Probiotic supplements aren鈥檛 just trendy, they鈥檙e ubiquitous. You can find bottles of probiotic pills, powders, and liquids for sale at any supermarket, each promoted听as a cure for various ills: digestive issues, fatigue, weak immunity, brain fog,听and more. While the evidence on these benefits is lacking, the marketing messages are working; the global probiotic market was worth about $49.4 billion in 2018, and it will grow to $69.3 billion by 2023. Prebiotics, the fibers that feed probiotics, have been riding the coattails of this popularity for some time.听Now听postbiotics鈥攖he metabolites produced when probiotics eat prebiotics鈥攈ave hit the scene. They鈥檙e being 听and are starting to make the rounds听on of the .
The hype around all of these microbes makes sense. Yes, prebiotics, probiotics, and postbiotics can enhance health by positively influencing the microbiome, a term that refers to the multitudes of microorganisms that live within you,听explains Carolina Guizar, a New York鈥揵ased dietitian and owner of the nutrition-coaching platform . But听as with probiotics and prebiotics, the postbiotic market is several steps ahead of the actual science.
While the microbiome has been a hot topic among nutrition experts (and amateur enthusiasts) for about a decade, microbiome research听is still in the very early stages. A in the European Journal of Nutrition starts its conclusion with: 鈥淭he role of the human gut microbiota in health and disease is beginning to be understood.鈥 The authors tell us what we know, which is that the gut microbiome plays a role in mood regulation, cognition, immune function, and digestive health. But they also explain that the details听are still unclear: we aren鈥檛 exactly sure what the benefits are, how the various microbes deliver them, and whether or not supplements offer any measurable benefits. Here鈥檚 what experts have to say about the state of the evidence.
It鈥檚 All Connected
We can鈥檛 talk about postbiotics without first talking about prebiotics and probiotics, because none of them stand alone. Probiotics are beneficial bacteria that live naturally in your microbiome. Your microbiome exists all over your body, but here we鈥檙e talking primarily about your gut.
Probiotics are powerful. A in Future Science OA found significant evidence for the digestive benefits of probiotics听and promising evidence for their potential听impact听on mood and mental health. But it鈥檚 not as simple as just taking one supplement and expecting something to happen, explains , a University of Connecticut professor听and the director of microbial genomics at the听,听a global nonprofit biomedical research institute. 鈥淧robiotics鈥 is an umbrella term for a variety of different bacteria. Roughly 5,000 strains from 1,000 species have been found in the human gut microbiome, although not everyone has all of them. Each strain acts slightly differently and has different potential health benefits.
Probiotics can鈥檛 do their thing without the help of prebiotics, a type of fermentable fiber found in plant foods that feed probiotics and keep them alive. , a New York鈥揵ased dietitian and author of , explains that when probiotics feed on prebiotics, they produce postbiotics, health-promoting by-products called microbial short-chain fatty acids. As with probiotics, 鈥減ostbiotics鈥 is an umbrella term that encompasses several different chemical compounds, all with different characteristics and potential health benefits.
Skip the Supplements
鈥淢icrobiome research really only hit the headlines a little over ten听years ago,鈥 Weinstock says. Since then听the market has exploded with supplements meant to improve the microbiome, and the public is increasingly interested in how food might affect it as well.
We know that a diet high in plant-based foods is key for听the body鈥檚 production of听prebiotics. 鈥淭he main sources of prebiotics in the typical American diet are whole-wheat bread, onions,听and garlic鈥攂ut so many other foods contain them,鈥 Freuman says. Many fruits and vegetables contain prebiotics, including apples, pears, mushrooms, artichokes, cauliflower, and jicama. Beans, lentils, barley, and rye also have significant amounts of prebiotic fiber. We need to consume prebiotic fibers regularly to reap their benefits鈥攐ur bodies don鈥檛 naturally house them听and can鈥檛 produce them. Since they鈥檙e so prevalent in common foods, supplements aren鈥檛 really necessary.
Probiotics are also present in our foods, primarily in fermented ones听like yogurt, kimchi, sauerkraut, and cheese, and in supplements. But what many people don鈥檛 realize is that, generally speaking, probiotics from your diet don鈥檛 have a huge impact on your gut microbiome. There are somewhere around听100 trillion bacteria in your gut. 鈥淲hen you take a probiotic supplement or eat a food that contains probiotics, you鈥檙e introducing them to a habitat [your gut]听that鈥檚 already densely populated with microorganisms,鈥 Weinstock explains. A supplement may boast 鈥渙ne billion live probiotics,鈥 but that鈥檚 just 0.001 percent of the bacteria already in your gut. Those one billion probiotics have to fight hard to colonize your already-packed microbiome听and might end up just passing through your stool.
Weinstock also notes that听although labels make it seem like probiotic supplements contain a huge variety and number of beneficial bacteria, this isn鈥檛 the case. Practically all probiotic supplements contain bacteria from just two genera: Lactobacillus and Bifidobacterium. The Food and Drug Administration deems them safe because they鈥檙e found in common foods that we鈥檝e been eating for centuries, like cheese. So听you鈥檙e not really getting any additional benefit from these supplements, because they only contain probiotic strains that are already in听your听diet.
Countless other potentially beneficial strains and species are being examined. This in the International Journal of Microbiology summarizes recent studies looking into various probiotics for potential benefits ranging from diabetes prevention to HIV treatment. Remember, up to 5,000 strains have already been found in the human gut microbiome鈥攂ut their effect on the body is not yet understood, so they鈥檙e not yet approved for sale or consumption. Even when other strains start being approved, you鈥檒l only benefit from supplementation if you鈥檙e taking a strain that isn鈥檛 already present in large quantities in your gut.
鈥淚 don鈥檛听typically recommend probiotic supplements,鈥澨鼺reuman says. 鈥淭here is such limited evidence that they do much of anything to change the microbiome in a meaningful way or contribute to enhanced gut health for most people.鈥
The evidence for postbiotic supplements is even more limited. 鈥淲e don鈥檛听have enough information on the safety or efficacy of postbiotic supplements at this time,鈥 Guizar says.
Freuman explains that a prebiotic-rich diet likely supports the existing probiotics in your gut, helping them to thrive. 鈥淚f you are truly interested in diversifying your gut microbiome and increasing the abundance of health-promoting species, the research strongly supports that high-fiber diets that contain very diverse types of plant-based foods are a much more effective approach,鈥 she听says.
DIY, Don鈥檛 Buy
The short of it is that there鈥檚 really no need to think about postbiotics at all. 鈥淭here is very little research as to whether taking postbiotics in supplement form does anything to enhance human health,鈥 Freuman says.
That鈥檚 not to say that postbiotics aren鈥檛 beneficial. We know that听these postbiotics听are health promoting. But why buy them in supplement form when your body is making them constantly? Part of the benefit of postbiotics likely comes from the prebiotic-postbiotic interaction鈥攖he breaking down of ingested prebiotics by health-promoting probiotics, which in itself can help you digest fiber more comfortably. You won鈥檛 reap听this benefit from a postbiotic supplement. Weinstock adds that many postbiotics听are volatile and difficult to preserve on the supplement shelf.
鈥淎 much surer way to secure the health benefits of these postbiotics听is to simply eat a healthy, diverse, fiber-rich diet,鈥 Freuman says.
Sit Tight
If you鈥檙e excited about microbiome research and the potential uses and benefits of prebiotics, probiotics, and postbiotics, great. So are the researchers and clinicians who study them. But spending lots of time and money on supplements right now is jumping the gun.
鈥淭here鈥檚 this huge amount of work that has to go into studying our tissues, metabolites, microbes, all of that, to try and correlate them with all different types of diseases,鈥 Weinstock says. Much of what鈥檚 being studied, like the effect of the microbiome on neurodegenerative diseases like Parkinson鈥檚 and Alzheimer鈥檚, will take years to figure out, because these conditions manifest very slowly over time and have to do with things happening inside the body at extremely low levels. Weinstock is hopeful and excited about all of this. 鈥淲e already have all of these microbes inside of us. We just need to figure out how to access them, how to use them,鈥 he says. But it will take time before we can come to any real, actionable conclusions.
Ultimately, the vague potential of various microbes and their metabolites might be what drives such fanatical interest in them. 鈥淧eople want to feel like they have influence over their health,鈥 Guizar says. No matter that probiotic and postbiotic supplements haven鈥檛 been shown to offer听any substantial benefit for healthy people, or that the best way to get prebiotics is to eat the same nutritious diet that鈥檚 been recommended for decades. There鈥檚 so much we don鈥檛 know about these microbes. And for many, it鈥檚 hard to resist the idea that maybe, just maybe, a certain pill or specific supplement might have benefits beyond what the science currently understands.