Dear Dietitian,

My friend is always on the latest health kick, so now she is taking probiotics every day and swears she feels so much better. She keeps bugging me to take them too, but I priced them at the drugstore, and they are expensive.  Are they worth it?

Sharon

Dear Sharon,

Probiotics are a popular health trend with sales of $1.4 billion in the United States in 2014. Since then, sales have nearly doubled, racking up $2.4 billion in 2018. Everyone wants to be healthy, especially if all it takes is a new pill, but are probiotics a wise use of your hard-earned money?

I’ve always had trouble keeping up with the difference in probiotics and prebiotics, so I consulted the Mayo Clinic’s website. As it turns out, prebiotics are specialized plant fibers that act as fertilizers in your gut, thereby increasing the number of good bacteria in your intestines.  Conversely, probiotics actually contain live organisms, usually certain strains of good bacteria, that add to the number of healthy bacteria in the gut. Both prebiotics and probiotics can be found in foods. Both can be purchased in capsule-form.

In order to be labelled as probiotic, a product must meet the definition set forth by the Food and Agriculture Organization of the United Nations (FAO) and World Health Organization (WHO).  This states a probiotic must contain “live microorganisms that, when administered in adequate amounts, provide a health benefit to the host.” 

According to research, probiotics have not been shown to increase overall health. However, they are showing promise in treating symptoms of irritable bowel syndrome (IBS). This is a gastrointestinal (GI) disorder that results in diarrhea, chronic constipation, or alternating diarrhea/constipation.  It is accompanied by abdominal bloating, gas, cramping, and pain. The probiotics that have been found most useful in alleviating symptoms of IBS are Bifidobacterium longum and Lactobacillus rhamnosus.  

It is important to consult your doctor before starting a probiotic regimen.  He or she will advise you on the best product for you, as well as the proper dosage.  Also, probiotics are not without side effects, as they have actually caused harm in people whose immune systems are compromised.

Fiber is another ally for people who suffer from IBS.  While insoluble fiber (bran) may increase abdominal discomfort, soluble fiber has been shown in studies to alleviate symptoms of irritable bowel.  Rich sources of soluble fiber include: whole grains like oats and barley; apples and pears in the fruit group; vegetables like brussels sprouts, broccoli, cabbage, and sweet potatoes; and legumes, such as beans and peas. The recommended amount of daily fiber is 25-30 grams. If currently you are not consuming a lot of fiber in your diet, start with 10 grams per day and increase by 5 g each week to reach your goal.  Drink plenty of water or decaffeinated, low-calorie beverages while increasing fiber intake.

As always, be healthy!

Dear Dietitian