Supplement well

“Taking probiotic supplements is like taking out an insurance policy — it protects you during the tough times,” Huffnagle says. To get the most mileage out of your supplement, Huffnagle suggests opening the pill casing and sprinkling the contents into a beverage or onto food so that the flora are introduced to your mouth and esophagus — important links in the digestive chain — as well as your stomach and intestines. Just be sure the food isn't scorching hot — anything above warm may kill the microbes.

Culture your kids

“Giving kids probiotic supplements helps set up their gut and immune health for life,” Lispki says. “It also counteracts the many rounds of antibiotics our kids are exposed to these days.” Here's her advice for babies up to a year old: Make a paste of Bifidobacteria infantis — typically the only probiotic babies are exposed to until they consume a wider variety of solid foods — and place it on their tongues. If you are breastfeeding, you can also simply take one or two capsules of the supplement yourself. For kids ages 1 to 4, try a supplement that contains Bifidobacteria infantis and Lactobacillus acidophilus, another common type of probiotic. “You can sprinkle it on their food,” Lipski suggests. Once kids reach age 4, they can take the same supplement you do.

Note: If you or your child begin taking supplements and experience an up-tick in digestive upset, it's likely a result of the bad bacteria dying off and releasing their toxins. Instead of stopping supplements altogether, Huffnagle recommends decreasing your dose and then gradually increasing it over time. “There's no evidence that you can overdo it,” he says.

Kate Hanley is a Brooklyn-based writer and the founder of www.msmindbody.com. She eats more yogurt, pickles, and kimchi since writing this article.

Probiotic SHOPPING TIPS

BRAND
Some manufacturers do a better job of delivering viable microbes (identified on the label as CFU, short for colony-forming units) than others. Gary Huffnagle, PhD, a professor at the University of Michigan Medical Center, recommends Align, Culturelle, Florastor, Jarrow, and Theralac.

FREEZE-DRIED
Freeze-drying, which removes all water from the microbes, makes them more likely to survive in pill form. When you take the supplement, the fluid in your digestive tract reanimates the bacteria.

REFRIGERATED
Although some high-quality supplements don't require refrigeration, most do. Lower temperatures increase the length of time microbes can survive.

MULTIPLE STRAINS
Look for a supplement that contains different species of bacteria, such as Lactobacillus and Bifidobacteria. “You want a variety in your probiotics just as you want variety in your diet,” says nutritionist Elizabeth Lipski, PhD, CCN, author of Digestive Wellness (McGraw-Hill, 1995). And look for a different formulation the next time you shop for supplements. “I generally have people take one supplement for a while and then switch so they get exposed to a wide range of benefits.”

OTHER INGREDIENTS
Because probiotics need food as soon as they reanimate, a supplement that contains a prebiotic, such as inulin, can improve the flora's chances of surviving in your digestive system.

DOSE
“For the average, healthy person, a dose between 5-10 billion microorganisms is protective and preventive, even if you take the supplements only a few times a week. If you've been on antibiotics or are recovering from illness, aim for 30 billion,” Huffnagle recommends. Look for supplements that clearly state each dose's CFU. Avoid those that list ingredients only by weight.

EXPIRATION DATE
Because probiotics contain live microbes, they won't remain viable forever. Make sure to purchase in quantities that will enable you to finish the supplements before the expiration date.
— K.H.