Probiotic Roundup

One supplement that I would rank high on your list of supplements (personally I rank them a 10 on my scale of 1-10) is probiotics.

However, there is a lot of confusion over this category of supplements. Consider this one of the most thorough breakdowns of probiotic supplements and your official guide in understanding probiotics and why and how to take them.

You are not alone.

Even if you're sitting in the most remote corner of the world, in a building all by yourself with no other living being for miles, you're not alone. Your body is crawling with live microorganisms that you can't see, feel, or hear. And one place that is literally packed with them is your intestines. You have trillions of microorganisms living in your digestive tract. Some are beneficial to your health, while others may be destroying it. This is where probiotics come in to save the day.

Probiotics are defined as live microorganisms which when administered in adequate amounts confer a health benefit to the host.

When it comes to supplements, probiotics typically refer to beneficial bacteria that live in the digestive tract. The bacteria helps to maintain or restore the normal balance of beneficial bacteria in the body and minimize the number of harmful bacteria. This can have a dramatic impact on health and even physique and performance.

To really understand probitoic bacteria you have to go back to high school biology.

I'll spare you the refresher course and leave you with this. The most commonly used probiotic bacteria are the genus Lactobacillus and Bifidobacteria, which are Gram-positive anaerobic bacteria that convert lactose and other sugars into lactic acid, but also produce other anti-pathogens. Lactic acid makes the environment unfavorable for other "bad" bacteria. These probiotics are commonly added to dairy products such as yogurt. Both have numerous species, such as L. acidophilus, L. casei, B. animalis, and B. infantis, to name a few. And each species has several strains, such as L. acidophilus DDS-1, L. acidophilus LA-5, and L. acidophilus NCFM. Today other probiotic bacteria are being used as our understanding of them grows. Some other commonly used bacteria include Bacillus coagulans, Streptococcus thermophilus, and Saccharomyces boulardii. I provide you a list of commonly used and researched probiotoc bacteria and their noted benefits at the end of this article.

The real noteworthy research on probiotic supplementation is fairly new.

After all it's only recently that we've realized just how critical this balance of beneficial bacteria is for our health and well being, not to mention their influence on our physique and physical performance. And so probiotic supplements are suddenly becoming de rigueur. And now that we have a small glimpse on all the benefits they provide, scientists have been busy studying them for a better understanding. And while our grasp on probitocis is still in its infancy, here is what the research to date suggests that they can do.

The most obvious benefit of probiotics is gut health.

After all, they live in the gut and can alter its environment. Too many of the bad bacteria can make your gut function less than ideal. Enough of the good ones and it runs like a well-oiled machine. This may be due to their ability to turn on certain genes in intestinal cells, as was shown in one study using a mix of the probiotic bacteria L. acidophilus Lafti-L10, L. casei CRL-431, and L. rhamnosus GG. One study published in BMC Gastroenterology reported that subjects with abdominal pain, bloating and flatulence, but no gastrointestinal diagnosis who took Bacillus coagulans BC30 for 4 weeks had reduced GI symptoms. Strenuous exercise, especially endurance exercise, can cause gastrointenstinal symptoms. One study from Finland shows that marathon runners supplementing with Lactobacillus rhamnosus for 3 months had their duration of GI-symptoms cut in half. And if a dose of antiobitoics is ever required, supplementing with probiotics can help to prevent the GI problems that often follow. Research studies confirm that supplementing with certain probiotics can prevent diarrhea from antibiotic use. A mixed probiotic supplement containing the bacteria L. plantarum, L. paracasei, L. bulgaricus, L. acidophilus, B. breve, B. longum, B. infantis, and Streptococcus thermophilus reduced the incidence of diarrhea and constipation in healthy elderly subjects.

Irritable bowel syndrome (IBS) is another condition that probitoics can help with.

Currently the research suggests that probiotic supplementation can help to keep IBS in remission. This may be due to the fact that some probiotic bacteria like Lactobacillus have proteins on their surface known as peptidoglycans (PGNs) that react with special receptors on the wall of the intestines to mount an inflammatory response. But most probiotics do little to help IBS symptoms once they start. Univeristy of Bristol (UK) researchers have shown that since iron levels rise during a bout of IBS, most probiotics are useless. Probiotics like Lactobacillus and Bifidobacterium are lactic acid bacteria, which have their growth inhibited by iron. So it makes sense that they do little during a bout of IBS. However, the UK researchers have identified an isolate of the bacterium Streptococcus thermophilus that can increase growth rate in response to increased iron availability and therefore help to battle IBS symptoms. Research even suggests that probiotics may help to prevent colorectal cancer.

Another well-known benefit of probiotics are their ability to boost immune function.

Probiotics have been shown to help support key immune markers upon exposure to cold and flu viruses in healthy subjects.  Research from the British Journal of Nutrition reported that supplementing with Bifidobacterium animalis ssp. Lactis (BB-12) or Lactobacillus paracasei ssp. paracasei (L. casei 431) increased immune function in healthy adults by about 50%. Another study reported that subjects taking Bacillus coagulans BC30 for 30 days had an increased T-cell production in response to adenovirus and influenza exposure. Swedish researchers reported in a 2011 issue of the European Journal of Nutrition that subjects taking a combination of L. plantarum HEAL 9 and L. paracasei 8700:2 helped to reduce the risk of catching the common cold and reduced the length of the cold when subjects were infected. 

Enhanced immune function can be particularly important for athletes and/or those who train intensely.

Intense exercise can suppress the body's immune system. Certain bacterial strains can increase the body's immune response to viruses that cause common viral respiratory tract infection. Research suggests that Lactobacillus fermentum VRI-003 may reduce the days of respiratory symptoms in athletes over a four-month period of winter training. There is also evidence that Lactobacillus casei Shirota may reduce the incidence of urinary tract infections in athletes, which may be related to better maintenance of saliva IgA levels during a winter period of training and competition. The most recent study reported that rats consuming cheese containing Lactobacillus acidophilus LA14 and Bifidobacterium longum BL05 experienced less immune suppression and inflammation after intense exercise as compared to those consuming normal cheese. While better immune function may not be something you think about until after you have the cold or flu, you should, especially as cold and flu season begin. Preventing these illness from knocking you off your feet means you miss less gym time and your body can keep expending energy on mucle recovery and growth and not on fighting viral invaders.

Research suggests that the right probiotics may even aid fat loss.

One study published in one of the most highly regarded scientific journals, Nature, reports that the gut microbial populations are different in obese and lean people. They also discovered that when obese people lose enough weight their gut microflora change to resemble that in lean people. The researchers suggest that the gut microbes in obese individuals may allow them to extract more nutrients from food, so that more macronutrients and calories are absorbed and less are loss in the feces than in leaner individuals. Finish researchers reported in a 2011 study that women taking L. rhamnosus GG (ATCC 53103) and B. lactis during pregnancy and after had gained less body fat 6 months after giving birth. French researchers also found that mice fed a high-fat diet but supplemented with B. lactis B420 for six weeks had lower blood glucose and insulin levels than those not getting the probiotic. They suggested that this may be due to the probiotic's ability to reduce inflammation and could have implications in preventing metabolic syndrome, which is associated with obesity, cardiovascular disease, and insulin resistance. Research on L. acidophilus and B. lactis show that they can lower cholesterol levels. Research also suggests similar benefits from B. bifidum and B. longum.

Another area that probiotics can help with is protein absorption.

Bacilus coagulans has been shown to enhance protein utilization by increasing amino acid uptake. The study reported that subjects consuming 1 billion colony forming units (CFUs) of Bacilus coagulans BC30 with a serving of protein were able to absorb more of the amino acids form the protein. Specifically they found that BC30 increased the body's uptake of the BCAA leucine by 23%, the BCAA Isoluecine by 20%, the BCAA Valine by 7%, Glutamine by 116%, Ornithine by 100%, Tryptophan by 100% and Citrulline by 128%. Being able to absorb more of the amino acids from the protein you consume can help to increase muscle growth in the long run. And if you take BCAAs, glutamine, and/or citrulline around workouts, taking it with a probiotic containing Bacilus coagulans BC30 can incerease the benefits you get from them and your results.

Probiotics have been shown to improve the stress response to physical and mental stress, meaning they act much like an "adaptogen".

This suggests that they may influence neurotransmitters and hormones in the body, which could enhance mood and brain function as stated in a Bioessays paper by Texas Tech University researchers. In fact, a study by Irish researchers found that mice supplemented with L. rhamnosus JB-1 had lower cortisol levels and changes in the expression of receptors for the neurotransmitter GABA. These changes were associated with fewer stress, anxiety and depression-related behaviors in the probiotic-supplemented mice as compared to those in the control group. Two studies from French researchers showed similar results in humans. They found that a probiotic formulation containing L. helveticus R0052 and B. longum R0175 improved measures for depression, anxiety, anger-hostility, and even problem solving. One recent study in male mice found that those getting a diet supplemented with probiotic-rich yogurt were more fertile and had larger testicles than those not getting yogurt. These results may be due to a higher production of testosterone in the mice getting the probiotic yogurt. Bottom line here is that probiotics may help to keep testosterone levels higher and cortisol levels lower, which can boost performance in the gym, muscle growth and fat loss, not to mention better sexual function, overall mood and maybe brain function.

Research has shown that probiotics can benefit oral health.

University of Copenhagen researchers reported that chewing gum that contained Lactobacillus reuteri reduced bad breath. Research from India suggests that probitocis may help to prevent tooth decay. The Indian researchers reported that children eating ice cream containing the probiotic bacteria Bifidobacterium lactis and Lactobacillus acidophilus for 10 days had a reduction in the amount of bacteria that is associated with tooth decay in their mouth as compared to those getting regular ice cream. A 2012 study from Spain suggests that taking probiotic capsules containing Lactobacillus reuteri may help fight gingivitis. Similar results were shown by German researchers in adults drinking a probiotic milk containing L. casei Shirota. And researchers from Teikyo University suggests that a strain of Streptococcus salvarius known as BLIS K12 can help to fight candidiasis (oral thrush).

The vagina is another area of the body where populations of bacteria reside. So it makes sense that like in the GI tract, probiotics can also provide a favorable environment. L. acidophilus has been shown in several clinical studies to help with the treatment of bacterial vaginosis. Similar results have been shown with L. rhamnosus GR-1 and L. fermentum RC-14.

When it comes to supplementing with probiotics my general rule regardless of the species and strain you are supplementing with is:

To take enough probiotic bacteria to provide 9-10 billion colony forming units (cfu) daily for approximately two weeks then follow with 1–3 billion cfu daily for maintenance taken with meals.

Confused about exactly what species of probiotic to take? Use my list below to help determine what benefits you want most to receive from a probiotic supplement and find one that contains the specific species and strain that provides it. Another good option is to use a probiotic supplement that provides numerous different species for combined benefits. Because probiotics need to be alive to offer benefit you must keep your probiotics refrigerated. There are a few products that do offer special delivery systems that keep the organisms alive without refrigeration. Either way read the label carefully for storage instructions. And consider purchasing your probiotics from your local vitamin store so that you know they've been stored properly.

There are so many different species and strains of probiotic bacteria that it can make even the most savvy supplement user confused.

Use this table as your probiotic bacterial species and strain Cliff Notes for what each species and strain has been suggested to help with.

B. stands for Bifidobacterium 

L. stands for Lactobacillus

References:

van Baarlen, P., et al. Human mucosal in vivo transcriptome responses to three lactobacilli indicate how probiotics may modulate human cellular pathways. Proc Natl Acad Sci U S A 108(Suppl 1):4562-4569, 2011.

Kalman, D. S., et al. A prospective, randomized, double-blind, placebo-controlled parallel-group dual site trial to evaluate the effects of a Bacillus coagulans-based product on functional intestinal gas symptoms. BMC Gastroenterol 18;9:85, 2009.

Kekkonen, R. A., et al. The effect of probiotics on respiratory infections and gastrointestinal symptoms during training in marathon runners. Int J Sport Nutr Exerc Metab.17(4):352-63, 2007.

West, N. P., et al. Lactobacillus fermentum (PCC®) supplementation and gastrointestinal and respiratory-tract illness symptoms: a randomised control trial in athletes. Nutrition Journals 10:30, 2011.

Hempel, S., et al. Probiotics for the prevention and treatment of antiobiotic-associated diarrhea. JAMA 307(18):1959-1969, 2012.

Dolin, B. J. Effects of a proprietary Bacillus coagulans preparation on symptoms of diarrhea-predominant irritable bowel syndrome. Methods Find Exp Clin Pharmacol 31(10):655-659, 2009.

Bailey, J. R., et al. Identification and characterization of an iron-responsive candidate probiotic. PloS ONE 6(10):e26507, 2011.

Zaharoni, H., et al. Probiotics improve bowel movements in hospitalized elderly patients – The proage study. Journal of Nutrition, Health and Aging 15(3):215-220, 2011.

Escamilla, J., et al. Cell-Free Supernatants from Probiotic Lactobacillus casei and Lactobacillus rhamnosus GG Decrease Colon Cancer Cell Invasion In Vitro. Nutr Cancer. In press, 2012.

Rizzardini, G., et al. Evaluation of the immune benefits of two probiotic strains Bifidobacterium animalis ssp. lactis BB-12 and Lactobacillus paracasei ssp. paracasei, L. casei 431 in an influenza vaccination model; a randomized, double-blind, placebo controlled study. British Journal of Nutrition 107:876-884, 2012.

Baron, M. A patented strain of Bacillus coagulans increased immune response to viral challenge. Postgrad Med 121(2):114-118, 2009.

Berggren, A., et al. Randomised, double-blind and placebo-controlled study using new probiotic lactobacilli for strengthening the body immune defence against viral infections. Eur J Nutr 50(3):203-210, 2011.

Cox, A. J., et al. Oral administration of the probiotic Lactobacillus fermentum VRI-003 and muscosal immunity in endurance athletes. Br J Sports Med 44:222-226, 2010.

Gleeson, M., et al. Daily probiotic's (Lactobacillus casei Shirota) reduction of infection incidence in athletes. Int J Sport Nutr Exerc Metab. 21(1):55-64, 2011.

Lollo, P. C. B., et al. Probiotic cheese attenuates exercise-induced immune suppression in Wistar rats. Journal of Dairy Science 95(7):3549-3558, 2012.

Ley, R. E., et al. Microbial ecology: human gut microbes associated with obesity. Nature. 2006 Dec 21;444(7122):1022-3.

Turnbaugh, P. J., et al. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature 2006;444:1027–31.

Ilmonen, J., et al. Impact of dietary counselling and probiotic intervention on maternal anthropometric measurements during and after pregnancy: a randomized placebo-controlled trial. Clin Nutr 30(2):156-164, 2011.

Amar, J., et al. Intestinal mucosal adherence and translocation of commensal bacteria at the early onset of type 2 diabetes: molecular mechanisms and probiotic treatment. EMBO Mol Med 3(9):559-572, 2011.

Ataie-Jafari, A., et al. Cholesterol-lowering effect of probiotic yogurt in comparison with ordinary yogurt in mildly to moderately hypercholesterolemic subjects. Ann Nutr Metab 54(1):22-27, 2009.

Starovoitova, S. A., et al. Cholesterol-lowering activity of lactic acid bacteria probiotic strains in vivo. Mikrobiol Z 74(3):78-85, 2012.

Lyte, M. Probiotics function mechanistically as delivery vehicles for neuroactive compounds: Microbial endocrinology in the design and use of probiotics. Bioessays 33(8):574-581, 2011.

Bravo, J. A., et al. Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Proc Natl Acad Sci U S A. 108(38):16050-16055, 2011.

Messaoudi, M., et al. Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects. Br J Nutr 105(5):755-764, 2011.

Messaoudi, M., et al. Beneficial psychological effects of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in healthy human volunteers. Gut Microbes 2(4):256-261, 2011.

Keller, M. K., et al. Effect of chewing gums containing the probiotic bacterium Lactobacillus reuteri on oral malodour. Acta Odontologica Scandinavica

Singh, R., et al. Salivary mutans streptococci and lactobacilli modulations in young children on consumption of probiotic ice cream containing Bifidobacterium lactis Bb-12 ATCC27536 and Lactobacillus acidophilus La5. 69(6):389-394, 2011.

Iniesta, M., et al. Probiotic effects of orally administered Lactobacillus reuteri-containing tablets on the subgingival and salivary microbiota in patients with gingivitis. A randomized clinical trial. J Clin Periodontol. 39(8):736-744, 2012.

Staab, B. et al. The influence of a probiotic milk drink on the development of gingivitis: a pilot study. J Clin Periodontol. 2009 Oct;36(10):850-6. Epub 2009 Aug 12.

Ishijima, S. A., et al. Effect of Streptococcus salivarius K12 on the In Vitro Growth of Candida albicans and Its Protective Effect in an Oral Candidiasis Model. Applied and Environmental Microbiology 78(7):2190-2199, 2012.

Falagas, M. E., et al. Probiotics for the treatment of women with bacterial vaginosis. Clin Microbiol Infect 13(7):657-664, 2007.

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