This is a question I am often asked. The problem is that there is no easy answer. It is like comparing apples and oranges. So instead, I will tell a story. Many years ago in 2007 (okay, that is not many), I was taking a probiotic supplement every day. The product was Florasmart Extra Strength and it was 6 billion per tablet and contained  8 strains. Some of these strains were from human microflora, which at the time, I did not know this meant they were “residential strains” which means they will re-populate in our intestines (in theory). It is actually more complicated than that but that is another story for another day.

I was taking 10 a day, sometimes 20. This far exceeds the amount on the bottle – something I do not recommend to others but I can do what I like to myself since I am the one who will pay the consequences, if I make a mistake. I did not know that by taking this amount at the time, I was ahead of the curve. Today probiotic supplements that contain 50 or 80 or even 100 billion are common but they were not then, way back in the olden days of 2007. Now I had been high-dosing probiotics since 2002. I know it sounds like I was a probiotic junky. However in 2002, I had a major bout of endometreosis that left me severely debilitated and my discovery of the probiotics and this probiotic in particular, saved me.  Good bacteria is essential for successfully detoxing out excess estrogen, which is part of the issue with endometriosis. This was a missing piece of my puzzle that helped me to finally feel normal and not continue to have issues, something other supplements and strategies has not been able to do, even though they had helped with symptoms.

However, I could not get off the probiotics and this was costly. Then I discovered kefir. The kefir I found was from the company Liberte and it was ( and is) really quite fermented. I actually do not care for the taste but I found out it that it contains 32 strains of beneficial yeasts and good bacteria. It is also 10 billion per tablespoon. Now you will not see that on their website. Health Canada has made them say it is only 5 billion. But I spoke with a microbiologist who had worked with the product for 10 years and he provided me with this information. I consumed ¼ – ½ a cup a day and I did this for 6 months. As I was doing this, I used less and less of the probiotic supplement. Finally I stopped completely and only used the kefir and then within a year, I only used a couple of tablespoons of kefir maybe 2 or 3 times a week.

From this story you might conclude that fermented foods, in this case, kefir, are better than the supplement. But we cannot conclude this because there is no way of knowing if the kefir would have worked for me, had I not used the probiotic supplements first. All we can say is that both fermented foods and probiotic supplements can be part of a protocol to help resolve a health issue. So to help in making a decision as to what to take, here are some tips to consider.

Benefits of a Probiotic Supplements

• They are available in high doses that can help show improvement faster, especially for acute issues – if you feel something going on in your intestines fairly suddenly  like  diarrhea or you are suddenly a little bloated or constipated, then a probiotic supplement can be the way to go.
• If you need residential bacteria, then a probiotic supplement with human microflora would be the one to take
• Any research that has showed the benefits of good bacteria to help a given condition like colitis or allergies, used probiotic supplements in the study.
• You know the quantity of good bacteria you are getting when you take a probiotic  supplement

Benefits of Fermented Foods

• The strains in fermented foods are transient which means they help you while they are there but they just pass through and do not contribute to colonization. However, fermented foods contain unique strains that research is starting to show help us in many different ways.   For example, both sauerkraut and kimchi have been studied for their anti-cancer benefits
• Fermented foods are great preventative. By eating a variety on a regular basis, you are providing the body with a cross section of strains a probiotic cannot match
• Fermented foods also contain vitamins, minerals and phytonutrients that are all more bioavailable to the body, providing it with more value from food.  More importantly, fermented foods often contain prebiotic fibre or substances like the GOS found in milk kefir. Prebiotics feed the residential bacteria and help them colonize. So while they do not contain residential strains, research has shown that prebiotics can increase the colonization of your own residential strains.
• Many delicious recipes and meals can be made by incorporating fermented foods, and can aid digestion, intestinal health and help prevent health issues

Needless to say, both have their value. For anyone with health issues that can be helped with good bacteria, using both may be the option at first with the fermented foods eventually being what is used for maintenance and probiotics just being used for acute situations as they might arise. For example, a  case of food poisoning would be a good reason to take a supplement.  If you are trying to repair your intestines, then try different probiotic supplements until you find the one that is right for you.  Do the same with fermented foods to find the ones you like the best and that fit into your eating lifestyle. This can be fun as experimenting with new foods and new recipes is what many of us love to do.

And whether it is with a probiotic supplement or eating fermented foods, getting good bacteria into your body is the important part.

References:

• Efficacy of Prebiotics, Probiotics, and Synbiotics in Irritable Bowel Syndrome and Chronic Idiopathic Constipation: Systematic Review and Meta-analysis Alexander C Ford et al, The American Journal of Gastroenterology 109, 1547-1561 (October 2014)
• A systematic review and meta-analysis of the prebiotics and synbiotics effects on glycaemia, insulin concentrations and lipid parameters in adult patients with overweight or obesity, Bruna T.S. Beserra et al, DOI: http://dx.doi.org/10.1016/j.clnu.2014.10.004
• Anticancer effects of kimchi fermented for different times and with added ingredients in human HT-29 colon cancer cells, Bohkyung Kim et al, Food Science and Biotechnology  April 2015, Volume 24, Issue 2, pp 629-633
•  Modulation of Carcinogen Metabolizing Cytochromes P450 in Rat Liver and Kidney by Cabbage and Sauerkraut Juices: Comparison with the Effects of Indole-3-carbinol and Phenethyl Isothiocyanate, Hanna Szaefer1 et al. Phytotherapy Research, Volume 26, Issue 8,  pages 1148–1155, August 2012