PROBIOTICS ARE LIKE DOGS

by drnieman on June 11, 2019

in Monthly

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Not so long ago I read a story about a man who spent all his energy to climb up a ladder. It was a long and difficult ladder to climb, but he gave it his best efforts and finally made it to the top…only to discover it was leaning against the wrong wall.

This story illustrates the truth about probiotics. Many parents have been told to give probiotic drops to restore the good bacteria in the large bowel. But does it lead us up the right wall?

We now know that the gut microbiome has changed quite a bit over the past 50 years. In the old days, antibiotics were not as strong, there were fewer classes of antibiotics available, people were consuming real food, high in fiber, caesarean sections were not performed as often as they are today, and the stool pH was lower then, than it is now.

A higher stool pH provides less protection against certain pathogens. It has also been associated with a higher incidence of diaper dermatitis.

Not all probiotics pass the test of time like B. Infantis.  I have learned that to say “probiotic” is like saying “dog.” There are many different species and sizes all with different functions and at times vastly different—like the difference between a Great Dane and a Chiwawa.

Researchers from the University of California at Davis studied the impact of a specific probiotic known as Bifidobacterium infantis ( B. infantis) on the gut microbiome and found that if it is given to babies regularly for the first 100 days of life there are many benefits: the stool pH is lower and resembles the pH of healthier fecies in the past; babies were less gassy and slept better, and the babies were at a lower risk for the development of asthma and allergic dermatitis later in life.

The large bowel is covered by mucus. This is known as the mucin layer. In the old days terms such as “leaky gut” brought tears of frustration to the eyes of some traditional allopathic clinicians. Know they know better. It is indeed possible for the integrity of the mucin layer to be improved and thus provide better protection against bacteria and other toxins which may enter the body via the gut. Research confirmed that babies exposed to B. infantis have a stronger mucin layer.

 Birth via Caesarian section deprives the baby from getting colonized and swallowing healthy bacteria when passing through the birth canal. Because it is not always clear in advance when a mom will need a Caesarian section, some researchers thought it may help to provide the mom prior to delivery with probiotics, hoping the benefits can be passed on the baby. So far it does not seem to be a good idea.

Though breast feeding is a good idea there is a difference between a baby consuming mom’s milk from the breast and expressed milk from the same breast. The areola area specifically—and not just the nipple—provides additional exposure to ideal bacteria.  B. infantis is found in great numbers in breast milk. It is very difficult to provide a similar situation by giving a formula.

Although the research on B infantis specifically looks promising, is there a certain link between a bowel colonized with healthy bacteria and a lower risk of allergies and inflammatory conditions later in life? Perhaps is it more like three minutes with a 1000-piece jig saw puzzle– the final picture is far from certain.

Some medical schools are moving gradually in the right direction in terms of educating future doctors about the good gut. At Stanford, authors Justin and Erica Sonnenburg, both PhD experts in gut health, and internationally respected for their research, wrote a book with the title “The Good Gut” In the foreword Dr. Andrew Weil states “I consider this work essential reading for all health professionals and for everyone interested in a broader understanding of health and wellness”

Because this field is constantly shifting and as new information unfolds at a dizzying speed, the Sonnenburgs provide very useful and comprehensive updates via their website (http://sonnenburglab.stanford.edu/

Many patients tell me they are too busy to sit down with a book or by a computer—they like to learn on the fly and find podcasts more user-friendly. The Exam Room podcast on May 15 is a recent resource I have found very helpful. This podcast specifically focused on how dysbiosis (unhealthy gut bacteria) predispose humans to weight gain.

In a complex world I am increasingly interested in simplicity and common sense. In the context of a healthy gut—for children and adults—I advise more fiber and thus more raw fruits and vegetable which have been shown to improve the production of healthy gut bacteria.

The recent enthusiasm for kombucha consumption requires much more research, before we can be 100% certain of its true usefulness. Meanwhile, enjoy its refreshing taste after a long workout!

DR. NIEMAN IS A PEDIATRICIAN IN CALGARY AND THE HOST OF A BLOG POST ON LIFESTYLE MEDICINE. SEE WWW.DRNIEMAN.COM FOR MORE INFORMATION

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