This is one of the questions frequently brought up when discussing whether or not the FDA should play a role in the marketing and administration of probiotic supplements. A recent policy piece in Science summarized the state of affairs with respect to the role the FDA could play in the probiotic supplement industry, and it really boils down to how you define 'probiotic supplement.' Is it a food or is it a drug? Is it sold with the intention of supporting gut health or influencing a disease state? It is certainly a challenging question to answer, and most likely one which will not be answered anytime soon. Research into this area is still in the 'information gathering' phase. So what do we know so far and how can we make positive changes to promote our gut health with this limited information?
1. We need both probiotics and prebiotics to support our gut microbiome. The probiotics are the 'good' bacteria - we need a variety of bacterial strains in a variety of ratios for optimum gut health. Everybody and everybody will have a different probiotic profile which fits them the best, and this profile likely changes over the course of life. For optimum support of your own personal microbiome, you need to feed these little guys! This is where prebiotics come into play. Prebiotics are food sources on which the probiotics feed and YOU are responsible for feeding them the right sorts of foods. Examples of prebiotics include garlic, oats, onions, asparagus, leeks, flaxseeds, bananas, cocoa, etc.
2. Consistency is KEY! The most significant time for microbiome development is during birth, when an otherwise sterile and undisturbed environment is introduced to the world and its microbes. After this event, especially as significant spans of time pass, the established microbiome becomes much more challenging to shift. There is not a 'one-size-fits-all' microbiome fix in a pill which can be taken daily to fix a gut-related problem. To truely influence your gut microbiome, diet and lifestyle modifications are a must! A plant-based diet (not necessarily excluding meat!) supplemented with lots of probiotic rich foods (think greek yogurt, kefir, kombucha, kimchi, tempeh...) adopted consistently as part of a reduced-stress and moderately active lifestyle is the best thing you can do for your gut!
3. This process takes time - don't expect to immediately feel like your younger, care-free self in 24 hours. Explore new foods, keep a food and feeling diary, go outside and play, incorporate relaxation techniques and indulge in treats every once in awhile! Look back after a few months and then compare how you generally feel. This is an inside job.
4. To further get to know your gut microbiome, pick up a copy of I Contain Multitudes by Ed Yong. Your multitudes will thank you!