Feeding the Microbiome

Presented by Jules Cattell

CHRONO BIOLOGY

LIFE-LOAD

• Antonie van Leewenhoek has been acknowledged with the first research into the human microbiome.1

• In the 1680s, he had compared his oral and faecal microbes and noted striking differences between these two habitats.

• He also compared and noted differences between samples from healthy and diseased individuals.

Where It All Began…

1.van Leeuwenhoek A. Philosophical Transactions of the Royal Society of London. 1684;14:568–574

Gut microbes are key to many aspects of human health including immune, metabolic and neuro-behavioural traits.1

Health & Disease

Valdes Ana M, Walter Jens, Segal Eran, Spector Tim D.BMJ 2018; 361 :k2179

• The Yanomami people in the Venezuelan rainforest have the most diverse microbial flora ever recorded.

• Living in tune with nature and eating a high fibre diet of mostly cassava these people have had no contact with western medications such as antibiotics.1

Healthiest Flora in the World?

1. Sarchet P New Scientist 17 April 2015 https://www.newscientist.com/article/dn27381-is-super-diverse-amazon-microbiome-something-to-strive-for/

• The earth contains a variety of different ecosystems - rain forests, coral reefs, deserts, woodlands, cottage gardens etc

• Each with its own particular communities of species.

• From an ecological perspective, it is thought that biodiversity is the key to resilience of life, the ability of natural systems, to adapt to change1.

Bio-Diversity

1. https://www.ecpa.eu/sites/default/files/7584%2BBiodiversity_V04_bàt.pdf

• Evidence indicates that the microbiota has undergone substantial remodelling over recent decades.

• Analyses of American and European faecal samples revealed 50–80 core bacterial species common to over half of the group.1

• Making up 99% of the total bacteria.1 • Most traditional populations, regardless

of continent, are enriched with species that are now are or absent in industrialised populations.

• Is this loss in diversity significant?

Industrialised Microbiota?

1. Schloissnig et al. Nature. 2013; 493: 45-50 Diagram: Vangay et al Call 2018, 175 (4):P962-972 (permission obtained)

Microbial Diversity - a Good Indicator of Health?

• Lower than normal bacterial diversity has been observed in: - Inflammatory bowel disease1 - Psoriatic arthritis2 - Type 1 and type 2 diabetes3,4 - Atopic eczema5 - Coeliac disease6 - Obesity7 - Arterial stiffness8

• “A species-rich gut ecosystem seems to be more robust against environmental influences, as functionally related microbes in an intact ecosystem can compensate for the function of other missing species”.9

1.Manichanh C et al. Gut 2006;55:205-11 2. Scher JU et al.. Arthritis Rheumatol 2015;67:128-39 .3. de Goffau MC et al. Diabetes 2013;62:1238-44. 4. Lambeth SM, et al. J Diabetes Obes 2015;2:1-7. 5.Wang Met al. J Allergy Clin Immunol 2008;121:129-34 6. Schippa S, et al.BMC Microbiol 2010;10:175. 7. Turnbaugh PJ et al.Nature 2009;457:480-4 8. Menni C et al.. Eur Heart J 2018.9.Valdes Ana M, et al BMJ 2018; 361 :k2179

• For the Yanomami people, infant and maternal mortality rates are high - life expectancy is low.

• Prevalence of infectious diseases.1

• In the 14th century ‘Black death’ caused the loss of 30-60% of the European population.2

• The bacterium Yersinia pestis, is believed to have been the cause.3

Black Death

1. Laserson KF et al The Journal of Infectious Diseases, 1999, 180, (6,): 2081–2085, 2.Austin Alchon, S University of New Mexico Press.2003: 21 3."Plague". World Health Organization. October 2017.

Microbes Have No Morals

• Many bacteria exist along a continuum - sliding from pathogen to commensal.

• Over the last 35 years, Helicobacter pylori has been characterised as the primary pathogenic factor for chronic gastritis, peptic ulcer, and gastric malignancy.1

• Eradication treatment is routinely prescribed. • Some recent studies have suggested a protective role for chronic H. pylori

infection - reducing risk of inflammatory bowel disease by inducing systematic immune tolerance and suppressing inflammatory responses.2

• Escherichia coli, is a healthy competent of the microbiome, contributing to healthy digestion and immune defence.3

• In certain scenarios, specific strains of E.coli can overgrow into a state of dysbiosis yielding negative consequences for the host.4

1.Sugano, K. et al. Gut 2015, 64: 1353–1367. 2.Arnold, I. et al Front. Cell. Infect. Microbiol.2012, 2, 10 3.reid G et al Trends in Microbiology 2001, 9 (9): 424-8 4.Ormsby MJ et al EBioMedicine 2019 Apr 26

• Soil is filled with bacteria, fungi, protozoa, nematodes, mites & micro-arthropods.

• There can be 10,000 to 50,000 species in less than a teaspoon of soil.1

• Much of our soil has been devastated through overuse of chemical fertilisers, fungicides, herbicides and heavy working.

• Soil microorganisms act as the ‘guts’ of plants - digesting and recycling nutrients and suppressing disease.

• Plant diversity improves soil microbial communities, and this in turn suppresses plant disease.

Lessons From the Earth Itself…

1.Amaranthus M and Allyn B The Atlantic Jun 11 2013 https://www.theatlantic.com/health/archive/2013/06/healthy-soil-microbes-healthy-people/276710/

Coombs A The Scientist Jan 1 2013

Cultivating a Healthy Ecosystem

• What we eat, and more specifically what does not get digested and absorbed, affects the population of bacteria that live within our intestines.

• Microbes feed on: - leftovers of digestion - sloughed of cells from intestine - killed bacteria - digestive enzymes and bile.1

Microbial ’Leftovers’

1. Lewis CA Enteroimmunology third edition Psy Press 2015 Caravelle Florida.

Manipulating the Microbiota

• Is it possible to make interventions to improve microbiota and health? • A study placed a group of African American’s on a high fibre, low-fat

African style diet for 2 weeks.1 • The results were increased fermentation of fibres with subsequent

increase in butyrate production and reduction in secondary bile acid synthesis.

• “A change in diet can be accompanied within a couple of weeks by a bloom of new bacteria, and a fall-off of other bacteria”.2

• Diet is a potent lever to control microbiota composition.3

1. O’Keefe SJ et al Nat Commun 2015; 6:6342 2. Walker AW et al ISME J 2011 5(2):220-30 3.Sonnenburg ED & Sonnenburg JL Nature Reviews Microbiology 2019 (17):383-390

• For hundreds of thousands of years, humans have been foragers consuming large amounts of plant material.

• The diets of industrialised societies have increased availability of sugar, protein and fat and the inclusion of food additives such as preservatives and emulsifiers.

• Western diets seem to shift the bacteria in the gut away from those who thrive on fibre in favour of species that thrive on mucus.

Industrialised Microbiota

Sonnenburg ED & Sonnenburg JL Nature Reviews Microbioloy 2019 (17):383-390

Plant Based MAC (Microbiota

Accessible Carbohydrates) diet

Westernised low MAC diet

Dietary MAC degrading Micro-organisms &

SCFA (Short Chain Fatty Acid) producing Micro-organisms

Mucus Degrading Micro-organisms

& Antibiotic Resistant Strains

INDUSTRIALISATION

Dietary Patterns & Microbiota

Valdes A M, Walter J, Segal E, Spector T D. BMJ 2018; 361 :k2179

FODMAP - High or Low?

• A study on people with functional gut disorders compared the low FODMAP diet, with use of the prebiotic fibre galactooligosaccharides (GOS).

• Both groups had significant reductions in symptoms, but symptom reduction persisted for 2 weeks with GOS but reappeared immediately when the low FODMAP diet was stopped.

• GOS supplementation also resulted in higher Bifidobacterum levels, while FODMAP reduced colonies.

• The low FODMAP diet also increased the growth of Bilophila wadsworthia, which is normally only present in minute amounts in the human gut.

• Bilophila wadsworthia is a hydrogen sulphide producer - can cause IBS symptoms, damage to the mucosal lining, & favour pathogenic growth.

1. Huaman JW et al Gastroenterology. 2018 Oct;155(4):1004-1007

One of the Biggest Deficiencies of Our Time?

• Hippocrates was the earliest known physician to study the health benefits of fibre.1

• Epidemiological evidence confirms a strong association between dietary fibre and reduced all-cause mortality risk.2

• Fibre is edible plant material that is resistant to digestive enzymes and thus not broken down into sugars and absorbable compounds.

• Bacterial fermentation of fibre releases energy, vitamins and other useful compounds such as short chain fatty acids (SCFAs).

1.Padayachee A et al Crit Rev Food Sci Nutr 2015 Apr 15 2.Chang SC et al Am J Clin Nutr. 2012 Jul;96(1):164-74

• The diversity and population mass of colonic bacterial species is highly correlated with the diversity and amount of vegetables consumed in the diet.1

• The more different types of plants a person eats, the higher their gut microbiome diversity.2

Eat More Plants

1.Lewis CA Enteroimmunology third edition Psy Press 2015 Caravelle Florida. 2. http://americangut.org/our-results-so-far/

Nutritional Compost

1. Lewis CA Enteroimmunology third edition Psy Press 2015 Caravelle Florida 2. Moshfegh AJ et al J Nutr 1999;129(7 suppl):1407S-11S 3. Muir JG et al J Agric Food Chem 2007 8;55(16):6619-27

Type of prebiotic Found inFructans: e.g.Inulin & Fructooligosaccharides FOS

Jerusalem and globe artichoke, banana, asparagus, garlic & onions, chicory, barley, wheat

Galactooligosaccharides GOS Breast milk and animal milk, green peas, beans, chickpeas, pistachios

Pectin Oranges, pear, apple, okra

Arabinogalactans Leek, carrot, radish, pear, tomaot, turmeric, larch trees

Beta-glucans Oats, barley, mushrooms

Resistant starches Cooked and cooled rice, pasta and potatoes, green bananas, plantains, beans & legumes

Fructans - Inulin & FOS

• Promotes colonies of beneficial bacteria in the colon.1,2

• Promotes intestinal epithelial integrity.3 • Modulates appetite, blood glucose & insulin

levels.4

• Protective against type II diabetes & fatty liver.5

• Increases faecal output & alleviate constipation.6

• Reduces detrimental impact of antibiotics.7 • Lowers beta-glucuronidase activity which can

contribute to oestrogen dominant conditions.8

1.Bouhnik et al. Nutr Cancer. 1996; 26 (1): 21-9 2.Roberfroid et al J Nutr. 1998; 128(1):11-9. 3.Russo et al. Nutr. Res. 2012 Dec; 32 (12): 940-6 4.Guess et al.Nutrition & Metabolism. 2015; 12 5.Kellow et al. BMC Endocr Disord. 2014 Jul 10; 14: 55 6.Chen et al.Nutrition Research. 2000; 20

(12): 1725-33 7.Johnson et al. Nutrients. 2015; 7 (6): 4480-4497 8. De Preter et al. Eur J Clin Nutr. 2008 Feb; 62 (2): 225-31

• Anti-pathogenic & anti-inflammatory - Attenuates inflammation

mediated by Nuclear-Factor Kappa B in intestinal epithelial cells.1

• Promotes Short chain fatty acid production.2

• Lowers beta-glucuronidase activity which can contribute to oestrogen dominant conditions.2

Galactooligosaccharides - GOS

1. Newberg et al. J Nutrition. 2016 Feb; 146(2):358-67 2.Van Dokkum et al. Eur J Clin Nutr. 1999 Jan; 53 (1): 1-7

Resistant Starch

• Resistant starch such as green banana can be fermented by gut bacteria in the large intestine into acetate and then ultimately, butyrate.1

• Improves microbial diversity.2 • Improves insulin sensitivity.2

• Increases production of satiety hormones & helps with regulation of appetite.3

• Supports detoxification by improving gut transit time.4

• Gene expression for glutathione transferase unregulated 3-10 fold (animal study).5

1. Keenan MJ et al. American Society of Nutrition. Adv. Nutri.2015 6(2):198-205. 2. Maier TV et al.American Society fro Microbiology. 2017. 8:5, e01343-17. 3.So PW et al PLoS One 2007;2:e1309. 4. Wollowski I, et al Am J Clin

Nutr2001;73(Suppl 2):451S–5S

Pectin

• Cardio-protective - shows an ability to lower LDL cholesterol.1

• Improves glucose tolerance.2 • Transit time - traditional role as an anti

diarrhoea agent. • Improves nutrient absorption - may

improve absorption of quercetin. • Increases bacterial production of SCFAs.3

1.Brouns et al. Eur J Clin Nutr. 2012 May; 66 (5): 591-9 2.Schwartz et al. Am J Clin Nutr. 1988 Dec; 48 (6): 1413-7 3.Titgemeyer et al. Am J Clin Nutr. 1991 Jun; 53 (6):1418-24

Arabinogalactans

• Occur abundantly throughout the plant kingdom, including leek, carrot, radish, pear, tomato, echinacea and turmeric.

• Increase production of SCFAs.1 • Decreases production and absorption of ammonia.2 • Promote colonies of beneficial bacteria • Immune supportive effects:

- Ability to promote a strong and responsive immune system.3

- Fragments of arabinogalactan digestion can be absorbed into the systemic circulation via M cells of GALT - priming the immune response.3

1.Dion, C et al. Nutr Metab. (London). 2016 Apr 12; 13-28 2.Kelly, GS. Altern Med Rev. 1999 Apr; 4 (2): 96-103 3.Dion, C et al Nutr Metab. (London). 2016 Apr 12; 13 -28 4.

Off the Menu?

• Conventional view is that prebiotics & probiotics should be avoided with SIBO.

• Most studies in this field actual suggest multiple benefits: - Lactobacilli probiotics have been successful in treatment of bacterial

overgrowth related diarrhoea.1 - A lactobacilli & bifidobacterium probiotic was show to be more effective

in reducing abdominal distension in SIBO than metronidazole.2 - Lactobacilli casei with FOS led to significant improvement in SIBO

symptoms.3

1. Gaon D et al Medicina 2002;62(2):159-63 2. Soifer LO et al Acta Gastroenterol Latioam 2010;40(4):323-7 3. Rosania R et al Curr Clin Pharmacol 2013, 8(2):169-72 4.

From Minor to Major

• The bacterium Pseudomonas aeruginosa remains relatively harmless in small amounts.

• Once its population size reaches a certain threshold the bacteria can rapidly overwhelm host defences by activating genes that regulate biofilm formation and virulence.

• These signals are referred to as ‘Quorum sensing’ - a system of stimuli and response correlated to population density.1

• Quorum sensing allows microbial populations to develop more quickly, gain access to more resources, and secure better chances of survival.

1. Miller MB & Bassier BL Annu Rev Microbiol. 2001;55:165-99.

Quorum Sensing inhibitors

• Certain foods have been shown to block the quorum sensing messages released from bacteria: - Garlic.1,2,3 - Cruciferous vegetables - horseradish, cabbage, cauliflower, broccoli,

cress and radish.4 - Foods high in hydroxybenzoic acids: basil, carrot, oregano, rosemary,

thyme, blueberry, cinnamon and strawberry.5 - Bean sprouts, chamomile, chervil, turmeric, garlic, lemongrass,

parmesan cheese, vanilla, yellow pepper, peaches and berries.6

1.Bjarnsholt T et al Microbiology 2005;151(Pt12):3873-80 2. Harjai K et al FEMS Immunol Med Microbiol 2010;58(2):161-83. Smyth AR et al Pediatr Pulmonol 2010;45(4):356-62 4.Jakobsen TH et al Appl Envrion Microbial 2012;78(7):2410-21 5.Huber B et al Naturforch C 2003;58(11-12):879-846. Rasmussen TB et al J Bacteriol 2005;187(5):1799-814

• Make a large proportion of your diet a diverse selection of plants.

• Avoid sugar, sweeteners and food additives • Include prebiotics (food &/or as a supplement).

- Some individuals may not tolerate large amounts of fibre/prebiotics as they lack the microflora for fermentation. Gradual increases are advised.

• Probiotics can then sustain the beneficial populations of bacteria. - Include probiotic foods such as sauerkraut,

kimchi, kefir etc. • Eat mindfully. • Fast - aim to eat the same calories in 2 meals.

Feeding Your Microbiome

Cultivating a Healthy Ecosystem Non-Dietary Factors

Harmful Habits

• Antibiotics (medicinal or via food chain) • Medications such as NSAIDs & laxatives. • The use of oral contraceptives1, hormone replacement therapy & infertility

treatments.2 • Antibacterial mouthwashes. • Over-cleaning - use of antibacterial sprays, hand sanitisers, body washes etc.

Use of detergents can disturb the natural lactobacilli in the vagina.3 • Chlorinated drinking water. • Poorly rinsed dishes. • Food preservatives and colouring agents. • Fast food diet - high sugar/refined vegetable oils/grains • Sterilised and pasteurised foods. • Spending too much time indoors - modern humans spend 90% of their time

indoors.4

1. Mårdh et al. BJOG 2003;110 (10):934-37 2. Schiefer Mycoses 1997;40 (Suppl 2).:33-36 3. Nwokolo et al.Drugs Ageing 2003; 16 (5):335-9 4.Klepeis NE et al J Expo Anal Environ Epidermiol 2001;11(3):231-252

Is There a Microbiome EMF interaction?

• Research is still limited but there is evidence that microbes are affected by exposure to electromagnetic fields.

• E coli & Listeris monocytogenes showed significantly higher growth rate after exposure to radiation equivalent to a mobile phone and wifi router1.

• Wifi and mobile exposure have also been shown to increase antibiotic resistance.1

• The effect of EMF on lactobacilli has also been studied. High frequency radiation appeared to affect bacterial DNA inhibiting growth.2

• Does an unhealthy microbiome enhance side-effects of EMF…and vice versa?

1. Taheri M et al Dose Response 2017 Jan 2.Vasistha S & Garg A J of Chemical and Pharm Res 2016,8(7):123-126

• Spend more time outdoors & open windows.

• Avoid over cleaning - house and body. - In fact get dirty!

• Minimise EMF exposure: - Use ethernet in preference to wifi. - Turn wifi off at night - Use airplane mode on phones at

night - Use headphones - always!!

• Learn, and make time, to switch off. - If you’re stressed, so are your bugs3.

The Life Your Bacteria Would Choose

1. Cellini L et al Bioelectromagnetics. 2008 May;29(4):302-11 2 Inhan-Garip P et al E. Int J Radiat Biol. 2011 Dec;87(12):1155-61 3. Wang B et al Dig Dis Sci 2011;56(11):3187-94

“No matter what infection these patients are fighting, you always need to support the terrain, immune system, and detox pathways”.

“Supporting these can often bring even the sickest of patients back without any antimicrobial treatment on board”.

Dr Drew Sinatra

Parting Words…

Key Products

Are you eating enough soluble fibre? Prebio NutriPowder - an all-in-one blend of plant prebiotics to support

the balance of the gut microbiome and energy/fat metabolism

• Jeff Leach of the ‘human food project’ says we should eat 25 different vegetables a week!

• Prebio NutriPowder includes a wide range of different prebiotics to mimic a highly varied diet including inulin, FOS, GOS, apple pectin, acacia gum, arabinogalactans and resistant starch.

• Instantly increase your dietary diversity!

• Normally prebiotic products are quite simple and contain only 1 or two types, usually FOS or inulin.

• Prebio NutriPowder is unique in its breadth and potency of prebiotic fibres, mimicking the optimum human plant diet and increasing microbial diversity.

RRP: £32.95 Size: 165g

Code: 141165

Prebio NutriPowder

Support Your Gut Integrity GI Complex - All-in-one blend of nutrients to repair the gut barrier, reduce

inflammation, and optimise gut immune response

RRP: £30.95 Size: 150g

Code: 731150

GI Complex

• Improved formulation with Glutamine, N-Acetyl Glucosamine, Nucleotides, Alpha Lipoic Acid, Ginger, LAB4 probiotics, Lactobacillus salivarius, antioxidants A, C, & zinc.

• Nucleotides are essential for tissue and DNA repair, including gut epithelium.

• In an easy to take & flexible powder form especially suitable for people who want to avoid tablets and capsules.

• Suitable for children, at a reduced dose. • Easy to mix into water or make into a smoothie for convenient

daily nutrition. • Combine with other powders to personalise your nutritional

support. • NEW BASE - Naturally flavoured with xylitol, stevia, apple and

blackberry. Berries provide antioxidant support. • Free of unnecessary ingredients and allergens, NOW dairy

(whey) and FOS free. Now in glass bottle!

BioCare International Distributors

Country Company Contact

Chile BioConnect contacto@biocarechile.cl biocarechile.cl/

Cyprus Pharmavet Ltd aypavlos@cytanet.com

Dubai Organic Foods and Café organicfoodsandcafe.com/

Estonia Via Naturale Oy info@vianaturale.ee vianaturale.ee/

Germany Agnetha Henne agnetha.henne@web.de

Greece Healthcode info@healthcode.gr healthcode.gr/

Ireland Natural Medicine Company pharney@naturalmedicine.ie naturalmedicine.ie/

Israel BioCare Israel info@biocare.co.il biocare.co.il/

Italy Natur Srl info@natur.it natur.it/

Lithuania Idejos Partneriai agneta@molecule.lt molecule.lt/

New Zealand Pacific Health chrisreiger@pachealth.co.nz pachealth.co.nz/

Norway Au Naturel Inc firmapost@solaray.no solaray.no/

Slovenia Nutrigen D.o.o. frenk@nutrigen.si

Switzerland Nourish Me info@nourishme.ch nourishme.ch

Goodnight!

• A recording will be available and we will send you your CPD. • Watch out for our new Autumn education programme, including the next

webinar. New dates to be released in late June.

www.biocare.co.uk/education

• Have a great evening and remember to Feed Your Microbiome!