The Importance Of Prebiotics And Your Gut Health
Our guts tell us a lot more than we think. Sometimes, they can even tell us what to think.
The gut microbiome—the collective bacteria and microorganisms that reside in our gastrointestinal tract—is a marvelously complex and diverse environment. Home to over 100 trillion[1] different strains of microbiota, our gut microbiome plays a significant role in regulating everything from immune responses[2] to emotional[3] and cognitive health.
But just like any other collective system in our bodies, it needs certain nutrients in order to function effectively. Not just certain nutrients, but the optimal amount of nutrients.
And understanding how those nutrients affect our gut health is the first step towards achieving better overall health.
The microbiota which reside in our GI tract produce and synthesize chemicals and nutrients which have a direct impact on both our digestive system as well as our immunity, our moods, our brain health and even our central nervous system[4].
These microbiota begin accumulating as early as the moment we’re born, and gradually diversify and grow into a spectrum that is still in the process of being calculated to this day. And the greater the diversity of bacteria in your gut microbiome, the greater the health of your immune system.
But there needs to be a certain balance of both “good” gut bacteria (the microbiota which regulate your GI tract and optimize gut health) and “bad” gut bacteria in order for the gut microbiome to function efficiently. Too much good gut bacteria can activate immune cells which cause digestive conditions, and in some cases, inflammatory diseases[5]. Too much bad gut bacteria and our overall immune response is weakened dramatically.
This imbalance is known as gut dysbiosis[6]. It can be triggered by anything from heredity to lifestyle factors, from preexisting conditions to certain medications. But we’re only now beginning to understand that it’s environmental factors[7] that are becoming a chief culprit in gut dysbiosis.
In particular, our diet. How Diet Affects the Gut Microbiome.
It’s important to remember that the composition and diversity of our gut microbiota differs dramatically from person to person. And for most healthy people, it tends to remain fairly stable.
But intervening factors can play a role in reducing the diversity of our gut microbiome. It’s been estimated that at least 20 percent[7] of the variability of our gut microbiota is directly influenced by environmental factors, with diet playing an active role.
But how does our diet actually affect the gut microbiome?
A diet that’s high in protein and fat can affect the structure of the gut microbiome in as little as one day in healthy patients by increasing the amount of bile-resistant microorganisms and decreasing the metabolic rate of plant based enzymes known as firmicutes. Firmicutes help produce a substance called butyrate, a short chain fatty acid (SCFA)[8] that has an inhibitory effect on cytokine production and other cells and pathogens responsible for inflammatory and autoimmune diseases.
By contrast, a diet rich in certain carbohydrates—chiefly dietary fiber and foods rich in resistant starches such as whole grains, oats, potatoes, brown rice, chickpeas and lentils—also have a role in shaping the gut microbiome. But they shape it in a much more positive way.
Resistant starches and dietary fibers are actually non-digestible. They ferment in the GI tract, helping to produce metabolites which lower the risk[9] of certain metabolic diseases such as type 2 diabetes, cardiovascular disease, and Irritable Bowel Syndrome (IBS.)
You may have heard of the health benefits of probiotics. And you may have also heard of prebiotics. But what is the difference between the two? And how do they affect our gut health?
On the other hand, prebiotics are fibers which nourish good bacteria, acting as nutrients which are necessary for their very survival.
The difference is a critical one. Probiotics add to the diversity of good bacteria, while prebiotics support that growth.
Both complement each other. And both can be taken in conjunction with one another, a process sometimes popularly referred to as microbiome therapy.
What occurs during microbiome therapy when taking probiotics and prebiotics together is actually fairly simple. Probiotics are absorbed and digested by the GI tract and produce enzymes which interact with existing microflora to produce new bacteria and strengthen existing forms. Since prebiotics are non digestible, they ferment in the gut to produce short chain fatty acids which support that new growth.
It’s common for dietitians to recommend both probiotic and postbiotic dietary supplements as a course of action during microbiome therapy. But they may also suggest obtaining both from as many food sources as possible.
While it’s always a good idea to introduce any dietary or supplement changes into your diet gradually, it’s particularly important with prebiotics. Our digestive system can be sensitive to even the slightest alteration in the composition of our microbiota; and while symptoms of gas and boating may be uncomfortable, they generally settle once our bodies get used to any changes.
There are, however, rare cases of individuals suffering from allergic reactions to prebiotic food sources, such as almonds and chicory root. Carefully reviewing the ingredients on any prebiotic supplement can help you distinguish whether or not it’s appropriate for you. Similarly, prebiotics may affect blood sugar levels due to rapid metabolism. Individuals diagnosed or at risk of hypoglycemia and diabetes should consult with a physician prior to starting a prebiotic regimen.
Much like a snowflake, no two microbiomes are alike. They follow a pattern which is unique and highly individualized. But environmental factors, including aging and lifestyle changes, can have an overwhelming impact on the composition of our microbiota.
It’s not a surprise that many Americans are looking to prebiotic dietary supplements to help optimize microbiota function. Nutritional supplements were recently estimated to be an industry worth $164 Billion[32] globally. Naturally, as new research emphasizes the increasing importance of gut health on our overall health, that includes prebiotics. The question is whether or not prebiotic supplements actually work.
Much of that depends on your own needs and whether or not you can obtain their benefits through diet alone.
Fiber supplements are without a doubt the most popular form of prebiotic supplements. They’re a fast, effective and accessible way to consume prebiotic fibers and (as we indicated earlier) work in tandem with probiotics to ensure the right balance of gut flora and bacteria.
But recent research[33] has found that consuming both prebiotics, probiotics and supplements containing immunoglobulin[34] can have mutually beneficial effects on the production of one another, helping to strengthen the immune system while also facilitating beneficial changes to the gut microbiome of patients diagnosed with gastrointestinal conditions.
While future research into the relationship between immunoglobulin and both prebiotics and postbiotics is ongoing, it’s not an understatement to say it’s an area which holds considerable promise in helping us understand just how gut health can affect our overall health.
As we come to a more complete and holistic understanding of how intertwined all aspects of our health are, it’s important to remember that understanding is a process and not an end. Processes take time to develop. They’re gradual by their nature. That’s as true for research as it is for optimizing our own personal health. Supplements can aid in the process of the latter, but they’re no substitute for a healthier lifestyle.
It’s the least we can owe to our gut. And subsequently, ourselves.
The gut microbiome—the collective bacteria and microorganisms that reside in our gastrointestinal tract—is a marvelously complex and diverse environment. Home to over 100 trillion[1] different strains of microbiota, our gut microbiome plays a significant role in regulating everything from immune responses[2] to emotional[3] and cognitive health.
But just like any other collective system in our bodies, it needs certain nutrients in order to function effectively. Not just certain nutrients, but the optimal amount of nutrients.
And understanding how those nutrients affect our gut health is the first step towards achieving better overall health.
Understanding the Gut Microbiome
The microbiota which reside in our GI tract produce and synthesize chemicals and nutrients which have a direct impact on both our digestive system as well as our immunity, our moods, our brain health and even our central nervous system[4].
These microbiota begin accumulating as early as the moment we’re born, and gradually diversify and grow into a spectrum that is still in the process of being calculated to this day. And the greater the diversity of bacteria in your gut microbiome, the greater the health of your immune system.
But there needs to be a certain balance of both “good” gut bacteria (the microbiota which regulate your GI tract and optimize gut health) and “bad” gut bacteria in order for the gut microbiome to function efficiently. Too much good gut bacteria can activate immune cells which cause digestive conditions, and in some cases, inflammatory diseases[5]. Too much bad gut bacteria and our overall immune response is weakened dramatically.
This imbalance is known as gut dysbiosis[6]. It can be triggered by anything from heredity to lifestyle factors, from preexisting conditions to certain medications. But we’re only now beginning to understand that it’s environmental factors[7] that are becoming a chief culprit in gut dysbiosis.
In particular, our diet. How Diet Affects the Gut Microbiome.
It’s important to remember that the composition and diversity of our gut microbiota differs dramatically from person to person. And for most healthy people, it tends to remain fairly stable.
But intervening factors can play a role in reducing the diversity of our gut microbiome. It’s been estimated that at least 20 percent[7] of the variability of our gut microbiota is directly influenced by environmental factors, with diet playing an active role.
But how does our diet actually affect the gut microbiome?
A diet that’s high in protein and fat can affect the structure of the gut microbiome in as little as one day in healthy patients by increasing the amount of bile-resistant microorganisms and decreasing the metabolic rate of plant based enzymes known as firmicutes. Firmicutes help produce a substance called butyrate, a short chain fatty acid (SCFA)[8] that has an inhibitory effect on cytokine production and other cells and pathogens responsible for inflammatory and autoimmune diseases.
By contrast, a diet rich in certain carbohydrates—chiefly dietary fiber and foods rich in resistant starches such as whole grains, oats, potatoes, brown rice, chickpeas and lentils—also have a role in shaping the gut microbiome. But they shape it in a much more positive way.
Resistant starches and dietary fibers are actually non-digestible. They ferment in the GI tract, helping to produce metabolites which lower the risk[9] of certain metabolic diseases such as type 2 diabetes, cardiovascular disease, and Irritable Bowel Syndrome (IBS.)
You may have heard of the health benefits of probiotics. And you may have also heard of prebiotics. But what is the difference between the two? And how do they affect our gut health?
Prebiotics vs Probiotics: What’s the Difference?
On the other hand, prebiotics are fibers which nourish good bacteria, acting as nutrients which are necessary for their very survival.
The difference is a critical one. Probiotics add to the diversity of good bacteria, while prebiotics support that growth.
Both complement each other. And both can be taken in conjunction with one another, a process sometimes popularly referred to as microbiome therapy.
What occurs during microbiome therapy
Microbiome therapy should not necessarily be confused with microbiome therapeutics[10], which refers to a much broader spectrum of therapies including both probiotics and prebiotics in addition to postbiotics[11], live-biotherapeutics[12] and fecal microbiota transplantation (FMT.)What occurs during microbiome therapy when taking probiotics and prebiotics together is actually fairly simple. Probiotics are absorbed and digested by the GI tract and produce enzymes which interact with existing microflora to produce new bacteria and strengthen existing forms. Since prebiotics are non digestible, they ferment in the gut to produce short chain fatty acids which support that new growth.
It’s common for dietitians to recommend both probiotic and postbiotic dietary supplements as a course of action during microbiome therapy. But they may also suggest obtaining both from as many food sources as possible.
The best food sources for postbiotics
- Yogurt
- Kefir[13] and other types of fermented milk
- Fermented cheeses
- Kimchi[14]
- Kombucha and other fermented teas
- Fermented olives and extra virgin olive oil[15]
- Apple cider vinegar
- Green peas[16]
- Pickled cucumbers[17]
- Sauerkraut[18]
- Soy-based food products, including natto, tempeh and miso
The best food sources for prebiotics
- Almonds[19]
- Asparagus[20]
- Bananas
- Blueberries[21]
- Cabbage[22]
- Chia seed[23]
- Chickpeas[24]
- Chicory root
- Eggplant[25]
- Flaxseed
- Raw garlic[26]
- Oats[27]
- Onions and leeks[28]
- Whole grain barley and rye[29]
- Whole grain corn[30]
- Whole grain wheat[31]
Are There Dangers Associated with Prebiotics?
Prebiotic toxicity may be rare, but it can occur as a result of consuming significantly more than the recommended amount rapidly. More common are temporary symptoms including gas, bloating and abdominal discomfort after introducing prebiotics into your diet. Individuals diagnosed with Irritable Bowel Syndrome should be aware that rapid fermentation can actually aggravate the condition, and should speak with a specialist before consuming prebiotic sources.While it’s always a good idea to introduce any dietary or supplement changes into your diet gradually, it’s particularly important with prebiotics. Our digestive system can be sensitive to even the slightest alteration in the composition of our microbiota; and while symptoms of gas and boating may be uncomfortable, they generally settle once our bodies get used to any changes.
There are, however, rare cases of individuals suffering from allergic reactions to prebiotic food sources, such as almonds and chicory root. Carefully reviewing the ingredients on any prebiotic supplement can help you distinguish whether or not it’s appropriate for you. Similarly, prebiotics may affect blood sugar levels due to rapid metabolism. Individuals diagnosed or at risk of hypoglycemia and diabetes should consult with a physician prior to starting a prebiotic regimen.
Prebiotic Dietary Supplements: Are They Right for Me?
Much like a snowflake, no two microbiomes are alike. They follow a pattern which is unique and highly individualized. But environmental factors, including aging and lifestyle changes, can have an overwhelming impact on the composition of our microbiota.
It’s not a surprise that many Americans are looking to prebiotic dietary supplements to help optimize microbiota function. Nutritional supplements were recently estimated to be an industry worth $164 Billion[32] globally. Naturally, as new research emphasizes the increasing importance of gut health on our overall health, that includes prebiotics. The question is whether or not prebiotic supplements actually work.
Much of that depends on your own needs and whether or not you can obtain their benefits through diet alone.
Fiber supplements are without a doubt the most popular form of prebiotic supplements. They’re a fast, effective and accessible way to consume prebiotic fibers and (as we indicated earlier) work in tandem with probiotics to ensure the right balance of gut flora and bacteria.
But recent research[33] has found that consuming both prebiotics, probiotics and supplements containing immunoglobulin[34] can have mutually beneficial effects on the production of one another, helping to strengthen the immune system while also facilitating beneficial changes to the gut microbiome of patients diagnosed with gastrointestinal conditions.
While future research into the relationship between immunoglobulin and both prebiotics and postbiotics is ongoing, it’s not an understatement to say it’s an area which holds considerable promise in helping us understand just how gut health can affect our overall health.
As we come to a more complete and holistic understanding of how intertwined all aspects of our health are, it’s important to remember that understanding is a process and not an end. Processes take time to develop. They’re gradual by their nature. That’s as true for research as it is for optimizing our own personal health. Supplements can aid in the process of the latter, but they’re no substitute for a healthier lifestyle.
It’s the least we can owe to our gut. And subsequently, ourselves.
Refrences:
[1] Guinane, C. M., & Cotter, P. D. (2013, March 26). Role of the gut microbiota in health and chronic gastrointestinal disease: understanding a hidden metabolic organ. Therapeutic Advances in Gastroenterology. https://doi.org/10.1177/1756283x13482996 [2] Wiertsema, S. P., Van Bergenhenegouwen, J., Garssen, J., & Knippels, L. (2021, March 9). The Interplay between the Gut Microbiome and the Immune System in the Context of Infectious Diseases throughout Life and the Role of Nutrition in Optimizing Treatment Strategies. Nutrients. https://doi.org/10.3390/nu13030886 [3] Lee, S. H., Yoon, S. H., Jung, Y. J., Kim, N., Min, U. G., Chun, J., & Choi, I. (2020, November 26). Emotional well-being and gut microbiome profiles by enterotype. Scientific Reports. https://doi.org/10.1038/s41598-020-77673-z [4] Cryan, J. F., & Dinan, T. G. (2012, September 12). Mind-altering microorganisms: the impact of the gut microbiota on brain and behaviour. Nature Reviews Neuroscience. https://doi.org/10.1038/nrn3346 [5] Eshleman, E. M., Shao, T. Y., Woo, V., Rice, T., Engleman, L., Didriksen, B. J., Whitt, J., Haslam, D. B., Way, S. S., & Alenghat, T. (2023, February 15). Intestinal epithelial HDAC3 and MHC class II coordinate microbiota-specific immunity. Journal of Clinical Investigation. https://doi.org/10.1172/jci162190 [6] Belizário, J. E., & Faintuch, J. (2018, January 1). Microbiome and Gut Dysbiosis. Experientia Supplementum. https://doi.org/10.1007/978-3-319-74932-7_13 [7] Ahn, J., & Hayes, R. B. (2021, April 1). Environmental Influences on the Human Microbiome and Implications for Noncommunicable Disease. Annual Review of Public Health. https://doi.org/10.1146/annurev-publhealth-012420-105020 [8] Rothschild, D., Weissbrod, O., Barkan, E., Kurilshikov, A., Korem, T., Zeevi, D., Costea, P. I., Godneva, A., Kalka, I., Bar, N., Shilo, S., Lador, D., Vila, A. V., Zmora, N., Pevsner‐Fischer, M., Israeli, D., Kosower, N. S., Malka, G., Wolf, B. C., . . . Segal, E. (2018, February 28). Environment dominates over host genetics in shaping human gut microbiota. Nature. https://doi.org/10.1038/nature25973 [9] Schulthess, J., Pandey, S., Capitani, M., Rue-Albrecht, K., Arnold, I. C., Franchini, F., Chomka, A., Ilott, N. E., Johnston, D., Pires, E., McCullagh, J., Sansom, S. N., Arancibia‐Cárcamo, C. V., Uhlig, H. H., & Powrie, F. (2019, February 1). The Short Chain Fatty Acid Butyrate Imprints an Antimicrobial Program in Macrophages. Immunity. https://doi.org/10.1016/j.immuni.2018.12.018 [10] Seo, Y. S., Lee, H. B., Kim, Y., & Park, H. (2020, March 18). Dietary Carbohydrate Constituents Related to Gut Dysbiosis and Health. Microorganisms. https://doi.org/10.3390/microorganisms8030427 [11] Yadav, M., & Chauhan, N. S. (2021, November 15). Microbiome therapeutics: exploring the present scenario and challenges. Gastroenterology Report. https://doi.org/10.1093/gastro/goab046 [12] Vinderola, G., Sanders, M. E., & Salminen, S. (2022, April 8). The Concept of Postbiotics. Foods. https://doi.org/10.3390/foods11081077 [13] Cordaillat-Simmons, M., Rouanet, A., & Pot, B. (2020, September 1). Live biotherapeutic products: the importance of a defined regulatory framework. Experimental & Molecular Medicine. https://doi.org/10.1038/s12276-020-0437-6 [14] Bourrie, B. C. T., Willing, B. P., & Cotter, P. D. (2016, May 4). The Microbiota and Health Promoting Characteristics of the Fermented Beverage Kefir. Frontiers in Microbiology. https://doi.org/10.3389/fmicb.2016.00647 [15] Song, E., Ai, L., Lee, H. W., Kim, M., Kim, Y. J., Jang, D. J., & Lee, M. S. (2023, April 3). Effects of kimchi on human health: a scoping review of randomized controlled trials. Journal of Ethnic Foods. https://doi.org/10.1186/s42779-023-00173-8 [16] Millman, J. F., Okamoto, S., Teruya, T., Uema, T., Ikematsu, S., Shimabukuro, M., & Masuzaki, H. (2021, February 12). Extra-virgin olive oil and the gut-brain axis: influence on gut microbiota, mucosal immunity, and cardiometabolic and cognitive health. Nutrition Reviews. https://doi.org/10.1093/nutrit/nuaa148. [17] Matsuzaki, C., Kamishima, K., Matsumoto, K., Koga, H., Katayama, T., Yamamoto, K., & Hisa, K. (2014, January 2). Immunomodulating activity of exopolysaccharide-producingLeuconostoc mesenteroidesstrain NTM048 from green peas. Journal of Applied Microbiology. https://doi.org/10.1111/jam.12411 [18] Are Pickles Healthy? (2023, December 14). Cleveland Clinic. https://health.clevelandclinic.org/are-pickles-good-for-you/Raak, C., Ostermann, T., Boehm, K., & Molsberger, F. (2014, November 1). Regular Consumption of Sauerkraut and Its Effect on Human Health: A Bibliometric Analysis. Global Advances in Health and Medicine. https://doi.org/10.7453/gahmj.2014.038 [19] Afzaal, M., Saeed, F., Islam, F., Ateeq, H., Asghar, A., Shah, Y. A., Ofoedu, C. E., & Chacha, J. S. (2022, October 21). Nutritional Health Perspective of Natto: A Critical Review. Biochemistry Research International. https://doi.org/10.1155/2022/5863887 [20] Liu, Z., Lin, X., Huang, G., Zhang, W., Rao, P., & Ni, L. (2014, April 1). Prebiotic effects of almonds and almond skins on intestinal microbiota in healthy adult humans. Anaerobe. https://doi.org/10.1016/j.anaerobe.2013.11.007 [21] Hamdi, A., Viera, I., Guillén, R., Rodríguez-Arcos, R., Muñoz, M. P., Moreno, J. M. M., & Jiménez-Araujo, A. (2022, December 23). Asparagus Fructans as Emerging Prebiotics. Foods. https://doi.org/10.3390/foods12010081 [22] Jiao, X., Wang, Y., Yang, L., Lang, Y., Li, E., Zhang, X., Zhang, Q., Feng, Y., Meng, X., & Li, B. (2019, February 1). Blueberry polyphenols extract as a potential prebiotic with anti-obesity effects on C57BL/6 J mice by modulating the gut microbiota. The Journal of Nutritional Biochemistry. https://doi.org/10.1016/j.jnutbio.2018.07.008 [23] Fuller, Z., Louis, P., Mihajlovski, A., Rungapamestry, V., Ratcliffe, B., & Duncan, A. (2007, August 1). Influence of cabbage processing methods and prebiotic manipulationof colonic microflora on glucosinolate breakdown in man. British Journal of Nutrition. https://doi.org/10.1017/s0007114507709091 [24] Mihai, E., Negreanu–Pîrjol, T., Crăciunescu, O., Ciucan, T., Iosăgeanu, A., Seciu-Grama, A. M., Prelipcean, A. M., Uțoiu, E., Coroiu, V., Ghenea, A. M., & Negreanu–Pîrjol, T. (2023, March 28). In Vitro Hypoglycemic Potential, Antioxidant and Prebiotic Activity after Simulated Digestion of Combined Blueberry Pomace and Chia Seed Extracts. Processes. https://doi.org/10.3390/pr11041025 [25] Hussein, H. A., Awad, S., Elsayed, I., & Ibrahim, A. (2020, June 1). Impact of chickpea as prebiotic, antioxidant and thickener agent of stirred bio-yoghurt. Annals of Agricultural Sciences. https://doi.org/10.1016/j.aoas.2020.03.001 [26] Nissen, L., Cattivelli, A., Casciano, F., Gianotti, A., & Tagliazucchi, D. (2022, October 1). Roasting and frying modulate the phenolic profile of dark purple eggplant and differently change the colon microbiota and phenolic metabolites after in vitro digestion and fermentation in a gut model. Food Research International. https://doi.org/10.1016/j.foodres.2022.111702 [27] Sunu, P., Sunarti, D., Mahfudz, L. D., & Yunianto, V. D. (2019, December 1). Prebiotic activity of garlic (Allium sativum) extract on Lactobacillus acidophilus. Veterinary World. https://doi.org/10.14202/vetworld.2019.2046-2051 [28] Xu, D., Feng, M., Chu, Y., Wang, S., Shete, V., Tuohy, K., Liu, F., Zhou, X., Kamil, A., Pan, D., Liu, H., Yang, X., Yang, C., Zhu, B., Lv, N., Xiong, Q., Wang, X., Sun, J., Sun, G., & Yang, Y. (2021, December 9). The Prebiotic Effects of Oats on Blood Lipids, Gut Microbiota, and Short-Chain Fatty Acids in Mildly Hypercholesterolemic Subjects Compared With Rice: A Randomized, Controlled Trial. Frontiers in Immunology. https://doi.org/10.3389/fimmu.2021.787797 [29] Carlson, J., Erickson, J., Lloyd, B., & Slavin, J. L. (2018, March 1). Health Effects and Sources of Prebiotic Dietary Fiber. Current Developments in Nutrition. https://doi.org/10.1093/cdn/nzy005 [30] Iversen, K., Dicksved, J., Zoki, C., Fristedt, R., Pelve, E., Langton, M., & Landberg, R. (2022, April 17). The Effects of High Fiber Rye, Compared to Refined Wheat, on Gut Microbiota Composition, Plasma Short Chain Fatty Acids, and Implications for Weight Loss and Metabolic Risk Factors (the RyeWeight Study). Nutrients. https://doi.org/10.3390/nu14081669 [31] Cooper, D., Martin, R. J., & Keim, N. L. (2015, May 29). Does Whole Grain Consumption Alter Gut Microbiota and Satiety? Healthcare. https://doi.org/10.3390/healthcare3020364 [32] Costabile, A., Klinder, A., Fava, F., Napolitano, A., Fogliano, V., Leonard, C., Gibson, G. R., & Tuohy, K. (2007, August 29). Whole-grain wheat breakfast cereal has a prebiotic effect on the human gut microbiota: a double-blind, placebo-controlled, crossover study. British Journal of Nutrition. https://doi.org/10.1017/s0007114507793923 [33] Dietary Supplements Market Size, Share & Trend Analysis Report By Ingredient, By Form (Tablets, Capsules, Soft gels, Powders, Gummies, Liquids, Others), By End-user, By Application, By Type, By Distribution Channel, By Region, And Segment Forecasts, 2024 - 2030. (2024, January 24). https://www.grandviewresearch.com/industry-analysis/dietary-supplements-market [34] Marzorati, M., Bubeck, S. S., Bayne, T., Krishnan, K., & Giusto, M. (2022, November 1). Effects of combined prebiotic, probiotic, IgG and amino acid supplementation on the gut microbiome of patients with inflammatory bowel disease. Future Microbiology. https://doi.org/10.2217/fmb-2022-0066 Amazon.com: Daiwa GastroImmune - Gut Health Supplements - Leaky Gut Repair - Bloating Relief for Women and Men - 60/ct : Health & Household. (n.d.). https://www.amazon.com/Daiwa-GastroImmune-Immunoglobulin-Health-Supplements/dp/B0BPZK6WGF?ref_=ast_sto_dp
