Latest / Silver FM 100.6 / Should I take a probiotic? And other gut questions, answered

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Should I take a probiotic? And other gut questions, answered · Silver FM 100.6

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  Speaker 3: Scientists know that our microbiome, it's not just involved in digestion.
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  Speaker 3: It's intimately linked with so much of.
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  Speaker 1: Our overall health.
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  Speaker 3: It influences our immune system, our mental health, our cognition,
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  Speaker 3: and much much more. Some of these links are only
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  Speaker 3: beginning to be fully revealed.
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  Speaker 6: You're listening to Life Kit. I'm Mariyel Sagata and that
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  Speaker 6: was NPR Health correspondent Will Stone. The gut microbiome is
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  Speaker 6: a way of describing the literally trillions of microbes that
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  Speaker 6: populate our intestines.
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  Speaker 3: A lot of these are bacteria, but we also have
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  Speaker 3: other organisms in there, fungi and viruses. So you want
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  Speaker 3: to picture this packed, dense ecosystem that's alive within you.
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  Speaker 6: Now, given what scientists are discovering that the microbiome is
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  Speaker 6: important to our health, people want to hack it. They
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  Speaker 6: want to have the very best, healthiest microbiome possible, Will says.
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  Speaker 6: The problem is the science hasn't come quite that far yet.
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  Speaker 3: Scientists haven't quite figured out how to even define what
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  Speaker 3: is a healthy microbiome. There's a lot of variability when
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  Speaker 3: you look around the world, depending on where you live,
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  Speaker 3: your diet, all kinds of things, and so unless you
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  Speaker 3: are acutely ill and you are having symptoms, it's hard
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  Speaker 3: to pin down what is healthy.
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  Speaker 6: We do have some clues though. It seems that the
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  Speaker 6: more diverse your gut bacteria are, the better. Also, if
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  Speaker 6: your microbiome bounces back well from disruption like antibiotic use,
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  Speaker 6: that's a good sign.
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  Speaker 3: And another area that scientists can look at are the
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  Speaker 3: different groups of bacteria that are present in your microbiome,
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  Speaker 3: and we know that some are associated with better health
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  Speaker 3: when you look around the world. You see this.
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  Speaker 6: On this episode of Life Kit Best Practices for your
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  Speaker 6: Gut Microbiome, I talked to Will about probiotic supplements, microbiome tests,
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  Speaker 6: and what you eat, which is still the most important
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  Speaker 6: factor here.
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  Speaker 6: this episode. Well, there's a huge market for gut microbiome tests.
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  Speaker 6: Are any of these worth spending money on?
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  Speaker 3: The short answer is generally no, at least when you
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  Speaker 3: look around the huge variety of products out there, and
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  Speaker 3: that's because they tend to overstate the science and be
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  Speaker 3: way ahead of the evidence. So just to run through
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  Speaker 3: a couple of these, you have these gut microbiome tests
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  Speaker 3: that you can buy. They're quite popular, and this isn't
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  Speaker 3: a test that your doctor orders because they think you
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  Speaker 3: have some illness. This is a test you would get
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  Speaker 3: commercially a couple hundred dollars to try to maybe optimize
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  Speaker 3: your microbiome or figure out what's wrong with it on
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  Speaker 3: your own. They'll give you hundreds of different measurements and
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  Speaker 3: it looks pretty legit. I talked to doctor Alexander Koritz
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  Speaker 3: about them. He's a GI specialist and researcher at the
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  Speaker 3: University of Minnesota. He says he'll get patients who are
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  Speaker 3: worried about their gut health, maybe they'll have some symptoms,
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  Speaker 3: and they'll send him their results.
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  Speaker 2: He usually comes as an entire book, colorful with many
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  Speaker 2: many entries of different bacterial species, fungal species, different tabolites.
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  Speaker 2: And I think the message the patient gets, well, jee
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  Speaker 2: might doctor never did this kind of test thing, this,
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  Speaker 2: this amount of information, this is this looks very impressive.
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  Speaker 2: It must mean something, And the reality is it's unfortunately,
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  Speaker 2: it's not very informative at all.
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  Speaker 3: And the fundamental problem is when we already discussed, which
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  Speaker 3: is we don't have a definite consensus on what even
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  Speaker 3: is a healthy microbiome. But beyond that, We've also seen
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  Speaker 3: research that shown the same patient with the same sample
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  Speaker 3: can send it to different companies and they get very
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  Speaker 3: different results. So it's not just interpretation. It's also kind
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  Speaker 3: of the reliability and variability you can get when you
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  Speaker 3: go out onto the market.
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  Speaker 6: Okay, so don't bother with the tests. And what about
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  Speaker 6: supplements like probiotics. For instance, if you walk into a
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  Speaker 6: health food store, there'll be shelves of many different probiotic
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  Speaker 6: capsules you can choose from.
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  Speaker 3: Yeah, and it can be pretty confusing, you know, to
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  Speaker 3: figure out is any of this it's worth my money. Now,
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  Speaker 3: probiotics can be helpful in specific circumstances. So, for example,
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  Speaker 3: there's good evidence they can be beneficial for reducing the
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  Speaker 3: risk of diarrhea associated with antibiotic use, also for preventing
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  Speaker 3: traveler's diarrhea, or for preterm infants who are at risk of complications.
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  Speaker 3: These are a few examples where we have better data.
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  Speaker 3: But beyond that, the idea that most people who are
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  Speaker 3: otherwise healthy should be taking a probiotic daily to support
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  Speaker 3: their gut health, it's really not backed by science yet.
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  Speaker 3: There may be a day where we actually have more
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  Speaker 3: targeted probiotics that can help people, but we are just
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  Speaker 3: not at that point yet.
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  Speaker 6: And for the cases that you mentioned, it's only certain
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  Speaker 6: strains that help with those things, right, Like, you need
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  Speaker 6: to pay attention to which strain you're using if you
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  Speaker 6: want to, for instance, prevent travelers diarrhea.
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  Speaker 9: That's right.
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  Speaker 3: Certain strains have been tested in high quality trials and
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  Speaker 3: been shown to be effective. One point that was made
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  Speaker 3: to me was you'll see sometimes marketing on these probiotics
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  Speaker 3: saying clinically tested. That didn't say they were effective, It
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  Speaker 3: just said they were tested. So you have to be
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  Speaker 3: mindful about what's actually being promised here and then what
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  Speaker 3: can be delivered by the evidence. I spoke to Hannah
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  Speaker 3: Holscher about this. She's at the University of Illinois Orbana Champaign,
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  Speaker 3: and she pointed me to a website called Usprobioticguide dot
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  Speaker 3: com that outlines in a very simple way the levels
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  Speaker 3: of evidence for each strain that's been studied and for
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  Speaker 3: which conditions.
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  Speaker 6: Okay, so what can people do, if anything, to try
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  Speaker 6: to optimize their gut microbiome.
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  Speaker 3: Yeah. The first place to start and how you can
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  Speaker 3: make the most difference by far isn't any special gut
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  Speaker 3: hack or magic solution. It's simple stuff that all of
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  Speaker 3: us already know we should be doing for our overall health.
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  Speaker 3: And that's because our gut microbiome evolved with us, and
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  Speaker 3: when we are healthy and thriving, so to our gut bacteria.
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  Speaker 3: Take a listen to doctor Fergus Shanahan. He's at the
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  Speaker 3: National Institute of Ireland and Cork and a longtime researcher
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  Speaker 3: and gut health.
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  Speaker 10: Like good sleep, plenty of exercise, fresh air, good food,
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  Speaker 10: good food meaning real food and not lots of low
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  Speaker 10: fiber ultra processed foods. Your mother probably told you all
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  Speaker 10: these things in different language, but all the things you
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  Speaker 10: were ever told, they're all good for your microbiome as well.
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  Speaker 10: There isn't any need for some health guru to come
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  Speaker 10: along and say, oh, I've got some major potion now
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  Speaker 10: that's going to improve your microbiome.
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  Speaker 3: Basically, he's like the gut researchers don't have some secret
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  Speaker 3: that they've been keeping from us that we all should know.
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  Speaker 1: It's just not the case yet.
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  Speaker 6: Any specifics that you learned about diet what we should
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  Speaker 6: be eating.
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  Speaker 3: Yeah, number one, without a doubt. Fiber and folks may
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  Speaker 3: have heard this, but most of us do not get
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  Speaker 3: enough fiber just in the general kind of Western die
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  Speaker 3: than most of us have. So you want to aim
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  Speaker 3: for anywhere from about twenty grams a day to forty
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  Speaker 3: depending on your age and sex. Thirty five grams is
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  Speaker 3: generally a good target. And it's not only the quantity
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  Speaker 3: of fiber. You want to make sure you're eating different
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  Speaker 3: types of fiber, because this diversity in your diet ends
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  Speaker 3: up really supporting the microbes in your gut. I spoke
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  Speaker 3: to Hannah Holscher about this, and here's the advice she gave.
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  Speaker 11: If you picture the rainbow of types of foods that
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  Speaker 11: you can eat, fruits, vegetables, whole grains, nuts, and legomes,
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  Speaker 11: you're going to see all of these different colors of
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  Speaker 11: the rainbow. And that means these foods have different phytonutrients
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  Speaker 11: in them, and they have different fibers, and just like
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  Speaker 11: an apple tastes very different from an orange and tastes
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  Speaker 11: different from an avocado or broccoli, you know, they have
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  Speaker 11: different fibers in them and different phytonutrients, and different microbes
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  Speaker 11: can go in and use those fibers as energy sources.
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  Speaker 3: Hannah has spent a lot of time doing well controlled
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  Speaker 3: where they feed people different foods and then see how
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  Speaker 3: that can influence your gut microbiome. One example, they did
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  Speaker 3: a trial with walnuts and they found that it enriched
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  Speaker 3: a bacteria called rose Buria, which is beneficial and linked
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  Speaker 3: to positive health. We do have some data showing that
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  Speaker 3: fermented food in particular can be pretty beneficial for lowering
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  Speaker 3: inflammation and overall got microbiome diversity in health. So these
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  Speaker 3: are things like sauer kraut, kim chi, yogurt, but you
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  Speaker 3: want to look and see whether the yogurt has live
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  Speaker 3: cultures of bacteria in it, not highly processed kinds of
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  Speaker 3: yogurt with sugar and they don't actually have bacteria in it.
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  Speaker 3: Those are a couple examples of beneficial probiotics that you
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  Speaker 3: can get from your food.
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  Speaker 6: Okay, and then is there anything that people should avoid
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  Speaker 6: to help their gut microbiome?
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  Speaker 3: Yeah, so probably no big surprise here unless you really
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  Speaker 3: need it. Antibiotics tend to be overused, overprescribed, so try
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  Speaker 3: to avoid those when not necessary. Beyond that, Hannah and
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  Speaker 3: others brought up some of the usual culprits we hear
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  Speaker 3: when we talk about other issues with our health foods
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  Speaker 3: like highly refined sugary that are low in fiber, sometimes
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  Speaker 3: called ultra processed foods. You want to try to keep
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  Speaker 3: those to a minimum. And you know, she's an advocate
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  Speaker 3: of moderation. You know, doesn't really think people need to
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  Speaker 3: be extreme here, but she says as much as you can. Unfortunately,
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  Speaker 3: alcohol is not great for our gut, and you know
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  Speaker 3: best to avoid that if you're concerned about supporting your
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  Speaker 3: gut microbiome.
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  Speaker 1: Will Stone, thank you so much, thanks for having me.
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  Speaker 1: It was fun all right.
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  Speaker 6: Time for a recap. Don't bother spending money on a
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  Speaker 6: gut microbiome test. They overstate the science and they're way
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  Speaker 6: ahead of the evidence. Some probiotic supplements have been shown
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  Speaker 6: to help with particular problems like travelers diarrhea and diarrhea
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  Speaker 6: associated with antibiotic use, but the idea that most people
• 13:04
  Speaker 6: who are otherwise healthy should be taking a probiotic daily
• 13:07
  Speaker 6: to support their gut health is not backed by science yet.
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  Speaker 6: We'll drop the names of a couple strains that are
• 13:13
  Speaker 6: well studied in the show notes, and you can also
• 13:16
  Speaker 6: check out a website called Usprobiotic guide dot com, which
• 13:20
  Speaker 6: outlines the levels of evidence for each strain that's been
• 13:23
  Speaker 6: studied and for which conditions. Now, the researchers who study
• 13:27
  Speaker 6: the guts say the best thing you can do for
• 13:29
  Speaker 6: your gut microbiome is eat enough fiber a day that's
• 13:33
  Speaker 6: about twenty to forty grams a day, depending on your
• 13:35
  Speaker 6: age and sex. Eat fermented foods like kimchi and yogurt.
• 13:39
  Speaker 6: Cut down on ultraprocessed foods and alcohol, and only take
• 13:43
  Speaker 6: antibiotics when you really need them. Also get enough sleep
• 13:46
  Speaker 6: and exercise. All right, that's our show.
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  Speaker 6: This episode of Life Kit was produced by Margaret Serino.
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  Speaker 6: It was edited by Megan Kin, Carmel Roth, and Lauren Gonzalez.
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• 14:28
  Speaker 6: Peter Alena. Fact Checking by Andrea Lopez Cruzsalo. I'm mariy
• 14:32
  Speaker 6: El Sagara. Thanks for listening.
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