If you’ve explored #guttock— the popular TikTok category about fixing bloat and hacking your GI tract— you’ve probably thought about prioritizing your own gut health. And then you’ve likely considered incorporating a prebiotic or probiotic into your diet.
But here’s the thing: There’s no quick fix for gut health concerns.
According to Tamara Duker Freuman, a registered dietitian at New York Gastroenterology Associates, “pro- or prebiotics could be part of the problem, they could be part of the solution, or they could be completely irrelevant to your situation.”
Before you get completely bio-wildered, we talked to Freuman about what probiotics are. How they’re different from prebiotics. And when antibiotics might come into play.
They are…living organisms, much of them found in the gut, aka your gastrointestinal tract. Sometimes considered your "friendly" bacteria. And there are many different kinds. What they’re not: an “interchangeable, one-size-fits-all” remedy for your digestive problems, Freuman said. Instead, each patient's needs must be assessed before a probiotic (or nothing at all) is prescribed.
They’re ingested…as a pill — if prescribed — and through food. Think: kefir, kimchi, yogurt.
They could benefit…digestion and immunity. Keyword: “could.” Adding a probiotic to your diet isn’t always helpful. In fact, Freuman said “most people with GI problems don’t benefit from probiotic supplements.” She said there’s only a “handful of conditions” where data shows that they’re helpful. So don’t just take one because you feel bloated. See a GI dietitian (like Freuman) or a gastroenterologist first.
To sum it up: Probiotics are useful bacteria, present throughout the body — including the gut. And prebiotics are food for those naturally-occurring probiotics. Probiotic supplements, on the other hand, add more strains of bacteria to your gut. Which isn’t always a good thing.
If you’re someone who likes to learn by metaphor, we got you. Freuman says your gut microbiome is the “ecosystem” inside the body. So think of the gut as a rainforest.
The native bacteria/probiotics are the frogs that have comfortably lived in the rainforest for years. The prebiotics are the crickets that feed those frogs.
But if you were to just drop in some new probiotics, like a new species of squirrel, you probably wouldn’t see any immediate benefit to your ecosystem, Freuman said. Because they're not adapted for the environment and there's no immediate role for them to play — those are taken already by the current resident probiotics. So that new squirrel might just die off without doing much good. (And IRL, the probiotic will probably just be pooped out without making much of an impact).
Bottom line: If you’re otherwise healthy and want to prioritize gut health, “forget probiotics,” Freuman said.
Instead, consider incorporating prebiotics. They’re “the most well-established ways to promote a diverse and abundant gut microbiome," Freuman said. And a diverse and abundant gut microbiome is the kind you want.
They are…certain types of fiber that are eaten by specific types of bacteria. Those gut bacteria then produce nutrients like short-chain fatty acids, “which we really love for gut health," Freuman said.
They’re ingested…via plant-based foods. And studies show it’s best when prebiotics come from a variety of different kinds of food per week, Freuman said. Think: onions, garlic, leeks, beans, and artichokes.
They could benefit…your long-term health. Prebiotics contribute to a healthy gut microbiome. One that’s been associated with a longer life and reduced risk of chronic illnesses like diabetes and heart disease, Freuman said.
They are…a whole different category. But because you asked: medicine used to kill unwanted bacteria. Quick linguistics lesson: “anti” means against and “biotics” relates to living organisms.
They’re ingested…orally (pills, liquids), topically (cream, dropper), or by injection.
They could benefit…someone who has a specific kind of bacterial infection. Think: a UTI, strep throat. But they’re related to your digestive health because taking too many can “suppress diversity and abundance of the gut,” Freuman said. And that can lead to problems like antibiotic resistance — when bacteria/fungi aren’t killed by antibiotics. But if a patient needed to take an antibiotic for an extended period of time, Freuman would make sure they’re eating plenty of fiber and a prebiotic. Again: Antibiotics take away unwanted bacteria — along with some of the good ones. Prebiotics help those good ones bounce back.
You could consider taking a prebiotic “if that’s not too gassy for you,” Freuman said. But otherwise, “you're not going to supplement your way into good gut health.”
If you want to make sure your gut is as healthy as can be, your focus shouldn’t be on pills or other quick fixes. Instead, it should be on eating a bunch of different kinds of fiber-rich foods that make for a diverse gut microbiome. And if you’re dealing with digestion issues, see a GI specialist before you start taking something like a probiotic.
Skimm'd by Carly Mallenbaum, Anthony Rivas, and Eleanor Goldberg
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