How to Take Probiotics - Ask a Nutritionist

September 28, 2023

Research has shown that the health of our gut and the health of our microbiome have far reaching effects on the rest of the body. One of the best ways to support that microbiomes is to supplement with a probiotic. Tune into this week's episode of Ask a Nutritionist with Leah to learn all about Probiotics.

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Welcome to the “Ask a Nutritionist” podcast, brought to you by Nutritional Weight and Wellness. We are thrilled to have you join us today as we discuss the connection between what you eat and how you feel, and share practical real life solutions for healthier living through balanced nutrition. Now let's get started.

LEAH: Hello and welcome to Dishing of Nutrition's midweek segment called “Ask a Nutritionist”. My name is Leah Kleinschrodt. I'm a Registered and Licensed Dietitian with Nutritional Weight and Wellness. And on today's show I will be answering a few related questions that we received from one of our dishing of nutrition listeners.

This listener asks, “Can you give an outline of how to take a probiotic for overall good gut health when no other underlying, underlying issues are present? Does it matter how many billions of CFUs it has, the number of strains it has, and should those quantities be rotated or increased or decreased every couple of months? And are there certain characteristics to look for when purchasing a probiotic?” So we will talk all about probiotics in the show today. These are wonderful questions. It's kind of a nice grouping of questions that I think will help a lot of people.

Probiotics have many health benefits

'Cause I've had, I've had lots of questions over the probiotics over the last couple of years. So probiotics are a really popular health topic, and if you, I mean, if you poke your head into Google or the internet at all, you'll see that research really in the last 15 to 20 years or so has shown that the health of our gut and the health of our microbiome, or everything that kind of makes up bugs that are in our gut, these things have far reaching effects on the rest of the body. So it certainly makes sense, even if we don't struggle with any kind of digestive symptoms or with a chronic health condition, that we'd still want to keep our gut, you know, tuned up should we say, and just try to keep that gut as healthy and as happy as we possibly can.

You know, before we get too much into some of those questions, I just put this little nugget in there just so that we, we kind of lay this foundation. I just talked about digestive issues. That's usually one of the biggest reasons why people think about taking a probiotic or think about probiotic rich foods. But as I mentioned, there are so many far reaching effect of effects of the gut that imbalances in the gut can show up in a lot of different ways. So yes, there are people that struggle with IBS or heartburn, constipation, diarrhea, again, gut symptoms, but even things like skin issues like eczema, psoriasis, brain fog, moodiness, or just mood issues, sleep issues, immune system issue, or like a predisposition to autoimmunity, all of these things and more can absolutely be impacted by what's going on in our gut.

But we're going to take this particular question at face value kind of thinking from the perspective of someone who is overall very healthy, really doesn't have a whole lot or really anything going on. And I will say, first of all, you don't have take a probiotic supplement in order to get that beneficial bacteria into your gut or even to get enough beneficial bacteria in the gut. More high level research that's come out recently says that we actually probably need fewer probiotics coming in either from a supplement or from our food. We need fewer of those probiotics than originally thought. It used to be thought that we needed 50 to even a hundred billion CFUs of probiotics per day. And CFU is just one way that we measure those probiotics. It stands for colony forming units.

Probiotic rich food sources

So we used to think, you know, we need 50, we need a hundred billion, we need a couple hundred billions of probiotics a day. And the research actually has come out and said, you know, even five to 10 billion CFUs per day, even a couple of times a week in that five to 10 billion CFU range can still have really great beneficial effects and can get people where they want to go.

So this is actually great news, especially if you're someone, and I've had these clients before where you'd rather lean into the food piece of things as opposed to taking a supplement. So when we think about probiotic rich foods or where might we find these good bacteria in our food system, we have to think about fermented foods. The common ones that most people are aware of or you've heard of before: yogurt is a big one. Kefir, sauerkraut, kimchi, kombucha is another one that's a fermented tea. The hard thing, just like the challenges, not necessarily setbacks, but just one of the challenges in terms of getting probiotics from food is that we can't always be a hundred percent sure how much probiotic we're getting from our food as they're just, there tends to be this natural variation in probiotics between the categories of these probiotics, of these fermented foods.

There's variety within the brands and even within batches within that brand, there just might be some variation in how much probiotic, how much of that good bacteria we're getting in there. And second of all too, there's just not as much research around food probiotics versus research around probiotics coming from supplements. I mean, and we could go down that rabbit hole, but there's just, there's not quite as much around actual food probiotics versus supplements for a variety of reasons.

But, but we do know that throughout history, that's how most of our ancestors, like mostly got their good probiotics or good gut bacteria, is that they got it through their food and the preservation methods that they were using back then. So it's not that it's not doable. It certainly is. And so if we kind of think in general, coming from that generally healthy perspective, I will tell people like, if you can get one serving of probiotic rich foods into your day somewhere, you're doing your gut a good service. This could look like, you know, maybe a quarter of a cup to half a cup of kimchi or sauerkraut per day.

Maybe you serve them with your morning eggs, you put them on your burger or, or maybe you add it to your daily salad that you're having. I mean, lots of different ways that you can get those in. I will note, make sure that the sauerkraut or kimchi that you're eating is from the refrigerated section of the grocery store versus the can or in the bag that's in the middle of the grocery store that's not refrigerated. It just means that those probiotics, those live cultures are being preserved when they're refrigerated.

Remember, yogurt and kimchi are great sources of good bacteria. So we might think about half a cup to a cup of yogurt per day. We recommend full fat, plain flavored yogurt just to take away all the extra sugars or other additives that might be kind of coming into that yogurt. That could be a cup of kefir per day. And usually most people are drinking kefir straight from the glass, but I know you can use it in other ways as well.

And then kombucha, this is where, you know, half a cup to a cup of kombucha per day is fine. Just with kombucha, especially if you're buying it from a store, buying it commercially, you do have to pay attention to the sugar content in kombucha. The, many commercial brands, they just will add a decent amount of sugar in there to compensate for some of that natural sourness or some of the bitterness that comes along with kombucha.

Probiotic supplementation

So I usually tell people, if you can find a brand that has five grams of sugar per serving or less, then you're probably doing all right. So those are ways that you could just do it, get some of these good probiotics and good bacteria into us through food. But I definitely have clients, and I admit I'm not hugely consistent with this myself, but you know, sometimes fermented foods just aren't your jam or you're inconsistent with getting those in or, or you just want something a little more simplified or a little bit more defined. And in that case, the route of doing a probiotic supplement is a great way to get those good gut bugs in.

And as I mentioned before, you don't need a ridiculously high amount of CFUs for a probiotic to be effective and to have benefit, even five to 10 billion CFU per day will be fine. And yes, you can go higher. There's usually not any big deal about going higher, and some people do need to go higher. If they're struggling with digestive issues or chronic conditions, they may need to go higher. But for general purposes, again, even that lower dose will likely do the trick.

What to look for in a probiotic supplement

So then the million dollar question that tends to come in is, okay, what do I look for in choosing a probiotic supplement? How do I know what's a good brand? How do I know if this is working for me? How do I know if I'm getting what I need to out of this? It can be really tricky to get to the root of that. So I kind of try to keep it high level and just say, what I recommend for my clients is, I say, you're probably your best bet is to probably get a probiotic from a licensed health professional if you can. So this would be like something like Nutritional Weight and Wellness, maybe your chiropractor.

A lot of chiropractors carry good high quality supplements; a functional medicine practitioner or a naturopath, you know, someone who has a license, and there are some good quality supplement companies out there that only work with licensed professionals. So we know that we're kind of going more into that pharmaceutical grade supplement realm. So it's much more likely that you'll get a higher quality. You can also go to your local health food store, like a co-op, even a Whole Foods or something along those lines. And that again, gives you a better chance that you're going to find a higher quality selection that you can choose from. And I recognize it's tempting to get on Amazon to see if you can find a great deal or find like a really great probiotic. And I'm positive there are good ones out there. It's just Amazon can be more of the supplement Wild, wild West, and it's just a bit bigger roll of the dice as to whether you're getting what you pay for, getting what you ordered; also, how it's handled during shipping and delivery. So there's just some wild cards there.

So I do recommend if people are able to go through a practitioner or a professional or just a really high quality company, that's probably your better bet. You don't have to get the most expensive probiotic out there, but you also probably don't want the cheapest one out there either. For just general overall health and wellness, I do usually recommend a multi-strain probiotic, since we know, I mean the gut has hundreds of different species or genuses of bacteria that live in that gut. There are single strain probiotics out there. Those can be great for people who have more sensitive systems. Or maybe it's the first time you're taking a probiotic as a way to ease in.

But for the most part, having a good variety of some bacteria that's coming in that that's usually a good, a good role there. Most probiotics are going to be a blend of lactobacillus and bifidobacteria genus. These are the major players in the digestive tract in that gut microbiome. But there's other classes of probiotics out there too. There's, there's beneficial yeast out there, there's soil-based probiotics. Those are just another class that have made their appearance more in recent years.

Is it recommended to rotate different probiotics/alter dosages?

So there's other options out there. But again, if you're kind of just trying to go for general overall health and wellness, usually as long as you tolerate it well, the lactobacillus and bifidobacterial blends are going to do great for you. One of the questions was, okay, do I need to rotate? Do I need to get different probiotics? Do I need to up or decrease my dose every so often? There's certainly a thought out there that rotating probiotics can be helpful because what we want is we want diversity in the gut. That is a hallmark of a healthy gut microbiome is that there are lots of different strains, lots of different bacteria in there, but I've also worked with plenty of clients who have taken the same probiotic for years and they've done great.

It just works well for them and that's what they stick with. So what we do know is that the thing that creates the biggest amount of diversity in the gut is not necessarily having more diversity in your probiotics or what you're, what you're taking from a supplement, but actually it's more of the diversity in your food choices. So especially when it comes to your plant-based foods or, or your vegetables and your fruits and things like that and, and grains and starchy root veggies and things like that. So when we are adding in especially those different kinds of fibers and different amounts of fibers, that's what's going to drive a lot more of that gut diversity than necessarily, you know, a probiotic that has three strains of bacteria versus one that has 10. Really, it comes down to more of what's the diversity in your diet or in your food choices look like.

More on what to look for in a probiotic supplement

A couple other things, just general broad brush strokes in terms of what might you look for for a probiotic. So I mentioned, you know, going through a healthcare professional or going to your local health foods co-op or store. Another thing that I'll often look for if I am kind of perusing and looking for other supplements outside of our company, I'll look to see if the company, or on the label, you'll see a GMP certification and that stands for good manufacturing practices. And that just means that the company that manufactured that supplement adheres to certain standards or best practices while they're making that supplement. So it's just one level of quality and reassurance that like, hey, there are certain standards being met by this company when they're making the the probiotic.

Another thing I'll look for is on the label, will it say, you know, free of the major allergens. So gluten, dairy products, nuts, tree nuts, peanuts, soy, things like that. Basically, you know, are we avoiding dyes? Are we avoiding other additives? Are we avoiding synthetic ingredients and, and other things, again, that might bother that immune system from the allergen perspective typically at least tells me that this company has taken care to create a cleaner product. And that hopefully somebody won't react to other ingredients that might be in that particular supplement, in that probiotic. So they don't just throw it out and say, well, the probiotic didn't work for me if they were more reacting to one of the other ingredients in it.

Is it beneficial or recommended to have prebiotics included in a probiotic supplement?

One of the other last big things that I will, that I will say about this is a lot of probiotics actually do also contain a prebiotic in it as well. And prebiotics are the, the fibers or like the plant matter that our gut cannot break down, but this is fuel for those probiotics. So our, the probiotics need prebiotics and need these fibers to fuel them. So some supplement companies kind of double dip in that sense and put some prebiotics in there with the probiotics. And in my experience, some clients do great with this and others sometimes that if you have a little bit more of a sensitive system, the prebiotics can create a little bit more disposition to having maybe some bloating or some gas or just like some uncomfortable symptoms to go along with it.

I usually point people towards probiotics that are just that, that are just probiotics that don't have other added prebiotics or fibers or anything like that in there. But of course there are, again, people who tolerate that and products out there that are still good and that actually work well for people. So that's just something to look at to see, you know, is that something that you want in a probiotic also?

But ideally, thinking back to that good food, actually, we should hopefully be getting most of that fiber and those good prebiotics actually through the food that we eat and, and through those fiber containing foods like our, our vegetables and our fruits and starchy root vegetables and things like that, that, that fiber should be coming in. I hope that is helpful for this listener and for all you listeners out there, just a little kind of briefer about probiotics, what are we looking for? How do we get them into our system? And even if we are healthy and don't have a lot going on in terms of our health, we still want to keep mindful that our gut is happy and healthy as well.

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