We harp on gut health all the time. About as often as your girlfriend talks about The Bachelor, or your mom wonders if you're eating enough. But like your mom's concerns (and unlike The Bachelor), gut health comes up a lot because it's important. However, important isn't synonymous with "easy", or "simple", and healthy bellies can require some new vocab words. If you've got one toe dipped in the wellness world, you've probably heard the words "probiotics", "prebiotics", and "enzymes". Those words leave a lot of people wondering if "pre" and "pro" are referring to the same things, what situations call for one or the other, and why you even need them in the first place! Let me clear up a few digestion questions, explain the difference between these 3 gut health buzz words, and let you know when you need them and why!
Let me introduce you to the power players when it comes to digestion: probiotics, prebiotics, and digestive enzymes.
Prebiotics are high fiber foods that feed probiotics (good bugs, to be explained shortly) to grow and multiply. By definition, fiber is something that can't be digested by the human stomach. This is why it keeps us full, and is super helpful for weight loss. Yet, magically, it still comes out at something brown at the end of the line... How? Little bugs in your colon (the probotics) ferment the fiber that you can't digest. This encourages the good bugs to grow and multiply, creating a healthy and balanced gut flora, which has HUGE health benefits. Prebiotics can boost your gut health, but not by themselves. Don't let them fool you, pre-biotics don't pack the power punch of taking a probiotic or a probiotics + eating prebiotic foods.
You can find prebiotics in: raw vegetables (especially jicama, asparagus, onions, and garlic, and under-ripe bananas -- the greenish ones), as well as chia and flax seeds.
We talk about probiotics ALL. THE. TIME (see here). If you hang out with us regularly, you might even be sick of it... unless you've been taking some... then you're probably not sick (they build immunity... get it? #nerdjokes). Probiotics can't be ignored for people looking to make changes in their health. They are good bacteria that should make up about 85% of the bacteria in our gut. If we have less than 85% good bacteria (or more than 15% bad bacteria) we have "gut dysbiosis." Meaning, the bad guys are winning, and it can lead not only to tummy troubles, but whole body inflammation and more. Dietary changes to add more prebiotics will be beneficial, but prebiotics alone takes longer to boost gut health and results can depend on multiple factors like stress, lifestyle, and medications. The major benefits of prebiotics only occur when they work together with probiotics to make them strong and capable. Probiotics are the construction crew, prebiotics are the midday snack. Not much work gets done with snacks alone! There's strong evidence in recent research that probiotics boost immunity, treat infections, lower rates of depression, and tame inflammation (including rashes, autoimmune, and skin disorders). Prebiotics alone are unlikely to make big changes in such cases, but the two of them together can do amazing things!
Remember, no two humans are the same! Which is why prebiotics alone might not be the answer for your health. The effectiveness of prebiotics depends on the quality and quantity of "good" bacteria you already have. If you've experienced things in the past (or currently) like: antibiotic use, processed and polluted foods, chronic inflammatory disease, undiagnosed food sensitivity or intolerance, birth via c-section, or overly sterile environments, then your good bugs might be on the low end of the scale. These cases most definitely call for a potent probiotic!
In grad school i had a chemistry professor that got FURIOUS when someone said "enzymes help digest food." He was very fancy, and a purist, so he always corrected us to say that "enzymes helps speed up chemical reactions" (I think in his head, he added "DAMN IT" at the end, but we'll never know)! It may as well have been tattooed on his face in a little speech bubble so he didn't have to waste breath saying it every time. Here's the thing, breaking down and digesting food IS a chemical reaction, and enzymes DO speed it up. So yes, enzymes do help digest food. Well everything except fiber, but we've covered that. Not everyone needs help digesting and absorbing their food, but many people do. Think about how fast you eat a meal. Personally, even before I had a newborn in my house I was speed eating meals so I could get back to (insert literally anything I needed to do). Add in a newborn babe, and I've never eaten SPEEDIER! Quick! Eat 2 full meals in the time it should take to eat half a meal because she might cry, or need to nurse, or blink in a cute way and you'll miss it! Luckily after about 2 weeks of speed eating I tuned in a bit and realized my stomach was hurting more than usual. Many people get mild stomach aches regularly. It may be due to this insane speed eating at our desks, in our cars, in front of the TV, etc. that's so common now. Why?
Your mouth is the first part of your digestive tract. If your teeth, lips, and tongue don't do their fair share of digestion (thoroughly chewing and liquifying your food), then the rest of your system has to work harder. This can lead to belly aches after you eat, even if you're eating the cleanest-paleo-whole 30-vegetarian-magic-whatever-diet. Larger food particles require more enzymes than smaller/well chewed food.
When food gets past your mouth and stomach it goes into the intestines where it meets some enzyme-rich juices from your pancreas. We're meant to make these enzymes naturally, but modern life can hinder enzyme production. Things like processed foods (all of the cookies, breads, drive thru windows, and bar foods), pesticides (non-organic foods), and environmental pollutants can make the pancreas gall bladder, and liver all stuffy and congested. The congestion plugs up the organ ducts and prevents the enzymes from reaching the food that needs digested. Taking a digestive enzyme 15-20 minutes before you eat can be MONUMENTAL in digesting your food more thoroughly (you get more nutrients that way!) and relieving aches and pains.
It's super important to note that ideally, you're not taking enzymes for the rest of your life. Ideally, enzymes would be a jump start to help your digestion in the short term (less than a year) while you change your diet (eating organic, non-processed foods) and lifestyle (take time to chew and SAVOR your food). But while you work on the big changes, taking enzymes before you eat is totally helpful and appropriate.
To sum up these power players: prebiotics are important, but are not as effective as pairing them with probiotics. The joy of being in private practice seeing patients every day, is that you get to see the application of nutrition, and its effect on people you care about. In our clinical experience, prebiotics alone don't cut it, in most cases. Research shows it's the combo that's truly helpful when it comes to kicking unwanted symptoms. Adding probiotics, prebiotics, and digestive enzymes can heighten your health. Like any other aspect of nutrition, it's important to make dietary changes to complement your supplement choices (ahem, that's why they're called supplements and not staples or foundations). I've seen a TOTAL 180 happen for people who are incorporate these 3 power players, and lifestyle changes to boot. It's because the state of our gut has the ability to make or break our health, and you need to take care of it!
Still wondering if this applies to you? Here are a few cases where the trio of gut helpers might be the answer:
1. Stomach aches after eating: Having a stomach ache after every meal might indicate the need for some enzymes. This can be due to your stomach working over time on large food particles that are difficult to digest. Enzymes should help alleviate this type of indigestion. You may also want to check in with yourself and make sure you're chewing your food instead of inhaling it!
2. Rashes or Eczema: When bumps or redness arise, most people jump to lotions, detergents, etc. to find an explanation. That's a great place to start, but if that fails the next place you should look is your intestines. Try cleaning up your diet, getting tested for food sensitivities, or implementing the gut power trio mentioned above to help heal mystery skin issues.
3. Depression and anxiety: There's a nerve that goes from your gut to you brain to say "Hey kid, you're ok! All is well!" Unfortunately that signal doesn't make it very far with an unhealthy gut. Making changes to your diet, lifestyle, and supplement regimen can actually have an effect on your mood. If you're not wanting to make the jump to a prescription medication fix just yet, fixing your gut might be worth a shot!
4. Colicky babies: Nothing is more stressful to new parents than a colicky baby. Calm, NORMAL babies are stressful, so adding non-stop spitting and crying on top of zero sleep is a recipe for disaster. If a baby is breastfed, its belly can be irritated by mom's diet. Babies can have trouble breaking down larger proteins in mom's milk. Giving little ones some baby-friendly probiotics, and giving mom a digestive enzyme can help calm a colicky baby. When your sleep pattern is equivalent to taking a red eye flight for 3 months (thanks, newborns) any little bit helps!
Prebiotics: Since prebiotics are mostly food, you can eat food whenever you're hungry. Sound good? Great.
Probiotics: There's been a lot of debate about the best time to take a probiotic supplement. A year ago, I would have told you to take it at night on an empty stomach, but after researching this over the past year, I highly suggest taking a probiotic AFTER a snack or meal to get the most out of it. It's not that it won't help on an empty stomach, but it may be more effective when food acts as a buffer between the probiotic and the acid created when it enters the stomach. Again, probiotic on an empty stomach is better than no probiotic at all, so if you're stressing about when to take it... don't. Be all Nike and just do it.
Enzymes: In order to help digest your food, enzymes need to get a head start on your meal so that they can be ready when the food shows up. Take enzymes 15-20 minutes before a meal to be most effective.