I get it. It seems like every other week there’s a new trend in the nutrition space…curcumin, Omega-3s, black seed oil, probiotics and psychobiotics, etc…It can be confusing and hard to keep up. Recently, clients have been asking about postbiotics…what are they, when do you take them, why do you take them and what do they help with? So here we go…a brief explanation of the current research!

To begin, let’s take a step back to review what prebiotics and probiotics are to help tie in postbiotics and how they may be useful. Probiotics are live microorganisms that can have a beneficial impact on your health if consumed in adequate amounts. According to the National Institutes of Health, there are an estimated 100 trillion different microbial cells living in our gut. These microorganisms can be bacteria, viruses, fungi, helminths, and archea, however bacteria comprise the majority of the microbiota. Most of these bacteria are harmless, while others are either helpful or can cause disease. The helpful or beneficial bacteria can influence your metabolism (weight loss), enhance your immune function, improve your digestion and the health of your skin, and reduce the risks of some diseases. The harmful bacteria can be ok as long as they stay in smaller numbers. However, when their numbers increase and the amount of the beneficial bacteria decreases, the harmful bacteria can begin to exert their negative effects on your health. Harmful bacteria have been linked to a number of diseases that include inflammatory bowel disease, metabolic syndrome, obesity, heart disease, colorectal cancer, and Alzheimer’s disease. A healthy microbiota strengthens the integrity of the gut and therefore, strengthens our overall health.

How then, you may wonder, do these numbers of helpful vs harmful bacteria get out of balance? Or, how does the harmful bacteria increase and cause disease? There are a number of reasons this can happen. Our diet has a huge influence on the landscape of our gut and the organisms that reside there. You can ingest probiotics by choosing to consume foods that contain them, such as yogurt, kefir, sauerkraut, tempeh, kimchi, miso, natto, and traditional (not cultured) buttermilk. You may also choose to take probiotic supplements. Choosing a probiotic supplement can be overwhelming, as there are a large number of products to choose from. Knowing which probiotics are helpful for a specific condition can help you narrow your products. Or, you may choose a multi-strain probiotic supplement. Either way, when choosing a supplement, know that they are not regulated by the FDA. So, be careful of false claims, ask your nutritionist or health care provider if the supplement looks like a good choice, and try to find brands that use third party testing. If you have ever taken antibiotics, especially for longer lengths of time, you may have noticed some unpleasant symptoms such as diarrhea. Usually this occurs because the antibiotics kill the harmful and commensal bacteria in your GI tract, which throws off the gut balance. Eventually, the effects of antibiotics may allow harmful bacteria to thrive.

Prebiotics are sometimes confused with probiotics, however prebiotics are the foods that fuel the microflora . Prebiotics are usually in the form of fiber…they are non-digestible carbohydrates found in foods like bananas, onions, garlic, soybeans, artichokes, chicory root, leeks, asparagus, barley, oats, apples, and cocoa. Beneficial microbes can then ferment these prebiotics, which leads to the production of short-chain fatty acids (SCFAs) that can have multiple beneficial effects throughout the body.

And finally, we have postbiotics. The term postbiotics has been defined by the International Scientific Association for Probiotics and Prebiotics (ISAPP) as “a preparation of inanimate microorganisms and/or their components that confers a health benefit on the host.” Basically, this refers to the left over waste created from your body digesting both prebiotics and probiotics. Because evidence of postbiotics health benefits to the host/human has been accumulating, the interest in developing postbiotic products as foods, therapeutics, etc…has also been increasing. However, while we wait for the scientific community to guide us on how to use these products in the future, for now the best way to increase the amount of postbiotics in your system is to increase your intake of fermented foods and foods containing probiotics.
N. Zastrow

The traditional medical paradigm has primarily been to treat those facing a disorder, disease, or diagnosis by focusing on symptoms instead of root-cause medicine. Generally, the current model of medicine and the focus on prescriptions as the primary treatment modality is just not working. Although there are several public health recommendations concerning the prevention of disease, whether it be from the American Heart Association, American Cancer Society, the Dietary Guidelines for Americans, or the American Diabetes Association, the information disseminated from these sources seems to be somewhat ineffective in creating shifts toward decreasing the diagnoses of disease and improving health outcomes. According to the CDC, 6 in 10 Americans live with at least one chronic disease (Diabetes, cancer, heart disease, arthritis, e.g.). The CDC also states that “most chronic diseases can be prevented by eating well, being physically active, avoiding tobacco and excessive drinking, and getting regular health screenings.” In 2010 the US Department of Health & Human Services and the US Department of Agriculture published what was considered extensive guidelines for Americans, describing what comprised of a healthy diet. They included the incorporation of nutrient-dense foods (in proper amounts) to help maintain an ideal body weight. Yet, with these recommendations, we are not seeing a decrease in chronic ailments. For decades the blanket guidance given to the public regarding their health has been confusing for many. Suppose you’re looking outside the advice from your medical provider or government-led sources for information, and you’ve tried to improve your well-being. In that case, whether through exercise, nutrition, or spiritual outlets, you may know what a task it can be to field the landscape of the abundant amounts of information you can find without hardly looking. It has become incredibly difficult to filter through the cascade of new diets, studies, new policies, and pills. We can do so much to change our health and the trajectory of our lives by paying attention to the industry, finding inspiration, and discovering new ways to improve how we feel, look and focus. However, we can also spend too much time and money and possibly end up doing more harm than good. There’s a reason the nutrition industry is predicted to hit $465.4 billion by 2025. Because while we’d like to think that this new diet or superfood will be the end of our search for optimal health, what works for some certainly does not work for all…or even most. So what kind of change do we need, and how will it help?

Fortunately, more and more research is coming out daily, showing us how we differ regarding weight loss, cancer and health risks, exercise and diet recommendations, and individual stress responses. However, we’re also discovering that the right practitioner can utilize novel tools to make more specific, personalized recommendations. These personalized tools include an array of evolving technologies in the areas of genomics, epigenetics, life and behavioral sciences, diagnostics and clinical medicine, and systems biology (Minich, Bland). For example, variants in the vitamin D receptor (VDR) gene impact absorption, metabolism, and utilization of vitamin D, perhaps making dietary intervention, supplementation, and increased sun exposure a possible requirement for better health outcomes. This variant is especially prudent, given that the VDR gene is involved in inflammation, insulin-like growth factor signaling, and estrogen-related pathways. Knowing a patient has this variant in their genetic profile, investigating symptoms, and examining their lab work to verify if the SNP is expressing, can lead the practitioner and patient in the right direction when trying to prevent and improve one’s health.

According to Deanna M Minich and Jeffrey S Bland from the Personalized Lifestyle Institute, personalized lifestyle medicine “encompasses a broad array of disciplines in order to effectively prevent and treat disease, including the interface of technological advances with modern medicine discoveries for eventual dissemination into clinical medicine approaches.” While the guidelines for the general public, mentioned earlier in this article, have been average, blanket recommendations to get people on the right path, those guidelines do not consider an individual’s genetics or environment. Rather than sticking with the status quo of preventative medicine through generalized recommendations, Personalized Lifestyle Medicine may be much more successful in helping with the prevention and treatment of disease. Using the new technology, experienced practitioners, and customized recommendations, an individualized plan may give people a much better and more direct understanding of where they are, where to go and how to get there successfully.

• Centers for Disease Control and Prevention. (2022, June 9). Chronic disease center (NCCDPHP). Centers for Disease Control and Prevention. Retrieved June 30, 2022
• Meticulous Market Research Pvt. Ltd. (2020, June 23). Human nutrition market worth $465.4 billion by 2025, growing at a CAGR of 6.6% from 2019- global market opportunity analysis and industry forecasts by meticulous research®. GlobeNewswire News Room. Retrieved June 30, 2022
• Minich, D. M., & Bland, J. S. (2013, June 26). Personalized lifestyle medicine: Relevance for nutrition and lifestyle recommendations. TheScientificWorldJournal. Retrieved June 30, 2022
• Sara Gottfried, M. D. (2020, December 10). Why personalized lifestyle medicine is the future of Healthcare. Sara Gottfried MD. Retrieved June 30, 2022
• For more information on Personalized Lifestyle Medicine, follow this link: https://plminstitute.org/

The community of diverse microorganisms that reside in each of our gastrointestinal tracts, is known as the gut microbiota. Research has exploded over the past decade investigating the impact our microbiota has on both our health and the development of disease. The more we research the gut microbiome, the more we realize the impact that our gut health, and the gut bacteria that make up the microbiome, have on our overall health. We now know that the bacteria that reside in our gut help regulate a number of our bodily functions, including our brain health, metabolism, and immune system.

Sometimes, it seems obvious to look at what might be going on in our gastrointestinal tract. For example, if you have a diagnosis of IBS, IBD, or colitis, or have stomach pain and/or bloating after eating. However, for many, the gut connection becomes less obvious when someone is having trouble with mental health issues, hormones, or systemic pain. Yet, they are often very much connected.

Going back to the community of microorganisms that live within our GI tract, we know that they play a large role in metabolizing nutrients and maintaining the health of the intestinal epithelial lining. The cells that line the surface of the intestinal epithelium, Intestinal epithelial cells (IECs), play a large role in digesting food, absorbing nutrients, and keeping “bad” microbes/microbial infections from harming the body. When the epithelial lining becomes compromised, or there is a lack of microbial diversity to maintain the health of the epithelial lining, this often leads to dysbiosis and is associated with many conditions. Stress, alcohol, poor diet and lifestyle, and antibiotics can all harm the cells lining the intestinal epithelium.

The gut microbiome actually contains several broad classes of organisms that include bacteria, fungi, parasites, and viruses. And although there is a large database of research on the microbiome, we still can’t say firmly what a “normal” microbiome looks like. That being said, we know that there is an association between a more diverse microbial community and better health. Aside from diversity, what we’re learning currently, is the importance of having what are called “Keystone” species of microbiota, which seem to carry unique functions and generally help hold the microbial system together. The removal of keystone species can cause a dramatic shift in both the structure of the microbiome, and its functioning. In the gut, some of these have been identified as Bifidobacterium pseudolongum, Bifidobacterium longum, Faecalibacterium prausnitzii, etc… Newer research has identified the bacterium, Akkermansia muciniphila, as a keystone species as well, showing it has highly promising probiotic activities against obesity and diabetes, while also being linked to more positive health outcomes such as lowering inflammation.

The mechanism for how Akkermansia muciniphila works is nearly in its name, as it feeds on mucin, the glycoprotein produced by various epithelial cells that form the mucosal lining in your gut. This mucosal layer helps keep microorganisms away and builds a protective barrier between the intestinal epithelium and the contents in your lumen, or gut. Emphasizing A. muciniphila as a positive component may then sound counterintuitive…, why would it be beneficial to feed on something like mucin that helps maintain the integrity of the epithelial lining? However, Akkermansia feeds on mucin and then produces (byproduct) propionate and acetate, which are two short-chain fatty acids that help feed other beneficial gut bacteria. These other beneficial bacteria then produce butyrate, another short-chain fatty acid that suppresses inflammation in the gut and is known to support our gut barrier by feeding goblet cells that produce more mucin. Therefore, although A. muciniphila is a mucin-degrader, it ends up increasing the number of goblet cells, eventually stimulating the production of more mucus.

The importance of having a healthy epithelial lining, which of course includes the mucin layer, is imperative to better health. The short-chain fatty acids mentioned above help keep the intestinal cells together, preventing undigested, larger molecules from passing through the lining and into your bloodstream. The condition that occurs when these larger molecules start passing through the intestinal lining is often called increased intestinal permeability, or “leaky gut” and is associated with inflammatory and autoimmune diseases. If higher levels of Akkermansia muciniphila help strengthen the gut barrier, it may be effective in the prevention of certain conditions and diseases.

While the relatively new attention to A. muciniphila as the next-generation probiotic sounds promising, research so far has been mostly limited to animal studies. We can, however, increase levels of Akkermansia muciniphila naturally by including foods containing prebiotics and polyphenols that these bacteria enjoy eating. This would include foods like pomegranates, blueberries, strawberries, bananas, avocadoes, walnuts, apples, and cashews. Trying some of these foods in powder form or concentrates added to healthy shakes will give you higher amounts per serving if you’re utilizing it for more therapeutic reasons. It’s also important to note that studies have shown in order to maintain abundant levels of A. muciniphila it may be helpful to avoid high-fat diets and heavier alcohol consumption.

The takeaway, for now, is to know the importance of keeping your gut healthy, and a large part of that is maintaining a healthy mucin layer. Aim for stimulating your endogenous levels of A. muciniphila by focusing on feeding that mucin layer. Try including, if possible, a variety of plant foods in your diet. If you’re interested in utilizing Akkermansia as a probiotic supplement, keep looking for current research about whether or not supplementation has been proven to be beneficial, or talk with your doctor or nutrition professional for advice. Every microbiome is different, and so is the overall health of that individual. Keep empowering yourself with the knowledge to make your health journey personal and remember to lean in to your strive.

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