A conversation with Dr. Jacob Allen (PhD – Gut Microbiota):
I obviously view digestive health as very important, and believe that manipulating the gut microbiota can lead to real and very relevant changes in physiology both within and beyond the gut. However, that being said, I do think that marketing ploys for probiotics and “digestive cures” have had a blinding effect on the consumer.
Here is why:
1) Most probiotics that you buy off the shelf are not live cultures as they need an anaerobic capsule to survive, and if they are not live they do not engraft the colon with any relevant efficiency.
2) The majority of marketed probiotics (i.e Lactobacilli and Bifidobactierum) feed off of carbon moieties on mucus structures that are more prevalent in babies than they are in adults…hence why Lactobacilli are prevalent in a silica acid rich environment of breast milk. (bacteria requires fuel to feed off of)
3) Overall, the probiotic field is lacking Randomized Control Trials in humans. My hunch is that the main reason for this is that the dairy industry is not interested in understanding if this is real, as they are making a fortune off of selling “probiotic yogurt” and other dairy products with natural lactate producing bacteria.
All this said, this does not mean that probiotics do not work, as I think there is some strong data to suggest otherwise. The most clinical research has been done on VSL#3, which is combination of 8 strains (mostly lactobacilli and bifidobacterium), that has shown to be fairly effective. One good thing is that the company does ensure live cultures with high viability and you can buy directly off of their website. I’m not promoting this company by any means, but it has had the most preclinical and clinical research completed on its product.
In my opinion, the best (and cheapest) route to improving digestive health is through eating whole foods high in prebiotics (e.g soluble fermentable fiber). This includes things like legumes, almonds, oats, vegetables with outer peel (including potatoes!!), steel cut oats, fruit (with peels), flaxseed, chia seed, etc. If not getting enough fiber through whole foods, I would then recommend supplementing with an Inulin (chicory root) or Short chain fructooligosaccharides (SC-FOS….just a short inulin chain) or Pectin. These are easy to take and fairly cheap products. Disclaimer : Some will experience flatulence when taking these! Overall, I’m starting to believe that every meal should have a fiber (soluble) content of at least 4-6 grams. This sounds crazy, but comparing to what we ate as hunter/gatherers this is undershooting.
Lastly, my work has shown that moderate, endurance exercise is also beneficial for the gut and gut microbiota. That being said, I would recommend that those with ongoing gut issues steer away too high of an exercise intensity (at least until gut symptomatology has subsided. but definitely do not stop exercising!
Here are some papers that might be helpful:
https://www.ncbi.nlm.nih.gov/pubmed/26626721 : a review paper from our lab on exercise and gut immune function
http://www.nature.com/nature/journal/v489/n7415/abs/nature11552.html: gut microbiota/ metabolism review
https://www.ncbi.nlm.nih.gov/pubmed/26466123: probiotic obesity
https://www.ncbi.nlm.nih.gov/pubmed/25460016: VSL3 chrohns
Evan’s Take Home:
Clearly part of this ambiguity is reflective of the limited randomized controlled trials in humans but fortunately I’ve done some of the leg work for you. Below I’ve listed a protocol you can follow on a daily basis to ensure you’re optimizing gut health and nutrient absorption. Additionally I’ve provided a select combination of products for specific occasions were indulgences are inevitable, this will eliminate potential toxins and reduce the effects of a big cheat meal.
Morning Combination: Taken Everyday
- Apple Cider Vinegar (i.e. Acetic Acid): https://www.amazon.com/Bragg-Organic-Apple-Cider-Vinegar/dp/B01EW16TCK/ref=sr_1_3_s_it?s=grocery&ie=UTF8&qid=1488321904&sr=1-3&keywords=apple%2Bcider%2Bvinegar&th=1
- Probiotics (mostly lactobacilli and bifidobacterium): https://www.amazon.com/Potency-Probiotic-Capsules-Ulcerative-Colitis/dp/B0014R4RZW/ref=sr_1_3_s_it?s=hpc&ie=UTF8&qid=1488323192&sr=1-3&keywords=vsl+3+probiotics
- Prebiotic Fiber (chicory root 2000mg): https://www.amazon.com/Body-Ecology-BE003-EcoBloom-8oz/dp/B001B109O4/ref=sr_1_1_s_it?s=hpc&ie=UTF8&qid=1488322406&sr=1-1&keywords=ecobloom
Combination before a “bad” meal: Only needed before a cheat meal
- Psyllium Husk (insoluble and soluble fiber): https://www.amazon.com/Organic-India-Whole-Psyllium-12-Ounce/dp/B0016AXN7A/ref=sr_1_3_a_it?ie=UTF8&qid=1498039750&sr=8-3&keywords=pysillum%2Bhusk&th=1
- Activated Charcoal : https://www.amazon.com/Natures-Way-Activated-Charcoal-Capsules/dp/B0006LCQ4Q/ref=sr_1_3_a_it?ie=UTF8&qid=1498040094&sr=8-3&keywords=activated+charcoal
In each case, I’ve provided links to high quality products I use personally.