The festive celebrations are just around the corner, and as thrilled as we are to dive into all of the yummy meals and snacks likely to be on our tables this year, there is one aspect that all of us don’t so much look forward to: digestive disorders from a holiday binge. Sharing the annual meal of reunion with the ones you love often means that overindulging and overeating – and the bloating, burning and belching feelings that follow – are unavoidable. It is the cause and effects! The good news is that probiotics can help. Both prebiotics and probiotics may support useful bacteria and other microorganisms in the gut. Yet although they sound alike, the two play different roles in maintaining healthy digestive tract. Probiotics are beneficial tiny living microorganisms, including bacteria and yeast, and prebiotics serve as food for these bacteria, which are a type of fiber that the human body cannot digest. In this article, we will discuss more about these components and explain what you need to know about.

Their Similarities

Prebiotics and probiotics both support the body in building and maintaining a healthy colony of bacteria and other microorganisms, which supports the gut and aids digestion. These components help stimulate good bacteria by providing food and creating an environment where microorganisms can flourish. The gut bacteria, collectively referred to as the gut flora, or gut microbiota, perform many important functions in the body. Eating balanced amounts of both probiotics and prebiotics can help warrant that you have the correct balance of these bacteria to keep your gut microbiota healthy. This allows digestive system to function properly and help you process and extract the nutrients in your foods. 

What are Probiotics?

Probiotics have been defined by The Food Agricultural Organization/World Health Organization (FAO/WHO) as "live microorganisms which when administered in adequate amounts confer a health benefit to the host”.¹ Although the common perception of bacteria and other microorganisms by general public are harmful “germs,” many are actually valuable. Some bacteria facilitate digestion of food, destroy disease-causing cells, or produce vitamins. Many of the microorganisms in probiotic products are the same as or similar to microorganisms that innately reside in our bodies. The most common probiotics belong to groups called Lactobacilli and Bifidobacteria. Clinically researched probiotic strains Lactobacilli and Bifidobacteria stick well to the intestinal cell lines and are resistant to low pH of the stomach acid environment and other gastrointestinal conditions (e.g. acid, bile, pepsin and pancreatin).²

Health Benefits of Probiotics

An imbalance means there are too many bad bacteria and not enough good bacteria. This can happen due to illness, medication such as antibiotics, poor diet and more. Diarrhoea is a usual side effect of consuming antibiotics. It happens because antibiotics can negatively impact the equilibrium of good and bad bacteria in the gut.³ In a systematic and meta-analysis review, researchers found that supplementing with probiotics reduced antibiotic-associated diarrhoea by 42%.⁴ Probiotics can also relieve other forms of diarrhoea not associated with antibiotics. A large review of 35 studies found certain strains of probiotics can reduce the duration of infectious diarrhoea by an average of 25 hours and reduce stool frequency on day 2.⁵ Probiotics minimised the risk of travellers’ diarrhoea by 8%.⁶ They also lessened the risk of diarrhoea from other causes by 57% in children and 26% in adults.⁶

Probiotics confer general wellbeing as it has impacts on the body’s defence system. It works by competing with pathogens and toxins for adherence to the intestinal lining wall, thereby preventing cascades of triggered immune system.⁷ Children in the Lactobacillus group had fewer days of absence from day care because of illness, 4.9 days versus 5.8 days in placebo group.⁸ There was also a relative decline of 17% in the number of children suffering from respiratory infections with complications and lower respiratory tract infections in the Lactobacillus group.⁸ The probiotic Lactobacillus crispatus has also been demonstrated to diminish the risk of urinary tract infections in women by 50%.⁹

What are Prebiotics?

Inulin, a fructooligosaccharide (FOS), is a soluble prebiotic fiber resistant to digestion, goes to the bowels where bacteria are able to use it to grow, present as intestinal probiotic’s food, which nourishes and maintains the intestinal health and function. Inulin occurs in around 36,000 species of plants, and researchers say that chicory roots are the most abundant source.¹⁰

Health Benefits of Prebiotics

Inulin aids digestion by increasing the number of good bacteria in the gut, particularly Bifidobacteria and Lactobacilli. This helps to decrease the quantity of bad bacteria that can result in a variety of symptoms including inflammation and reduced nutrient absorption. Inulin also adds bulk to your stool and increases the frequency of your bowel movements. You may have more bowel movements, but inulin slows overall digestion, including the digestion of carbohydrates. This enables your body to better absorb nutrients from the food you eat, and allows sugar to be released slowly without spiking, which encourages healthy blood sugar levels. In a systematic review and meta-analysis published in the European Journal of Clinical Nutrition, they found that supplementation with inulin helped to lower fasting blood sugar, reduce fasting insulin, and improve good (HDL) cholesterol in people with type 2 diabetes.¹¹ Researchers also established that supplementation with inulin helped to lower bad (LDL) cholesterol.¹¹ A 2015 study revealed that inulin might benefit people with prediabetes. It can act as a potential blood sugar stabilizer when present in your diet over a long period of time.¹²

It appears that inulin supplementation may be a good way to help increase feelings of fullness, which inherently may affect weight loss. Some research suggests these properties make inulin a good weight management aid.¹³ Both inulin and placebo groups lost approximately 5 % of their body weight by week nine, but the inulin group lost significantly more weight (-2.3kg vs -0.6kg) between 9 and 18 weeks.¹³ A randomized control trial published in the American Journal of Clinical Nutrition found that supplementation with 8 grams oligofructose-enriched inulin reduced appetite and overall calorie intake in children with overweight and obesity.¹⁴ There was a trend for prebiotic supplementation to reduce BMI score to a greater extent than placebo by 3.4%-3.8% reduction.¹⁴

Conclusion

With so many important roles that it has in protecting your health, there is increasing attention to the role that probiotic and prebiotic play in maintaining the health of your gut microbiota and overall wellbeing. Prebiotics such as inulin act like food for these ‘good’ bacteria or probiotics that help to promote the growth of beneficial bacteria in the gut. Thus, when used in conjunction, the probiotics and prebiotics have a synergistic effect.

References:

1. Food and Agriculture Organization of the United Nations/World Health Organization (FAO/WHO) Report of a joint FAO/WHO working group on drafting guidelines for the evaluation of probiotics in food. 2002. ftp://ftp.fao.org/es/esn/food/wgreport2.pdf
2. Kailasapathy K, Chin J. Survival and therapeutic potential of probiotic organisms with reference to Lactobacillus acidophilus and Bifidobacterium spp. Immunol Cell Biol. 2000 Feb; 78(1):80-8.
3. Dethlefsen L, Huse S, Sogin ML, Relman DA. The pervasive effects of an antibiotic on the human gut microbiota, as revealed by deep 16S rRNA sequencing. PLoS Biol. 2008 Nov 18;6(11):e280.
4. Hempel S, Newberry SJ, Maher AR, Wang Z, Miles JNV, Shanman R, Johnsen B, Shekelle PG. Probiotics for the prevention and treatment of antibiotic-associated diarrhea: a systematic review and meta-analysis. JAMA. 2012 May 9;307(18):1959-69.
5. Allen SJ, Martinez EG, Gregorio GV, Dans LF. Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev. 2010 Nov 10;2010(11):CD003048.
6. Sazawal S, Hiremath G, Dhingra U, Malik P, Deb S, Black RE. Efficacy of probiotics in prevention of acute diarrhoea: a meta-analysis of masked, randomised, placebo-controlled trials. Lancet Infect Dis. 2006 Jun;6(6):374-82.
7. Yan F, Polk DB. Probiotics and immune health. Curr Opin Gastroenterol. 2011;27(6):496-501.
8. Hatakka K, Savilahti E, Ponka A, Meurman JH, Poussa T, Nase L, Saxelin M, Korpela R. Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial. BMJ. 2001 Jun 2;322(7298):1327.
9. Stapleton AE, Au-Yeung M, Hooton TM, Fredricks DN, Roberts PL, Czaja CA, Yarova-Yarovaya Y, Fiedler T, Cox M, Stamm WE. Randomized, placebo-controlled phase 2 trial of a Lactobacillus crispatus probiotic given intravaginally for prevention of recurrent urinary tract infection. Clin Infect Dis. 2011 May;52(10):1212-7.
10. Shoaid M, Shehzad A, Omar M, Rakha A, Raza H, Sharif HR, Shakeel A, Ansari A, Niazi S. Inulin: Properties, health benefits and food applications. Carbohydrate Polymers, Volume 147, 2016, Pages 444-454, ISSN 0144-8617.
11. Liu F, Prabhakar M, Ju J, Long H, Zhou HW. Effect of inulin-type fructans on blood lipid profile and glucose level: a systematic review and meta-analysis of randomized controlled trials. European Journal of Clinical Nutrition 2017 volume 71, pages9–20.
12. Guess ND, Dornhorst A, Oliver N, Frost GS. A Randomised Crossover Trial: The Effect of Inulin on Glucose Homeostasis in Subtypes of Prediabetes. Ann Nutr Metab. 2016;68(1):26-34.
13. Guess ND, Dornhorst A, Oliver N, Bell JD, Thomas EL, Frost GS. A randomized controlled trial: the effect of inulin on weight management and ectopic fat in subjects with prediabetes. Nutrition & Metabolism 2015 volume 12, Article number: 36.
14. Hume MP, Nicolucci AC, Reimer RA. Prebiotic supplementation improves appetite control in children with overweight and obesity: a randomized controlled trial. The American Journal of Clinical Nutrition, Volume 105, Issue 4, April 2017, Pages 790–799.