Pre- and Probiotics Post Berlin for the Win?

“Death sits in the bowels; a bad digestion is the root of all evil,” claimed Hippocrates a few hundred years BC. The very same man who advised us to “let food be thy medicine and medicine be thy food” which has been quoted ad nauseam ever since.

Boasting a surface area the size of a tennis court, the big, bad bowel is our largest immune organ. It defends us to the death by providing:
1. An ecological barrier, provided a favourable balance of gut flora is maintained,
2. A physical barrier to pathogens through its lining and mucus (pathogens are disease-causing bacteria, viruses, fungi etc), and
3. An immune barrier: the bowel’s GALT (Gut-associated lymphoid tissue), Peyer’s patches (more lymphatic tissue to combat nasties), lymph nodes (‘glands’), white blood cells (immune system cells which thwart infectious disease and foreign invaders) and antibodies (bug-neutralizing proteins).

There are trillions of bacteria navigating our digestive tract at all times. That’s a lot of zeros! They weigh upwards of 2kg. ‘Good’ or ‘friendly’ bacteria have hogged yards of media attention over the past decade or two…

But what’s all the fuss about? And how do they confer the far-reaching health benefits that are ascribed to them?
I’m feeling a little worse for wear after a last minute jaunt to Spain and a weekend in Berlin and I need to maximise my own immunity at the moment…

‘Good’ bacteria were christened “Probiotics” in the 1960s, meaning ‘pro life’ (as distinct from antibiotics). Probiotics are “live microorganisms (i.e. bugs), which when administered in adequate amounts confer a health benefit on the host,” according to the World Health Organisation. The most common types are lactobacilli and bifidobacteria; names which yoghurt advertisements have made quotidian.

Antibiotics, stress, alcohol and other toxins eradicate swathes of beneficial gut microorganisms. This phenomenon often results in digestive problems including malabsorption of nutrients as well as more chronic inflammatory conditions.

Those who stand to gain the most from optimising their levels of probiotics include those who suffer from:

– frequent yeast/fungal infections, including candidiasis (thrush) and tinea (fungal toes/jock itch/athlete’s foot),
– compromised immune systems,
– food intolerances,
– seasonal allergies/hayfever,
– atopic dermatitis (eczema) and other inflammatory skin conditions,
– chronic inflammatory conditions such as inflammatory bowel disease (ulcerative colitis and Crohn’s disease), irritable bowel syndrome and intestinal infections.

Probiotics work in various ways.
They compete with pathogens (bad bugs) for adhesion sites and energy which keeps the undesirables in check. They also exert an anti-inflammatory effect, enhance our immune response and are involved in the metabolism of nutrients to render them ripe for absorption.

There are many factors that influence our gut microbiota. Your mother’s bugs, your mode of delivery (don’t dwell on the thought for too long!), heredity, your use of medications (antibiotics, chemotherapy and anything that suppresses your immunity), your medical history including that of infectious diseases, your travel history, nutrition (unsurprisingly, highly processed, low fibre diets are bad news), chronic bowel disease, alcohol consumption as well as that of other toxins, cigarette smoking and so on.

Breastfed babies have higher levels of probiotics than their bottle-fed peers. Thankfully, newer milk formulas are often fortified with probiotics.

Foods that are rich in probiotics include:

Sour cream
& Aged cheese

If you wish to eschew (or curtail your intake of) dairy products (see my post on dairy for why… I know I’m going to start any day now!), try

Water or Coconut Kefir
Sour pickes
& Ginger beer(!)

Of course supplements are also an option but are expensive and should rarely be warranted.

And what then are PREbiotics?

The concept of prebiotics was introduced in the mid-90s as: “non-digestable food ingredients that beneficially affect the host by selectively stimulating the growth and/or activity of a limited number of bacteria in the colon that can improve host health”. They are essentially fertilisers for probiotics. Consumption in tandem with prebiotics usually yields the best results, i.e. replenishing our body’s friendly bacteria while feeding them for an enduring effect.

Foods that contain prebiotics include:

& Breast milk

As well as the aforementioned general anti-inflammatory and immune-boosting effects of pre- and probiotics, some more specific knowledge and clinical applications have emerged from research conducted more recently.

Regarding food intolerances, probiotics produce beta-galactosidase to digest lactose. While actual lactose allergy is a rare beast, lactose intolerance due to an enzyme deficiency is relatively common.

Lactic acid bacilli also optimise our metabolism of lipids(cholesterol) which can dispense with the need for taking medications, not to mention the need for tackling the repercussions of long-standing elevated ‘bad’ cholesterol levels.

Off-kilter gut microbiota have also been implicated in depression and anxiety.

Talk of the skin’s microbiome has exploded in the past couple of years. Maintaining an adequate barrier and a balanced skin microbiome helps to lock in moisture and ward off inflammatory skin conditions such as atopic dermatitis (eczema), acne and rosacea. Brand such as La Roche Posay have launched lines of “Prebiotic Skin Care” which purport to exert a nourishing, prebiotic effect on your skin’s microbiome. Early research shows they also confer protection against UV rays as well as expedite wound healing, including the healing of burns.

In the past, when bugs were implicated in the aetiology of various cancers, the culprit was usually a virus rather than a bacterium, e.g. subtypes of Human Papilloma Virus (HPV) and cervical cancer. In recent years, bacteria have been hauled into court for the first time. In two substantive studies, conducted in 2012 and 2016, the bacterium Fusobacterium nucleatum was found in an overwhelming majority of colorectal cancers. Furthermore, reduced survival rates were found in patients whose tumours tested positive for the bug. JAMA Oncology (the esteemed Oncology Journal of the American Medical Association) published a study in January 2017 demonstrating that the levels of this bug could be altered by dietary modification, demonstrating the role of the gut microbiome in this cancer. A fibre-replete diet was associated most robustly with a reduced risk of developing Fusobacterium nucleatum-rich bowel cancer. Dr. Chan et al, of Massachusetts General Hospital, Brigham and Women’s Hospital, and the Broad Institute of MIT and Harvard extrapolate from their research that a prudent diet, avoiding red and processed meats and smoking and consuming a minimal amount of alcohol can chop our risk of developing this cancer in two. In addition, novel cancer diagnostic tools have emerged. Faecal microbiota can be used to detect cancer, rather than, for instance, the screening programme currently underway in Ireland which lacks sensitivity and specificity. (It detects faecal occult blood to screen for cancer.)
The (quite treatable) bacterium Helicobacter Pylori is accepted as a culprit in the multi-step process behind the development of certain cancers of the stomach owing to its inflammatory effect which leads to the development of ulcers which can progress to cancer.

The evidence for optimising our gut microbiome is mounting. And for something involving little or no hardship or adverse effects that involves eating (at which, not to blow my own trumpet, I excel), I feel it’s worth a shot!

As always queries welcome and if you’d like to read more, please visit!

As for Berlin, it’s as much a beaut of a city as I recall from my first visit in my teens. As well as rifling through the must-sees (Checkpoint Charlie and the myriad of superb museums, monuments and architectural masterpieces), I’d highly recommend a visit to the flea market at Mauerpark, if only for a perfunctory rummage and a casual bite and an earful of the eclectic range of music infiltrating the place. I stayed at Mani hotel (by the Amano group) on Torstrasse in the Mitte Region which is conveniently-located and inexpensive relative to its tone and character. The restaurant is great too!

Photos to follow when whatever glitch is currently at play is fixed!!


My name is Michelle and I’m a Dublin-based GP (family doctor). Life is short: take the minimalist approach to maximise your health!

You may also like


Instagram Feed

Something is wrong.
Instagram token error.
Load More

Subscribe to Blog via Email

Enter your email address to subscribe to this blog and receive notifications of new posts by email.