Category: nutrition

THIS CALCULATES THE BMI

the body mass index is the calculation weight corrected for the hight

if a person is very muscular the muscle will count to the weight and the BMI will be artificially high but the person will be really much fitter

If the person is excessive thin, the BMI will calculate the muscle as fat and it will be lower that it should be in that person

in such persons a body fat analysis will provide further information

PLEASE CLICK TO SEE THE DETAILS

“A plant-based diet is a powerful tool for preventing, managing, and even reversing type 2 diabetes. Not only is this the most delicious ‘prescription’ you can imagine, but it’s also easy to follow. Unlike other diets, there’s no calorie counting, no skimpy portions, and no carb counting. Plus, all the ‘side effects’ are good ones. ”

Neal Barnard, MD, FACC, President, Physicians Committee

Probiotics: What You Need To Know

What are probiotics?

Probiotics are live microorganisms that are intended to have health benefits when consumed or applied to the body. They can be found in yogurt and other fermented foods, dietary supplements, and beauty products.

Although people often think of bacteria and other microorganisms as harmful “germs,” many are actually helpful. Some bacteria help digest food, destroy disease-causing cells, or produce vitamins. Many of the microorganisms in probiotic products are the same as or similar to microorganisms that naturally live in our bodies.

What types of bacteria are in probiotics?

Probiotics may contain a variety of microorganisms. The most common are bacteria that belong to groups called Lactobacillus and Bifidobacterium. Other bacteria may also be used as probiotics, and so may yeasts such as Saccharomyces boulardii.

Different types of probiotics may have different effects. For example, if a specific kind of Lactobacillus helps prevent an illness, that doesn’t necessarily mean that another kind of Lactobacillus or any of the Bifidobacterium probiotics would do the same thing.

Are prebiotics the same as probiotics?

No, prebiotics aren’t the same as probiotics. Prebiotics are nondigestible food components that selectively stimulate the growth or activity of desirable microorganisms.

What are synbiotics?

Synbiotics are products that combine probiotics and prebiotics.

How popular are probiotics?

The 2012 National Health Interview Survey (NHIS) showed that about 4 million (1.6 percent) U.S. adults had used probiotics or prebiotics in the past 30 days. Among adults, probiotics or prebiotics were the third most commonly used dietary supplement other than vitamins and minerals. The use of probiotics by adults quadrupled between 2007 and 2012. The 2012 NHIS also showed that 300,000 children age 4 to 17 (0.5 percent) had used probiotics or prebiotics in the 30 days before the survey.

How might probiotics work?

Probiotics may have a variety of effects in the body, and different probiotics may act in different ways.

Probiotics might:

• Help your body maintain a healthy community of microorganisms or help your body’s community of microorganisms return to a healthy condition after being disturbed
• Produce substances that have desirable effects
• Influence your body’s immune response.

How are probiotics regulated in the United States?

Government regulation of probiotics in the United States is complex. Depending on a probiotic product’s intended use, the U.S. Food and Drug Administration (FDA) might regulate it as a dietary supplement, a food ingredient, or a drug.

Many probiotics are sold as dietary supplements, which don’t require FDA approval before they are marketed. Dietary supplement labels may make claims about how the product affects the structure or function of the body without FDA approval, but they aren’t allowed to make health claims, such as saying the supplement lowers your risk of getting a disease, without the FDA’s consent.

If a probiotic is going to be marketed as a drug for treatment of a disease or disorder, it has to meet stricter requirements. It must be proven safe and effective for its intended use through clinical trials and be approved by the FDA before it can be sold.

Learning About the Microbiome

The community of microorganisms that lives on us and in us is called the “microbiome,” and it’s a hot topic for research. The Human Microbiome Project, supported by the National Institutes of Health (NIH) from 2007 to 2016, played a key role in this research by mapping the normal bacteria that live in and on the healthy human body. With this understanding of a normal microbiome as the basis, researchers around the world, including many supported by NIH, are now exploring the links between changes in the microbiome and various diseases. They’re also developing new therapeutic approaches designed to modify the microbiome to treat disease and support health.

The National Center for Complementary and Integrative Health (NCCIH) is among the many agencies funding research on the microbiome. Researchers supported by NCCIH are studying the interactions between components of food and microorganisms in the digestive tract. The focus is on the ways in which diet-microbiome interactions may lead to the production of substances with beneficial health effects. 

What has science shown about the effectiveness of probiotics for health conditions?

A great deal of research has been done on probiotics, but much remains to be learned about whether they’re helpful and safe for various health conditions. 

Probiotics have shown promise for a variety of health purposes, including prevention of antibiotic-associated diarrhea (including diarrhea caused by Clostridium difficile), prevention of necrotizing enterocolitis and sepsis in premature infants, treatment of infant colic, treatment of periodontal disease, and induction or maintenance of remission in ulcerative colitis. 

However, in most instances, we still don’t know which probiotics are helpful and which are not. We also don’t know how much of the probiotic people would have to take or who would be most likely to benefit. Even for the conditions that have been studied the most, researchers are still working toward finding the answers to these questions.

The following sections summarize the research on probiotics for some of the conditions for which they’ve been studied.

Gastrointestinal Conditions

Antibiotic-Associated Diarrhea

• Probiotics have been studied for antibiotic-associated diarrhea in general, as well as for antibiotic-associated diarrhea caused by one specific bacterium, Clostridium difficile. This section discusses the research on antibiotic-associated diarrhea in general. C. difficile is discussed in a separate section below.
• A 2017 review of 17 studies (3,631 total participants) in people who were not hospitalized indicated that giving probiotics to patients along with antibiotics was associated with a decrease of about half in the likelihood of antibiotic-associated diarrhea. However, this conclusion was considered tentative because the quality of the studies was only moderate. Patients who were given probiotics had no more side effects than patients who didn’t receive them.
• Probiotics may be helpful for antibiotic-associated diarrhea in young and middle-aged people, but a benefit has not been demonstrated in elderly people, according to a 2016 review of 30 studies (7,260 participants), 5 of which focused on people age 65 or older. It’s uncertain whether probiotics actually don’t work in elderly people or whether no effect was seen because there were only a few studies of people in this age group. 
• A review of 23 studies (with 3,938 participants) of probiotics to prevent antibiotic-associated diarrhea in children provided moderate quality evidence that probiotics had a protective effect. No serious side effects were observed in children who were otherwise healthy, except for the infection for which they were being treated.

Clostridium difficile Infection

• The bacterium Clostridium difficile can infect the colon (large intestine) of patients who have received antibiotics, causing diarrhea that can range from mild to severe. C. difficile infection is difficult to treat and sometimes comes back after treatment. It’s more common in people who take antibiotics long-term and in elderly people, and it can spread in hospitals and nursing homes. C. difficileinfection affects about half a million people a year in the United States and causes about 15,000 deaths. 
• A 2017 analysis of 31 studies (8,672 total patients) concluded that it is moderately certain that probiotics can reduce the risk of C. difficile diarrhea in adults and children who are receiving antibiotics. Most of these studies involved hospital patients. The analysis also concluded that the use of probiotics along with antibiotics appears to be safe, except for patients who are very weak or have poorly functioning immune systems.
• The types of probiotics that would be most useful in reducing the risk of C. difficile diarrhea, the length of time for which they should be taken, and the most appropriate doses are uncertain.

Constipation

• A 2014 review of 14 studies (1,182 participants) of probiotics for constipation in adults showed some evidence of benefit, especially for Bifidobacterium lactis. 
• A 2017 evaluation of 9 studies (778 participants) of probiotics for constipation in elderly people indicated that probiotics produced a small but meaningful benefit. The type of bacteria most often tested was Bifidobacterium longum. The researchers who performed the evaluation suggested that probiotics might be helpful for chronic constipation in older people as an addition to the usual forms of treatment. 
• A 2017 review looked at 7 studies of probiotics for constipation in children (515 participants). The studies were hard to compare because of differences in the groups of children studied, the types of probiotics used, and other factors. The reviewers did not find evidence that any of the probiotics tested in the children were helpful. A second 2017 review, which included 4 of the same studies and 2 others (498 total participants in the 6 studies examined), took a more optimistic view of the evidence, noting that overall, probiotics did increase stool frequency, and that the effect was more noticeable in Asian than European children. 

Diarrhea Caused by Cancer Treatment 

• Diarrhea is a common side effect of chemotherapy or radiotherapy for cancer. It’s been suggested that probiotics might help prevent or treat this type of diarrhea. However, a 2018 review of 12 studies (1,554 participants) found that the evidence for a beneficial effect of probiotics was inconclusive.

Diverticular Disease

• In diverticulosis, small pouches develop at weak spots in the wall of the colon (large intestine). In most cases, this does not cause any symptoms. If symptoms (such as bloating, constipation, diarrhea, or cramping) do occur, the condition is called diverticular disease. If any of the pouches become inflamed, the condition is called diverticulitis. Patients with diverticulitis can have severe abdominal pain and may develop serious complications.
• A 2016 review of 11 studies (764 participants) of probiotics for diverticular disease was unable to reach conclusions on whether the probiotics were helpful because of the poor quality of the studies. 

Inflammatory Bowel Disease

• Inflammatory bowel disease is a term for a group of conditions that cause a portion of the digestive system to become inflamed; the most common types are ulcerative colitis and Crohn’s disease. Symptoms may include abdominal pain, diarrhea (which may be bloody), loss of appetite, weight loss, and fever. The symptoms can range from mild to severe, and they may come and go. Treatment includes medicines and in some cases, surgery.
• A 2014 review of 21 studies in patients with ulcerative colitis (1,700 participants) indicated that adding probiotics, prebiotics, or synbiotics to conventional treatment could be helpful in inducing or maintaining remission of the disease. The same review also looked at 14 studies (746 participants) of probiotics, prebiotics, or synbiotics for Crohn’s disease and did not find evidence that they were beneficial.

Irritable Bowel Syndrome

• A 2018 review of 53 studies (5,545 total participants) of probiotics for irritable bowel syndrome (IBS) concluded that probiotics may have beneficial effects on global IBS symptoms and abdominal pain, but it was not possible to draw definite conclusions about their effectiveness or to identify which species, strains, or combinations of probiotics are most likely to be helpful.

For more information, see the NCCIH fact sheet on irritable bowel syndrome.

Traveler’s Diarrhea

• A 2018 review evaluated 11 studies (5,143 participants) of probiotics or prebiotics for prevention of traveler’s diarrhea and found evidence that they may be helpful. However, the review didn’t assess the quality of the studies and didn’t include data on side effects. 
• A 2017 clinical practice guideline by the International Society of Travel Medicine stated that there’s insufficient evidence to recommend probiotics or prebiotics to prevent or treat traveler’s diarrhea. The guidelines acknowledged that there’s evidence suggesting a small benefit but pointed out that studies vary greatly in terms of factors such as the probiotic strains used, the causes of the diarrhea, and geographic locations. Also, some studies had weaknesses in their design.

Conditions in Infants

Infant Colic

• Colic is excessive, unexplained crying in young infants. Babies with colic may cry for 3 hours a day or more, but they eat well and grow normally. The cause of colic is not well understood, but studies have shown differences in the microbial community in the digestive tract between infants who have colic and those who don’t, which suggests that microorganisms may be involved.
• A 2018 review of 7 studies (471 participants) of probiotics for colic, 5 of which involved the probiotic Lactobacillus reuteri DSM 17938, found that this probiotic was associated with successful treatment (defined as a reduction of more than half in daily crying time). However, the effect was mainly seen in exclusively breastfed infants. 
• No harmful effects were seen in a review of 4 studies (345 participants) of L. reuteri DSM 17938 for colic or in a small NCCIH-funded study that included repeated physical examinations and blood tests in infants with colic who were given this probiotic, as well as parents’ reports of symptoms. 

Necrotizing Enterocolitis

• Necrotizing enterocolitis is a serious, sometimes fatal disease that occurs in premature infants. It involves injury or damage to the intestinal tract, causing death of intestinal tissue. Its exact cause is unknown, but an abnormal reaction to food components and the microorganisms that live in a premature baby’s digestive tract may play a role. 
• A 2017 review of 23 studies (7,325 infants) showed that probiotics helped to prevent necrotizing enterocolitis in very-low-birth-weight infants. However, the results of individual studies varied; not all showed a benefit. Probiotics that included both Lactobacillus and Bifidobacterium seemed to produce the best results, but it was not possible to identify the most beneficial strains within these large groups of bacteria.
• None of the infants in the studies described above developed harmful short-term side effects from the probiotics. However, the long-term effects of receiving probiotics at such a young age are uncertain. Outside of these studies, there have been instances when probiotics did have harmful effects in newborns. In several instances, babies developed bloodstream infections from microorganisms intentionally included in a probiotic product, and in one case, a premature baby died after being infected with a mold that had contaminated a probiotic dietary supplement. 

Sepsis in Infants 

• Sepsis is a serious illness in which the body has a harmful, overwhelming response to an infection. It can cause major organs and body systems to stop working properly and can be life threatening. The risk of sepsis is highest in infants, children, the elderly, and people with serious medical problems. One group particularly at risk for sepsis is premature infants. 
• A review of 37 studies (9,416 participants) found that probiotics were helpful in reducing the risk of sepsis in premature infants. 

Dental Disorders

Dental Caries (Tooth Decay)

• A small amount of research, all in infants and young children, has examined the possibility that probiotics might be helpful in preventing dental caries (also called cavities or tooth decay). A review of 7 studies (1,715 total participants) found that the use of probiotics was associated with fewer cavities in 4 of the 7 studies, but the quality of the evidence was low, and no definite conclusions about the effectiveness of probiotics could be reached.

Periodontal Diseases (Gum Disease)

• Periodontal diseases result from infections and inflammation of the gums and bone that surround and support the teeth. If the disease is severe, the gums can pull away from the teeth, bone can be lost, and teeth may loosen or fall out. 
• A 2016 review of 12 studies (452 participants) that evaluated probiotics for periodontal disease found evidence that they could be a helpful addition to treatment by reducing disease-causing bacteria and improving clinical signs of the disease. However, effects may differ for different probiotics. 

Conditions Related to Allergy

Allergic Rhinitis (Hay Fever)

• A review of 23 studies (1,919 participants) in which probiotics were tested for treating allergic rhinitis found some evidence that they may be helpful for improving symptoms and quality of life. However, because the studies tested different probiotics and measured different effects, no recommendations about the use of probiotics could be made. Few side effects of probiotics were reported in these studies. 

Asthma

• A review of 11 studies (910 participants) of probiotics for asthma in children had inconclusive results. 

Atopic Dermatitis

• Atopic dermatitis is an itchy chronic skin disorder that’s associated with allergies but not caused by them. It’s most common in infants and may start as early as age 2 to 6 months. Many people outgrow it by early adulthood. Atopic dermatitis is one of several types of eczema.
• A 2017 review of 13 studies (1,271 participants) of probiotics for the treatment of atopic dermatitis in infants and children did not find consistent evidence of a beneficial effect. A review of 9 studies (269 participants) in adults provided preliminary evidence that some strains of probiotics might be beneficial for symptoms of atopic dermatitis. 

Prevention of Allergies

• It’s been suggested that changes in people’s lifestyles and environment may have led to reduced contact with microorganisms early in life, and that this decrease may have contributed to an increase in allergies. This is sometimes called the “hygiene hypothesis,” although factors unrelated to hygiene, such as smaller family size and the use of antibiotics, may also play a role. Studies have been done in which probiotics were given to pregnant women and/or young infants in the hope of preventing the development of allergies. 
• A 2015 review of 17 studies (4,755 participants) that evaluated the use of probiotics during pregnancy or early infancy found that infants exposed to probiotics had a lower risk of developing atopic dermatitis, especially if they were exposed to a mixture of probiotics. However, probiotics did not have an effect on the risks of asthma, wheezing, or hay fever (allergic rhinitis). 

Other Conditions

Acne

• Research has identified mechanisms by which probiotics, either taken orally or used topically (applied to the skin), might influence acne. However, there has been very little research in people on probiotics for acne, and the American Academy of Dermatology’s 2016 guidelines for managing acne state that the existing evidence isn’t strong enough to justify any recommendations about the use of probiotics.

Hepatic Encephalopathy

• When the liver is damaged and unable to remove toxic substances from the blood, the toxins can build up in the bloodstream and affect the nervous system. This may lead to impairments of brain function called hepatic encephalopathy. 
• A 2017 review looked at 21 studies (1,420 participants) of probiotics for hepatic encephalopathy and concluded that they were generally of low quality. There was evidence that compared with a placebo (an inactive substance) or no treatment, probiotics probably had beneficial effects on hepatic encephalopathy, but it was uncertain whether probiotics were better than lactulose, a conventional treatment for liver disease. 

Upper Respiratory Infections

• Probiotics have been tested for their effects against upper respiratory infections (a group that includes the common cold, middle ear infections, sinusitis, and various throat infections). A 2015 evaluation of 12 studies with 3,720 total participants indicated that people taking probiotics may have fewer and shorter upper respiratory infections. However, the quality of the evidence was low because some of the studies were poorly conducted. 

Urinary Tract Infections

Can probiotics be harmful?

• Probiotics have an extensive history of apparently safe use, particularly in healthy people. However, few studies have looked at the safety of probiotics in detail, so there’s a lack of solid information on the frequency and severity of side effects. 
• The risk of harmful effects from probiotics is greater in people with severe illnesses or compromised immune systems. When probiotics are being considered for high-risk individuals, such as premature infants or seriously ill hospital patients, the potential risks of probiotics should be carefully weighed against their benefits. 
• Possible harmful effects of probiotics include infections, production of harmful substances by the probiotic microorganisms, and transfer of antibiotic resistance genes from probiotic microorganisms to other microorganisms in the digestive tract. 
• Some probiotic products have been reported to contain microorganisms other than those listed on the label. In some instances, these contaminants may pose serious health risks. 

NCCIH-Funded Research

NCCIH sponsors a variety of research projects related to probiotics or the microbiome. In addition to the previously mentioned studies on diet-microbiome interactions in the digestive tract, recent topics include:

• The mechanisms by which probiotics may help to reduce postmenopausal bone loss
• Engineering probiotics to synthesize natural substances for microbiome-brain research
• The mechanisms by which certain probiotics may relieve chronic pelvic pain
• The effects of a specific Bifidobacterium strain on changes in short-chain fatty acid production in the gut that may play a role in antibiotic-associated diarrhea.

More To Consider

• Don’t use probiotics as a reason to postpone seeing your health care provider about any health problem.
• If you’re considering a probiotic dietary supplement, consult your health care provider first. This is especially important if you have health problems. Anyone with a serious underlying health condition should be monitored closely while taking probiotics.
• Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decision

Probiotics are made of good live bacteria and/or yeasts that naturally live in your body. You constantly have both good and bad bacteria in your body. When you get an infection, there’s more bad bacteria, knocking your system out of balance. Good bacteria helps eliminate extra bad bacteria, returning the balance. Probiotic-supplements are a way to add good bacteria to your body. 

What are probiotics?

Probiotics are a combination of live beneficial bacteria and/or yeasts that naturally live in your body. Bacteria is usually viewed in a negative light as something that makes you sick. However, you have two kinds of bacteria constantly in and on your body — good bacteria and bad bacteria. Probiotics are made up of good bacteria that helps keep your body healthy and working well. This good bacteria helps you in many ways, including fighting off bad bacteria when you have too much of it, helping you feel better.

Probiotics are part of a larger picture concerning bacteria and your body — your microbiome. Think of a microbiome as a diverse community of organisms, such as a forest, that work together to keep your body healthy. This community is made up of things called microbes. You have trillions of microbes on and in your body. These microbes are a combination of:

• Bacteria.
• Fungi (including yeasts).
• Viruses.
• Protozoa.

Everyone’s microbiome is unique. No two people have the same microbial cells — even twins are different.

For a microbe to be called a probiotic, it must have several characteristics. These include being able to:

• Be isolated from a human.
• Survive in your intestine after ingestion (being eaten).
• Have a proven benefit to you.
• Be safely consumed.

Where do beneficial probiotics (microbes) live in my body?

Though the most common place linked to beneficial microbes is your gut (mostly large intestines), you have several locations in and on your body that host good microbes. These locations are in contact with the “outside world” and include your:

• Gut.
• Mouth.
• Vagina.
• Urinary tract.
• Skin.
• Lungs.

How do probiotics work?

The main job of probiotics, or good bacteria, is to maintain a healthy balance in your body. Think of it as keeping your body in neutral. When you are sick, bad bacteria enters your body and increases in number. This knocks your body out of balance. Good bacteria works to fight off the bad bacteria and restore the balance within your body, making you feel better.

Good bacteria keeps you healthy by supporting your immune function and controlling inflammation. Certain types of good bacteria can also:

• Help your body digest food.
• Keep bad bacteria from getting out of control and making you sick.
• Create vitamins.
• Help support the cells that line your gut to prevent bad bacteria that you may have consumed (through food or drinks) from entering your blood.
• Breakdown and absorb medications.

This balancing act is naturally happening in your body all of the time. You don’t actually need to take probiotic supplements to make it happen. Good bacteria is just a natural part of your body. Eating a well-balanced diet rich in fiber every day helps to keep the number of good bacteria at proper levels.

What are the most common types of probiotic bacteria?

Though there are many types of bacteria that can be considered probiotics, there are two specific types of bacteria that are common probiotics found in stores. These include:

• Lactobacillus.
• Bifidobacterium.

Probiotics are also made up of good yeast. The most common type of yeast found in probiotics is:

• Saccharomyces boulardii.

Can I use probiotics to help with medical conditions?

There is currently a large amount of research happening around the idea of what probiotics can do for your body. Even though there are a lot of possibly positive outcomes, researchers are still working to find definitive answers about how probiotics can help with various conditions.

However, there are some medical conditions where probiotics may help. This can vary between people meaning that what works for one person may not work for another. These can also vary based on the certain probiotic that is taken.

Some of the conditions that might be helped by increasing the amount of probiotics in your body (through food or supplements) include:

• Diarrhea (both diarrhea caused by antibiotics and from Clostridioides difficile (C. diff) infection).
• Constipation.
• Inflammatory bowel disease (IBD).
• Irritable bowel syndrome (IBS).
• Yeast infections.
• Urinary tract infections.
• Gum disease.
• Lactose intolerance.
• Eczema (atopic dermatitis).
• Upper respiratory infections (ear infections, common cold, sinusitis).
• Sepsis (specifically in infants).

Can I take or eat something to increase the good probiotics (microbes) in my body?

You can increase the amount of good microbes in your body through foods, drinks and supplements. You may already have certain foods in your daily diet that contain probiotics. Fermented foods in particular (yogurt and pickles, for example) are home to a host of good bacteria that benefit your body. There are also fermented drinks like kombucha (fermented tea) or kefir (fermented dairy drink) that introduce extra probiotics into your diet.

Apart from food, you can add probiotics to your diet through dietary supplements. These aren’t drugs, so they do not need to be approved by the Federal Drug Administration (FDA). It’s important that you always talk to your healthcare provider before starting any kind of supplement or major change to your diet.

Can I get probiotics from food?

You can absolutely increase beneficial microbes in your body from the foods you eat. Certain foods have probiotics (good bacteria) in them and can benefit the health of your microbiome.

These foods can be introduced into your diet at any point of the day. You may even be regularly eating them now and not realize that they contain probiotics. You will want to check the food label for “live and active cultures.” A few suggestions for just some of the probiotic-rich foods you can add to your diet and some times to try them include:

For breakfast, try:

• Yogurt.
• Buttermilk.
• Sourdough bread.

For lunch, try:

• Cottage cheese.
• Kombucha.
• Tempeh.

For a snack, try:

• Fermented pickles.

For dinner, try:

• Fermented sauerkraut.
• Kimchi.
• Miso soup.

Make sure you are still creating a balanced and healthy meal each time you sit down to eat. Though adding probiotic-rich foods into your diet won’t hurt you, balance is still key. Adding too much of just one food prevents your body from reaping the benefits of other food groups.

How do I take a probiotic supplement?

There are several ways you can take a probiotic supplement. They come in a variety of forms, including in:

• Foods.
• Drinks.
• Capsules or pills.
• Powders.
• Liquids.

Probiotic supplements may be combined with a prebiotic. Prebiotics are complex carbohydrates that feed the microorganisms in your gut. Basically, prebiotics are the “food source” for the good bacteria. They help feed the good bacteria and keep it healthy. Prebiotics include inulin, pectin and resistant starches.

When you have a supplement that combines a probiotic and prebiotic, it’s called a synbiotic.

How effective are probiotics?

Researchers are currently unsure how effective probiotic supplements are for treating conditions. There’s constant research on the topic. While many research studies have had positive results on the impact of probiotic supplements, more research is still needed.

It’s also important to keep in mind that unlike medications, dietary supplements do not need to be approved by the FDA. This means that manufacturers can sell supplements simply with “claims” of safety and effectiveness.

Always talk with your healthcare provider (or pediatrician) before taking a supplement or giving one to your child. Supplements might interfere with medicines you may be taking. If you are pregnant or breast feeding, check with your provider before taking any supplement.

Are there any storage instructions for probiotics?

Several probiotic strains are very fragile and need to be protected from heat, oxygen, light and humidity. The probiotics might start to break down or die if they are exposed to these elements. Because of this, you may need to refrigerate your probiotics or store it in a particular place. Refrigerating certain probiotic strains ensures that they’re still viable when you go to use them and will still provide the full benefit of the probiotic. Always read the labels on any probiotic product you purchase to make sure you store it correctly and use it within the expiration date.

How safe are probiotics?

Because microbes used as probiotics already exist naturally in your body, probiotic foods and supplements are generally considered safe. They may trigger allergic reactions, and may also cause mild stomach upset, diarrhea, or flatulence (passing gas) and bloating for the first few days after starting to take them.

There are certain people who need to use caution when using probiotic supplements. There is a risk of infection in some people. These people include those who have:

• A weakened immune system (those going through chemotherapy for example).
• A critical illness.
• Recently had surgery.

Caution should also be used when giving probiotics to very sick infants.

Always talk to your healthcare provider before starting a probiotic supplement.

Can probiotics hurt me?

For most healthy people, probiotics don’t cause any harm. They are generally considered safe and are often “given a try” to see if they could help with various medical conditions. There’s a lot of research around the topic of probiotics. Scientists are trying to determine when and how they should be used, as well as how effective they are. Talk to your healthcare provider before starting a probiotic supplement because there are some cases where you shouldn’t be taking them. It’s always best to have the conversation first before starting a new supplement.

Are there any risks related to probiotics?

Probiotics are generally considered safe. However, there are some risks linked to the supplements. These risks are increased if you have a medical condition that weakens your immune system, have recently had surgery or have other serious medical conditions.

Unlikely, but possible, risks can include:

• Developing an infection.
• Developing a resistance to antibiotics.
• Developing harmful byproducts from the probiotic supplement.

Should I give probiotics to my kids?

Probiotics can be beneficial for both adults and kids. If your child has an illness that requires an antibiotic medication for treatment, taking a probiotic can help shorten symptoms. Probiotics can also be used to help relieve constipation, acid reflux, diarrhea, gas and eczema in children. 

Introducing probiotics into your child’s diet through food is typically a safe way to give them probiotics. Foods like yogurt and cottage cheese are often part of a balanced diet and can add in good bacteria without much risk. 

There are commercially available probiotic supplements specifically designed for infants and children. However, it is important to talk to your child’s pediatrician before giving them any probiotic supplement or changing the child’s diet to include probiotic-rich foods. 

Do I need to take probiotics after I take antibiotics?

Antibiotic medications are often needed to fight an infection. However, while antibiotics are killing the bad bacteria, they are also knocking out the good bacteria in your body. Some people develop conditions like diarrhea after taking an antibiotic. In other people, this may allow for really bad bacteria to take over and populate the gut, such as with C. diff. Some research has shown a positive connection between taking probiotics after an antibiotic and relief from diarrhea. This hasn’t been proven yet and doesn’t work for everyone.

The thought behind adding probiotics back into your body after taking an antibiotic is that it can repopulate the good bacteria that was destroyed by the antibiotics and re-boot your system. The extra good bacteria helps repopulate your gut and fight off any remaining bad bacteria. Many people feel that adding in probiotics won’t hurt, might help you feel better a little faster and prevent diarrhea.

Should I try probiotics?

If you are interested in adding probiotics to your diet, it’s worth a conversation with your healthcare provider. Many providers may suggest giving them a try to see if they help with your general health. It is important to remember that not all probiotics behave the same way and have the same effects. Each has their own individual benefits. They generally don’t cause harm. One easy way to start can be by simply introducing probiotic-rich foods into your diet, like yogurt.

Before you start any supplements, make sure you talk to your healthcare provider. Your provider may be able to point you in the right direction, helping you figure out the best probiotic to take, how much to take and when to take it. A conversation is always worth the time when it concerns your health.

https://my.clevelandclinic.org/health/articles/14598-probiotics

based on the Clevelandclinic website

https://www.monash.edu/medicine/ccs/gastroenterology/prebiotic/faq

BASED ON THE LINK TO MONASH UNIVERSITY AUSTRALIA

What is dietary fibre?

Dietary fibre, can be defined as ‘the edible parts of plants or analogous carbohydrates that are resistant to digestion and absorption in the human small intestine with complete or partial fermentation in the large intestine’.    

Dietary fibre plays a vital role in the gut including:

• bulking/ laxation and  hastening ‘transit’ through the gut (ie. roughage)
• providing fermentation substrate for the production of short chain fatty acids (SCFA) acetate, propionate and butyrate.  Some fibre types (eg. resistant starch) are a good substrate for the production of butyrate (a SCFA with a special role in keeping the gut healthy).
• stimulating the selective growth of certain beneficial gut bacteria (ie. prebiotic)
• slowing the rate of absorption from the small intestine (eg. lower the glycemic  and insulinemic response).

Different fibre types, however, vary in how well they perform these different roles.  For example, there are some fibres that are particularly good at bulking and laxation. Resistant starch is an excellent substrate for the SCFA-butyrate production and fructans (inulin) are very effective at stimulating the growth of bacteria (i.e. prebiotic).  For this reason it is important to eat a wide variety of foods to ensure you are getting enough of all the different fibre types.

What are the health benefits of eating a diet high in fibre?

Dietary fibre has been credited with a host of health benefits, including the potential to reduce the risk of coronary heart disease, stroke, hypertension, diabetes, obesity and certain gastrointestinal disorders. Adequate intakes of dietary fibre may also improve blood lipid profiles, reduce blood pressure, improve glycaemic control, improve laxation, promote weight loss and improve immune function.

What is a prebiotic?

A prebiotic is a type of fibre (but not all fibre is prebiotic).  To be classified as a prebiotic, the fibre must pass through the GI tract undigested and stimulate the growth and/or activity of certain ‘good’ bacteria in the large intestine.  Prebiotics include fructans and galacto-oligosachairdes (GOS).  See Table 1 below for examples of food that are naturally high in prebiotics.

What are the health benefits of eating a diet high in prebiotics?

Because prebiotics are a relatively new discovery, evidence supporting their health benefit is only beginning to emerge. Some health benefits attributed to prebiotic intake includes modulation of the gut microbiota, improved mineral absorption, possible protection against colon cancer, improved blood glucose and insulin profiles, protection against intestinal infections and alterations in the progress of some inflammatory conditions.

How can I maintain a healthy balance of good bacteria in my gut?

One way of increasing the number of good bacteria in the gut is by eating prebiotics.

Which foods are naturally high in prebiotics?

Dietary fibres classified as having high prebiotic effects includes inulin, fructo-oligosaccharides (fructans , FOS) and galacto-oligosaccharides (GOS). Table 1 outlines food sources of prebiotics and see our recipe suggestions:

Table 1

Vegetables	Jerusalem artichokes, chicory, garlic, onion, leek, shallots, spring onion, asparagus, beetroot, fennel bulb, green peas, snow peas, sweetcorn, savoy cabbage
Legumes	Chickpeas, lentils, red kidney beans, baked beans, soybeans
Fruit	Custard apples, nectarines, white peaches, persimmon, tamarillo, watermelon, rambutan, grapefruit, pomegranate.  Dried fruit (eg. dates, figs)
Bread / cereals / snacks	Barley, rye bread, rye crackers, pasta, gnocchi, couscous, wheat bran, wheat bread, oats
Nuts and seeds	Cashews, pistachio nuts
Other	Human breast milk

It is important to note that in addition to natural ‘prebiotics’, many of these foods are also excellent sources of dietary fibre (roughage) and resistant starch.

How do I reduce flatulence or ‘wind’ on a high fibre diet including legumes/pulses?

Some foods such as legumes produce excessive wind.  The wind is the result of excessive gas produced through the action of the gut microflora.  This often happens when people change from a low fibre diet to include very high fibre foods such as legumes.  We recommend you introduce these high fibre foods very gradually over 7 days.  This will give your gut and gut bacteria time to adapt to the greater quantity of fibre arriving in the large bowel.  You should have less  problems with excessive ‘wind’.

How much fibre should I eat each day?

The National Health and Medical Research Council Australia) recommend that women and men consume at least 25g and 30g of fibre per day, respectively. Despite these recommendations, many Australians do not eat enough fibre.

What are some strategies I could use to increase my fibre intake?

The following strategies may help you to increase your fibre intake.

o    Eat a high-fibre breakfast cereal
o    Add a few tablespoons of unprocessed bran or psyllium husks to cereal, soups, casseroles, yoghurt, smoothies, dessert and biscuit recipes 
o    Add nuts, dried fruits and seeds to cereals 
o    Eat wholegrain breads 
o    Eat fruit and vegetable skins, don’t peel them
o    Snack on fruit, nuts, and seeds. 
o    Read food labels and choose foods that are higher in fibre 
o    Add legumes and lentils to soups, casseroles and salads. 
o    Eat legume or lentil based dishes a few nights a week, for example felafels, chickpea salad, dhal or lentil soup  
o    Eat fruit instead of drinking fruit juice or soft drink

I have medically diagnosed irritable bowel syndrome (IBS) and have been advised to  avoid eating many of the high prebiotic foods listed here.

If you have received a diagnosis of IBS by your doctor  then you  may have been placed on the ‘Monash University low FODMAP diet’.  The low FODMAP diet is a special therapeutic diet designed to alleviate the undesirable gastrointestinal symptoms associated with this condition.  You must seek the guidance of a qualified dietitian with experience in this area.  We recommend that the Low FODMAP diet is followed for a period of 2-6 weeks followed by review from your dietitian.  Your dietitian will provide advice on which foods (and how much) can be re-introduced.  The long-term goal of dietary management  is for you to be able to return to a normal diet (that includes high fibre foods) with no (or very few) dietary restriction.  You must seek advice from a health professional before restricting your FODMAP intake.  A low FODMAP diet will reduce the intake of foods high in fibre and natural prebiotics, which in turn may impact of the growth of certain bacteria in the gut.  This is why we advise against following a strict low FODMAP diet  unnecessarily.

PLEASE SEE VIDEO ABOVE ABOUT THE BENEFITS OF BEET

THE BEET HAS SUCROSE AND THERE IS A CONTROVERSY OF TAKING BEET IN PATIENTS WITH DIABETES. IN GENERAL IT BELIEVED TO BE GOOD BECAUSE OF OF ANTI OXIDANTS AND OTHER ” SUPERFOOD ” NUTRIENTS. HOWEVER BEET JUICE IS NOT RECOMMENDED

PLEASE DISCUSS YOUR PHYSICIAN IF YOU HAVE DIABETES OR PREDIABETES

Non-starchy Vegetables

Eat more! You don’t often hear that when you have diabetes, but non-starchy vegetables are one food group where you can satisfy your appetite.

Vegetables are full of vitamins, minerals, fiber and phytochemicals—and with so few calories and carbohydrate, everyone can enjoy more!

There are two main types of vegetables—starchy and non-starchy. For this section, we are going to focus only on the non-starchy vegetables.

Choose fresh, frozen and canned vegetables and vegetable juices without added sodium, fat or sugar.

• If using canned or frozen vegetables, look for ones that say no salt added on the label.
• As a general rule, frozen or canned vegetables in sauces are higher in both fat and sodium.
• If using canned vegetables with sodium, drain the vegetables and rinse with water to decrease how much sodium is left on the vegetables.

For good health, try to eat at least three to five servings of vegetables a day. This is a minimum and more is better! A serving of vegetables is:

• ½ cup of cooked vegetables 
• 1 cup of raw vegetables

Common non-starchy vegetables

The following is a list of common non-starchy vegetables:

• Amaranth or Chinese spinach
• Artichoke
• Artichoke hearts
• Asparagus
• Baby corn
• Bamboo shoots
• Beans (green, wax, Italian)
• Bean sprouts
• Beets
• Brussels sprouts
• Broccoli
• Cabbage (green, bok choy, Chinese)
• Carrots
• Cauliflower
• Celery
• Chayote
• Cucumber
• Daikon
• Eggplant
• Greens (collard, kale, mustard, turnip)
• Hearts of palm
• Jicama
• Kohlrabi
• Leeks
• Mushrooms
• Okra
• Onions
• Pea pods
• Peppers
• Radishes
• Rutabaga
• Salad greens (chicory, endive, escarole, lettuce, romaine, spinach, arugula, radicchio, watercress)
• Sprouts
• Squash (cushaw, summer, crookneck, spaghetti, zucchini)
• Sugar snap peas
• Swiss chard
• Tomato
• Turnips
• Water chestnuts
• Yard-long beans