It’s hard to be healthy alone

March 18, 2019

As humans, we rely on a symbiotic relationship with the microbes around us for good health.  Our relationship with the microbes starts the instant we are born (or rather during delivery to be more specific) and then continues to be affected by a lifetime of choices related to diet, antibiotic use, other medications, sleep habits, the development and activation of the immune system, and exposure to pathogenic (bad) and commensal (good) bacteria.  Since these factors individually affect the development and progression of diseases as well as influencing the microbiome, carefully designed research studies are required to tease out the specific effects of the microbiome as a whole or certain strains of bacteria.

Recent studies have highlighted the effect the microbiome has on our health, from depression to diabetes to inflammatory bowel disease (IBD) to non-alcoholic fatty liver disease (NAFLD) to obesity.  These studies have also provided insights as to what affects the microbiome and how we can alter it to improve our health.

While there is a lot we don’t know about this symbiotic relationship, we do know that a certain level of diversity of microbes and a relative abundance of certain strains is associated with good health.  Take NAFLD for example.   A study saw patients improve after taking probiotics.  The improvement correlated with an increase in Ruminococcaceae-2, Lachnospiraceae-2, Coprococcus, Lachnospiraceae-1, Ruminococcus, and Dorea.  These strains of bacteria probably don’t sound familiar.  That’s because this area of research is entering a new stage where we will learn about new bacteria strains.  Obesity is another example.  There is a link between obesity and an imbalance in the gut microbiome.  Low levels of the phylum of bacteria known as Bacteroidetes and high levels the phylum Firmicutes are associated with obesity.  Research suggests that one way to turn the ratio of Firmicutes to Bacteroidetes around is to follow the Mediterranean diet.   Flipping the ratio not only helps with weight loss but also with insulin resistance syndrome, which is another good example.  One study concluded that patients with insulin resistance syndrome are likely to see an improvement with dietary changes if they have a diverse gut microbiome.

Choices as simple as eating whole grains and more fiber make a difference.  Whole grains support Faecalibacterium prausnitzii, Prevotella copri, and Clostridiales and likely subsequently help reduce systemic low-grade inflammation and reduce body weight.  A high fiber diet significantly alters the microbiome in a way that is likely correlated with improved blood-glucose regulation.  What you eat is obviously important, but don’t forget about what you drink too!  Certain types of tea improve glucose and lipid metabolism, likely by decreasing Faecalibacterium and Oscillospira.  Medications also affect the gut microbiome.  Metformin, a medication commonly used to treat type II diabetes, increases a beneficial Blautia spp and decreases opportunistic bacteria.

There is an enormous number of unanswered questions around the specific details of how factors like medication and diet relate to different diseases.  Keep an eye on the ETP blog for the latest updates.

If you’re interested in the scientific details, check out the following scholarly article.

Álvarez-Mercado AI, Navarro-Oliveros M, Robles-Sánchez C, Plaza-Díaz J, Sáez-Lara MJ, Muñoz-Quezada S, Fontana L, Abadía-Molina F. Microbial Population Changes and Their Relationship with Human Health and Disease. Microorganisms. 2019 Mar 3;7(3).

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