You are what you eat!
So, since I have been off of work for a while I started to catch up on medical literature that is outside of COVID-19 and other million updates in medicine. I have been taking some functional medicine courses in gut's role in our overall health and reading some research when I found this article and thought I would share my two cents. (link included at bottom of page).
I know a lot of people are critical of Physicians for not knowing more about supplements, the gut and etc. but the truth is research is only now taking off in this realm. We hesitate to say things without hard evidence because at the end of the day we want to do the right thing!
Now couple that with the medical world of 10 minute visits, it leaves very little time to discuss nutrition and the GI problems, hence why you are referred out in the hopes that someone else has more time and background in this. Let's be honest the gut-brain axis was a small component of the million other things we have to learn in medical school.
So on to the article. I'll sum it up for you. There is some evidence that a poor gut microbiome leads to decreased cognitive function. Can we help curb Alzheimers, depression and cognitive decline as we age by fixing our gut? Maybe!
Your gut is a space of serotonin production 95% of it is made by gut bacteria so how can it not contribute to mood regulation, memory and learning?
Gut bacteria plays a role in motility. Overproduction of a certain bacteria in the small intestine leads to bloating, abdominal pain, feeling of fullness and constipation.
Bacteria in your gut produces important things like vitamin K and stores it in the fatty tissue and the liver. Vitamin K is necessary in forming clotting factors. This is why newborns get vitamin K shots, to prevent fatal bleeding disorders. Vitamin K is not produced much until they start eating and that gut bacteria has kicked in to do the job. Not enough of vitamin K gets passed through breast milk so the injection of vitamin K helps decrease unnecessary infant deaths.
Your gut microbiome plays a role in your immunity and so much more that I can't list everything here.
Specifically the focus is on short chain fatty acids (SCFAs) such as butyrate, which is a metabolite, important in restoring intestinal barrier function in inflammatory conditions, regulates luminal bacterial interaction and producing antimicrobial peptides as line of defense against pathogens, exerts anti-inflammatory effects and contributes to intestinal homeostasis. Some studies in mice even suggest a role in cancer prevention.
Research has shown some evidence that SCFAs is low in patients with intestinal bowel disease showing loss of microbiome diversity. There are specific bacteria in your gut that produce these SCFAs and it's not as simple as just taking a probiotic to solve this problem. Use of prebiotics, probiotics have shown to not have much effect in Chron's disease but did in Ulcerative colitis. Use of these supplements in Chron's patients can even cause abdominal pain and bloating proving how complicated the gut and microbiome really is. It's not a one solution fits all scenario so treatments must be tailored accordingly. This exactly why fecal transplants were the hope of treating things such as Clostridium dificile infections. I say this because people jump to buying probiotics as if this is the answer! It is...only sometimes.
So how do we improve this?
"Prevention is better than intervention."
Couple of ways and it's not your amazon prime solution, it's about focusing on prevention. Support the good bacteria while you have it. Here are some things you can do.
-Avoid the so-called SAD diet (Standard American Diet), the fast foods, fried foods, the eating out, the processed meat, bread for every meal, and the corn syrup addiction. Invest in a good and diverse food source. Go back to eating the nutritious diet (fresh fruits and vegetables). Broaden your diet. Diversify because just like us different gut bacteria like different things. Too much of one thing can proliferate certain bacteria which will decrease the number of other bacteria. Read my words, YOU DO NOT NEED MEAT FOR EVERY MEAL!
One interesting fact suggested through mice studies is that fermented foods such as pickles, pickled cabbage etc. are enriched in SCFAs and can be used to improve the gut microbiome. This in addition to yogurt (I'm talking about the non-sweetened yogurt that only contains live active culture, no extra sugar/flavoring etc).
-Antibiotic over use. What easier way to kill the good bacteria than to demand a Z-pack or Amoxicillin for every sniffle we have. If you need to see a Doctor let it be for reassurance and evaluation not for an exchange for a prescription. You can't undo antibiotic resistance and trust me you don't want the dreaded diarrhea from C. diff that is on the rise thanks to antibiotic use. But when you do need it make sure you're eating well and hydrating.
-Avoid diabetes. Diabetes means more sugar and bacterial love sugar and will lead to bacterial overgrowth. More bacteria does not always mean better, the goal is diversity, not more of one thing! I have diagnosed few patients with recurrent urinary tract infections and vaginal yeast infection that ended up being their clue to their underlying diabetes condition. We controlled diabetes and thus we controlled their infections.
-Avoid chronic use of acid reflux medication. Why not fix your diet instead? Unless you have risk for certain esophageal cancer/Barett's esophagus and few other reasons most of us should not be using the daily Omeprazole, Esomeprazole, or Zantac to solve our reflux. We should get it evaluated, control constipation, eat smaller meals, avoid certain food triggers and sometimes avoiding certain medications. Sometimes over the counter supplements can cause reflux. Weight loss can help reduce reflux. Coffee, carbonated drinks, alcohol and certain teas can make reflux worse. That stomach acid is a necessary part of digestion to help break foods and kill bacterial/fungus/and other harmful things that may make their way into our gut. Let's not mention there has been an observed association of protnix with c. diff associated diarrhea in addition to other nasty side effects. I know taking these meds are a quick solution to your discomfort, but it's not necessarily the right solution.
-Exercise- helps the gut move, decreases constipation and improve overall health.
-Fasting. Wow, who knew. So many cultures and religions have been doing this but we really are not meant to have something to chew all day long. This is a developed world phenomena and I believe partially to do with being bored/unhappy state of mind. Sometimes your digestive tract needs a break and so does your pancreas. Even the gut microbiome deserves some time off from all the good work it's doing. The only problem is most of us don't know exactly how to prescribe it, so if you don't have a religious obligation involving fasting then at least start with not snacking between meal times and if you're so hungry that you can't do that then maybe we need to look at what foods your eating.
There's a growing body of study to suggest repletion with certain bacteria can improve symptoms, but I will leave it at this now. If you have gut problems and we have ruled out major contributors then it's time to look into how well you're taking care of your gut bacteria for short term and long term benefits.
And don't forget colon cancer screening starts at age 45 and younger if you have family history.
Healthy eating everyone!