The Science of Digestive Health (Digesting the Facts: Probiotics, Prebiotics and Enzymes for Improved Digestion)

New research in the field of probiotics continues to unfold great opportunities. For example, researchers at University College London found Lactobacillus casei Shirota may restore the immune function of white blood cells in alcoholics.⁴¹ A yogurt fermented with Lactobacillus delbruekii var bulgaricus and Streptococcus thermophilus was supplemented with L. rhamnosus GR-1 and L. reuteri RC-14 can ease the suffering of diarrhea and nausea in individuals with HIV and AIDS.⁴² On the heels of a report that L. rhamnosus reduced the duration of gastrointestinal symptoms in marathon runners,⁴³ another study found Lactobacillus fermentum may boost immune health and protect long distance runners from respiratory illnesses.⁴⁴ In a pilot study, daily ingestion of a delayed release, four-species probiotic supplement (Immunobiotix®, from Nutraceutix) over an eight-week period could enhance innate immune function.⁴⁵

“Probiotics are hot, and not just for digestive health,” said Gamble. “There is a wealth of research, both past and present on the digestive health benefits of probiotics; however, there is increasing evidence and interest in the system benefits of probiotic supplementation particularly in the area of immune system stimulation and weight loss.”

Henri Durand, R&D director, Institut Rosell-Lallemand, added the future holds promise for new probiotic innovation and findings. “Strain selection is evolving, thanks to the advent of molecular genetic-based technologies we now have a different approach for strain selection and identification,” he said. “By applying genomic and metabolomic studies at both bacterial and host cells level, we are able to analyze precisely the properties and function of a probiotic strain, as well as their potential effects on gut epithelium, for example, and select the best strains. Thanks to the predictive power of these tools we are moving from a trial and error selection strategy toward rational strain selection.”

Bolstering the Effects

Prebiotics have a key role to play in the digestive arena, serving as a natural food for probiotic bacteria, thus supporting their growth. “Probiotics are live bacteria that confer a benefit when consumed in sufficient quantities,” Shahani said. “Prebiotics are substances, primarily certain kinds of carbohydrates that act as a stimulus or ‘fertilizer’ for the probiotic bacteria.”

Researchers from the Dundee University Gut Group reviewed published evidence for prebiotic effect on gut function and human health.⁴⁶ They found three prebiotics—oligofructose, galacto-oligosaccarides and lactulose—alter the balance of the large bowel microbiota by increasing bifidobacteria and Lactobacillus numbers.

Regularly consuming short-chain fructooligosaccarides (sc-FOS, as NutraFlora® from GTC Nutrition) was found to improve digestive comfort in a working population not undergoing medical treatment in a comparative double blind trial with 2,235 subjects.⁴⁷

Supplementation with the prebiotics inulin and oligofructose may extend one’s life by more than 30 percent, according to a study that evaluated male and female rats fed a prebiotic-containing diet.⁴⁸ The researchers also noted the animals had lower body weight, cholesterol and plasma triglycerides compared to rats fed the control diet.

A synbiotic product contains both a probiotic and a prebiotic ingredient. “Combinations of prebiotics with probiotics offer better opportunities for the probiotic bacteria to grow,” noted Dash. “They can then multiply faster in the gastrointestinal tract as prebiotics selectively feed probiotics. Since yeast and pathogenic cultures are absent, and the probiotic product has its own supply of prebiotics, this is an excellent choice for yeast sufferers.”

In a randomized, double blind crossover trial, 53 adults were randomly assigned to receive either daily supplements of placebo or oligofructose (Orafti P95, 6.6 g/d) and probiotics (Lactobacillus fermentum Me-3, Lactobacillus paracasei 8700:2 and Bifidobacterium longum 46) for three weeks.⁴⁹ The researchers reported total antioxidant activity in subjects receiving the synbiotic product was higher than the placebo: 42.4 vs. 41.9 percent. Additionally, levels of oxidized low-density lipoprotein (LDL) cholesterol were reduced, suggesting a combination product could reduce levels of biomarkers linked to oxidative stress.

“The combination of probiotics and prebiotics is promising,” Gamble said. “Reviewing the current literature, it would seem that supplementation with probiotics and prebiotics is best done in two steps. First, supplement with quality probiotics to establish intestinal balance and reduce the presence of pathogenic bacteria. Then, if desired, a prebiotic can be added to a regimen.”

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