You’ve probably heard the hype on probiotics. According to a survey done by the National Institutes of Health, the number of adults in the U.S. taking probiotics in 2012 was three million more than in 2007—an increase equivalent to about 4x. More recently, San Francisco–based Grand View Research estimates that the global probiotics market surpassed $35 billion in 2015 and would grow to $66 billion by 2024.
Why are so many trying probiotics? The purported benefits include everything from improving digestion to reducing inflammation and burning body fat. Does that mean you should run out and pick some up? The answer is maybe.
Probiotics are “good” bacteria that help you digest your food.
Good bacteria? Yep, there is such a thing. Your body is comprised of billions of microorganisms (fun fact: these bacteria make up the majority of your feces) that help it function. For instance, the NIH explains that “bacteria in our intestines help digest food, destroy disease-causing microorganisms, and produce vitamins.” It also credits Nobel laureate Elie Metchnikoff, the so-called “father or probiotics,” for introducing the world to these live bacteria and yeasts in the early 20th century.
Probiotics are already in you, but you can find them increasingly marketed in everything from yogurt (where they’re naturally occuring) to chocolates (where they’re added). They’re also sold in pill form. These health supplements typically contain the bacteria Lactobacillus and Bifidobacterium, as well as the yeast Saccharomyces boulardii. They’re meant to help bolster the probiotic activity already occurring in your body by:
- Processing indigestible fibers to help maintain normal bowel movements.
- Producing vitamins B6, B12, K2.
- Aiding in the absorption of iron, calcium, magnesium, and other minerals.
- Fending off bad bacteria, such as salmonella and e coli.
Note that probiotics, whatever their form, don’t work alone. In order to function, they need to be fed prebiotics, such as fibrous fruits, veggies, and grains. Supplements marketed as “synbiotics” combine probiotics (bacteria and yeasts) with prebiotics (dietary fiber).
The FDA doesn’t back the health claims of probiotic products.
Probiotics are regulated as a food or supplement, not a medicine, by the FDA. That means that the FDA has not approved any probiotics for the treatment of any particular disease. It also means that the makers of probiotic supplements don’t have to prove their products are effective or even safe (although the FDA may be taking steps against the latter).
As a result, manufacturers can tout a slew of health benefits without thorough research to back it. In an article for Prevention, Gregor Reid, PhD, chair of human microbiology and probiotics at the Lawson Health Research Institute says, “no more than 10% of products that claim to be probiotic have been proven in human trials.” Indeed, according to the NIH, “some say that the marketing of these supplements has outpaced research backing it.” Scientific American observes that probiotics have even been added to cosmetics and mattresses.
All of this can translate to a variety of issues in probiotic products. A formula may not have enough bacteria, it may not have the right kind, or it may not have been processed in a way that the bacteria will survive the acidic environment of the digestive tract. The specific bacterial strains may have been selected because they’re easy to grow in large numbers, rather than because they’re known to improve health. Labels are not always accurate: the number of bacteria could be overstated or the types can vary. Not all strains of Lactobacillus and Bifidobacterium are the same.
Taking probiotics is really only necessary if you have digestive issues.
Remember: probiotics are already in you. As Matthew Ciorba, a gastroenterologist at Washington University in St. Louis, tells Scientific American, “there is no evidence to suggest that people with normal gastrointestinal tracts can benefit from taking probiotics.”
However, if your digestion is temporarily or chronically strained, a high quality probiotic can help. Here are some of the reasons to consider starting a regimen:
- You’ve been diagnosed with IBS (irritable bowel syndrome) or IBD (inflammatory bowel disease).
- You’re taking or recently took antibiotics, which can kill off good bacteria in the gut.
- You have diarrhea, whether infectious or antibiotic-related.
As always, consult with your doctor before starting any new supplement to ensure it’s right for you, won’t interfere with other medicines, and is good quality. If you’re ready to take the plunge and have your doctor’s blessing, look for the following on product labels:
- A seal of approval from a third-party, independent lab.
- At least a billion CFUs, or colony forming units.
- A variety of strains of bacteria.
- Terms like “acid stabilized” or “microencapsulated” to indicate the bacteria will survive your digestive tract’s acidic environment.
- An expiration date and instructions on how to store, such as in a cool environment.
For more details and product recommendations, read our review of the best probiotics. You should also be aware that probiotics are contraindicated for individuals with a weakened immune system, as they can run the risk of infection.
Probiotics aren’t a cure-all; for healthy digestion, maintain a healthy lifestyle.
Whether or not you decide to take a probiotic supplement, in order to keep digestion humming smoothly, it’s important to also maintain an overall healthy lifestyle. That means staying physically active and eating a varied diet rich in fiber. Get plenty of prebiotic fruits and vegetables and minimize preservatives, which are inherently antimicrobial.
You may also want to set a goal to regularly incorporate fermented foods and other natural sources of probiotics in your diet. For instance, eat yogurts labeled with “live and active cultures.” Try drinking kombucha or kefir, or even make your own pickles or sauerkraut. Above all, steer clear of the hype, like probiotic pizza crusts, and focus on good common sense.