The term ‘probiotic’ has become a familiar one in recent years. However, it is not such a new concept and indeed in the early 1900s, Ilya Mechnikov was the first to propose the use of live microorganisms in maintaining bowel health and prolonging life. Now, the term probiotic is used to describe dietary microorganisms that are beneficial to the health of the host. It is not unusual now to be encouraged to take a course of probiotics along with or soon after a course of antibiotics.
What is the big deal about probiotics? And why should we take an interest in this area for our health?Let me attempt to summarise this interesting world we are beginning to gain insights on and how we can use this information to enhance our own and our community’s health!
We are effectively a fancy scaffold for the complex micro biome that lives in and on us. (A micro biome is the term given to the community of microorganisms that lives on any environmentally exposed surface of our bodies. This includes the skin, orifices such as the respiratory and genitourinary tract and for the most part the lower end of the gut or colon.) From the moment we are born we are colonised by this diverse world through our environment, until the microbiome stabilises usually at the age of 1 or so. Being born naturally from a healthy mother who breastfeeds for these initial years can provide a very solid basis for the microbiome to establish and thrive. (However this scenario is often not the start that many babies get and it is fair to say that many of the population may not have the healthiest microbiome!) This symbiotic relationship between the human body and the microbiome is truly remarkable and in recent years researchers have gained much understanding on the role that gut bacteria have in our bodies. Much of the research involves using germ free (GF) animals. The GF animals themselves show particular defects in their organs’ structure and function and this gives us an insight to how valuable our gut bacteria actually are (Seikirov 2010). Selective probiotic strains can be thus tested for their effects on the GF animals, for example. We now know that bacteria can supply essential nutrients to the body, help metabolise indigestible compounds, protect the body from invading pathogens, and even develop the architecture of the intestine (Round and Mazmanian 2009).
Much research has also been done on how the gut bacteria influence the correct functioning of the body’s immune system and help maintain a healthy homeostasis in the body. In many ways the research is still in its infancy, but exciting prospects are certainly in view as we delve deeper into this micro world.
One of the realities of our modern day healthcare approach is the disruption to this fine microbial balance. Overuse of antibiotics is one such reality. While the advent of antibiotics heralded a new direction in healthcare decades ago, and no doubt was a major contributor to lowering mortality rates, there is now increasing recognition of the longterm adverse effects of antibiotics (and other medication) on the host organ systems. It takes quite some time for the microbiome to recover- Antibiotic resistance among pathogenic bacteria is also a major issue to contend with. Many frontline staff will be all too aware of the practicalities of dealing with clostridia difficile infection and its implications. Regardless of this awareness, antibiotics are often easily prescribed in the world of disability and readily accepted as part of the system of healthcare.
What harm are we ultimately doing to our micro world? There are alternatives to antibiotics that work very well and must be looked at in practical terms for our individuals and communities (McKenna 2003). Overuse of chemicals, cleaners and disinfectants are also directly altering the gut bacterial numbers and balance. While there is a strong culture of cleaning and disinfecting in institutions to prevent infection, it is worth recognising that this practice is going to have longterm implications for the health of the microbiome. When we have been educated to believe that bacteria cause disease (think of the advertised products that remove 99.9% of bacteria!), it is a shift to learn just how powerfully protective they are and how we may be accelerating our own ill health. Recent research also highlights the dangers of the chemical glyphosate found in the liberally-used weedkiller Roundup. While it is considered ‘safe’ for humans, it now emerges that it is not so safe for our microbiome (Samsel 2013). It is not rocket science to work out that our lifestyle may not be conducive to our wellbeing. Disorders of the gastrointestinal tract are directly related to the disruption of the gut bacteria.
Conditions such as IBD, Allergies, H. Pylori infection, inflammation, gallstones and even obesity are notably linked. Unfortunately, our health problems are not localised in the gastrointestinal tract and it now looks like our gut bacteria can move (known as translocation) due to intestinal permeability or leaky gut (Papoff 2012). Thus they can cause problems in other areas of the body and can trigger autoimmunity. Type 1 diabetes, for example, has been found to be linked to changes in the microbiota(Seikirov 2010). Toxins released by a disturbed microbiome also can cross the blood-brain barrier and cause behavioural problems. There is mounting evidence that autism is linked with altered gut bacteria (Kang et al. 2013). It is clear that we cannot ignore the relationship we have with these vital organisms!
Dietary protocols such as the GAPS diet (Gut and Psychology Syndrome) developed by Dr Natasha Campbell McBride aim to improve the gut flora balance and are amassing much anecdotal evidence in their success at reversing the symptoms of autism as well as autoimmune conditions (Campbell McBride 2012).
A controversial therapy that is showing really positive effects in redressing the gut flora is called faecal transplants. Basically some faecal solutions from healthy volunteers are placed in the intestines of the patients through an NG tube or through a colonoscopy procedure. Remarkable results are happening in trials on C. diff patients and there are plans to try this therapy in autistic children in the US soon. Perhaps not the most tasteful of therapies, but indeed it shows just how powerful the gut microbiome can be. Not quite available in Ireland yet, but one to watch for sure!
So what does all this research mean to us and what can we take from it? In a nutshell, we need to take care of our microbiome and cultivate health-promoting strains for our benefit. On a day-to-day basis what can we do?
■ Include fermented foods in the diet every day! For the uninitiated these are foods that contain probiotic strains of bacteria naturally. Yoghurt is a well recognised example, but there are many others, including kefir, sauerkraut, kombucha and kimchi. A tablespoon of sauerkraut has as many bacteria as a course of probiotics bought in the pharmacy! In the home setting this may be more doable, however I strongly feel this area needs to be explored, particularly in the residential settings as the benefits are too great to ignore. Many parents are using kefir as a natural way to address constipation issues and finding very positive results. These foods are particularly easy to make and store for a long time—making them a very practical and therapeutic option. They can be also easily incorporated into the catering menu in a residential setting.
■ Find alternatives to the chemicals in your environment.
■ Filter your water supply.
■ Use bread soda, vinegar and lemon juice as household cleaners.
■ Avoid chemical air fresheners.
■ Rethink the types of personal-care products used. There are many non-toxic alternatives available, such as coconut oil as a moisturiser.
■ Use vinegar to ‘burn down’ the weeds in the garden, instead of Roundup.