Probiotics, Omega 3s and Chronic Inflammation: Part 2

In part 2 of this look at what we currently know about the benefits of probiotic and omega supplementation on chronic, low-grade inflammation, we’ll be looking at the most common and best studied probiotics, alone and in combination.[i]

 As I mentioned in Tuesday’s Part I post ,  Lactobacilli and Bifidobacteria are very widely studied.  They have been shown, for example, to improve the health of the intestinal barrier via a variety of mechanisms including the production of the short-chain fatty acid (SCFA), butyrate, which I have discussed in many prior posts (like here).  Low butyrate is associated with intestinal barrier dysfunction, among other health issues.

A quick note:  I have included in this summary the exact strains used in the studies listed.  I’m not sure how completely relevant they are to efficacy, but for the sake of completeness, you’ll have them in front of you.

Let’s look at Lactobacillus first.   This is a review of a few of the clinical studies we currently have:

1. L.acidophilus NCFM and L.paracasei Lpc-27, as well as other strains of Lactobacillus, are known to adhere to intestinal cells blocking the adherence of a variety of pathogens.
2. Regular use of Lactobacillus delbrucckii Bulgaricus 8481 prevents cytomegalovirus reactivation in the elderly and could counteract some “…hallmarks of immunosenescence.” (I’ve talked about this in previous posts like here.)
3. Lactobacillus rhamnosus GG reduces proinflammatory cytokines, as shown in a study of healthy subjects, and a combination of paracasei DSM 13434, L. plantarum DSM 15312, and L. plantarum DSM 15313 reduces them in the digestive systems of people with neuroinflammation, which may be extremely important for people as they age.
4. L.plantarum has been shown to improve cognitive performance (especially attention) in older people with mild cognitive issues.

Bifidobacterium:

1. B.lactis B1-04 can enhance immunity of mucosal surfaces, like the gut lining, and seems to provide benefits for healthy adults in reducing the risk for upper respiratory tract infections.
2. B.longum subsp. Infantis decreases LPS concentrations, reducing inflammation, and B. infantis 35624 may also reduce inflammatory cytokines. This likely leads to improved intestinal barrier function, and relieves gut issues like IBS.
3. IBS patients show a 1.5-fold decrease in Bifidobacteria.

Lactobacillus and Bifido Combinations:  “Combining probiotic strains may produce synergistic effects, conferring additive benefits…”  A couple of examples, for your reading pleasure:

1. Combining L.paracasei Lpc-37 with L.acidophilus 74-2 and B. animalis subsp. lactis 420 reduced the symptoms of adult atopic dermatitis and overall health.
2. A combination of helvetics R0052 and B. longum R0175 has been shown to reduce psychological stress.
3. lactis Bi-07 combined with L. acidophilus NCFM has been shown to improve digestive health and to reduce bloating.
4. lactis Bi-07 combined with L. acidophilus NCFM benefits the immune system of children thereby reducing illness, need for antibiotics and missed days of school.
5. One last one: a combination of Bifidobacterium and Lactobacillus, along with thermophiles DSM 24731 may reduce chronic low-grade inflammation in older adults, as well as reducing homocysteine levels – which could, in turn, reduce the risk of age-related conditions including neurological ones.

We know that fatty acids have a highly beneficial effect on inflammation, and recent research shows that it may take markedly higher levels than previously recognized to make a physiological difference – as high as 2000 mg (or more) per day.  On their own, omega 3s potentially can have a positive effect on inflammation-related conditions like Alzheimer’s and diabetes, and other diseases of aging.  In combination though with probiotics, there may be a highly significant beneficial effect:  omega 3s “…can act as prebiotics in the gut…”  The mechanism is not yet fully understood, but it seems to increase the levels of LPS-suppressing bacteria (like Bifidobacteria) and decrease LPS-producing gram-negative bacteria (like Enterobacteria).  Omega 3s’ interaction with probiotics also seems to promote the growth of bacteria which produce SCFAs, like butyrate, which improve the health of the epithelial barrier, while also promoting the growth of bacteria that are associated with leanness.

A randomized, controlled trial of 60 overweight adults, given a combination of omega 3s and the probiotic, VSL-3, resulted in “…greater improvement in insulin sensitivity than probiotic administration alone.”   In fact, evidence is rapidly mounting that shows that “…combining probiotics and omega-3 fatty acid supplements may be a particularly beneficial strategy as they seem to promote health in various areas through synergistic effects.”

To conclude then this marathon discussion of some of the latest research findings:  “Hypothetically, combining omega-3 fatty acids with probiotics offers a promising strategy to prevent the development of low-grade inflammation as well as offering non-pharmaceutical treatment modalities, which might be especially relevant in patient groups that suffer from increased systemic inflammation, such as aged and obese individuals. However, this research field is still in need of well-conducted and properly controlled clinical trials to further support this hypothesis.” While of course more research is desperately needed, seems to me that this is one of those “can’t hurt, could help” kind of scenarios!

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[i] Hutchinson, A.N.; Tingö, L.; Brummer, R.J. The Potential Effects of Probiotics and ω-3 Fatty Acids on Chronic Low-Grade Inflammation. Nutrients 2020, 12, 2402.