Good bacteria

I opened up the paper today and right there on the front page of the Washington Post (Oct. 11, 2011) was the headline that screamed, "'Good bugs'  may be the key to staying healthy."

What a way to start the morning... good news all around!  For years, clinicians have been touting the significance of the beneficial bacteria in the body.  We are still very far from knowing the details and all the benefits they bring, but it was so good to see a very main stream outlet think this news worthy of the front page.  Not that long ago, the folks that advocated probiotics and yogurt consumption were thought of as grungy, granola-loving, hippie health nuts.  In less than a decade, that has turned around to the point where there is genuine interest from conventional health care professionals, doctors and researchers alike.  The article quotes Rob Knight, a professor at the University of Colorado as saying,

"In terms of potential for human health, I would place it with stem cells as one of the two most promising areas of research at the moment."

The author of the piece, Rob Stein, writes,

"Moreover, scientists are becoming more convinced that modern trends — diet, antibiotics, obsession with cleanliness, Caesarean deliveries — are disrupting this delicate balance, contributing to some of the most perplexing ailments, including asthma, allergies, obesity, diabetes, autoimmune diseases, cancer and perhaps even autism."

These bacteria are so important.  It leads to the question, what is causing a disruption in the balance, health or functionality of these populations of bacteria.  If these bacteria are potentially involved in all these diseases, then what causes their dysfunction?

When you take a step back from this piece and assess it in its entirety, it paints a very clear picture that most chronic diseases process are multifactorial. If most chronic diseases have a multifactorial origin, then shouldn't the therapeutic effort also be multi-pronged? 

To say it differently, while many pharmaceuticals have enormous potential, doesn't it stand to reason that in the absence of healthy lifestyle, even the most powerful drug will be handcuffed in terms of efficacy.   If Mr. Stein is reporting accurately and many scientists are concerned that diet and other variables are disrupting the delicate balance, then how can we restore health in the absence of a healthy diet?

Science will always reveal greater insight into the mysteries and complexities of our physiology.  But while we are waiting for more and more truth to emerge, let's also keep in mind that science also often validates "common sense" principles as it pertains to health.

Multiple Sclerosis 3- Gut

The gut appears to have particular significance in managing MS.  It is an emerging area of research so let's look at some recent findings.

In one study, alterations in the gut microbiota (in mice) significantly altered the susceptibility to autoimmune encephalitis.  (Autoimmune encephalitis is the experimental model for multiple sclerosis in mice.)   In this particular paper, mice who were put on antibiotics to wipe out the bacteria in their guts fared better than those that did not take antibiotics.  Based on what we know about gut microbiota, this may be somewhat surprising as we generally think of these bacteria as protective.

However, the authors conclude that "microbial populations that selectively persist in the gastrointestinal tracts of mice treated with antibiotics... could be inducing the antiinflammatory reactions reported in this study."  In other words, there are bacteria in the gut that seem to have a protective effect in this condition.

These findings were confirmed by researchers at Cal Tech.   These researchers state, " intestinal microbiota profoundly impacts the balance between pro- and antiinflammatory immune responses..."  They go on and "suggest that modulation of gut bacteria may provide therapeutic targets for extraintestinal inflammatory diseases such as MS."

 If these findings are accurate, then it would appear that healthy gut bacteria are necessary to protect the brain from inappropriate immune assault.  We do not know to what extent this protective effect exists.  We do not know what co-factors are necessary. We do not know to what extent healthy gut microbiota reduce the progression in those individuals already with the disease.  There is so much we have to learn.  But this much is clear; disrupted microbiota massively influence immune function.  The degree and extent of immune disruption is related to MS.

Let's try and make this meaningful to the current MS patient; it stands to reason that maintaining a healthy gut should have some priority.  This line of research opens up new questions that are pertinent to individuals with MS.  What destroys gut bacteria?  What foods?  Additives/preservatives/toxins? Lifestyle habits? How can I maintain a healthy balance? 

A healthy gut is essential for everyone; with or without MS. 

Heart Disease- Gut

The gut appears to be the root of many problems, including heart disease. This may be a result of increased bacteria and their toxins crossing the gut and affecting heart function.

Unfortunately...
"In recent research, the gut has received very little attention from cardiologists as its role in the pathogenesis of cardiovascular disease is poorly understood." Eur Heart J 2005 Nov;26(22):2368-74. Epub 2005 Jun 24.

However, we are beginning to understand that when you have a leaky gut, you experience ...

"chronic inflammation and malnutrition....therefore, future studies need to address the pathophysiology of the intestinal barrier whose reactivity seems to be crucial for heart function." Curr Opin Clin Nutr Metabl Care 2008 Sep;11(5):632-9.

While leaky guts may adversely affect heart health, the bacteria that live in the gut also play a role. Microbiota that normally reside in our gut have profound implications on many aspects of human health; the heart is no exception.

"Understanding these microbial activities is central to determining the role of different dietary components in preventing or beneficially impacting on the impaired lipid metabolism and vascular dysfunction that typifies coronary heart disease and type II diabetes."
Curr Med Chem 2006;13(25):3005-21.

An important point to make here is that people who have problems with their gut often have absolutely no gut symptoms! Common extraintestinal manifestations include,

"symptoms of physical distress, such as fibromyalgia and irritable bladder and alterations in vital functions, such as sleep, libido, appetite and energy level." European Journal of Surgery Volume 164, Supplement 583, 31 December 1998 , pp. 29-31(3)

If you have heart disease, be sure to ask your doctor about underlying gut dysfunction that may be making your heart condition even worse.

Weight Loss Strategies- Probiotics

Gut microbiota (aka the normal bacteria that live inside your gut) also play a role in weight regulation. This article in Interdisciplinary Perspectives on Infectious Disease (Dec 2008) describes how important these bacteria are.

"... imbalances in the composition of gut microbiota have been associated with susceptibility to infections, immune-based disorders, and recently also with insulin resistance and body weight gain"

Does an imbalance in gut flora promote obesity or do obese people have imbalances? It becomes a bit of a 'chicken and egg' scenario. More than likely, it's a bit of both.

Without a doubt, steady diets of junk food promote obesity as well as gut flora imbalances. On the other hand, when gut flora balance is disturbed, energy regulation, nutrient absorption, immune function and hormone activity are all dysregulated.

From the same article above,
"The metabolic role of the gut microbiota is essential to the biochemical activity of the human body, resulting in salvage of energy, generation of absorbable compounds, and production of vitamins and other essential nutrients... "

Bottom line:
Probiotics may play a role in your overall strategy toward weight loss. It is not a weight loss method alone. But it plays a significant role in shifting your overall physiology to health and metabolic balance.

Your Gut and Brain are Married

If you have seen your neurologist recently, you may need to be screened for celiac disease.

I wanted to share a recent journal article from the Canadian Journal of Gastroenterology that talks about neurological disorders in adults with celiac disease.

If you have gluten intolerance, your only symptoms may be nerve pain! Or it may be dementia, ataxia or other symptoms you are likely to see your neurologist for. Let's put this in perspective folks; this is a GUT journal talking about how your GUT affects your BRAIN.

The brain and the gut are married together. Convinced of this fact, these authors recommend screening for celiac disease in patients with neurological symptoms.