Leading a successful life means preserving the incredibly fragile balance in the many existential dimensions, of which the biological or the social are just components. Today, we will be talking about an instrument designed to maintain a certain physical balance, precisely the desired balance in a person’s gut, probiotics.

The organic metaphor has had a long life in the fields of social and philosophical thought, however, a person’s digestive system can be considered an organism in itself. The well-being of everyone’s insides is heavily dependent on the bacterial balance that smooths the chain of biochemical processes which account for normal digestion.

Probiotics are designed to “normalize” imbalances that may arise in the bacterial framework of an individual’s digestive tract. In the complicated network of interdependencies that is the human body, the importance and the implications of a healthy digestive system are critical.

Probiotics do have their share of controversy, as every (relatively) novel development and direction of research has. That being said, the potential applications of these substances are only beginning to be fathomed – ranging from gastro-intestinal to neurologic. Therefore, let us take a look into the world of probiotics, where we will consider their nature, their history, their legal and scientific status, and ultimately discuss some probiotic foods and supplements available on today’s market to see if the hype surrounding them is warranted or not.

The ABC of Probiotics

Every semi-ignorant high school student knows that there are millions of microorganisms residing inside the human body, of bacterial, viral or fungoid nature, symbiotic with our body. As a corollary, a disturbance in those relationships can have deeper implications, leading to effects ranging from momentary discomforts to potentially dangerous disorders.

In line with these certainties, there is no giant intellectual leap to envision that humans can play around, tweaking the proportions of the microorganisms above. In fact, eating or drinking anything does just that. The underlying principle behind probiotics is identical – scientifically tweaking those proportions to achieve the desired effect.

The World Health Organization (WHO) defined in 2001 probiotics as being “live micro-organisms that when administered in adequate amounts confer a health benefit on the host”. In scientific terms, the layout of bacteria (plus the viruses and fungi) that I was talking about is called microflora. Each organ has a microflora, and each microflora can suffer modifications (from external or internal factors) causing the organ to stop functioning optimally.[2]

To further enhance the explanation, let us consider the etymologic couple anti-biotics and pro-biotics. Antibiotics are designed to kill harmful bacteria in our bodies (they also have the penchant for destroying benevolent ones), therefore probiotics are meant to perform the opposite. Interpretation in a more humorous tone would be that they are as “pro-life” as pro-life can get.

The colonies of bacteria that are an integral part of any organ’s microflora can become de-structured because of stress, illness, an unhealthy diet or aging. Their rejuvenation can have significant benefits for any organism.

The larger implications of a healthy digestive system go far beyond our general sense of well-being. Imagine, for instance, that a vital component of the immune system lies in the digestive tract. Furthermore, the enteric nervous system (the second largest division of the nervous system) also resides in the gut. Besides pressures from the central nervous system, this enteric group also has critical demands placed upon it from the sympathetic and parasympathetic nervous systems. Being able to control some of the processes that are even adjacent to digestion suddenly opens pages that are yet to be written in biology, medicine or pharmacology. [3]

To further underline the fact that probiotics is swiftly moving away from the status of hypothesis or interesting speculation, it should be noted that an institutional framework is under development with the existence of the International Probiotics Association, which organizes annual (well-attended) symposiums and could be transformed into an arbiter on these matters in the years to come.

That being said, to get a clearer picture let us delve a bit into the history of probiotics and see the (seemingly ordinary) evolution from reality to concept and back again.

History of Probiotics[4]

The history of what we now (retroactively) call probiotics begins sometime in the Neolithic age when the advent of an agricultural-based society led to the discovery of the benefits that the process of fermentation entails. Fermentation is a process that, in addition to making particular products feasible for consumption for a longer time, lowers the pH of the product making its digestion less of a challenge for the human body. The discovery of fermentation was also a technological landmark in the history of humanity, being one of the first methods of food preservation. Many dietary staples are a result of fermentation – bread, yogurt, wine, beer, pickled vegetables, etc.

Fast-forward to the Modern Age, it took modern science quite some time to establish connections between bacteria, food, digestion and overall health. It was not until the latter part of the 19th century, with the activity of Louis Pasteur, that micro-organisms (bacteria, in his case specifically) were deemed responsible for the process of fermentation. In the wake of this discovery, distinct strands of bacteria were associated with the different processes of fermentation. The great French scientist published his findings on the actions of bacteria in the bacteria-induced decomposition of sugars in 1860.

The first modern medicinal use of what we today call probiotics happened at the turn of the 20th century when French researcher Henri Tissier discovered colonies of the lactic bacteria Bifido when analyzing the stools of children at the age of breastfeeding. The discovery prompted further research into the human intestinal flora. The conclusion of these early experiments was the advice of administering Bifidobacteria in patients with severe cases of diarrhea.

The probiotic principle – which states that the global health of an organism may be improved through the ingestion of substances containing strands of bacteria that have a beneficial effect on the flora of the gastrointestinal system – was first stated by Ilya Metchnikov, a Russian chemist who elaborated on the findings of Louis Pasteur, later becoming head of the Pasteur Institute and Nobel-prize laureate in Medicine.

After these breakthroughs, the study of enzymes involved in the fermentation process and the study of digestion from a microbiological point of view became widespread. In 1935, as a result of Japanese studies led by Minoru Shirota, a drink containing strands of the Lactobacillus became available for commercialization in Japan. This is today considered an important event in the history of probiotics, marking the departure from using solely foods containing beneficial bacteria, and the advent of probiotic synthetic supplements.

The definitive entrance of the term probiotics in the scientific jargon (and in the extensive vocabulary) is considered the 1989 definition of British microbiologist Roy Fuller, taken from his article Probiotics in Man and Animals, a definition which focuses on the ingestion of live bacteria as supplements.

Probiotic Foods for a Healthy Body

Before describing the proven and possible beneficial effects that probiotics have in the treatment of certain conditions, let us take a look at the readily available probiotic foods. While there are still debates on the quantities in which these foods should be consumed, a moderate and systematic inclusion in one’s diet is regarded as having a positive impact not just on the digestive function, but on overall welfare.

Kefir – is a dietary staple in Eastern European and Western Asia cultures, being a product of the breaking down of lactose in milk (goat milk in the initial recipe, but also cow and sheep in today’s variants) by bacteria in yeasts. Because of this chemical action, kefir is an alternative to people presenting lactose intolerance. While similar to yogurt, kefir has a much higher number of probiotic strains, although it has the relative downside of being a bit more acidic. The translation from Turkish is literally “feeling good”. [5]

Sauerkraut – provides more of a bacteria-friendly environment, not containing as many strains of probiotics in itself (at least in comparison with kefir). Sauerkraut is made from the fermentation of vegetables, cabbage, in particular, thus possessing a diversity of organic acids – the ideal breeding ground for lactic bacteria. It has been used since medieval times against conditions like diarrhea and constipation. Among its benefits is the high concentration of vitamin C.

Kimchi – is the Far Eastern version of sauerkraut. Its main ingredient is fermented Chinese cabbage, though there are lots of variations in the secondary components, ranging from red peppers to fish sauce. There is some preliminary data that points to links between the consumption of kimchi and the traditional longevity of populations in the Far East. [6]

Natto – also hailing from the Far East, though more limited to Japan, this traditional dish is made from fermented soybeans. It has been studied in the field of probiotics because of its containing the strain Bacillus subtilis. It also helps in maintaining the overall health of the human body by containing large quantities of vitamin K and B12. [7]

Kombucha – is a byproduct of the fermentation of sweet black tea. It can be found in many national markets in the form of a sweet and slightly acidic beverage. The two principal probiotics found in Kombucha, saccharomyces boulardii and Bacillus coagulans, are known to be beneficial in the prevention and/or alleviation and treatment of diarrhea.

Miso – is a traditional side dish used in Asian cuisines, produced from the fermentation of soybeans and brown rice. Its primary fermentation agent is Lactobacillus acidophilus, one among more than 150 strains of probiotics identified in this salty accompaniment.

Yogurt – is probably the best known and the most widely and readily available of all probiotic foods. What is designed as yogurt is specifically Greek yogurt, manufactured from a cow, sheep- or goat milk. In the modern manufacturing process, selected colonies of bacteria are added to the pasteurized milk to prevent exposure to not-so-friendly strains of bacteria.[8]

More Probiotic Insight – Status, Action, Possible Aid in Treatments

The historical section shows that in the microbiological realm probiotics have a relatively extensive past. That should not lead to further assumptions, because when it comes to the medicinal and pharmacological field (and the legal superstructure that is associated), probiotics are very much a novelty. This should not be a cause for a surprise because the cost that thorough testing performed for a large number of bacterial permutations would be walloping, therefore a lot of time will pass before the marketing of probiotics as medicine will become a legal reality.

Commercial supplements are always a tender subject, especially among medical professionals. It has to be stated that there is a fair share of truth in their decrying the ambiguity of some (many suggest most) of these products. One[9] frequent observation made is that most tests of probiotic products are performed in an “in vitro” setting, with what is observed in this particular situation being what is then advocated on the label.

Another area of frequent criticism is the manner of quantifying the balance in the gastrointestinal microflora. With this being a novel field of study and the difficulties associated with obtaining numerous and viable samples (not to mention the considerable variations from individual to individual), there cannot be a consensus on what constitutes a balanced microflora. Most of the tests are based on levels of bacterial presence in the fecal matter, with no necessary correlation with what exists on the global standard of the gastrointestinal tract. [10]

Currently, probiotic supplements need not be supervised by the FDA as long as they do not make claims to concrete courses of action for the treatment or prevention of a disease. This is a cause for the marketing of supplements that would have a slim chance to be considered probiotics according to the definition above. The same issues are true for the European market, with the corresponding regulation agency taking similar stances to the FDA. [11]

The causes for this position do have a straightforward explanation. The beneficial effects that have been witnessed in the cases of the Lactobacillus and the Bifidobacterium (the strains on which most tests have been performed) cannot be extrapolated to the many other bacterial strains. That being said, there is a consensus among medical professionals that side-effects of the use of probiotics are mild and do not pose significant risks to the average healthy person. [12]

On the other hand, there is a considerable amount of preliminary data suggesting that probiotics can be useful (if not in the treatment) in the managing of symptoms of conditions such as colic, diarrhea (both of infectious causes and that associated with a course of antibiotics), urinary tract infections, Crohn’s disease, irritable bowel syndrome or eczema in children.

The opposite process, which is ingestion of substances that destroy naturally occurring “good” bacteria, can also be considered as being part of a larger picture involving probiotics as they trigger unwanted responses in your body caused by the imbalance in the digestive microflora. Prescription antibiotics and other medications or chemicals, tap water, genetically modified organisms, sugars, and alcohol are among the biggest probiotic “killers”. Naturally, stress also plays an important part. [13]

Probiotics indeed present another interesting facet of the whole question of nutrition and the increasing number of possibilities that healthy eating may influence our lives for the better. Food supplements will always reside adjacent to this ideal of healthy eating because shortcuts are always appealing. On the other hand, science is always evolving and the jury is still out on the many implications this field of study proposes. Nevertheless, at the moment there are a few certainties – probiotic foods can be a major factor in the quest for a healthy body (barring any allergies of course) and in the case of probiotic supplements, always consult a specialist before taking any!

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