11 Aug 2017
The most frequently asked questions when it comes to probiotic are usually about how to take them. "What time should I take my probiotic supplement?”, “Should I take it with a meal or on an empty stomach?” and "Can I take it with antibiotics?" are some of the most common. Ultimately, we all want to make sure that we’re able to get the best out of our probiotic supplements.
The concern is that bacteria are delicate by nature, and that they may not survive stomach acid. Taking probiotics at a certain time of day (when stomach acidity may be more neutral) could help you to ensure the highest survival rates of your probiotic. Confusingly though, different healthcare professionals and probiotic manufacturers, have different guidelines about when is best to take these supplements! So let's try to clarify a few things.
First of all, let's look at the logic behind having probiotics on an empty stomach, advocated by some. Well, because acid is stimulated by consumption of food, it is thought that taking probiotics on an empty stomach (mainly first thing in the morning), is ideal because there is less residual acid in the stomach. However, it’s also important to note that there is a lag time (up to 30 minutes) between when food is eaten and when acid is released into the stomach. As a nutritionist, I like to recommend that clients take their supplements with a meal, as the food helps to buffer the effects of stomach acid; it may also help to facilitate the passage of the probiotics through the stomach, and ensures that they are well mixed with the stomach contents as they pass into the small intestines.
With that being said, there are hundreds of probiotic strains available in the market, and different products may need to be administered at a specific time of the day for a reason. Take Saccharomyces boulardii for example; this is a strain that can be taken at any point in the day, with or without a meal. Now that’s because it is very robust, so this recommendation might not apply to all probiotic strains.
Some probiotic supplements that contain prebiotics could also lead to initial bloating and gas, so you’d find that these products might be best taken before bed.
Although we can get caught up with getting the timing right, and yes, generally you want your probiotics to survive as well as they can, there are other factors which matter more than the timing. For example, of greater concern would be checking that you have the best specific probiotic supplements tailored to your client’s needs. Not all probiotics have the same health benefit as they all have different properties, so apply specific probiotic strains to target specific health conditions. Don’t forget to also make sure these strains have lots of clinical trials to back up their efficacy!
Many gold standard clinical trials involving the use of probiotics don’t specify the time of the day the supplements were administered and it’s not a strictly controlled factor, which indicates that the researchers do not see it as a limitation. But, it still brings up the question of "is there a right or wrong time to take probiotics?"
Which is why I found this new clinical trial, published in the World Journal of Gastroenterology, intriguing as it’s the first of its kind to explore this topic.
The aim of the study was to assess if the time the probiotics were administered affected their ability to colonise in the gut and provide health benefits by modifying the composition of the gut flora.1
The study involved 20 participants split into two groups of 10. They were all given the same amount of a probiotic supplement containing Bifidobacterium longum BB536 and Lactobacillus rhamnosus HN001; however, the first group took the supplement 30 minutes before their breakfast, and the other group had the supplement 30 minutes after breakfast.
They found that the ability of these strains to reach the intestine, colonise and provide beneficial health effects were not significantly affected by the time the probiotic supplements were administered.
There was also an overall reduction in the levels of potentially harmful bacteria and an increase in beneficial bacteria in both groups.
So to conclude, whilst we recommend that probiotics are taken preferably with breakfast for a number of reasons, it's equally important to take the probiotics at a convenient time, especially if taking it at an inconvenient time means you'd forget to take it completely.
Check out the following links for further reading;
Are all types (strains) of friendly bacteria the same?
1. M. Toscano, R. De Grandi, L. Stronati, E. De Vecchi and L. Drago, "Effect of Lactobacillus rhamnosus HN001 and Bifidobacterium longum BB536 on the healthy gut microbiota composition at phyla and species level: A preliminary study," World Journal of Gastroenterology, vol. 23, no. 15, pp. 2696-2704 , 2017.
2. Tompkins et al. (2011) The impact of meals on a probiotic during transit through a model of the human upper gastrointestinal tract. Beneficial Microbes; 2, 4: 295-303.