There’s a lot of hype out there about probiotics. But just what are probiotics? And what is the best time to take probiotics, so that you can maximize the health benefits that come with them?

What Are Probiotics?

Bacteria are an essential part of our body, amounting to 1 kilogram of weight in our intestines alone (never mind the rest of our body!) and outnumbering our own cells 10:1. Now that’s a lot of bacteria! Technically, probiotics are officially defined as “live microorganisms which, when administered in adequate amounts, confer a health benefit on the host.” These microbes help us digest foods, fight off diseases, and regulate our body systems.

The first known probiotic was isolated from yak milk and was officially categorized by Elie Metchnikoff, who had worked with Louis Pasteur in the 1800s. She came across lactobacilli (a very common probiotic bacterium, found in your Activia yogurt), and found this had a positive effect on overall health. Now, we know probiotics are found (or added to) a variety of foods, including yogurt, cheese, chocolates, cream, meat, and milk, providing us with a wealth of powerful disease fighters.

The Probiotic Market

Of course, when researchers and doctors heard that this miracle cure was natural as well as effective, it took off like wildfire. To date, more than 700 human clinical trials have been run, and in 2008 alone, probiotics resulted in over 1,000 articles, and 2,000 probiotic products launched into the natural/holistic medicine market. Because probiotics are naturally found in the human body and many foods, they are considered safe. This means safety studies and regulations are not always as stringent as with other pharmaceuticals, which may be a cause for concern.

That said, probiotics are typically well-tolerated, but many pseudo-science products are now called “probiotics” when they do not meet the criteria of a probiotic. In a study performed on commercially available E.coli probiotics, researchers found the amount of probiotics that survive the gut was actually two orders of magnitude lower than the label claimed, meaning that the amount of probiotics you get is approximately100 times less than advertised.

Considerations of Probiotics

The biggest challenge facing probiotics as health supplements are making sure they meet several criteria. First, the probiotic survives until it reaches the target organs, including stomach acid and extreme pH of the small intestine. To do this, most probiotics have a polymer coating that protects against the extreme pH conditions of the intestine.

The probiotic should also have antipathogenic properties, meaning either through competition (killing off other bacteria in our digestive system) or foreign contaminants, it reduces our pathogenic microbe count.

From a manufacturing perspective, the resulting probiotic should be stable for storage, be easy and cheap to produce, and withstand humidity during storage. The board in charge of governing probiotics, including whether or not foods and supplements can be called probiotics, is the International Scientific Association for Probiotics and Prebiotics.

When Should I Take My Probiotics?

Several studies have been performed to determine when the optimal time to take probiotics is. It turns out, the best time to take probiotics is with a meal or 30 minutes before you eat. This is because, once you’ve eaten, stomach acid and other digestive juices increase, which can break down and reduce the effectiveness of probiotics. Ideally, probiotics should be taken just before a meal containing fat or 1% milk, which showed the best final absorption.

The worst survival and effect of probiotics was seen when taken with water or juice or taken 30 minutes after eating a meal. Probiotics are most effective when they’re actively being taken, with studies showing they lose effectiveness approximately 1–4 weeks after you stop taking them. For some good ideas about how to incorporate probiotics into your diet, take a look at our articles “5 Vegetables that Affect Your Gut,” and “What Is the Healthiest Milk?”

So, What Can Probiotics Treat?

Health Canada recommends taking 1×109 CFU (colony forming units, a form of measuring the amount of bacteria present), and these should be taken for at least 5 days. Probiotics have been used for the treatment of antibiotic-associated diarrhea, irritable bowel disease, inflammatory bowel disease, and C. difficile associated diseases. Other conditions it can treat include hypercholesterolemia and atopic dermatitis (probiotics seem to have an anti-allergy effect too, although it’s unclear why).

Likely, these effects are because probiotic bacteria are able to inhibit the dangerous bacteria that cause these disorders and bulk up the lactobacillus and bifidobacteria that are the good bacteria in our digestive system. By decreasing the number of harmful bacteria and increasing our helpful bacteria, probiotics can regulate and reduce the symptoms of these conditions.

Some probiotics have recently been used experimentally for cancer therapy, and seem to target tumors. Probiotics have also been investigated for their ability to reduce fasting glucose levels in diabetic patients. They can also stimulate the immune system, and research is currently examining their applicability as a delivery system for vaccines and booster for treatment effectiveness.

Anti-inflammatories and antibiotics can change the gut microbiome (proportions of good and harmful bacteria in our gut) incredibly quickly, and probiotics taken with or shortly after these treatments may reverse negative changes and restore the natural microbiome.

As an added bonus, probiotics can also help lower cortisol (the stress hormone). Read our article “Stay Calm with These Cortisol-Lowering Foods (Including Chocolate!)” to learn more.

A Brief Word of Caution

Probiotics are largely considered safe but can pose a problem for geriatric patients or those with immune disorders. They are not formally recommended by doctors, but in the words of Anthony Komaroff, MD, “There is some evidence that probiotics may help prevent or treat several different conditions. … For now, what I tell my patients is that if they find probiotics help them … I know of no reason not to take them.”

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