fermentation

Probiotics. Are they all the same?

We all know that probiotics are great for digestive health, but how do you know which one your gut needs? The bottle lists the various species of bacteria (or yeasts) contained within and offers a vague description of what they do, which really doesn’t give away a lot unless you know what to look for! This article is all about what to look for in a probiotic and in addition, I will dispel some common myths about how they work.

Let’s start basic. What is a probiotic?

The World Health Organisation officially defines a probiotic as “live microorganisms which when administered in adequate amounts confer a health benefit on the host” (1). Probiotics can be bacteria, such as the commonly seen Bifidobacterium or Lactobacillus species, or yeasts such as Saccharomyces boulardii. You will find probiotics in health food stores, chemists and health clinics, sold as capsules or powders, either alive or freeze dried (alive, but sleeping). Proper storage of probiotics is essential in ensuring they are still alive and healthy by the time they reach your gut, so always follow the storage instructions on the bottle and be mindful when transporting your probiotics.

How do probiotics work?

Myth number 1 – probiotics permanently make our gut their new home. It is a common misconception that we take probiotics to replace healthy bacteria that have been lost, for example, following antibiotic treatment or during times of stress. Probiotics work their magic while they are in transit through our gut and are eventually flushed with the stool (2). They may stay in there a bit longer than our food, but it isn’t forever.

Myth number 2 – all types of probiotics fight off bad bugs. Many (not all) probiotics do have the ability to compete with bad bugs and stop them from taking over, however the beneficial action of probiotics goes far beyond (3). Additional examples of how they work includes:

  • Reducing inflammation in the gut
  • Speeding up or slowing down the time it takes for food to travel along the digestive tract
  • Reducing how sensitive our gut is to internal gas
  • Repair and strengthen the gut lining
  • Interacting with immune cells (think allergies as well as infections)
  • Influence intestinal secretions
Naturopath in Melbourne

Why are probiotics named the way they are?

As probiotics are living organisms, they are given latin names just like all plants and animals. In order to differentiate probiotics, you need to understand the terminology around their naming. I will use an example of the probiotic bacteria Lactobacillus rhamnosus GG.

  • The first word is the genus – Lactobacillus
  • The second word is the species – rhamnosus
  • At the end of the latin name is the strain – GG

The strain may be a combination of letters, numbers or both.

How important is the strain?

The strain is very important when it comes to treating a particular complaint or condition. You could compare strains of probiotic to breeds of dog – all dogs are the same species, but they come in a range of shapes, colours and designs. Likewise in probiotic species, different strains can have a different effect in our guts (1). For example, some strains of Escherichia coli cause intestinal or urinary tract infections, whereas the strain Escherichia coli Nissle 1917 is protective against infections (4).

The strain is commonly omitted from probiotic labels and left out of the discussion when talking probiotics. A good quality probiotic will always include the strain, just like a good clinical trial (a human study) will always state which strain has been tested. Unfortunately, many strains that have been studied are not yet available in Australia.

Which probiotic should I take?

If you wish to treat a specific health condition with probiotics, it is best to do your research and find some positive human studies, then use the same strain. It may be more expensive, but at least you can be sure your money is going into something that will work. There are many articles out there on probiotics, particularly in treating digestive, skin and immune issues such as IBS, traveller’s diarrhoea, inflammatory bowel conditions, asthma and eczema(5).

To give you a few examples, Lactobacillus plantarum CJLP133 can reduce the severity of eczema (6). Lactobacillus rhamnosus GG and Bifidobacterium breve Bb99 can increase the eradication rate of Helicobacter pylori, an infection that causes stomach ulcers (7). At Narayani Wellness, we use Bifidobacteria lactis HN019 to treat SIBO, just one of the probiotics that we keep in our supplement toolbox.

If you are healthy and just looking for a probiotic to support general health, my recommendation is to get stuck into some fermented foods, such as yoghurt, kimchi, sauerkraut, kefir or kombucha. Strictly speaking, fermented foods are not considered a probiotic as the exact microorganisms are typically not known, nor can they be measured. However fermented foods that have been stored correctly are considered safe and beneficial to consume as they increase overall diversity in the gut when consumed regularly, which has been linked to a lower incidence of disease (5). Fermented foods also contain compounds that help to break down your food and keep your digestion working optimally.

If you are still unsure, take the hard work out of your shopping and make an appointment with us today to help find the right probiotic for you.

By Lucy Mason, Naturopath

Fermented Curried Cauliflower

Who would have thought food and drinks affected by bacteria and yeasts would be so sought after? Yes, we are talking about fermented products. No doubt you have heard about them on social media, at your local health food store, or from a health conscious friend.

Did you know, fermentation is traditionally a food preservation technique that has been traced back thousands of years. Fermentation has also helped us create new foods such as turning milk, wheat and grapes into delicious cheese, bread and wine(1). Yum!

It was only in early 20th century that scientific researchers proposed that fermented products might have health benefits (2). Fast-forward to today and we have stacks of science supporting the presence of good bacteria in these foods and how they can provide us with wonderful health benefits (1).

One of our favourite ways to reap the health benefits of fermentation is through eating fermented veggies. You may be familiar with fermented cabbage in the form of sauerkraut or kimchi, but did you know you can ferment a tonne of other vegetables including cucumber, carrot, beetroot and broccoli? Given that cauliflower is in season I thought this would be the perfect time to create a fermented cauliflower recipe.

Curried Cauliflower recipie

Ingredients

  • 1 tsp mustard seeds
  • ½ tsp coriander ground coriander
  • ½ tsp ground cumin
  • ½ tsp turmeric powder
  • ½ tsp freshly grated ginger
  • 1 pinch cayenne pepper (optional)
  • 1 head (600-700g) cauliflower
  • 2 grated medium sized carrots, grated
  • 1 spring onion, finely sliced
  • 1 -1 ½ tsp fine Himalayan or Celtic sea salt
  • Glass jar

Method

1. Rinse the cauliflower in cold water and cut into florets and slice as thinly as you can. Place in a bowl along with carrot, spring onion, spices and salt and mix with your hands. Ensure everything is well mixed and then let this rest for 30 mins.

2. Get your hands dirty again and massage the mixture again for a few minutes.

3. Press the mixture tightly into the jar, adding bit by bit, pressing down to realise the veggie juice (brine) as you go. Don’t worry if the mixture feels dry, as fermentation continues the vegetables will continue weeping.

4. After the mixture is in the jar, make sure it is pressed down and the brine is covering the cauliflower mixture.

5. After 8 hours, open the jar and give the mixture one more press down, to ensure the brine covers the vegetables.

6. Rest the jar on a plate (in case the brine seeps out) and place it in a warm place, such as above the fridge, and cover it with a tea towel. Depending on time of year you can start to taste the ferment from day 4 or day 7. When it’s ready you will be able to sense a pleasant sour and pickled taste.

7. Give the mixture another press to submerge in brine, screw on the lid and store in the fridge.

8. You will have this delicious ferment if kept refrigerated for 9-10 months. 

Things to look out for when fermenting

  • Brine. Always have your veggies covered, if your veggies are above the liquid push them back under. If you realise this later in the fermentation process, remove the veggies that have been on top of the brine level as they are no good. 
  • Note: if you are new to eating fermented foods, start consuming small amounts and increase gradually. Also if you have an issue with histamines, fermented foods may not be a great choice.

Created by Rachel Larsson

 

Low FODMAP Winter Warming Soup

You have just discovered the low FODMAP diet and your tummy is feeling much better for it, but traditional Winter food feels so bland without onion and garlic! It doesn’t have to. This delicious soup uses ginger, chilli and high quality chicken stock to give it some serious flavour. These warming ingredients are perfect for cold Winter nights, and the mix of fresh veggies makes it light, healthy and refreshing.

Not only will low FODMAP be gentle on your tummy, but the gelatin in the chicken stock may aid the healing of a leaky gut, which often accompanies FODMAP issues. At Narayani Wellness we encourage the use of high quality organic chicken broth, as pesticides accumulate in connective tissue and are therefore often found in high quantities in non-organic meat broths. You can make your own organic broth or buy it ready made from most health food stores. For a vegan/vegetarian variation of this soup, substitute chicken stock with a homemade veggie stock. Tofu, tempeh or boiled eggs could be used instead of poached meat.

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Serves 3-4. Preparation and cook time 30-40 minutes.

Gluten free, dairy free. Vegan/vegetarian option.

Ingredients:

  • Thumb sized piece of fresh ginger, finely grated
  • One fresh chilli finely chopped (seeds removed)
  • 1 tbsp oil (we like olive, coconut or ghee)
  • 1 large carrot, grated
  • 1 large zucchini, seeds removed and grated
  • ½ large capsicum, thinly sliced
  • 4 stalks/1 cup broccolini, chopped
  • 500g organic meat of your choice (I used chicken drumsticks) (optional)
  • 1.5 L organic chicken stock
  • Salt and pepper to taste
  • Fresh coriander to serve

 Method

  1. In a large pot, saute the chilli and ginger in oil for 2 minutes on medium-high heat
  2. Add the chicken stock.
  3. If using meat, add it now to poach in the stock
  4. Remove the meat with tongs once cooked through and place on a cutting board to cool
  5. Turn pot down to a simmer, add the vegetables and cook until just soft
  6. Meanwhile, shred the cooked meat with a couple of forks or chop into small pieces
  7. Add the meat back to the pot
  8. Serve into bowls, salt and pepper to taste and top with fresh coriander!

Created by Lucy Mason

BHSc (Naturopathy)

Are prebiotics good or bad in SIBO?

Since my previous blog about IBS and SIBO I have had so many questions from my patients wanting to know more about SIBO. What stands out to me the most is a confusion around what to eat, with the most common questions surrounding prebiotic, fibre rich foods and if they help or hinder SIBO.

 

What is a prebiotic food and what does our gut do to it?

A prebiotic is a non-digestible food ingredient that it is not broken down or absorbed in the higher parts of our gastrointestinal tract(1). There are a lot of foods with prebiotic properties including chickpeas, legumes, leeks, rye bread, garlic and cashews(2). They play a special role in our health - they act as food to our gut's good bacteria, increasing their numbers (lactobacilli and bifidobacteria(3)) and improving our overall health(1).  

 

Why do these healthy foods cause discomfort?

In SIBO, the overgrowth of bacteria causes inflammation and hurts your gut wall affecting your ability to breakdown and digest food. The bugs themselves play havoc with your own enzymes and body processes. For example there is loss/decrease in an enzyme called disaccharideses, which is important for breaking down carbohydrates and sugars. This means that any food, like a prebiotic food that contains fructose, lactose and sorbitol, may not be digested properly, resulting in those uncomfortable symptoms you experience(4).

 

Treating SIBO… with prebiotics?!

You may notice that some of the foods that cause your discomfort are also considered to be high FODMAP foods. FODMAP describes a group of of short-chain carbohydrates and sugar alcohols comprising of fructose, lactose, fructo- and galactooligosaccharides (fructans, and galactans), and polyols(5).

To provide symptom relief from SIBO we may suggest avoiding these high FODMAP prebiotics foods (looking at you apples, onions and garlic!) for a short period of time. It is really important to know that excluding these foods long term is not the answer and will not fix SIBO(6). A healthy gut is dependant on you eating a fibre rich, highly diversified diet so restricting these foods for a long period of time will only worsen your situation and increase your sensitivity to more foods(7). It's not uncommon that we see patients tolerating only a handful of foods and it's best to avoid this! 

Garlic, a wonderful prebiotic food.

Garlic, a wonderful prebiotic food.

As part of our treatment for SIBO we use certain types of prebiotics in combination with probiotics and specific antimicrobials (bug killers). These types of prebiotics have beneficial roles in our gut health that are important for restoring your gut health.

The following are four common prebiotic supplements on the market, three of which we use regularly in the treatment of SIBO. The fourth is not advised!

1. Lactulose

Lactulose is made up of two sugars, galactose and fructose, which is not broken down or absorbed in our small intestine. Lactulose increases our good bugs like bifidobacteria(8) and decreases the bad ones like clostridia(9). It is generally well tolerated, however you can take too much of it and end up with loose bowels(8)

2. Partically Hydrolysed Guar Gum (PHGG)

PHGG is a natural water soluble fibre that has been broken down by an enzyme to make it smaller and to decrease the amount of galactomannon (10). PHGG increases the good bugs Bifidobacterium and Lactobacillus species and decreases nasty waste products such as ammonia(11). PHGG can also give softer stools to assist constipation(12). Studies also show that PHGG in combination with an antibiotic to treat SIBO was more useful in eradicating SIBO compared with the antibiotics alone(13), how amazing!

3. Galacto-oligosaccarrides (GOS)

GOS is formed by breaking down lactose, a common sugar found in dairy. GOS is known to increase the good bugs bifidobacteria and reduce the bad bugs, clostridia and bacteroides. Another benefit of GOS alone or in combination with a probiotic is that it can support our immune system. GOS used in its recommended dosage range is well tolerated. Again, too much of a good thing can lead to problems; abdominal discomfort, cramping, flatulence and diarrhoea(14)

4. Inulin

Inulin is beneficial to out gut because it supports our good bugs bifidobacteria. However, because it is made up fructans(15), it can be really uncomfortable to consume if you have SIBO. Studies have found inulin increases flatulence, rumbling, stomach and gut cramps, and bloating(16). So best to avoid this one! 

Take home messages

Prebiotics are very powerful and beneficial for SIBO. But remember, not all prebiotics are the same.

If certain foods are causing you pain, bloating, constipation, or diarrhoea, this is your body communicating to you that your digestion system is struggling. Ironically the foods that cause discomfort are the same foods that are important to your health. Instead of excluding these foods, we need to improve your digestive system so you can tolerate these and improve your health in the long run. This can be impossible to navigate by yourself so get a professional on board to help correct your bugs, restore your gut wall and find the diet and fibre that is right for you.

After this, you may even be able to handle eating delicious lentils, onion, garlic and apples!

By Rachel Larsson

BHSc (Naturopathy), BPH (Nutrition)

Prebiotics for health

The exciting possibilities of prebiotics for a variety of digestive, immune and mood related complaints are only just being discovered. Prebiotics are receiving more attention with the increasing understanding of the human microbiota (all of the bacteria, viruses and fungi that live on and in us), as the two together can have an incredible impact on our health.

 

What are prebiotics?

Essentially, prebiotics are ingredients found in whole, unprocessed vegetables, fruits, legumes, grains, nuts and seeds which are not digestible to us, but provide the perfect food for beneficial gut bugs living within us(1). These ingredients are broken down by the microorganisms in the digestive tract into compounds that have a beneficial effect in multiple areas of the human body, which can include altering the activity of the same bugs that created them! Most prebiotics are carbohydrate fibres, and it’s the knock-on effect of eating them that makes them so special.

 

How do they relate to probiotics?

I often hear prebiotics being confused with probiotics. While they act very similarly in the gut, they are in fact different. Probiotics are live organisms that we take in supplement form, where the species of bacteria are known and measured(2) Much like the gut bugs that have been living in us since the first few days of life (our microbiota), probiotics also love to munch on prebiotics. You will often find probiotics and prebiotics in combination in a supplement to enhance the products therapeutic quality. A lot of the research around prebiotics looks at how they interact with two of the most common probiotics, Lactobacilli and Bifidobacteria(3).

 

What’s the difference between fibre and prebiotics?

Most prebiotics are fibre, however not all fibres are prebiotic. Fibre is often classified as insoluble or soluble, which also provides a good basis for distinguishing which ones are prebiotic.

Insoluble fibres do not get broken down by us or by our gut bugs, however they do bulk out the stool, helping to keep us regular(4). These are the stringy fibres that give a lot of foods their rough texture, such as the skin of nuts, seeds, fruits and vegetables.

Soluble fibre, found in a variety of whole foods, cannot be broken down by us, but are easily fermented by bacteria. Those that exert a proven beneficial effect on us are termed prebiotics.

 

Types of prebiotics

Here is a little bit of extra information for the science lovers out there. A clear cut catagorisation of what is and what isn’t a prebiotic has not yet been established as it is still a young area of science. If we consider what has the potential for prebiotic activity, the following fibres and their respective foods are included:

  • Non-starch polysaccharides such as beta-glucans (mushrooms), pectins (pear, apple, plum, citrus), gums (guar gum, xanthum gum), hemicellulose (psyllium husk) and cellulose (broccoli, cabbage, kale, cauliflower).
  • Non-digestible oligosaccharides such as galactans (legumes) and fructans, primarily inulin (onion, garlic, artichoke, asparagus, leek, chicory root, banana).
  • The disaccharide lactulose (only found in supplement form).
  • Sugar alcohols including sorbitol (pears, plums, dried fruits) and mannitol (button mushrooms).
  • Resistant starch, which is starch that resists digestion in the small intestine, making it available in the large intestine for fermentation (potatoes, legumes, whole grains).
Prebiotic gut health

How do prebiotics improve our health?

Prebiotics selectively stimulate the growth of beneficial bacteria that are indigenous to our guts, including the well-studied Bifidobacteria and Lactobacilli species. These bacteria, when thriving, help to seal the barrier between the intestine and bloodstream, improve our immunity and keep potential bad bacteria/fungi (such as clostridia and candida) to a minimum.(3). With a healthy microbiota, improvements are noted in mood, skin, allergies and autoimmune conditions, just to name a few.

In addition, bacteria create short chain fatty acids (e.g. butyrate, propionate and acetate) from prebiotic fibres, which have beneficial effects throughout the body. For example, butyrate, made by Lachnospiraceae and Ruminococcaceae bacteria, is a major energy source for the cells that make up our colon. Propionate acts at the liver to suppress cholesterol synthesis and acetate is utilised by the heart, brain, kidneys and muscles(1).

 

When prebiotics can be problematic

For people that have certain intestinal issues, such as Small Intestinal Bacterial Overgrowth (SIBO) or Irritable Bowel Syndrome (IBS), eating the wrong types of prebiotics can make symptoms worse. For example, fructans and sugar alcohols (which are both considered FODMAP foods) are known to cause bloating, flatulence and discomfort in certain people(5). However, complete avoidance of prebiotics deprives healthy gut bugs of food and can make the situation worse in the long run. If you fall into the SIBO or IBS, or are unsure, an appointment with us can help minimise symptoms while still making sure your good bugs are fed! 

By Lucy Mason

BHSc (Naturopathy)

Why your IBS could actually be Small Intestinal Bacterial Overgrowth (SIBO)

Picture this.

For years you have been suffering from Irritable Bowel Syndrome (IBS).  You may have experienced abdominal pain, discomfort and bloating, frustrating bowel motions and reactions to ‘healthy’ food.  You have tried diets, supplements and medications yet you are still suffering. How frustrating!!

But perhaps there is something else going on.

In our experience, many of our patients don't just have IBS but actually have Small Intestinal Bacterial Overgrowth (SIBO), which can be tested for and treated. Symptoms of SIBO are similar to symptoms of IBS, which is why it may have been overlooked (1).

SIBO explained

SIBO occurs when there is an increased number of bacteria in your small intestine (1). Having an increased bacterial load can cause havoc to your gut wall and can lead to trouble with digestion, poor nutrient absorption, immune dysfunction and reactions to food (2).  SIBO left untreated has also been linked to nutrient deficiencies, depression, anxiety (3), fibromyalgia (4), hypothyroidism (5) and rosacea (6).

How did I get this?

The risk factors for developing SIBO are far and wide and are commonplace in today’s society. They include low stomach acid, which can naturally happens as we get older or through nutrient deficiencies that may occur if you have an underlying gut issue, chronic illness or poor diet. You also increase your risk of developing SIBO if you have used antibiotics or the oral contraceptive pill, if you drink alcohol or experience stress (1)

Can you relate to one or two of these?

Digestive Health Diet

How can I find out if I have SIBO?

In clinic, I regularly hear patients say things like ‘after a meal I look and feel four months pregnant’ or ‘I react to so many foods’. These statements make me consider SIBO as part of the their problem. The SIBO test is wonderful as it identifies its presence and helps us choose the most appropriate treatment for you. It is a test that can be performed at home or in a laboratory. After drinking a sugar, the breath test measures hydrogen gas and methane gas when you exhale, which indicates if SIBO is present, the type you have (methane dominant or hydrogen dominant) and how severe SIBO is for you.

To get SIBO under control we use a gentle combination of herbal, nutritional and dietary interventions. We follow a principle of 'do no harm' and we make sure we are supporting you and any the good bugs that are already in your gut. In addition we address risk factors that caused your SIBO to give you the best chance of it never returning and to live a life free of digestive distress. 

If this sounds like something you or someone you know has experienced, it's time to take the next step forward to get you back to good health.

It’s time to beat the bloating and get our bugs back in balance!

Rachel

BHSc (Naturopathy), BPH (Nutrition)

Fermented Beet Kvass

One of our favourite gut loving recipes is beet kvass. Beet kvass is type of fermented drink, you know, similar to kefir or kombucha. Kvass has so many health benefits and is great for your gut. Due to it's fermentation process it is a wonderful source of probiotics which can help the health of your gut and immune system, it is also rich in antioxidants with is excellent for your liver. Using beetroot is traditionally known for it's blood cleansing properties, in addition to being a great source of nutrients.

Kvass typically has a tangy, salty flavour which can be an acquired taste. Using beetroot also gives it a wonderful earthy flavour. If beetroot isn't your thing, you can use other foods to ferment like fruits (strawberries and raisins) and herbs (mint). 

 Ingredients        

  • 2-4 organic beetroot
  • 1-2 tsp sea salt or Himalayan salt
  • Filtered water
  • A few tablespoons whey, dripped from yoghurt or milk kefir (optional)
  • 1-1.5 litre glass jar

Directions

1. Wash unpeeled beets and chop into large cubes

2. Place beets in a jar and add salt and optional whey (if not using whey add an extra tsp of salt)

3. Fill jar with filtered water, you want to cover the beetroot by at least two inches

4. Seal with lid and leave on the counter at room temperature for 4-7 days to ferment (4-5 days in summer)

5. Transfer to fridge

6. Have about ¼ cup daily on own or dilute with water

Image: Courtesy of CERES Fair Food.

Image: Courtesy of CERES Fair Food.