People Are Taking More Probiotics, but Still Skimping on Fiber

If you struggle to get enough of certain nutrients from food alone, taking a supplement can help. But research suggests that more people may be skipping straight to supplementation without trying to make tweaks to their diet first.

Meet the experts: Melissa Prest, D.C.N., R.D.N., spokesperson for the Academy of Nutrition and Dietetics; Keri Gans, M.S., R.D.N., C.D.N., registered dietitian and author of The Small Change Diet

The finding comes from a recent study published in Clinical Gastroenterology and Hepatology, in which the researchers analyzed National Health and Nutrition Examination Survey (NHANES) data to identify trends in probiotic supplementation. The results revealed that the number of people under 20 taking a probiotic supplement increased from 0.63% to 5.58% between 2009 and 2023. For people over 20, the rate increased from 1.8% to 6.96% during the same time period.

But while the number of people taking a probiotic supplement increased significantly, they didn’t seem quite as keen to make diet-related changes known to improve gut health—the amount of fiber people were consuming in their diet remained virtually unchanged. So what can this mean for our gut health? Ahead, dietitians break it down.

What do the findings tell us?

The findings reveal an intriguing incongruity, according to Melissa Prest, D.C.N., R.D.N., spokesperson for the Academy of Nutrition and Dietetics. “What I find most interesting is the disconnect between growing interest in gut health and the dietary habits that actually support a healthy gut microbiome,” she says.

That suggests that rather than looking at the overall pattern of their diet—which may be tedious to adjust—people are increasingly looking to supplements as a quicker fix. Convenient, yes, but also probably not as effective as it seems. “Supplements can have a role, but they don’t replace the many benefits we get from eating a variety of fiber-rich plant foods, including fruits, vegetables, whole grains, beans, nuts, and seeds,” Prest explains.

Is this disconnect really a bad thing?

The increase in probiotic use alone isn’t necessarily a cause for concern. In fact, Prest says it’s an encouraging sign “that people recognize the importance of the gut microbiome and are actively looking for ways to support it.” After all, probiotics can support better gut health by restoring a healthy balance of the bacteria in your microbiome.

The problem, though, arises when that increased interest in gut health doesn’t result in more meaningful dietary changes.

When that happens, only one piece of the gut health puzzle is being addressed, explains Keri Gans, M.S., R.D.N., C.D.N., registered dietitian and author of The Small Change Diet. “Fiber is one of the most important dietary factors for supporting beneficial gut bacteria, so increasing probiotic use without improving fiber intake may overlook a key aspect of gut health,” she says. “And when we eat fiber-rich whole foods, we’re getting much more than fiber—we’re also getting vitamins, minerals, and thousands of plant compounds that contribute to overall health,” Prest adds.

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Paying more attention to your overall diet could even help your probiotic supplement work better. “Gut health is about more than taking a probiotic capsule,” Prest says. “Think about the whole dietary pattern. A diverse, plant-forward diet gives your gut microbes a variety of fibers and other compounds to work with.”

What does this mean for you?

Prest’s takeaway is simple: “don’t let the supplement aisle distract you from the grocery store.”

If you’re looking to put that into practice by finding more ways to support your gut health beyond probiotic supplements, Prest and Gans suggest the following strategies:

• Pay attention to fiber. “Eat a variety of fiber-rich foods, including vegetables, fruit, legumes, 100% whole grains, nuts, and seeds, and stay adequately hydrated to support regularity,” Gans suggests. “Fermented foods such as yogurt and kefir can also support gut health as part of an overall eating pattern.”
• Mix it up. “I also recommend increasing variety,” Prest says. “The goal isn’t to find one magic probiotic or one perfect food. It’s to build a dietary pattern that consistently gives your gut microbiome a diverse variety of nutrients to work with.”
• Start small. If you’re not used to eating a lot of fiber in your current diet, Prest recommends gradually increasing the amount to avoid digestive upset.
• Opt for whole foods. “I also recommend limiting excess added sugars and highly processed foods and choosing minimally processed whole foods more often,” Prest says.
• Look beyond the kitchen. “Remember that gut health isn’t just about food,” Prest points out. “Getting enough sleep, staying physically active, and managing stress are all part of supporting overall gut health.”

Should you take a probiotic supplement for gut health?

So, if you’re doing all of that, do you really need a probiotic supplement? Prest says the answer is complicated. Most healthy people don’t necessarily need a probiotic supplement, but they can be helpful in specific cases. “For example, some probiotics have been studied for reducing the risk of antibiotic-associated diarrhea, but that doesn’t mean every probiotic product will provide that benefit,” she explains.

“Probiotic supplements can be a useful addition for some people, especially when there’s a specific reason to take one,” Gans adds. That said, the benefits can be strain-specific, which is why Gans says to consider discussing your needs with a healthcare provider or registered dietitian to help determine which probiotic, if any, makes sense for you. “People with serious illness or a compromised immune system should also speak with their physician before taking one,” she says.

The bottom line

Both Prest and Gans point out that while the results identify some interesting trends, it’s important to recognize that they don’t show cause and effect. “The researchers analyzed data from NHANES, which provides a large snapshot of Americans’ health and dietary behaviors over time,” Prest explains. “It can tell us that probiotic supplement use increased while fiber intake remained relatively stable, but it cannot tell us that people are necessarily replacing healthy foods with supplements.”

Still, the findings are illuminating. “The main takeaway is that interest in gut health appears to be growing,” Gans says. However, she says it’s important to remember that supplements are only one part of the bigger picture. “What we eat every day still matters.”

Dietary supplements are products intended to supplement the diet. They are not medicines and are not intended to treat, diagnose, mitigate, prevent, or cure diseases. Be cautious about taking dietary supplements if you are pregnant or nursing. Also, be careful about giving supplements to a child, unless recommended by their healthcare provider.