The Importance of Probiotics

You’ve probably heard of probiotics as an excellent way to regulate your gut health. But have you ever stopped to wonder what probiotics are? According to the Food and Agriculture Organization of the United Nations World Health Organization, probiotics are “live microorganisms which, when administered in adequate amounts, confer a health benefit on the host.” However, experts claim this working definition can be misleading. Evidence suggests that even dead probiotics, or non-viable probiotics, can benefit one’s health. Keep reading to learn how probiotics, both dead and alive, can help you stay healthy.

Viable Probiotics

The scientific evidence that points to probiotics’ health-enhancing ability is continuously expanding. As a result, manufacturers have applied probiotics to their products within the food industry. Health professionals promote probiotics to improve intestinal health, reduce symptoms of lactose intolerance, and reduce the risks of other diseases.

Different Microbial Species

As mentioned in their current definition, probiotics are live microorganisms or microbial species. Many microbial species may exercise beneficial probiotic properties. As far as obtaining the proper nutrients is concerned, only the strains classified as lactic acid bacteria are significant. Among these lactic acid bacteria, the ones with the most beneficial properties belong to the genera Lactococcus and Bifidobacterium.

Desirable Probiotic Properties

Following the definition of viable probiotics, we expect them to carry specific properties that allow them to exert their beneficial effects. The properties currently determined by in vitro tests include:

• Acid and bile tolerance (vital for oral consumption)
• A connection to mucosal and epithelial surfaces (effects immune reaction, prevention of pathogen adhesion and colonization, and competitive exclusion of pathogens)
• Antimicrobial activity against infective bacteria
• Bile salt hydrolase activity

Typically, probiotic products should contain a minimum concentration of 10million CFU (colony forming unit)/mL or gram, and an individual should consume about 10billion to 100billion CFU daily to experience the beneficial probiotic effects.

Viable Probiotics’ Health Benefits

There is expanding evidence supporting the various health benefits of probiotics. These include improving intestinal health, reducing serum cholesterol, enhancing the immune response, and cancer prevention. However, it is vital to know that health properties are strain-specific and are impacted by various mechanisms of action, like short-chain fatty acid production, lowering of gut Ph, and immunomodulation.

Treating Diarrhea

Clinical research shows that you can use probiotics to help treat various forms of diarrhea. This section will focus on three different types of diarrhea that probiotics can help treat.

1. Antibiotic-associated diarrhea – Antibiotic therapy can cause mild to severe episodes of diarrhea. This reaction occurs because antibiotics naturally suppress the normal microflora, encouraging the overgrowth of opportunistic or pathogenic strains. The spectrum may range from mild diarrhea without mucosal abnormality to severe pseudomembranous colitis. A 2012 meta-analysis concluded that probiotic administration (specifically, L. rhamnosus, L. casei, and the yeast S. boulardii) is associated with a reduced risk of antibiotic-associated diarrhea.
2. Infectious diarrhea – Probiotics are probably best known for treating and preventing infectious diarrhea. Clinical studies show that probiotics like L. rhamnosus GG, L. reuteri, L. casei Shirota, and B. animalis Bb12 can shorten the duration of acute rotavirus diarrhea. The strongest evidence points towards the effectiveness of L. rhamnosus GG and B. animalis Bb12.
3. Lactose intolerance-related diarrhea – In people with lactose intolerance, when the undigested lactose reaches the large bowel, it is degraded by bacterial enzymes, leading to osmotic diarrhea. While improvement of lactose metabolism is an observable health benefit of probiotics, it seems to depend on specific strains and concentrations.

Probiotics and Allergies

A 2001 study observed that improved hygiene had altered early microbial exposure by reducing childhood infections. Researchers believe that is the cause for the rising prevalence of atopic diseases. Atopic diseases, or atopy, make your immune system more sensitive to common allergens that you breathe or eat. The study concluded that the state of neonatal gut microflora precedes the development of atopy, suggesting a crucial role of the balance of indigenous intestinal bacteria for the development of human immunity to a nonatopic state. In other words, research suggests that exposure to bacteria in early life may play a protective role against allergy. In this context, probiotics may be a safe alternative for the microbial stimulation needed for the developing immune system of infants.

Other Health Benefits

There is evidence that probiotics, as dietary components, may help decrease cancer incidence. According to the National Library of Medicine, studies show that specific members of the Lactobacillus and Bifidobacterium spp. “decrease the levels of carcinogenetic enzymes produced by colonic flora through normalization of intestinal permeability and microflora balance as well as production of antimutagenic organic acids and enhancement of the host’s immune system.”  

Evidence suggests that food products containing probiotics could help prevent coronary heart disease by reducing cholesterol levels and blood pressure.

Does Probiotic Viability Matter?

While probiotics’ viability is typically considered a prerequisite for health benefits, evidence shows that non-viable probiotics may still provide significant health benefits. For example, some studies suggest that inactivated lactobacilli and cell-free supernatants of probiotics may improve epithelial integrity. Other clinical studies indicate that non-viable probiotics can positively affect the immune system.

Several in vitro and animal studies directly compared the effects of viable and inactivated probiotics on innate immunity. The viable and inactivated probiotics proved to be equally effective in many cases. Overall, it’s vital to point out that clinical evidence suggests that some beneficial mechanisms associated with probiotics may not be directly dependent on cell viability. These mechanisms include binding to host tissues and adjustment of innate immune responses.

What Can Non-Viable Probiotics Treat?

We already mentioned that probiotics are best known to treat infectious diarrhea. In one study, researchers found that treatment with heat-killed (non-viable) Lactobacillus acidophilus LB was more effective than treatment with viable, non-specified strains of L. acidophilus.

The efficacy of probiotics in preventing and treating cancer is far from understood. Nevertheless, early reports suggest that heat-killed Lactobacillus casei Shirota could be useful in treating carcinoma of the uterine cervix and lung cancer. Researchers believe heat-killed lactic acid bacteria are preventing and treating certain cancers by their ability to more effectively bind to aflatoxin (a potent dietary carcinogen) than viable bacteria.

Overall, there may be situations when the health effects of probiotics are not dependent on viability status. There are clinical reports that support the efficacy of products containing inactivated probiotics. So, while manufacturers should try their best to keep their probiotics viable, there are benefits to both viable and non-viable probiotics. As long as you purchase your supplements from a trusted source, you can rest assured that you are receiving the proper benefits from your probiotics.

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