In the vast and complex universe of our digestive system, health is often determined by the presence and balance of beneficial microorganisms.
Prebiotics and probiotics are two key categories of substances that play a crucial role in maintaining this delicate balance, promoting gastrointestinal health and contributing to the body's overall well-being.
These compounds, often associated with terms like “fermentable fiber” and “good bacteria,” are the subject of growing scientific interest and are gaining popularity as key elements of a balanced diet.
In this article, we will explore what exactly prebiotics and probiotics are, how they affect our health, and how we can integrate them into our daily diet to improve our well-being.
What is the microbiota?
Our bodies are home to a vast community of microscopic organisms, such as bacteria, viruses, and fungi , collectively known as the human microbiota .
These microorganisms settle mainly in our digestive system, significantly influencing the maturation, development and regulation of the immune system , the central nervous system and the gastrointestinal tract .
One of the benefits of this interaction is that host organisms can enhance their immune system by enhancing immunological responses to diseases, including infectious and inflammatory diseases.
The beginning of this "colonization" occurs both through the surrounding environment and from the mother during the moment of birth.
The composition of this group of microorganisms can be influenced throughout life by several factors such as genetics, environment, lifestyle, diet and the use of drugs, including antibiotics .
There is a difference between microbiota and microbiome
Microbiota and microbiome are two closely related concepts, but differ in their specific meanings.
Microbiota:
Microbiota refers to the community of microorganisms (such as bacteria, viruses, fungi, and other microscopic organisms) found within a given biological environment, such as the human body or another host organism.
For example, the gut microbiota is the population of microorganisms present in the intestine.
Microbiome:
The microbiome is a broader term and includes not only the organisms themselves but also their genetic material and the set of all interactions between these microorganisms and the host environment.
The microbiome can include the complete genome (set of genes) of all microorganisms present in a given environment.
What are probiotics?
According to the Food and Agriculture Organization/World Health Organization guidelines, probiotics are " live microorganisms which, when administered in adequate amounts, confer a health benefit on the host ."
These microorganisms, which are mainly bacteria but also include yeasts, are naturally present in fermented foods, can be added to other food products, and are available as dietary supplements.
The term probiotic is a term recognized only in some countries to identify live lactic ferments, Switzerland is not among them.
Probiotics are identified by their specific strain , which includes the genus, species , subspecies (if applicable), and an alphanumeric strain designation .
The seven major genera of microbial organisms most often used in probiotic products are Lactobacillus , Bifidobacterium , Saccharomyces , Streptococcus , Enterococcus , Escherichia , and Bacillus .
Table 1 shows examples of the nomenclature used for different commercial strains of probiotic organisms.
| Table 1: Nomenclature of commercial probiotic strains | ||||
| Type | Species | Subspecies | Strain designation | Stump nickname |
| Lactobacilli | rhamnose | Nobody | GG | LGG |
| Bifidobacterium | animalis | milk | DN-173 010 | Regular bifid |
| Bifidobacterium | long | long | 35624 | Bifanti |
In which foods are prebiotics found?
Common sources of probiotics include yogurt , cultured buttermilk , and cheese .
Other foods obtained through bacterial fermentation include Japanese miso , tempeh , sauerkraut , beer , sour dough , bread , chocolate , kimchi , olives , and pickles .
Another fermented dairy product is kefir .
However, among these, yogurts and fermented milks remain the main food vehicles for probiotics, providing a relatively low pH environment essential for the survival of probiotic bacteria.
Probiotic strains are also found in non-dairy fermented substrates, including soy products, cereals, legumes, cabbage, corn, pearl millet, sorghum, and so on.
Dairy products are the most common and preferred food category among consumers, rich in lactic ferments.
However, dairy products are associated with an increased risk for people with lactose intolerance , galactosemia , milk protein allergy , and high cholesterol levels.
For this reason, the market increasingly requires the use of supplements based on probiotic lactic ferments as a valid alternative.
What are lactic ferments?
“Lactic ferments” and “probiotics” are often confused, even by health professionals. Lactic ferments or lactic bacteria are bacteria capable of producing lactic acid from the fermentation of lactose.
The term therefore refers to a microbial function that microorganisms, even different ones, are able to perform.
The term “lactic ferment” is more famous than “probiotic”; the reason is probably historical, as the use of lactic ferments in ancient times served to preserve milk.
The difference is clear: on the one hand, lactic ferments whose possible effects we cannot be sure of; on the other, probiotics, deposited in databases, of which we know exactly the species, the strain and the molecular detail, with the safety, technological, functional and physiological criteria required by the WHO.
These criteria are necessary for a certain product to be called a probiotic and to be sold as such.
However, in some countries “like Switzerland”, there are ordinances that require the description of “lactic acid bacteria” on the packaging of a probiotic supplement, which, in our opinion, increases the confusion."
What are probiotics for?
Probiotics are important for improving digestion and absorption of nutrients in our body.
They also help break down foreign substances (such as drugs or pollutants) reducing the risk of side effects and are essential for gut health.
The microbiota, made up of beneficial bacteria, helps produce important substances such as fatty acids, vitamins and amino acids , contributing to nutritional needs.
Probiotics maintain a healthy gut by preserving its structural integrity and barrier function.
These good bacteria compete with the harmful ones in the intestine , protecting it and contributing to the correct immune balance.
When consumed, probiotics improve the composition and activity of the intestinal microflora, bringing health benefits.
The gut microbiota also plays a key role in supporting a healthy immune system and interacts with different parts of the body through complex biochemical signals.
This interaction is known as the microbiota-gut-brain axis and the microbiota-gut-lung axis.
Gut bacteria can affect not only the intestines but also anatomical districts such as the brain and lungs.
Changes in the microbiome, caused by chronic stress, medications, or contaminated foods, could alter immune function and balance in the central nervous and respiratory systems.
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Intestinal dysbiosis: a predisposing factor to disease
Intestinal dysbiosis is a condition characterized by an imbalance of the microbial composition within the intestine, with an alteration in the quantity and diversity of bacterial communities.
Intestinal dysbiosis can be a predisposing factor for diseases such as “Inflammatory Bowel Disease” (IBD), a group of disorders characterized by chronic inflammation , including ulcerative colitis and Crohn's disease .
The composition of bacteria in the gut plays a crucial role in the relationship between environmental factors and the development of food allergies and other allergic diseases , such as atopic dermatitis and asthma .
Therefore, not only is the gut microbiota essential for oral tolerance to food allergens, but its effects on the immune system are most evident in the first years of life.
What is the difference between probiotics and prebiotics
Prebiotics are not to be confused with probiotics, as they are non-digestible food compounds that selectively promote the growth and activity of beneficial bacteria in the colon.
In other words, they are substances that provide the necessary nourishment for beneficial gut bacteria.
Common examples of prebiotics include fructooligosaccharides (FOS) , galactooligosaccharides (GOS) , inulin , and other non-digestible dietary fibers .
Prebiotics are often found in foods such as onions, garlic, bananas, asparagus, and whole grains.
Prebiotics are supposed to be free of serious side effects, however intestinal enzymes cannot break down oligosaccharides and polysaccharides, so they are transported to the colon to be fermented by the gut microbiota.
Therefore, the side effects of prebiotics are mainly the result of their osmotic functions.
In this regard, subjects who received prebiotics may experience osmotic diarrhea, bloating, cramps and flatulence.
The chain length of prebiotics is an influential parameter for the development of their side effects .
Interestingly, prebiotics with a shorter chain may have more side effects .
The possible explanation for this phenomenon is that the shorter inulin molecules are metabolized mainly in the proximal colon and ferment more rapidly ; while the longer chain ones ferment later and more slowly in the distal colon.
A daily dose of 2.5–10 g of prebiotics is necessary to exert their beneficial functions on human health. Most prebiotic products on the market contain doses of 1.5–5 g per serving
In short, while probiotics are live microorganisms, prebiotics are substances that promote the growth and activity of beneficial bacteria already present in the intestine.
Often, it is beneficial to consume both in the diet to support a balanced intestinal bacterial flora and promote the health of the organism.
The minimum quantity to obtain a probiotic action
The minimum recommended level provided by the US FDA and food industries when consuming probiotic foods is 10 6 CFU ( Boylston et al., 2004 ) to obtain probiotic action in the human intestine.
What does CFU or Colony Forming Units mean?
Probiotics are measured in colony forming units (CFU), which indicates the number of viable bacteria. Amounts may be written on product labels as, for example, 1 x 10 9 for 1 billion CFU or 1 x 10 10 for 10 billion CFU.
Many probiotic supplements contain 1 to 10 billion CFU per serving, but some products contain up to 50 billion CFU or more.
In Table 2, we have the amount of viable bacteria per type of fermented food.
Table 2
Summary of lactic acid bacteria (LAB) counts in all fermented foods. Bar graphs represent a range (minimum to maximum) of counts found across the studies reviewed. The number of studies used here for each fermented food is indicated in square brackets. For cheese, products were categorized by maturation time (60 days) and excluded if maturation time was not reported.
When to take probiotics
The question of the optimal time to take a probiotic supplement remains a matter of debate, as numerous factors influence the product's effectiveness.
The variety of bacterial strains present in the probiotic, the gastrointestinal resistance of the capsule , the amount of CFU (colony forming units) strains , and the type of food consumed can all contribute to the effectiveness of the treatment.
Probiotic packages suggest different times for taking them: before, during, after meals, or even independently of meals.
This diversity of recommendations has generated considerable confusion among consumers.
Most manufacturers rely on a specific study published in 2011 entitled “The impact of meals on a probiotic during transit through a model of the human upper gastrointestinal tract” which evaluated the impact of the timing of administration in relation to the meal and the influence of the buffering capacity of the food on the survival of probiotics during gastrointestinal transit.
This study used an in vitro digestive system (IViDiS) model , essentially a machine that simulates the upper gastrointestinal tract, to examine the survival of a commercial multi-strain probiotic.
This product, presented in capsule form, included four different microbes: two lactobacilli (Lactobacillus helveticus R0052 and Lactobacillus rhamnosus R0011), Bifidobacterium longum R0175 and Saccharomyces cerevisiae boulardii.
The counting carried out during and after transit through the gastric and duodenal models showed that the survival of all the bacteria present in the product was better when administered during a meal or 30 minutes before the meal, it should be noted that the meal consisted of oatmeal cooked with milk , a meal not very common in our latitudes.
Probiotics given 30 minutes after this meal showed lower survival.
The presence of fat appears to have a significant impact, as survival in 1% fat milk and oat milk porridge was significantly better than in apple juice or spring water.
Saccharomyces cerevisiae boulardii was not affected by meal time or meal buffering capacity.
In conclusion, there is not enough data to define with reasonable certainty the best time for hiring.
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GO TO THE NUTRITIONAL TESTThe best lactic ferments
If you are considering purchasing a probiotic supplement, it is essential to keep in mind that, although they may seem similar, there are often notable differences that affect their effectiveness.
Here are five useful parameters that you can easily evaluate before making a decision on which product to choose.
- Number of bacterial species with specific number , a supplement that contains more different species derived from international collections is considered more effective
- Number of live bacteria (CFU) per capsule , efficacy is dose dependent
- The absence of allergens , such as lactose and gluten, makes it suitable for people with allergies or intolerances.
- Absence of additives such as sweeteners or artificial colors, some additives can affect the stability of the bacteria themselves as well as develop adverse reactions.
- Number of live bacteria (CFU) in relation to price
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Buy NowParticularly relevant, especially in relation to point 5, which considers the number of live bacteria (CFU) in relation to the price , is the incredible difference found between one brand and another.
According to our market analysis, the best-selling probiotic lactic ferment supplements in Switzerland have an average cost per billion bacteria that is almost 100 times higher than that of PRO-BIO24 .
This data is of particular importance because, reiterating that the efficacy, for the same specific strains, is determined by the quantity of live and viable CFU, highlights a considerable economic disparity between the different options on the market.
Safety of Probiotics
Probiotics are generally recognized as safe by the U.S. Food and Drug Administration (FDA) or are subject to a Qualified Presumption of Safety (QPS) by the European Food Safety Authority (EFSA).
However, while probiotics are available to healthy consumers in the form of dietary supplements or foods, some patient populations rely on them.
It is important to remember that long-term studies aimed at demonstrating the safety of probiotics in at-risk populations, such as individuals with weakened or compromised immune function, older people, and neonates (especially premature infants), are still limited.
Currently, the use of probiotics in vulnerable populations is suggested with caution.
In particular, in the presence of a single major risk factor, such as an immunocompromised state, or more than one minor risk factor, special caution should be exercised in the use of probiotics.
Research continues on this topic to gain a deeper understanding of the safety of probiotics, especially in specific clinical settings.
Sources:
- Cells. 2023 Jan; 12(1): 184.doi: 10.3390/cells12010184 , Probiotics Mechanism of Action on Immune Cells and Beneficial Effects on Human Health
- Gut Microbes. 2023; 15(1): 2185034. doi: 10.1080/19490976.2023.2185034 , Emerging issues in probiotic safety: 2023 perspectivesNutrients doi: 10.3390/nu14235155. Microbiome Therapeutics for Food Allergy
