The gut microbiome is made up of a community of microorganisms that includes bacteria, viruses and fungi. Most of these microbes are beneficial and keep us in good health by helping to fight off infection and break down food. Searches on how to boost the gut microbiome often point to probiotics – the so-called “good” bacteria found in food or supplements that are believed to restore balance, particularly after a round of antibiotics or a bout of irregular bowel movements.
In today’s booming wellness market, a multitude of probiotic pills lines the shelves of health stores, but do we need a dietary supplement to populate our gut with good bacteria, and are they as effective as we are led to believe?
Opinions from the scientific community are – as so often in matters of diet – more nuanced than definitive. Emeran Mayer, a UCLA gastroenterologist and brain-gut-microbiome expert, tells us, “If you are on a diet rich with different types of fermented foods (kimchi, kombucha, yoghurt, kefir or sauerkraut), there is no need for an additional supplement.” Professor Tim Spector, co-founder of ZOE and one of the world’s leading experts on nutrition, is of the same opinion, and points out that there are added benefits to the food-first approach. “When we consume fermented foods that naturally contain probiotics, we also get the benefits of the food itself,” he says. “In the case of fermented plants, this includes fibre and hundreds of healthy compounds, which also support our gut bacteria and overall health.”
He adds that “supplement manufacturers often choose probiotic strains based on which species are most convenient to use rather than evidence that they benefit health. So, regularly eating a diverse selection of probiotic foods is a good way to hedge your bets – you’ll consume a wider range of probiotic strains while benefiting from the fibre and plant chemicals.”
To understand the limitations of off-the-shelf probiotic supplements, we need to take a closer look at the gut, and it is personalised nutritional programmes like ZOE that have given us a consumer-friendly insight into just how complex the microbiome is. Now, more than ever before, we understand that each person has a unique network of microbes shaped by early life as well as lifestyle factors including diet and geographical location. When asked about the efficacy of supplements, Mayer notes, “The same microbes may not be effective in everybody, and based on current knowledge, the effectiveness of a particular microbe is likely to depend on the unique composition and function of the gut microbiome of a particular individual.” He adds that, “Until we are able to design custom cocktails of probiotic strains that match an individual’s microbiome and evaluate their effectiveness, it may be impossible to demonstrate significant benefits in clinical trials.”
This seems to be the sticking point with probiotic supplements. Despite the marketing hype by some companies, it is not yet possible to address individual gut health needs with reliably effective personalised products. As it stands, there is a lack of evidence to support claims made by brands, meaning they are often unsubstantiated. Spector comments, “It’s not as easy as simply providing bacteria that we think are beneficial – how that species interacts with other species in your gut and your unique metabolism is also important.”
While the advantages of generic probiotic supplements sound rather slim – and truly customised alternatives are still in development – there is some evidence of their benefits in treating minor digestive issues like indigestion and bloating, and clinical studies suggest that certain strains – particularly Lactobacilli and Bifidobacteria – can help treat diarrhoea caused by antibiotics.
Looking to the future, Spector is optimistic that probiotic supplements will become very effective once we start to personalise them; however, he says that “first we need to untangle the complex relationships between individual species of bacteria and human health, which is no mean feat”. For the time being, the advice is to focus on eating foods that will help gut microbes flourish, and following a predominantly plant-based diet consisting of a wide variety of fruits, vegetables, whole grains and fermented foods is considered to be the most reliable way to maintain a thriving microbiome.
Set on a verdant island just 30 minutes from Bangkok’s international airport, RAKxa offers comprehensive seven- or ten-night Gut & Immunity Support Programmes, in which extensive medical assessments and expert consultations give rise to a wide range of treatments and therapies, from traditional Thai Ya-Pao to detoxifying yoga and hyperbaric oxygen therapy.
Kamalaya combines the traditional healing principles of Ayuverda and TCM with the latest findings in nutrition. The Enriched Gut programme aims to reduce inflammation and restore balance through a combination of healthy cuisine, herbal remedies and holistic therapies, including stimulating abdominal massage and yoga.
Photo: Kamalaya Koh Samui
This at-home test delivers an inside look at blood fat, blood sugar and gut microbiome health. Based on your results, the Zoe team will teach you how to swap, add and combine foods so you can eat in the best way for your body.
At this Austrian health resort, testing the microbiome plays a crucial role in shaping effective treatment plans by providing valuable insights into individual gut health. During the one- to two-week programme, the team assesses and works on not just nutrition but movement and mental strength, too.
Another at-home test that measures what’s happening inside your gut microbiome. Viome results look at the presence of live microorganisms but also their activities, such as producing harmful toxins or beneficial nutrients.
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