Probiotic has become more than just a buzzword in the last few years, with countless books, articles, research papers and TV shows putting the microbiome under the microscope.
This article won’t painstakingly document everything you need to know about gut health. Instead, we want to ask which is the best form of probiotic to take, insofar as such a question – simple on the face of it – can be answered.
Should those looking to boost gut health pop a probiotic pill, binge on sauerkraut or guzzle kombucha? What about probiotic yogurt, probiotic water or probiotic powder?
There is no shortage of probiotic options out there, but which is the best? Which contains the most ‘friendly’ probiotic bacteria, and which are healthiest to take on a regular basis? Read on to find out.
Firstly, let’s give a very brief summary of what a probiotic is. Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. Everyone got that? OK.
Our gut microbiota – the name given to the microorganisms living on or in us – numbers in the hundreds of trillions, but as for bacteria specifically, there are thought to be several thousand species. Break it down into individual gut microbes and you’re looking at anywhere between 30 and 400 trillion.
Not all of these microbes are probiotic, of course. Probiotics are healthful bacteria recommended to restore balance to a gut which is, so to speak, unbalanced, with ‘friendly’ bugs in short supply.
Imbalance, or dysbiosis, can occur due to many lifestyle factors, stress, diet, exercise levels, underlying health conditions and antibiotic consumption.
Probiotics encompass a vast range of bacterial strains, with those from the genus Lactobacillus and Bifidobacterium most commonly touted for their health benefits.
If you’ve passed through your local supermarket’s dairy section recently, you won’t have failed to notice the dazzling assortment of probiotic yogurts and drinks (hello, kefir) now on display. Probiotic water has hit the market too.
Probiotics can also be found in aged cheeses and traditional cultured buttermilk and, beyond the dairy aisle, in kimchi, kombucha, sauerkraut, miso, natto and tempeh.
The sudden proliferation of probiotic-rich food and beverages is only new to an extent. While there are more products than ever, oftentimes the manufacturer has simply added the word ‘probiotic’ to the label, capitalising on the fact that probiotics are now in vogue.
Probiotic food and drink represent decent options, although you should scrutinise the label as very many contain sugars – which are harmful to gut bacteria.
While one cup of sauerkraut contains around three billion CFUs of probiotic bacteria, most quality-brand probiotic yogurts deliver a similar amount and a litre of kombucha slightly less, about half a billion.
The vast majority of dietary probiotics contain, on average, anywhere between five and ten billion ‘friendly’ bacteria per serving.
To warrant the coveted ‘Live and Active Cultures’ sticker, yogurt manufacturers in the EU must ensure their product contains a minimum of 100 million CFU per gram of live bacteria.
There is some debate about how much probiotic bacteria is needed to exert a beneficial effect. According to Derrien and van Hylckama Vlieg (2015), 10 billion bacteria is needed to stimulate an effect on the microbiota and host health.
For more information about dietary sources of live organisms, and their respective probiotic content, this 2018 research paper is a great resource.
Almost all probiotic supplements come in tablet form, although some of the higher-strength options are supplied as powdered sachets instead. In the latter case, sachets can be mixed into yogurts or sprinkled into cold drinks.
As with probiotic foods and beverages, there is much disparity in terms of CFU count with probiotics. You can walk into a pharmacy and buy a supplement professing to contain a billion probiotics; or grab the next one on the shelf boasting 500 times that amount.
If Derrien and van Hylckama Vlieg are to believed, you should disregard any supplement containing less than 10 billion CFU right off the bat. Having said that, even a capsule or tablet containing 10 billion bacteria is going to be outmatched by at least 1:3,000 in the gut.
The microbiome is a famously competitive place, with exogenous bacteria vying for territory held by entrenched microbes. (And that’s if the bacteria even survive the inhospitably acidic environment of the stomach.)
What’s more, most probiotic supplements contain bacteria and yeasts that are not intuitive to the human gut. Bacteria cultured from the dairy industry is not uncommon. You might be able to count on one hand (and certainly on two hands) the number of commercially-available probiotics that are, in any sense, worth your time.
Progurt is a high-strength, multi-species probiotic supplement whose bacteria is 100% human-derived. A single Progurt sachet contains one trillion Colony-Forming Units, including commonly missing or fragile strains which are able to replicate and colonise in their familiar environment of the human gut.
Because Progurt contains twice as much probiotic bacteria as its closest competitor, it should be the #1 choice of supplement.
Although some may question the wisdom of “stronger is better”, the evidence appears to bear this out. First, there was the 2018 Israeli study which showed that after taking a daily probiotic containing 5 billion CFU, the microbes either “passed right through” the volunteers or briefly lingered before being crowded out by fiercely competitive resident microbes.
In 2019, another study compared a 7 billion CFU probiotic to a 70 billion probiotic and showed that people who ingested the latter enjoyed “higher, earlier and longer recovery of the probiotics in their feces.”
The probiotic market is a bit of a minefield, but it’s good that this discussion is even taking place. For too long, people have neglected to factor their microbiome into the equation at all. More and more, scientists and nutritionists are coming to regard the gut as our true seat of health, with the population of microbes living there profoundly influencing our brain, heart and nervous system.
The best advice might be to follow a sensible probiotic- and prebiotic-rich diet, and use supplements as and when required. Just remember that there are many factors which affect the microbiome, not least age, diet, antibiotic intake, food supplements, medical conditions and patterns of circadian activity. If in doubt, consider working alongside a dietitian to ensure you’re getting all the probiotics you need.
According to Derrien and van Hylckama Vlieg (2015), 10 billion bacteria is needed to stimulate an effect on the microbiota and host health.