Triple-Action Gut Health Support

by Kyle Perkovich, BS

The gut, often referred to as the body’s “second brain,” is central to overall health, influencing everything from digestion to immune function, metabolism, and even mental health.^1-3 Emerging research consistently demonstrates that a balanced and diverse gut microbiome is essential for overall health and a key aspect of every patient’s wellness.

The gut microbiome – a complex ecosystem containing trillions of bacteria and other microorganisms – helps regulate digestion and communicates with various body systems through neurotransmitters, hormones, and other pathways. Even minor disturbances to its balance can have major health impacts; unfortunately, modern diets often lack the nutrients needed to maintain a proper homeostasis.⁴

As this understanding deepens, focus has increasingly shifted to ways of proactively supporting gut health; the most popular strategies include supplementation with either prebiotics, probiotics, or postbiotics.  Each uniquely contributes to gut health, but their combined effects may have profound benefits for this key aspect of health.

Prebiotics – Fuel for the Good Intestinal Bacteria

Prebiotics are non-digestible fibers that serve as nourishment for beneficial gut bacteria. These compounds are essential for maintaining a healthy gut microbiome, selectively stimulating the growth of healthy bacteria in the body.⁵ Acting like a food source for essential microorganisms in the gut, prebiotics are an important supportive component of comprehensive gut health.

One example of a prebiotic with scientific backing is inulin, a type of fermentable fiber found in chicory root. It has been shown to significantly enhance gut health by increasing the abundance of beneficial bacteria, particularly Bifidobacterium species.^5,6 The fermentation process produces short chain fatty acids (SCFAs), which are crucial for maintaining gut barrier integrity and reducing inflammation.⁷ One meta-analysis found that inulin may improve bowel regularity, reduce bloating, and even support metabolic health, demonstrating some of the many potential benefits of prebiotic supplementation.⁶

Probiotics: Live Microbes that Restore Balance

Probiotics, the most widely used of these gut health options, are live microorganisms that confer health benefits when taken in adequate amounts. Probiotics supplement the “good” bacteria in the gut and enhance healthy intestinal function, helping to restore balance to the gut microbiome, which can be disrupted by factors such as diet, stress, disease, and medication.⁸

Bifidobacterium lactis is one of the most extensively studied probiotic strains, providing evidence of some of the many benefits probiotics can provide, such as improved metabolic and gut barrier health. In a pivotal study with 225 overweight and obese adults, supplementation with Bifidobacterium lactis, especially when combined with dietary fiber, resulted in a significant decrease in body fat mass and waist circumference compared to placebo.⁹ This strain also improved gut barrier integrity by reducing levels of lipopolysaccharides (LPS) – endotoxins linked to systemic inflammation and metabolic endotoxemia.¹⁰

Postbiotics: Beneficial Byproducts of Probiotics

Postbiotics are bioactive compounds produced by probiotics during fermentation, acting as byproducts that serve a purpose for gut health. These include SFCAs, enzymes, peptides, polysaccharides, and other useful metabolites that have beneficial effects on the intestine and general health.¹¹ Unlike probiotics, postbiotics are not live organisms, making them more stable and often easier to incorporate into forms of supplementation.  

Akkermansia muciniphila is a particularly valuable postbiotic option, deemed to be a “next generation bacteria.” This bacterial strain resides in the mucus layer, a critical defense barrier for the gut, interacting with epithelial cells and producing beneficial SCFAs that reduce inflammation and increase gut barrier integrity.¹² Studies have shown that Akkermansia muciniphila is associated with increased insulin sensitivity, lower cholesterol, and reduced body fat.^12,13. Its clinical effectiveness is significantly increased in its pasteurized, postbiotic form, highlighting how the added stability of postbiotics can have real-world effects on health.¹⁴

Triplebiotics: A Three-Pronged Approach to Support the Gut

While prebiotics, probiotics, and postbiotics each offer distinct benefits, their combination – often referred to as “triplebiotic” supplements – can create a synergistic effect that enhances gut health more than any single ingredient alone. This approach captures the unique benefits of these supplements and leverages their complementary actions to help build and sustain a diverse gut microbiome. With the array of vital aspects of health influenced by the gut, providing a variety of support can have profound impacts on overall wellness.

Clinical Evidence

The mechanisms of action between prebiotics, probiotics, and postbiotics have compounding effects on the health benefits they may be able to confer. Research shows that prebiotics can increase the efficacy of probiotics by providing the necessary nutrients for growth, thereby improving their ability to colonize the gut and exert health benefits.^5,6 Probiotics, in turn, produce post biotics as they digest prebiotics, leading to the creation of beneficial compounds like SCFAs. These compounds not only nourish gut cells but also modulate the immune system and reduce inflammation.⁷

Clinical studies on the combination of prebiotics and probiotics, generally known as “synbiotics” for their ability to synergistically complement each other, highlight evidence for the effectiveness of combining these ingredients. Researchers have found that successful synbiotics are most effective when the prebiotic selectively favors or provides nutrition for the probiotic organism or when the prebiotic component improves survival of the live probiotic as it passes through the intestinal tract – both of which can help maintain gut homeostasis.^15,16 Similarly, one study found synergy between prebiotics and postbiotics, with evidence for possible increased anti-lipid, anti-inflammatory, and microbiota balancing activities when paired together.¹⁷

The combination of Bifidobacterium lactis and Akkermansia muciniphila exemplifies this synergy. Bifidobacterium lactis supports the growth of Akkermansia muciniphila, which produces postbiotics that enhance gut barrier integrity and support metabolic health.¹⁸ The combination amplifies the benefits of both bacteria, leading to improved gut health and overall well-being.^9,14

Enhancing Patient Gut Health Supplementation

Incorporating triplebiotics into a daily regimen can help provide a comprehensive approach to gut health. For healthcare practitioners, understanding the unique and complementary effects of prebiotics, probiotics, and postbiotics is crucial to recommending the most effective interventions for patients to achieve improved gut health.

One of the most compelling applications of this combination is in supporting metabolic health. Studies suggest, for example, that Bifidobacterium lactis and Akkermansia muciniphila can both improve insulin sensitivity and weight management – key factors in the management of metabolic disorders such as diabetes.^9,12 These three supplement types also play a critical role in modulating the immune system and gut integrity. Prebiotics help nourish and support probiotics, which in turn produce postbiotics and increase helpful compounds in the gut. The increase in SCFAs from this combination can help strengthen the gut barrier by increasing the expression of tight junction proteins, which prevent harmful substances from leaking into the bloodstream.⁷ Additionally, these byproducts have anti-inflammatory properties, making the gut more resilient to infections and inflammatory diseases.¹⁸

A Comprehensive Approach to Gut Health

In the delicate ecosystem of the human gut, maintaining a balance of beneficial microorganisms is crucial for everyday health. Prebiotics, probiotics, and postbiotics each play a unique role in supporting this balance, and their combined use offers a comprehensive solution to tackle gut health. By understanding the distinct and complementary benefits of each of these biotics, practitioners may better guide patients toward optimal gut health, ultimately supporting broader health outcomes.

Whether it is to improve digestion, support immune function, or enhance metabolic health, considering prebiotics, probiotics, and postbiotics in your regimen helps provide a robust foundation for achieving the optimal wellness the gut can provide.

Citations

1. Bull MJ et al. Part 1: The Human Gut Microbiome in Health and Disease. Integr Med (Encinitas). 2014;13(6):17-22.
2. Hills RD et al. Gut Microbiome: Profound Implications for Diet and Disease. Nutrients. 2019;11(7):1613.
3. Nesci A et al. Gut Microbiota and Cardiovascular Disease: Evidence on the Metabolic and Inflammatory Background of a Complex Relationship. Int J Mol Sci. 2023;24(10):9087.
4. Ji J et al. Probiotics, prebiotics, and postbiotics in health and disease. MedComm. 2023;4(6):e420.
5. Cherbut C. Inulin and oligofructose in the dietary fibre concept. Br J Nutr. 2002;87(Suppl 2):S159-S162.
6. Nagy DU et al. Effect of chicory-derived inulin-type fructans on abundance of Bifidobacteriumand on bowel function: a systematic review with meta-analyses. Crit Rev Food Sci Nutr. 2023;63(33):12018-12035.
7. Koh A et al. From Dietary Fiber to Host Physiology: Short-Chain Fatty Acids as Key Bacterial Metabolites. 2016;165(6):1332-1345.
8. Bajinka O et al. Gut microbiota and the human gut physiological changes. Ann Microbiol. 2020;70(1):65.
9. Stenman LK et al. Probiotic With or Without Fiber Controls Body Fat Mass, Associated With Serum Zonulin, in Overweight and Obese Adults—Randomized Controlled Trial. EBioMedicine. 2016;13:190-200.
10. Stenman LK et al. Potential probiotic Bifidobacterium animalis lactis 420 prevents weight gain and glucose intolerance in diet-induced obese mice. Benef Microbes. 2014;5(4):437-445.
11. Aguilar-Toalá JE et al. Postbiotics: An evolving term within the functional foods field. Trends Food Sci Technol. 2018;75:105-114.
12. Derrien M et al. Akkermansia muciniphila nov., sp. nov., a human intestinal mucin-degrading bacterium. Int J Syst Evol Microbiol. 2004;54(Pt 5):1469-1476.
13. Cani PD et al. Akkermansia muciniphila: paradigm for next-generation beneficial microorganisms. Nat Rev Gastroenterol Hepatol. 2022;19(10):625-637.
14. Depommier C et al. Supplementation with Akkermansia muciniphila in overweight and obese human volunteers: a proof-of-concept exploratory study. Nat Med. 2019;25(7):1096-1103.
15. Markowiak P et al. Effects of Probiotics, Prebiotics, and Synbiotics on Human Health. Nutrients. 2017;9(9):1021.
16. Pandey KR et al. Probiotics, prebiotics and synbiotics- a review. J Food Sci Technol. 2015;52:7577–7587.
17. Zhao Y et al. Combating Obesity: Harnessing the Synergy of Postbiotics and Prebiotics for Enhanced Lipid Excretion and Microbiota Regulation. Nutrients. 2023;15(23):4971.
18. Hibberd AA et al. Probiotic or synbiotic alters the gut microbiota and metabolism in a randomised controlled trial of weight management in overweight adults. Benef Microbes. 2019;10(2):121-135.

Kyle Perkovich is a medical writer with a background in clinical research and leading medical writing teams in the completion of clinical reports to get products approved for global sale. He graduated from the University of California, Santa Barbara with a degree in microbiology and a minor in professional science writing, while writing for the university newspaper and completing a technical writing internship with the Vandenberg Air Force Base. Kyle has helped manage documentation for large-scale clinical studies of medical devices and has been involved in various clinical and scientific research studies. He hopes to educate healthcare practitioners and consumers on the science behind the world of supplements and vitamins to help people better understand the complexities of nutrition and live healthier lives.