In a recent Washington Post op-ed, Dr. Trisha Pasricha challenges the hype surrounding the multibillion-dollar probiotics industry.
Despite widespread claims from physicians, health influencers, and what Pasricha refers to as self-proclaimed “gut health experts,” that probiotics can enhance gut microbiome health and address issues ranging from digestion to mental well-being, she remains unconvinced.
The marketing claims about over-the-counter probiotics largely do not match the evidence, Dr. Trisha Pasricha wrote in her op-ed. As a gastroenterologist, she rarely recommends probiotics to her patients—often leaving them surprised.
“They’re even more surprised when I tell them this aligns with evidence-based guidelines: The American Gastroenterological Association does not recommend probiotics for most digestive conditions,” she explained.
So, if the gut microbiome is crucial to overall health, what’s the better alternative? According to Pasricha, the answer is simple and backed by many dietitians and doctors today: a high-fiber diet.
Dr. Pasricha highlights that research has shown low-fiber diets can cause the permanent loss of certain gut bacteria, reducing microbial diversity and potentially harming overall health.
To support a thriving gut microbiome, she advises focusing on a diet rich in *plants, nuts, and fermented foods*, which provide the diverse nutrients beneficial bacteria need.
“This time-tested recommendation remains one of the strongest-studied ways to promote and preserve a healthy microbiome and improve your overall health,” Pasricha wrote.
The Probiotic Dilemma
Dr. Pasricha highlights a major issue with probiotic research: inconsistency. With over *1,000 clinical trials* conducted, the vast differences in *bacterial strains, dosages, and measured outcomes* make it difficult for scientists to reach a clear consensus on their effectiveness.
Adding to the uncertainty, she points out that *probiotics—like other supplements—aren’t subjected to the same rigorous FDA testing* as prescription drugs. This lack of regulation means consumers have no guarantee that the probiotics they buy are as effective as manufacturers claim.
"Probiotics have incredible potential," Pasricha acknowledged, but she emphasized that the science is still in its early stages. Since *each person’s microbiome, medical history, and diet is unique*, researchers have yet to develop a personalized approach to probiotic treatments.
She stressed the need for *more rigorous studies* to determine how probiotics can be tailored to individuals for maximum effectiveness.
Misinformation and Marketing Hype
Dr. Pasricha points out that both *marketing campaigns and social media* contribute to widespread confusion about probiotics. She explains that some companies *cherry-pick data*—taking the benefits of one probiotic strain and using it to promote their product, even if the strains are completely different. This misleading approach *creates the false impression* that all probiotics offer the same benefits.
Social media further amplifies the issue. Pasricha references a 2023 study that found the majority of YouTube videos on probiotics not only endorsed them positively but were also created by amateurs, not medical experts—adding to the spread of misinformation.
Prioritize a High-Fiber Diet Instead
Health experts emphasize that fiber is a crucial defense against diseases like cancer, particularly colorectal cancer, which is rising among millennials and Gen Xers.
Additionally, nutritionists have found that people who focus too much on protein intake often overlook the numerous health benefits of fiber—potentially harming their overall well-being in the process.
Americans Are Falling Short on Fiber
The U.S. Department of Agriculture’s Dietary Guidelines recommend a daily fiber intake of 22–28 grams for women and 28–34 grams for men. However, the average American consumes only 10–15 grams per day, according to Harvard Medical School—far below the recommended amount.
While fiber supplements may seem like a convenient fix, registered dietitians like Abbey Sharp emphasize that whole-food sources are the best option. In addition to fiber, they provide essential micronutrients, vitamins, and minerals that supplements simply can’t replicate.
Easy Ways to Add More Fiber to Your Diet
Incorporating more fiber-rich foods into your meals can improve digestion and overall health. Here are some great options to start with:
✅ Legumes: Beans, lentils, and split peas
✅ Nuts & Seeds: Almonds, walnuts, chia seeds, and flax seeds
✅ Fruits: Raspberries, blueberries, apples, and pears (with skin)
✅Vegetables: Broccoli, Brussels sprouts, green peas, and potatoes (with skin)
✅Whole Grains: Oatmeal, farro, barley, and brown rice
✅Other High-Fiber Foods: Popcorn and avocados
A Simple Formula for a Fiber-Packed Meal
If you’re unsure where to start, nutritionist Federica Amati suggests this easy plate-building method:
Half your plate → A plant-based source like salad, broccoli, or sautéed zucchini
One-quarter → A lean protein like salmon, chicken breast, tofu, or edamame
One-quarter → A high-fiber complex carb like brown rice, barley, or sweet potatoes
This balanced approach ensures you're getting the fiber, protein, and nutrients your body needs for optimal health.
Who Should Consider Taking Probiotics?
Dr. Pasricha explains that clinical guidelines recommend probiotics in only a few specific cases, including:
Reducing the risk of C. difficile infections – This bacterium can cause severe diarrhea, especially when taking antibiotics.
Managing pouchitis – A condition that can develop after surgery for inflammatory bowel disease (IBD).
However, Pasricha emphasizes that even these recommendations aren’t strongly supported, as the quality of evidence is rated “low” or “very low.”
Are Probiotics Ever Beneficial?
While Dr. Pasricha is skeptical about probiotics for most people, she acknowledges that some individuals do experience benefits from taking them.
“In these cases, I tell my patients I’m glad they’ve found something that has helped them and feel reassured if they’ve bought a probiotic from a company vetted by a third party,” she wrote.
However, she cautions against using probiotics to relieve belly pain or bloating, as many people may find no improvement and realize they’ve wasted money.
“That’s a good moment for us to pause and consider the data together,” she said, encouraging patients to look at the evidence before continuing probiotic use.
