[5 min read] Gut microbiome: Prebiotic and probiotic treatments

Our knowledge of the human gut microbiome has grown rapidly in the last decade. Compelling evidence supports the use of probiotic and prebiotic treatments to support health and wellbeing in primary care settings.

Did you know that gut microbes represent over 50 per cent of the cells in the human body (1)? The gut microbiome refers to the complex community of bacteria, viruses, and fungi that live the gastrointestinal tract (2). While bacteria are often pictured as harmful, gut bacteria are beneficial and can make a huge difference to an individual’s physical and mental wellbeing.

A healthy gut contributes to effective digestion and absorption of nutrients from food, promotes the development of a strong immune system, and contributes to metabolic functions essential to the prevention of disease and dysfunction (3, 4). Imbalances in the gut microbiome can increase inflammation and lead to the development of metabolic disorders, liver disease, certain mood disorders and autoimmune conditions (5).

Diet and nutrition are a major factor shaping the microbiome, from infancy to old age (6).  Prebiotics and probiotics are a popular dietary approach to modify gut bacteria, as they are affordable, effective and accessible. But what are these nutrients, and how can you implement them in your general practice?

What are probiotics?

Probiotics refer to “good”  bacteria and yeasts that restore and support the good bacteria in the digestive system (7). They are found yoghurt, kimchi, and other fermented foods, and can be taken as dietary supplements. Probiotics can help repopulate the beneficial bacteria in the gut, for example after taking a course of antibiotics. Probiotic treatments have also shown promise for the prevention and management of gut symptoms such as bloating and inflammatory gastrointestinal conditions such as Crohn’s disease and irritable bowel syndrome (8).

What are prebiotics?

Prebiotics refer to certain carbohydrates that cannot be digested by the body and instead feed and enhance the growth of good gut bacteria (9). They include fibre such as inulin and oligosaccharides, which are found naturally in foods such as whole grains, legumes, garlic, and bananas. When these foods are eaten, the prebiotics stay intact through to the large intestine, where bacteria break the fibres down (fermentation) and use them as fuel to reproduce, leading to larger populations of good bacteria (10).

Supporting a healthy gut microbiome

Probiotics and prebiotics can be used as tools to manage the balance of the gut microbiome. It is important to recognise that individuals have unique microbiomes and that treatments will depend on many factors such as digestive health issues, diet, and lifestyle. Patients who seek specific advice should be referred to an Accredited Practising Dietitian for personalised nutrition care. General strategies for a healthy and happy gut include:

  • Eating prebiotics such as apples, bananas, and oats.
  • Eating natural sources of probiotics such as plain yoghurt, kimchi, and kefir.
  • Avoid taking unnecessary antibiotics.
  • Drink water, especially if eating more high-fibre foods.

Learn more about how prebiotic and probiotic treatments can be incorporated into your practice in the online Professional Diploma Program in Medical Nutrition.

– Lynette Law, Bond University

See more recent research.


References

  1. Sender R, Fuchs S, Milo R. Revised Estimates for the Number of Human and Bacteria Cells in the Body. PLoS Biol. 2016;14(8):e1002533.
  2. Bull MJ, Plummer NT. Part 1: The Human Gut Microbiome in Health and Disease. Integr Med (Encinitas). 2014;13(6):17-22.
  3. Evans JM, Morris LS, Marchesi JR. The gut microbiome: the role of a virtual organ in the endocrinology of the host. J Endocrinol. 2013;218(3):R37-47.
  4. Durack J, Lynch SV. The gut microbiome: Relationships with disease and opportunities for therapy. J Exp Med. 2019;216(1):20-40.
  5. Sidhu M, van der Poorten D. The gut microbiome. Australian Family Physician. 2017;46:206-11.
  6. David LA, Maurice CF, Carmody RN, Gootenberg DB, Button JE, Wolfe BE, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature. 2014;505(7484):559-63.
  7. Slavin J. Fiber and prebiotics: mechanisms and health benefits. Nutrients. 2013;5(4):1417-35.
  8. Tsai Y-L, Lin T-L, Chang C-J, Wu T-R, Lai W-F, Lu C-C, et al. Probiotics, prebiotics and amelioration of diseases. Journal of Biomedical Science. 2019;26(1):3.
  9. Carlson JL, Erickson JM, Lloyd BB, Slavin JL. Health Effects and Sources of Prebiotic Dietary Fiber. Curr Dev Nutr. 2018;2(3):nzy005-nzy.
  10. Singh RK, Chang H-W, Yan D, Lee KM, Ucmak D, Wong K, et al. Influence of diet on the gut microbiome and implications for human health. J Transl Med. 2017;15(1):73-.

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