Do You Need Prebiotics?

The Importance of Prebiotics

Everyone has heard of probiotics it seems, which are found in foods like yogurt as well as in supplements and have a wide range of health benefits, which you can read more about in my article on probiotics, more and more research is coming out showing how beneficial they are to many aspects of our health, but how many people have heard of prebiotics?

How important are prebiotics to our health? Research is coming out showing that prebiotics are as important to the health of our gastrointestinal system as probiotics, because without prebiotics in our diet the beneficial bacteria in our intestines cannot survive and thrive.

What are prebiotics?

Prebiotics are defined as "a nondigestible food ingredient that beneficially affects you by stimulating the growth of one or more bacteria in the colon", what does this actually mean! It means indigestible by humans as these prebiotics travel through the stomach and small intestine to become food for our beneficial bacteria in the large intestine.

For food ingredients to be classified as a prebiotic they must do 4 things:

1/ Neither be broken down or absorbed in the stomach or small intestine (because you want them to reach the large intestine where they become food for your good bacteria)

2/ Act as a food source for one or more potentially beneficial bacteria in the large intestine

3/ Change the colonic microflora ecosystem towards a healthier balance, in other words increase the good bugs so they outnumber the negative bacteria

4/ Improve gastrointestinal health, and health in general including the immune system and reducing inflammation

Types of Prebiotics

There are 4 main types of prebiotics that are commercially available and I will discuss each of them along with their benefits and any side effects

1/ Fructooligosaccharides

Thankfully also known as FOS and this includes inulin, oligofructose and neosugar.

Foods that contain FOS include onion, jerusalem artichoke, dandelion, asparagus, leek, garlic, banana, chicory, salsify and burdock. FOS can also be purchased in a supplement form and it is sometimes added to probiotic supplements. During studies showing the effectiveness of FOS a supplement was used, and to get a therapeutic dose it is necessary to supplement.

FOS is used to improve dysbiosis by enhancing growth of bifidobacteria, decreases growth of potentially pathogenic bugs and enhances the immune system.... studies have shown that administration of FOS to toddlers resulted in a significant reduction in infectious diseases requiring antibiotics, episodes of diarrhea and vomiting, episodes of fever in combination with cold symptoms.

FOS is important after antibiotic therapy to increase beneficial bacteria and can be healing to damaged intestinal mucosa. Other studies have shown FOS to reduce allergies, eczema, improve satiety and improve calcium absorption.

It is important to start off with a low dose of FOS as high doses may cause abdominal bloating, flatulence and pain. Dosages of 1-3 grams (1/2 to 1 tspn) a day are unlikely to cause side effects and this is a perfect dose for infants and toddlers, adults and older children can increase the dose slowly providing there are no adverse digestion symptoms to 10 grams a day.

2/ Lactulose

Lactulose is a semi-synthetic disaccharide made from fructose and galactose, it's made from the heating of lactose which is the sugar found in milk and is often sold in pharmacies as a laxative.

Lactulose enhances the growth of both lactobacilli species and bifidobacteria, while FOS only enhances bifidobacteria. It is used to decrease growth of potentially pathogenic intestinal bacteria like E.col, clostridia and bacteroides.

The uses of Lactulose are broad due to it's ability to increase beneficial bacteria and this includes the treatment of candida, constipation, damaged intestinal mucosa, low immunity, prevention of urinary tract infections, inflammatory bowel disease and skin conditions such as eczema.

The optimal dose for Lactulose is 10 grams twice daily but like the FOS you need to start on a small dose and slowly work up, otherwise you may cause digestive symptoms like bloating. As your levels of beneficial bacteria increase they will need more "food" which is the lactulose, so you will be able to tolerate a higher dose. If you are sensitive to FODMAPS you can still take Lactulose but you may have to start at a very low dose like 3 grams a day.

3/ Resistant Maltodextrin which is my current favorite prebiotic due to it's low level of side effects and is available in the Metagenics supplement Ultra Flora Digest.

Resistant Maltodextrin has many of the benefits of other prebiotics and specifically increases levels of Lactobacilli so if you need to increase Bifidobacteria numbers I would still use FOS (especially in young children).

The Ultra Flora Digest improves digestion by increasing beneficial bacteria and also is excellent for increasing immunity by increasing secretory IgA, which provides immune protection to the gut's mucosal surfaces, which is our primary immune defence. 

4/ Galactooligosaccharides 

Another mouthful to say and this prebiotic is commonly known as GOS. It is found in human breast milk which shows how essential it is, and can also be manufactured from lactose.

Like Lactulose, GOS also enhances both Lactobacilli and bifidobacteria species of beneficial probiotic bacteria and can be used to decrease potential pathogenic bacteria in the digestive tract which will lead to a lot of beneficial uses.

Studies have shown GOS to be useful in the treatment of constipation, allergies, increasing resistance to infections, treating irritable bowel syndrome, metabolic syndrome, traveler's diarrhea and gut infections in general. GOS show's a wide range of benefits but currently it is not available for sale in Australia though it is available in supplement form in the U.S, hopefully we will have a local supplier soon as it seems to have a wide range of benefits and the side effects are very low. 

Who are Prebiotic's for?

While prebiotics could be taken by anybody quite safely, they are most beneficial to children suffering from recurrent infections and allergies as they are not unpleasant tasting and there has been a lot of research into this area. For children I would recommend FOS as a starting point. They are also for anybody experiencing some of the conditions I mentioned above, especially if they are chronic in nature and you are not getting results with other treatments. My current favourite for older children and adults is Ultra Flora Digest

I also recommend an appropriate probiotic supplement which has been shown to help improve the specific condition being treated, as not all probiotics are the same. It is amazing the results that you can get with your health by following a good quality diet free from allergens combined with a prebiotic and good quality probiotic.

If you have any questions or comments let me know.

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