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今天佳格健康GO 小編和佳格專職營養師何佳蓉一起討論了和益生元、益生菌、消化酵素有關的問題，一起來解密益生元、益生菌、消化酵素吧！

=★佳格營養師介紹★= 

★可以和我們的讀者介紹一下什麼是益生元、益生菌、消化酵素，還有它們對腸道健康的好處嗎？

益生菌（Probiotics）的定義為給予適量補充時，對宿主有益健康的微生物（活菌）。常見的益生菌菌種有乳酸桿菌（Lactobacilli）、雙歧桿菌（bifidobacterium）、布拉酵母菌（Saccharomyces boulardii）。而益生質（prebiotics）也被稱作益生元、益菌生，其定義為不被腸胃道中的消化酵素消化或吸收，但能選擇性地被與宿主共生的微生物利用，因而促進宿主健康的物質。

常見的益生質如果寡糖（FOS）、半乳寡糖（GOS）、菊糖等，這些益生質富含於香蕉、洋蔥、燕麥、小麥等天然蔬果與穀物中。益生菌在腸道中分解醣類產生乳酸與醋酸，可酸化腸道環境、抑制有害菌的生長，以調整腸內菌叢平衡。

此外，膳食纖維、抗性澱粉以及寡糖物質被腸道微生物所利用後所產生的短鏈脂肪酸代謝產物，可作為結腸細胞之能量，有助於結腸細胞的分化，幫助維持腸黏膜完整性。

消化酵素於人體體內自行合成、分泌，就分解的物質不同有蛋白酵素（proteases）、澱粉酵素（amylase）、脂解酵素（lipase），顧名思義就是在進食後在消化道中分解食物中的蛋白質、澱粉以及脂肪成小分子，利於腸道吸收這些營養。

★益生菌因除了有助於消化道健康外，在不同的生理性別，例如女性，有不同的效果嗎？

益生菌不只存在於腸道中，在皮膚以及女性的私密處也存在許多益菌，例如乳酸桿菌（Lactobacillus）。這些好菌在陰道中維持酸性環境，有助於維持陰道內生態系統，避免致病菌感染。然而，還是會受到有些內外在因素所影響，例如生理期前後、更年期婦女荷爾蒙改變、飲食習慣、高壓生活型態以及潮濕悶熱的生活環境等，使陰道中益生菌叢生態平衡受到影響，使益生菌減少、致病菌生長。另外，女性罹患大腸激躁症（irritable bowel syndrome, IBS）相較男性高，其症狀為腸道功能異常而造成患者反覆腹部疼痛、腹瀉、便秘等，而在生活品質受影響。

過去研究指出，補充益生菌對於細菌性陰道炎（bacterial vaginosis, BV）之患者可增加陰道中健康菌叢、降低復發率，另外對於大腸激躁症（irritable bowel syndrome, IBS）患者可改善腸胃道不適症狀、排便頻率，改善生活品質。

★食用益生元、益生菌、消化酵素有什麼應該要注意的副作用或風險嗎？我們該如何將風險降到最低？

大部分益生菌、益生元、消化酵素在建議服用之劑量下都是安全的。不過還是存在一些輕微副作用之風險，如腹脹、腹瀉、噁心或過敏反應（部分補充劑含有可能過敏原），而嚴重副作用極為罕見。

★大家對益生元、益生菌、消化酵素常常有什麼迷思或誤解嗎？

常見的迷思或誤解為益生菌對身體有幫助，所以多吃沒有關係。

如上面提到，大部分益生菌在建議服用劑量下是安全的。然而對特定人群來說，如免疫功能不全者、正進行化學治療之癌症患者以及早產兒，仍需要在服用前與醫師或營養師討論。

★有什麼女性常用的藥物或飲食限制會和益生元、益生菌、消化酵素產生交互作用嗎？女性如果想開始食用這些補充品，需要有任何預防措施嗎？

許多藥物與食物會有交互作用，例如女性在發生泌尿道感染或陰道炎時，醫生會所開立抗生素藥物進行治療。然而，服用抗生素會同時殺死腸道中的好菌與壞菌。此時，若同時補充益生菌也可能會使益生菌被抗生素破壞。而過去已有許多研究指出，益生菌可預防抗生素所造成的腹瀉（antibiotic-associated diarrhea, AAD）。因此建議服用抗生素治療的患者如果要補充益生菌，建議時間間隔開，避免同時服用。

★男性和女性食用益生元、益生菌、消化酵素的是否有最佳的建議劑量、頻率、時間有什麼差異嗎？如果有，是為什麼呢？

目前沒有針對特定性別的最佳服用劑量或使用時機，此外，不同益生菌菌株在研究結果上有不同調節機能。

建議在選擇益生菌產品時，優先選擇過去有較多確保功效性與安全性研究的益生菌菌株。另外，由於空腹時胃部酸鹼值較低，其酸度不利於益生菌存活，但在進食後因食物緩衝中和，使酸鹼值略為上升，此時為對益生菌較為適宜存活的環境，因此建議可於餐中或餐後補充。

★有哪些食物富含益生元、益生菌、或消化酵素呢？是否有推薦的食譜讓女性族群可以在日常飲食吃得到這些食物呢？

女性每個月的生理期所帶來的經前症候群（premenstrual syndrome, PMS）是一種常見症狀，除了在情緒上會有沮喪、焦慮、注意力不集中等情形，在生理上也造成影響，例如頭痛、失眠以及常見的腹痛、腹瀉等腸胃道症狀。在這裡介紹一道蜂蜜水果優格，在一道料理中即可攝取到有利女性生理週期的食物。

優格

是含有如乳酸菌（lactobacillus）、雙歧桿菌（bifidobacterium）等好菌的食物來源之一，過去許多研究證實補充益生菌可有效改善腸胃道不適症狀與糞便型態。此外，由牛乳發酵製成的優格，含鈣（calcium）與鎂（magnesium）可改善經前症候群所造成的水腫與頭痛症狀。

奇異果

女性在生理期前因黃體素分泌，經常會有腸道蠕動變慢而造成腹脹、便祕等不適症狀。奇異果含豐富的膳食纖維，可以促進腸胃道蠕動。此外奇異果所含的蛋白酶-actinidain，可幫助蛋白質分解與消化。

香蕉

香蕉含多種維生素、礦物質，以及提供腸道菌叢作為能量的菊糖（inulin），幫助維持消化道機能。

蜂蜜

蜂蜜除了能夠提供風味外，蜂蜜也含有一些寡糖（oligosaccharides）成分，有利於腸道中的菌叢生長，維持健康的菌叢生態。

★根據你的經驗，有什麼消化問題是比較常出現在女性身上的？而益生元、益生菌、消化酵素可以怎麼樣幫助她們緩解或避免這些問題？

如上面提到，女性因荷爾蒙改變而造成腸道蠕動減慢、便秘、腹瀉等腸胃道症狀。補充富含益生菌如優格、泡菜、味噌、康普茶、酸菜發酵食物可獲取對身體有益的好菌，維持腸道健康。

不過需要提醒，泡菜與味噌等部分發酵食物含較多的鈉含量，造成體內蓄積水分，使得身體水腫、血壓上升，因此建議在攝取這些發酵食物時須留意營養標示中的鈉含量。根據調查女性比男性更容易有便秘困擾。而大麥、燕麥、蘆筍、大蒜、菊苣等穀類與蔬菜富含膳食纖維，可幫助腸道蠕動、有助於排便。

另外，這些天然食物也含有不被腸胃道所消化吸收但可作為腸道益菌養分的益生元，幫助腸道健康。

<免責聲明>：本文章僅供參考，並不是專業的醫療建議，如果你有任何疑慮或特殊的身體狀況，請在食用補充品或補充劑或改變飲食習慣前諮詢專業醫療人員。

Interview with our Nutritionist Dr. Amanda Ho on Prebiotics, Probiotics, and Digestive Enzymes 

Amanda Ho, our in-house nutritionist, discusses the benefits of adding prebiotics, probiotics, and digestive enzymes to your diet, and outlines how they can especially benefit women. For more information on these super nutrients, read this article that lists which foods you (probably already) eat that contain these gut-enriching nutrients. 

★ Introducing Our Nutritionist ★

★ Can you outline the gut health benefits of prebiotics, probiotics, and digestive enzymes?

Prebiotics, also known as prebiotic fiber or prebiotic substances, are indigestible substances that selectively promote the growth and activity of beneficial microorganisms in the gut, contributing to the host's health. Common prebiotics include fructo-oligosaccharides (FOS), galacto-oligosaccharides (GOS), and inulin, which are abundant in natural fruits, vegetables, and grains such as bananas, onions, oats, and wheat.

Additionally, dietary fiber, resistant starch, and the metabolites produced by gut microbiota after utilizing prebiotic substances, known as short-chain fatty acids (SCFAs), provide energy for colon cells, aiding in maintaining intestinal mucosal integrity.

Probiotics are defined as beneficial microorganisms (live bacteria) that provide health benefits to the host when administered in appropriate amounts. Common probiotic strains include lactobacilli, bifidobacterium, and saccharomyces boulardii. Probiotics in the gut break down carbohydrates, producing lactic acid and acetic acid, which acidify the gut environment, inhibit the growth of harmful bacteria, and help balance the gut microbiota.

Digestive enzymes are naturally synthesized and secreted in the human body, each responsible for breaking down different substances such as proteins (proteases), starches (amylase), and fats (lipase), facilitating the absorption of nutrients in the intestines.

★ Do prebiotics, probiotics, and digestive enzymes specifically benefit women's digestive health compared to men? Are there any important differences to take note of?

Probiotics, such as Lactobacillus, are not only present in the intestines but also in the skin and in women’s intimate areas. These beneficial bacteria in the vagina help maintain an acidic environment, which supports a healthy vaginal ecosystem and prevents the growth of harmful pathogens.

However, they can be influenced by internal and external factors, such as hormonal changes before and during menstruation, menopause, dietary habits, stressful lifestyles, and humid environments, which can disrupt the balance of vaginal microbiota and lead to a decrease in probiotics and the growth of harmful bacteria. Additionally, women are more prone to developing irritable bowel syndrome (IBS) compared to men, which can cause recurrent abdominal pain, diarrhea, and constipation, affecting their quality of life.

Previous studies have shown that supplementing with probiotics can increase healthy vaginal flora and reduce recurrence rates of bacterial vaginosis (BV) in patients with BV. For individuals with irritable bowel syndrome (IBS), probiotics can help alleviate gastrointestinal discomfort and improve bowel frequency, thus enhancing their quality of life.

★ What are the potential side effects or risks of consuming prebiotics, probiotics, and digestive enzymes, and how can we minimize them?

Most prebiotics, probiotics, and digestive enzymes are safe when taken at recommended dosages. However, there is a slight risk of mild side effects, such as bloating, diarrhea, nausea, or allergic reactions (some supplements may contain potential allergens), but severe side effects are extremely rare.

★ Are there any common misconceptions or misunderstandings about prebiotics, probiotics, and digestive enzymes?

One common misconception is that all probiotics are beneficial, so it's okay to consume them without considering the dosage. As mentioned earlier, most probiotics are safe at recommended dosages. However, for certain groups, such as immunocompromised individuals, cancer patients undergoing chemotherapy, and premature infants, it's essential to consult with a physician or nutritionist before supplementation.

★ Can certain medications or dietary restrictions interact with prebiotics, probiotics, and digestive enzymes? Are there any precautions for women who want to start taking these supplements?

Many medications and foods can interact, for instance, when women have urinary tract infections or vaginal infections, doctors may prescribe antibiotics for treatment. However, taking antibiotics can kill both good and bad bacteria in the gut. If probiotics are taken simultaneously, they might also be affected and killed by the antibiotics. Previous studies have shown that probiotics can prevent antibiotic-associated diarrhea (AAD). Therefore, it is recommended for patients taking antibiotics to space out the time between antibiotic intake and probiotic supplementation to avoid taking them simultaneously.

★ Based on what you’ve mentioned, are there any differences in the recommended dosage, frequency, or timing of taking prebiotics, probiotics, or digestive enzymes for women compared to men? If so, what are they and why?

Currently, there are no gender-specific optimal dosages or timing for consuming prebiotics, probiotics, and digestive enzymes. Different probiotic strains have varying regulatory functions in research results.

When choosing probiotic products, it is advisable to prioritize those with more confirmed efficacy and safety through research. Additionally, probiotics are less likely to survive in an acidic stomach environment on an empty stomach, as the acidity hinders their viability. However, after eating, the food buffers the acidity, creating a slightly elevated pH level, making it a more suitable environment for probiotics' survival. Therefore, it is recommended to take probiotic supplements during or after meals.

★ What are some foods rich in prebiotics, probiotics, and digestive enzymes? Are there any recommended recipes for women to incorporate these foods into their daily diet?

Premenstrual syndrome (PMS) is a common condition experienced by women during their monthly menstrual cycle, resulting in emotional symptoms like depression, anxiety, lack of focus, and physical symptoms such as headaches, insomnia, abdominal pain, diarrhea, and other gastrointestinal issues. Honey fruit yogurt can provide women with beneficial foods for their menstrual cycle. Here are some reasons why this is a beneficial combination of ingredients.

Yogurt:

Yogurt is a source of beneficial bacteria, such as Lactobacillus and Bifidobacterium, and numerous studies have shown that supplementing probiotics can effectively improve gastrointestinal discomfort and bowel movements. Additionally, yogurt made from fermented cow's milk contains calcium and magnesium, which can alleviate menstrual symptoms such as edema and headaches caused by hormonal changes.

Kiwi:

Due to the secretion of progesterone before menstruation, women often experience slower intestinal motility, leading to bloating, constipation, and other discomfort. Kiwi is rich in dietary fiber, which can promote intestinal motility. Furthermore, the protein enzyme "actinidin" in kiwi can aid in protein breakdown and digestion.

Banana:

Bananas are rich in various vitamins, minerals, and the prebiotic substance "inulin," which provides nourishment for gut bacteria, supporting gut health.

Honey:

Apart from adding flavor, honey contains some oligosaccharides, which can promote the growth of beneficial gut bacteria and maintain a healthy gut microbiota.

★ In your experience, what are some common digestive issues that women experience, and how can prebiotics, probiotics, and digestive enzymes help alleviate or prevent these issues?

As mentioned earlier, women experience slower intestinal motility, constipation, diarrhea, and other gastrointestinal symptoms due to hormonal changes. Consuming probiotic-rich foods such as yogurt, kimchi, miso, kombucha, and sauerkraut can provide beneficial bacteria, maintaining gut health.

However, it's essential to be cautious as some fermented foods like kimchi and miso contain higher sodium levels, which can lead to fluid retention, causing bloating and elevated blood pressure. Therefore, it is advisable to check the sodium content on the nutritional label while consuming such fermented foods. According to research, women are more prone to constipation compared to men. Barley, oats, asparagus, garlic, and chicory are rich in dietary fiber, which can aid in intestinal motility and improve bowel movements. Additionally, these natural foods contain prebiotics that are not digested or absorbed in the gastrointestinal tract but serve as nourishment for gut bacteria, promoting gut health.

If you're curious to learn more, read our article on how prebiotics, probiotics, and digestive enzymes benefit digestion or learn what foods to always keep in your fridge so you can get all the benefits from these super nutrients.

Disclaimer: This article is for informational purposes only and does not substitute professional medical advice. If you have specific health concerns or conditions, consult with a healthcare professional before starting any new dietary regimen or supplement.