Probiotics and prebiotics: the difference most people miss, by Cleveland Clinic
The words sound alike but do different jobs. Cleveland Clinic explains which one brings the gut bacteria and which one feeds them, and how to include both.
- Probiotics are live bacteria, prebiotics are the fibres that feed them.
- Cleveland Clinic suggests starting from food before reaching for capsules.
- Yoghurt, kefir, sauerkraut and kimchi deliver probiotics.
- Banana, garlic, onion, oats and pulses deliver prebiotics.
Did a pharmacist last month recommend a probiotic for 1,800 dinars without explaining what it actually does? You are not alone.
The Cleveland Clinic, one of the five largest medical centres in the United States, has spent years publishing guidance on gut flora. The main problem it flags is that people confuse probiotics and prebiotics, and so buy one while thinking they are buying the other.
What Cleveland Clinic experts advise
Probiotics and prebiotics work as a pair, but they are not interchangeable. Probiotics are live bacteria; prebiotics are the food for the bacteria that already live in your gut.
Probiotics are live bacteria and yeasts useful to the digestive system, while prebiotics are a type of fibre that feeds the beneficial bacteria already present in the gut.
Cleveland Clinic suggests trying food first, and only then capsules if a doctor specifically advises them.
Probiotics, what they are
Probiotics are live bacteria that survive the journey through the stomach and settle in the gut. The most common species are Lactobacillus, Bifidobacterium and Saccharomyces boulardii (a yeast).
They settle temporarily and stay as long as you feed them. Cut the supporting food and they slowly fade.
Prebiotics, what they are
Prebiotics are a type of fibre humans cannot digest, but the bacteria in the colon break them down. The most common ones are inulin, fructo-oligosaccharides (FOS) and galacto-oligosaccharides (GOS).
Without prebiotics, probiotics have nothing to eat. That is why dietitians point to foods that carry both, which they call a synbiotic.
Five probiotic foods from the local shop
Most of these do not require a pharmacy. Five items you can find in any Maxi or Idea shop:
- yoghurt with live cultures, the label must say “live probiotics”
- kefir, more sour than yoghurt, with a wider range of bacteria
- sauerkraut from a tursija jar, not the pasteurised tin version
- kombucha, a fermented tea that has caught on in Serbia over the last five years
- kimchi, the Korean staple, stocked at larger Maxi outlets and Lidl
Prices range from 120 dinars for yoghurt to 450 dinars for a small jar of kimchi, around one to four euros.
Five prebiotic foods you already have
Prebiotics are cheaper because they are part of everyday cooking. Five sources you likely already use:
- bananas, especially slightly green ones
- garlic and onion, raw they hold more inulin than cooked
- oats, as porridge or in muesli
- pulses, beans, lentils, chickpeas
- artichokes, the strongest plant source of inulin
The Cleveland Clinic golden rule: combine one probiotic and one prebiotic a day. A morning yoghurt with banana covers both.
When capsules make sense
Cleveland Clinic is clear that capsules are not a first choice for healthy adults. They make sense in these cases:
- after a course of antibiotics, when the flora has been disrupted
- in irritable bowel syndrome, on a gastroenterologist’s recommendation
- in chronic diarrhoea of various origins
- in immunocompromised patients, only under medical supervision
- in babies with colic, with a specific strain recommended by a paediatrician
The cost of capsules at Serbian pharmacies ranges from 600 to 3,500 dinars, around 5 to 30 euros per pack.
What not to do
Cleveland Clinic flags a few common mistakes.
Do not buy a probiotic just because the pharmacist pushed a promo box across the counter. Ask which strain it contains and for which indication. If the answer is not clear, walk out and ask a doctor.
Do not exceed the dose with capsules. More is not better; the body simply clears the surplus.
Do not take probiotics in the same hour as antibiotics. A gap of at least two hours gives the probiotics a chance to survive.
A practical plan for the first month
Before reaching for capsules, give food a four-week trial. Yoghurt and banana for breakfast plus an evening potato salad with onion is a simple formula.
If the complaints persist (bloating, irregular stools, fatigue), then see a gastroenterologist. They can recommend a specific strain that fits your case.
The golden middle rule, food in the first month, doctor in the second, capsules in the third only if the doctor asks for them.
Do you already eat fermented foods regularly, or do you prefer capsules? What made the difference for you? Tell us in the comments.
