Probiotics for Dummies: Health or Hype?

Nibbles

A couple months ago I was approached by the publicist of Dr. Shekhar Challa, M.D., Board-Certified Gastroenterologist and author of Probiotics for Dummies. Knowing a little bit about probiotics, already, and intrigued by the promise of the recipes included in the book, I accepted a digital copy of the book for purposes of review.

This is probably not the sort of review they were hoping for.

To start, let me explain where I was coming from. Already I knew that:

  • Bacteria are not all bad. Probiotics are the good guys, the ones that help our bodies in a variety of ways. Antibiotics, on the other hand, kill bacteria–sometimes both the good and the bad, which can lead to secondary infections.
  • Some of those secondary infections can be prevented by priobiotics, like the active cultures in yogurts, so it’s not a bad idea to up the intake while on broad-spectrum meds.
  • My aunt, holder of a Ph.D. in microbiology and owner of a DNA lab, recommends taking a particular brand of probiotic that helps her with the “Hoover stomach”–what we call the tummy troubles most of our side of the family seems to have.

I, however, take enough pills for the things I have to, if there’s a way to get my probiotics from food I’m much more interested in that method.

First, though, there were the chapters leading up to the recipes that demanded my attention. Unlike most of the For Dummies books I’ve read (and I’ve got half a dozen or so on my shelf), the writing was dry and repetitive. Perhaps it’s the subject matter, but there has to be a way to make this sort of thing more interesting.

Chapter 3, though, starts the pro-supplement rhetoric that would continue throughout the book.

But today, evolving diets and longer lives (age tends to shift the bacterial balance in our bodies) mean that most people need supplements to get adequate probiotics.

Probiotics for Dummies, page 31

I really thought he’d have encouraged a more varied diet before going straight to supplements (this is the note I attached to the above–by the way, my Kindle is awesome for reading books for review purposes).

But let’s talk prebiotics for a moment. These were new to me. Basically, the good bacteria need the right diet of their own, namely fibers they can break down and ferment to feed themselves and make more good bacteria. This is yet another reason to keep a good level of fiber in your diet, to keep the good bacteria happy and plentiful.

Although you can get your prebiotics through foods, the standard American diet–full of processed foods, high in sugar, and low in fiber–doesn’t typically provide enough prebiotics to help the good bacteria in your digestive system. So look for prebiotics in your probiotic supplement. Common prebiotics are inulin and oligofructose.

Probiotics for Dummies, page 39

And now we’re back to the pills. Highlighted with the familiar For Dummies Tip icon, Dr. Challa points out that Probulin is a “good example of a synbiotic, where the two elements, probiotics and prebiotics to work together as a one-two books to your system”.

This is not the only time Probulin is mentioned, or other products that are not food (probiotic straws and chewing gum, for instance), and the probiotic market is also mentioned more than once, about how it’s booming and expected to be worth $32.6 billion by 2014.

I’m sorry, when did this become a investment prospectus?

Getting back to health, Dr. Challa mentions various ailments from eczema to anxiety to obesity that could be helped through the proper administration of probiotics, but the research is still very much in the early stages. So early, in fact, that these ailment-specific chapters are brief and one wonders why not wait until there’s more information rather than writing a book with a lot of theories, maybes, and mights before getting people’s hopes up.

Oh, wait, I know! It’s because you wouldn’t sell as many pills.

So my bs-meter was pinging pretty solid by the time I was halfway through the book, but I was sticking it out. After all, the facts about each bacteria, good and bad, weren’t showing a bias, it was more the treatment and acquisition that was skewed. Finally I got to the food portions of the book: Chapters 11 & 12. But 5 pages in we’re back to “choosing a probiotic supplement.” That’s not adding probiotics to your diet, that’s adding pills to your regimen.

Cue frustration.

And then came the confusion.

You see, in Chapter 11 the fact that heat kills priobiotics comes up in a very real way: Miso, for instance, is a probiotic-rich food, but you’re supposed to add it to a dish after cooking, since heat kills the probiotics. We’re also instructed not to eat or drink anything hot with or within an hour after consuming probiotics, as this could kill them, too.

And the recipes were not much more help. Where I was expecting to see notations on each about which bacteria would be most likely to appear in a dish, there was nothing. Fermenting foods at home is one of those dicey propositions for those of us who’ve taken food safety & sanitation courses, which is why the first recipe, Fermenting with Whey: Sweet Potato Fly, (contributed by Sandor Katz, author of Wild Fermentation) rang a bell or two when step four reads:

Crush the cleaned eggshell into the mixture. The recipe that inspired me called for folding in stiff beaten egg whites at this point; I don’t eat raw eggs so I didn’t try it, but it sounds intriguing, doesn’t it?

Most folks avoid raw eggs because of the threat of salmonella, right? So it surprises me that the cook would rather use the shell–which is where the boatload of contamination risk is located–rather than the white, and then ferment the thing for 3 days. Yes, cleaning is stipulated, but you’d have to sterilize it for it to truly be safe, and I doubt most folks are going to do that.

Oh, and many of the non-fermented recipes are cooked in some way, shape, or form, so I’m left still wondering, how does this increase the probiotics in our diet? Are these recipes meant to give us prebiotic fiber instead?

I suggest that if the author had any interest in the readers actually benefiting from the recipes, more information would have been provided and the process would have jived more with the previous text. I also suggest that Probiotics for Dummies might as well be subtitled: Why Probulin is Awesome.

Consider the Source

Back when the Internet was still fresh and young and students were beginning to use websites for research papers, a lot of caution was expressed about the ownership of the websites being for facts. For instance, medical research was considered somewhat suspect if the site was owned or sponsored by a pharmaceutical company, compared to one that was not. In other words, monetary support leads to potential bias.

Now, even though Probulin lists only 2 mentions, according to the Index, the pro-supplement vibe is pretty strong here and I was wondering from early on whether Dr. Challa was a spokesperson or in someway affiliated with a particular probiotic supplement.

When I got through the book and was flipping through the last pages, imagine my lack of surprise to see 4 full-page ads, after the usual For Dummies lists. First was a “Why Choose Probulin” ad, followed by Probulin’s New Profresh Mints, then a Coming Soon advertisement for “everything probiotic”, with the Probulin logo at the bottom. Finally, a split-page ad (again, sponsored by Probulin) for the Probiotics video game (Microwarriors: The Battle Within) and a new DVD documentary (Microwarriors: The Power of Probiotics).

Doesn’t take a genius to put 2 and 2 together and come out with Dr Challa is obviously involved with Probulin.

Not that there’s anything inherently wrong with that: doctors develop treatment therapies and drugs all the time, and endorsing something is a personal and professional choice. I just want the person presenting themselves as an expert to be upfront about it.

No where in the book does is it disclose the relationship between the author and the advertiser or its product. But I was able to find, with a little searching, that the trademark for Probulin was registered by Challa Enterprises, LLC (per the Trademark Electronic Search System) and that Challa Enterprises is owned, at least in part, by Shekhar Challa (per the Kansas Secretary of State). Now, Probulin, according to the label included with the trademark registration, is “Manufactured Exclusively for NutraCenter Enhanced Nutraceuticals”. I had a tough time finding out any ownership or board information for the sites probulin.com and nutracenter.com, but a WHOIS search gives us the information that both sites are registered to the Kansas Medical Clinic, which Dr. Challa is (finally) stated in the book as being the President of. Going back to the Kansas Secretary of State, we find that Dr. Challa is also the Secretary, sole member of the Board of Directors and sole shareholder for the Kansas Medical Clinic.

Again, none of this is technically wrong, bad, or otherwise nefarious. Unless you want your medical guidance from an unbiased source.

If that’s the case, as it is for me, I’d take everything but the basic facts from Probiotics for Dummies with a grain a salt. In fact, I think looking for another source of probiotic information would be in your best interest.

FTC Disclaimer: I was provided with a digital (pdf) copy of Probiotics for Dummies for the purpose of review. All opinions are entirely my own.