Haroon Rashid Chaudhry
For medical personnel; be it the human medical practitioners, dental surgeons, physiotherapists, veterinarians, pharmacists, or those associated with allied health sciences; terms of probiotics, prebiotics and postbiotics may be very enticing words, words in vogue, discussion for passion. At the moment, these medical terms are also gaining a strong footing in almost every house, especially those with a bit of first-hand knowledge and dubbed as educated/elites. Still the basic gist of these terms in vogue goes imperceptible.
Let’s try putting them in simpler form for a better understanding of all and sundry.
The story originated with the development of ‘bread’ which in all of its various forms is mostly consumed food of the world. In historical perspective, bread first appeared around 8000 BC in the Middle East (Probably in Egypt). Grain was crushed and the bakers produced what we today commonly call Chappatis (India), Roti (Pakistan) or Tortillas (Mexico). Yeast was carefully stored in moist clothed bundles and the wives would inoculate their bread with yeast on daily basis, and bake it to form bread. Egyptians were already famed for their beer brewing. Adding wild yeast to bread mixture they emerged as the ‘Booze and Bread People’.
In the following centuries, different nations innovated their own methods of bread-making with various versions of bread being ‘leavened’ or ‘un-leavened’.
The ‘leavened’ bread contains baking yeast, baking powder or baking soda- the ingredients that cause the bread to bubble and rise- and create a light airy product. The ‘un-leavened’ bread, on the other hand, is a flatbread, resembling more of a cracker. Other to the leavening agent, the remaining ingredients in both breads are the same.
The unleavened bread was going out of fashion in Rome though Asia was still learning this method in the times to come by. No harm was done, and resultantly a new thing was adopted which the men found very palatable. Various flavors for the bread were later on devised as well. It was very nutritious and men would sweat it out, burn the extra calories and it became a healthy food. Then entered commercialization and bread became a highly commercialized item. Men stopped sweating it out, the calories were not being burnt accordingly any more. The wheat flour and corn flour was being processed and refined to smallest particles. The roughages and bran was extracted out and the whole of the world was running after processed, refined flour. The essentiality of the roughage for gut health had altogether been forgotten. And the medicine men were trying to figure out what had suddenly gone wrong with the human gut and why such soaring digestive abnormalities in humans? Research revealed that it was in fact, certain germs rather microbes such as Sacchromyces cervsiae and Lactobacillus bulgaricus which were essentially beneficial for gut health.
They named them Probiotics- Live bacteria and yeast beneficial for human digestive system. Everyone was running after these bugs. Slowly and steadily these two passed the test of time and started becoming household names.
From being simple probiotics they matured into a common food item. People started taking it as food and started forgetting their benefits and that they were the original probiotics. Yogurt and yeast were dubbed as best original probiotics known to man. But, the tumbling question was: How would the medicine/pharmaceutical industry benefit from it when these are simply household items?
The commercialization and industry directed its search towards heat-tolerant bacteria which could withstand acidic environment of the stomach and cooking heat.
Resultantly, spore-forming bacteria such as butyrate-producing Clostridia were found. Since yogurt and yeast needed to be replenished in the gut on daily basis, whereas, these newly found clostridial species would colonize the gut for a longer time benefiting human gut as well as the nervous system. The later found their way in human consumption at a larger scale through commercialization. But it had flaws of its own that it would not tolerate antibiotic therapy. The stalwarts of science came up with another spore-forming bacteria which would be able to withstand antibiotic therapy and they termed it multi drug resistant (MDR) bacteria (bacteria which were resistant to many antibiotics). A combo of heat-resistant and antibiotic-resistant bacteria was, since then, a hot cake to sell.
Another discovery that surfaced up about this combo was that they were more useful if some non-digestible fiber was present in the gut, and it simply will not work with refined sugars. For that, man had already been using Ispaghol, wheat bran, and oat fiber but those had long been ousted from human nutrition through enhancement in baking. These fibers were found to assist the bacteria in colonizing the gut, aid in gut motility, and would be digestible by these beneficial bacteria making them flourish.
These fibers were coined as Prebiotics- Food for beneficial bacteria of the gut. As the wheat bran, gluten, corn gluten or oat bran could not be sold for higher prices. The pharmaceutical industry came up with algal fibers and resultantly Mannan Oligosaccharides are the most famed of all prebiotics in today’s times.
As the time flew by, the scientists found out that certain probiotic and prebiotic combinations did not work effectively because the organic acids produced were not enough. A new term was added to our misery- Postbiotics- Functional bioactive compounds, generated through fermentation, used to promote intestinal health of humans. Simply put, the postbiotics are, in fact, immobilized, modified, inactivated non-viable probiotics. Their use has escalated in developed counties especially in pediatric practice and immunocompromised patients owing to less tolerance of probiotics in them.
Differently put, postbiotics are those organic acids which are produced by the probiotics while they digest the prebiotics. Top of the list postbiotic is the butyric acid which acidifies the small intestine. It has been found that this butyrate is good for gut health, gut bacteria and the general body condition of the body with beneficial effects on immune system, nervous system and what not system.
The big question here is that were we not already using yogurt, brans, various fibers, pickle, sauerkraut and the fermented cabbage (by Koreans) long before these findings? Haven’t we started dubbing these new entrants (probiotics, prebiotics and postbiotics) as Nutraceutics leaving behind our natural gut-promoting and general health promoting foods? Far from nature, nearer to pharmaceutics. Do we need to be back at square one or let the commercialization and pharmaceutical industry take us farther away? Point to ponder.