Kombucha (and fermented foods) are the new black.

The probiotics industry is a health food gold mine. Global Industry Analysts expected the probiotic market to be worth US $28.8 billion in 2015(1), and by 2020 is expected to reach $52.34 billion (2). With the large sums of money at stake, health consumers, will continue to face both a growing market of products along with claims for health benefits associated with probiotics.

Cordelia Molly / Science Photo Library ©

Why you should consume probiotics, how much you should consume, and how much money you should spend on probiotics are questions which are not likely to be answered by a Dannon TV ad campaign. Actually, it’s more likely Jamie Lee Curtis (and Dannon) will make false claims that DanActive yogurt are “clinically” and “scientifically” proven to regulate digestion and boost immune systems (3–4).

Activia Settled with the FTC for $21 million in 2010 for falsely claiming activia yogurt helps regulate your digestive system
The clinical use of probiotic is promising yet complex. The use of probiotics potentially have many beneficial effects, however the translation of the research findings into nutritional recommendations has been very inconsistent with the strength of the evidence (5). The potential benefits arise from probiotics ability to positively affect metabolic activities that process nutrients and energy, promotion of intestinal epithelial integrity and immune function, and protection of the host against invasion by pathogenic microbes (6–8). Additionally, studies suggest probiotics have clinical effects in diseases such as irritable bowel syndrome, gastric ulcers, rotavirus, traveler’s and antibiotic-associated diarrhea, and cardiovascular diseases (9). For the use of probiotics in treating a specific disease, you should consult with a physician.

Here is the good news, it’s possible for you to experience the health benefits associated with probiotics! Are you ready? Here is the short chapter version about what kinds of probiotics, how much and when you to use.

Short and simple:

Eat Real food: The best quality and quantity of probiotics come from eating real fermented foods. A few I enjoy eating include sauerkraut, raw apple cider vinegar, kimchi, and kombucha. I buy kombucha weekly at a local farmer's market from 3rd Coast Kombucha, Galveston Tx. Update: I’m currently refilling 64 oz Growler fills for $10 from Kickin’ Kombucha, Houston Tx.

3rd Coast Kombucha is a Galveston based kombucha brewer

Probiotic supplements and yogurts

The problem with commercially available probiotics supplements is they can be unreliable; one study analyzing 18 probiotics products found about 40% had differences between stated and actual concentrations of bacteria (10). Additionally, the company Labdoor tested 30 top probiotic products and found 21 having at least 50% off their label claim total viability count(11).

The problem with store bought yogurt…let's just be honest, the majority of these products have lots of sugar added. Danone claims each serving of Activia “contains over 1 billion live, active” bacteria, called Bifidobacterium lactis CNCM I-2494. However, keep in mind this same serving has about 20g of sugar along with other processed ingredients including modified corn starch, carmine, agar agar, guar gum, carrageenan, and sodium citrate.

If you are buying store products look for a “Live and Active Cultures” label, this specifies the product contained a minimum of 100 million viable bacteria per gram at the time of manufacturing.

How much probiotic should you take daily?

There is no consensus regarding the minimum number of microorganisms, or how much you should probiotic needed daily for beneficial effects (12). Some literature suggest, for health benefits to be achieved, a dosage of 10⁸–10⁹ CFUs (colony forming units) is needed (13–15). Mike Mutzel, author of Belly Fat Effect suggest the minimum effective dose is thirty billion (30 x 10⁹)CFU per dose (16). However, some studies use up to 1.8 trillion (10¹²) CFU (17). A 2013 study published in the Journal of Applied Microbiology found between 10⁷ and 10⁸ CFU/ml of Lactobacillus delbrueckii subsp. bulgaricus within a commercial brand of yoghurt (Activia® from Danone) —suggesting a serving of yogurt does contain the marketed 100 million viable bacteria(18). Still, to reach suggested 30 billion CFU would require three hundred serving sizes.

Specific strains of organisms and different dosages are used for each individual clinical trial. For the use of probiotics in treating a specific disease, you should consult with a physician who can recommend a dose of probiotics used in clinical practice based on human studies that support the intended health benefit.

It’s hard to quantify the amount of CFU in fermented dishes such as kimchi and sauerkraut, as it will depend on the method of fermentation. Sauerkraut has been reported to have as low as 1–1.5 billion per 1 oz (19) and up to 1 trillion (20). Additionally, kimchi has been reported to contain 10⁷ to 10⁹ CFUs/gram of lactic acid bacteria (LAB)(21).

How often should you consume probiotics?

Probiotics are transient members of our microbiota. Most can survive our gut, but are not well suited for the environment. Which is why it’s recommended for their daily consumption (22).

Additional list of fermented foods:

Live-cultured yogurt, Kefir, Kombucha Tea, Kimchi, Sauerkraut, Pickles (must be pickled in brine, not vinegar), Picked fruit and vegetables (e.g. carrot sticks).

This post is aimed to discuss the evidence and research behind probiotics, and is not not intended to treat, diagnose, or prevent, any medical disease. Please consult your physician regarding utilizing nutrition in your health managment.

References

  1. Global Industry Analysts, Inc. “Probiotics (MCP-1084).” Probiotics (MCP-1084) — Global Industry Analysts, Inc. Global Industry Analysts, Inc., n.d. Web. 11 Mar. 2016.
  2. Grand View Research, Inc. “Probiotics Market Analysis By Application (Probiotic Functional Foods & Beverages, Probiotic Dietary Supplements, Animal Feed Probiotics), By End-Use (Human Probiotics, Animal Probiotics) And Segment Forecasts To 2020.” Grand View Research, Inc. February 2016. ISBN Code: 978–1–68038–093–4
  3. http://abcnews.go.com/Business/dannon-settles-lawsuit/story?id=9950269
  4. https://www.youtube.com/watch?v=HLDHK_RiXFc
  5. Sanders et al. Probiotics and prebiotics: prospects for public health and nutritional recommendations. Ann NY Acad Sci.2014 Feb;1309:19–29. doi: 10.1111/nyas.12377
  6. Guarner F, Malagelada JR. Lancet. 2003; 361 (9356): 512–519.
  7. Sekirov I, et al. Physiol Rev. 2010;90(3): 859–904.
  8. Preidis GA, et al. Gastroenterology. 2011; 140 (1):8–14.
  9. Upadrasta A, and Madempudi R. Probiotics and blood pressure: current insights. Integrated Blood Pressure Control 2016: 9 33–42.
  10. Katz JA, Pirovano F, Matteuzzi D et al. Commercially available probiotic preparations: are you getting what you pay for? Gastroenterology. 2002; 122(suppl 1): A-459. Abstract.
  11. https://labdoor.com/rankings/probiotics
  12. William Nancy. Probiotics. AM J Health Syst Pharm. 2010; 67(6):449–458.
  13. Oliveira RP, et al. (2009). Effect of different prebiotics on the fermentation kinetics, probiotic survival and fatty acids profiles in nonfat symbiotic fermented milk. International Journal of Food Microbiology 128(3):467–472. PMID 19000641
  14. Reid G (2008). How science will help shape future clinical applications of probiotics. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America 46 Suppl 2:S62–66; discussion S144–151. PMID 18181725
  15. Govender M, et al. (2014). A review of the advancements in probiotic delivery: Conventional vs. non-conventional formulations for intestinal flora supplementation. AAPS PharmSciTech 15(1):29–43. PMID 24222267
  16. Mike Mutzel. Belly Fat Effect. 2014.
  17. Mimura T, Rizzello F, Helwig U et al. Once daily high dose probiotic therapy (VSL#3) for maintaining remission in recurrent or refractory pouchitis. Gut. 2004; 53:108–14.
  18. Herbel SR, et al. (2013). Species-specific quantification of probiotic lactobacilli in yoghurt by quantitative real-time PCR. Journal of Applied Microbiology 115(6):1402–1410. PMID 24024971
  19. Plengvidhya et al. Investigation of Lactic Acid Bacteria in Sauerkraut Fermentation by DNA fingerprinting. Journal Series of the Department of Food Science. published online ahead of print on 5 October 2007.
  20. http://articles.mercola.com/sites/articles/archive/2012/05/12/dr-campbell-mcbride-on-gaps.aspx
  21. Lee D, Kim S, Cho J, & Kim J (2008). Microbial population dynamics and temperature changes during fermentation of kimjang kimchi. Journal of Microbiology46(5):590–593. PMID 18974963
  22. Sonnenburg, Justin, and Erica Sonnenburg. The Good Gut: Taking Control of Your Weight, Your Mood, and Your Long-term Health. Penguin Press, 2015.
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