One Lifestyle Change Might Work Better Than Probiotics

Whether it’s the latest TikTok influencer praising their newest probiotic find or the ad about how to support your gut health that interrupts your favorite show, one thing’s for sure: probiotics are “in.”

Probiotics are microbes you can take with the aim to boost your health or treat a condition you might have. When someone refers to your microbiome, they’re generally talking about the genetic material that makes up the microorganisms that live inside us; and the microbiota, or the community of microorganisms that live in your digestive system.

You may have heard probiotics referred to as “healthy bacteria” because they’re said to promote healthy digestion.

But with so many probiotic options at the drugstore, how can you know which ones to choose, which ones to avoid, or if any of them work?

Where to find probiotics that work

After studying the microbiome and its effects on health for 20 years, Dr. Chris Damman, a gastroenterologist at UW Medicine, says it’s hard to know when an over-the-counter probiotic may or may not work.

“There are plenty of over-the-counter probiotics that you can get either in the refrigerated section or off the shelf at a pharmacy or supermarket,” says Damman. “The problem with a lot of those is they’re not highly regulated. So, you don’t really know what you’re getting.”

If you want to add probiotics to your diet, Damman first recommends that you talk with your doctor about how you can do so effectively (and in a way that’s evidence-based).

When do you need a probiotic?

Again, it’s good to talk with your doctor to determine when adding additional probiotics into your diet may or may not be effective. But typically, probiotics could be used to help prevent certain bacterial infections that can happen when you’re taking antibiotics, or infections you can pick up when you travel to certain parts of the world.

Adjusting your diet can give you probiotics

One way to get a healthy dose of probiotics without risking the shelf-roulette of endless brands is simple: your diet. Damman notes that much of the work that promotes a healthy microbiome centers on putting the right foods and nutrients back into your diet. He refers to the microbiome-promoting nutrients as the four phonetic Fs of food: fibers, healthy fats, phenols and fermented foods.

“Eat foods that your microbiome likes to snack on, like fiber,” says Damman. “Fibers are carbohydrates that our body can’t absorb. They make their way down into the last part of the small intestine and colon, where they promote the growth of our own natural biomes.”

Think about it: During food processing, certain elements taken out of the food might mean your gut microbiome is left starving. Damman says trillions of bacteria live in one’s gut, and what we eat is crucial in maintaining those microorganisms.

“People focus on the nutrients their body needs when they eat, but they haven’t focused as much on the nutrients their microbiome needs,” says Damman.

Here are some of the foods the four phonetic Fs include:

• Fiber: foods high in whole grains (like oatmeal), nuts, seeds, beans, fruits and vegetables.
• Healthy Fats: foods like olives, avocadoes and others with oils high in monosaturated and polyunsaturated fatty acids, like omega-3.
• Phenols: foods that are typically colorful fruits and vegetables, like blueberries, red peppers and purple cabbage.
• Fermented Foods: foods like yogurt, sauerkraut, brined pickles and kimchi.

Damman says many fermented foods contain live bacteria, many of which are found in probiotics. He encourages his patients who ask about probiotics to enjoy some yogurt or sauerkraut instead — unless they’re looking to treat a specific condition.

Other ways to support your microbiome (that’s not a probiotic)

Damman says that exercise, consistent sleep and mindfulness can all support a healthy microbiome.

“Getting a good night’s sleep and reducing stress affects your gut and the rest of your body,” he says.

Finally, Damman notes that the gut is almost like the gateway to the whole health of the body, so make sure you’re listening to your gut (and your doctor) — not internet trends — for the best way to care for those little microorganisms.

“If you revamp your microbiome by focusing on the nutrients the microbes consume, they’ll produce metabolites that stimulate the body to naturally produce factors that help reset the metabolism, blood glucose regulation and appetite,” says Damman.

Don’t just feed yourself; feed the little microbes that coexist with you. This partnership is a great way to help keep a healthy gut and body.

Barbara Clements contributed to this article. A version of this story originally appeared in the UW Medicine Newsroom.