Tag Archive for: probiotics

Research Update on Probiotics and Healthy Skin

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There has been so much research on probiotics published that it’s hard to keep myself informed, and you as well. This week I’ll summarize three recent studies on probiotics. Let’s begin with research on probiotics and skin conditions.

Researchers examined the effects of three strains of probiotics on skin inflammation in mice: two strains of lactobacillus and one strain of bifidobacterium. Three groups of mice were given one of the probiotics for two weeks while two control groups were given a placebo. After two weeks, the skin of four groups of mice was chemically exposed to an irritant to cause inflammation while the fifth group was exposed to a control chemical.

The researchers examined both blood and skin of the mice for indicators of inflammation after seven days of exposure. The markers for inflammation were lower in the groups who took the preventive probiotics than either of the positive or negative controls. While this was a small study on mice, it did demonstrate that probiotics helped reduce the skin response to chemical irritation. This may be the first step in identifying a probiotic that could help conditions such as atopic dermatitis in the future.

Keep taking a wide-spectrum probiotic, especially if your skin has been less healthy than you want it to be. If you have a teen with skin problems, probiotics may make a big difference. Another research update on Thursday.

What are you prepared to do today?

Dr. Chet

 

Reference: Beneficial Microbes, 2018; 9(2): 299-309.

 

Research Update on Probiotics

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Probiotics are the beneficial microbes that reside in and on our body. When a health headline suggests that taking probiotics may be hazardous to our health, that gets my attention. As a result, I spent the weekend going through two studies published in the journal Cell. That will form the basis of this week’s Memos.

The researchers used a different approach in assessing the microbiome of the subjects before and after the interventions. Typically this type of research uses fecal samples to assess changes in bacterial content. In this case, they used endoscopic procedures to sample the microbiome throughout the digestive system.

The studies had different purposes. The first placebo-controlled trial compared the change in the microbiome before and after administration of a commercially available probiotic. The second trial examined the microbiome before and after the administration of a course of antibiotics in a group of control subjects, a group given probiotics, and a group given a fecal transplant collected before the study began. We’ll cover the results on Thursday.

What are you prepared to do today?

Dr. Chet
References:
1. DOI:https://doi.org/10.1016/j.cell.2018.08.041.
2. DOI:https://doi.org/10.1016/j.cell.2018.08.047.

 

Why You Need Prebiotics

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As kids go back to school, let’s start the week after Labor Day by answering some questions. You know about probiotics, the beneficial microbes that live in and on our bodies and compose our microbiome, but one question that seems to be on a lot of people’s minds is prebiotics: why do you need them?

Prebiotics are substances, typically found in plant-based foods, that can be used as food for probiotics. Two well-known types of prebiotics are plant fibers such as inulin and fructooligosaccharides, or FOS for short. There are undoubtedly many more types, but research in this area is really just getting started.

No matter. If you want to make sure you’re feeding your microbiome, eat your vegetables, fruits, and beans on a regular basis. You don’t have to worry about what the prebiotics are called; they’re in there. Still working on your diet? Take a probiotic with FOS. To back up the fruit sugars, take some soluble fiber such as inulin as well. That’s the way to keep your microbiome healthier and doing its job for your health.

What are you prepared to do today?

Dr. Chet
Reference: Curr Opin Biotechnol. 2016 Feb; 37: 1–7. doi: 10.1016/j.copbio.2015.09.001.

 

More Reasons to Use Probiotics

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One of the most frequently asked questions I get is this: “Should I take probiotics when I take antibiotics? I don’t want to negate the benefits of the antibiotics.” Based on the summary of the Cochrane Review, I think there’s enough evidence to say that you should take probiotics any time you have to be on antibiotics. The research evidence is not perfect and the authors called for more and better research to confirm the results, but there appears to be no harm when taking probiotics during antibiotic use. If it doesn’t harm, then it’s a good idea to do it, even if the rate of C. diff is relatively low to begin with. But it’s a good idea to clear it with your doctor because reasons for taking antibiotics can be different.

There are a couple of things that we don’t know. What is the best type of probiotics to take? And how much should we take? In spite of those unknowns, when examining the data summary of all the studies, there was an overall benefit when probiotics were used. That means whether it was just one strain or several, in differing quantities, they all seemed to work. Whatever probiotic you typically use, take it during antibiotic use until we know more.

Another Review Paper

I’m currently going through a review paper on the brain-microbiome connection (3), and it’s one of the best reviews I’ve read in a long time. I’m still checking the background research; it’s complicated physiology and biochemistry. I can’t get it into the typical three Memos per week so it will be a new Bottom Line in the near future.

What I’ve taken away so far is that we should all be taking probiotics every day, unless there’s a reason you can’t. If you buy a quality product, they’re not inexpensive, but it’s still a good decision based on the potential benefits. In addition, it would be a good idea to add fermented foods to your diet every day: yogurt, especially Greek yogurt, kefir, sauerkraut, kim chi, and more. They all contain a variety of probiotics that can add to your microbiome.

You should also take a fiber supplement every day. Fiber supplements contain prebiotics that feed the probiotics—you’re feeding the good bacteria. In addition, eat foods with more fiber, and that means vegetables and fruits. Again, they can provide positive bacteria to help the microbiome if you eat them raw as well as the food the bacteria needs to thrive.

The Bottom Line

There is a long way to go until we have enough research that identifies the best strains and amounts of probiotics to take as well as the best sources. There’s always the possibility we’ll find a better way, such as eating specific varieties of fruit grown in a specific region of the world that has the right strains of bacteria. We just don’t know. But what we do know is that there are benefits to taking probiotics every day right now. I think that’s the path forward at this point for almost everyone.

What are you prepared to do today?

Dr. Chet

 

References:
1. JAMA. doi:10.1001/jama.2018.9064.
2. Cochrane Database Syst Rev. 2017 Dec 19;12:CD006095.
3. Cell Mol Gastroenterol Hepatol 2018;6:133–148.

 

Probiotics Can Cut C. Diff Rates

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The authors reported that there were 39 studies included in the Cochrane review; 33 on adults and six on children. They included studies that were in-patient, out-patient, and using varying strains and quantities of probiotics. Here’s what they found.

There was moderate evidence that the use of probiotics together with the administration of antibiotics did reduce the occurrence of C. diff. The risk of getting the C. diff infection was reduced by 60% when compared to control subjects or those who were not treated; typically about 4% of the subjects got C. diff when treated by antibiotics, and it was reduced to 1.5% when probiotics were given concurrently. The phrase “moderate evidence” is one I haven’t used before. It’s generally specific to Cochrane Reviews and is assessed using various factors, ending with a number that reflects the quality of studies included in the analysis.

There was also a reduction in abdominal cramping and diarrhea in those subjects who were given probiotics with their antibiotics compared to those who didn’t get probiotics. In this case, the quality of the research was considered of poor quality. Does that mean that the probiotics were ineffective? No. More than likely it was due to the subjective assessments of pain by individuals. You can test stool to see if C. diff is present, as would have been done in the other part of the research, but relying on people’s self-assessment of pain is less objective. (That’s why my website offers the pain scale developed by the Missoula Project; it has physical activity descriptors that make it easier to determine where you are on the scale. Look for it on the Health Info page.)

Where does that leave us? I’ll finish on Saturday with some recommendations for the use of probiotics.

What are you prepared to do today?

Dr. Chet

 

References:
1. JAMA. doi:10.1001/jama.2018.9064.
2. Cochrane Database Syst Rev. 2017 Dec 19;12:CD006095.

 

Can Probiotics Prevent C. Diff?

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Probiotic research is hot right now. Researchers are trying to figure out what these beneficial microbes can do for our health for a number of reasons. What types of infectious diseases can be prevented, whether food-borne or not? What are the best microbes to treat specific conditions? After all, there are estimated to be around 5,400 different bacteria, yeasts, and fungi. Which ones are best for an E. coli infection? Or salmonella? How about inflammatory bowel disease? Can probiotics benefit other organs in the body by not allowing negative bacteria to enter the blood stream? The questions are almost endless at this point.

We may be starting to get some answers. This week I’m going to focus on the role probiotics may play in preventing clostridium difficile, commonly known as C. diff, infections in people who’ve had to take antibiotics for different diseases. Antibiotics are beneficial when we need them but they do not discriminate; they kill microbes whether they’re beneficial or not. As a result, our gut bacteria—our microbiome—can be decimated. As a result, people who are on heavy doses of antibiotics are prone to C. diff infections. While treatable in most cases, it can have devastating effects on some people including severe pain, cramping, and uncontrolled diarrhea. Not fun!

The authors of a recent paper examined whether probiotics, administered with courses of antibiotics, helped to reduce the rate of C. diff in patients. A Cochrane Review paper examines all available studies from around the world, ranks the quality of the research, and analyzes all the data. Some of the authors of that paper published a summary of that review in JAMA. We’ll take a look at the results on Thursday.

DrChet.com

Tomorrow is the anniversary of the launching of the new DrChet.com website. This past weekend I was speaking in Texas, and several people who are Insider members said that the free monthly Insider Conference Calls were very informative and helped their personal health and the health of their family and clients. Think about becoming an Insider as we begin our second year of memberships.

What are you prepared to do today?

Dr. Chet

 

References:
1. JAMA. doi:10.1001/jama.2018.9064.
2. Cochrane Database Syst Rev. 2017 Dec 19;12:CD006095.

 

I’m Recommending a Broccoli Bath

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This week’s final question is whether cooking destroys the nutrients in vegetables. If it does, is there any method better than others for preserving the nutrient content? Let’s take a look.

Researchers examined three cooking methods with several vegetables including broccoli. The methods were boiling, sous-vide cooking, and water immersion cooking at temperatures below 212 degrees F, water’s boiling point. The objective was to see the effect on phytonutrient content of each vegetable.

Your first question is probably this: what is sous-vide cooking? I didn’t know even after all the cooking shows I’ve watched. Sous-vide is French for under vacuum. The general idea is that the food is placed in a plastic bag, air is removed by vacuum, and the food is cooked in a water bath at relatively low temperatures (130–150 degrees) for a longer period of time. A low-tech alternative is to place the vegetables in a plastic bag, immerse the bag in water until the air escapes, and submerge it in a low-temp water bath during cooking.

Which worked best? Sous-vide cooking preserved chlorophyll, carotenoids, phenolic content, and antioxidant activity to a greater extent than boiling for all of the vegetables tested. Second was cooking in hot water below the boiling point (150–160 degrees). The lower temperature improved the qualities of the samples cooked in water including the color of the vegetables. Boiling resulted in the greatest loss of the most nutrients.

If you usually microwave broccoli as we do, that’s a good method as well. It compares most closely with cooking vegetables at a low temperature as long as you cook it for as short a time and with as little water as possible. A microwave steamer is your best bet.

The important point is that cooking, including boiling, does not remove all beneficial nutrients. Probiotics will be sacrificed but some vitamins, minerals, and phytonutrients will still be in the cooked broccoli.

 

The Bottom Line

The bottom line on broccoli, as well as almost all vegetables, is that processing, whether by cutting, freezing, or cooking, will not remove the nutrients from the vegetables. The most important thing you can do is to eat them. The benefits to your body will be there.

What are you prepared to do today?

Dr. Chet

 

Reference: Food Chem. 2017 Feb 15;217:209-216. doi: 10.1016/j.foodchem.2016.08.067.

 

How to Reduce Disease-Related Pain

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The first two memos on pain were relatively easy: joints and nerves. From that point forward, it can get very challenging: Lyme disease, irritable bowel syndrome, shingles—the list of diseases that lead to pain could go on and on. To complicate matters, with the concern over opioid addiction, many people in pain don’t want to even try those medications. What do you do?

The key is to work with your physician and specialists to develop a strategy for pain relief. That will vary by disease. A medication that benefits the nerves for shingles pain may be helped by NSAIDS or other pain relievers, but NSAIDS may not be beneficial for someone with IBS; the absorption of the pain reliever may cause more bowel pain.


Two Strategies to Help

There are two things you can try that may directly or indirectly help with pain. The first is to reduce inflammation and as I mentioned on Tuesday, the supplements that may help are omega-3s, turmeric, and glucosamine. They can help reduce inflammation in more than joints.

The second would be to strengthen the immune system. Lyme disease is bacterial, shingles is a virus, and IBS is an attack on the lining of the intestines. While strengthening the immune system is not directly involved, it may assist the body in dealing with the cause and reduce the pain. To me, that means using probiotics, antioxidants such as vitamin C and E, and using herbs such as echinacea and garlic. As I said, it may not directly affect pain but may indirectly help the body cope with the condition.


The Bottom Line

The two strategies won’t work for every disease. Every form of cancer can result in different pain. Some diseases such as type 2 diabetes can impact the extremities and eyes in ways that require professional guidance. But in general, strengthening the immune system may help over the long term. That also means increasing the intake of vegetables and fruit and getting some exercise within the limitations of the condition. That’s a topic for another time.

What are you prepared to do today?

Dr. Chet

 

The Microbiome of Your Lungs

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When we think of the microbiome, it’s logical to think only of the digestive system and our skin. In reality, the microbiome includes every microbe in and on our entire body, including our lungs. At one time, the lungs were thought to be microbe free; that certainly seemed to be the case for newborns. As babies are exposed to various bacteria and other microbes, a microbiome develops in the lungs much as it does throughout the body. It seems to have the same balance of good and bad microbes, although not as extensive as the gut.

Research has shown that in serious lung conditions such as cystic fibrosis as well as chronic lung conditions such as asthma and allergies there’s a dysbiosis of the lung microbiome. In other words, the lung microbiome is out of balance.

What can be done to restore the balance? Nothing other than traditional treatments for now, but this is an area of great research interest. I believe that focusing on eating foods with probiotics as well as prebiotics can help our entire microbiome, not just our gut.

Vegetables, beans, yogurt, fermented foods, and fruit should still be the foundation of our diet. Whether it helps the lung microbiome is not known, but it will help the gut microbiome. As we know, what helps the gut microbiome can influence other parts of the body; it’s reasonable to believe that it just may help the lung microbiome as well.

What are you prepared to do today?

Dr. Chet
References:
1. JAMA. 2017;317(17):1713-1714. doi:10.1001/jama.2017.3023
2. http://www.news-medical.net/life-sciences/Lung-microbiome.aspx

 

What’s Wrong with Processed Foods

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If you do an Internet search for processed foods, you’ll get a whole lot of opinions on why they’re a bad thing. There isn’t a substantial amount of research behind the opinions when you look closely. In fact, there isn’t a substantial amount of research on processed foods at all and why they’re difficult to resist. Keep in mind that I’m talking about extensive processing; fruits and vegetables that are frozen immediately have been shown to have more nutrients than fresh produce that’s been sitting in the grocery display case for a while, and canned fruits and vegetables are a close second.

What’s the problem with processed foods, other than the fat, sugar, and salt? Two things stick out in my mind. First, the act of processing alters the vitamin, mineral, and phytonutrient content of the foods. Whether we’re talking about grains such as wheat or corn, beans such as soy, or dairy such as milk, some if not most nutrients are lost in the processing.

Second, you lose the fiber, and given how little fiber adults get, that might be the most serious loss of a nutrient. Fiber acts as a prebiotic to feed the microbes in our gut and helps with satiety and digestion. Breads, pastas, rolls, bagels, and every other processed food that uses grains come up short.

I’ll add one more to the list: probiotics. Processing destroys the good bacteria and other microbes that are valuable to our health. It isn’t just what we are getting in processed foods that harmful; it’s what we’re not getting that compounds the problem.

What’s the solution? I’ll finish this up on Saturday.

What are you prepared to do today?

Dr. Chet