Are Prebiotics or Probiotics Better For Your Gut Health?

You may be familiar with the health terms prebiotic and probiotic. In my Melbourne clinic, I am talking a lot about these to my patients and how they can support the health of their gut. So what do they mean and how do you know when to use them?

I want to share my knowledge as a naturopathic gut health specialist to help you understand their roles and ultimately help you make better decisions about your health, here are the facts.

What is a prebiotic?

A prebiotic is classified as non-digestible compound that, through its metabolisation by selected microorganisms (bacteria) in the gut, changes the composition and/or activity of the gut microbiota and provides beneficial effects to the host (us, humans)(1).

Simply put, prebiotics are food for select organisms which when fed are able to create products we benefit from.

There are a variety of prebiotic substances that are naturally found a variety of foods and come in a variety of forms:

Oligosaccharides in the form of fructooligosaccharides (FOS), galactooligosaccharides (GOS), isomaltooligosaccharides (IMO), xylooligosaccharides (XOS), transgalactooligosaccharides (TOS), and soybean oligosaccharides (SBOS).
Polysaccharides such as inulin, resistant starch, cellulose, hemicellulose and pectin
Lactitol
Lactosucrose
Lactulose (2)

A lot of these you may identify them as high FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols), which is another reason a long term strict low FODMAP diet can be problematic for your health.

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What is a probiotic?

Probiotics are defined as live microorganisms that, when consumed in adequate amounts, confer a health benefit to the host. Based on current interpretations of the probiotic definition, it technically excludes traditional (wild) ferments like sauerkraut, kimchi, yoghurt and kefir.

These are considered food sources of “live and active cultures”, but not probiotics (3)

Simply put, probiotics are the live organisms. Probiotics differ from our indigenous bacteria, in that probiotics are transient in nature (they do not stay in your gut permanently)(4).

Should you take prebiotics and probiotics?

You do not have to take both to get benefits, however it is important to understand their differences to help make the best decision.

How prebiotics help your gut

Technically, a healthy and varied diet will contain adequate food sources of prebiotics, so the addition of a prebiotic supplement could be considered when you want to further.

Support the health of your gut and the bacteria within large intestine. Prebiotics (in a healthy gut) avoid breakdown and fermentation in the small intestine. If however you experience bloating or react to these healthy fibres like onion, garlic, apples and chickpeas, reach out and see what's really going on in your gut.
Provide a food source that will selectively promote the growth of beneficial indigenous organisms
Provide long term microbiome changes, provided prebiotic foods are consumed long term
Support the production of beneficial byproducts, such as short chain fatty acids (SCFA) from the fed bacteria. The benefits of SCFA's are endless and include providing immune support, anti-inflammatory actions and acting as fuel for your gut cells.

How probiotics improve your gut health

Support the health of your gut and the bacteria within the small AND large intestine
Help the overall health and balance of the species currently inhabiting your gut
Provide competitiveness with respect to microbial species inhabiting your gut i.e. the presence of some species support the growth of others
Protective activity towards pathogens (e.g., H. pylori, Salmonella sp., Listeria monocytogenes, Clostridium difficile).
Provide support in the adherence and ability for species to colonise within in (2)
Have a condition or symptom that requires specific bacterial strain for support. Some conditions and symptoms that have strain specific probiotics proven to be beneficial include leaky gut, ulcerative colitis, IBS, constipation and diarrhoea, eczema, depression and anxiety.

Is it safe to take probiotics and prebiotics at the same time?

Yes, you can. In fact some products have been formulated to contain both prebiotics and probiotics and may be classified as a synbiotic product. The term synbiotic should be reserved for products in which the prebiotic compound selectively favours the probiotic compound (5) for example:

Lactobacillus genus bacteria + inulin
Lactobacillus, Bifidobacterium, Enterococcus genus bacteria + FOS

Synbiotics are used to improve the survival of beneficial microorganisms and for the stimulation of the proliferation of specific native bacterial strains present in the gastrointestinal tract (6).

What is best prebiotic to take?

The consumption of prebiotics is difficult to measure since they are found in very diverse food groups. The key is to have a diet that is consistently rich with a variety of prebiotic foods that include fruit, vegetables, grain, nuts and seeds, pulses and legumes.

By doing this, you will promote the growth of your beneficial indigenous species that view those prebiotic foods as their preferred fuel. For example by eating foods high in the prebiotic substances fructooligosaccharides (FOS) and inulin you will support your Bifidobacteria species (7).

If you need a bit of extra help you can buy prebiotic powders such as inulin and have them too, however I always suggest optimising the diet first. Some example of prebiotic rich foods you may want be familiar with include:

Leeks, asparagus, onions, wheat, garlic, chicory, oats, soybeans, and Jerusalem artichokes that contain inulin.
chickpeas, legume beans (e.g. baked beans, kidney beans, borlotti beans), lentils, pistachio nuts and cashews as they contain GOS (8).

What is a good probiotic to use?

Choosing the right probiotic for your health is a little more involved than you may think. It is generally a process of selecting a bacteria strain that is specific to your condition and symptom. For general health, a multi-strain probiotic and regular consumption of fermented foods could be good place to start.

**My answer to 'are probiotics or prebiotics better?'**

One is not better than the other. As you can see they are different in how they function, and yet are both are incredibly effective and important at supporting gut health. My take home tips are:

If high fibre foods cause digestive symptoms like bloating, look into why this is rather avoiding the food.
A multi-strain probiotic could be a nice addition for general maintenance, but as mention, may not be adequate for treating certain conditions.
Optimise the diet and consume high fibre, high prebiotic foods and fermented foods daily. Fermented foods also have a powerful role in helping you overcome sugar cravings and managing your weight.

If your gut health is a little or a lot more complex than taking a simple prebiotic or probiotic, check out Bloated to Body Confident . It is the step-by-step strategy for finding your root cause, comprehensive functional and diagnostic testing, personalised dietary advice, holistic support, effective treatments and sustainable solutions, empowering evidence-based information and a clear action plan.

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