Food & Nutrition
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The Bacteria Basics

An RD discusses prebiotics, probiotics & diabetes

Eating bacteria on purpose? Phrased like that, it might sound awful, but many people are looking to probiotics, a type of “good” bacteria that may help with digestion, to increase the healthy bacteria in their guts. Probiotics are found in foods like some yogurts, kefir, and sauerkraut. You might not be aware that you already have trillions of bacteria and other microorganisms in your intestines. In fact, bacterial cells outnumber the human cells in your body by a factor of 10! So why are people seeking out more? The term probiotics refers to live microorganisms that might provide health benefits if consumed in adequate amounts.

Buyer beware

You may see claims suggesting that probiotics can “treat” or “cure” any number of health problems. For most health conditions, research surrounding the use of probiotics is sparse. Thus, the Food and Drug Administration (FDA) has not approved any health claims for probiotics. Some evidence suggests that probiotics may be healthy for the gut. But any effect depends on the specific strain of probiotic – not every strain of “good” bacteria or yeast behaves the same way in the gut. Even the food or supplement that contains the probiotic affects the viability of the microorganism. For probiotics to do any good, they must be alive when consumed and stay alive as they travel through the stomach acid into the intestine. Consuming a food or supplement that was stored at the wrong temperature or is much past its expiration date is unlikely to deliver live organisms.

I know many people living with diabetes are especially interested in learning about probiotics; I suggest they talk to their healthcare team before trying them. In addition, my colleague Toby Smithson, RDN, CDE*, spokesperson for the Academy of Nutrition and Dietetics and a person living with type 1 diabetes, advises that you check that each of the following is listed on the label:

  • Specific type of probiotic (different types do different jobs in your gut)
  • Number of colony-forming units per serving (ask your care team what a good number might be)
  • Expiration date
  • Serving size
  • Proper storage requirements to keep the probiotic active
  • Company’s contact information

“Additionally, when choosing a food containing probiotics, be careful to read the Nutrition Facts,” warns Smithson. The sodium content of these foods may be very high, especially for fermented foods such as sauerkraut and kimchi. Be sure to select low-fat and nonfat yogurt and kefir to avoid the unhealthy saturated fats. (Read more about fats here.) And as always, count the carbohydrates to make sure the food fits into your meal plan.

Feeding the probiotics

Prebiotics are essentially the food for the probiotics. As bacteria, probiotics need food to stay alive in the intestine. A plant-rich diet helps, as these fibers and other carbohydrates that are poorly digested make their way into the intestine. There, they feed the beneficial bacteria helping them to thrive over the harmful ones. Prebiotics are naturally present in wheat, onions, garlic, legumes, bananas, asparagus, and many other plant foods. Additionally, they are frequently added to granola bars, chocolate bars and yogurt, in the form of inulin or chicory root. When my clients ask how they can increase their intake of prebiotics, I remind them to eat a variety of foods naturally rich in fiber such as fruits, vegetables, whole grains, and beans (of course this is only one of many reasons to eat these whole foods!). Foods with added prebiotics serve a purpose too, but they are often more processed and less nutritious, so they should not be the main source of fiber or prebiotics. A few overzealous clients have eaten several servings of foods with added prebiotics in a single day and developed quite a bit of gas and discomfort.

Safety first

Talk to your healthcare team before adding probiotic foods or supplements to your diet to be certain they are right for you and to help you choose the proper strain of organism. There is a perception that probiotics can’t hurt. However, their safety hasn’t been thoroughly tested, and more data is needed, especially among the elderly, children, and individuals with existing health conditions.

Jill Weisenberger, MS, RD, CDE*, is the author of Diabetes Weight Loss Week by Week, contributing editor for Environmental Nutrition, and has written for many publications including EatingWell, Diabetic Living, Her Sports + Fitness, and LifeScript. Weisenberger is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies, or affiliates.

*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.© 2013 The DX: The Diabetes Experience

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