Submitted by Dr. Hoberman on Thu, 06/02/2011 - 16:48
Over the years, I have been asked a number of questions about the differences among probiotic supplements. Most of these questions center around which probiotic to select:
- Do you want a probiotic in the form of a capsule, liquid or food supplement like yogurt?
- Is refrigeration important?
- Is the dose or number of bacteria in a serving size important?
- Does it make a difference as to whether the probiotic has one or multiple strains and species of bacteria?
- Should you use a probiotic containing yeast?
- What about prebiotics - should the probiotic contain prebiotics such as FOS (fructooligosaccharides)?
What type of probiotic supplement is better – capsule or food?
There are no studies suggesting that getting your probiotic in pill form or food supplements makes any difference. It is important, though, to consider how many probiotic bacteria there are in a food supplement versus pill. For example, it is very difficult to find out how many bacteria are in a serving size of Activia. All good probiotics should list the amount and type of probiotics in each serving size. Another issue to consider is the extra calories associated with taking a food-based probiotic.
As far as powder, liquid, capsules or enteric forms of probiotics, no study has shown one form of delivery to be better than another. Probiotics that are enteric coated pass through the stomach and deliver the bacteria to the small intestines, helping the bacteria to not be destroyed by the stomach acid. The truth, though, is that for a bacterium to be considered a probiotic, it has to survive acid exposure before it was selected.With this definition in mind, there are no studies proving enteric-coated probiotics more effective than other forms of supplements.
Does refrigeration increase shelf life?
Most probiotics are stable at room temperature, but it’s advisable to keep probiotics out of heat and light. After being opened, they should also be kept away from moisture to prevent the organisms from becoming activated and then dying. Although not always a requirement, labels on some probiotic products suggest that they be refrigerated to prolong their shelf life.Don’t be concerned if the product is not constantly refrigerated.
Does the number of active probiotic per serving make a difference?
The number of organisms per serving size is very important. Studies have generally found that it takes 8-10 billion organisms/serving to ease the symptoms of Irritable Bowel Syndrome, prevent antibiotic-related diarrhea and traveler’s diarrhea.No studies have demonstrated that amounts greater than 8-10 billion are more effective.
How many and what type of bacteria is best?
A common question is whether a probiotic mixture is more effective than a single strain. There have been a number of published studies that have reviewed this issue(1,2,3). The general findings have been that probiotics containing multiple strains of Lactobacillus and Bifidobacteria are more effective at correcting the underlying disorder. The investigators believe that the advantage lies in that fact that different strains and species of bacteria provide different benefits. Some alter the immune system, some improve intestinal motility and some improve intestinal digestion. These types of probiotics offer numerous benefits over their single-strained counterparts.
What is a yeast probiotic?
The yeast, Saccharomyces boulardii, has been found to be effective for many intestinal disorders. There have been a number of studies that have shown positive benefits for traveler’s diarrhea and antibiotic associated diarrhea.The bacteria may also improve the symptoms of IBS and prevent C. difficile recurrence, but further studies are needed. It is one of the more expensive probiotics, so I would suggest starting with one of the bacterial probiotics. If that is not effective, then consider trying S. boulardii before giving up on probiotics.
How does a prebiotic improve the benefits of a probiotic?
Prebiotics are starches that we can’t digest. The healthy intestinal bacteria – like Bifidobacteria – ferment these starches and produce short chain fatty acids (SCFA) like butyrate, which promotes the function and nutrition of the colon lining cells. Adding prebiotics like fructooligosaccharides (FOS) to a probiotic has been shown to enhance the overall benefits of the probiotic(4).
I hope that this review of common questions will help you decide which probiotics to consider. There are a lot of marketing claims, but the above qualifications are important criteria to consider when purchasing a probiotic.
Take Home Message
When choosing a probiotic, it is best to find one that contains multispecies, multistrain bacteria in a total amount of at least 8-10 billion organisms per serving. Check on whether the probiotic also contains FOS.
Finally, consider purchasing EndoMune Advanced or Junior – they both meet all the above recommendations.
Eat healthy, exercise and live well!
Dr. Hoberman
(1) Int J Food Microbiol. 2004 Nov 15;96(3):219-33.Monostrain, multistrain and multispecies probiotics--A comparison of functionality and efficacy.Timmerman HM, Koning CJ, Mulder L, Rombouts FM, Beynen AC.
(2) Clinical trial: multispecies probiotic supplementation alleviates the symptoms of irritable bowel syndrome and stabilizes intestinal microbiota. Kajander K, Myllyluoma E, Rajili?-Stojanovi? M, Kyrönpalo S, Rasmussen M, Järvenpää S, Zoetendal EG, de Vos WM, Vapaatalo H, Korpela R. Aliment Pharmacol Ther. 2008 Jan 1;27(1):48-57. Epub 2007 Oct 5.
(3) Eur J Nutr. 2011 Feb;50(1):1-17. Epub 2011 Jan 13.Health benefits of probiotics: are mixtures more effective than single strains? Chapman CM, Gibson GR, Rowland I.
(4) Br J Nutr. 2010 Aug;104 Suppl 2:S1-63. Prebiotic effects: metabolic and health benefits. Roberfroid M, Gibson GR, Hoyles L, McCartney AL, Rastall R, Rowland I, Wolvers D, Watzl B, Szajewska H, Stahl B, Guarner F, Respondek F, Whelan K, Coxam V, Davicco MJ, Léotoing L, Wittrant Y, Delzenne NM, Cani PD, Neyrinck AM, Meheust A.
(5) World J Gastroenterol. 2010 May 14;16(18):2202-22.Systematic review and meta-analysis of Saccharomyces boulardii in adult patients.McFarland LV.
