Pre-, Pro- and Postbiotics: The Benefits on Health

by Joy Choquette | December 1, 2022

Beyond digestive health, what do natural practitioners recommend biotics for?

Though probiotics have been around since ancient times, they only began to gain popularity approximately 150 years ago. And since the 1990s, these “good bacteria” have garnered increased interest. While much is known about the benefits of pre-, pro- and postbiotics when it comes to gut health, what other conditions might they be good for? How are natural practitioners utilizing products containing these with patients? And what’s new and trending in this arena?

Before diving into these questions, let’s first explore the traditional role of probiotics in the human body.

Traditionally Used for Digestive Health

Yogurt, kefir, sauerkraut, beer, kimchi—what do all these foods and drinks have in common? Besides being traditionally enjoyed in a variety of different cultures, all contain probiotics. In an article titled, “Recycling Metchnikoff: Probiotics, the Intestinal Microbiome and the Quest for Long Life,” the author explains how Elie Metchnikoff first “discovered” the benefits of probiotics by studying why parts of Eastern Europe—particularly the Balkan States and Russia—had an unusually high number of centenarian residents. These individuals were poor, living extremely simple lifestyles. So why were they healthier and living longer than their richer, more extravagant neighbors? In addition to access to fresh air, daily exercise no matter the weather, and alcohol-free lives, it was discovered by Metchnikoff that these centenarians ate yogurt, regularly.

Today, probiotics are used regularly to help with a wide array of digestive disorders including “antibiotic-associated diarrhea, Clostridium difficile colitis, infectious diarrhea, ulcerative colitis, Crohn’s disease, pouchitis, and irritable bowel syndrome, among other disorders,” according to an article in Therapeutic Advances in Gastroenterology.

The market for biotics continues to grow rapidly. According to Jenna Nelson, EpiCor channel lead—functional food and beverage in Minnesota, interest in these supplements is on an upward swing. “Research from the International Food Information Council’s (IFIC) 2022 Food & Health Survey supports this view, finding that both digestive health and immune support are a top priority for adults,” she stated. “In the recent survey, one in four consumers reported seeking out immune health benefits from foods, beverages and nutrients, and three in 10 were similarly targeting digestive health.” All of this suggests, said Nelson, that consumers are actively seeking new health-supportive solutions and that the momentum around biotics will continue to increase.

Other Conditions Pre-, Pro- and Postbiotics May Be Useful For

Studies have proven the efficacy of biotics in digestive health. What other conditions might pre, pro and postbiotics be helpful for? Clinical pharmacist, Dragana Skokovic-Sunjic, works at the Alliance for Education on Probiotics, in Hamilton, Canada. She’s also the author of the book, Clinical Guide to Probiotic Products. In her extensive work on this topic, Sunjic stated that in addition to utilizing probiotics for gut health there are other promising areas to consider. “More recently, the research is looking at probiotics as an intervention to improve immune health, increase resiliency and prevent common infectious diseases, support vaginal health, prevent migraines, assist in weight management and even improve mood.”

Managing Director and Founder of Kibow Biotech in Pennsylvania, Dr. Natarajan Ranganathan, is excited about the possibilities for health improvement that lie outside of digestive health when it comes to pre-, pro- and postbiotics. “Because of the diverse functions of the various microbes that populate the gut, they all have wide-ranging effects on multiple body systems. Therefore, it should be no surprise that pre- and probiotics that change and bolster the microbiome can be used to alleviate health problems beyond digestion.”

For example, the company’s kidney health supplement, Renadyl, reduces strain on the kidneys by breaking down uremic toxins that are usually processed by these organs, explained Dr. Ranganathan. “Detoxifying the gut, in turn, decreases uremic toxin levels in the blood and can improve the quality of life for people with kidney problems.”

Brain and mood connection is another up-and-coming area of study when it comes to probiotics, said Dr. Ying-Chieh Tsai, gut-microbiome expert and chief scientist at Bened Life. The company, located in California, produces a medical-grade probiotic product called Neuralli, which is billed as “The first gut-brain medical probiotic,” by the company. “For some people, probiotics, and especially psychobiotics, can support a positive mood and better sleep quality because of the strong connection between the gut and the brain,” said Dr. Tsai. “Psychobiotics are probiotic strains such as L. plantarum PS128 that demonstrate a neurological or mental health benefit.”

Reduction of inflammation in the body is another potential benefit of using biotics, said Jocelyn Strand, ND, of Biocidin Botanicals in California. “It’s no surprise that supplements that modify the microbiome affect digestive health, but they also have systemic effects. This can be directly through the production of beneficial molecules (postbiotics) and reduction in pathogen-associated irritants—resulting in a reduction in systemic inflammation,” she said. “There are added indirect effects of healing the gastrointestinal tract, and the downstream tonification of immune function, mental health, musculoskeletal health and vitality.”

Technical Writer, Vicky Mak, at California-based Childlife Essentials, noted that the link between pre-, pro- and postbiotics and children’s health is one that the company is focusing on, not only in digestive health but also immune and cognitive health as well. “Studies conducted among infants and children have demonstrated a strong association between gut microbiome profiles and cognitive and immune function,” said Mak. “For example, probiotic genera lactobacillus and bifidobacterium contain beneficial bacterial strains which have roles in the production of neurotransmitters, indirectly altering emotional processing, mood and behavior. Prebiotics feed and nourish specific beneficial bacteria to help stimulate their growth and activity, which can influence downstream processes involved in maintaining cognitive and immune health.”

Likewise, she explained that postbiotics, like short-chain fatty acids (SCFAs), help promote the integrity of the intestinal barrier along with the production of the protective mucus layer of the intestinal epithelium. Both can enhance the body’s defense against potential pathogens entering through the gut, Mak said. “This shows that postbiotics can work to maintain normal immune function while optimizing gut health during childhood growth and development.”

In addition to the conditions mentioned above, Marketing and Communications Manager NORAM, Stacey Smith, DC, at Gnosis by Lesaffre headquartered in France, noted that interest in the biotic market during COVID-19 went up, as individuals looked for additional immune support. “The increase in consumer awareness has dramatically impacted the opportunity to educate on the effectiveness of pre-, pro- and postbiotics to improve health in the preventative healthcare space and beyond,” said Dr. Smith. “Not just an opportunity to educate, but demand from consumers to understand the science behind it, so they make informed decisions.”

In addition to the conditions mentioned previously, Dr. Smith stated that sleep, mood, energy improvement, stress support, obesity and recurrent vaginal infections may all be positively affected by biotics.

What’s #Trending

The field of study in pre-, pro- and postbiotics continues to grow and change as new information is gleaned. “In the last decade, we witnessed a new interest and research looking into the role of the microbiome and its influence on health,” said Sunjic. “Specifically, the part of interventions such as probiotics and, more recently, prebiotics have been on the rise. Postbiotics are just entering this arena,” she noted. “Since the pandemic, since 2020, there has been an exponential increase in the popular demand for any-biotic interventions. The expansion is continuing even now.”

Pre-, pro- and postbiotics are clearly hot products right now. Dr. Tsai concurred with Sunjic, “The beneficial effects of postbiotics are the big news over the last year or so—they are of increasing interest to scientists and the wellness industry,” he noted. “Nearly 200 science articles about postbiotics have been published so far in 2022, and the number has been doubling year over year since 2019.” He calls the market for these products now, “quite strong.” “In 2021, the global market for probiotics was valued at $58.2 billion (U.S). We see a great deal of demand for our probiotic and postbiotic strains from product manufacturers around the world.”

One of the challenges of utilizing probiotics is the need for efficient ways to stabilize strains against the rigor of shipping and long-term storage, Dr. Tsai noted. “In the past, product makers could simply create a commercial probiotic product using strains that had reasonably good activity for gut health and high-temperature stability to make a product. Now that more ‘artisanal’ probiotic strains, and single-strain products containing them, are coming into the marketplace, we need new strategies to improve the stability of these strains in commercial products,” he said. He’s especially interested in strategies to protect probiotics from humidity and heat, increasing their hardiness during shipping and storage. “New acid-resistant capsules have recently become available that dissolve more rapidly in the neutral environment of the intestines, which should improve the deliverability of probiotics. Liposomes, coatings and double layer coatings are also ways of improving the shelf life of probiotics in a powder form that is currently under investigation.”

Delivery Methods: What Natural Practitioners Should Know

Vice President of Education for Enzyme Science, Julia Craven, stated that the Florida-based manufacturing company is always on the lookout for the next technological advancement to better deliver digestive enzymes and probiotics. It’s not enough, she noted, to include billions of CFUs in a product. “They need to be the right strains to support not only digestive but also immune health—and for convenience, they need to be shelf-stable.”

Pill fatigue is a real thing, Dr. Smith stated, whether prescription medication or supplements and [consumers] are looking for something that is easy to consume and tastes good too. “The shelves are filled with gummies right now, and this area continues to explode with high growth of over 20 percent exceeding that of capsule/pill format. Pill packs are gaining traction because consumers can tailor-make their daily packs to include only what they need,” she said. “The idea is to create ease of ordering, cutting down on having multiple bottles for convenience and increasing compliance with ease for ‘grab-and-go’ travel. Soft gels and liquids are also unsurprisingly a favorable delivery method making some traction.”

Plaza stated that she’s noticed some out-of-the-box concepts when it comes to delivery methods.

“Innovative ideas in the way of nasal sprays and lozenges may become an avenue for product development also, however manufacturers need to be careful in quality assurance for many of these products,” she noted. “This is particularly important for supplements such as probiotics, which need to retain their viability in order to be effective.”

What Is the Key Thing to Know About Pre-, Pro- and Postbiotics?

“Practitioners depend upon those of us in the supplement manufacturing industry to stay on top of [microbiome] research and to respond with thoughtful and effective solutions,” said Dr. Strand. “Our experience is that practitioners want quality products that address their patient’s needs—both tried and true and new.”

Meat eaters? Vegetarians? Vegans? Do they need different types of probiotics? Dr. Smith says not if they’re created properly. “The main sources of biotics are yeast and bacteria. Lynside Immunity Prebiotic is derived from Saccharomyces cerevisiae yeast and is positioned for its personalized micro nutrition,” she noted. “We’re interested in it because the concept supports microbiome diversity no matter the basis of your diet, from vegetarians to meat eaters. This creates a well-balanced microbiota helping support the immune response by degrading toxic compounds, teaching the immune system to understand the good from the bad pathogens in the GI (gastrointestinal) tract, and defending against harmful microorganisms.”

Dr. Smith said, “I recommend this for anyone who eats food, but especially for those with stressful jobs to help diversify and adapt their gut microbiome, as well as the frequent travelers who often eat out and/or varying cuisines and those who eat the same staple foods.” Additionally, she noted, “Consumers are most familiar with probiotics. Greater awareness of prebiotics and the combination of synbiotics are increasing in level of familiarity and popularity. Postbiotics have a lower understanding.”

Nelson agrees. “Specific health benefits can vary widely as there are different kinds of pre-, pro- and postbiotic products. Even within the postbiotic space, each one is unique, based on the microorganism, the fermentation medium and method used, and the post-fermentation process,” she noted. “Cargill’s offering, EpiCor postbiotic, is backed by a substantial body of scientific evidence. Over a dozen published studies, including multiple human clinical trials, show that EpiCor postbiotic supports year-round and seasonal nasal health, immune defenses to face daily challenges and healthy gut function.”

Danna Pratte, CEO/Founder of NB Pure, located in Arizona, noted, “I think the entire industry always continually shifts but there has been increased attention to pre-, pro- and postbiotics. With post-pandemic focus on healthy foods and supplements to enhance a healthy lifestyle, the biotic family plays a large role in this.” Likewise, Pratte noted that individuals purchasing biotics are looking carefully at the specifics. “The demand for shelf-stable, targeted probiotics has been on the rise. Consumers are not looking for catch-all strains, but instead targeted strains to help deal with issues, combat problems or rebuild their microbiome.”

Postbiotics are showing up in many food items, said Technical Advisor & Nutritional Therapist, Kim Plaza, at ADM Protexin located in Florida. Bread, cereal bars and other products that can be ingested warm or hot, such as teas, are all popular products infused with biotics. “Postbiotics have in fact become the fastest growing area in terms of gut health-related Google searches, with nearly 1,300 percent increase in the last two years,” she noted pointing to an article on NutraIngredients.com. “Many uses of postbiotics are currently being investigated for immune support, however, the potential benefit of postbiotics is not limited there; future developments may soon show how this class of products may be comparable to probiotics, without the challenges of working with live bacteria,” said Plaza.

Obviously, there are a great number of potential benefits to using biotics. For busy natural practitioners, what are some of the key pieces of information about pre-, pro- and postbiotics to know when working with their clients? Several of the experts weigh in:

Dragana Skokovic-Sunjic: “If planning to use a probiotic as an intervention—careful selection is a must. An appropriate diet, balanced and rich in fermented foods, fiber and polyphenols, is essential,” she stated. “Speaking with the health care provider consulting the Clinical Guide to Probiotics would be the first step.” Additionally, not everyone needs to take probiotics, said Sunjic, just as not everyone needs to take medicine. It’s important to work with a knowledgeable health care provider to assess this.

Childlife Essentials: “When it comes to probiotics…we recommend directing customers to look for strain-specific probiotics as this level of specificity is necessary for understanding the science backing product efficacy,” said Mak. “For example, several products on the market contain different strains of lactobacillus. Because each strain is unique, the efficacy of lactobacillus bacteria can also vary from strain to strain. As a result, customers should check and make sure that the product they are purchasing contains that strain-specific probiotic they are interested in.”

Biocidin Botanicals: “As a botanical company, we always utilize the power of plants as the backbone of our formulations,” said Dr. Strand, “then we add other nutrients to support their activity. We have a team of doctors and a product development team, and you will see us coming out with some innovative formulas, as well as delivery systems—think outside the capsule—in the near future,” she said.

Enzyme Science: Consumers recognizing the difference between digestive enzymes and probiotics is something that Craven finds exciting. “We’re seeing that they also know that prebiotics and probiotics are different. Probiotics don’t break down food—that’s what digestive enzymes do. But we have two popular formulas, Critical Digestion and Complete Digestion, that deliver both probiotics and digestive enzymes,” she noted.

EpiCor: “With the robustness of postbiotics, consumers can be assured they’re receiving the full health benefits afforded by postbiotics,” said Nelson. “There’s also the convenience factor—while probiotics must be kept alive until they’re consumed, postbiotics are extremely shelf stable.”

Healthy Take Aways

• Biotics are best known for their potential benefits on digestive health—individuals use them to potentially improve symptoms of diarrhea, IBS (irritable bowel syndrome), ulcerative colitis and other digestive problems.
• Pre-, pro- and postbiotics may be helpful for several other conditions beyond digestive health, including improved sleep and mood, reduced risk of vaginal infections and more.
• In 2021 alone, the global market for probiotics was valued at $58.2 Billion (U.S.).