Prebiotics and Probiotics - Why Are They so Important for Your Wellbeing?

In order to understand the complexity of prebiotics and probiotics, it is important to know about the human microbiome. There are more microbes- bacteria, fungi, protozoa and viruses that live on and inside the body than human cells. The genetic material of these micro organisms is called the microbiome and the organisms themselves are microbiota. The majority (70%) live in our gut, particularly in the large intestine.

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The bacteria in the microbiome:

• help digest food

• protect against bad bacteria that cause disease

• strengthen body's immune defences

• produce certain vitamins

including B 12, thiamine, ribofavin and vitamin K, an important vitamin needed for blood clotting. More scientific studies are now being done to understand the human microbiota and microbome.

We know that the bowel starts to be colonised by bacteria in the uterus. Emerging research shows that gut microbiota in early life depends on factors such as:

• mode of delivery (vaginal or ceasarean)

• nutrition(breast or formula feeding)

• diet

• illness

• exposure to antibiotics

• air pollution

Immune system rapidly changes and develops during the first 3 years of life. By the age of three, the gut microbiota resembles that of an adult. A healthy breast fed infant's gut is dominated by Bifidobacterium species of bacteria which is passed onto the infant via breast milk. Breast milk also contains, prebiotics, non-digestible oligosaccharides ( short chain fatty acids) which are broken down by these species of bifidobacteria into nutrition that helps them grow and thrive. On the other hand research shows C-section delivery can lead to a loss of these beneficial bacteria. Since breast feeding is not always possible, infant formulas have been fortified with specific strains of probiotics and prebiotic oligosaccharides.

So, probiotics are live beneficial micro-organisms in the gut and prebiotics are carbohydrates which promote the growth of these beneficial bacteria.

Probiotic Rich Foods

Some food that have undergone fermentaion which contain probiotics are:

• kimchi

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• sauerkraut

• miso

• kombucha

• pickled food

• yoghurt and cultured milk

• kefir

• tempeh ( fermented soy beans)

Prebiotic Rich Food

Non-digestible oligosaccharides fructans and galactans are the most researched

prebiotics which include:

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• garlic

• onions

• leeks

• tomato

• asparagus

• Jerusalem artichokes

• honey

• barley

• rye

• milk both cow's and human

What do experts say about taking probiotics?

A study published in The Journal of pediatrics suggests that probiotic Lactobacillus reuteri may be safe for infants with colic. Recently Dr Rupert Hinds, gastroenterologist at Monash children's hospital also agreed that this strain of bacteria may be beneficial in:

• allergy prevention in babies with atopic eczema

• colic reduction especially in breast fed babies

• prevention of antibiotic associated diarrhoea

In his experience he says probiotics are safe and very well tolerated and there have been a vast majority of studies confirming this finding. Probiotics can be safely given to school age children with abdominal pain excluding other confirmed diagnosis due to its safety profile.

Other uses of probiotics

Probiotics effectiveness is patient dependent and the site of action. It may not be the answer for everyone but may help some individuals. Probiotics have been used to reduce thrush symptoms or a long period of time. Thrush is a fungal infection caused by the overgrowth of a species of yeast, Candida albicans. It increases in number when there is an imbalance or dysbiosis between good and harmful microorganisms in the vagina. Lactobacilli is the protective bacteria which produces lactic acid (keeps the pH below 4) making it an acidic environment which is unfavourable for C.albicans, therefore keeps its growth in check. This fine balance can be disrupted due to:

• medications- namely antibiotics, contraceptive pill, corticosteroids and hormone replcement therapy

• hormonal changes such as in pregnancy

• diet such as high sugary substances, excessive alcohol intake and low fibre

• sexual activity

• medical conditons such as diabetes mellitus

A lot of clinical trials suggest taking appropriate strains and quantities of probiotics can help reduce vaginal microbial dysbiosis and help with thrush.

Some important lactobacillus strains of bacteria which help with vaginal thrush are:

• Lactobacillus reuteri

• Lactobacillus rhamnosus

• Lactobacillus acidophilus

It is well known that antibiotics can disrupt the gut microbiome by altering the quantity and diversity of native microbiota present in the gut. Prolonged use of antibiotics can cause gut microbiome dysbiosis which leads to overgrowth of pathogenic microorganisms. This in turn causes antibiotic associated diarrhoea

(AAD) which can linger for a while longer after antibiotic course is completed.

Saccharomyces boulardii have been shown in clinical trials to reduce overgrowth of pathogenic bacteria and inhibit AAD.

There are other clinical trials being done indicating the potential benefits of probiotic use in, Irritable bowel syndrome, urinary tract infection, over use of acid supressing medication, mood changes, mild anxiety, immune system, hayfever and allergy and mild ulcerative colitis.

Probiotics have to be alive to be active, therefore correct storage conditions is vital to keep temperature and moisture fluctuations to a minimal.

Finally, prebiotics are indigestible fibre and fuel for probiotics which keep microorganisms in a good balance in the human microbiome which plays a vital role in health and disease. It is important to take the right strain for the right health condition.