Trillions of tiny bacteria live inside our intestinal tract. Scientists are learning more all the time about how these friendly gut bacteria play a major role in our health.

Our digestive tract hosts a fascinating kingdom of bacteria known as the microbiome. The human microbiome is a complex ecosystem comprised of trillions of bacteria which keep our digestive processes running smoothly and contribute to our immunity and overall health.

Every time we eat, we are also feeding our microbiome. In general, choosing whole, nutrient-rich foods contributes to a healthy gut while eating highly processed, empty calorie foods high in sugars and unhealthy fats can adversely affect our microbiome.

Certain supplements and foods have very specific roles in the health of our gut. Two of the best known categories include prebiotics and probiotics. Together, they are known as synbiotics because of the way they work together inside our intestinal tract.

Prebiotics

Simply put, prebiotics comprise the fiber that feeds the healthy gut bacteria known as probiotics. Many whole fruits, vegetables and whole grains provide this fiber and foods that are especially good sources of prebiotic fiber include onions, garlic, leeks, asparagus, artichokes, dark green leafy vegetables, bananas, blueberries, ground flaxseed, and whole-wheat foods. While fiber is technically not digested by humans, it is used as fuel for the good bacteria in the intestine.

Probiotics

Probiotics are strains of good bacteria that are found in normal, healthy digestive systems. In children under 2 years of age, bifidobacteria is the dominant strain and breast milk is an important source of bifidobacteria. In children over 2 years of age, this changes to lactobacillus. Both are helpful in promoting both a healthy digestive and immune system. Probiotics occur in fermented foods such as yogurt, kefir, sauerkraut, kimchi, miso, tempeh and kombucha. Probiotics are also available in supplement form.

Fermented Dairy Products

Probiotics are naturally found in both yogurt and kefir.  There are many brands available but not all contain high levels of probiotics. Check the label for the following:

·  Probiotics are living organisms. The label should indicate that the product contains live, active cultures. Some brands are made with “cultured milk” but this is not the same as a product that contains living bacteria strains.

· Look for brands that contain both live lactobacillus and Bifidobacterium strains. Often, you will see live cultures that start with L. or B. which indicates these strains (e.g. L. acidophilus or B. Lactis) Another common bacterial strain found in yogurt is streptococcus thermophilus (S. thermophilus), which is integral to the yogurt production process and also provides digestive benefits.

Supplements

Choosing a probiotic supplement can be confusing since there are so many products on the market which tout a variety of claims. At times, the marketing of these products is ahead of the science. While researchers and health care providers understand that they are beneficial, there is much work to be done in fully understanding how probiotics work in the body and which strains and dosages are most beneficial.

Guidelines for Probiotic Supplementation

• Probiotics are considered a nutritional supplement and are available for purchase without a prescription.

• If taking antibiotics, take probiotics 2 hours before and 2 hours after the antibiotic is given, and for at least 2 weeks after the antibiotics are finished.

• When experiencing antibiotic-associated diarrhea, Saccharomyces Boulardii (brand name Florastor) has an advantage over other probiotics since it is a yeast, not a bacteria. Antibiotics kill all bacteria, even the good guys, while S. Boulardii will survive a course of antibiotics.

• Possible indications for giving your child probiotics include cesarean birth, colic in infants, irregular bowel movements, constipation or diarrhea, and during cold and flu season.
• For kids and teens, a general guide for supplementation is to start with 10 billion colony forming units (CFUs) for daily maintenance. During illness, double that amount to at least 20 billion CFUs.