Pre, Pro and Post-Biotics: What Are the Differences?

Health starts below the belt. Literally. Your microbiome (gut)  is home to 70% of your immune system and what goes into your gut day after day, meal after meal is closely connected to the well-being of your heart brain, skin and respiratory system as well as your gut.  The good news is that there’s a lot you can do to protect yourself from a variety of ills — not just the digestive ones like bloating, acid reflux, and IBS,  but a lot of above-the-belt conditions–  if your diet includes probiotics and its two cousins, prebiotics and postbiotics.  Which is which and how do they work as a team?  Here’s what, where, and how, starting with the biotic that we know the best.


Probiotic translates as “for life.”  It makes sense. The term describes dietary supplements and foods that provide large amounts of the so-called “good” bacteria that occur naturally in the human intestine, but not always in the amount needed.  The human gut is home to billions of bacteria which we know as the microbiome (or the microbiota) according to the Human Microbiome Project of the National Institutes of Health (NIH) which is busy mapping this gutsy phenomenon. Among adults, probiotics or prebiotics have been the third most commonly used dietary supplement other than vitamins and minerals. Their use quadrupled between 2007 and 2012. Indeed, in 2012 alone, almost four million Americans used them. In 2014, the global market for probiotics was more than $32 billion. And sales have only gone up since. There are plenty of good reasons.

Probiotic bacteria promote intestinal barrier function, helps with constipation, diarrhea, diverticular disease, inflammatory bowel disease, and irritable bowel syndrome. Some research suggests they also may help reduce cancer risk, improve cholesterol metabolism and normalize blood pressure.

But wait, there’s more, Probiotics in the laboratory have been seen to affect the aging process, aid in weight loss, even help to heal hay fever, and periodontal disease. Probiotics on the skin even affect the microbiome that’s present on your skin. Good bacteria in the gut are capable of producing mood-stabilizing neurotransmitters, like serotonin and dopamine, because good bacteria have a direct link to the central nervous system, via an important pathway called the vagus nerve.


All probiotic products aren’t created equal or designed for the same task. Look for a product with strains and doses designed to target the body zone or condition you are treating. Some strains are meant to treat actual gut issues like diarrhea; others target respiratory concerns, or mood or weight, for example. Although the popularity of probiotics taken in supplement form, pills, powders, and liquids has increased over the last decade, there is still some confusion about what kinds of bacteria we should take and in what dosages. Although there are at least 400 different species of microflora that colonize our gut, the most important strains used commercially appear to be Lactobacillus and Bifidobacterium. Typically, an adult probiotic should provide at least 1 billion cells daily. More quantity isn’t more quality. Probiotics are usually taken on an empty stomach 30 minutes before a meal.

Ask your pharmacist for guidance if you are ((justifiably) confused about what to buy for the best results. And buyer beware: Dr. Aaron Carroll writing in the New York Times, reminds us probiotics are regulated less tightly than drugs. They don’t need to be proven effective to be marketed, and the quality control can be lax. . For some peace of mind and pocketbook, consider subscribing to, a site that impartially reviews and rates dietary supplements, issues alerts, and publishes a valuable newsletter.

But pills aren’t your only source of immune-supporting bacteria. There are plenty of probiotic-rich foods and drinks that get the job done.  Especially fermented and cultured foods – –yogurt, kefir, sauerkraut, kimchi, miso, kombucha, apple cider vinegar (with the “mother”), and sourdough bread.


Prebiotics are types of indigestible soluble fiber found in certain carbohydrates, such as flax and inulin.  Probiotics feed on these prebiotics through a process of fermentation. Instead of being digested and absorbed,  they pass right through the digestive system until they reach the lower part of the large intestines.  The best prebiotic food sources are root veggies, whole wheat, and other grains and legumes, raw garlic, Jerusalem artichokes, jicama,  greens, raw onions,  and under-ripe (slightly green) bananas. Note: When probiotics are combined with prebiotics, a blockbuster product category called synbiotics is created in which the prebiotics support growth of the probiotics and the survival and activity of the microorganisms.


Postbiotics are formed through fermentation, a process that happens when the food is processed in the intestines. . Postbiotics can also be found in probiotic-rich foods such sauerkraut, buttermilk, cottage cheese, apple cider vinegar, and fibrous foods like oats, flaxseed, seaweed, fermented pickles to name a few.

Another more specialized source to boost postbiotic concentration besides the foods above includes spirulina and chlorella (types of algae that help detox the body, reduce inflammation, feed beneficial bacteria, and possibly help increase secretory immunoglobulin A, which improves gut health). Researchers believe that postbiotics, with their important antimicrobial abilities, may be the next frontier in supporting the immune system against pathogens, reducing inflammation, mimicking the effects of probiotics, killing pathogens, regulating hormone and insulin levels, and increasing overall immunity.

Commercial postbiotic supplements (which should supply short-chain fatty acids such as butyrate) are still not widely available,


The good news is that the three categories of biotic foods interact and overlap, as it were—so when you eat a combo like oats and buttermilk, or pickled vegetables over whole-wheat noodles  or dip your sourdough bread in a little yogurt you are getting the whole pre/ pro/ /post caboodle all in one bowl.

Okay, the following recipe won’t replace a supplement containing billions of live good bacteria, but it certainly is a day-to-day health-boosting preventative and can boost the efficacy of any microbiome pill, liquid, or gel you’re taking.


  • 2  pounds Napa cabbage
  • 1 bunch green onions, roots trimmed
  • 2- large carrots peeled, thinly julienned
  • ¼ cup kosher salt
  • ¼  cup  (or less) chili powder
  • 10  cloves garlic  peeled
  • 4- inches ginger root peeled and  chopped
  • 1 tablespoon fish sauce (or substitute soy sauce)
  • unsweetened apple juice
  • 1 tablespoon miso paste
  • Cut the cabbage in half long ways, then in half again long ways. Remove the core and chop cabbage into 2 inches squares.  Place in a bowl with carrots. Sprinkle with salt, massaging it in so the cabbage starts to soften and wilt.
  • Cover with cold, (chlorine-free) water and soak for at least 1 hour.
  • Pour cabbage liquid into a strainer. Drain off brine.
  • Put green onions in a food processor with the garlic cloves, ginger, miso paste, and pepper powder. Process on high until smooth. Add fish sauce and vinegar and juice and process. Set aside.
  • Put the brined vegetables in a bowl.  Pour the chili paste combo over the vegetables and massage well.
  • Pack tightly into 200r 3 large canning jars. Add a two-piece lid without screwing it tightly. Let sit at room temperature for up to 2 days until bubbly and fragrant. Once a day, insert a clean chopstick or knife to release air bubbles. Add more brine if needed.
  • Refrigerate being sure that the vegetables stay submerged.  The longer it sits, the stronger the flavor. Keeps up to 6 months if refrigerated.

-Frances Goulart


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