Tag Archive for: microbiome

Research Update on Probiotics

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Probiotics are the beneficial microbes that reside in and on our body. When a health headline suggests that taking probiotics may be hazardous to our health, that gets my attention. As a result, I spent the weekend going through two studies published in the journal Cell. That will form the basis of this week’s Memos.

The researchers used a different approach in assessing the microbiome of the subjects before and after the interventions. Typically this type of research uses fecal samples to assess changes in bacterial content. In this case, they used endoscopic procedures to sample the microbiome throughout the digestive system.

The studies had different purposes. The first placebo-controlled trial compared the change in the microbiome before and after administration of a commercially available probiotic. The second trial examined the microbiome before and after the administration of a course of antibiotics in a group of control subjects, a group given probiotics, and a group given a fecal transplant collected before the study began. We’ll cover the results on Thursday.

What are you prepared to do today?

Dr. Chet
References:
1. DOI:https://doi.org/10.1016/j.cell.2018.08.041.
2. DOI:https://doi.org/10.1016/j.cell.2018.08.047.

 

Why You Need Prebiotics

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As kids go back to school, let’s start the week after Labor Day by answering some questions. You know about probiotics, the beneficial microbes that live in and on our bodies and compose our microbiome, but one question that seems to be on a lot of people’s minds is prebiotics: why do you need them?

Prebiotics are substances, typically found in plant-based foods, that can be used as food for probiotics. Two well-known types of prebiotics are plant fibers such as inulin and fructooligosaccharides, or FOS for short. There are undoubtedly many more types, but research in this area is really just getting started.

No matter. If you want to make sure you’re feeding your microbiome, eat your vegetables, fruits, and beans on a regular basis. You don’t have to worry about what the prebiotics are called; they’re in there. Still working on your diet? Take a probiotic with FOS. To back up the fruit sugars, take some soluble fiber such as inulin as well. That’s the way to keep your microbiome healthier and doing its job for your health.

What are you prepared to do today?

Dr. Chet
Reference: Curr Opin Biotechnol. 2016 Feb; 37: 1–7. doi: 10.1016/j.copbio.2015.09.001.

 

More Reasons to Use Probiotics

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One of the most frequently asked questions I get is this: “Should I take probiotics when I take antibiotics? I don’t want to negate the benefits of the antibiotics.” Based on the summary of the Cochrane Review, I think there’s enough evidence to say that you should take probiotics any time you have to be on antibiotics. The research evidence is not perfect and the authors called for more and better research to confirm the results, but there appears to be no harm when taking probiotics during antibiotic use. If it doesn’t harm, then it’s a good idea to do it, even if the rate of C. diff is relatively low to begin with. But it’s a good idea to clear it with your doctor because reasons for taking antibiotics can be different.

There are a couple of things that we don’t know. What is the best type of probiotics to take? And how much should we take? In spite of those unknowns, when examining the data summary of all the studies, there was an overall benefit when probiotics were used. That means whether it was just one strain or several, in differing quantities, they all seemed to work. Whatever probiotic you typically use, take it during antibiotic use until we know more.

Another Review Paper

I’m currently going through a review paper on the brain-microbiome connection (3), and it’s one of the best reviews I’ve read in a long time. I’m still checking the background research; it’s complicated physiology and biochemistry. I can’t get it into the typical three Memos per week so it will be a new Bottom Line in the near future.

What I’ve taken away so far is that we should all be taking probiotics every day, unless there’s a reason you can’t. If you buy a quality product, they’re not inexpensive, but it’s still a good decision based on the potential benefits. In addition, it would be a good idea to add fermented foods to your diet every day: yogurt, especially Greek yogurt, kefir, sauerkraut, kim chi, and more. They all contain a variety of probiotics that can add to your microbiome.

You should also take a fiber supplement every day. Fiber supplements contain prebiotics that feed the probiotics—you’re feeding the good bacteria. In addition, eat foods with more fiber, and that means vegetables and fruits. Again, they can provide positive bacteria to help the microbiome if you eat them raw as well as the food the bacteria needs to thrive.

The Bottom Line

There is a long way to go until we have enough research that identifies the best strains and amounts of probiotics to take as well as the best sources. There’s always the possibility we’ll find a better way, such as eating specific varieties of fruit grown in a specific region of the world that has the right strains of bacteria. We just don’t know. But what we do know is that there are benefits to taking probiotics every day right now. I think that’s the path forward at this point for almost everyone.

What are you prepared to do today?

Dr. Chet

 

References:
1. JAMA. doi:10.1001/jama.2018.9064.
2. Cochrane Database Syst Rev. 2017 Dec 19;12:CD006095.
3. Cell Mol Gastroenterol Hepatol 2018;6:133–148.

 

Can Probiotics Prevent C. Diff?

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Probiotic research is hot right now. Researchers are trying to figure out what these beneficial microbes can do for our health for a number of reasons. What types of infectious diseases can be prevented, whether food-borne or not? What are the best microbes to treat specific conditions? After all, there are estimated to be around 5,400 different bacteria, yeasts, and fungi. Which ones are best for an E. coli infection? Or salmonella? How about inflammatory bowel disease? Can probiotics benefit other organs in the body by not allowing negative bacteria to enter the blood stream? The questions are almost endless at this point.

We may be starting to get some answers. This week I’m going to focus on the role probiotics may play in preventing clostridium difficile, commonly known as C. diff, infections in people who’ve had to take antibiotics for different diseases. Antibiotics are beneficial when we need them but they do not discriminate; they kill microbes whether they’re beneficial or not. As a result, our gut bacteria—our microbiome—can be decimated. As a result, people who are on heavy doses of antibiotics are prone to C. diff infections. While treatable in most cases, it can have devastating effects on some people including severe pain, cramping, and uncontrolled diarrhea. Not fun!

The authors of a recent paper examined whether probiotics, administered with courses of antibiotics, helped to reduce the rate of C. diff in patients. A Cochrane Review paper examines all available studies from around the world, ranks the quality of the research, and analyzes all the data. Some of the authors of that paper published a summary of that review in JAMA. We’ll take a look at the results on Thursday.

DrChet.com

Tomorrow is the anniversary of the launching of the new DrChet.com website. This past weekend I was speaking in Texas, and several people who are Insider members said that the free monthly Insider Conference Calls were very informative and helped their personal health and the health of their family and clients. Think about becoming an Insider as we begin our second year of memberships.

What are you prepared to do today?

Dr. Chet

 

References:
1. JAMA. doi:10.1001/jama.2018.9064.
2. Cochrane Database Syst Rev. 2017 Dec 19;12:CD006095.

 

Health Headline: Antibiotics and Kidney Stones

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For this week’s Memos, I picked three health headlines from the past week and examined the studies behind them to see if they were headline worthy. Let’s begin with the use of antibiotics and the risk of kidney stones.

Researchers in the United Kingdom examined the incidence of kidney stones in over 13 million children and adults between 1994 and 2015. They examined the medical records of over 25,000 subjects with stones and compared them with over 250,000 matched-control subjects. The researchers wanted to compare the use of antibiotics with the onset of kidney stones.

The researchers found that there was a relationship between the use of five different classes of antibiotics and the onset of kidney stones. The relationship appeared to be stronger with younger subjects and the risk lasted longer: up to five years.

Headline worthy? In the abstract, the researchers wrote about the relationship between changes in the microbiome and kidney stones. Antibiotics can cause changes to the microbiome, but they did not test the microbiome of any subjects. Therefore, there’s a statistical relationship but nothing more. On top of that, the risk of getting a kidney stone over 21 years was just 0.19%.

Conclusion: not headline worthy. It’s worth researching further to establish whether there’s a cause and effect relationship along with the role of the microbiome in the process.

What are you prepared to do today?

Dr. Chet

 

Reference: JASN. 2018. doi: 10.1681/ASN.2017111213.

 

Bioavailability Begins with Digestion

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Last Saturday’s Memo introduced a new concept: a systems approach to nutrition. One term that gets bounced around a lot related to dietary supplements or different types of food is bioavailability. Claims are made that “this form of our supplement is 10 times more bioavailable than that form.” It sounds so simple, right? It’s not—we’ll spend this week looking at all that’s involved in bioavailability. It begins with the entire digestive system.

Digestion is the process of breaking down a food or nutrient for absorption. There may be plenty of a nutrient consumed, but it has to be broken down into a form that can be absorbed. That begins in the mouth by chewing, and then the action really heats up in the stomach; acids are released to break the food into smaller molecules, if required. After leaving the stomach, the digestive enzymes begin to work on the food to continue the process. If it’s a nutrient from a supplement, it may be absorbed as it is or it may need to be modified biochemically. As the nutrient continues through the small and the large intestine, it may require a modification by bacteria before it can be absorbed.

There are many points in the process that can affect absorption. Does a person’s stomach release enough acid? Does the pancreas make enough digestive enzymes? Is there enough food that provides chelating agents for minerals? Is the microbiome healthy enough to continue the breakdown of the nutrient? You can see how the system can be affected in numerous places. But we’re not done yet. On Thursday, we’ll talk about absorption.

What are you prepared to do today?

Dr. Chet

 

Reference: http://bit.ly/2raDviy

 

The Microbiome of Your Lungs

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When we think of the microbiome, it’s logical to think only of the digestive system and our skin. In reality, the microbiome includes every microbe in and on our entire body, including our lungs. At one time, the lungs were thought to be microbe free; that certainly seemed to be the case for newborns. As babies are exposed to various bacteria and other microbes, a microbiome develops in the lungs much as it does throughout the body. It seems to have the same balance of good and bad microbes, although not as extensive as the gut.

Research has shown that in serious lung conditions such as cystic fibrosis as well as chronic lung conditions such as asthma and allergies there’s a dysbiosis of the lung microbiome. In other words, the lung microbiome is out of balance.

What can be done to restore the balance? Nothing other than traditional treatments for now, but this is an area of great research interest. I believe that focusing on eating foods with probiotics as well as prebiotics can help our entire microbiome, not just our gut.

Vegetables, beans, yogurt, fermented foods, and fruit should still be the foundation of our diet. Whether it helps the lung microbiome is not known, but it will help the gut microbiome. As we know, what helps the gut microbiome can influence other parts of the body; it’s reasonable to believe that it just may help the lung microbiome as well.

What are you prepared to do today?

Dr. Chet
References:
1. JAMA. 2017;317(17):1713-1714. doi:10.1001/jama.2017.3023
2. http://www.news-medical.net/life-sciences/Lung-microbiome.aspx

 

Potatoes and Your Microbiome

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A Cherokee legend talks of two wolves inside us, one good and one evil. Which one will win? The one you feed. It applies to our microbiome as well. We have good and bad microbes within us at all times. Which ones dominate? It depends on how we feed them.

In a recent study, researchers tested a prebiotic made up of a harder-to-metabolize starch extracted from potatoes. The subjects were a group of elderly and middle aged men and women. The objective was to compare the types of bacteria that responded positively to the prebiotic.

At baseline, the elderly subjects had higher amounts of the bad microbes, proteobacteria such as E. coli, compared to middle-aged subjects. After three months of using the prebiotic, there was a decrease in the bad microbes in the elderly subjects while both groups experienced in increase in bifidobacteria, the good microbes. The conclusion was that the prebiotic helped create a better microbiome balance.

While this was a small study that focused on one type of prebiotic, there’s a lesson. If you have a diet that includes vegetables, beans, and some starchy root vegetables such as potatoes, you will get a variety of prebiotics including the type used in this study. They will help you feed the good microbes to create the right balance in your digestive system. Which microbes will win? Your diet determines which ones dominate.

What are you prepared to do today?

Dr. Chet

 

Reference: DOI: http://dx.doi.org/10.1016/j.clnu.2017.03.025

 

Fiber and Your Microbiome

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Researchers used gnotobiotic mice in a recent study to test the importance of fiber; gnotobiotic mice are born with no bacteria of any type. Researchers used a synthetic human microbiome to introduce a bacteria colony into the mice. Once the colony was established, they withheld fiber from the diet of the mice. Then it gets scary: the mice’s microbiome used the naturally occurring mucus layer of the digestive system as food, which led to exposure of the underlying cells. The mice were exposed to a pathogen similar in effect to strains of E. coli in humans, and the mice that were deprived of fiber became ill as a result of the bacteria and died.

This mucus barrier is the same in our digestive system. The fiber we eat feeds our microbiome; if we don’t get adequate fiber in our diet, the possibility exists that a similar destruction of the mucus can take place.

The solution seems simple: eat vegetables, beans, and other fiber-containing foods to strengthen your microbiome and use a fiber supplement as insurance.

What are you prepared to do today?

Dr. Chet
Reference: http://dx.doi.org/10.1016/j.cell.2016.10.043

 

Men, Their Microbiome, and Infertility

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What role does a man’s microbiome play in infertility? Maybe a lot more than we thought. There are many more factors that affect fertility, with more studies published every day, but this week’s posts have focused on the microbiome. We’ll finish with a study on men.

Researchers examined the sperm of men who contributed semen to an in-vitro fertilization clinic before IVF with their partners. They wanted to determine whether there was a relationship between periodontal disease and sperm quantity and motility—how many sperm and how well those sperm moved. They found that men with periodontal disease had low sperm counts and the sperm were not as active. Those two problems can contribute to infertility.

Just as with women who have periodontal disease, the pathogenic bacteria appear to have an affect on fertility. The same type of treatment for periodontal disease may help fertility issues for both partners. But let me be clear: the microbiome is only one aspect of fertility; there are other issues that contribute to infertility that may also need to be addressed.

What are you prepared to do today?

Dr. Chet

 

Reference: J Clin Periodontol. 2011 Jun;38(6):542-6.