Expert: occasional use of probiotics is not enough to take care of the microbiota

Microbiota, the billions of microorganisms that inhabit our bodies, helps us maintain our physical and mental health. Taking probiotic supplements isn't enough to maintain it, emphasized Professor Dariusz Koziorowski of the Medical University of Warsaw.

"The best thing we can do for our microbiota is to lead a healthy, balanced lifestyle. A daily diet, physical activity, adequate sleep, and the ability to manage stress are much more important than occasional use of probiotics," neurologist Prof. Dariusz Koziorowski from the Medical University of Warsaw told PAP. The specialist conducts research on topics including how microbiota transplantation affects the symptoms and progression of Parkinson's disease.

The term microbiota refers to the billions of microorganisms (bacteria, viruses, fungi, archaea) that inhabit our intestines, skin, mouth, and other parts of the body. It plays a crucial role in bodily function. It aids in digestion, strengthens immunity, protects against infections, and also influences mood, metabolism, and lifespan.

Microbiota imbalances can result not only in digestive problems but also in heart disease, depression, and immune deficiency. Recent research on the microbiota indicates a link between imbalances in its composition and obesity and neurodegenerative diseases.

"More and more studies show a link between the state of the gut microbiota and neurodegenerative diseases such as Parkinson's disease and Alzheimer's disease. Changes in the composition of the microbiota may affect the functioning of the gut-brain axis, exacerbate neuroinflammatory processes, and contribute to disease progression," Prof. Koziorowski explained to PAP. He added that research in this field is still progressing.

The specialist identified older adults as among the groups in which microbiota disorders occur more frequently or have more serious consequences. This translates into a greater risk of infection and inflammation.

"The next group consists of children under two years of age – this is when their gut microbiome is actively developing, influencing immunity, metabolism, and health later in life," emphasized Professor Koziorowski. He explained that any antibiotic therapy early in life, poor nutrition, or lack of contact with natural sources of microorganisms can disrupt this process and have "long-term consequences for the child's health – both in terms of immunity and the risk of chronic diseases."

The specialist reminded us that two factors are important here: the mode of delivery and breastfeeding. Babies born vaginally have a different, richer microbiota than those born by cesarean section. Breast milk, in turn, provides not only nutrients but also special oligosaccharides that stimulate the growth of beneficial bacteria.

Other groups that often have microbiota disorders include patients with chronic diseases (such as diabetes, obesity or autoimmune diseases), which may worsen their course, as well as people living with chronic stress, which lowers immunity and destroys the microbiological balance.

Due to the impact of microbiota on our health, we should all take care of it. Professor Koziorowski pointed out that the most common mistake we make when trying to do this is believing that microbiota can be "fixed" with supplementation alone. "However, lack of physical activity, chronic stress, poor diet, and insufficient sleep have a destructive effect on it. Microbiota requires a varied diet, exercise, stress reduction, and avoiding excessive medications, especially antibiotics. Supplements are effective, but they are not a silver bullet," the expert emphasized.

The study, titled International Microbiota Observatory, conducted online by the Biocodex and Ipsos Microbiota Institute in early 2025 on a representative sample of 7,500 people from 11 countries, including Poland, showed that 58% of surveyed Poles take probiotics to care for their microbiota, and only a few focus on lifestyle changes, including dietary changes.

- Of course, it is worth remembering that some probiotics with documented effects have their place in specific medical indications, e.g. in the prevention and treatment of diarrhea associated with antibiotic therapy, irritable bowel syndrome (IBS), and as a supportive treatment for inflammatory bowel disease - explained Prof. Koziorowski.

According to him, in such cases, probiotics containing precisely defined strains with proven safety and effectiveness in clinical trials should be used. "Not all preparations on the market have such documented effects, so it's worth consulting a doctor or pharmacist before choosing one. Probiotics are still too often treated as 'universal' products – however, their effectiveness depends on the specific strain, dose, indication, and duration of use," the expert explained.

He emphasized that caring for microbiota isn't a one-time treatment, but a process. It's crucial to limit not only antibiotics but also other medications that can affect gut flora. "More and more research shows that some commonly used medications, such as heartburn and reflux medications, over-the-counter pain relievers, and some diabetes medications, can also disrupt the microbial balance in the gut, especially if taken regularly and for long periods," explained Professor Koziorowski.

He emphasized that the point isn't to forgo necessary treatment, but to always use medications consciously—as recommended by a doctor, not "just in case," and not on our own. Meanwhile, we too often resort to antibiotics unnecessarily. "Our microbiota thrives on common sense and regularity. The fewer unnecessary interventions, the greater the chance of its stability," the specialist assessed.

To support the development of a health-promoting microbiota, it's essential to follow a proper diet. "A diet rich in fiber—vegetables, fruits, legumes, and whole grains—is best for the microbiota. Fermented products, such as kefir, plain yogurt, and pickled foods, are also important—these are natural sources of "good" bacteria," explained Professor Koziorowski. He added that processed foods, excess sugar, and saturated fats, which disrupt the microbial balance, should be avoided. "The microbiota doesn't like monotony—the more diverse the diet, the better for our gut health," he emphasized.

He also noted the so-called weekend effect—we try to eat healthily five days a week, and then overindulge in unhealthy snacks, which leads to fluctuations in our gut microbiota. Meanwhile, our gut microbiota thrives on regularity.

The specialist assessed that due to the importance of microbiota for our physical and mental health, it would be worthwhile to include basic knowledge about it in health education programs, preferably already at school.

"Secondly, training is essential for primary care physicians (PCPs) and dietitians, who can serve as ambassadors for this knowledge in daily contact with patients. Patient education shouldn't end with prescribing a medication. Finally, social campaigns with experts are needed, not only to inform but also to explain how to implement the knowledge," Professor Koziorowski pointed out. He added that sometimes a small change, such as adding fermented foods to the daily diet, is enough, but to implement it, "you have to understand why it's important."

"Microbiota isn't a fad; it's part of our health. In an era of simplified information flooding social media, it's increasingly difficult to deliver reliable knowledge. It's often replaced by simplistic slogans like 'gut detox' or 'superfoods,'" the specialist concluded.

Joanna Morga (PAP)

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