Tag Archive for: probiotics

Timing for Enzymes, Prebiotics, and Probiotics

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My digestive system has undergone changes—it doesn’t work like it used to work. Hence, I’ve been paying closer attention to digestive supplements. My voice had been getting raspy, and I had occasional reflux; I was concerned the two were related. I had an endoscopy and found I was correct. They also found a hiatal hernia.

When your body doesn’t work as well as it should, you look for something to help. In this case, digestive enzymes, probiotics, and prebiotics are where you begin.

Digestive Enzymes

These are products that contain pancreatic enzymes that will help digest proteins, fats, dairy, and several kinds of carbohydrates. For them to be most effective, take them just before or as you begin eating, about five to ten minutes before.

Here’s a change in my recommendations from the past: You can take the digestive enzymes up to an hour after you began to eat. They work all through your small intestine, and that takes hours. They’ll catch up to the food you’ve eaten.

Unless you are taking them only because you know that protein gives you excessive gas or you need them to digest a meal with cheese, take them before every meal. Even snacks? Yes, unless you know the specific food. How do you know? Trial and error.

Will using the supplement cause your body to stop making the enzymes naturally? Apparently your body already isn’t making them, so don’t be concerned. The only other thing to work on is the volume of food you eat. Maybe for you, the amount is the issue, not the enzymes you naturally produce. It’s really trial and error.

Prebiotics and Probiotics

The only real research that’s been done on timing of probiotics and the foods that feed them, the prebiotics, was done with models of the digestive system in test tubes. Based on that, the best time to take probiotics with prebiotics is just before or with meals. Personally, I take my probiotics with a fiber prebiotic any time because the right food for the probiotic is going with them. But if it helps you to remember to take them, take them before, during, or after a meal. Just take them and if it’s with some fruit and vegetables, that’s great—more food for them to eat.

The Bottom Line

Your digestive system changes at various stages of life. That’s not a bad thing; it’s normal. Digestive products can help adapt to changes in your gut, as they helped me.

I’ve tried to give you the best approach for maximum benefits from your supplements. While the timing may be important, nothing is as important as taking them consistently. We tend to stop when we feel better; don’t do that! Remember, these are supposed to be made by our body or obtained from the food we eat. Take digestive supplements consistently to get results.

What are you prepared to do today?

        Dr. Chet

Reference: Benef Microbes. 2011 Dec 1;2(4):295-303. doi: 10.3920/BM2011.0022

Identifying the Supplementation Sweet Spot

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I believe everyone should add a foundation of supplements to their diet, but there’s no reason to take supplements you don’t need. The last two weeks, I’ve written about the sweet spot for nutrition and exercise as I see it, so it just seems logical to do the same thing for dietary supplements. While supplementation can be very complex, there’s a foundation where we all begin. To me, that’s the sweet spot.

It all begins with a multivitamin-multimineral. With the gaps we have in our diet and with research confirming the gaps, that’s where we should start, but how to choose? Your ideal daily multivitamin-multimineral would have at least the recommended dietary allowance (RDA) for all the major vitamins and minerals. It should also have a blend of dehydrated plant material to provide the phytonutrients we’d get in plants if we ate them. That’s it. Too many brands on the market throw in herbs for men’s health or women’s health. Not everyone needs them, so why put them in a foundation supplement?

The second nutrient is actually not a nutrient; it’s probiotics. If we don’t eat enough raw or fermented foods, we’re not adding to our microbiome; adding a probiotic supplement will help build a stronger, more effective microbiome. Does the number of strains matter? No, but it’s better with strains shown by research to be beneficial. Do the colony forming units (CFUs) matter? Again, no. What does matter is whether it contains a prebiotic or not, typically a fiber such as inulin. Because our diets are poor in this food source, purchase one that contains prebiotics.

Those two supplements are the foundation of nutrition for people of every age and condition; there are two more that most people probably need, and we’ll talk about those on Saturday. If you’re interested in more of the science behind my choices, pick up a copy of Supplementing Your Diet as either a download for yourself or the CDs to share with others. They’re all on sale at 25% off, and that’s in addition to Member and Insider discounts.

What are you prepared to do today?

        Dr. Chet

Research Update on Probiotics and Adult Allergies

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Researchers recruited a total of 95 adults, ages 19 to 65, with allergic rhinitis for a double blind, randomized, placebo-controlled clinical trial; all the subjects were from two hospitals in South Korea. They were not allowed to take their usual medication to treat seasonal allergies.

In the experimental group, 47 subjects received the probiotics, and 48 subjects were in the placebo group. The probiotics used in the study was a novel blend called NVP-1703. The variables the researchers selected to track were markers associated with the immune response such as IgE and interleukins. They also tracked the symptoms of the subjects by having them complete daily diaries noting responses such as sneezing, itching, nasal congestion, runny nose, etc. The subjects also took standardized written allergy questionnaires.

The researchers found significant positive changes in the questionnaire assessment from baseline through weeks one, three, and four between the probiotic group and the placebo group. The IgE levels and serum IL-10 levels were significantly improved between the probiotic and the placebo group.

The improvement in questionnaire results meant that the subjects that were taking the probiotics saw their allergy symptoms decrease. By assessing the immune responses, they saw that somehow the probiotics stimulated the production of IgE and IL-10. Both of those allow the immune system to control symptoms associated with allergic rhinitis.

The researchers concluded that this blend of probiotics could be beneficial to treat seasonal allergies; I’m not sure I would go that far since the study contained fewer than 100 subjects. I would say that it was nice progress, although there’s still more to do. But if you have allergies, taking your probiotics regularly may be helpful for your allergy symptoms as well as all the other benefits.

What are you prepared to do today?

        Dr. Chet

Reference: Nutrients 2020. 12: 1427-41.; doi:10.3390/nu1205142

Research Update on Probiotics for Infants

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Let’s begin this week’s research review with a study on the potential long-term benefits of probiotic use in infants. Researchers in Slovenia collected data on 316 healthy-weight newborns whose parents had test-confirmed allergies.

The families were divided into two groups: 115 infants were placed into a probiotic group and received probiotics every day between the ages of four weeks to twelve weeks while breastfeeding. The remaining 201 infants were put in the control group and breastfed without any supplements.

All children were followed by the same pediatrician through nine years of age to assess the children over the years to see who developed allergic rhinitis or allergic rhino conjunctivitis at some point. The results showed during the follow-up that 19.6% of the children had developed either form of allergy. They confirmed the diagnosis by examining the children for levels of IgE and skin prick tests.

Children in the probiotic group were three times less likely to develop allergic rhinitis than those in the control group, 4.3% versus 13.9%. When examining allergic rhinoconjunctivitis, the difference between the probiotic group and the control group was much lower although still statistically significant at 8.7% versus 9.5%.

I like this study because the children were tracked for an extended period of time. It may be that if the infants were tracked only through one year of age or if the study were terminated when they were four or five, there might not have been the same significant differences. Sometimes seeing the benefits can take longer than we expect.

You have to wonder what the results would be if the children were given probiotics beyond twelve weeks (some may have been; probiotics weren’t prohibited beyond the study.) We make sure Riley, who’s five, gets his probiotics every day.

Is that reduction in allergies worth the effort? Paula says any lessening of allergies is worth doing. Next month will be the 57th anniversary of her first allergy shots, and she’s been getting shots nearly continuously ever since—three at a time these days. If probiotics will spare some children years of shots or medications, let’s go for it.

What are you prepared to do today?

        Dr. Chet

Reference: EAACI Digital Congress 2020. Besednjak-Kocijančič, L. et al.

The Bottom Line on Preschoolers, Probiotics, and Gastroenteritis

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“These studies are likely to have significant impact towards eliminating use of medications that don't seem to work.”

That’s a quote from a physician interviewed by NPR who wrote a commentary accompanying the two research papers on probiotic use for gastroenteritis or GE (1). I think it perfectly illustrates the fallacy of the pharmaceutical model of research on nutrition and its impact on health:

Nutrients are not medications.

They may come in pill form, they can be administered like medications, but they’re nutrients nonetheless.
Questions About the Studies
The . . .

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Did Probiotics Help Preschoolers with Gastroenteritis?

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The use of probiotics to stop diarrhea and vomiting for preschoolers with gastroenteritis (GE) was studied in two major studies published in the New England Journal of Medicine. In the U.S. study, 55 of the 468 subjects who got the probiotics had scores of nine or greater on the scale while 60 of 475 in the placebo group has scores of nine or greater for the two weeks after the study began. This was a 20-point scale and the higher the score, the worse the GE symptoms. No significant differences.

In the Canadian study, 108 of the 414 subjects in the probiotics group and 102 of the 413 subjects in the placebo group had scores of nine or greater for the two weeks after the study began. Again no significant differences were found.

This led both research groups to conclude that the probiotics used in the studies were ineffective in preventing negative GE outcomes compared to those who received the placebo.

The press releases and follow-up interviews were much harsher in their criticism of probiotics. One of the study leaders concluded that “These two probiotics did not work. They should not be used for GE.” I would emphasize “period!” was implied. But is that true? If you’re a regular Memo reader, I’ll bet you have an idea where this is going; I’ll explain on Saturday.

What are you prepared to do today?

Dr. Chet

 

References:
1. N Engl J Med 2018; 379:2015-2026. DOI: 10.1056/NEJMoa1802597.
2. N Engl J Med 2018; 379:2002-2014. DOI: 10.1056/NEJMoa1802598.

 

Preschoolers, Probiotics, and Gastroenteritis

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Estimates are that close to two million preschool children will be taken to the emergency room for vomiting and diarrhea every year; the term generally used is gastroenteritis (GE). Two research groups, one from the U.S. and one from Canada, conducted studies to see if probiotics would have any impact on the course of GE from the time of the ER visit for at least two weeks after. Here’s what they did.

Researchers in Canada recruited close to 900 children and researchers in the U.S. had close to a thousand; all the children had symptoms of GE. The subjects were randomly assigned to a placebo or experimental group. The subjects in the experimental groups were given a five-day course of probiotics; the Canadian group used two strains and the U.S. used one strain. The subjects were then tracked to see whether there was a difference in the severity of the GE between those kids getting the placebo and the ones getting probiotics. Both research groups used the same GE symptom scale to monitor the severity of the GE.

Did the probiotics have any impact on the severity of the GE? We’ll check out the results on Thursday.

What are you prepared to do today?

Dr. Chet

 

References:
1. N Engl J Med 2018; 379:2015-2026. DOI: 10.1056/NEJMoa1802597.
2. N Engl J Med 2018; 379:2002-2014. DOI: 10.1056/NEJMoa1802598.

 

Winterize Yourself

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The official start to winter is quickly approaching, but for most of us the cold, wet, snowy, rainy weather has already begun. Today’s Memo contains some tips on how to winterize your body by focusing on basic nutritional supplementation.

Water: Make sure you increase fluid intake during the winter. The humidity is lower because the heat is on in your home, work, and school. You breathe out more water as a result. You have to replace those fluids. Every day drink one-half your body weight in ounces of water or any other fluid; if you weigh 150 pounds, drink 75 ounces of water daily.

Multivitamin-mineral (MVMM): If you haven’t been consistent in taking your MVMM, this is a good time to begin. Your immune system needs some basic nutrients and a MVMM is a good place to start, especially if it’s one that contains plant concentrates and extracts.

Probiotics: The immune system starts in the gut. Taking a probiotic every day can help your immune system function better. In addition, taking fiber with the probiotic can help feed all the good bacteria in your digestive system.

Vitamin D: Consider adding vitamin D to your regimen because we get a lot less sun during the winter. Ask your physician to test your vitamin D levels; if it’s below 30 ng/ml, add 2,000 IU vitamin D to your supplementation. There’s no real danger in taking vitamin D, so make sure you’re getting some even without a test.

Antioxidants: Help your immune system; add additional vitamins C, E, and beta-carotene to your supplementation.

Supplementation may or may not help you avoid getting a cold or the flu, but it may help reduce the severity and duration of a respiratory infection if you do get one. That’s worth the small expense of the supplements in my opinion.

 

Happy Thanksgiving!

Paula and I wish you all a Happy Thanksgiving. We are grateful for your support throughout the year. This week is one to spend with family and friends, so this will be the only Memo of the week. Thanks for being a member of the Dr. Chet family.

What are you prepared to do today?

Dr. Chet

 

Research Update: Gut on a Chip

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In the final research paper I’ll review, the headline that caught my attention was “Probiotics are not always ‘good bacteria’.” That’s something I really hadn’t seen before so I had to check it out.

In this case, I had to learn about a new technology called organ-on-a-chip. Over the past five years or so, researchers have tried to develop a three-dimensional approach to doing research on various organs including the gut. Essentially what they have done is develop what are called chips with living tissue on different sides of a membrane. As it relates to the gut, they have the epithelial layer, the actual absorbable tissue from the gut, on one side and the endothelial layer on the other side. They can then control fluids and nutrients to study what happens in healthy versus diseased conditions.

In the study that resulted in the headlines, the researchers examined what happened when probiotics were introduced into a damaged gut such as we would see in irritable bowel disease or Crohn’s. Using a mouse-model chemical that destroys the gut tissues, what they found was that once the chemical was removed, the inflammation was reduced and the gut was repaired.

If the probiotics were introduced before the gut damage, the destruction was ameliorated, thus preventing some damage. When the probiotic was introduced after the damage, the inflammation was reduced but the repair process was impeded.

Prior research has demonstrated that probiotics are beneficial in human trials for people with damaged epithelial cells or simply stated, the inner portions of the gut. It seems curious that it would slow repair in this gut-on-a-chip model; even so you might feel better because inflammation is reduced.

What should we do? The digestive system, just like any other organ system, is part of a total organism. On a chip, even with more than one component represented, it’s still not the entire organ and certainly is missing the effects of some other organs that may have an impact. The only way to know for sure is to duplicate the study in living beings, whether in rodents or humans.

Based on human trials, there’s no reason to change the use of probiotics if you have inflammatory bowel disease. Talk with your physician, but at this point there’s no reason to stop using probiotics.

The Bottom Line

Probiotic research continues at a rapid pace, and I believe that the ultimate “cure” for any disease or condition will be found there. It doesn’t mean we’ll live forever; it could mean we get to live healthier all the days we’re alive. I continue to take my probiotic as does everyone in the family, including my three-year-old grandson Riley. And don’t forget you can get even more good bacteria from vegetables and fermented foods.

What are you prepared to do today?

Dr. Chet

 

References:
1. https://doi.org/10.1016/j.jcmgh.2017.12.010.
2. www.pnas.org/lookup/suppl/doi:10.1073/pnas.1810819115/-/DCSupplemental.

 

Research Update on Probiotics and Staph Infections

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One of the primary threats to our health is infection—specifically, antibiotic-resistant infections. We’ve all probably heard of people who became critically ill due to a life-threatening staph infection. A new research paper may give us insights on how we might be able to reduce the risk of getting infected with staphylococcus bacteria.

Researchers selected a remote village in Thailand to examine the relationship between bacillus and staphylococcus bacteria in humans; the researchers from the U.S. felt that residents of the remote location would be less likely to be exposed to food sterilization or antibiotics than people who live in urban areas. They collected and examined fecal and nasal samples from 200 volunteers from the village for the types and quantities of bacteria present.

They found that half the subjects had bacillus bacteria growing in their digestive system, and about two dozen subjects had fecal and nasal staphylococcus bacteria. They also noted that no subjects who had the bacillus bacteria had any signs of the staph bacteria.

The researchers then went on to do a rodent study to explain how the bacillus bacteria destroy the staph bacteria. While the how is important, it would take a lot of words to explain. Suffice it to say that regular consumption of bacillus probiotics can be protective against a staph infection. You can find it in sauerkraut, kim chi, and yogurt, or in supplement form.

One more research paper to review on Saturday.

What are you prepared to do today?

Dr. Chet

 

Reference: Nature 562:532–537 (2018).