2015.04.031. PMID 26044853.
"The skin and the gut go hand in hand," explains Shapiro. "Since probiotics help improve the gut microbiome and aid in reducing inflammation, skin conditions will also improve. When eating a healthy, whole food diet as well, skin conditions get better over time. When the gut is not intact, other parts of the body also start to break down and become toxic. With probiotics, your gut becomes healthier and therefore, your skin problems start to disappear. "
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The takeaway: Certain strains were found useful in preventing diarrhea among children being prescribed antibiotics. A 2013 review showed that after antibiotic use, probiotics help prevent Clostridium difficile-associated diarrhea. A review focused on acute infectious diarrhea found a benefit, again for certain strains of bacteria at controlled doses. There’s also evidence that they may help prevent necrotizing enterocolitis (a serious gastrointestinal condition) and death in preterm infants.
In 2015, the global retail market value for probiotics was US$41 billion, including sales of probiotic supplements, fermented milk products, and yogurt, which alone accounted for 75% of total consumption.[42] Innovation in probiotic products in 2015 was mainly from supplements, which produced US$4 billion and was projected to grow 37% globally by 2020.[42] Consumption of yogurt products in China has increased by 20% per year since 2014.[43]
Can you take one probiotic for digestive health and a different one for vaginal health? “Unless recommended otherwise by a healthcare professional, I would recommend staggering intake within a day,” says Anthony Thomas, PhD, director of scientific affairs at Jarrow Formulas. In other words, take one probiotic with breakfast and the other at lunchtime. 

To boost the immune system, B. Lactis is a promising choice. One study had participants taking either a probiotic or a placebo for six weeks. At the end of this period, researchers measured antibody levels and found greater increases in antibodies of the B. lactis group than in placebo participants, concluding that this probiotic may help improve immune function [1]. In addition, a 2009 study found that supplementation of the strain B. lactis DN-173 led to self-reported improvements in digestive comfort [2].
Jotham Suez, Niv Zmora, Gili Zilberman-Schapira, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Max Horn, Yotam Cohen, Andreas E. Moor, David Zeevi, Tal Korem, Eran Kotler, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Meirav Pevsner-Fischer, Hagit Shapiro, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT. Cell, 2018; 174 (6): 1406 DOI: 10.1016/j.cell.2018.08.047
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