Tuesday, September 17, 2013

Probiotics, Prebiotics, Potato, Potahto.


       Probiotics, Prebiotics... ring a bell? Anyone? No one? Bueller? Bueller? Most people don't know what they are or the difference between the two. There's been a lot of buzz lately as everyone seems to be taking these supplements without fully understanding the reasoning behind them. They just know that the dreadlocked woman working in the vitamin section of Whole Foods said they're "good for you." Sorry to break it to you, but Moon Fire the Whole Foods employee is not a doctor or dietitian (if she were, she wouldn't be toiling away in a super market for 30K a year), so I wouldn't hold her as a reputable source. So, what are prebiotics and probiotics? Why should we take them?
Seems Legit
      Let's start at the root of the issue: your small intestine, home to colonies upon colonies of the "good" bacteria that promote health by producing vitamins, digesting food, alleviating infection, and helping the immune system. When your body is under harsh conditions such as a poor diet, infection, antibiotic treatment, or stress, something called dysbiosis occurs- an overgrowth of "bad" bacteria and yeast that outnumbers the "good" bacteria. Dysbiosis can cause a range of conditions from diarrhea to yeast infections to irritable bowel disease (IBD). How do we fix this? Well, if the problem is having more bad bacteria than good bacteria, wouldn't the natural solution be to add more good bacteria? Correct. So, where do we get good bacteria?
Dysbiosis: When Good Bacteria is Outnumbered
       That's where probiotics come in- they're the good bacteria that keep a healthy balance in your gut. Probiotics are found in fermented foods such as yogurt, kimchee, and sauerkraut or in capsules as supplements. Common strains of probiotics are lactobacilli and bfidiobacteria.
Food Sources of Probiotics
      Another way to increase the number of good bacteria in your gut is by consuming prebiotics- the food for beneficial bacteria that helps them grow. The human body cannot digest prebiotics, so they act as a fertilizer for good bacteria instead. Prebiotics also aid gut health by hindering the growth of bad bacteria. Prebiotics come in the form of oligosaccharides, such as inulin and oligofructose. The foods that are the absolute best sources of prebiotics, in order from greatest to least, are raw chicory root, raw Jerusalem artichoke, raw dandelion greens, raw garlic, raw leek, raw onions, cooked onions, raw asparagus, raw wheat bran, cooked whole wheat flour, and banana.
Food Sources of Prebiotics
       The recent buzz about pre/probiotics stems from recent studies that have shown that ample pre- and probiotics in a diet can alleviate the symptoms of Crohn's disease and IBD, reduce diarrhea and constipation, improve allergies, and boost the immune system. It is especially useful to treat/ prevent antibiotic induced diarrhea, as antibiotics kill off the good bacteria in our gut.

       Despite the increasing evidence for the use of pre/probiotics, there are some important points to remember. Firstly, our understanding of them is quite limited as to exactly how great of a margin of benefit they have- it might not be enough to make it worth taking them. Moreover, the methods by which many of these studies were conducted is faulty. The correct way to perform a study is a double blind randomized placebo controlled study in which one group of people is given a probiotic and another group is given a placebo to treat a condition, such as diarrhea, for a period of time, and then their recovery is recorded. Neither group knows whether they have the probiotic or the placebo. The person who is in charge of collecting results also has no knowledge of treatment in order to prevent bias and expectations from skewing the results. This painstaking method is not the norm for studies. It usually goes something like this: probiotics are doled out to a bunch of people and after a few months, they are asked how many times they had diarrhea. If this number is lower than the average instance of diarrhea in the U.S., then the probiotic is reported to alleviate diarrhea- simple as that.  

       It's also important to keep in mind that no probiotic is a magical cure all. Each bacteria strain treats one specific condition. So a certain probiotic can treat only one condition, not every ailment in your body- whether it be real or imaginary. Which brings me to my next point, do you even need to take pre/probiotics? Most of the people who take these supplements are already healthy, but then hear Gwenyth Paltrow talking about probiotics on E! to treat her "digestive conditions", and all of a sudden, annoying rich girl Stacey Kleinbergerstein from Brentwood has some imaginary ailment as well. "Oh my gawd guys, I've been soooo much more, um,...better! Now that I take these probiotics, I feel healthy! I just glow!" I don't see any glow, I just see someone taking a fake treatment for a fake ailment. You don't have a condition, you're just annoying and you want attention. If you really had a condition, you'd see a doctor, like a normal person.
Try Flaritin! A Fake Treatment for Fake Conditions!
       "But Michelle, if it doesn't work then how can they sell  it?" Vitamins and supplements do not require FDA approval since they aren't considered food or drugs. That means anyone can sell anything and can say whatever they want about it. Which reminds me, I have a line of supplements that make you poop 24 carat gold... The fact that pre/probiotics don't require FDA approval should make you especially wary since they can be unsafe. For example, a lack of FDA approval means that the factories that produce them aren't bound to safety and sanitation checks. So these capsules can be infected or laced with lord knows what. 
       Since the FDA doesn't control supplements, you should buy them from a reputable brand that a doctor or dietitian recommends. Please, for the love of all that's holy, DO NOT buy pre/probiotics from a spam email that advertises a top secret European supplement that the government doesn't want you to know about. It's just not true. At the very best, you'll get plain old sugar pills, but you could also get something seriously dangerous. There have been numerous cases of online supplements being tainted with lead or actual harmful bacteria.
       People who are immune compromised, such as cancer patients, or those who have a surgically placed device should not take probiotics at all. These are live strains of bacteria and although they are "good" bacteria, serious infections can result in these cases. 
       I bet Moon Fire didn't mention all of this. That's because Moon Fire is an idiot, she's also probably stoned. Oh, and she's getting all her info from the companies that produce these supplements. These details are left out when trying to suck out billions of dollars from the public each year...it wouldn't help business.
       What's the bottom line on pre/probiotics? I'm not against them at all. By all means, incorporate more food sources of them (listed above) in your daily diet. Doing so can possibly help your digestive health. If you want to take them in supplement form, I'm not against that either. Check with a doctor and a registered dietitian first though to see if you should and which brand to buy as well as which particular probiotic will help you.     
       Thanks so much for reading everyone.

Until next week,
Michelle Azizi