Probiotics and prebiotics and synbiotics
What is a probiotic and how is it different from a prebiotic? Which probiotic for children is the best? How to take a probiotic: whether together with an antibiotic or after antibiotic therapy and for how long? Does the prebiotic work together with the probiotic? What are natural probiotics and prebiotics and where to look for them? Is it worth taking probiotics and prebiotics supplements? In the text below you will find answers to these and many other questions.
All microorganisms inhabiting the human body are defined by the term microbiota. It is estimated that microbiota consists of 300 to 1000 species of microorganisms. Disturbances in the composition and function of microorganisms inhabiting the human digestive tract, i.e.. dysbiosis it is a factor predisposing to the development of many diseases, including diarrhea associated with the use of antibiotics, irritable bowel syndrome, allergic diseases, diabetes or obesity. The role of microbiota in maintaining health and in the pathogenesis of many diseases means that its modifications are currently the focus of many researchers.
What is a Probiotic?
The word probiotic comes from the Greek language, where ,,pro bios " means "for life". The term probiotics according to FAO (Food and Agriculture Organization of the United Nations) and WHO (World Health Organization), Living organisms which, when administered in appropriate amounts, show beneficial health effects.
How does a probiotic work?
Beneficial mechanisms of action of probiotics they consist, inter alia, in:
- producing substances that inhibit the growth of pathogenic bacteria,
- competition with pathogenic microorganisms for nutrients,
- acidification of the intestinal contents, which protects against the multiplication of pathogenic microorganisms,
- beneficial modulation of the immune response,
- reducing inflammation of the intestinal mucosa,
- production of B vitamins,
- increasing the absorption of certain vitamins and minerals from the gastrointestinal tract.
In order for a microorganism to be considered probiotic, it must meet certain criteriawhich include:
- the origin of the natural healthy microflora of the human colon,
- history of safe use and no side effects,
- resistance to gastric juice and bile, which allows them to survive in the digestive tract,
- competition for nutritional substrates and the site of colonization with pathogenic microorganisms on the mucosa of the gastrointestinal tract,
- production of lactic acid, which creates unfavorable conditions for the development of most pathogenic microorganisms,
- resistance to factors produced by the microflora living in the digestive tract,
- the ability to colonize specific places in the body.
Expert advises
Each probiotic microorganism requires precise identification not only on the basis of its type (e.g. Lactobacillus), genre (e.g. Lactobacillus rhamnosus), but also a strain (e.g. Lactobacillus rhamnosus ATCC 53103). This is important because the properties of probiotics are strain-dependent. Thus, each strain requires separate tests to determine its probiotic properties and effectiveness in a well-defined health problem. The probiotic effect of a given strain must also be demonstrated for a specific dose, because the proven effectiveness of a probiotic in a given dose does not mean that a similar effect can be achieved by using a different dose. The role of the carrier used in the probiotic preparation, which may also affect the properties of the strain, is also emphasized.
The microorganisms with a probiotic effect are primarily lactic acid-producing bacteria of kinds Lactobacillus i Bifidobacteriumand also yeasts Saccharomyces boulardii and some strains Escherichia coli i Bacillus.
Sources of probiotics - examples
Certain foods are the source of probiotics. Belong to them fermented milk drinkssuch as sour milk, kefir, buttermilk, natural yoghurt or acidophilic milk. Lactic acid bacteria are also used in production cheeses and are located in silage, for example in sauerkraut or cucumbers.
The source of probiotics are also pharmaceutical preparations registered as medical products, and dietary foods for special medical purposes or dietary supplements.
Expert advises
It should be remembered that dietary supplements are subject to registration procedures different than drugs, and the supervision of these products is limited. According to the ESPGHAN Working Group on Prebiotics and Probiotics (European Society for Pediatric Gastroenterology, Hepatology and Nutrition, European Society of Gastroenterology, Hepatology and Nutrition for Children) information on the labels of dietary supplements regarding both the content of the declared bacterial strains and their amount is not always reliable.
It is considered that the risk of infection with probiotic microorganisms is low, and it is safe to take preparations containing probiotics by healthy peopleas confirmed by the FDA (Food and Drug Administration, Food and Drug Administration) GRAS status (Generally Recognized as Safe - widely recognized as safe).
Which Probiotic is Best for Children?
Parents often ask for the best / best probiotic for children. It is difficult to answer this question because the properties of probiotics are strain-dependent, so a probiotic that is effective in the prevention and / or treatment of a specific health problem may not be as effective in another health problem. In addition, it would be necessary to conduct studies comparing the effectiveness of specific strains of probiotic bacteria used in a specific clinical indication, e.g. in the prevention of diarrhea associated with the use of an antibiotic, and such studies are not available. So there is no "one size fits all" probiotic for children.
What probiotic should be used in the prevention of diarrhea associated with antibiotic therapy?
The occurrence of diarrhea - both during the use of antibiotics and after its completion - is observed in 11 to 40% of children. It can be caused by any antibiotic, but the greater risk of its occurrence is associated with the use of so-called antibiotics. a broad spectrum of antibacterial activity. When considering the use of probiotics to prevent antibiotic-associated diarrhea in children, the ESPGHAN Working Group on Prebiotics and Probiotics recommends Lactobacillus rhamnosus GG (LGG) or Saccharomyces boulardii (S. boulardii).
How long to take a probiotic after an antibiotic?
In the conducted studies on the prophylaxis of diarrhea associated with the use of an antibiotic, the probiotic was usually administered during antibiotic therapy and this was the basis for the assessment of its effectiveness. There are no studies showing the benefits of using a probiotic after antibiotic therapy. Therefore, in order to answer the question whether the use of a probiotic after the end of antibiotic therapy is justified, and if so, for what period of time it should be used, it is necessary to conduct appropriate tests.
What is a good probiotic for Irritable Gut?
The role of gastrointestinal microbiota disorders in the development of irritable bowel syndrome (IBS, with English Irritable Bowel Syndrome). According to the position of ACG (American College of Gastroenterology), although there is some evidence that the use of probiotics may be beneficial in IBS, it is difficult to interpret the results of available studies on their effectiveness in treating this disease. It results, inter alia, from the small size of the studied groups, the use of various bacterial strains, including preparations containing several strains, as well as different research methodology. All this makes for Currently, there is no recommendation as to the use of probiotics in the treatment of IBS symptoms in adults. This position also applies to the use of probiotics in children with functional abdominal pain, including IBS.
Which probiotic should I choose to treat acute infectious diarrhea?
The main treatment of acute dehydrated diarrhea is rehydration with oral rehydration fluid or intravenous rehydration. Probiotics such as LGG or boulardii. Ideally, probiotics should be started early in the course of diarrhea.
How Do I Take a Probiotic?
The probiotic should always be taken in accordance with the instructions on the label of the specific probiotic preparation that you want to use. It is important not only to follow the dosage indicated on the packaging, but also the method of preparing / administering the probioticfor example, dissolving the contents of the sachet in lukewarm or warm water and drinking it after preparation, or giving the contents of the sachet directly into the mouth.
Probiotic and prebiotic
The topic of probiotics is usually brought together with that of prebiotics. Prebiotics are non-digestible food ingredients that selectively stimulate the growth and / or activity of one or a limited number of bacterial strains in the large intestine and thus favorably affect human health. Thus, the development of probiotic bacteria is conditioned, inter alia, by the availability of prebiotics. Prebiotics are carbohydrates (sugars), among which there are oligosaccharides and polysaccharides.
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Head of the Department of Assessment and Development of Cooperation at the Institute of Mother and Child
Prebiotics - examples
Among the oligosaccharides, the best known beneficial properties show fructooligosaccharides (FOS), galactooligosaccharides (GOS), lactulose and soy oligosaccharideswhile examples of the best known polysaccharides are: inulin, resistant starch and pectins.
Sources of prebiotics
Some products of plant origin are a natural source of prebiotics, incl. onions, chicory, asparagus, garlic, leeks, artichokes, potatoes, tomatoes, Jerusalem artichoke, beans, peas, wheat, barley, oats, bananas and honey. Women's food is a valuable source of oligosaccharides.
Some of the prebiotics obtained through chemical and enzymatic processes are used as an additive to food products or the production of dietary supplements. Prebiotics can be found, for example, in baby food, yoghurts, jellies and jams, bread, fruit drinks, and also in low-calorie foods (due to their properties, oligosaccharides are used as a substitute for fat and sugar).
Price of prebiotics: natural, cheaper than supplements
Prebiotics, as dietary supplements, are available in liquid, powder and capsule form. The prices of such preparations can be very different. Before we reach for a supplement containing a prebiotic, it is worth remembering that meeting the body's needs for prebiotics is possible taking into account their natural sources in the diet.and the price of such a natural prebiotic is lower than that of a supplement. In addition, natural sources of prebiotics are also rich in other essential ingredients, such as vitamins and minerals.
Probiotic with prebiotic, i.e. synbiotic
Combining a probiotic with an appropriate prebiotic is called a synbiotic. Name synbiotic comes from the words "view”- together and "bios" - life. This combination allows probiotic bacteria to multiply better, because both components, the prebiotic with the probiotic, show a synergistic effect.
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https://www.worldgastroenterology.org/guidelines/global-guidelines/probiotics-and-prebiotics/dostęp 10.03.2021
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