Last Updated on December 16, 2021 by Team THIP
Sukanya Verma was under the weather at the onset of winter in Delhi. Her symptoms included chest pain, nasal inflammation, low blood pressure and consequently low energy. Her doctor diagnosed it as a viral infection. The doctor prescribed an antibiotic plus a probiotic lactobacillus capsule to tide over the infection. “I asked him what was the cause of the inflammation but he didn’t reply. Thankfully, we were aware of the gut microbiome analysis that had clearly mentioned high histamine in her body,” informs her husband Akshat.
The production of histamine was triggered in Sukanya’s body because of the consumption of food rich in histamine such as rice, vinegar, fermented vegetables, citrus products, walnuts, dark chocolates, wheat germ, legumes, etc. “The probiotic capsule would have had an adverse impact on her. It would have knocked Sukanya off completely, and landed her in hospital. The medicine was prescribed without a zilch knowledge about her gut composition but thankfully, it wasn’t consumed,” adds her husband.
Sushant Kumar, founder of Genefitletics, clarifies, “Every patient has a unique biology and before prescribing anything, doctors should evaluate how these supplements would impact the biological function at the molecular level.” Explaining Sukanya’s case for a layman, Kumar adds how probiotics such as fermented vegetables, sauerkraut, kimchi or even probiotics capsules, could increase histamine production in the body, making the rate of histamine production exceed the rate of release of Diamine Oxidase (DAO), an enzyme that is required to suppress histamine, triggering Histamine Intolerance.
While numerous studies have shown numerous health benefits of having probiotics, including improving gastrointestinal functions, modulating the immune system, cancer prevention, overcoming irritable bowel diseases such as chronic diarrhoea and most importantly, healing the gut. So what exactly are probiotics & prebiotics?
Ahmedabad-based Nutritionist & Lifestyle Consultant Palak Chaturvedi emphasises that probiotics are good because they can improve immunity, aid in better digestion, absorb calcium, and prevent allergies and colon cancers. “Probiotics are foods or concentrates of live organisms that contribute to a healthy microbial environment and suppress the potential harmful microbes. Probiotics can be bacteria, moulds, or yeasts, with the first being fermented milk,” says Chaturvedi. On the other hand, prebiotics are selectively fermented dietary ingredients that result in specific changes in the composition and activity of the gastrointestinal microflora. “Unlike probiotics, a prebiotic targets the microflora already present within the ecosystem. It acts as food for these targeted microbes. Prebiotics are the component of soluble fibre. Widely accepted prebiotics are FOS (fructooligosaccharides) and GOS (galactooligosaccharides),” states Chaturvedi.
Adding further, Kumar describes how one can consume probiotics either through food or supplements while prebiotics are non-digestible food components that stimulate the growth or promote beneficial microbial activities in one’s body. “At times, probiotics find it hard to colonise the gut. In such a scenario, prebiotics help fertilise them,” says Kumar.
Many studies conducted across the globe have established the importance of probiotics and their immense role in improving intestinal health and building the immune system. “Apart from synthesizing and enhancing the bioavailability of nutrients in the gut, probiotics help in providing better health with added nutritional benefits. Probiotics and prebiotics functional food compounds together are known as symbiotics and they are much more beneficial when consumed together,” adds Chaturvedi.
UK-based Nutrition and Lifestyle Coach Anumeha Gupta agrees that it’s certainly true that gut bacteria or probiotics play an important role in one’s health, the exact mechanisms they use to influence the health of a host are still a hot topic of research. Elucidating the process of colonisation, Gupta says, “The human body naturally presents a hostile environment for colonization. In their journey from the mouth to the stomach through to the large intestine and finally the colon, the bacteria are greatly challenged not only by harsh conditions including gastric acid, bile salts and degrading enzymes but also by the presence of commensal bacteria which compete for nutrition and adhesion sites, and therefore, resist colonisation (Han et al, 2021). Several studies show that the colonisation of gut bacteria is transient and that they are globally shed in the stool shortly after consumption (Han et al, 2021).”
Gupta is quick to add that these issues do not diminish the need for a healthy gut microbiome. “While there is an increasing body of evidence that probiotics play an active role in alleviating a variety of conditions including chronic, infectious, autoimmune and pediatric diseases, opinions are not quite as aligned on the mechanisms and the results of studies are contrasting,” she argues on the effectiveness of probiotics.
On the one hand, there is a technique called microencapsulation which coats probiotics with a protective shell to help them better survive the journey to the gut, and on the other, there are studies that show that “the effects obtained from ‘live’ probiotics can also be obtained from dead ones (Han et al, 2021).” Another report mentions, “the impact of probiotics as well as of bacteria colonizing food does not reside in their ability to graft in the microbiota (a.k.a colonisation) but rather in sharing genes and metabolites, supporting challenged microbiota, and directly influencing epithelial and immune cells (Wieers et al, 2020).”
Kumar couldn’t agree more with Gupta. He explains how a human body has close to eight thousand strains of microbes while probiotics contain only a few specific strains so there is nothing called one solution that fits all probiotics. “It all depends upon which bacterial strains are missing in your gut and which probiotic can help reinstate the diversity or abundance of those strains. So if someone tells you to have a lot of yoghurt or some probiotic supplement without evaluating the gut microbiome, please use your discretion before following that advice.”
One must be careful to do all things in moderation, and the case with probiotics is no different. Having too many probiotics is not good, and may do more harm than good. “Precautions are necessary even with something as beneficial as probiotics as excess bacteria is known to interact with the body negatively. Blood infections have been linked to probiotics in persons with weaker immune systems. Lactobacillus-containing probiotic supplements can induce infection in the inner lining of the heart chambers and heart valve. Although exceedingly rare, patients with compromised heart valves may be more susceptible to this sort of illness. Probiotics should be avoided by those who have damaged heart valves before dental or surgical treatments,” advises Chaturvedi.
The duration of consumption of probiotics can’t be indiscriminate and one must be mindful before having it. As Kumar explains, “The duration of consumption of a particular probiotic would depend upon which strain one is taking, how much and for what. Probiotics may work well when one is suffering from diarrhoea to bring back the gut into balance after the onslaught of antibiotics or to prevent the damages of wrong dietary choices.”
Nutritionists are of the opinion that one has to feed probiotics and it is not enough to take and forget. “Colonisation or not, as with any living microorganism, they do need to be fed! But that said, it is a myth that one needs to consume prebiotic supplements, which are often touted as being essential for the survival of probiotics,” says Gupta.
Probiotics are meant to be taken consistently and regularly to be effective and produce beneficial results in the body. “Among the general population, probiotic supplements can be consumed once a day or as prescribed by the physician. In contrast, naturally occurring probiotic foods can be consumed every day along with the usual diet,” adds Chaturvedi.
Also, probiotic products can cause adverse reactions in those who have yeast allergies. “Taking antibiotics alongside these probiotics might impair their effectiveness. Probiotic supplements should be taken at least two hours before or after antibiotics to avoid this reaction,” warns Chaturvedi.
A large intake of prebiotics could lead to issues like gas and bloating due to excessive fermentation (Stone, 2020). Gupta, therefore, recommends the consumption of prebiotics in their natural form – whole foods that contain dietary fibre which is the best fuel for the gut microbiome. “High fibre, low-fat diets replete with food like fruits, vegetables, nuts, legumes and whole grains confer not just dietary fibre that helps the gut bacteria flourish, but a host of other nutrients that improve overall health and vitality (Ravella, 2017),” emphasises Gupta.
To measure your health up to the epigenetic level and ascertain the right probiotics for the gut that brings back the gut microbiome homeostasis, Kumar suggests gut microbiota analysis. “One must remember that all our health problems have one solution, and it lies in the gut microbiome,” he says in the parting.
Probiotic supplement, Yakult, versus natural yogurt: Which is better and why?
Palak Chaturvedi, Nutritionist & Lifestyle Consultant says,
Yakult is fermented milk with high amounts of strain concentration of probiotics with low sugars and natural sweeteners. However, being a packaged product, it does contain preservatives. Instead of curd, yoghurt is a much better source of probiotics with beneficial microorganisms that can benefit the overall health. It is prepared from milk fermented by friendly bacteria, primarily lactic acid bacteria and bifidobacteria. Yoghurt consumption has been linked to a variety of health advantages, including increased bone health. It’s also good for folks who have high blood pressure. Yoghurt may also be good for persons who are lactose intolerant. This is due to the bacteria converting some of the lactose to lactic acid, which is also why yoghurt tastes sour. Keep in mind, however, that not every yoghurt includes active probiotics. In certain situations, living bacteria were destroyed during the preparation. As a result, it’s important to make sure to select yoghurt with active or living cultures and check the label on yoghurt before purchasing it. Even if it is branded low-fat or fat-free, it may still contain a lot of added sugar.
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