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Everything You Need to Know About Probiotics

Probiotics may be popular, but are they right for you?

By Maria Masters

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Unless you do your grocery shopping online, you've probably noticed quite a few new products on the shelves with a label boasting that they contain probiotics. Right now, these "good" bacteria are being hailed as nutritional rock stars. The claim: They can whisk you away to wellness. But as beneficial as probiotics seem, our enthusiasm for them may be outpacing the science showing what they can actually do. Before you plunk down your cash, here's what you need to know.

How Probiotics Work

To make sense of how probiotics work, you'll need to understand a few details about your stomach's landscape. There are more than a trillion bacteria cells hanging out in your digestive system. And that's a good thing. Most of these bugs are "friendly" bacteria; they extract nutrients from your diet and boost your immunity by fighting off germs.

Even though the adult digestive system is dominated by a few common bacteria species, scientists suspect that each person can harbor more than 500 different kinds. Your own gut bacteria are like a fingerprint; no two people's are the same. Despite the differences, scientists know that these bacteria mainly coexist harmoniously, helping to maintain a healthy digestive system. But this gastrointestinal (GI) party is crashed by stress, illness and even antibiotics (which can fight infections by indiscriminately killing off both the good and bad bacteria). That's why some experts believe that consuming probiotics—either in food or supplement form—can help improve or maintain your health. Since they're similar to the good bacteria that are already living in your stomach, you'll kick out your digestive system's unwanted guests, which may alleviate depression, assist with weight loss and reduce the duration and symptoms of some illnesses.

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Should You Take Probiotics?

If you're tempted to dash to the nearest grocery store, we won't stop you. Scientists believe that probiotics have some pretty huge health potential. But here's the caveat: "We're still scratching the surface of understanding probiotics," says John Y. Kao, M.D., a physician scientist who studies probiotics at the University of Michigan. "Since people's gut flora are so different, it's difficult to determine which ones are healthy. And much of the probiotic research has been done in the laboratory—as far as what they do in each person's digestive system, that's another hurdle."

So should you take probiotics? Maybe. For starters, they are found in many healthy foods, like yogurt, kefir and kimchi. You can also consider taking your probiotics in pill form.

Another way to improve your gut health is by eating more produce, which may help the probiotics already inside your body to flourish. "These bacteria have evolved to break down fruit and vegetable fibers and use them as fuel," says Dr. Kao. Shoot for five servings a day, and vary the kinds and colors of produce you eat. According to one study, a "healthier" gut contained a more diverse number of bacteria species than an "unhealthier" one. By expanding your diet to include a more diverse amount of whole foods, you'll establish a diet plan that will improve more than just your stomach health—your whole body will benefit too.

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How to Choose a Probiotic Supplement

"When it comes to a product's quality, it's a buyer-beware situation," says Tod Cooperman, M.D., president of ConsumerLab.com, which tests supplements. "But for some people, the pros may outweigh the cons." Follow these three tips to make a smart purchase.

1. Seek out specific strains.

"Not all probiotics are created equal," says Matthew Ciorba, M.D., assistant professor of medicine at Washington University in St. Louis. "Different strains exert different effects on the body, so you should look for the one that's helpful for your condition."

Studies show that Lactobacillus rhamnosus GG can reduce the duration and severity of diarrhea caused by some viruses and antibiotics. And Bifidobacterium infantis can help IBS-related diarrhea and constipation. Find the former strain of probiotics in the Culturelle supplement and the latter in Align.

2. Pay attention to packaging.

"Don't be misled by an 'at the time of manufacture' label," says Dr. Cooperman. "Just because these organisms were alive when bottled doesn't mean that they survived transportation and storage." A better bet is to look for a "best by" date; companies that list one probably included more probiotics to compensate for some bugs dying off. Check for at least 1 billion colony forming units (CFU), and note the storage instructions; many require storage in a dry place, while others don't.

3. Be your own judge.

For people without a GI disorder, probiotic supplements might be a good option, says Dr. Kao. But unless you have a specific digestive health problem, it's hard for researchers to quantify their benefits. After all, a person who's healthy at the beginning of a study will most likely still be healthy at the end.

Plus, the FDA doesn't regulate supplements like it does medications, so there's no guarantee that a bottle's contents match its claims. According to a study by ConsumerLab.com, 5 out of 19 probiotic products didn't contain as much good bacteria as the manufacturer promised. (Culturelle and Align, mentioned above, both passed the test.) To some extent, it's up to you: Monitor whether your symptoms are getting better or worse or staying the same. Science can only tell us so much—listen to your body as well.

Originally published in the July 2014 issue of Family Circle magazine.

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