Do you really understand how to use Probiotics and do strains matter ?

Do you think you have been fed a few misstatements about probiotics ? If you have been you probably aren’t the only one! There were a few myths busted at a recent conference that I have also been guilty of believing in recent years. So what were those myths and what’s the real story ?

Have you ever been told that your probiotics need to be kept in the fridge ? (Was it me?) Turns out that many strains are heat resistant and don’t need to be kept in the fridge including the range from Activated Probiotics. Probiotics are living organisms and so are sensitive to heat, moisture and oxygen, however if appropriately treated and packaged the product is heat stable. Activated Probiotics freeze dry the probiotic and use specific packaging technology to encapsulate it so that it survives stomach acid and is effective in the gut. The best advice generally is to follow the advice on the packaging, however when travelling a heat stable option is usually better as its less likely to be left behind (in the mini bar fridge!).

The other common myth is that you should take probiotics separately from antibiotics or even after you have finished the antibiotics. Actually since antibiotics are designed to be absorbed into the bloodstream and probiotics into the gut then it really doesn’t matter. For the best result with probiotics ideally they are taken with food and that food contains a little fat.

For many people they may be a little concerned about taking medications with probiotics so it might be a good idea to review the strategies in my recent blog Are your medications impacting your ability to age outrageously well? . When you do have specific side effects from your medications probiotics can be of use in managing those symptoms where they is specific research to support use for those conditions.

One of the big ones is that probiotics replace “lost bacteria” but it turns out that whilst probiotics have a therapeutic effect they do not stay permanently in the gut. Estimates of how long the probiotics will last are usually between 1-3 weeks. The point is that whilst the strain is there it is having a therapeutic effect, for example a lactobacillus plantarum strain which is anti-inflammatory and has been shown to reduce the symptoms of IBS. Therapeutically we might use this strain whilst making dietary changes to reduce systemic inflammation, so that you do not need to be on a probiotic permanently.

This probably brings us to the biggest myth – isn’t a mix of strains better ? Really it is a bit like spraying buckshot you might get lucky but the reality is a specific strain or strains based on the research and your signs and symptoms will result in better outcomes for you.

So what about prebiotics should I just take those instead ? A prebiotic is different to a probiotic, the easiest analogy is that its a bit like fertiliser in the garden. It doesn’t create a broader range of plants but it does feed the useful ones. If you want to improve the diversity of your gut flora you really need to look at supporting it with a wide range of vegetables as well as nuts and seeds. What are the best vegetables for feeding your gut ? covers this topic in more depth but in addition to variety of vegetables it is also useful to add in organic sources as much as possible.

For more information on maintaining or improving your health have a look at my program Ageing Outrageously which covers six key areas for ensuring that you age well. These include improving brain health, balancing blood sugar, improving gut and digestion as well as strategies for assessing and monitoring your health. The program has been designed for people who may not have the time or resources to work with me directly but would like to invest in improving their health. The program cost of $249 is similar to the cost of my initial appointment but you can run through the program under your own pace at home and it covers content from a series of 6-8 appointments .

Supporting Vaccinations holistically

Are you planning to get the vaccine shortly ? Are you on a priority list? As Australia moves to the 1B list approximately 6 million Australians will now be offered either the AstraZeneca or the Pfizer vaccine . Both of these will require two shots over a period of up to 12 weeks.

If you are in a position where you can take up the vaccine then it may be useful for you to consider how you can support yourself to ensure that you minimise side effects and that you produce antibodies. To a certain extent these are new vaccines and information is being slowly developed on the optimal way to support clients through the process so this blog is based on the most recent information released.

First up protocols may change slightly between the two different vaccines due to the different composition of the components. The Pfizer vaccine is based on using messenger RNA whereas the AstraZeneca vaccine uses a virus vector based on an adenovirus. Both have clinical trials that show an efficacy rate that is much higher than the annual flu vaccine, Pfizer is estimated to be above 90% and the Astra Zeneca has had a recent trial showing an efficacy rate of 79%, interestingly it appears that a longer gap between doses appears to improve efficacy.

The common ground is the need to support the immune system to have a reasonable but not excessive response, regardless of which vaccine is given. It is recommended is that you ensure that Vitamin D levels are adequate and that you take both prebiotics and probiotics to support immunity for up to two weeks before and two weeks after each round of vaccination.

What sort of dosing is appropriate? Generally around 1-2000 IU of Vitamin D3 as well as a reasonable dose of prebiotics and at least one capsule a day of a reasonable quality probiotic, with a good variety of strains.

Vitamin D levels will be lower for you if yo are just coming out of Winter and a higher daily dose like 2000IU would be helpful.

First up what are prebiotics and how much should you be taking? Prebiotics are fibres which assist in the proliferation of beneficial bacteria. Prebiotics are available in supplement form , such as partially hydrolysed guar gum (PHGG) and larch. Prebiotics contain insoluble fibres which feed bacteria in the colon. Prebiotics are also sourced from fruit and vegetables, so a useful way to increase prebiotics in the diet is to make sure you are having three cups of vegetables a day from a variety of sources. Ideally have one cup each of brightly coloured vegetables, one cup of brassica and one cup of leafy greens. More information is in this blog about What are the best vegetables to feed your gut bacteria .

Adding probiotics which support the immune system can also be really useful and ideally you need to select strains which will compensate for any underlying gut dysbiosis. In a relatively healthy individual a broad strain probiotic with at least 5-10 billion colony forming units (CFU’s) for two weeks pre and post vaccine should provide good support. Strains which can be helpful include Lactobacillus Rhamnosus and Lactobacillus Paracasei as these can modulate the immune response to an appropriate level.

Fermented foods such as yoghurt, sauerkraut and pickles also contain useful probiotics however it can take a long time to build up levels so it is probably preferable to add a suitable probiotic in at this point.

It may also be helpful to just ensure that you are in the best condition possible before you are vaccinated. Ideally make sure you are getting 7-8 hours of good quality sleep, exercising regularly and eating an anti-inflammatory diet. If you are taking a number of medications, particularly those that affect your digestion, it might be a good idea to see a practitioner and work on your overall health before you vaccinate to assist in an appropriate immune response.

A reasonable percentage of people will experience some side effects as a result of the vaccinations. These could just be soreness at the vaccine site, which is fairly common or 24 -48 hours of flu like symptoms. At the moment based on the few vaccinations I have been able to support I have found the homeopathic Gelsemium in a 30c or 200C potency given every two hours for three doses and then as needed to be helpful in managing side effects. The advantage of using homeopathics in this instance is that it will not interfere with the vaccine process.

Christine Pope is an experienced Naturopath and Nutritionist based at Elemental Health at St Ives. She is available for appointments on Tuesdays and Wednesdays and can be contacted on (02) 8084 0081.

What are the best vegetables for feeding your gut ?

Eating six serves of vegetables a day is a good way to feed your microbiome but are there better choices ? Actually it depends on what is going on with your gut so lets look at six different types of prebiotic fibres from vegetables. They all have different roles so the activity should give you an idea of what may be helpful for you and then you can determine if you may need to increase your consumption of one of these groups.

Six types of prebiotic fibres are inulin, pectin, galactooligosaccharides (usually referred to as GOS) , arabinoxylan, resistant starch and proanthocyanidins.

Inulin is found in artichokes, asparagus, garlic, onions and leeks, bananas, grapefruit and peaches. Inulin as a prebiotic fibre decreases the desire for sweet and fatty food and increases the feeling of fullness after a meal. A small study reported by the American Journal of Clinical Nutrition showed a 3.8 fold increase in the beneficial Bifidobacterium from consuming inulin for 3 weeks. (Vol 109, Iss 6, June 2019, pp1683-1695).

Pectin is found is peas, beans, carrots, potato, beetroot, tomato, eggplant, lentils and pumpkin as well as fruits such as banana, apples, berries, pears, apricots, lemons and kiwifruit. Increasing foods containing pectin is associated with an increase in the range of bacterial species in the gut as well as a specific increase in beneficial strains such as F praausnitzii which is anti-inflammatory. It is also considered a marker for good gut health.

Galactooligosaccharides (GOS) are found in most legumes such as green peas, lentils chickpeas and beans as well as nuts like hazelnuts, cashews and pistachio. GOS has a role in reducing IBS symptoms in particular bloating and flatulence and it also increases the level of beneficial bacteria. (2).

Arabinoxylan is found in almonds, bamboo shoots, brown and white rice, flaxseeds and sorghum. It is anti-inflammatory, reduces cholesterol and improves insulin sensitivity as well as increasing the beneficial levels of Bibfidobacterium Longum.

Resistant starch is found in most legumes as well as potato, sweet potatoes, taro, plantains, greenish bananas, sorghum and brown rice. The levels of resistant starch are also higher if root vegetables such as potato are allowed to cool and then served as a potato salad. Resistant starch is so called because it doesn’t get broken down in the small intestine but is partially broken down further in the bowels and serves as a useful food for bacteria in the large intestine. Its primary role seems to be to feed bacteria so they can produce butyrate. Butyrate is a useful fuel for the cells so it helps them stay healthy and resistant starch may also assist in the maintenance of healthy cholesterol.

Proanthocyanidins are found in almonds, pecans, hazelnuts peanuts, pistachios, pecans, cinnamon, sorghum, berries, cranberries and plums as well as dark chocolate. Proanthocyanidins have a number of health benefits due to their anti-oxidant status however the impact on the microbiome may also explain some of this benefit. These nutrients have an anti-microbial impact which may reduce problematic species such as helicobacter pylori (known for its role in causing gastric ulcers) and also through their prebiotic effect they increase beneficial bacteria such as Lactobacilli and Bifidobacterium (3)

Generally speaking ensuring you are eating a range of vegetables as well as a small serve of nuts and some berries may be the optimal approach for maintaining a healthy gut.

Christine Pope is a Naturopath and Nutritionist based at Elemental Health at St Ives. You can make appointments with her on (02) 8084 0081 or online at her website www.elementalhealth.net.au .

1. Prebiotics , Definitions, Types, Sources , Mechanisms and Clinical

applications. Accessed. at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463098/

2. The effects of a trans-galactooligosaccharide on faecal microbiota and symptoms in IBS. Accessed at https://pubmed.ncbi.nlm.nih.gov/19053980/https://pubmed.ncbi.nlm.nih.gov/19053980/

3. The Gastrointenstinal Tract as a key organ for the Health Promoting effects of Proanthocyanidins accessed at https://www.frontiersin.org/articles/10.3389/fnut.2016.00057/full#h1

Carrots – seasonal veggie inspirations

Carrots are a versatile vegetable and nutritionally a great source of Beta-Carotene, Vitamins B6 and K as well as minerals such as potassium . The beta carotene in carrots can be converted to Vitamin A. They are also good food for the microbiome as the soluble starch in carrots is largely pectin.

Carrots have the advantage of being ideal raw or cooked. Carrots are available year round and are usually very reasonably priced so a great addition to the weekly shop.

How do you include carrots in your meal plan? Well in addition to being a great side dish on their own they combine well with so many flavours to add to a meal. Often the base of many casseroles or pasta sauce is to start by sauteeing carrot and onion as these “fragrant” vegetables add to the flavour profile of a dish. Adding a carrot can be a good way to increase the quantity of vegetables in a dish.

Here is a list of recipe suggestions for including more carrots in your cooking. Some of these are from recent blogs and others are just recipes I use all the time at home. Carrots are also a favourite to add to roasts as they absorb flavours beautifully specially if you cook them with the lamb or chicken.

Turkey Mince bolognaise – turkey mince is a good light option for pasta sauce.

Carrot and Apple Salad – an easy and quick combination from Carol Ray with walnuts and a lemony dressing. A nice change from coleslaw.

Carrot Pumpkin and Coriander Dip this is a slightly spicier combination but makes a really interesting change from humuus.

Carrot and Onion Side Dish

  • 500 g carrots peeled and cut into rings
  • 2 brown onions peeled and sliced in thick rings
  • 2 Tblsp fresh chopped continental parsley
  • Olive Oil

Steam carrots lightly for 3-4 minutes so they are still crisp but cooked. Saute onions in olive oil for 3-4 minutes until clear and then add carrots. Saute for 2-3 minutes. Serve with chopped continental parsley.

My favourite way to serve carrots is roasted however this combination with roasted parsnip (Maple roasted carrots and parsnip) is simple and a delicious way to get children to eat more vegetables as well.

Christine Pope is a naturopath and nutritionist based at Elemental Health St Ives. You can make an appointment on 8084 0081 or online.

Microbiome or genome – what tells you more?

shutterstock_609019046What tells us more about your risk of developing a disease, DNA or your microbiome? The explosion of DNA testing has meant that we have developed much more knowledge about an individual’s DNA. It’s also clear that simply having a particular gene or a snip does not mean you will necessarily develop the relevant condition. Our DNA is the terrain but the environment is the trigger.

The microbiome on the other hand can tell us more about whether the environment is triggering a condition. Microbial diversity is more critical to health. Loss of diversity seems to have a more negative impact on health and an overgrowth of particular strains of bacteria can also contribute to a higher risk of developing chronic diseases.

Cholesterol is a good example. Looking at the risk factors for cholesterol levels close to 50% is derived from your underlying genetics and 50% from your microbiome. A good diet which increases microbial diversity can make all the difference to your cardiovascular risks. In fact the microbiome strongly influences many of our metabolic risks including factors such as fasting glucose, lactose intolerance and waist circumference.

The bacteria in our gut enable exert their effects by the production of key metabolites. Certain gut bacteria can control the production of these metabolites and therefore significantly influence our function. An example of this is Bifidobacterium lactis. It increases the production of short chain fatty acids in the bowels. These activate the vagal nerve and signal that we feel full. So a deficiency of Bifidobacterium lactic can mean that we don’t have that signal working quickly and therefore we are prone to overeating.

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In conditions such as Rheumatoid Arthritis, Osteoarthritis and Ankolysing Spondylitis the gut bacteria is often low in strains that produce a metabolite called butyrate. It is often the case that the microbiome has an elevated level of Prevotella Copri or another problematic strain. That is why treatment needs to be focused as much on rebalancing the microbiome to support the strains that are healthy and to crowd out the problematic strains. Prebiotic fibres such as Saccharomyces cerevisiae (Boulaardi) can be a useful part of treatment. The other critical factor is to ensure that you are feeding the microbiome and my blog on 6 Tips for feeding your gut bacteria right! is a useful guide.

There is still a lot of emerging research in this area so please follow my blog to see the latest updates.

Christine Pope is a naturopath and nutritionist based at Elemental Health at St Ives in Sydney. If you think your microbiome needs some attention you can make an appointment online at http://www.elementalhealth.net.au or phone on 8084 0081.

 

 

Prebiotic vs probiotic ?

shutterstock_583825927You are taking a probiotic and you think you understand what that does. Now people are talking about prebiotics and you’re not sure whether you should be taking that as well ?

A prebiotic is a food that feeds the  gut bacteria whereas a probiotic is a  combination of strains of various gut bacteria. Different types of prebiotics can feed different strains of bacteria so the prebiotic can be used therapeutically to promote beneficial strains at the expense of more problematic strains.

Lots of different foods are prebiotics as well as various supplements. For an appropriate  list  of foods look at my most recent blog Feed your Good Gut Bacteria . In terms of prebiotic supplements there are a number of interesting options to consider.

  1. Hydrolysed Guar Gum is a partially broken down soluble fiber which is extracted from the Indian Cluster bean.
  2. Galacto-oligodisaccharidases (GOS) are made from either a milk product source or from chicory roots.  It is helpful if someone is also constipated and may increase bifidobacteria as well.
  3. Larch is the bark of a tree. It supports the production of a key fuel to support the integrity of the gut lining known as butyrate. It also has been shown to support the growth of good gut bacteria such as Bifidobacteria and Lactobacillus which reducing the growth of E Coli and Clostridia. It is thought that the larch stimulates the immune system and therefore keeps opportunistic bugs in check.
  4. Lactulose is made of up of two sugars galactose and fructose and is used to treat constipation. It is not digested like other sugars and therefore when it moves through to the colon the bacteria can feed on it and it draws water into the stool making it easier to pass.

Once you know the composition of your gut flora you can really assist in building better diversity by supporting the growth of beneficial strains or by crowding out problem bacteria. Ideally using testing such as a Comprehensive Digestive Stool Analysis or directly through a group like Ubiome you can improve your knowledge of your gut bacteria.

If you need assistance with gut health please make an appointment with Christine Pope on 8084 0081.