Ch Christ stine Kessler M MN, A ANP NP-BC, C CNS NS, B BC-ADM, - - PowerPoint PPT Presentation
Ch Christ stine Kessler M MN, A ANP NP-BC, C CNS NS, B BC-ADM, C CDTC, F FAANP NP Founder, Metabolic Medicine Associates King George, VA ckessler@maranatha.net DISCLOSURES Clarion Brands (Floragen) National Study Chair: use of
Ch Christ stine Kessler M
MN, A ANP NP-BC, C CNS NS, B BC-ADM, C CDTC, F FAANP NP Founder, Metabolic Medicine Associates King George, VA ckessler@maranatha.net
DISCLOSURES
Ò Clarion Brands (Floragen)
É National Study Chair: use of probiotics with antibiotics
OBJECTIVES
Ò Describe t
the i intimate l linkages b between t the g gut h hormones, , microbiome a and t the C CNS a and m metabolic h health (i (immune, , CV, p , pulmonary, n , neuro-psychologic, a , and e endocrine). ).
Ò Develop a
a s strategy t to p promote g gut m microbiome i integrity a and he health
Ò Discuss t
the b benefits a and l limitations o
pre- and p probiotic use use.
BEFORE WE GET STARTED….
IT’S P PUZZLING—WH WHY…. Y….?
Ò Has there been a continuing increase in autoimmune diseases
and obesity during the past 4 decades?
Ò Do therapeutic diets improve CV health for some but worsen it
for others?
Ò Are asthma rates skyrocketing in developed countries, but not
in ”less civilized” countries?
Ò Are dogs actually beneficial for overall health?
TO K KNO NOW W WHAT’S H HAPPENI NING NG...
We need to look to the gut as the biggest player in chronic health and autoimmune disease!
The Coffee (Heart & Cancer) Gene Conundrum
FA FAST T vs vs SLOW metabolize zers
SLOW = incr crease sed MI/ tach chy FA FAST= T= ca cardioprotect ctive ve
Cornelius M, et al. Genome-wide meta-analysis identifies six novel loci associated with habitual coffee consumption. Molecular Psychiatry, online October 7, 2014, doi: 10.1038/mp.2014.107 (accessed 1/20/2016) Sagioglou C. & Greitemeyer T., Individual differences in bitter taste preferences are associated with antisocial personality traits, Appetite (2015), doi: 10.1016/ j.appet.2015.09.031. (accessed 2/20/2016)Are yo you cr crazy? zy?
“All disease begins in the gut”
THE G GENIUS O OF T THE G GUT
Ò Gut-brain connections É Incretins—gut hormones (biodirectional via neurons & circulation) É Role in appetite regulation/ nutrient acquisition/ energy metabolism Ò Major immune functions É Houses > 70% of immune system É Leaky gut & inflammation Ò Major neuropsychiatric function É The gut is the “2nd brain É Many neuropeptides in gut—all influenced by microbes É Gut has 80-90% serotonin (happy); 50% dopamine (motivation);
acetylcholine (memory) & GABA
Ò Digestion & Nutrient acquisition É Diabetes, dyslipidemia, weight excess, GI pathologies ÎMicrobiome (affects all of this)
HOW THE GUT IMPACTS THE ENDOCRINE & METABOLIC SYSTEM
Ò Altered enterocyte integrity: Due to: É Lack of sleep
É Exposure to toxins, viruses!!!!! É STRESS É Reduced blood flow (dehydration/shock/ischemia)
Ò Altered microbiome Ò Leaky gut É Inflammation—autoimmune processes Ò Food intolerances & allergies!!!
É Food intolerances common —GI upset, rhinitis, mental fog, “fluish,” anxiety,
pain
FAST FACTS ON AUTOIMMUNE DISEASES
Ò Autoimmune disease: body produces antibodies that attack its own tissues,
leading to the deterioration/destruction of such tissue.
É 139 diseases associated autoimmunity! Ò Autoimmune diseases, along with obesity & autism, have had an astonishing
increase over past 3 decades!
É A staggering epidemiologic & epigenetic change!!!!!! Ò Rare autoimmune diseases now becoming common-- É One in twelve Americans—1 in 9 women—will develop an autoimmune
disorder!!
WHAT ARE THE AUTOIMMUNE DISEASES?
ÒAddison’s ’s d disease
ÒAg Agammaglobulinemia
ÒAl Alop
cia ar areat eata
ÒAm Amyloi
Ankylosing s spondylitis
ÒAnti-GBM/Anti-TBM nephritis
ÒAntiphospholipid s syndrome
ÒAutoimmune h hepatitis
ÒAutoimmune inner ear disease (AIED)
ÒAxonal & neuronal neuropathy (AMAN)
ÒBehcet’s disease
ÒBenign m mucosal p pemphigoid
ÒBullous p pemphigoid
ÒCastleman disease (CD)
ÒCeliac d disease
ÒChagas d disease
ÒChronic i inflammatory d demyelinating p polyneuropathy (CID IDP)
ÒChronic recurrent multifocal osteomyelitis (CRMO)
ÒChu Churg-St Strauss
ÒCicatricial pemphigoid
ÒCogan’s syndrome
ÒCold a agglutinin d disease*
ÒCongenital h heart b block
ÒCoxsackie m myocarditis
ÒCREST s syndrome
ÒCrohn’s ’s d disease
ÒDe Dermatitis he herpetiformis
ÒDe Dermatomyositis
ÒDevic’s disease (neuromyelitis optica)
ÒDiscoid l lupus
ÒDressler’s ’s s syndrome
ÒEn Endome metriosis
ÒEosinophilic e esophagitis ( (Eo EoE)
ÒEosinophilic fasciitis
CATEGORIZED AS AUTOIMMUNE DISEASES
ÒEr Eryt ythe hema ma no nodosum sum
ÒEssential mixed cryoglobulinemia
ÒFi Fibromyalgia
ÒFibrosing alveolitis
ÒGiant c cell a arteritis ( (temporal a arteritis)
ÒGiant c cell m myocarditis
ÒGl Glomerulonephritis
ÒGoodpasture’s ’s sy synd ndrome
ÒGranulomatosis with Polyangiitis
ÒGraves’ d ’ disease
ÒGu Guillain-Barre s syndrome
ÒHashimoto’s ’s t thyroiditis
ÒHemolytic a anemia
ÒHe Henoch-Sc Schonlein purpura ( (HSP)
ÒHerpes gestationis or pemphigoid gestationis
ÒHy Hypo pogammalglobulin inemia ia
ÒIg IgA N Nephropathy
ÒIgG4-related sclerosing disease
ÒIn Inclusion b body m myositis ( (IB IBM)
ÒIn Interstitial c cystitis ( (IC IC)
ÒJuvenile a arthritis
ÒJuvenile d diabetes ( (Type 1 1 d diabetes)
ÒJuvenile myositis (JM)
ÒKawasaki disease
ÒLambert-Eaton syndrome
ÒLeu Leukocytoclas astic va vasculitis
ÒLichen p planus
ÒLichen sclerosus
ÒLigneous conjunctivitis
ÒLinear IgA disease (LAD)
ÒLu Lupus
ÒLyme d disease c chronic
ÒMeniere’s ’s d disease
ÒMicroscopic polyangiitis (MPA)
ÒMixed connective tissue disease (MCTD
CATEGORIZED AS AUTOIMMUNE DISEASES
ÒMooren’s ulcer
ÒMucha-Habermann disease
ÒMultiple s sclerosis
ÒMyasthenia g gravis
ÒMy Myositis
ÒNa Narcolepsy
ÒNeuromyelitis optica
ÒNe Neutropenia
ÒOcular cicatricial pemphigoid
ÒOptic n neuritis
ÒPalindromic rheumatism (PR)
ÒPA PANDAS
ÒParaneoplastic cerebellar degeneration (PCD)
ÒParoxysmal nocturnal hemoglobinuria (PNH)
ÒParry Romberg syndrome
ÒPars planitis (peripheral uveitis)
ÒPe Pemphigus
ÒPeripheral n neuropathy
Òerivenous encephalomyelitis
ÒPernicious a anemia ( (PA)
ÒPOEMS s syndrome
ÒPo Polyarteritis no nodosa sa
ÒPo Polymyalgia rh rheumatica
ÒPo Polymyositis
ÒPostmyocardial infarction syndrome
ÒPo Postpericardiotomy sy synd ndrome
ÒPrimary b biliary c cirrhosis
ÒPrimary Progesterone dermatitis
ÒPremature ovarian failure
ÒPs Psor
Psoriatic a arthritis
ÒPure red cell aplasia (PRCA)
ÒPyoderma gangrenosum
ÒRaynaud’s ’s p phenomenon*
ÒReactive Arthritis
CATEGORIZED AS AUTOIMMUNE DISEASES
ÒReflex s sympathetic d dystrophy
ÒReiter’s ’s s syndrome
ÒRelapsing polychondritis
ÒRestless l legs s syndrome ( (RLS)
ÒRetroperitoneal fibrosis
ÒRheumatic f fever
ÒRheumatoid a arthritis
ÒRo Rosecea*
ÒSa Sarcoidosis
ÒSchmidt syndrome
ÒSc Scleritis
ÒSc Scleroderma
ÒSjogren’s ’s sy synd ndrome
ÒSperm & testicular autoimmunity
ÒStiff p person s syndrome ( (SPS)
ÒSubacute b bacterial e endocarditis ( (SBE)
ÒSusac’s syndrome
ÒSympathetic ophthalmia (SO)
ÒTakayasu’s arteritis
ÒTemporal a arteritis/Giant c cell a arteritis
ÒThrombocytopenic p purpura ( (TTP)
ÒTolosa-Hunt syndrome (THS)
ÒTransverse myelitis
ÒType 1 1 d diabetes
ÒUlcerative c colitis ( (UC)
ÒUndifferentiated connective tissue disease (UCTD)
ÒUv Uveitis
ÒVa Vasculitis
ÒVi Vitiligo
ÒWegener’s ’s g granulomatosis ( (or Granulomatosis with Polyangiitis (GPA)) https://www.aarda.org/diseaselist/
FAST FACTS ON THE GUT MICROBIOME
Ò The gut microbiome is the most complex ecosystem ever discovered É The richness & biodiversity is critical to the health (need healthy biota
interaction)
Ò We are home to vast numbers of microbial organisms (>100 trillion!)
É The are > 1000 bacterial species in just a few bacterial phyla (Gut most diverse); É contain 150 TIMES as many genes as our human genome!!
Ò Dominant human bacterial phyla: É Bacteroidetes, É Firmicutes, É Actinobacteria, É Proteobacteria! Ò Can go from good bacti to bad bacti……
Genome Med. 2016; 8: 39. Published online 2016 Apr 13. doi: 10.1186/s13073-016-0294-z (accessed 4/20/2019)
MORE O ON T THE M MICROBIOME
Ò It contains 150 TIMES as many genes as our human genome!!
(3.3 million genes)
Ò We each have a microbial “fingerprint.” --unique microbial
composition (species & ratios)
Ò Gut microbiota have pathogenic and health promoting roles
(“pathobionts”)
Ò Can produce toxins and carcinogens Ò Balance is critical (“richness & diversity”): harmful if number of
certain species in the microbiome is too high or too low
Ò The richness of the biodiversity is critical to the health – need
healthy biota interaction
ENERGY SOURCE FOR MICROBIOME
Ò Short-chain Fatty Acids—SCFAs are an essential energy
source for the intestinal mucosa and the microbiome
Ò SCFAs critical for modulating immune responses and
tumorigenesis in gut.
Ò Fermentation of non-digestible dietary components liberates
short-chain fatty acids (SCFAs)
É (e.g., butyrate, propionate, acetate) É Get from some fruits, veggies, grains
Ò More talk about prebiotics later!!!
WHAT INFLUENCES THE MICROBIOME?
Ò Genotype of host…contribution mostly from mom Ò Type of birth: vaginal or C-section Ò Cleanliness: Excessive Hygiene Ò Diet: macronutrients, fiber, phytochemicals ,alcohol
É (diet leads to 50% of the changes in biome)
Ò Probiotics and prebiotics (more later) Ò Medications: Antibiotics, PPIs, NSAIDs, metformin, hormones, Ò Stress (emotional, physical, social…PTSD) Ò Endocrine disrupting chemicals: (BPA, glyphosate, lead,
arsenic, mercury, dioxin, glycol ethers, etc)
Plos One. 2011;6(12):e2828
ENDOCRINE D DISRUPTING C CHEMICALS ( (EDCS)
THE D DIRTY D Y DOZEN
Ò BPA Ò Dioxin Ò Atrazine Ò Phthalates Ò Perchlorate Ò Fire retardants Ò Lead Ò Arsenic Ò Mercury Ò Perfluorinated chemicals (PFCs) Ò Organophosphate pesticides Ò Glycol Ethers
Fe Fertility Th Thyroid Di Diabetes Ob Obesity Mo More re…
A A 2005 st study dy, rese sear arche hers s found 287 287 industrial chemicals in in n neonate te’s ’s co cord rd b blo lood!
Environmental Working Group analysis of tests of 10 umbilical cord blood samples conducted by AXYS Analytical Services (Sydney, BC) and Flett Research Ltd. http://www.ewg.org/research/body-burden-pollution-newborns/test-results
DEVELOPMENT OF THE MICROBIOME
Ò Vaginal delivery exposes baby to the Mom’s vaginal and perineal
microbiome (takes 1 mo to establish baby’s microbiome)
É Mom’s vaginal microbial community contains many bacteria –some
involved in digesting milk (Lactobacillus)
Ò C-Section – exposed mostly to bacterial species of the mom’s and
hospital staff’s skin flora (takes 6 mos to establish GI microbiome)
É Increases risk of allergies, asthma, Celiac Disease, Type 1 diabetes, IBD
Ò Breast feeding provides bacteria from the mother’s GI tact!!
É Also complex sugars that biome eats & confers gut immunity
Ò FYI: antibiotics taken by mom prior to delivery a problem
.Ding T, Schloss . Dynamics and associations of microbial community types across the human body. Nature 2014; 509:357–360
We start off with streptococcus, enterobacteria, and staph that create an anaerobic environment for anaerobes to flourish
RISK S SUMMARY O Y OF M MICROBIOME DY DYSBIOSIS IN E EARLY L Y LIFE
Ò C-section Ò Formula feeding Ò Early feeding of cereals or grains (<6 mos)**
É increase risk of celiac disease
Ò Early antibiotic use (obesity risk) Ò Eat overly refined sugars Ò Stress of mother or caregiver Ò Overly h
hygienic e environment ( (im immunopa pathy)! )!!!!
Abrahamsson T. et al. Low diversity of the gut microbiota in infants with atopic eczema. J. Allergy Clin. Immunol. 129 434–440
DYSBIOSIS OF MICROBIOTA & LEAKY GUT
Ò Poor diet, endotoxins, drugs, viral & bacti infections, shock and
STRESS disrupt gut microbiome… and c-diff will change it forever!
Ò An increase in gut mucosal permeability may occur (prompted by
zonulin releaase and others biopeptide)
Ò There is then passage of colonic microbiota (pathobionts) & food
particles through the gut lining into the systemic circulation
Ò Results in an inflammatory-immune response with release of
cytokines (local & systemic)
Drugs Altered pH & enzymes
St Stress
Gluten, lectins
In Infl flammatory cytokine r release ( (also by m microbiota)
GU GUT-IN INFLA FLAMMATIO ION-DY DYSBIOSIS AX AXIS
Le Chatelier et al., Nature 500, Aug 29, 2013
Endocrine disrupting chemicals
Overgrowth of Pathogens—causing widespread inflammation
Reduced sulfate
Loss of beneficial bacteria
Leak Gut
We have gut feelings?
THE MICROBIOME NEURO-PSYCH CONNECTION
Ò The C
CNS d directly i impacts G GI e I enteric n nervous s system a and f function: altered motility, mucin production, enteric hormone production and immune & microbiome function
Ò The g
gut/microbiome a affects t the C CNS via vagus altering mood, pain perception, memory, infections and below:
É Autism É Depression/anxiety É Bipolar illness É Dementia/Alzheimer's É Addiction Ò Re
Remember: the microbiome can increase or decrease serotonin/GABA production & other neurotransmitters (GI produces >90% of our serotonin!)
Can diet help?
POINTS ON THE MICROBIOME & AUTISM
Ò Likely link between the microbiome autism spectrum disorder (ASD)— Ò Increased ASD found when breast feeding is limited! Ò >70% children with ASD have marked G
GI d I disturbances
É (8-fold risk of major GI symptom)
Ò ASD has a distinctive g
gut m microbiome associated with less diversity; fewer bacteroidetes
Ò ASD p
preferences t to e eat more starchy foods; less vegetables
É (Less bacteroidetes to break down plant fiber) Ò Abnormal b
behavior: : ASD biome has more clostridia & its metabolites cause less dopamine conversion to norepinephrine
Gut Microbiome and Autism: Recent Advances and Future Perspectives N A J Med Sci. 2016;9(3):104-115
Microbiome affects the heart?
https://doi.org/10.1161/CIRCULATIONAHA.116.024251.
GUT BACTERIA AND THE CV SYSTEM
Ò Altered microbial metabolism of dietary phosphatidylcholine
turns it into pro-athrogenic trimethylamine-N-oxide (TMAO)
É Increases MI & stroke in those with CV risk
Ò Those with CVD have fewer gut microbes that make anti-
inflammatory compounds and more that promote inflammation
Ò Infected gums increase CVD 2-fold—found in plaque—and
increases stroke & T2DM! See your dentist!
Ò Is mouth wash ok?
Tang WH, et al. Intestinal microbial metabolism of phosphatidylcholine and cardiovascular risk. N Engl J Med 2013; 368:1575–1584.
MICROBIAL CV INTERVENTION?
Ò Resveratrol (& polyphenols, acanthanins) in red wine & skin
Ò Vegan vs omnivore diet? (Contrary data) Ò Mediterranean diet has less red meat substrate (e,g, L-
carnitine) that may convert to higher TMAO
Ò More fiber and fermented foods? Ò Antibiotics may help? Huh? Ò More later….
THE MICROBIOME AND ASTHMA FAST FACTS
Ò The first year of life is critical to the development of asthma. Ò Children receiving more than four courses of antibiotics in
the first year of life have 1.5 times the risk of asthma
Ò Likely Th17 response underlies/augments severe asthma in
response to clostridia-related bacteria
Ò Children most likely to develop asthma are deficient of four
types of microbiota at 3 months:
É Faecalibacterium, Lachnospira, Veillonella & Rothia (nicknamed
FLVR—”flavor”)
É Catch up with these by 1 year but risk remains
http://www.canadianchildstudy.ca/ (accessed 6/11/2017)
HOW CAN WE HELP?
Ò Careful and reasoned use of antibiotics in early life Ò Vaginal delivery & breast feeding reduces risk Ò Play in the dirt? Ò Research into providing deficient bacteria to infant…. Ò Take at look at Canada’s healthy infant longitudinal study
http://www.canadianchildstudy.ca/
Ò Will prebiotics or probiotics help in prevention…? http://stm.sciencemag.org/content/7/307/307ra152. (accessed 6/11/20170
THE M MICROBIOME & & GI GI DI DISEAS EASE
C-Di Dificile infections c cause a
14,000 d deaths a a y year
FECAL T TRANSPLANT
(BA BACTERI RIOTHERAP RAPY)
FECAL MATTER TRANSPLANT (FMT)
Ò 4th century “golden soup (syrup)” used by Chinese Dr. Ge Hong Ò Was dry or fermented stool from healthy person—given by mouth
to treat severe diarrhea
Ò Lost favor until used in 4 critically ill pts in 1958. Ò Gone again and now back again
Patient: 61 year old woman Unspecified chronic diarrhea (every15 min for 8 mos!) Lost 60 lbs Confined to W/C Donor: Husband
Patient Day 0 Donor
EXAMPLE O OF F FECAL T TRANSPLANT
AND G GUT M MICROBIOTA C CHANGES
J Clin Gastroenterology (2010) 44:354-360
WHAT HELPS C-DIF?
ÒOf course oral vancomycin (but not great for
recurrences)—30% effective
ÒFecal transplant (NG, via enema, capsules) 70-94%
effective
É Changed microbiome for at least 6 months
ÒProbiotics?
ÉBest are : Saccharomyces boulardi and Lactobacillus GG ÉBifidobacterium also helps
FYI: I IBS A AND T THE M MICROBIOME
Ò Found marked reduction in microbiota diversity and richness
(decreased number of certain clostridium)
Ò IBS symptoms d/t microbiota-gut-brain axis!! Ò Appears inversely linked to:
É Poor sanitation in early years of life and É Consumption of fruits, veggies, and unprocessed foods.
Ò Appears directly linked to
É Good hygiene in children É Lack of breast feeding É Consumption high sugar and fat in early life É Use of antibiotics in early life.
MICROBES THAT MAY HELP IN IBS
Ò For c
constipation: Bacillus Lactis
Ò For d
diarrhea-prone IB IBS
É B. coagulans, É S. boulardii É A combination of several Lactobacillus and Bifidobacterium
Ò For d
diarrhea pr prevent ntio ion
É Lactobacillus rhamnosus GG, É Lactobacillus acidophilus É Lactobacillus bulgaricus
MICROBIOME AND WEIGHT/OBESITY
Ò Obesity results from/in chronic low-grade metabolic inflammation—source is the
gut!
Ò Microbiota increase pro-inflammatory cytokines, (IL-1, IL-6, TNF-α) which also
results in insulin resistance
Ò Microbiota more efficient at energy (calorie) extraction É More calorie absorbed and less in feces Ò Obese pts have less Bacteroidetes which can increase gut permeability. (leaky
gut) -- also inceased firmacutes
Ò Also associated with the bacteria gene species associated with carbohydrate &
lipid metabolism
Ò Early Antibiotic use increases risk for obesity
MICROBIOME FOCUS FOR WEIGHT LOSS
Ò Gut microbiota (and incretins) are altered with Roux-en-Y gastric bypass surgery
(RYGB)—facilitates weight loss
Ò Administration of probiotics after the bariatric procedure has been shown to
accelerate weight loss
Ò Obesity may be positively impacted by these microbiome approaches: É Pre- and probiotics? É Bariatric surgery É Fecal transplantation…..welllllll?
Lei A. Obesity and the human microbiome. Curr Opin Gastroenterol. 2010;26(1):5
WHAT CAN BE DONE TO PREVENT OR DECREASE DYSBIOSIS?
Ò Can’t do much about those pesky genes Ò Sleep Ò Reduce stress as able Ò Breast feed! Ò Get a dog???? Ha! Ò Eat organic $$$$ Ò Avoid PPIs and other biome-disrupting drugs Ò Diet is key! (Especially fiber) Ò Prebiotics, probiotics, synbiotics
DIETARY HELP
Ò Fish & veggies improve the AHR receptors in gut—the “detox
pathway” that is a source of anti inflammation
É BUT…caution is needed
Ò Some studies infer that low fat and high fiber help asthma Ò High fiber (and good amount of gut bacteroides) reduce breast
cancer risk?
É But are pickled veggies or fermented soy good for you….maybe n
not! t!
Helped me Helped patients
SO….DOES DIET CAUSE DISEASE?
Di Dise sease se
Di Diet
THE P PATH T TO P PATHOLOGY I IS N NOT S STRAIGHT
Di Dise sease se
Di Diet
Body size
Physical activity Metabolic differences Cooking & storing
method
Genetic factors
Which ch incr crease ses s or decr crease ses s risk sk
Food co components Microbiome Stress ss
FOODS & & S SUPPLEMENTS M MAY P PROMOTE M MICROBIOME H HEALTH
Ò Prebiotics: prepare a healthy environment for the microbiata Ò Probiotics: provide a variety of microbiota Ò Synbiotics: (both pre- & probiotics) Ò FYI– only thing we know is that probiotics beneficial with
antibiotic use...nothing else is proven
Ò They are NOT like vitamins
Barengolts E. Gut Microbiota, Prebiotics, Probiotics, and Synbiotics in Management of Obesity and PrediabetesEndocr Pract. 2016;22(10):1224-1234
REALITIES OF THE “MICROBIOME” DIET
Ò No randomized trials have fully proven that pre-, pro- or synbiotics (both
pre & pro) supplements beneficial in morbidity or mortality risk
Ò Diets with higher prebiotic-containing food (e.g., high fiber) DO appear
beneficial
Ò Foods with probiotics harder to study due to variable fat and acid content
in probiotic foods
PREBIOTIC FOODS
Ò Helps probiotics thrive (promotes growth & activity of commensal
microbiota (bacti & fungi)
Ò Intake appears to reduce mortality risk with and without DM Ò Also associated with bowel health, anti-inflammation, destressing
(lower cortisol)
Ò Fiber main source of prebiotic in US diet
É Recommend 25-38 g/d (14 g/1000 kcal/day) É Average intake is 12.5 to 18 g/day É Inulin fiber important too!
BEST PREBIOTIC FOODS
Ò Chicory root (coffee flavor) Ò Jerusalem artichoke Ò Garlic & onions Ò Dandelion leaf Ò Leeks & asparagus Ò Banana & apple Ò Jicama root, burdock root Ò Flaxseed Ò Wheat bran…but? Ò Cocao & dark chocolate,,,hooray!
https://thequantifiedbody.net/category/biomarkers/microbiome (accessed 3.30.18)
PR PROBIOTI TICS
Literal meaning:
“F “For l life”
(Elie Metchinikoff, 1907)
Probiotics are living non-pathogenic microorganisms, which may protect the gut barrier, attenuate pathogen
prevent infection.
PROBIOTIC FOODS
Ò Dairy is the most common source of probiotic foods in US Ò FERMENTED dairy: yogurt, kefir, goat/sheep, aged soft cheese
É Aged, soft cheeses—such as cheddar, gouda, parmesan, & swiss best
Ò Other TOP probiotic foods include:
É Sauerkraut, Kimchi, Kombucha É Tempeh (fermented soy) É Miso Soup É Pickles (salt gherkin-in brine), green Olives É Peas?! É Apple cider vinegar É Ginger É Sourdough bread
CHOOSING PROBIOTIC SUPPLEMENTS
Ò Brand Q
Quality –
Ò High C
CFU C Count –
É at l
least 1 15 b billion
Ò Strain D
Diversity
É multiple b
bacterial s strains
Ò Su
Survivability –
Ò DO T
THEY W WORK?
Ò Most b
beneficial s strains
Ò
Bif Bifid idobacteriu ium bi bifidum
Ò
Bif Bifid idobacteriu ium lo longum
Ò
Bifidobacterium b breve
Ò
Bif Bifid idobacteriu ium in infantis is
Ò
La Lactobacillus ca casei
Ò
Lactobacillus a acidophilus
Ò
La Lactobacillus bu bulgaricus
Ò
Lactobacillus b brevis
Ò
La Lactobacillus rh rhamnosus
Ò
La Lactobacillus pl plantarum*
Ò
La Lactobacillus Pe Pentosus
Ò
Bacillus s subtilis
Ò
Ba Bacil illus s co coagulans
Ò
Bacillus lactis
Ò
Sa Sacch ccharomyce ces bo boulardii
Only proven to reduce GI side effects from antibiotic use (take tandem with AB but 2 hours after AB dose)
POINTS ABOUT PROBIOTICS
Ò Probiotics are typically measured in colony-forming units (CFU).
Generally,
É higher doses have been found to produce the best results in most
studies (5).
Ò Some probiotics may be effective at dosages of 1–2 billion CFU
(refrigerated!!)
É others may require at least 20 billion CFU (OTC)
Ò Taking extremely high doses hasn't been found to cause harm.
É But expensive and no added help
POINTS ABOUT THE PROBIOTIC CHOICE
Ò Bifidobacteria have also been associated with reduced gut
leakiness
É High fat diet may reduce this
Ò Lactobacillus is best for anxiety and immune function Ò OTHERS….. Ò Probiotics are one of the fastest-growing sectors in the global
functional food market
WHY IS IT HARD TO NAIL DOWN PROBIOTICS
Ò No FDA or Federal Trade Commission approval Ò Contrary findings…for example
É Lactobacillus reuteri sup
supresses esses immunity by producing histamine (in the presence
stimula ulates es immunity in the presence of H1 receptor
É Apparently dietary content provides biological signals to the microbiome
Ò BTW: Prebiotics can affect the microbiota but are impacted by intestinal
transit time
Ò What about the following popular p-biotics? Floragen, Align and
Culturelle?
FUTURE MICROBIOME HELP
Ò Develop “sense and destroy” probiotics that can activate a
genetic program to kill their microbial target
Ò Fecal microbe transplant (FMT) might become a critical tool to
limit the spread of antibiotic resistance (what can it do to help metabolic diseases?)
Ò Phage therapy (viruses) an old treatment making a comeback
(bacteriophages); good in AB resistance too
Get e enough S SLEEP EEP! And w watch w what y you e eat
It Is Illogical to Assume It Is Illogical to Assume All Individuals are All Individuals are Equally Responsive to Equally Responsive to Drugs, Foods or Food Drugs, Foods or Food Components Components (or have same gut bugs!!) (or have same gut bugs!!)
ckessler@maranatha.net
But first….