House Call, MD: Health Carefully Explained

by Leah Frankel, MS, RD

There’s been a lot of buzz regarding prebiotics and probiotics lately.  You’ve heard rumors about yogurt and the “healthy” bacteria that yogurt contains but what’s the real deal?  Do they really work?  Do prebiotics and probiotics function differently in our body?  Do we need to be taking supplements daily?

What are probiotics and prebiotics?

There is a large debate regarding the definition of probiotics but the World Health Organization and Food and Agriculture Organization of the United Nations define probiotics as “living microorganism which, when administered in adequate amounts, confer health benefits to the host.” These microorganisms are usually bacteria and are sometimes referred to as “healthy”, “friendly”, “good” or “beneficial” bacteria. Probiotics are microorganisms similar to those that naturally exist in the gut.  The idea is that in order to stay healthy, we must maintain a delicate balance of microflora (i.e. a mix of different bacteria) in the gastrointerstinal tract.

Prebiotics are defined by several criteria: they are indigestible by the stomach and are not absorbed, they are fermented by the GI microflora (that mix of bacteria we just mentioned) and stimulate the growth and proliferation of beneficial bacteria in the gut. Prebiotics essentially help facilitate the effect of probiotics.

Where can we get probiotics and prebiotics in our diet?

Probiotics (which include species of Lactobacillus, Bifidobacteria and Yeast) can be found in food as well as dietary supplements including yogurt, milk, miso, tempeh, and soy beverages. The largest group of probiotics are lactic acid bacteria (Lactobacillus acidophilus, found in yogurt, is the most well known).

Prebiotics can be derived from plants or synthesized. Sources include: soybeans, whole grains, onions, chicory root, bananas, garlic, leeks, artichokes and raw oats.

What are the proven health benefits of probiotics and prebiotics?

Studies have found multiple benefits associated with probitioics; typically probioitics are beneficial in a situation when the natural microflora in the gut may have been disturbed, as is commonly the case with antibiotic use. Probiotics have been found to:

• Treat diarrhea

• Treat IBS (Irritable Bowel Syndrome)

• Prevent and treat a UTI (Urinary Tract Infection)

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  Reduce the recurrence of bladder cancer

• Shorten the duration of intestinal infections

• Prevent and manage eczema in children

• Prevent and treat inflammation following colon surgery (called Pouchitis).

Prebiotics have been shown to have multiple benefits including:

• Increased absorption of calcium and magnesium

• Increased immune system effectiveness

• Inhibition the growth the lesions in the gut, such as adenomas and carcinomas, therefore reducing risk factors associated with diseases in the rectum and colon.

Are there any side effects or risks associated with the use of probiotics and prebiotics?

While probiotics are generally found to be safe, few studies have been conducted on the elderly, young or immune compromised populations. In populations where probiotic use has been studied, side effects are typically mild (for example, increased gas or bloating).

As with probiotics, prebiotics can cause gas, bloating and increased frequency of bowel movements when consumed in large quantities (i.e. you may fart and poop more).

When prebiotics and probiotics are used together they are commonly referred to as “synbiotics”…essentially, when used together they work synergistically to provide a more beneficial probiotic effect than either would alone.

Daily consumption of foods containing these functional components is beneficial; however the effects of probiotics are dependent on the strain and species ingested and can only be assessed through clinical trials. While probiotics and prebiotics have been shown to have a variety of advantageous effects, additional supplementation is not vital since these bacteria already naturally exist in your gut and reproduce independently.

As with any supplement, always check with your doctor before beginning a new regimen. It’s important to note that dietary supplements (including vitamins and minerals) are not regulated by the FDA and therefore the product may not have the quality or purity that the label suggests. Choosing a well-known brand or looking for a USP label will ensure the product is safe.

by Kelly Erickson

Whatever you choose to call it – gas, farts, and flatulence – it’s a fact of life. Our body produces gas continually regardless of where we are or the company we are in (as we all have inevitably experienced). In case you feel alone in your flatulence-producing universe, most people produce between 1 to 4 pints of gas per day, causing an average of 14 gas-passing events daily!

At some point you have probably wondered, “Where in the heck does all that gas comes from?” There are two possible sources:

1. Swallowed Air: Aerophagia, or swallowed air, usually occurs unconsciously and is increased during activities such as chewing gum, sucking on hard candy, drinking too fast, smoking tobacco (another excellent reason to quit) or drinking carbonated beverages. The majority of this gas is expelled via belching, however, a portion of it is passed into the small intestine and eventually be passed per rectum (i.e. a fart).

2. Byproduct of the Breakdown of Carbohydrates: The remainder of gas is produced by bacteria in our gut which break down carbohydrates that our bodies cannot digest independently. Undigested carbohydrates, which are contained in higher concentrations in certain foods (for example, beans the “musical fruit”), are the primary source of gases produced in our own digestive tract. These hard-to-digest carbs are passed into the large intestine, which harbors a more extensive selection of bacteria. While these relatively harmless bacteria will not make you sick, they will devour these carbohydrates, releasing gas as they munch on your leftovers.

Gas in the Digestive Tract

So what can you do to reduce your natural gas-producing predisposition? First, and most importantly, remember that everyone produces and releases gas on a daily basis…it cannot be avoided altogether. Also know that each person harbors a different cocktail of bacteria which responds uniquely to varying diets. Which brings us to the question: Which foods can I avoid to keep myself from another embarrassing predicament? If it was possible to recommend a 100% gas-free diet, we would, but you now realize such a diet does not exist. However, there are specific foods that are rich in hard-to-digest carbs which will undoubtedly escalate your gas output. Here’s a lineup of the usual suspects:

· Raffinose: A carbohydrate found in beans, cabbage, brussel sprouts, asparagus and broccoli

· Lactose: Found in all dairy products

· Fructose: A simple sugar found in onions, artichokes, pears, melons and wheat

· Sorbitol: A sugar substitute found in apples, peaches, prunes, artificial sweetener and sugar-free candy

If your gas is particularly inhibiting, try starting a food diary to look for patterns or particular foods that seem to create the biggest stink, and avoid those before your important meetings and hot dates. But if all else fails and you’re stuck with some particularly noxious flatulence, take advantage of the one truly productive aspect of gas (it has its name for a reason). Cancel your date, find yourself a lighter, and make some fireworks!

For more information about your natural gas-producing abilities visit The National Digestive Diseases Information Clearinghouse (NDDIC)