The current consensus states that the average number of cells in the body is 37.5 trillion, while the average number of bacterial cells we host on and within our body is 39 trillion.
There are complex interactions between the bacterial cells we host within our body and the human cells they are attached to.
We will explore some of the relationships and their associated health benefits. We also look at the best way to support the complex population of gut bacteria and other microorganisms, which are collectively known as the Gut Microbiome.
What We Lose From Our Body As We Age
We have all been told that we lose calcium from our bones as we age, resulting in a skeleton that becomes more fragile. We know that women are losing calcium faster than men.
Some of you also know that we lose collagen from the body as we age at the alarming rate of 1-2% per year for our total body's collagen reserve, resulting in the common appearance of sagging skin, fine lines, and wrinkles.
Others might know that, like bone density, we also lose muscle mass with age from a condition known as sarcopenia. Like the loss of bone mineral density, sarcopenia can have a negative impact on our health as we age.
So, it should be no surprise that researchers have shown that we also lose gut bacteria with age, which is highly correlated with the quality of our health as we get older. To be specific, researchers found that aged individuals who lose the diversity of their gut bacteria have far poorer health outcomes than those who keep a wide diversity of gut bacteria.
What Are Probiotics, and Why are they so important to our Health?
The idea of taking a probiotic supplement is an evolution of a very old practice that extends back to a time when humankind first started to domesticate animals and harvest crops for food. The extra food that these new farming practices produced was far more than could be immediately consumed, so the stockpiling and storage of food became something to deal with because left too long, it would spoil from bacteria yeasts and mold.
Drying food was a solution to food preservation but not always practical, especially in higher latitudes where the temperatures were cooler and the weather was damp. It was soon discovered that fermented foods and beverages or preserving food through the process of pickling could ensure that they would last much longer while still retaining their nutritional value.
The process of fermenting foods requires that the raw food be emersed in water, often with a pinch of salt to make the water a little more isotonic and thereby a more friendly environment for the fermentation bacteria to thrive.
Several strains of common bacteria can live in this low oxygen environment and feed on the food that is being fermented. As these bacteria start to grow in number, they produce a byproduct of metabolism that is an organic acid, often lactic acid. This gives the food its sour flavor, but the acid also ensures that pathogenic or spoilage bacteria can not grow since they generally do not tolerate these acidic environments.
Given enough time, what actually prevents these fermenting bacteria from consuming all the food being fermented and leaving only organic acid behind? The answer is that even acid-based bacteria have a limit to what they can tolerate. Once the pH of the ferment drops to a certain level, the fermenting bacteria will stop growing, and further fermentation effectively stops.
For centuries humankind has fermented food and beverage to store for long periods when food might be in short supply.
In the 1840's the first commercial refrigeration units were built, which meant we could become less dependent on fermentation for food storage. However, the fermentation of dairy products still plays a big part in our food supply; from cheese to yogurt, it is still a great way to extend the shelf-life of milk.
Sixty years of the first refrigeration units appeared, it was a Russian Nobel laureate named Élie Metchnikoff who was widely recognized for his discovery that the bacteria on some types of fermented dairy yogurt extended the lives of the Bulgarian peasants who consumed it and the first probiotic organism was discovered. It was called Lactobacillus bulgaricus after those Bulgarian peasants.
Today there is a wide range of probiotics available to the consumer, mostly from the genus of acid-producing bacteria called Lactobacillus.
What To Look For In A Probiotic
A probiotic bacteria is likely to endure a series of challenges as it transits through your gastrointestinal system. Despite these challenges, it still must function correctly by providing a health benefit to its host.
The First Challenge is to survive the acidic environment of the stomach.
- Acid Tolerance
The Second Challenge is to survive the start of the small intestine near the region of the common bile duct. Bile is very alkaline and is intended to neutralize stomach acid. Bile can also kill certain bacteria.
- Bile Salt Tolerance
The Third Challenge is to be able to adhere or stick to the lining of the intestinal wall without being swept away into the lower gut and excreted as waste.
- Adhesion Ability
If the probiotic can overcome and succeed against these three challenges, which destroy most other probiotics, it still needs to function correctly by providing a benefit to its host.
- Functional Effectiveness
Finally, what you want in a good probiotic is one that will remain shelf stable and not die off within a week or so of getting it home, which is a common issue with several brands of probiotic bacteria. One useful approach to extending the shelf life of your probiotic is to keep them in the refrigerator. Even if your probiotic claims to be shelf stable at room temperature, it will always be most effective, and you will greatly extend its shelf life if it is kept refrigerated.
- Shelf Life
What's the Difference between Probiotics and Fermented Foods?
Fermented foods generally contain many of the same bacterial species that are widely sold as probiotics. However, not all the microorganisms used to ferment foods and vegetables would be regarded as probiotics.
The WHO established a definition of what it means to be a probiotic. It needs to be a "live" organism that, when it is given in sufficient quantities to its "host"( that means us), will confer a health benefit. This definition has implications for fermented foods because, while a fermented food or beverage will often start with high numbers of beneficial bacteria, those numbers quickly decline the longer the food is fermented due to the production of organic acids from these fermenting bacteria.
If the fermented food is commercially prepared, the picture is even worse; these products will often undergo a pasteurization step before being sold, further reducing the levels of live bacteria in the product you might eat.
Probiotics are generally produced with pure strains of known bacteria in clean fermentation vessels; they are harvested at the end of their growing cycle and freeze dried. This process does not kill the bacteria but puts them into a dormant state, from which they quickly revive once they are added to water and a suitable food source (we call a prebiotic).
What is the Advantage of Eating Fermented Foods Over Probiotics?
If you pickle your own fruits and vegetables or have found a trustworthy retail product that offers a minimally processed product, then there are several benefits that you can get from fermented foods that you can't get from a probiotic supplement.
The most obvious Advantage of consuming fermented food is that fermentation bacteria can pre-digest food components and release essential nutrients and metabolites that we would struggle to digest and absorb; an example of this would be fermented cabbage, such as sauerkraut or kimchi.
- There are several hard-to-digest compounds found in our food, which can be improved through the broken down of fermentation. Some of the more common ones include lactose (Milk sugar) and short-chains of glucose molecules called oligosaccharides, which are commonly found in grains. A good option for those who are lactose intolerant.
- Fermentation bacteria can also break down protein into smaller, more digestible peptides or amino acids. This is a great choice for those with food sensitivities or, even in some cases, mild protein-based allergies to the foods they consume.(NB fermented foods are not a solution for anyone with moderate or severe food allergies)
- Organic fats and lipids are further broken down to digestible and biologically active fatty acids that are associated with a wide variety of health benefits, but to their lack of shelf stability, these fatty acids are esterified to prolong their shelf life, rendering them less biologically active.
- There are several times during the human lifecycle when it would be useful to remove the stress and metabolic burden of digestion by consuming a pre-digested, fermented food. This includes during infancy or when someone is compromised due to illness, aging, or stress. This is a great option for those who suffer from IBS or SIBO.
Because conditions like IBS and SIBO can impair or damage the lining of the intestinal tract, the effectiveness of our digestive functions can become compromised, resulting in a lower nutrient status and nutrient deficiencies. As a result, our body becomes less able to repair the damage to the intestinal lining, and this further compromises the ability to absorb nutrients from food. It becomes a vicious cycle that is hard to break.
Fermented Food Unlocks More Nutrients With Fewer "Anti-Nutrients"
It has been well researched and proven that the process of fermenting food makes it more nutrient dense than its non-fermented equivalent.
And not only does fermentation unlock the hard-to-digestion essential nutrients by making them more bioavailable (easier to absorb), but the process of fermentation also destroys several "anti-nutrient" compounds that a plant uses to discourage herbivores from grazing it. These "anti-nutrient" compounds actually block our ability to absorb key nutrients from the food we eat.
During fermentation, there are several bacteria that produce additional vitamins, including B1, B2, B6, B12, folate, and biotin. These B group vitamins are essential for many of our normal cell functions, but they are not well absorbed from unfermented foods without extensive bacterial breakdown in the gut.
Pickled or cultured olives, for example, are known to contain twice the level of beneficial polyphenolic compounds when compared with non-fermented olives (polyphenolic compounds include hydroxytyrosol, tyrosol, luteolin, and quercetin) due to the effects of fermentation.
Fermentation blocks the effects of anti-nutrients such as phytic acid by 40%.Phytic acid is a compound found in many grains, legumes, and seeds. Phytic acid binds essential minerals, such as iron, reducing its absorption in the gut. Such a process like fermentation that destroys these anti-nutrients greatly enhances our ability to maximize the nutrient value from the food we eat.
Fermentation Results In Fewer Food Pathogens
The process of fermentation results in the production of organic acid as a byproduct of bacterial metabolism. For many of the beneficial bacteria that occupy our gastrointestinal tract and the bacteria, we use in fermentation, a mild to moderately acidic environment is well tolerated.
For some bacteria, however, including many harmful and pathogenic bacteria, an acidic environment can be destructive. Eating fermented food introduces a natural source of acidity into the diet and can lessen or even inhibit the impact from other food-borne pathogens.
Increase The Diversity Of Bacteria In The Gut
The Advantage that Fermented Foods have over Probiotics is that Fermented Foods generally contain a wider diversity of microorganisms, unlike many commercial brands of probiotics that tend to focus on a single strain.
In 2021, several studies were published that showed a strong correlation between older individuals with a high diversity of gut bacteria and good health compared to others that had limited bacterial diversity in the gut and tended toward frailty or poorer health outcomes.
Do Microbes in Fermented Food Survive Digestion?
The acidity of the stomach has numerous implications for nutrition and health in nutrition; stomach acid improves the absorption of iron, it improves the effectiveness of acid-dependent enzymes that are required for the breakdown of protein, and it helps to "sanitize" the food from excessive microbial contamination by killing many of the acid sensitive pathogens that can do us harm. Because fermentation bacteria have a higher tolerance to acid, they have a much better chance of surviving through the stomach intact.
However, neither Fermentation bacteria nor acid-producing probiotics will tolerate the exposure to the extremely acidic environment of an empty stomach - Never take a probiotic on an empty stomach. However, if you are hungry and want to snack on pickles between meals, go ahead. You are not generally eating fermented food for its probiotic content; think of it instead as a food source for the beneficial bacteria that already live in the gut.
Signaling Molecules Which Regulate Human Metabolism
A less obvious and less well-known impact of fermented foods on human health is the effect on human health from the signaling molecules and bacterial metabolites that these fermentation bacteria produce throughout their lifecycle. Bacteria communicate with each other through the production of unique chemicals that other bacteria can sense and respond to.
These chemicals are known as signaling molecules, and they are not just detected by other bacteria but are recognized by our own human cells. These bacterial signaling molecules can "talk" to their host cells and initial and "up-regulate" important cell functions in our own body.
Many of these signaling molecules remain intact within the fermented foods we eat; while they generally don't have the same impact on our health that a colony of live beneficial bacteria might have, there is no mistaking that there are positive health benefits to these signaling molecules. Some companies have seen the value in these signaling molecules and even started to market them as "ghost" probiotics or "Post-Biotics"
Eating A Range Of Fermented Foods
- Lacto Fermented Pickles
- Raw milk cheese
- Raw Apple Cider Vinegar
- Miso
- Lacto-fermented Sauerkraut (Europen fermented cabbage)
- Curtido (El Salvadorian fermented cabbage)
- Kimchi (Korean fermented cabbage)
- Fermented Sauces
- Fermented Ginger
- Umeboshi Plum
What are the Benefits of Probiotics Compared To Fermented Foods?
The value of purchasing a probiotic is that they are a known quantity. Manufacturers of probiotics often go to great lengths to identify, test, and measure the organisms that go into making a probiotic. You know exactly what's in the bottle as opposed to fermented food, where the type of microorganism and the number of live cells remaining in the retail product are often unknown. The benefit of this approach is that you can seed the gut probiotics to produce more beneficial bacteria of specific strains.
While the concentration of live organisms in a serving is low compared to a probiotic capsule or tablet, nutritionists estimate that a typical serving of a fermented food weighing around 110g would provide around 50 Billion live organisms (CFUs), which is a useful target. Some probiotic manufacturers offer tablets and capsules with much lower amounts per serve, between 2-10 billion CFUs per serve, but the trend toward more effective probiotic supplementation has seen this increase toward 40-50 Billion per serving in recent years.
While the effective amount of probiotic bacteria needs to be at least 40 billion CFUs per serve, manufacturers are still focused on offering a limited range of bacterial species.
The current research supports the idea that a broader diversity of gut bacteria is associated with better health outcomes as we age. The article which studied this effect was published in the highly respected and peer-reviewed journal called Nature Metabolism in Feb 2021.The research team examined over 9000 older adult subjects and matched their health status to the diversity of their Gut Microbiome, and the results were significant and very impressive. Perhaps one of the most important and under-rated things that you can do for your health as you age is to manage your gut health and support your Gut Microbiome.
Probiotics have been shown to clinically improve the following:
Diarrhea
Specific strains of probiotics have positive results in managing diarrhea and inflammation of the gut's lining, which can cause diarrhea.
Mental health Issues
There are strong connections between the gut microbiome and the brain. It is called the gut-brain axis. Researchers now suggest that gut bacteria, including some probiotics, could affect the way that people think and feel.
High cholesterol
More recently, a research paper from 2017 suggested that Lactobacillus bacteria could reduce LDL or "bad" cholesterol and improve total cholesterol. This was further supported in 2018 when researchers studied nearly 2000 subjects and reported that probiotics could significantly reduce total cholesterol levels in the blood.
High blood pressure
A research team has found Lactobacillus fermented milk can help lower blood pressure. The research team also concluded that probiotics resulted in an increase in levels of vitamin D, which helps prevent high blood pressure.
Irritable or inflammatory bowel
IBS is a major gastrointestinal problem without a cure. However, in 2019 paper was published that concluded a multi-strain probiotic could improve the symptoms of IBS.
Infection
Another probiotic strain called Lactobacillus paracasei shows the ability to protect the gut from infection by a harmful bacteria and pathogen called Listeria. The Advantage that Probiotics offer against a hard-to-treat gut infection like Listeria is that they are less likely to disrupt and disturb the balance of the gut microbiome than an antibiotic would.
Psoriasis and chronic fatigue syndrome
In 2013 a paper was published indicating the evidence that certain probiotics could help those with psoriasis and chronic fatigue syndrome.
In summary, there are unique and historically proven health advantages to consuming fermented foods. They are the best choice for providing the widest range of microorganisms into the diet.
They provide a form of pre-digested foods that key micronutrients already released and available for absorption, but the extent and abundance of the microorganisms and bacteria available in fermented foods can vary considerably. The other benefit of fermented foods is that they are a great source of nutrients and food for the beneficial bacteria to reside within our gut. Fermented foods feed our microbiome and this can strengthen and increase the population of healthy bacteria in the gut.
Probiotics by comparison, are provided in higher numbers and can offer very targeted therapeutic benefits.
The real magic happens when fermented foods are combined with a wide range of different probiotic strains.
The ideal gut health product to support gut diversity as you age would be a blend of a broad range of fermented foods (Prebiotics) combined with a minimum of 16different and well-known probiotic strains, which provides a minimum of at least 40 billion CFUs per serving.