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The Importance of Probiotics & Prebiotics

By Dr. Ashraf Girgis ND.

These days, for those of us in health care, not a day passes by without us hearing about the importance of gut bacteria and how it can impact our health and wellbeing in a fundamental way that was never thought possible. You hear about how there has been a link to diseases like Alzheimer's, anxiety, depression, and many inflammatory diseases to gut health and the numbers of good bacteria in our gut. The fact is becoming more and more clear that our health is connected directly to the health of our gut.

In this article, I would like to address one of the main tools for finding ways to restore the good bacteria that is fights diseases. One way to do this is to eat probiotics. Of course, another easier way is to take supplemental probiotics. 

 Our immune system consists of an intricate network of the lymph nodes, spleen, bone marrow, thymus gland, chemicals, tonsils, and billions of bacteria, good and bad. In order for us to live a normal, healthy life, we need to keep our immune system in good, strong, and healthy shape so that our body can defend itself against germs and bacteria that cause diseases. Our immune system, if kept in check and in good shape, acts like a guard standing in front of a bank to prevent any possible bank robberies. Interestingly, our food choices can HUGELY strengthen and impact our immune system by preventing bad bacteria from spreading and robbing our body of good health. After all, we are truly what we eat.

 Organs Involved in the Immune System

 We can alter our gastrointestinal tract’s microflora in two ways: probiotics and prebiotics. The concept of probiotics was introduced by Russian Scientist and nobel laureate, Elie Metchnikoff. He who won the Nobel Prize in medicine in 1908 with german Paul Ehrlich for their work on immunity.

 Elie Metchnikoff was fascinated by Bulgarian and Russian peasants who lived in the mountains and drank raw sour milk because they seemed to live very long lives. He theorized that live bacteria living in sour milk was responsible for the peasants’ longevity; he called this yogurt the elixir of life.  He believed bacteria that live in the intestinal tract produced toxins that invite diseases and shorten lives. Lactobacillus Bulgaricus was one of the bacteria isolated by Elie Metchnikoff.

 Today we know our gut flora is essential in keeping our immune system in good shape. In fact 70-80% of our health is contributed to our gut bacteria. Our bacteria outnumber our cells by 10:1. This means that for every human cell there is 10 bacteria cells. We also know that eating certain fermented foods increases the number of these good bacteria. Elie Metchnikoff used to drink sour milk every day in hopes of reaching old age. Unfortunately, he died at the age of 71 due to heart failure.

 The good bacteria residing in our colon acts to normalize the gut flora, get rid of the bad bacteria, and assist in making Vitamin K and Vitamin B. It also gets rid of the yeast, enhances GI mobility, helps with food digestion and absorption of nutrients, and prevents abdominal distension due to gas. Since good bacteria in the gut are important in regulating many functions, they are considered very important to overall good health. Probiotics have been used to stabilize gut flora after antibiotic therapy, as antibiotics do have detrimental effects on our good bacteria in the gut. 

 We can directly provide our body with probiotics from the food we eat, or we can eat food that stimulates our own body to create more probiotics. This category of food is called prebiotics.

 Below I have provided a list of foods that are considered probiotic and links to websites that provide recipes on how to make them. These are all foods that can strengthen our immune system and can easily be included in our daily food intake.

 Foods Containing Probiotics:

1.     Yogurt

 Cup of Persian Yogurt (Mast)

Yogurt is an excellent source of good bacteria that are commonly known as probiotics. Yogurt possibly originated in Iran. In the Persian Old Testament, longevity has been attributed to the consumption of yogurts. Yogurt is also mentioned in 500 BC in Persia.

Each cup of yogurt is filled with billions of good bacteria that are essential in fighting off the bad bacteria that are responsible for causing illness. Even half a cup of yogurt can provide the therapeutic amount needed. Antibiotics can be very destructive toward these good bacteria; make sure that if you have been on antibiotics for any period of time, you add another cup of yogurt to your daily food intake. In general, however, adding a cup of yogurt is excellent for your health. Even if you have not been on any antibiotics, if you are getting sick or you feel as though your immune system is weakened, then keep your cup of yogurt (preferable homemade yogurt) handy.

It is also important to mention that yogurt is a source of calcium, protein, vitamin B6, Vitamin B12, and riboflavin. The amount of bacteria available in each serving is also important. In order to just simplify things and ensure you are getting good bacteria in the billions, I recommend you either make your own yogurt or buy a good brand of locally made fresh yogurts. Sometimes, yogurt making companies go through the process of fermentation first and then pasteurize. The heat in pasteurization will destroy the good bacteria. In addition many commercial yogurt add sugar and artificial sweeteners that are not good for your health.  I suggest you stay away from it or get plain yogurt and add your own fruits and flavors.  

Is yogurt the only fermented food that provide us with acidophilus (a type of good bacteria)? No! There are other foods that can do the same:


We all know that eating seafood has amazing health benefits, due to the high omega 3 fatty acid content in some fish. Remember when your grandmother gave you cod liver oil to keep you healthy? Well, she was right all along. We know fish oil is very beneficial for our health and well-being. A study of Eskimos and Japanese Okinawans who are very famous for their longevity and good health both show eating fish as their common trends. Here I would like to bring some scientific evidence for the benefits of eating fish:

1.     In a study conducted by Harvard Medical School, Drs. Mozaffarian & Rimm concluded that eating seafood twice a week lowers the risk of heart disease by 36% and overall mortality rate by 17%. We do know heart disease is the number one killer not only in the United States but around the world. In the United States alone, heart disease kills about 650,000 people per year. The reason behind seafood’s benefits lies in its content of omega n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

In another study conducted in the Netherlands by( Kromhout D at al) in 1971, the scientists followed 272 people born before 1907 for 17 years and concluded: “The results from the present study suggest that the protective effect of a small amount of fish in relation to CHD (coronary heart disease) observed in middle-aged people seems also to be present in the elderly.”

In another study by Italian doctors published in Prestige Journal of Lancet, 11,324 patients with myocardial infarction were given 1 gram of fish oil n-3 polyunsaturated fatty acids (PUFA) and 300 mg of vitamin E for two years from 1993-1995. The doctors concluded: “Dietary supplementation with n-3 PUFA led to a clinically important and statistically significant benefit. Vitamin E had no benefit. Its effects on fatal cardiovascular events require further exploration.” There are several more studies that show the significant impact of fish and fish supplements on all heart diseases.

2.     Combatting inflammation.

On May 14, 2012, scientists at the University of California - Santiago published their findings and experiments on cellular levels in mice in the online Early Edition of the Proceedings of the National Academy. The of study indicated that omega 3 fish oil does change and impact inflammation at the cellular level, even before the inflammation can spread and become detrimental for health. The researchers explained that the omega 3 fatty acid found in some fish and supplements can reduce level of an enzyme called COX (cyclooxygenase), almost the way aspirin does in reducing pain and inflammations.


In a study of 250 patients with rheumatoid arthritis by Dr. Hendler, all of the participating patients had morning stiffness and tenderness in their joints. Patients were given 3 grams of fish oil containing an omega enzyme called prostaglandin, which produces hormones, thereby triggering the inflammation process.

Disrupting the COX2 (cyclooxygenase) pathway results in reduced pain and inflammation. Both n-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are present in fish. Studies done on people eating fish twice a week for period of 12 weeks demonstrated remarkable reduction in pain and stiffness without the need for NSAID (non-steroidal anti-inflammatory drug) use.

Osteoarthritis is the result of breakdown of cartilage in joints, but somehow fish oil reduces the component resulting in inflammation, therefore resulting in less pain and possibly preventing the cartilage breakdown.

Another study published in the Journal of Experimental Medicine on March 7 by Arita and her colleagues identified a substance that has anti-inflammatory effects in human beings, derived from the essential fatty acids in fish oil. These scientists identified new anti-inflammatory substances called resolvins. These classes of aspirin-triggered bioactives are made from omega 3 fatty acids by cellular enzymes. These bioactive lipid substances are called resolvin E1. The scientists were also able to identify similar anti-inflammatory lipid substances in individuals given omega 3 fatty acids called human resolvin E1. These substances lowered inflammation at the cellular level in mice.

Balance Stones

To fight the inflammation with fish oil means fighting all diseases that fall in to the inflammatory category. As I stated previously, there are at least 80 diseases that are categorized as inflammatory diseases, plus another 40 which may have inflammation as a cause, but they are not added to the list as of now.

So that covers a huge section of the diseases. Meanwhile, studies show that eating fish and fish oil is beneficial in diabetic patients because it helps to keep blood sugar stable and slow down neuropathy. Several other studies show that EPA (eicosapentaenoic acid) in fish or in fish oil can reduce symptoms of lupus. In addition, eating fish a few times a week or taking fish oil or both can help with other diseases, such as depression ADHD.

So keep eating fish at least twice a week or take a fish oil as supplement if you do suspect having an inflammatory disease. Most fish oil does contain 18% EPA (Eicosapentaenoic acid) and DHA (docosahexaenoic acid), or a total of 30% omega 3 fatty acid. Omega 3 fatty acids can also be found in flaxseed and some other vegetable oils.

Mackerel, salmon, herring, sardines, and cod liver oil all contain large amounts of EPA and DHA, in addition to albacore tuna, wild game, and sablefish (black Cod). Overall, taking fish oil is very beneficial for health.



But despite all the beneficial effects of fish oil supplements in patients with heart disease and diabetes, in some patients, it caused increased blood sugar and cholesterol levels. So if you are diabetic or have heart disease, it is important to ask your doctor before taking fish oil supplements. Studies have shown that taking fish oil does lower triglyceride overall, but in a few studies, it increased of the level of the LDL – the bad cholesterol – in some individuals. So it is better to eat fish as opposed to taking supplements. As for concerns about level toxins in fish such as mercury, PCBs( polychlorinated biphenyls),etc., the smaller the fish the lesser the amount of toxins, as bigger fish contain more toxins than small fish. I will try to address fish toxicity in another article. 


Thanks for visiting To begin adopting a healthier lifestyle, you can call our office at (616)-777-0608 to make an appointment with Dr. Ashraf Girgis.  


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