“Calories in vs. calories” out may be the most tirelessly repeated phrase in the nutrition world. From a strict thermodynamic view, it’s entirely correct – weight change is the result of energy balance. But, what exactly is “calories in”? When you eat 100 calories worth of something, did 100 calories actually enter in your body? If food enters from your mouth and into your stomach, is it actually in your body? It’s a complex answer actually – your body is a series of compartments after all. This is where “calories in vs. calories out” can be misleading. Absorption, distribution, and metabolism all affect how a calorie is used by your body for energy, each layered with complexity (take a look at any of the number of articles on metabolism that I’ve written as an example of this). This topic is too big to tackle here, but the question(s) serve to introduce the idea of gut health and how a probiotic supplement may help. By viewing it this way. hopefully your views on nutrition expand and are readily applicable to whatever your goal may be.
Establishing A Healthy Gut
There are billions of bacteria living in the intestinal tract, referred to as microflora. The term “probiotic” gets thrown around quite often, but what are does it really mean? Probiotics are live, “good” bacteria in the microflora that work to keep a health intestinal balance by replenishing and maintaining beneficial strains. The maintenance of this balance is essential for optimal functioning of the body. Surely, you’ve seen foods being marketed for their probiotic content (such as yogurt), but these typically aren’t high enough in number to elicit any significant change (at least not in a short period). Direct probiotic supplementation provides the highest amount of beneficial live and active cultures. Probiotic supplementation isn’t by any means a necessity for everyone, but surely can provide a number of benefits to most if done correctly.
What Should You Look For?
Because probiotics are live organisms, there are many challenges associated with the manufacturing and distribution of them. For a probiotic to be effective, it must remain stable through its expiration date. One thing to look for is the statement, “guaranteed potency at time of expiration” on the bottle – this ensures the bacteria is being delivered to the intestinal tract, where it has the most benefit. If the supplement says something along the lines of, “guaranteed potency at time of manufacture”, I’d recommend exercising some caution before purchasing. It’s not the end all to be all, but could be a red flag.
Purchasing a quality probiotic can be a somewhat difficult task as a probiotic, by it’s very nature, is a complex amalgamation of several key strains of bacteria. Bear in mind that there are roughly 500 known strains of bacteria comprising the gut’s microflora, making its supplementation a delicate science. There are 4 genus and species (each with multiple strains) that have significant research-driven backing. This area of research is quickly growing and, by the time you read this, may have more.
How do you decipher what the ingredient label of a probiotic supplement means? One look at it, and it understandably reads like a foreign language. Let’s figure it out:
Common Name: Lactobacillus Acidophilus (sometimes written simply as L. acidophilus)
There are numerous strains, each serving a different function in the body – in fact, L. acidophilus has over 180 strains recorded. For our purposes, we’re looking for a few specific strains, usually CUL-60, CUL-21, La-5 and/or La-14. These are shown in parenthesis next to the common name on labels: Lactobacillus Acidophilus (La-14), for example. If a product does not list the strain, I’d chalk that up as another red flag and likely not buy it (probiotics aren’t cheap, are they?).
Lactobacillus acidophilus (along with one the aforementioned strains) is commonly found in most probiotic supplements, and for good reason – it has been shown to protect intestinal cells by essentially “competing” for space with harmful bacteria. Moreover, and probably most applicable to your goals, is its ability to increase the absorption and bioavailability of minerals – specifically calcium, copper, magnesium, and manganese. What other names and strains should you look for?
Bifidobacterium bifidum (Bb-02 or CUL-20)
Similar to lactobacillus acidophilus, bifidobacterium bifidum helps maintain microflora balance by competing for space with harmful bacteria, such as E. coli, S. aureus, and Camplyobacter jejuni.
Bifidobacterium lactis (BI-04 or CUL-34)
This bacterium is notable in that it has been shown to support gut health by reducing intestinal permeability – that is, ensuring the gut “border” is soundly in place. This ensures that substances the body deems harmful are kept out of circulation.
Lactobacillus rhamnosus (Lr-32, GG, or HN001)
Lactobacillus rhamnosus offers a perfect example for how the strain dictates the function of the bacteria. For example, the GG and HN001 strains have demonstrated effects on reducing eczema, but the Lr-32 strain has not. Yet, it is often marketed in such a manner. Lactobacillus rhamnosus, regardless, has been found to positively affect inflammatory and immune gene signaling in over 1,700 genes.
There are numerous bacteria and strains that may serve some form of benefit, unique to your situation, so I encourage diving deeper into the research. The bacteria listed above are staples, usually found in most quality products. More isn’t necessarily better, so don’t think that a product that offers a a higher number of bacteria is superior to one that doesn’t – it might be more so about the quality of the product as opposed to its content.
Probiotic Dosing: A Progressive Approach
How is this stuff used? The answer largely depends on your current gut health status – something that may be somewhat of an abstraction. People typically don’t understand where their current health lies until they see noticeable improvement. Unless you have taken a proactive approach towards the improvement of your gut health, chances are that starting at too high of a probiotic dose will cause severe gastric upset. Gas and bloating are common symptoms seen if the starting dose is too high and, while not too serious of concern, can be entirely avoided with the right approach. A safe starting dose typically falls within the 10-20 billion CFU (colony forming units) range. In a slow (every 4-6 weeks) and gradual manner, this dose should could be increased by about 20 billion, until some benefit is noticed. This can take time. I’ve had clients who’ve supplement from 20 to 450 billion CFU and everything in between. Sometimes benefit is noticed with days, sometimes with months. It is entirely unique to the individual. As newer research begins to surface, the argument for higher doses is gaining ground.
What Brands Are The Good Ones?
There are now many probiotic supplements on the market today, and (unfortunately) many should be avoided. Being that this is living bacteria, its mode of transport into the gastrointestinal tract is important. Ensuring that the microorganisms in a probiotic are protected from the stomach’s acidic environment isn’t a perfect science, but a few companies have gained my trust:
Ortho Biotic by OrthoMolecular
PureProbiotic, Probiotic-5, and Probiotic 50B by Pure Encapsulations
Multi-Probiotic by Douglas Laboratories
These companies must meet stringent regulations for all of their products, and go through rigorous third-party testing. Be careful ordering these online – pharmaceutical-grade nutrition companies work to have their products removed from major third party distributors, like Amazon. Apparently, a common problem OrthoMolecular has faced is people replacing the contents of their bottles with something else (who knows what) and re-selling at a higher price. It’s best to visit wellness practices, small medical offices specializing in functional medicine, or some pharmacies to purchase high quality nutrition supplements. Interestingly enough, these products are usually no more expensive than what can be found in traditional supplement stores. I can offer Douglas Labs and Pure Encapsulations products through my storefront. If interested, check out the link to Fullscripts on the homepage.