Another Look at the Question of Probiotic Use in Healthy People

There was an interesting discussion on probiotics today on Medical Express, pondering the question of whether or not healthy people should take probiotics.[i]  There’s absolutely no question that we are still in the earliest stages of researching the human biome.  The complexity of it boggles the mind.  So it’s always a good idea to take a look at what we currently know and don’t know.  (Just about a year ago, I wrote about another summary article addressing this same subject.  I will continue to address this question over time, watching and waiting to see if there are changes in the “expert” consensus over time.)

The authors reviewed 45 studies from the medical literature on probiotic use in healthy adults, and have published  the results in the European Journal of Clinical Nutrition.[ii]  What seems to be established is that probiotics can:

1. Increase the amounts of good bacteria in the gut.  In cases of mild dysbiosis, where bad bacteria are outnumbering good, probiotics can help restore balance.
2. Probiotics can help with irregular bowel movements and constipation
3. Probiotics can help with the vaginal microbiome, staving off urinary tract infections and bacterial vaginosis.
4. Probiotics seem to boost the immune system, may help reduce the frequency and duration of the common cold. (I have also written before about how they seem to help reduce the incidence of flu.)

The authors point out that if you do not supplement probiotics regularly, the gut will resort to its pre-supplementation condition within a few weeks.  They state that for  longer-lasting changes, feeding good bacteria through a fiber-rich diet (ie. prebiotics) is your best bet.  “So if you have a poor diet (you eat too much take-away food and not enough fruit, vegetables and whole-grain products, or you drink alcohol too much and too often) and don’t exercise regularly, your digestive bacteria may benefit from probiotic supplements, though you’ll have to keep taking them to get lasting effects.”

I STRONGLY agree, as you all know, that enriching and improving the biome is not as easy as popping a probiotic pill.   Eating a healthy, mostly plant-based diet may be the single most important thing you can do for your health.  So yes…if you’re eating an unhealthy diet, not exercising, and so forth, simply taking a probiotic is not going to stop you from getting the many diseases associated with an unhealthy biome.  On the other hand, I’m not sure I agree with their concluding sentences:  “… if you are otherwise healthy, probiotic supplements are likely to be a waste of money. Here’s some simple advice: take what you spend on probiotic  supplements, and use it to buy and eat more fruit and vegetables.”

Even if it’s simply to help boost the immune system, such as they note above, probiotics certainly are only going to do good for someone who is otherwise healthy.  But more than that:  ironically, take note of the related stories at the bottom of this page on Medical Express:

I would be willing to bet there are very few of us who will not get SOME (if not a lot of) benefit, in the long term, from regular consumption of probiotic containing foods and/or supplements.  Simply take a moment to consider the diseases we now know are associated with a depleted biome.  Not to sound like the grim reaper but…even if you are healthy today, aging alone causes negative alterations to the biome, as I have written about many times (for example, here).  It seems to me that the weight of evidence is starting to tip the scales toward biome enrichment always being a good idea.

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[i] https://medicalxpress.com/news/2018-06-healthy-people-probiotic-supplements.html

[ii] Khalesi, S, Bellissimo, N, Vandelanotte, C, Williams, S, Stanley, D, Irwin, C. A review of probiotic supplementation in healthy adults: helpful or hype?  European Journal of Clincal Nutrition. 2018.  doi.org/10.1038/s41430-018-0135-9