Yogurt, pickles and sauerkraut- oh, my!

Imagine a breakfast of pickles, sauerkraut, tempeh and kimchi with yogurt and sourdough bread a la carte. Probably not as tempting as pancakes and bacon unless, of course, the goal is probiotics. Probiotics are live microorganisms, such as bacteria and yeasts naturally present in fermented foods. Unsurprisingly, many consumers purchase probiotics as dietary supplements. 

Bacteria and other microorganisms are generally considered to be harmful “germs,” but many are beneficial. Some bacteria help digest food, destroy disease-causing cells or produce vitamins. Probiotics contain several beneficial microorganisms, usually bacteria belonging to the Lactobacillus and Bifidobacterium groups. Probiotics also include good yeast, such as saccharomyces boulardii.  

The microorganisms in probiotics have fermented food for thousands of years and probiotic supplements remain popular. A National Health Interview Survey (NHIS) showed roughly 4 million American adults per month purchase probiotics. Among consumers, probiotics are the third most common dietary supplement behind vitamins and minerals. Adults’ use of probiotics quadrupled between 2007 and 2012.  

Probiotics live mainly in the gastrointestinal tract. With enough probiotics, these healthy microorganisms help protect the GI tract from harmful microorganisms, improve digestion and may provide other health benefits. Probiotics can cause gas in healthy people, but rarely cause infections or other health issues. “Probiotics are most likely to cause problems, such as bacterial infections, in patients who are already seriously ill or have weak immune systems,” said Sean Beach, Registered Dietitian with Genesis Diabetes & Nutrition Education. “People considering using probiotics should consult a medical professional first.”  

The FDA regulates probiotics as a dietary supplement, food ingredient or a drug depending on intended use. Probiotics sold as dietary supplements require no FDA approval. Their labels may say they improve bodily function, but without FDA approval probiotic dietary supplements are not permitted to make health claims, such as lowering disease risk. 

Acquiring probiotics from diet alone can be tricky because food manufacturers are not required to show a specific dose of a specific probiotic and the microorganisms must be live to provide benefit. For example, when purchasing yogurt ensure its container lists “live” or “active cultures.” Pasteurization usually kills live bacteria, but unpasteurized products—particularly unpasteurized sauerkraut—provide live bacteria. Pickles made with vinegar have no probiotic effects, but fermented pickles do. 

Despite probiotic supplements’ popularity, most studies fail to prove significant benefits to healthy individuals. The bacteria apparently help only those suffering from a few specific intestinal disorders. A balanced diet including yogurt and fermented foods should provide enough probiotics to keep most people healthy.