15. Pre, Pro and Post-biotics: How can they improve our gut health?

Nutrition Unlocked // EP014 - Pre, Pro and Post Biotics 

// Jackie Intro // 

[00:00:01] Jackie: Nutrition fuels our bodies and minds. Our strength, mobility, energy, and even mood rely on the right nutrition, and scientists are continually uncovering new secrets.  

Welcome to Nutrition Unlocked, the podcast celebrating innovations, advancing the role of nutrition and health, sponsored by Nestle Health Science. 

In each episode, we'll talk to experts from around the world about the latest topics, and we'll bring you insights and discuss innovations that are unlocking healthier futures.  

On today's episode, we'll be talking about the connection between pre pro and post biotics and nutrition.  

Our host is Amir Nashed.  

// Ep intro //  

[00:00:40] Amir: Welcome back to Nutrition Unlocked. I'm Amir Nashed. In this episode, we're going to discuss pre, pro and post biotics, a very popular and trending topic in nutrition.  

We're joined by Dr. Joe Petrosino. Chief Scientific Innovation Officer, Chair of Molecular Virology and Microbiology, Director of the Center of Metagenomics and Microbiome Research at Baylor College of Medicine. 

In this episode, we'll be learning about what pre, post, and probiotics are, the positive roles that they play in our gut health, and how they work to ensure a balance in our microbiome and beyond. 

Welcome to the show, Joe.  

[00:01:20] Joe: I appreciate it. Thank you so much, Amir. Glad to be here. 

// Main chat //  

[00:01:22] Amir: So in this episode, what we'll be trying to do is to help the audience learn a little bit more about pre, pro, and postbiotics and the positive roles that they play in our gut health. How do they work? How they work together to perform different roles, but, let's get started with some of the basics of gut health and let's talk a little bit about microbiome.  

I would say from my little experience, the word microbiome was not really mainstream as it is today. Maybe if we think four or five years ago, you could only see that in medical literature. So, first of all, tell us a little bit more about the microbiome, what it means exactly, and is it surprising you that microbiome is becoming really mainstream? 

[00:02:09] Joe: The microbiome is a very important topic today, and I'm glad it's getting the recognition that it is. The microbiome, to define it, is the collection of microorganisms, the bacteria, viruses, and fungi, that live on the body, lives on and inside the body. And many of the external surfaces of our bodies, as well as a number of our internal surfaces that are exposed to food in particular, are coated with these organisms, and they contribute to our, daily health in new and important ways that we're beginning to explore in great detail. 

[00:02:41] Amir: Fantastic. So when we talk about microbiome, this could potentially mean skin microbiome, mouth microbiome, and of course there is gut microbiome. Particularly today, I guess we will be taking a deeper dive into the gut microbiome. 

[00:02:57] Joe: The gut microbiome is by far one of the more important collection of microorganisms that we have. They help us metabolize our food and provide almost a cross talk between our environment and our bodies. And so the food that we digest turns into a variety of molecules that we'll talk about in a moment called post biotics and they influence everything from our immune health, our metabolic health, and our mental health. 

[00:03:21] Amir: So I guess we're, we're starting to get into the topic already. Prebiotics, probiotics, postbiotics, in the context of the gut microbiome, let's help our audience understand what they are and what function do they perform. 

[00:03:37] Joe: Probiotics are the organisms themselves. They're the bacteria, the collection of bacteria, viruses, fungi, that contribute to the beneficial health that we like to think about when we think about maintaining a healthy microbiome. The probiotics are the organisms themselves. Prebiotics are the food for those organisms.  

So, bacteria need to eat just like we need to eat, and the food that we give them, the food that they like are undigestible, carbohydrates that we get from plants and other plant based nutrition sources. Not only do plants have a benefit for ourselves directly, but they also have benefits that we get to take advantage of through the metabolism of those plants by the bacteria, by the probiotics. And then finally, those beneficial products coming from the eating of prebiotics are called postbiotics. Postbiotics are the nutrients, the enzymes, the amino acids that are essentially, the bacterial waste products, that result from the probiotics eating the prebiotics, and those postbiotics then are used by our bodies for a variety of beneficial purposes, such as immune health, metabolic health and mental health, among others. 

[00:04:49] Amir: Fantastic. Thanks, Joe. This is I think, really starts to put the picture together. Probiotics are the good stuff that lives in our gut and performs the benefit. Prebiotics is the food and postbiotics is, let's say, the waste or what comes after them. So this makes it really very easy for everyone listening  

Now, let's try to get a little bit deeper into the topic and understand how these three forms of biotics help perform health functions Because that's really what people would like to understand about what do they actually do for us. 

[00:05:28] Joe: Sure. So the probiotics, we start off in life when we're born, we're basically sterile. There's no organisms that are inside of us. We start to acquire them immediately from our moms and our family and our immediate environment. And even in that rapid development period from birth to the first three years of life, is when really the microbes start collecting in our bodies. Those first organisms colonize and we start to see their benefits right away. They're fed by mother's milk. So those prebiotic molecules that we were just talking about, the food, infants can get them through their mom. And so they were feeding the child and the microbiome already from day one. And the products that are produced by those microbes have been shown in a variety of studies to help benefit the developing infant. Their mental health, reaction to social stimuli, all the signals in the brain that are being wired as the child is developing in those first few years of life are aided by the molecules that are produced by the microbiome.  

[00:06:25] Amir: I think this is very interesting. So, the microbiome is developed as early as we're starting in life. So I just wanted to ask you a couple of questions there. 

Does the way a child is born impact the microbiome development? If it's a normal delivery versus a cesarean section, does that have an impact at all? 

[00:06:45] Joe: Yes, so that's actually been a very interesting and hot area of study for microbiome researchers who are working in pediatrics.  

We and others have observed that children born by cesarean versus natural delivery, do start off with a slightly different microbiome. The microbes that are colonized from someone who's born naturally, as you would imagine, are colonized by the organisms that line the birth canal of the mom. Those are sort of among the first organisms that are colonizing that infant. Those born by cesarean will have a few of those organisms, but they'll also have organisms that are dominated by those that are found on the surface of the skin.  

And in the cohorts that we've studied in Western Europe and the United States, those differences stay for about 10 months or so. After which point, the microbiome of children, both born by cesarean or born naturally start to look the same. 

So there is a window of time, early in life where they seem to be different, but after which, the environment and other exposures that they've collected over the first 10 months of life will start to help them look very similar.  

Now, you may think, well, that's great. We're off and running in the same track after about 10 months. And that is a good thing, But there are studies that also have shown that differences, even in short windows following birth or during weaning or breastfeeding, 

can have a dramatic impact on developing, systemic behaviors in the body. 

So, microbial signals in the gut can impact microbial signaling in the brain when the brain is going through normal development, responding to social stimuli, responding to learning and cognition exercises. Those signals early in life from gut bacteria, if they're not there, can have an impact on how those pathways are wired in the brain. 

[00:08:25] Amir: Wow, so despite of the fact that you would say all infants at a certain stage reach the same destination, the journey to get there really creates a big difference on health. What other health benefits for adults does the healthy microbiome play a role in? 

[00:08:42] Joe: Many of us are familiar with a variety of gastrointestinal symptoms that one can have when things are just off. So whether you're constipated or have diarrhea or perhaps you have a more chronic condition such as irritable bowel syndrome, a lot of times the signals and the molecules coming from the gut microbiome are a reflection of the organisms themselves and therefore, need to be taken into account as we look for treatment of these conditions. They also are needed for immune support, so vitamins and other post biotic products that are made by our influence things such as our immune system. They can both reduce inflammation. We know that inflammatory signaling can have a dramatic impact on the state of inflammation in the body, and so by improving our microbiome, we can again improve the postbiotic molecules that are produced and therefore reduce inflammation and then alleviate a number of chronic immune conditions, that people deal with today.  

Of course, as you probably expect, given the fact that we're talking about the gastrointestinal microbiome, a lot of metabolic health is also influenced by bacteria. And we're just still uncovering just the depth and breadth by which bacteria can improve our metabolic health.  

 There have been a number of studies now showing how microbial, postbiotic molecules passing through our circulatory system and working in conjunction with our liver, can provide signals to our bodies that could actually influence cardiovascular health, both positively and negatively. 

And then finally, I alluded to this with the infant microbiome, but we also know that the postbiotic molecules provided by probiotics can influence our mental health. We refer to that as the gut brain axis. And so things such as mood and anxiety or depression, can be influenced by the microbes that are living in our bodies and the molecules that are produced and some of this can be attributed to how we eat or tend to want to eat when we're feeling a variety of feelings. We're starting to learn more about how that gut brain axis really works. 

[00:10:38] Amir: This is fascinating stuff. This is why you guys probably have a lot of work at Baylor's! This is a lot of stuff to research. I heard gut health. I heard immune system support, metabolic health, mental health, cardiovascular health. 

What do you say to people who hear all of these health benefits and they might think how is this possible for our gut microbiome to influence all of this stuff? 

So let's say people are skeptic about the role of microbiome. What would you say to them? 

[00:11:13] Joe: Yeah, so I would say that, as you mentioned, the microbiome has really started to come back into vogue now in the last, probably the last 15, 20 years, but in public eye, more like the last five to 10 years and you're right, we get lots of questions. Does it really have an influence?  

And you know, it's funny, because some people will walk into the conversation with a,. I knew" there was something going on with the bacteria that are inside us and how they help us!" So whether it's through natural medicine, for example, the microbiome was always a part of the conversation there. And then, yes, of course, you're going to have skeptics as well. One of the early cocktail party facts, if you will, about the microbiome is just the number of microbial cells that live on in the human body as it relates to the number of human cells that make up the human form. And, you can say that there's somewhere around a one to one, or ten to one, it's almost the same number of bacterial cells that make up the human body as there are human cells. And if you think about the fact that each one of those makes about a thousand different molecules as part of its natural daily life, you can think about each bacterial cell being a little chemical factory that's working in their bodies. And there are a lot of them, about fourteen trillion of them.  

But I think that the more that the next generation of probiotic and prebiotic, I think people are starting to wake up to the fact that they can have a dramatic influence on just daily wellness. 

I tend to tell people who are generally healthy already, say, Hey, what can I do to help make my microbiome better? What should I be doing to take care of my microbiome? I would say, do what you're doing. If you don't have any chronic disease, if your digestive health is in good shape and just keep eating a good diet, you're good to go. Feed the good guys. 

[00:12:47] Amir: You're probably doing a lot of things right. 

[00:12:49] Joe: Yeah, exactly. Exactly. And for those that do have, you know, a number of people come with a variety of issues that they think may have a microbial component to it based on the conversation we've just had, I think the best way to influence it is through prebiotic supplements. 

So, it's like fertilizing your garden in your yard. You want to take care of the good plants and you want to get rid of the weeds. And that's pretty much the same thing with the microbiome. It's just living inside of you and it's microscopic. And the best way to do that is to eat more fiber, dietary fiber. So all those leafy greens and Jerusalem artichokes and blueberries, they also like polyphenols, so, supplementing your diet with those really, has a dramatic effect on your microbiome health.  

[00:13:28] Amir: Yes. You mentioned a little bit about food and a little bit about supplements, so I want to go a little bit deeper into these two topics. But let's start with food first, because I think it's a little bit obvious culturally to many people, whether it's a Western culture or Eastern culture, we always had this familiarity with probiotics in food. Yogurt, kefir, and other things are very well embedded as healthy foods in our culture.  

Can you talk a little bit more about some of these foods that are probiotic rich, but also highlight, and you mentioned some of them in the previous discussion, what are the sources of foods that can really help us get some prebiotics and then postbiotics as well, which I think will be probably the most surprising to our listeners. 

[00:14:23] Joe: Yes. When you are looking to shape your diet around improving your gut health, to your point, one of the best sources are fermented foods, so sauerkraut and kefir and yogurts and the foods that where you have microbes that are growing inside of them, or a part of the formulation of the food itself, those microbes have been shown time and time again to have a great impact on your gut health.  

And they're being supplemented with, with the food that helps them grow. So you're getting both prebiotics and probiotics at the same time. So it's a great source, the fermented foods. 

The prebiotic foods that you want to consume with them, you'll find them in your produce department largely. So plant-based diets really drive the fiber intake that will help you improve your microbial communities that are growing in your body. So, artichokes, spinach and kale and all leafy greens are probably the number one food source for good sources of fiber... But also the colorful foods too. So the colorful foods will have a compound called polyphenols. And so polyphenols are also very important a food source, for a number of good bacteria that live in you. So the blueberries and blackberries and raspberries among others, will have a really strong influence on, a good microbial growth in your body.  

And ironically, or not ironically, many of those foods will also contain some of the post biotics that we talk about too. Again, you're really wanting to drive your bacteria to make those post biotics, because they make them most efficiently and provide them in quantities that your body is needing to consume, the vitamin K and some forms of vitamin B and certain amino acids that our bodies wouldn't naturally be able to make itself. 

But you're right. Certain foods also have those vitamins as well and many of them are the ones we just talked about. The fiber containing leafy greens, broccoli is a significant source of good vitamins. I don't think there's probably a mystery in there or a surprise food in there that your listeners won't say, well that makes sense. 

So I think as we eat those foods, I think you're doing the right thing. And then you can also think about the foods maybe we should avoid, a little bit more to avoid killing off the good bacteria. And again, it's the usual suspects. I wish I could tell you that eating donuts was a great source of nutrition for your microbiome, but it's just not the case. 

[00:16:33] Amir: Now I'm disappointed! 

[00:16:34] Joe: Yeah. Yeah, so foods that are high in sugar tend to increase the growth of actually bad bacteria. So the bacteria that'll fight off and try to kick out the good bacteria. So sugar not only is not good in high quantities for us, but it's also bad for your good bacteria. Alcohol consumption, same type of thing. You'll start to kill off the good guys and encourage the growth of the bad guys, and that can lead to a variety of other problems. And that's how you often get things such as increased inflammation. And so as we think about our diets, of course, if you have a condition, go with your doctor's instruction, but in general everything in moderation, but really load up on those leafy greens and fermented foods to help benefit the microbes that are there and keep seeding good bacteria that'll join the friends that are already inside of you for good gut health. 

[00:17:20] Amir: I'm sure the plant based diet enthusiasts listening will be cheering right now, because I think, the menu you've just put together is really primarily plant based.  

All right, so let's shift gear a little bit. And so, okay, I have a good diet, I'm eating all the right things and I know, the foods that have, the good probiotic bacteria and I'm eating prebiotics and postbiotics. So why do we need supplements? What are they for? 

[00:17:52] Joe: It's a fantastic question. If you are in great health, Some people just still don't, there's some aspect of health or wellness that's just not there and they need something a little bit more. That's really where we start to talk about the supplements or other interventions.  

if there are things that are wrong. Like if you've had to take a course of antibiotics, because you were recently sick, or if you do suffer from bouts of constipation. 

You could be eating perfectly well, but if you don't exercise, or if you're under stress quite a bit, or if you don't sleep well enough, all of those things are non dietary factors that can influence the wellness of your microbiome and your gut health. And because of that, sometimes your gut health may need a little bit of help. If your body is under stress quite a bit, you may not be metabolizing foods quite the way you want to. You may not be getting the nutrients out of them. And so in those cases, supplements may be helpful. And it's often good to work with a wellness provider or doctor that can help recommend the best supplements for you. 

I will say that probiotic supplements in particular, now you start to see them in refrigerated sections. And that's because the practices of preserving microbes has advanced over the last 15 years or so. And also the capsules themselves have improved. Now that there's better technology to help get the microbes, when they finally get them all dried up and put into a little capsule that you can eat and swallow, that capsule stays whole as it passes through your acidic parts of your digestive tract, your stomach.  

If capsules released all the microbes, or if you ate all these microbes that are supposed to be good for you and they all released into the stomach at the same time, a lot of them wouldn't survive this set of conditions. And so,, some of the technologies around the supplement, has improved so they can get to the lower part of the GI tract that's necessary to get the good guys where they need to be, off at the right station in your GI subway, if you will! 

[00:19:34] Amir: Great.  

 Well, I think as we come to the final part of this podcast, I hope this episode of Nutrition Unlocked has left everyone with a greater understanding of pre, pro, and postbiotics and how they can support our nutritional needs and health. To finish, Joe, I'd like to ask you, what is one key thing that you want to leave to our listeners? 

[00:20:02] Joe: So, I'll leave your listeners with something that's influenced my health, specifically as well and I think it's one of the most important things we can do, dietarily at least, to help improve our wellness and that is to increase daily intake of fiber. I know it sounds boring, . it's not a very sexy conversation. 

But you know, in studies that we've seen, we've been talking about the microbiome as a source of improving wellness. Much of the work that my laboratory does in a number of laboratories around the world are working on right now, is the use of the microbiome as either a co-factor or as a completely alternative mechanism for drug delivery, or as a drug. And so, we see microbes that can improve things like treatment for cancer or treatment for things such as inflammatory bowel syndrome or Crohn's disease. And so, in all of those situations, one of the biggest factors for determining the success of a particular clinical trial or better outcomes is the influence of fiber intake. 

This is something that we can be doing even when we're not sick and I think the daily recommended, dosage is somewhere between 25 and 30 grams of fiber per day. And so I would challenge everyone to get to 40.  I think 40 tends to be a magic number when we look at outcomes with specific clinical trials. I think in the future we will start to see even higher recommendation for fiber intake. And so, I shoot for 40. I don't get there every day. In fact, I probably only get there maybe half the time, if that. And I have to lean on foods that are almost supplemented with certain types of fiber to help get there, because I don't eat 10 fruits and vegetables every day. I'm lucky if I get to 5. But by getting there, I know I feel better. 

And so, I think if an individual does it, I think they'll start to feel the benefit as well. 

[00:21:42] Amir: I couldn't agree more. The more, the better, I think, when it comes to fiber. Thanks for highlighting this one.  

[00:21:49] Joe: Joe, thank you so much for sharing your expertise and giving us a better understanding of pre, pro, and postbiotics and their importance to our health. We've learned a lot from you.  

 I really appreciate it. And thank you for having me. 

// Outro // 

[00:22:03] Amir: If you haven't already, please subscribe to Nutrition Unlocked so you don't miss an episode. 

We'd love to hear from you so please use hashtag Nutrition Unlocked on social media to let us know your thoughts on this episode about the pre, pro, and post biotics and how can it improve our gut health.  

We look forward to sharing more insights on the science of nutrition with you soon. See you next time on Nutrition Unlocked. 

// END //