Now more than ever, people are becoming curious about the role that gut health plays in overall wellness. Meanwhile, medical researchers are looking at the connection between gut dysfunction and chronic disease, hoping to target specific bacterial populations in the prevention and treatment of type 2 diabetes, heart disease and mental health. Today’s post provides a quick overview of what a gut microbiome is, what happens when it isn’t functioning optimally and steps you can take to support your gut health.

What is a gut microbiome?

A gut microbiome is the individual collection of approximately 1000 different bacteria, fungi and viruses that live in your gastrointestinal tract. Recent studies have shown that the presence or absence/imbalance of certain bacteria in the gut can play a key role in the development of disease states.

Research supports the assertion that the composition of the gut microbiome is largely influenced by dietary and environmental factors. Much of this information was derived from studying the change in gut flora from populations emigrating to the US. Emigrating to the US resulted in a decrease in both the diversity and function of the gut flora. This change was attributed to the typical Western diet that is high in animal proteins and saturated fats.

What pathologies are associated with poor gut health?

• Irritable Bowel Syndrome
• Inflammatory Bowel Disease (Crohn’s and Ulcerative Colitis)
• Type 2 Diabetes
• Obesity
• Heart disease
• Colon Cancer
• Mental health issues
• Abdominal pain

How is gut health related to chronic disease?

Bacteria in our gut digest fibers (that we cannot breakdown) and turn them into short chain fatty acids or SCFAs. These SCFAs then function as chemical signals in the body and mediate a number of physiological processes including:

• Increasing energy expenditure
• Secretion of the hormone leptin (this gives the feeling of satiety)
• Decreases food intake
• Suppresses inflammation in the colon
• Prevents breakdown and circulation of fats into the blood (thereby lowering the concentration of LDL and triglycerides which can cause plaque formation)

Differing types and levels of SCFAs (created by gut microbes) are found in patients with IBD, as well as those with high levels of circulating lipids and cardiovascular disease.

Gut- brain axis:  disruptions and alterations in GABA (gamma aminobutyric acid) secretion are implicated in many neurological diseases including Parkinson’s, Alzheimer’s and anxiety. Gut bacteria are responsible for the conversion of glutamate (an amino acid) into GABA.

Obesity: Studies demonstrated high variability in the gut microbiomes of lean individuals. In contrast, those with low variability had elevated levels of inflammation, adipocytes (fat cells), insulin resistance and an unfavorable cholesterol profile. Lean individuals had higher levels or bacteria that fermented fiber to create SCFAs (butyrate, propionate, and acetic acid). These SCFAs act as chemical messengers in the body and increase energy expenditure, decrease food intake, suppress inflammation and help prevent plaque formation.

Type 2 diabetes: there are three main ways that a healthy gut biome can support blood glucose levels:

1. Bacterial fermentation of soluble fibers to create SCFAs
2. Bacterial fermentation of soluble fibers to create a viscous gel- and delay nutrient absorption
3. Reduce insulin resistance by altering protein absorption (insoluble fiber)

Okay so now that you have a better understanding of the disease processes that gut dysfunction can produce, let’s go over what we can do to support a healthy gut microbiome.

How does one optimize their gut health?

1. Minimize your use of antibiotics- they ruin your gut! Sometimes this is not avoidable, if you do have to take antibiotics, be sure to take a probiotic (live organism supplement that benefits your health) with your prescription, it will help restore the gut balance.
2. Try to minimize your consumption of alcohol (it can decrease your lactobacillus counts)
3. Try to minimize your intake of saturated fats (can also decrease your lactobacillus counts)
4. Supplement with omega-3 fatty acids (they decrease inflammation by supporting the growth of lactobacillus and bifidobacterium)
5. Avoid high consumption of refined carbohydrates (sugary drinks, bread, beer, savory snacks) – they reduce your microbial diversity.
6. Make sure to eat a variety of fruits and vegetables, as well as moderate amounts of coffee and tea- they increase microbial diversity!
7. Intermittent fasting- trying to eat in an 8-hour window- studies show that fasting may improve microbial diversity, gut barrier function, support antioxidant pathways, and decrease inflammation.
8. Avoid long-term use of PPI (proton pump inhibitors)- reduces microbial diversity.

Individual response to probiotics is dependent on your personal microbiome. Research is currently being done to explore the benefits of targeted probiotic therapy in the treatment of obesity, diabetes, CVD, and mental health conditions. If you decide to take a probiotic, be sure to discuss with your PCP first so you can work as a team to decide which ones will work best for you and your individual needs.

In the meantime, pick a few of the steps above to help support your best gut health!

Sincerely,
Corsano MD- your friendly neighborhood PCP

resources:

Gut Microbiome: Profound Implications for Diet and Disease
Ronald D. Hills Jr. 1,* , Benjamin A. Pontefract 2,3, Hillary R. Mishcon 1, Cody A. Black 1,4,
Steven C. Sutton 1 andCoryR.Theberge1