Antibiotics, Probiotics, Prebiotics

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There is a lot in the press about pro- and prebiotics at the moment and Tatu wanted to provide a more in-depth look at the topic. She also includes her killer kimchii recipe to give you an alternative form of probiotic.

Microflora and disease processes: the link

Each human has a vast number of bacteria and microbes that live within and on us. Some of them are welcome and we share a symbiotic, mutually beneficial relationship; others are not so welcome and cause unwanted disease.

It is estimated that there are approximately 1.3 bacteria for every human cell. However there are, of course, many other organisms including fungi, viruses and so on which would bring the non-self:self ratio to around 10:1. When we have an overgrowth or invasion of the less desirable ones we become unwell exhibiting symptoms associated with infection (elevated body temperature, fatigue, confusion, myalgias (pains) and so on).

With the discovery of penicillin in 1920s and the development of antibacterial medicines, we have been able to easily overcome bacterial infections which, prior to these developments, would have meant certain death to many.

One might wonder how it is possible for a pathogen or bacteria-killing drug to have negative effects on our health and lead to further infections. One published research piece highlighted that poorly absorbed and metabolised drugs may travel further through the digestive system into the colon (where we have a huge colony of helpful bacteria who aid us in a number of ways). When this occurs we start to see decimation of the ‘good bacteria’ populations whose function is not only to assist with the breakdown of food and fibres but also to prevent over population of ‘bad bacteria’.

Probiotics

Probiotic supplementation can be an excellent tool for individuals who have an altered microbiome as a result of, for example, virulent infection, poor diet, drug (antibiotic or recreational) and alcohol use. If the population numbers drop, introducing new colonies is extremely beneficial in order to maintain healthy numbers. The mutually beneficial commensal bacteria crowd out the pathogenic strains. They also have their own defence and offence systems including membrane targeting chemicals that act much like the antibiotics listed above.

Taking good care of yourself with good quality probiotics when they are needed is a great idea. There is plenty of research to support this approach however sensationalist headlines about probiotics are often based on one research paper that may have industry funding.

One clinical trial, for example, tested the effects of Actimel and balancing Th1 from Th2 dominance and showed positive results. However, it is important to note that the trial was on mice and they were fed only Actimel. There is no justification for extrapolating to suggest that if a human drank their daily caloric intake in Actimel they may exhibit lower levels of Th2 cytokines and Interlukin 10!

Prebiotics

The ‘good bacteria’ need to be fed to allow them to grow, much like feeding your pets or fertilising soil for plants. Each pet or plant thrives on a different diet and environment, and the owner must cater to their needs. Prebiotics are the beneficial bacteria’s food, an example being inulin. Inulin is an indigestible fibre found naturally in foods but can also be found in supplements.

In the immune system, we have little guys called T regulatory cells who modulate the immune response, swaying towards one end of its spectrum and to the other end. This is based on the Th1/Th2 Dominance theory (See P. Kidd for further reading on this theory). Most people have a dominance of one or another Th cell; Th2 is associated with allergies and intolerances and has higher risk of cancer development. Th1 is more associated with autoimmune diseases such as Rheumatoid Arthritis and Multiple Sclerosis and lower risk of cancer development, this being the rarer of the Th dominance. 90% of T regulatory cells are found in the immune system of the gut and therefore an imbalance in the commensal bacteria will inevitably lead to detrimental effects on the T-reg populations and functionality.

Therefore, we can see the links made by Park et al in regards to both anticancer and immune promotion as well as colorectal function. If the immune system is functioning optimally, the T-regulatory cells will have immediate inflammatory response and therefore reduce unneeded inflammation and the oxidative stress that arises as a result of it. Oxidative stress damaged telomeres (the end bits of chromosomes) which is the main driver of ageing of cells, organs and organisms. Once the immune system is working optimally it can create a clean and efficient working environment for Schwan cells to continue to create myelin sheaths around neuron axons in the brain as well as ensure the microglial cells in the brain are being good cleaners and sweeping away the mess inevitably caused by energy production and utilisation in the mitochondria of each cell.

In regards to anti-obesity, one might explain probiotics positive effect by reducing toxic load due to promotion of beneficial commensal bacteria, producing useful by-products instead of toxins. ,Toxins cause stress on the body resulting in the release of cortisol releasing hormone from the hypothalamus in the brain, that then tells the pituitary to release cortisol which has physiological effects on the peripheral cells of the body. Leptin is a hormone that is produced by fat cells when they are full of fat. Leptin acts on the hypothalamus, but if the hypothalamus is inundated with cortisol it is going to ignore leptin. In addition, the insulin receptors on individual cells are deactivated by cortisol. The cells then signal for the release of more insulin to ensure they get glucose in to make energy but the cortisol keeps blocking the receptors resulting in an excess of insulin. Eventually this leads to insulin resistance, which is also a driving factor behind obesity. Both physiological stress, in the form of toxins in the gut, and external mental and emotional stresses can drive these pathways.

Supplements vs Food Source

Post surgery, during the use of antibiotics, virulent GIT infections resulting in an imbalance in the microflora, periods of fasting and travelling are all good times to think about taking a good quality, high population probiotic, (billions not millions!) as well as adding fermented foods with live bacteria in them, to your diet. For most, probiotics will not be needed on a regular basis given a balanced diet and lifestyle. However a quick rebalance for 1-6 months may help when medications, stress, trauma, illness and fasting feature in a person’s life. Of all the products on the market Optibac is the most thoroughly researched with published trials available. T his doesn’t mean that others do not work, it just means that Optibac products are proven to work in trial.

For those who feel well, healthy and energised but want to maintain that feeling then considering probiotic foods would be sensible. Raw and live fermented products including kimchi, sauerkraut, kefir both lactose based and water based, raw fermented yoghurts and milks etc. There is a new movement of soil bacteria products emerging which, in theory, would be more closely related to the palaeolithic probiotic intakes available.

Tatu’s simple kimchi recipe

  • 1 heap of nappa/Chinese cabbage, sliced

  • 1 large red onion, sliced

  • 1 daikon cut into thin sticks or two large handfuls of regular radishes, sliced

  • 2 carrots, cut into thin strips

  • 2-3 cloves garlic, minced

  • 2 inches ginger, grated

  • 3 tbsp fish sauce

  • 1-2 tbsp sea salt

  • 1 tbsp raw honey/agave/maple syrup

  • Water to cover

Toss all the vegetables together so evenly mixed and set aside whilst you mix the garlic, ginger, cayenne pepper/chilli, fish sauce, salt and honey with ½ cup of warm water. Stuff the vegetable mix into a large pickling jar and pour over the liquid. Add more water to cover all the vegetables and leave to ferment for 3-7 days ensuring to check regularly that the water still covers the vegetables. Add to soups, curries, salads or scrambled eggs.

If you don’t fancy the faff of preparing your own, you can grab a jar of kimchi, sauerkraut or kefir yogurt from Biona or a Kaffir water drink from Bouncing Biotics.