Antibiotics, probiotics, prebiotics - they all sound the same, and if you aren’t quite clear on what the differences are between them, that’s understandable. Many of us only grew up learning about (and taking) antibiotics. We knew those helped with infections, and maybe you vaguely remembered something about them being developed from mold, but we have a lot more information these days. Here’s a quick breakdown of these three terms, what they mean, and how to take this information and use it.
The use of antibiotics actually dates back to ancient times, though as you can imagine not all of the attempts to fight disease were effective or pleasant. Moldy bread and animal feces were used along with herbs with varying degrees of success (1). The 17th century brought a functioning microscope, and the 19th century scientists like Koch and Pastuere were able to link bacteria with disease. Sexually transmitted diseases in the upper classes prompted further exploration, and early attempts to kill bacteria often killed the patient, as well (some posit that Jane Austen may have died of arsenic poisoning, a common ingredient in 18th century remedies).
Penicillin was the first true antibiotic, discovered in 1928, and Prontosil followed shortly after. It wasn’t long before antibiotic resistance became a concern, but that concern was not wide-spread until much later. Now, we have a huge variety of antibiotics available, but a superbug resistant to all known antibiotics has become more and more likely.
“Probiotics are live microorganisms that are intended to have health benefits when consumed or applied to the body.” (2)
Fermented foods can be found in every culture throughout history, and while the microscopic benefits may not have been understood, their popularity and renown was endemic in every culture. Fecal transplants are known to date back as far as the fourth century in China and elsewhere, and other probiotic-based remedies were implemented based on the availability of different fermenting processes and food sources.
Though the concept of probiotics did not become popular with the general public until the past few decades, scientists have been considering them quite as long as antibiotics. Elie Metchnikoff worked closely with Louis Pasteur in Paris, but his focus at the Pasteur Institute was on how human health was affected by microbes, both good and bad. He studied the longevity of the rural Bulgarian population and posited that their copious use of fermented milk products may have positively contributed to their long lives. He also suggested that lactobacilli may positively impact digestive health. He argued “the dependence of the intestinal microbes on the food makes it possible to adopt measures to modify the flora in our bodies and to replace the harmful microbes by useful microbes.” (3)
Today, we know that the gut microbiome is one of the greatest indicators of health in the human body, that we have more bacteria than human cells within us, and that everything from mood and cognitive function to digestive health and body weight can be related back to the gut microbiome. Probiotic supplements stack the shelves, and fermented foods like kombucha, sourdough, and kimchi are more popular than ever (for help picking a probiotic, check out Nichole’s article here).
Finally, let’s discuss prebiotics, the one most people find most confusing. “Prebiotics are a group of nutrients that are degraded by gut microbiota.” (4) They are, essentially, the parts of food that the probiotics eat and use to survive. The breakdown process of prebiotics affects not only the gut, but nearby body systems as well.
There are three types of prebiotics: Fructans, Galacto-Oligosaccharides, and Starch and Glucose-Derived Oligosaccharides. (5)
There are lots of foods you can eat to increase your prebiotic intake, like garlic, onions, and asparagus. A great list can be found here.
So there you have it! Antibiotics, probiotics, and prebiotics are all different but related, so hopefully this has helped you make a bit more sense of your gut!