“The best, most natural forms of probiotics are fermented foods,” say Dr. Lisa Ganjhu, board certified gastroenterologist /Hepatologist with focus on obesity. Fortified foods, such as probiotic-enhanced dough, may deliver less of a health infusion since the manufacturing process can kill off many of the healthy live cultures. Besides yogurt and kefir, some common foods made using fermentation include, sauerkraut, kimchi (spicy pickled cabbage), and pickles.
The amount and kind of live cultures per bite vary, but words like raw, lacto-fermented, or unpasteurized on the packaging will indicate that the bacteria haven’t been killed off in the manufacturing process, says Jenny Sansouci, a certified health coach with Eleven Eleven Wellness Center in New York City. Yogurt with the “live active cultures” seal indicates that it has not been heated after the fermentation process and contains at least 100 million cultures per gram (or 10 million cultures per gram for frozen yogurt). Unless it contains one of the bacterial strains that have been studied, however, it still may not have proven probiotic benefits.
“It’s great if you can eat some fermented foods every day, but two or three times a week is a good place to start,” says Sansouci.
Some foods to try: DanActive; some research suggests that it can help ease some types of gastrointestinal distress. Lifeway Frozen Kefir; Kefir can improve digestion and restore beneficial bacteria after a round of antibiotics Mama O’s Premium Kimchi; Lactobacilli, found in kimchi, can help prevent yeast infections. Real Pickles Organic Sauerkraut; A study published in the British Journal of Nutrition found that eating sauerkraut may help prevent cancer.
If you aren’t sure that you’re getting enough probiotics from your diet, a daily supplement can be helpful, says Sansouci. (It’s nearly impossible to overdose on probiotics.)
Most probiotic supplements include Lactobacillus and Bifidobacterium, two of the most well-studied strains. Products with more bacterial strains-sometimes called “mega probiotics”- aren’t necessarily better, but some experts say it’s a good idea to switch supplements every month or two. Recommendations vary, but Sansouci says she has found supplements with at least 20 billion live organisms per dose to be the most effective in her practice.
You can choose among powders, pills, and liquid shots. Some are sold chilled and must be kept that way to maintain their effectiveness. But the success of a product has more to do with specific microbes it contains than what form it takes.
Some supplements to try: Align; it contains Bifantis, which helps maintain digestive balance. Florastor; a study found it alleviates antibiotic-related diarrhea and may help aid the immune system, so it’s smart to take when traveling. RepHresh Pro-B; the only probiotic clinically shown to balance yeast and bacteria daily. Dr. Frank Lipman’s Be Well Probiotic Powder; can be helpful for chronic indigestion and bloating. Culturelle Digestive Health Probiotic Chewables; has been shown to boost general digestive health.