No longer taken solely by granola-crunching hippies or relegated to health food store shelves, probiotics are now as ubiquitous as multivitamins. But with each brand touting different strains, CFU counts and delivery systems, how can health conscious consumers choose the right one? Here, we consult with nutrition experts to get the scoop on what you should be looking for on labels, to ensure that you get the most probiotic bang for your buck.
CFU count: In probiotic-speak, “CFU” is short hand for colony forming units, which basically measure the actual amount of probiotic bacteria being ingested. The amount ingested is not nearly as important as the amount that actually makes it into your intestinal tract, however, and it is for this reason that CFU are measured in the billions, with higher doses generally making for a more potent product. “In a standard probiotic supplement, it is inevitable that a certain percentage of probiotic bacteria will be destroyed by stomach acids,” says Gene Bruno, MS, MHS, Provost and Chief Academic Officer of the Huntington College of Health Sciences. “The higher doses help assure an adequate quantity of these microorganisms will make it through intact to provide their benefits. Within the range of 5-10 billion cells or CFU is common. Higher doses may be indicated for shorter periods of time, however, if a specific medical need is being addressed.”
While the 5-10 million CFU range is enough to maintain an already healthy intestinal environment Bruno recommends doses of 30-50 billion CFU for some cases of inflammatory bowel disease. Other conditions that can be treated with higher probiotic doses include eczema, allergies and some respiratory illnesses. It is important, however, to speak with a physician well-versed in integrative/alternative medicine before trying to treat a condition yourself.
Delivery system: At the end of the day, even if a probiotic’s CFU count is in the double-digit billions, it’s all moot if the product suffers from a shoddy delivery system, preventing the bacteria from ever reaching their intended destination. Conversely, a superior delivery can more than compensate for a product with a lower CFU count.
The delivery systems of probiotics vary as widely as the brands that manufacture them, and can range from liquids to powders and, most commonly, pills. On the pill front, there are those with enteric-coating (a polymer barrier made from fatty acids, waxes, shellac, plastics or plant fibers that protects oral medications from stomach acid), alginate coating and, as Bruno prefers, BIOtract. “BIOtract is a patented technology that protects the majority of a supplement’s probiotics from gastric acid, helping to ensure that a significantly higher percentage of microorganisms reach the intestines alive,” he says.
There are also supplements with delayed-release technology, thus ensuring more efficient delivery of the bacteria to the intestine. Whatever the choice, it’s important to choose a probiotic that specifically states it will reach its destination.
Bacteria source: These days, a casual stroll through any neighborhood grocery store will turn up numerous products made with fermented ingredients – including kefir, kimchi, tempeh and sauerkraut – and, according to celebrity trainer and nutritionist Fadi Malouf, these foods are some of the best probiotic sources available. “Fermentation is an amazing process that has many health aspects,” he explains. “It helps with digestion, and it provides important nutrients that include the elusive Vitamin B that many vegetarians are missing because they do not consume meat products. And fermented products also contain the good bacteria, probiotics.”
For folks who like their probiotics in supplement form, there are soil-based and vegetable-based varieties, says Melanie Angelis, a nutrition expert with a masters of science in complementary alternative medicine, and soil-based are generally preferred. “Soil-based probiotics like Prescript Assist more closely resemble the diversity of gut flora we’re supposed to obtain as children playing in the dirt,” she adds. “[We don’t obtain these flora] because of sterile c-sections as opposed to vaginal births, anti-bacterial hand soap and other factors that are harmless in themselves, but lead to a colon with not enough healthy germs. People are also more likely to tolerate soil-based probiotics from a digestive and allergen standpoint.” Another benefit of soil-based probiotics? They don’t have to be refrigerated.
Celebrity nutritionist and New York Times bestselling author Kimberly Snyder is also a fan of soil-based organisms and developed her new line of probiotics, Probiotics+, around them. “In the case of probiotics, it turns out that nature has a perfect solution for probiotics — and it’s found in the soil,” she writes in her blog. “Just imagine being alive 3,000 years ago. One of your food sources would be wild plant leaves and fruits grown natively in your area. You would pick them, and then eat. And on the surface of those fruits and vegetables, there are natural, invisible probiotics called Soil-Based Organisms (SBOs)… SBOs are what we’d normally find in nature–when eating organic food from your garden, or a berry in the wild. They are mother nature’s first digestive and immune system aid.”
Probiotic strains: If attempting to read the ingredients in a bottle of probiotics has you feeling like you’ve been trapped in a foreign country with no translator, you’re not alone. All of the different bifido- and lacto- strains can look like jibberish and mean absolutely nothing to the lay shopper.
“The most common strains that you’ll find at pharmacies are bifidobacterium and lactobacillus; these benefit digestive health and will be helpful for about 80 percent of the population,” explains Dr. Their Raby, MD, founder of the Raby Institute for Integrative Medicine and a pioneer in the field. “However, those with a high sensitivity to dairy – these strains are grown on dairy products – or very specific ailments may want to consider a probiotic with bacteroides, a soil-based strain that can offer a wider range of microorganisms. And for those taking antibiotics, it’s good to start a Saccharomyces boulardii probiotic while still taking the antibiotic. This is a yeast strain rather than bacteria and can help prepare the internal environment to welcome new “good” bacteria back into the body once the antibiotic has done its job of clearing bacteria from the body.”
Raby recommends Swisse Ultiboost Inner Balance, a product that can be found nationally at Walgreens stores. “It contains 35 billion strains, which is a higher potency than you would likely find in other products on the same shelf, and it includes a clinically-evidenced premium strain of bifidobacterium lactis, which is important to ensure the safety and efficacy,” she adds.
Searching for the right probiotic for your specific needs will certainly take some time and effort, but one thing’s for sure: It’s worth the trouble.
“Research on probiotics is fascinating,” says Malouf. “In short, they are the best line of defense your body has from infection. Most people do not realize it, but the gut carries as much as 70% of your immune system, and in your gut sits millions – if not billions – of bacteria. Probiotics are good bacteria and should remain in high levels in your gut; I recommend consuming natural and supplemental probiotics on a daily basis.”