Probiotics and prebiotics have been in the public’s eyes for these recent years. It has been widely discussed between scientists, nutritionists and doctors; more and more probiotic and prebiotic supplements are released in the market; more and more research has been done to examine the potential health benefits of probiotics and prebiotics.
They have been linked to lowering the risk of many chronic diseases, such as cardiovascular disease, diabetes, obesity etc. And the results are generally promising.
Therefore, it has come to our curiosity that “if probiotics and prebiotics are beneficial to a lot of chronic diseases other than gut health, will they also have an effect on attenuating eczema symptoms?”. Well, probiotics and prebiotics really have certain beneficial effects on eczema.
A quick recap – What is probiotics and prebiotics?
We have often heard of the name ‘probiotics’ or ‘prebiotics’ from various places. But what exactly are they? And what is the difference between them?
Probiotic refers to food that contains living organisms (e.g bacteria, fungi) that can reach our intestine when consumed and live in our gut without harming us, composing our gut microbiota. Our gut microbiota consists of 100 trillion microorganisms6 and the probiotics we consume from food are just some parts of it. The most common probiotic found in food is the Lactobacillus and Bifidobacterium family.
On the other hand, prebiotics is substrates that we cannot digest but they can be selectively utilized by our host microorganisms (i.e gut microbiota) conferring health benefits to us7. Simply speaking, prebiotics is like fertilizer for your gut microbiota. Our gut microbiota will digest them and stimulate their growth, causing significant changes in the composition of the gut microbiota that will beneficially affect the host, which is us. Dietary fibre, resistant starch, polyphenols and inulin are some commonly found prebiotics in foods.
It has been discovered that eczema patients have a reduction of gut and skin microbiota diversity.
Eczema and our gut health are strongly related. This unhealthy microbiota that lost its beneficial homeostatic balance is known as ‘dysbiosis’. Under dysbiosis, our gut loses its anti-infectious barrier potency, a.k.a leaky gut, as our gut microbiota plays a fundamental role in the induction, training and function of our immune system.
With a leaky barrier, pathogens can easily enter our bloodstream and our immune system will initiate inflammation in our gut and throughout our body to kill the bacteria. Thus, triggering skin inflammation and eczema flares.
But how probiotics and prebiotics are related to reducing severity of eczema?
The species of Lactobacillus and Bifidobacterium will lower those pro-inflammatory cytokines, attenuating the eczema inflammation, flare and itchiness.
It is due to the immunomodulatory effect of probiotics and the anti-inflammatory effects of prebiotics. By consuming probiotics, we can restore the diversity of our gut microbiota, which will improve our intestinal barrier and immune system.
From some recent studies, the supplementation of probiotics has lowered the severity of eczema symptoms in adults. In these studies that show promising results of probiotics on eczema, most of them have applied probiotics supplements consisting of Lactobacillus, Bifidobacterium or a combination of them, this shows that Lactobacillus and Bifidobacterium may play a role in alleviating eczema symptoms.
To be concise, the species of Lactobacillus and Bifidobacterium will lower those proinflammatory cytokines, attenuating the eczema inflammation, flare and itchiness. While if we consume prebiotics, our nice and friendly gut microbiota will help us break them down, producing some short-chain fatty acids (SCFAs). These SCFAs have anti-inflammatory effects15 and are important for lowering the inflammation of the skin. These SCFAs will also be used as an energy source for our gut lining, which will keep our gut barrier strong, modulating our immune system.
Where and how to consume probiotics and prebiotics?
With all these benefits that probiotics and prebiotics bring to eczema patients, consuming enough probiotics and prebiotics are important.
Currently, the recommended daily fibre intake is 25-30 grams per day and there is no recommended daily intake for probiotics.
So where can we find food with high probiotics and prebiotics?
Fermented foods are high in probiotics, for example, yoghurt, cheese, kimchi, sauerkraut, kefir. Other non-fermented foods are rich in probiotics just like kombucha, apple cider vinegar and spinach. For foods that are rich in prebiotics, common fruits, vegetables, whole grains, nuts, seeds and legumes are very good choices.
Extra virgin olive oil is a very special source of prebiotics, it is rich in polyphenols and also rich in monounsaturated fat and omega 3 fats, which will bring substantial health benefits to us. However, before enjoying the abovementioned food and gaining the benefits of probiotics and prebiotics, we have to also beware of foods with naturally high amounts of chemicals, like histamines and salicylate, that can induce allergic responses.
Unfortunately, most of the grains, vegetables and dairy products are high in histamines and salicylate. Aren’t this mean that we are not able to obtain the benefits of these probiotics- and prebiotic-rich foods? No worries, this is where an elimination diet can help to identify your own food allergens. Not all the food that are high in chemical loads will induce allergic responses and you will definitely find foods that are suitable for you. So be good to your gut microbiota, keeping them healthy and happy, and they will return the favour back to us.
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