By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
You may think you know your body, but I’ll bet you didn’t know your body serves literally as a hotel for something like a hundred trillion bacteria, most of them in your intestines. You likely never realized it but you are providing food and shelter for masses of microorganisms and how you treat them has a lot to do with how healthy or unhealthy you are, and even your mental state.
I’m not exaggerating about the importance of your inner bacteria. Experts are currently harking the dawn of “a new era” in medical research that is constantly shedding light on the critical role of this collective “forgotten organ” – known variously as microbiota, bacterial flora, and microbiome – in health and disease.
Ninety-five percent of your bacterial residents live in the nooks and crannies of your gastrointestinal tract. As a population, they outnumber the cells in your body, and if you weighed them altogether they would tip the scales at about 3.5 pounds.
A 2014 article in the Journal of Medicinal Food describes them as a “bioreactor programmed to synthesize molecules which direct the mammalian immune system, the mammalian epigenome, and regulate host metabolism.” What that means in plain English is that they produce a multitude of substances that speak to, and influence, your immune system, your genes, and the countless cellular mechanisms that govern growth, maintenance, and response to environmental changes.
That covers an awful lot of activity influence, from your resistance to illness and infections, to your energy level, to digestion, bowel health, and elimination, to sleep, and, yes, even how much you weigh. Researchers are also intensely studying relationships to the central nervous system, neurologic disorders, and cognitive and emotive function.
People normally think of bacteria as agents of sickness with the potential to wipe us out. Indeed, many strains of bacteria are pathogenic. But surprisingly, many strains are absolutely central to life and health, and are, if you think about it, part of the very fabric of who and what you are. It is the colonies of these vital strains, commonly called probiotics, that you want to promote.
Probiotics is a word derived from the Greek that means “for life,” and the most famous of these bacterial “good guys” is the lactobacillus family, among them acidophilus. This common component of yogurt is highly active in your small intestine. Bifidobacteria, another great bacterial family, protects your colon.
Within the bacterial universe of your gut a sort-of turf warfare is being waged between varying and vying bacterial strains, all of whom produce substances that respond to the ever changing environment. What you eat, the medications you take, the stress in your life, are factors that can effect stability and favor one side or another. Even traveling by air may affect your microbiome (more on that in a moment).
The bottom line is this: in return for the warmth, shelter, and food you provide your friendly bacteria, they carry out many important duties on behalf of you − their host.
Tom Sult, M.D., a Minnesota physician who has been prescribing microbiome-improvement strategies to improve the health of his patients for more than two decades, puts the symbiotic relationship this way: “Are we humans carrying the microbiome or are we a microbiome carrying a human?”
In 2015, I talked to Dr. Sult, about the importance of keeping our microbiome healthy in order to keep ourselves healthy. Here are excerpts from my interview:
Dr. Sult: This is a big deal. So much of our immune system is located right in the gut, in the populations of these microbial colonies. Until recently, we have grossly underestimated their impact on health. And in order to have optimum health, we need to have an optimally-healthy microbiome. This was understood so many years ago by visionary healers, people like Bernard Jenson, D.C., who preached the message that disease and death starts in the gut and colon. Today, we have become an antibiotic nation and the overzealous use of antibiotics has wreaked great havoc on our natural gut flora. To be sure, antibiotics do a lot of good things, against pneumonia and acute infections, just to name a couple of things, but the impact on the gut has been disastrous. One of the reasons that we are seeing so many bizarre illnesses and rise in auto-immunity has a lot has to do with destruction of the gut flora.
Dr. Sinatra: For sure, antibiotics have long been overused by doctors. What’s more, there hasn’t been any awareness of the fact that antibiotics kill not just the bacterial pathogens but the friendly bacteria as well, which opens the way for pathogens, or less desirable strains, to recolonize the gut. Doctors haven’t been trained to use probiotic supplements, for instance, as a strategy to replant good bacteria.
Dr. Sult: This is definitely, and unfortunately, overlooked. Maybe with all the growing interest in microbiome research, doctors will realize they can help their patients in very simple ways.
Dr. Sinatra: Dysbiosis is a common phenomenon meaning basically a deficiency of the beneficial bacteria, and doctors aren’t paying much attention to it even though it has been cited as a causal factor in so many problems, ranging from food allergies and inflammatory bowel conditions, to even possibly autism. I understand that the microbiome is currently a leading focus of interest in autism research. Dysbiosis often follows taking antibiotics, chemotherapy, and antacids, and can lead to an overgrowth of one of the resident bacteria called Clostridium difficile, a prime culprit in infectious diarrhea. The point is that we do so much to disturb the good bacteria. Not just the drugs, but basic lifestyle issues like poor, unnatural diets overloaded with sweeteners, and stress.
Dr. Sult: That’s correct. Diet is indeed a major culprit in all this, and specifically the progressively refined diet. The impact of food on the microbiome is, in fact, an area of intense study at this time, and particularly on the metabolic repercussions relating to obesity, diabetes, and cardiovascular disease. People often don’t want to clean up their diets. They just want to take a pill. You used to go to a store and buy staples. And you would make your meals. Now, you buy processed, ready-made food, full of junk, added sweeteners, and substances you never heard of. This is a huge factor that helps explain why the microbiome is taking a shellacking. The microbiome used to be a rainforest, and now it is like the desert. It is not the same robust microbiome as before. It has modified, and typically not for the best, in reaction to the food and chemicals it is exposed to.
Dr. Sinatra: Can you offer more examples?
Dr. Sult: Every week there is some new paper coming out on microbiome disruption on depression, on arthritis, or some autoimmune disease, or cardiovascular disease, and on and on and on. There was an astounding study with laboratory mice that showed how bad artificial sweeteners are, and how they derange the microbiome and appear to contribute to insulin resistance…
Dr. Sinatra: Which of course is at epidemic proportions, and a forerunner of diabetes and cardiovascular problems. I also found the research quite revealing and reported on the study in 2014.
Dr. Sult: The research concluded that non-caloric artificial sweeteners in both mice and humans increase the risk of glucose intolerance through adverse metabolic effects as a result of intestinal dysbiosis. The researchers call for a reassessment of the widespread use of such products.
Dr. Sinatra: And it is not just the artificial sweeteners, but the excess sugar as well, and all the refined carbohydrates and white flour products that get broken down into sugar.
Dr. Sult: Absolutely. Whatever you eat changes the microbiome in some way. If you eat sweets and simple carbohydrates, and fast foods, you are going to have a simple microbiome that allows the less desirable strains to proliferate. If you have a complex diet, you are going to have a more complex and robust microbiome. With the former, the broad balance is upset. Sugar and other sweeteners give a marginal leg up for the less desirable bacteria that actually replicate somewhat faster than the more desirable bacteria. So, if you preferentially fertilize the less desirable colonies, they will slowly but surely overgrow the gut, and you will end up with an unfavorable, less protective balance leading, among other things, to low-grade inflammation, hyper-permeability (leaky gut), food sensitivities, auto-immune disease, and other dysfunction. The imbalance leads also to insulin resistance and weight gain. What’s more, there is also good evidence that the microbiome actually influences our food cravings. An unbalanced microbiome craves sugar. It sends out signaling molecules for sugar. That’s not what you want to be eating.
Dr. Sinatra: What else has been found to alter the microbiome?
Dr. Sult: There’s a distinct possibility that flying over great distances is not in the interest of your beneficial bacteria. Gastrointestinal symptoms are common with mountaineers, and researchers believe that one cause is the accompanying lack of oxygen that has the potential to alter gut microbial composition. When you fly on a commercial airliner for hours, as so many people do, you may also be disturbing your microbiome in the same way. There is no precise research yet on flying and gut health, but something is going on. The cabin pressure of an airliner is about the equivalent of 8,000 feet, so you aren’t getting as much oxygen as you normally would get, and what you do get is recirculated air, including ‘air soup’ full of spray from your fellow passengers’ cough.
Dr. Sinatra: Everybody flies these days. I fly a lot, and never thought of this connection. How do you address this potential issue?
Dr. Sult: I am waiting for the research that will confirm flying as harmful to your microbiome and one reason why so many people get sick after long flights. We have to remember that the gut bacteria have a lot to do with the immune system, how good it works or doesn’t work. Meanwhile, I tell my patients to take a vitamin D supplement (2,000 IUs daily) and to increase their daily probiotic supplement intake for at least three days before, during, and three days after a long flight. For travel, I recommend taking a good multi-strain probiotic with about 100 billion units. Most probiotic servings are in the 30 billion range, so you would take that much three or four times a day. Many patients take the higher dosage during their entire trip. That includes folks who go to Mexico for the sun in the winter, and even eat the street food the whole time they are down there. The feedback I get is that they never have any problems. I’ve been using this travel strategy for years and my patients just don’t get sick. This is powerful prevention.
Dr. Sinatra: And what do you recommend for routine supplementation?
Dr. Sult: It is good to routinely take fermented food such as sauerkraut, plain yogurt or kefir, all of which are loaded with beneficial bacteria strains. However, I also strongly recommend taking a multi-strain probiotic supplement in the 15 to 30 billion range. Such a practice helps keep the good guys in your gut strong and happy.
Dr. Sinatra: What about kids? Can they benefit as well from beneficial bacteria?
Dr. Sult: Absolutely. A 2015 study in the European Journal of Clinical Nutrition reported an experiment in which 57 children, ages 3-6, were given a multi-strain probiotic supplement along with a small amount of vitamin C (50 milligrams) for six months. The kids had a significant reduction in the incidence of upper respiratory tract infections, namely colds, the number of days with symptoms, and the rate of absence from school or preschool. These kids also needed less medication. The researchers used a daily supplement with 12.5 billion bacterial units. In my own practice, I recommend 10-20 billion units routinely for kids and have had similar results. Many of my young patients’ parents tell me their children bring home far fewer colds than they did prior to taking the probiotics.
Dr. Sinatra: Do you see doctors and the public become more aware of probiotics and the microbiome in the future.
Dr. Sult: Absolutely. I regard the microbiome as a genuine organ in the body, and I’ve described it as the “forgotten organ” for years. We ignore it at our own expense. The research is growing, so I expect awareness will grow. Within the overall growing interest in the microbiome, there are advances in fecal transplantation methods, as strange as it sounds, where good bacteria are harvested from healthy individuals and transferred to others. I have personally used this practice among patients with success, along with other methods, for a variety of conditions, including inflammatory bowel disease and irritable bowel syndrome. At this point, the Food and Drug Administration only permits doctors to use fecal transplantation as a treatment for diarrhea associated with Clostridium difficile. As such, it is very effective. One company is now developing a standardized fecal-derived probiotic capsule. So you will be hearing more about this promising application in the future.
Dr. Sinatra: There are so many unexplained illnesses today. The research on the microbiome makes it increasingly clear that answers – both partial and whole – may indeed be lurking among the trillions of bacteria in our GI tract. Until these connections become clear, however, it seems that fortifying the gut with probiotics is truly good medicine, along with staying away from the carbohydrate loaded diet, and eliminating as many of the impurities and sweets as possible. Thank you, Dr. Sult.
References & Resources:
- 3rdopinion.us – Dr. Thomas A. Sult, M.D.
- Quigley EM. Gut bacteria in health and disease. Gastroenterol Hepatol, 2013. 9(9):560-9. Published online at http://www.ncbi.nlm.nih.gov/pubmed/24729765
- Galland L. The microbiome and the brain. J Med Food, 2014. 17(12):1261-72. Published online at http://online.liebertpub.com/doi/full/10.1089/jmf.2014.7000#utm_campaign=jmf&utm_medium=email&utm_source=pr
- Suez J, et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature, 2014. 514(7521):181-6. Published online at http://www.nature.com/nature/journal/v514/n7521/full/nature13793.html
- Adak A, Maity C, Ghosh K. Dynamics of predominant microbiota in the human gastrointestinal tract and change in luminal enzymes and immunoglobulin profile during high-altitude adaptation. Folia Microbiol (Praha), 2013. 58(6):523-8. Published online at http://www.ncbi.nlm.nih.gov/pubmed/23536261
- Carvalho A, Poirier V. So you think you can fly? Determining if your emergency patient is fit for air travel. Can Fam Physician, 2009. 55(10): 992–95. Published online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762297/#!po=1.38889
- Garaiova I, et al. Probiotics and vitamin C for the prevention of respiratory tract infections in children attending preschool: a randomised controlled pilot study. Eur J Clin Nutr. 2015;69:373-379. Published online at http://www.nature.com/ejcn/journal/v69/n3/abs/ejcn2014174a.html?WT.ec_id=EJCN-201503
- The Fecal Transplant Foundation. What is fecal microbiota transplant? Published online at http://thefecaltransplantfoundation.org/what-is-fecal-transplant/
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