There is increasing scientific interest in the molecules and chemicals probiotics secrete, i.e. the postbiotics. — Filepic
More and more people are consuming gut health supplements nowadays.
These can consist of prebiotics, probiotics, and more recently, postbiotics.
Prebiotics
Prebiotics are fermentable substrates (such as FOS and inulin).
In simple terms, they are food to probiotics.
They are usually indicated to help promote regular bowel movement or to help modify your gut bacteria to become healthier and more balanced.
However, they may also lead to bloating and exacerbation of irritable bowel syndrome (IBS) symptoms due to their by-products (e.g. hydrogen gas and methane gas), which are produced during the fermentation process.
Low doses (e.g. less than 6g/day) may help reduce the likelihood of these side effects.
Probiotics
Probiotics are live microorganisms.
They usually help in antibiotic-associated diarrhoea and some paediatric diarrhoea illnesses.
Different probiotics strains have distinct health benefits – in other words, we cannot expect one strain to work miracles for all conditions.
For instance, the efficacy of Lactobacillus GG has been demonstrated to reduce the risk of antibiotic-associated diarrhoea in children.
Clinical trials have demonstrated that a dose of 108-110 CFU (colony-forming units) per day is effective.
When it comes to preventing eczema and asthma, as well as boosting immunity, the evidence for probiotics has generally been inconsistent.
If parents would like to give it a try, a meta-analysis found that combinations including Bifidobacterium triplex (multi-species), demonstrated the highest chances of benefit when consumed alongside conventional treatment for childhood asthma.
Probiotics supplementation is usually safe for daily consumption in healthy children when strain-specific products are taken at doses supported by research studies.
However, caution is needed with immunocompromised children, in whom probiotics should only be used under the supervision of healthcare professionals.
Postbiotics
Postbiotics have recently stepped into the spotlight of microbiome science.
They are non-viable microbial components or metabolites that are produced by probiotics.
To simplify, postbiotics are the “finished products” produced after probiotics have “digested” prebiotics.
Examples of postbiotics include short chain fatty acids (e.g. butyrate and acetate), peptidoglycans, bacteriocins and organic acids, among others.
They have become candidates for new functional foods due to their stability and safety.
Postbiotics are non-living, hence they are more stable during processing and storage than live probiotics.
They are potentially safer to consume for immunocompromised individuals, as they are not live microorganisms and do not carry the risk of infection.
Research on postbiotics has been gaining popularity in recent years, due to its possible roles in digestion, immune response and mental health.
Current studies indicate that postbiotics could help to maintain the integrity of the intestinal barrier.
Its sealing effect could prevent the movement of harmful or pro-inflammatory molecules into the bloodstream.
They could support the immune system and inflammation by regulating the balance between pro-inflammatory and anti-inflammatory cytokines.
And they could help with mental health by acting as neuroactive signalling molecules within the brain-gut axis.
Research has also found that postbiotics demonstrate promising effects in relieving symptoms of depression and anxiety.
However, their effectiveness is still too early to determine as the current research evidence is still not sufficient to draw any definitive conclusions.
Despite that, manufacturers are already incorporating postbiotics into infant formula.
Breast milk, which naturally contains prebiotics, probiotics and postbiotics, has always been promoted as the best for babies, with mothers encouraged to exclusively breastfeed their newborns up to six months of age.
Scientists have observed that breastfed babies have high levels of beneficial postbiotics in their systems.
Hence, infant formula manufacturers are now including postbiotics in their products in order to mimick breast milk contents as closely as possible.
Such products are commonly labelled as containing “bioactive compounds” or “metabolites”.
Varied response
Individual response to prebiotics, probiotics and postbiotics varies widely.
This is why clinical guidance always focuses on personalised trials and monitoring, rather than sweeping recommendations.
The use of prebiotics, probiotics or postbiotics as supplements should be guided by clinical evidence with advice from healthcare professionals.
Assistant Professor Dr Chee Huei Phing is a dietitian at Universiti Tunku Abdul Rahman. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
