Probiotic drinks: What really works for gut health, from kefir to probiotic sodas

I’ve been noticing a trend during my weekly grocery runs — beverage cases brimming with probiotic drinks, all promising to support gut health. Some of these drinks I’ve enjoyed myself, such as kefir. But recently, some of these beverages have the same look and feel as soft drinks.

Once I noticed, I began seeing these drinks everywhere. You might have seen brand names such as Poppi, Olipop or Culture Pop at a neighborhood cookout or your friends might have opted for kombucha on tap at your last happy hour.

Of course, it’s important to be mindful about what foods and drinks you consume — which can be especially true for the estimated 60 to 70 million Americans living with a digestive condition. But do probiotic and prebiotic beverages really work for gut health?

The answer depends on what you’re drinking, according to Lioudmila V. Karnatovskaia, M.D., a critical care specialist and gut researcher at Mayo Clinic in Rochester, Minnesota.

Below, Dr.Karnatovskaia answers your top questions about gut health and beverages, including how probiotics and prebiotics work, how often to drink probiotics, and the difference between kombucha, kefir and other beverages.

Probiotics versus prebiotics

Although they are sometimes confused, probiotics and prebiotics are not the same thing.

Probiotics are beneficial living microorganisms in food — such as bacteria or yeast — that make their home in your digestive tract. You may hear these organisms called “good bacteria” and they occur naturally in fermented foods, such as yogurt, pickles, kimchi, sauerkraut and some cheeses. Emerging evidence suggests that probiotics help maintain healthy gut flora, aid digestion and nutrient absorption, and produce short-chain fatty acids (SCFAs).

According to Dr. Karnatovskaia, both probiotics and SCFAs help maintain the gut barrier, regulate mood, reduce inflammation, support the immune system and help maintain energy homeostasis. Probiotics and SCFAs also show anticancer effects. “As this is an area of active research, many of these findings have not yet transitioned to clinical practice,” Dr. Karnatovskaia notes.

Prebiotics, on the other hand, are not alive. These fiber-containing foods are not fully digested by the body. They feed the good bacteria in your gut. Think of them like the human body’s fertilizers — just as fertilizers help the plants thrive in a garden, prebiotic foods help the right types of bacteria thrive in the gut. Some examples include legumes, whole grains, asparagus, oats, bananas, garlic and onions. In the large bowel, gut bacteria ferment prebiotics, releasing SCFAs.

Some beverages, such as kombucha or kefir, naturally contain probiotics because they have been fermented. Other drinks, such as sodas or energy drinks, may have probiotics added in.

Probiotic beverages that really work for gut health

There are two beverages Dr. Karnatovskaia recommends: kefir and kombucha.

Kefir is a milk-based beverage fermented with grains of a specific blend of beneficial bacteria and yeast. Kefir has a thin, yogurtlike texture with a tangy taste. Typically, kefir is made with dairy, but you can also find it made with coconut water or nut milk.

Kombucha is made by brewing tea with sugar and then fermenting it with a symbiotic colony of bacteria and yeast (SCOBY). The sugar is largely consumed during the fermentation process. Kombucha is slightly bubbly, has a tart taste, and may be flavored with fruits or juices.

Both kefir and kombucha are rich in probiotics and can be found in most grocery stores in the U.S. In addition, kefir is rich in calcium and vitamins. Dr. Karnatovskaia says kefir is also known to have antibacterial properties due to the unique bacteria present only in this drink.

Drinks with added probiotics

Some other drinks, such as sodas or energy drinks, may have probiotic bacteria added, but they do not undergo fermentation. It is unclear how many of these added bacteria may survive in the acidic environment of the stomach. As a result, these drinks may not contain enough gut-healthy ingredients in a serving to be beneficial.

In addition, sodas may contain added sugar and artificial sweeteners that are generally not good for gut health.

However, there can be some benefits to reaching for a probiotic or prebiotic soda, especially if you are looking to reduce your overall soda or alcohol intake. These sodas tend to be lower in calories and sugar compared with traditional sodas, so it can make for a nice mocktail base or an occasional treat.

Still, kombucha is usually the better beverage swap. Kombucha comes in a number of flavors, and with its sour notes and slight fizz, it can offer a satisfying replacement for soda, beer or other alcoholic beverages.

Generally speaking, the best way to support your gut health is to eat a range of fruits, vegetables, whole grains and fermented foods. As a rule of thumb, kefir and kombucha count as probiotic-rich foods. Gut health sodas don’t.

How often to drink probiotics for optimal gut health

There is no “right” amount of probiotic beverages you should have in a day. It depends on a number of factors, including your lifestyle, overall health, taste and preferences.

The key is to incorporate probiotic foods and drinks into a sustainable part of your overall diet and lifestyle. You may start with one serving a day — such as a yogurt drink with breakfast, kombucha with lunch or a quarter cup of sauerkraut with dinner — and slowly build up your servings over time. As your body adjusts, you may have some temporary bloating at first.

If you are looking to incorporate more probiotic drinks in your diet, Dr. Karnatovskaia recommends the following tips:

• Stick to the refrigerated section. Live bacteria cultures need to be kept cool. You can usually find kefir near the yogurt section, and kombucha is usually kept with other cold beverages.

• Look at food labels. Check for products that list strains of bacteria or yeast on the packaging. The more strains listed, the better. Often the amount of bacteria is listed in colony-forming units, shortened to CFUs; the higher the colony count, the more gut-friendly bacteria or yeast cells are present. Try to avoid drinks with added sweeteners, including sugar, sugar substitutes or high-fructose corn syrup.

• Consider total nutritional value. Think about other nutrients your beverage can bring to the table as well. Dairy-based drinks may offer calcium, protein and vitamins.

• Opt for a do-it-yourself gut shot. You may see gut shots — small, often very sour servings of probiotics — on menus or in stores. These shots can be expensive. Instead of buying these, pick up a jar of fermented pickles during your next grocery haul. Unlike typical pickles, fermented pickles don’t contain vinegar and will be in the refrigerated section. The brine appears cloudy. You can eat the fermented pickles, but don’t throw away the probiotic-rich brine. Drink 2 fluid ounces each day for an at-home gut shot.

One cautionary note: Dr. Karnatovskaia says that people with severely compromised immune systems or those who take a monoamine oxidase inhibitor (MAOI) antidepressant should speak with their healthcare professionals before increasing their intake of probiotic foods or beverages.