HI, I'm Wendy Zukerman you're listening to Science Vs… from Gimlet Media, we are back with a brand new season…and today we are pitting facts against feces as we dive into the science of the gut…
Over the last few years we've been hearing more and more about all the gut bugs that live in our belly[1]… And how important they are for our health. And these days - it's like you can't open up instagram or grab a shopping trolley without seeing some product saying it'll fix up your gut bugs… and keep you healthy. And so I went out to the supermarket - to hunt for these products that are promising to help me with my gut…
Do dodod o
My gut
do dododo
Alright I'm heading in…
Kefir, here, referred to ancient texts, Kefir is more than probiotic superfood.
Kimchi - it's a fermented super food,
Now we're in the Kombucha[2] section… with billions of living probiotics supports digestive health
Sauerkraut - on the back it says gut smart and just plain good
It's not like this stuff is new… it's just they have a sparkling new image… like when my great grandparents were buying Sauerkraut in the old country.. they weren't saying it was a probiotic superfood … But still at the shops I wasn't done yet… there were still the bottles of probiotic pills
Supports healthy digestion
Helps digestion after meals
There's a lot of digestion…
Promotes healthy and comfortable movements! They're talking about poo
But it wasn't all about my poo ... Some products were saying they can keep my brain healthy[3]
or even help my immune system[4]…
How would that work?
That’s what we’re digging into today. Cos… the wellness industrial complex[5] says that you should be taking probiotics every day - like a vitamin. These companies say their products are chock full of bugs that can supercharge your gut and put you in the peak of health[6]. And the thing is - we do know there's bunches of bacteria, viruses, fungi and other stuff… happily living in our gut and on our body[7] … So… can all the bugs living in us be that important? And can these products really help you out?
When it comes to the gut there's a lot of
Probiotic superfood!
But then there's science…
AAHHHH
Science Vs The Gut and all the creatures inside it … coming up after the break….
PRE ROLL
Welcome back… today we’re getting down and dirty with our gut bugs ... and working out what you can do to keep yours healthy…
So there’s all these bacteria and other little tackers in and on your body… known as the microbiome… And basically from the time we're born… these bugs just jump all over us[8]… you can get them from your mum's vagina[9] your dad's skin, from your environment[10][11][12] and the food we eat[13]. ... And there's a lot of them.
IB I mean in total there are trillions and trillions[14] of organisms in our gut
This is Ilana Brito[15], a professor of biomedical engineering at Cornell University. And Ilana says that while most of these microbes live in our gut[16][17]… you can also find them elsewhere too.
IB We have a lot of microbes around our mouths and our gums, and they're totally different to the microbes found in our gut[18]. They're almost different habitats in the world, rainforest, tundra
And what science has come to realise is that all these bugs … they aren't just lazing about… they're hard at work… Like, let's zoom in to what they're doing in your gut. Because, funnily enough, this is kind of what the marketing hype gets right.[19]
WZ On a scale of 1 to 10 how important is the microbiome to a health gut
IB Oh I would put it at a 9 or 10, we definitely need them
So we know that when we eat certain foods… bacteria in our gut can mulch them up and then spit out these products called fatty acids[20], which do a bunch of things - like help our metabolism[21][22] and repairing cells lining our gut[23][24][25] . Another thing gut bugs can do?
IB They directly synthesise vitamins for us
WZ what!
IB Yeah
Bacteria in our gut can make B vitamins[26],[27], [28] and Vitamin K[29]
WZ Why is the bacteria going to all this trouble?
IB It's just them making a living, we basically benefit from their byproducts
WZ I love that I love how you put it that we are benefiting from their byproducts, I feel like we're so human centred, but we're benefiting from their poo in a way
IB Yeah, just like they're benefiting from ours.
WZ Right
And to Ilana the fact that gut bugs are doing all this stuff for us - kind of makes sense when you think about the fact that we evolved alongside these tiny critters ever since we were tiny critters[30][31],. And now? We’re basically a ball of human and microbe cells…
IB So after all of these millions of years of evolution we've figured out ways of surviving together and helping each other out, so that we can all live happily ever after, pretty much! And we're just learning all the things they can do. I kind of feel like these bacteria have superpowers!
So that's just some of the superpowers of bacteria in our gut: making vitamins for us, and pumping out fatty acids[32]. But just how powerful can they really be? Next we’re going to dive into this other big idea that's being flaunted about our microbiome: that it can work wonders for our immune system.
How would that work?
To find out more, I went on a trip… to Bethesda Maryland… (this was before the coronavirus)...
WZ I'm here at the National Institutes of Health, time for Science! Science!
** cough**
Hello hello, Hi I’m Wendy
This is Dr. Yasmine Belkaid[33],… she's an immunologist who came to the NIH a couple of decades ago from Algeria, via France,.. and fell in love..
YB It was like a candy store, this is amazing, you had an enormous amount of research all fields were represented I thought it was the best place on Earth
Yep, Yasmine is possibly the first person ever to refer to Bethesda, Maryland, as the best place on Earth - but she is a massive nerd… And I came to see Yasmine because she heads up this lab that.. has one of the best tools scientists have to unravel the mysteries of the microbiome: GERM. FREE. MICE[34]. That is mice that have been created no basically no microbiome. And scientists create these mice to see what happens in the body when the bugs are gone.
Only problem? Making these mice is tricky because bugs are EVERYWHERE. In the air. On the ground. In food[35].
YB You may not realise there are microbes around us ready to contaminate
They also cover us from the moment we're born… So how the devil do you do this, that is:
YB How do you make mice that is germ free?
Well, it has to start from the moment the mice are born. The researchers don't want them to pick up microbes from a mousey mum's vagina… Because the vagina of a mouse mum… and your mum by the way… is teeming with bacteria[36]… so they do tiny little mouse C-sections[37]
YB This can be maintained sterile, because they can actually be collected sterilely.
Then they give the mouse babies to a mum that’s also germ-free. It all sounds like a chapter from A Hand-Mouse-Tail. From there, Yasmin's task is to create an artificial world with NO MICROBES… I got a peek inside
Door opening…
Yasmin took me inside a room with basically a very hot, giant oven -
YB Which is not very glamorous but it’s an autoclave
it's called an autoclave and before stuff gets near the mice. It has to be popped inside this autoclave ... To kill off any possible germs
YB The food, the water, the bedding, the cages.. Everything needs to be autoclaved
All those things get wrapped up and taken across the hall to where the squeaky clean germ free mice live…
WZ So we're about to head into the facility where the mice have no germs…Yeah
Wait wait…I almost ruined everything!!
YB They’re going to dress you
Woopsy… I need some protective gear. Cos I'm full of bacteria..
YB As you can see we're all wearing hats, masks and lab coats… so good. Ok!
We walk into the room with the mice… And the first thing I noticed are the cages... they're not normal...
YB These are these bubbles,
they kind of look like an aquarium, made of flexible plastic
YB It's a big plastic bubble on this bizarre white table, with a lot of like cylinders and things around… So,what you see inside is completely sterile,
WZ And how do they breathe in the bubble? How do they breathe clean... non germy air?
YB It’s entirely filtered.This bubble has to be maintained in a perfect condition, a tiny hole that would be with a needle will destroy an entire experiment.
OK, so that's what it takes to get yourself a germ free mouse... and the thing is these little beasties? they look like regular mice….
YB Completely fine and happy, in fact very shiny fur, and running around like happy little mice
But… when scientists like Yasmin investigate these mice closer… They don’t seem like such happy little healthy mice. Here's how Ilana Brito described them …
IB They're very weird , their intestinal lining doesn't look healthy, it doesn't have all the nice folds that we have or that a healthy mouse has[38], they don't produce the same type of mucus[39]that we produce, , their immune system is all weird and out of whack,[40] they're just not healthy. For sure.
That is, they don't have a proper immune system[41][42][43]. Like without microbes, germ-free mice don’t pump out as many white blood cells as they should, those are the soldiers of the immune system[44]. And while healthy mice have little bundles of tissue in their small intestine, packed with immune cells. The germ free mice? Those little bundles never develop fully.[45][46] All this means that our germ free mousies can really struggle to fight off some infections. So for example, in one experiment it just took a teeny tiny dose of a particular Salmonella bug to kill a bunch of them.[47][48]
WZ: So from these mice, so you can live without a microbiome.
YB But you can live in the bubble.
WZ: You can live in the bubble. If you want to live in the real world you need microbiome
YB Exactly haha
So how is this possible? Like, how on earth could not having germs -- the things we've been told to keep out of our body -- be so important, that without them - the immune system of these mice doesn't develop properly? Well, for one thing, when you have a microbiome, friendly bacteria can take up space that unfriendly bacteria might otherwise colonize[49]. -- But something else is going on here too.. we're realising is that some bacteria ... act like little life coaches for the mice’s immune system. They send out signals nudging the body to make immune cells. To Yasmine it's like the microbiome and the the immune system are having a conversation [50] [51] .
YB I mean the word conversation is the right one. They are constantly dialoguing. Talking back and forth.
Like, some bacteria have a little tail[52] that whips around helping them move… and as these bugs get around they chat to certain immune cells[53][54][55], tickling them, getting them to create an immune reaction that helps fight off dangerous bacteria.
YB It's super cool. It’s absolutely fascinating to think that the microbes are actually able to manipulate the immune system to protect the host.
WZ Why would they do that?
YB Well we are home! So you want to preserve your home
Now, a lot of gut bug science comes from mouse studies. We don’t have these kinds of experiments in humans - since we don’t go around wiping out people’s microbiome. What we DO have, though, are studies on what happens when people take antibiotics[56][57]. So as you might know - when you take these meds to kill bad bugs, it also kills some good bugs[58]… Studies have found that taking antibiotics as an adult can increase your risk of getting nasty infections.[59][60] And if you give babies antibiotics, they're more likely to get asthma[61][62] and allergies when they're kids[63], which is a sign of an out of whack immune system. A big review paper on this topic said that by keeping our immune system healthy, preventing nasty bugs from invading, and doing other stuff[64]… gut bugs have "far-reaching impacts on human health."
So far the microbiome is sure living up to its hype. After the break we look at the weird ways that gut bugs might affect your mind — and whether downing kombucha or probiotic pills will keep these gut bugs happy.
BREAK
Welcome back… From everything we've heard so far - the microbiome is kinda a big deal. It's the Scottie Pippen to our body's Michael Jordan. Underpaid. And Underappreciated. At least when it comes to our gut and our immune system. But what about the brain? Some of these products are claiming they can boost your mood - and even help with depression.[65] Is that true? Or, this time, will the microbiome foul out?
TD Hello good morning to you, Ted here.
This is Ted Dinan[66] he’s a psychiatrist at University College Cork in Ireland, and several years ago Ted led a study[67] that kind of rocked the world of microbes. You see, Ted had been working with depressed patients for decades, and some of them were really tough to treat.
TD These patients were describing intense sadness, they weren’t enjoying life to the extent that they would have previously, most of them were quite anxious
These patients had the kind of depression that wasn’t getting better with treatment. Ted had been reading and doing his own research into these newfound powers of the microbiome[68], and he wanted to know: Could the microbiome have something to do with his patients' depression? And so one day - he asked them for well…
TD A sample of poo basically, an early morning sample of feces..
WZ Early morning cos you knew you could get the early morning one
TD Yeah… hehehe
Ok he actually did it to keep the samples consistent, but anyway… So, Ted wanted to see if it was even plausible that some of the gut bugs in that poo… could affect the brain…. any brain.
TD So we did a fecal transplant from humans into rats.
WZ How do you transfer human poo into a rat?
TD Ok, it's not difficult. Because rats are by nature coprophagic[69], in other words, they eat feces. They eat their own, they’ll eat other rats’ feces. It’s just the natural behaviour of a rat
So he took the human poo and popped it in the rats’ cage.
TD They just simply ate it
WZ They just gobbled it up
TD Yeah exactly. And that then became their microbiota[70]
A week later[71] Ted went back to the rats. And put them through some tests… to see if they were acting any different.
TD When we looked at the behaviour of animals, their behavior altered, and they just seemed to develop depressive type behaviours
WZ How do we know that the rat is depressed, does it start watching season 5 of The Good Wife or something?
TD Well rats are normally - first of all, they’re social creatures. They tend to interact with other rates… They also tend to be quite exploratory. They will explore any environment they’re in
But when Ted gave these rats a little maze to go exploring in… they weren't too interested in it.[72] And Ted noticed that they were also hanging out with their friends less. And he was surprised.
TD I was, I was very surprised
And no, these rats weren’t just sick or depressed from having to eat poo. Because when he gave rats poo from people who weren't depressed - they seemed totally normal. Another team of researchers basically repeated Ted's experiment, but in mice - and found the same thing[73]. And all this led Ted to wonder
TD What is it that the microbiome does normally that is good for our mood? In other words, if a bad microbiome is bad for our mood, what is a normal microbiome doing?
Well we know… that a burst of certain chemicals in our brain, like serotonin, can affect our mood.[74] And here's the thing… a swell of research in petri dishes is showing that certain bacteria found in our gut - can also make those chemicals, which are called neurotransmitters[75]…
TD The gut microbiota is capable of producing every human neurotransmitter that we currently know of [76]
WZ Whoa!
Certain gut bugs can literally pump out serotonin[77], while others make chemicals that are later transformed into these neurotransmitters[78]. Now it's not entirely clear whether these so-called happy chemicals in our gut affect our brain[79]… because we don't think they can swim from your gut to your noggin. But they actually don't have to… there are tons of nerves around our gut[80][81][82] - that connect up into the brain via the vagus nerve[83]… so these gut chemicals might be poking the nerves and sending signals up into the brain that way.
Now depression has shown itself to be a tricky beast to study in humans[84], so it's really not clear how [85][86][87] important these gut bugs are to people with depression… a lot of the research is in rodents. But for now Ted is excited about the possibilities - this gut-brain connection has opened up a door... that's been closed for a while now …
TD Well, I think, y’know, the study of the biology of mental illness has been in a bit of a rut, for a long long time, there have been no new drugs coming along.. and i think the brain-gut microbiota axis is a new paradigm, it’s a new way of looking at mental health, so in that sense I think it is a game changer.
So while we're still working out a lot of the details about the microbiome's superpowers... we do think that these bugs are super important for our health.
Ok so our final question is this. We know a happy microbiome is key to keeping us healthy. But how do we get one? There's all this stuff promising to give us a better microbiome - from kombucha to kimchi, sea moss[88] to sauerkraut, pickles[89] to probiotic pills. Are they onto something?
Well, there’s a little bit of evidence that specific microbes can help with certain ailments, like eczema and irritable inflammatory bowel disease[90][91] [92] [93] [94]. And if you're taking antibiotics? There's actually mixed research on whether downing probiotics can help you at all. [95][96][97][98] But just generally -- I’d say the studies here are pretty underwhelming[99].[100]
And there's a bunch of reasons why probiotics aren’t the amazing medicine that they’re claimed to be … A big thing is that there are thousands[101][102] of different species in our body[103] — and for the most part we don't know which concoction of bugs might help with which illnesses. So take mental health, for example — scientists like Ted run these clinical trials in people testing different species of bugs; and sure, some show promise, but not all.[104]
TD Absolutely. I mean we've tested a lot of different bacteria[105][106][107], and most bacteria don't have an impact on mental health. Y’know I suppose it'd be a strange situation, if out of a thousand strains in our gut if they all had a mental health benefit
And the odds that the stuff on the supermarket shelf - be it the bugs in kombucha, yoghurt or probiotic pills… are the secret ingredient that’s gonna mend your microbiome..it's pretty small. In fact, a lot of products with probiotics have the same handful of bugs in them, it's stuff like Lactobacillus acidophilus. And that's not because Lactobacillus acidophilus has some AMAZINGLY WONDERFUL bacterial property -- it's because we've been eating it in stuff like yoghurt[108] for a really really long time, and so FDA has said it's not dangerous to eat[109] — you can shove it in food or pills if you want.
TD I would warn listeners, most probiotic on the shelves have no data behind them whatsoever. Companies make outlandish claims, for which they very little data often or sometimes no data at all
WZ Do you use probiotics?
NI No they're sore of a sore point for me,
That’s Dr. Namrata Iyer over at Trinity College in Ireland[110]
NI I don't take probiotics
And she gave us one important final reason - why you wouldn’t need to guzzle probiotics - in pills or food - if you’re healthy. You see, from what we know, Namrata says that what makes a healthy gut - is the fact that it has a diverse microbiome. One that's full of different kinds of bacteria, fungi, viruses… she says that we should think of our microbiome as a rainforest[111][112]
NI You have trees, and you have tons of animals, and you have insects and all of that!
There's toucans, monkeys, sloths, the turquoise browed motmots[113] - it's a kind of bird… they make this noise.. do you hear it? It's kind of like a maaahh maaah… Anyway. Point is that rainforest is way healthier and resilient to disease than, say, a field of corn[114]. And Namrata's like… taking these probiotics, it's like?
NI If you try and introduce one thing, like say a bird or something?
Throw in an extra mot mot into your beautiful rainforest… big whoop...
NI Yeah, they wouldn't change that ecosystem in any noticeable way. There's just so much excitement amongst people about the power of the microbiome and what it could mean for quality of life and therapies, and it’s all true, the potential is enormous. But I feel like the probiotic market has sort of tried to cash in on that prematurely.
WZ: It's sort of the perfect storm for marketing hype. On one hand you have genuinely exciting research showing that the microbiome plays this integral role in possibly so many aspects of our health. But the science is not there to show how we give ourselves perfect microbiome- so there's this big vacuum and enter the probiotics, enter kombucha bottles! It's just perfect! You couldn’t create a better scenario for a fad, basically.
NI Exactly, and I mean, I grew up eating yoghurt every day of my life, and it’s the best. Kimchi is super tasty, and kombucha looks a little gross to me, but people love it. But if you start selling bottles of stuff that say we have live bacteria and claims to cure 5 different things, that's just misleading.
So if probiotics aren't the cure... what can you do for a healthy gut? Ok here's one thing that's popping up in the research… a hot tip. And here it is… Lean in close. Raise the volume on your headphones… cos it's so groundbreaking… that I'm just going to whisper it… *eat fruits and veggies and whole grains[115]*... And the reason that eating that stuff is good is because it’s full of fibres - and the bacteria already in your gut… love to eat it[116][117][118][119]. So when you munch on an apple it's like sunshine and rain for your inner forest! Studies have found that eating more fibre, essentially feeding our gut bugs, is linked to a more diverse microbiome[120]…[121]. And every scientist I spoke to agreed on this fibre point.
TD Absolutely
IB I eat a lot of Kale, I sometimes think my microbes are happy with that because it's high in fibre, and microbes love fiber..
YB Eating a healthy diet is fundamental…
WZ It always comes back to that-02
YB At the end of the day we’re going to do all this fantastic research and then eat your fruit and vegetables.
That’s Science Vs
One more thing! We’re working on an episode about ORGASMS! Yes. We’re excited too. As part of it, we’d love to hear your stories — any tales of unexpected, first, or nonexistent orgasms. Or if it’s always been easy for you, we want to hear about that too. Can be totally anonymous. You can call 774-481-1238 and leave a message if you’re in the US, or record a voice memo and send it to sciencevs@gimletmedia.com. Thank you!
NICK: 121 Citations!!
This episode was produced by me, Wendy Zukerman, with help from Nicholas DelRose, Rose Rimler, Meryl Horn, Michelle Dang, Sinduja Srinivasan, and Hannah Harris Green. We’re edited by Blythe Terrell. Fact checking by Diane Kelly. Mix and sound design by Peter Leonard. Music written by Peter Leonard, Marcus Bagala, Emma Munger, and Bobby Lord. A huge thanks to all the researchers we got in touch with for this episode, including Professor Martin J Blaser, Dr Kirsten Berding Harold, Professor Andrew Holmes, Professor Eran Elinav, Professor Margaret J. Morris, Professor Tim Spector, Professor Dena Lyra, Professor Eric Alms, Dr Joel Babdor, Joana de Cruz Pereira, Josh Jones and all the others. And special thanks to Walter Rimler, the Zukerman family and Joseph Lavelle Wilson.
[1] https://trends.google.com/trends/explore?date=all&geo=US&q=probiotics "Digestive health a top trend heading into 2019" "Probiotic Market Growth" "Why Gut Health Is The Next Big Wellness Trend"
[2]https://www.google.com/search?q=kombucha&source=lnms&tbm=shop&sa=X&ved=2ahUKEwiJ7625jpDoAhXVhXIEHcMOA-EQ_AUoAXoECB4QAw&biw=1298&bih=758#spd=11659309927118014188
[3] e.g. Brain Superkraut and kombucha influencers saying "Better gut health will result in feeling better, improved mental health, clearer skin, and lower risks of a whole host of diseases." and claims that " The new research shows how kefir and probiotics can lower anxiety and depression.
[4] Claims for kombucha: Support gut health & aid digestion, promote overall well being, provide immune support, and improve vitality https://gtslivingfoods.com/faq/raw-kombucha/
[5] supplements manufacturers suggest that of course you need a daily dose! (ad copy here: https://www.amazon.com/Digestive-Advantage-Daily-Probiotic-Capsules/dp/B01ND16K2I)
[6] e.g. Kombucha, like other fermented foods, contains healthy acids and living probiotics - both of which are key ingredients to a healthy gut!
[7] https://www.sciencedirect.com/science/article/pii/S1931312811002940 The human microbiome includes "bacteria, archaea, eukaryotic viruses, bacteriophages, and eukaryotic microbes... that call the human body home and interact with the human host to prime immunity and to maintain host health.”
[8] But the major introduction of the naïve human fetus to the world of microbes occurs during labor, when the water breaks and the microbes ascend the birth canal, even as the baby is descending face backward.
[9] Vaginally delivered infants have microbes that resemble their own mother's vaginal microbiota while C-section babies have bacterial communities similar to those found on the skin surface e.g dominated by Staphylococcus, Corynebacterium, and Propionibacterium spp.
[10] The microbiota composition of an adult may therefore in part reflect the history of exposure to microbes and environmental factors in early life. This concept is supported by experiments with mice and familial studies in humans that indicate that the environment in early life may account for, at least in part, microbial composition in the adult.
[11] In a very fun study…a team of researchers looked at the poo and saliva of 2 people for a year - and looked at what life events changed things. Travel from the developed to the developing world in one often led to a nearly two-fold increase in the Bacteroidetes to Firmicutes ratio, which reversed upon return. Another subject got a gut infection… which lead to a permanent decline of most gut bacterial taxa, which were replaced by genetically similar species.
[12] Limited animal and human research findings imply that exercise may have a beneficial role in preventing and ameliorating such diseases by having an effect on gut immune function and, recently, microbiome characteristics.
[13] Bacteroides was associated with a long-term diet rich in animal protein, several amino acids and saturated fats, and Prevotella was associated with carbohydrates and simple sugars
[14] Bacteria constitute, with 10^14 citizens, the most dominant and most diverse group of microorganisms present in the human colon.
[16] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4191858/ There are other human microbiome sites as well, including skin, oral, and vaginal, but the gut is the most popular and diverse neighborhood!"
[17] https://depts.washington.edu/ceeh/downloads/FF_Microbiome.pdf "The majority live in our gut, particularly in the large intestine"
[18] When combining data from 12 different published studies of the human microbiota (Table 1), including three studies of multiple individuals that sequenced multiple body sites from the same person over time (HMP, Costello_whole_body, and Dense_timeseries; see Table 1),This clustering was "driven by taxa that have previously been shown to characterize the different body sites". The results "demonstrate that differences in the human microbiota across body sites are sufficiently large that samples from each site
cluster together even when experimental protocols differ substantially"
[19] Digest fiber… fortify our gut: “commensals can also contribute to the fortification of the intestinal barrier by various mechanisms, including the promotion of epithelial cell maturation and angiogenesis”
[20] Carbohydrate fermentation is a core activity of the human gut microbiota, driving the energy and carbon economy of the colon. Dominant and prevalent species of gut bacteria, including SCFA-producers, appear to play a critical role in initial degradation of complex plant-derived polysaccharides, collaborating with species specialised in oligosaccharide fermentation (eg, bifi- dobacteria), to liberate SCFAs and gases which are also used as carbon and energy sources by other more specialised bacteria
[21] Diet-derived fibers are metabolized and fermented to SCFAs such as acetate, propionate, and butyrate by intestinal bacteria
[22] a large part of the SCFAs is used as a source of energy. In humans, SCFAs provide ∼10% of the daily caloric requirements
[23] The barrier function of intestinal epithelial cells is an important first line of defense and ensures appropriate permeability characteristics of the epithelial layer. Butyrate is known to repair and enhance barrier function of intestinal epithelial cells... (partly by upregulating genes that make mucins)
[24] SCFAs have been shown to increase the AMPK activity in liver and muscle tissue. Activation of AMPK triggers peroxisome proliferator-activated receptor gamma coactivator (PGC)-1α expression, which is known to control the transcriptional activity of several transcription factors such as peroxisome proliferator-activated receptor (PPAR)α, PPARδ, PPARγ, liver X receptor (LXR), and farnesoid X receptor (FXR), all important in regulation of cholesterol, lipid, and glucose metabolism...SCFAs have been shown to reduce plasma concentrations of cholesterol in rodents and humans
[25] The SCFA butyrate, a main end product of microbial fermentation of dietary fibers in the human intestine, plays an important role in the maintenance of intestinal homeostasis and overall health status….butyrate plays a regulatory role on the transepithelial fluid transport, ameliorates mucosal inflammation and oxidative status, reinforces the epithelial defense barrier, and modulates visceral sensitivity and intestinal motility.
[26] The intestinal microflora synthesizes vitamin K, which is a necessary cofactor in the production of prothrombin and other blood clotting factors. Treatment with antibiotics, particularly in individuals eating a diet low in vitamin K, can result in low plasma prothrombin levels and a tendency to bleed. Intestinal bacteria also synthesize biotin, vitamin B12, folic acid, and thiamine.
[27] This study systematically explored the genomes of 256 common gut bacteria for the presence of biosynthetic pathways for eight B vitamins, namely biotin, cobalamin, folate, niacin, pantothenate, pyridoxine, riboflavin, and thiamin…. "it seems likely that bacteria provide human intestinal cells with sufficient B-vitamins to avoid deficiencies during short periods of vitamin-poor diet. ...(But there are limitations:) According to our estimation, the gut microbiota would not be able to provide the host with the daily recommended intake of B-vitamins
[28] the gut microbiota were estimated to contribute over a quarter of the suggested dietary intake for four vitamins --(including folate, niacin, and pyridoxine)
[30] The transcriptional responses of the host to bacterial colonization are in part evolutionarily conserved, as shown by reciprocal microbiota transplantations between mice and zebrafish.
[31] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5744394/
[32] The vitamin and fatty acid relationships have been identified in humans, too: see for example,
https://link.springer.com/article/10.1186/s12864-019-5591-7.
[34] Mice raised in germ-free environments, without any exposure to microbes, and then colonized at specific life stages with different microbial communities are referred to as gnotobiotic animals, and provide an excellent system for controlling host genotype, microbial community composition, diet, and housing conditions
[35] https://academic.oup.com/bioscience/article/54/8/777/238268
[36] Study of the vaginal microbiome of reproductive-aged women (N=396): a total of 282 taxa were observed in the vaginal microbiota of these women
[37] At birth, they are removed from the mother by Caesarean section and live in the isolators with germ-free foster mothers.
[38] the instensines and livers of germ-free mice show massive alterations in the expression of a range of genes with metabolic and non-metabolic functions
[39] The first comparisons of GF rodents with “microbiota-colonized animals” resulted in the observation that there were gross physiological differences between GF and the specific pathogen–free (SPF) state, including an enlarged cecum, principally due to an accumulation of undegraded mucus (15), and reduced gastrointestinal motility (16), due to the loss of the critical digestive functions of the inhabiting microbiota. In parallel, GF rodents display an aberrant intestinal epithelial cell (IEC) morphology that includes longer villi and shorter crypts in comparison with that observed in conventionalized mice
[40] The earliest comparisons of germ-free and colonized mice revealed a profound effect of microbial colonization on the formation of lymphoid tissues and subsequent immune system development…. individual commensal species influence the makeup of lamina propria T lymphocyte subsets that have distinct effector functions
[42] GF animals exhibit major defects in the development of primary and secondary lymphoid organs—including the GALT, spleen, and thymus—which is associated with a decreased frequency of CD4+ and CD8+ intestinal T cell subsets as well as reduced numbers of intraepithelial lymphocytes that express the αβ T cell receptor (TCR)
[43] Lymph node development: pg 481 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1949649/pdf/amjpathol00317-0091.pdf
[44] In the absence of the microbiota, myeloid-cell development in the bone marrow is reduced, which results in the delayed clearance of systemic bacterial infection.; (importance of myeloid cells for white cell development described here: https://www.frontiersin.org/articles/10.3389/fimmu.2014.00423/full)
[45] For example, isolated lymphoid follicles in the small intestine do not develop in germ-free mice
[46] The total number of CP/ILF structures found in germ free mice matches that of
conventionally reared mice … CP formation is independent of gut bacteria whereas maturation of the
structures, i.e. generation of ILF, requires signals deriving from the intestinal microflora
[47] Germfree mice infected orally with as few as 10 mouse virulent S. enteritidis quickly developed severe diarrhea and died within 5 to 8 days as a result of a spreading systemic disease.
[48] In contrast to germ-free mice, in a normal lab mouse—despite the ability of a small oral challenge by S. enteritidis to bring about a widespread systemic infection, the slow rate of evolution of the disease allowed sufficient time for the development of a high level of acquired resistance to the challenge infection by the host. As a result, the host has a better chance of controlling the infection before it can reach lethal proportions, so that the LD50 by the oral route is extremely high.
[49] The microbiota contributes to the health of the host by colonizing the mucosal entry sites of pathogens, where it occupies biological niches and prevents invasion of the ecosystem by foreign elements — a concept known as colonization resistance
[50] gnotobiotic mice are relatively immunocompromised due to lack of microbial stimulation promoting immune maturation
[51] This complex, bilateral interaction between the host and its microbiota has a crucial role in human health.
[52] https://www.pnas.org/content/104/17/7116
[53] This sensing initiates an intracellular signaling cascade that culminates in the activation of a variety of proinflammatory and immune response genes.1, 6 Proinflammatory cytokines provide augmentary signals through the upregulation of co-stimulatory and adhesion molecules, which are essential for the activation of adaptive immune cells and the subsequent development of protective immune responses against the infectious nonself antigens
[54] We show that flagellin administration induces RegIIIγ in epithelial cells along the entire length of the small intestine of antibiotic-treated mice. The extensive upregulation of RegIIIγ was likely caused by systemic stimulation of TLR5 and secretion of IL-22. .
[55] B cells are directly activated by flagellin through either cross linking of BCRs or signaling through TLR5, depending on the form of flagellin that is involved. B cells require TLR5 signaling, in addition to T-cell help, for T-dependent antibody production65 or production can occur in presence of cytokines, such as TNF-α.66 Monomeric flagellin activates TLR5 signaling in B cells and promotes a long-lasting, T-dependent antibody response.
[56] A cohort study looking at medical records from 1488 adult inpatients found that 20% of hospitalized patients receiving at least 24 hours of antibiotic therapy developed an antibiotic-associated ADE (Adverse Drug Events)
[57] Also seen in kids: https://www.jpeds.com/article/S0022-3476(19)31101-1/fulltext This meta-analysis of 82 studies looks at incidence of side effects in children, resulting from antibiotic treatment for acute otitis media. Adverse events included diarrhea and candidal diaper rash
[58] despite the well-documented resilience of the commensal microbiota, treatment with antibiotics is associated with persistent changes in microbial composition and with potential long-term consequences for host immunity
[59] For instance, C. difficile is a normal gut resident that can cause disease when antibiotics compromise the stable adult gut communities;
[60] . Overall use of antibiotic agents is associated with a 3-fold increased risk of community-acquired CDI, but we also detected substantial variation in risk associated with different antimicrobial classes, with fluoroquinolones, CMCs, and clindamycin associated with the greatest enhancement of risk.
[61] The microbiota of infants is affected by antibiotic use, whether they were breastfed and the method of delivery, although whether differences in the microbiota in early life affect the composition of the adult microbiota is not well understood28,29. However, differences in composition driven by factors in infancy may affect susceptibility to immunological diseases into adulthood, such as asthma and atopic diseases29.
[62] Researchers took more than 300 Canadian babies. They compared those who developed wheezing and skin atopy at age 1 year with those who remained well. The authors found that early exposure (in the first year of life) to antibiotics was linked with the presence of wheeze and atopy, " antibiotic exposure in the first year of life (OR, 5.6; P = 0.009) and atopic dermatitis at 1 year (OR, 6.4; P = 0.005) as factors that increased a subject’s risk of being classified in the AW group compared to controls") - which together are a strong marker for the later development of asthma.
[63] antibiotic use within the first 6 months of life is associated with an increased susceptibility to allergy and asthma at 6 years of age… antibiotic exposure during the first year of life is associated with the development of wheezing and eczema at 8 years of age, even after taking into account early-life respiratory infections
[64] Gut microorganisms perform a diverse set of functions with far-reaching impacts on human health, such as extracting energy from a wide array of host-indigestible carbohydrates, producing vitamins, promoting immune homeostasis and preventing colonization of the gut by pathogens
[65] CLAIM: "It has been established that there is a link between the anti-inflammatory properties of probiotics and anxiety or depression, suggesting that drinking probiotic-rich Kombucha may help alleviate some of the symptoms of depression and could help promote positive mental health."
[70] See figure on the last page 5A-D https://www.ncbi.nlm.nih.gov/pubmed/27491067
[71] Behavioral tests started 1 week after microbiome transfer; lasted several weeks. See experimental design chart, figure 4 https://www.ncbi.nlm.nih.gov/pubmed/27491067
[72] . The rats that received the depression FMT exhibited (B) anhedonia like behaviour, indicated by a decrease in the 24 hour 1% sucrose preference test (p = 0.022) and an increase in anxiety like behaviour measured by (C) a decrease in open arm visits in the elevated plus maze (EPM) (p = 0.029) and ) and (D) a decrease in time spent in the open field (p = 0.013) and compared to rats that received the healthy FMT.
[73] Fecal microbiota transplantation of GF mice with ‘depression microbiota’ derived from MDD patients resulted in depression-like behaviors compared with colonization with ‘healthy microbiota’ derived from healthy control individuals. https://www.nature.com/articles/mp201644
[74] Serotonin release happens in conjunction with lots of things -- but eating carb-rich foods is a classic (https://onlinelibrary.wiley.com/doi/abs/10.1002/j.1550-8528.1995.tb00215.x)
[75] In cell culture studies, gut microbiota have been found to make precursors to neurotransmitters, such as tryptamine (112), and neurotransmitters including GABA (9), serotonin, norepinephrine, and dopamine
[76] ... bacteria have been shown to produce and/or consume a wide range of mammalian neurotransmitters, including dopamine, norepinephrine, serotonin, or gamma-aminobutyric acid (GABA).
[77] Several bacterial strains are known to produce serotonin directly
[78] https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-019-0704-8
[79] Other mechanisms of how gut bugs could influence the immune system- 1) Microbiome fart out signals that stimulate the vagus nerve; 2) Cytokines - microbiomes might get into the blood (or secrete molecules that enter the blood) and stimulate cytokines that could cross the blood brain barrier. 3) When microbiomes break down dietary fibre, they produce these short chain fatty acids - these acids can directly affect cells in the gastrointestinal tract - triggering the release of various compounds that could affect hunger.
[80] The enteric nervous system (ENS) is the largest component of the autonomic nervous system and is uniquely equipped with intrinsic microcircuits that enable it to orchestrate gastrointestinal function independently of central nervous system (CNS) input
[81] The ENS produces more than 30 neurotransmitters and has more neurons than the spine.
[82] The enteric (intrinsic) nervous system (ENS) in most regions of the gut consists of two main ganglionated layers; myenteric and submucosal ganglia, containing numerous types of enteric neurons and glial cells. Axons arising from the ENS and from extrinsic neurons innervate most layers of the gut wall and regulate many gut functions. The majority of ENS cells are derived from vagal neural crest cells (NCCs), which proliferate, colonize the entire gut, and first populate the myenteric region.
[83] The vagus nerve represents the main component of the parasympathetic nervous system, which oversees a vast array of crucial bodily functions, including control of mood, immune response, digestion, and heart rate. It establishes one of the connections between the brain and the gastrointestinal tract and sends information about the state of the inner organs to the brain via afferent fibers
[84] The limited existing human studies of depression and gut microbiota report depression-specific findings regarding proportions of microbiota; however, the sample sizes are small, and no consensus has emerged concerning which bacterial taxa are most relevant to depression. Therefore, the effect size of depression-related microbial differences is presently unclear.
[85] ...opposite correlations for closely related OTU’s in our dataset were both striking and surprising. This may indicate that certain phylogroups interfere with particular mode-modulating pathways, but that the effect of the interference represents a fine tuned balance.3 Furthermore, the lack of statistically signif- icant univariate correlations may also indicate that interaction networks are important. These findings, however, must be verified in larger cohorts due to the risk of overseeing effects in small cohorts.
[86] Despite profound interindividual variability, levels of several predominant genera were significantly different between the MDD and HC groups. Most notably, the MDD groups had increased levels of Enterobacteriaceae and Alistipes but reduced levels of Faecalibacterium. A negative correlation was observed between Faecalibacterium and the severity of depressive symptoms.
[87] A growing body of literature supports and characterizes a gut-brain axis, and elucidates a possible role of gut microbiome dysfunction in major depression.
[89] https://www.walmart.com/ip/Near-Sour-Pickle-Raw-Fermented-Probiotic-Natural-Gluten-Free-Vegan-3-12oz/726741408
[90] https://www.bmj.com/content/361/bmj.k2179 “probiotic supplementation in the first several years of life did have a significant impact on development of eczema”
[91] Analysis of 12 RCTs revealed that in general, oral administration of probiotics improved the recognized clinical signs of chronic and aggressive periodontitis such as probing pocket depth, bleeding on probing, and attachment loss, with a concomitant reduction in the levels of major periodontal pathogens. Continuous probiotic administration, laced mainly with Lactobacillus species, was necessary to maintain these benefits. https://www.tandfonline.com/doi/full/10.1080/14787210.2016.1194198
[92] Vouloumanou- 2009 review- “probiotics may have a beneficial effect on the severity and duration of symptoms of RTIs but do not appear to reduce the incidence of RTIs… Reduction in the severity of subsequent RTIs was found in five of six trials that reported relevant data
[93] 2015 Cochrane review- Hao et al. “12 RCTs, which involved 3720 participants”-
“Probiotics were better than placebo in reducing the number of participants experiencing episodes of acute URTI, the mean duration of an episode of acute URTI, antibiotic use and cold-related school absence. This indicates that probiotics may be more beneficial than placebo for preventing acute URTIs. However, the quality of the evidence was low or very low.”
[94] See table 1 with very specific strains https://journals.lww.com/jcge/Abstract/2015/11001/Recommendations_for_Probiotic_Use_2015_Update_.17.aspx
[95] Moderate-quality evidence suggests that probiotics are associated with a lower risk of C difficile infection and very low–quality evidence suggests that probiotics are associated with fewer adverse events vs placebo or no treatment.
https://opus.lib.uts.edu.au/bitstream/10453/131431/1/00005407-201808070-00022.pdf
[96] Bacteroides were significantly reduced between weeks 0 to 4 in probiotic treated subjects. Ruminococcus (family Lachnospiraceae), tended to be more abundant at week 8 than week 4 within the placebo group and at week 8 than week 0 within the probiotic group.
[97] S. boulardii alone does not alter the microbiota, in this study the combination of S. boulardii with Amoxicillin-Clavulanate modified the microbiota changes caused by an antibiotic.
[98] randomized, double-blind trial involving 827 children. A combination probiotic didn’t prevent development of moderate-to-severe gastroenteritis in kids who came to the ER with gastroenteritis (also, no change in diarrhea duration in sick patients)
[99] This has led to multiple suggested prophylactic and therapeutic health indications and claims, such as prevention or treatment of acute, antibiotic-associated and Clostridium difficile–associated diarrhea; amelioration of inflammatory bowel disease and irritable bowel syndrome (IBS); and reduction of risk for neonatal late-onset sepsis and necrotizing enterocolitis…. Regretfully, despite the fact that some clinical trials related to the above health claims are of high methodological quality and validity12–16, for most of the above indications, there are also studies of similarly high methodological quality featuring negative or opposing results, collectively leading to conflicting, ambiguous and debatable overall conclusions.
[100] 943 kids- prospective, randomized, double-blind trial, of children with gastroenteritis: those who received a 5-day course of L. rhamnosus GG did not have better outcomes than those who received placebo.
[101] It is estimated that the gut microbiota is composed of more than 100 trillion cells and 5 million unique genes, outnumbering our own cells and genes6 . Although the gut microbiota is composed of thousands of species, the majority of them belong to six bacterial phyla: Firmicutes, Bacteroidetes, Actinobacteria, Proteobacteria, Fusobacteria and Verrucomicrobia
[102] Paper: catalogue of nearly 5000 species of human gut bacteria (200,000 genomes and up to 171 million protein sequences), from samples all across the world
[103] https://www.nature.com/articles/nature11234 Using data from the Human Microbiome Project, this paper reported several examples of "functionally relevant inter-individual variation at the species and strain levels" occurring throughout the microbiome.
[104] See Table 1 of clinical trials and what has worked (not Ted's trials though; Ted coauthored this paper) https://www.annualreviews.org/doi/10.1146/annurev-pharmtox-010919-023628
[105] Negative results in one of Ted's clinical trials: The potential psychobiotic Lactobacillus rhamnosus (JB-1) fails to modulate stress or cognitive performance in healthy male subjects https://cora.ucc.ie/bitstream/handle/10468/3316/1864.pdf?sequence=1
[106] Ted's clinical trial: Repeated measures, placebo controlled trial of 22 men using Bifidobacterium longum 1714 as a translational psychobiotic: report some detectable effects on modulation of stress, electrophysiology and neurocognition in healthy volunteers https://www.nature.com/articles/tp2016191
[107] Ted's review on strategies to find psychobiotics- live bacteria conferring mental health benefits.—
"Only by adequate preclinical evaluation coupled with good clinical studies will effective algorithms emerge for identifying likely psychobiotics. Not all prebiotic, probiotic or synbiotics will have psychobiotic potential, and not all that show preclinical promise will be suitable for further development."
[108] Yogurt is the food produced by culturing one or more of the optional dairy ingredients specified in paragraph (c) of this section with a characterizing bacterial culture that contains the lactic acid-producing bacteria, Lactobacillus bulgaricus and Streptococcus thermophilus
[109] Prior sanctions were granted for the use of harmless lactic acid producing bacteria, such as Lactobacillus acidophilus, as optional ingredients in specified standardized foods. These bacteria are permitted for use in cultured milk (which includes buttermilk) (§ 131.112), sour cream (§ 131.160), cottage cheese (§ 133.128), and yogurt (§ 131.200), provided that the mandatory cultures of Lactobacillus bulgaricus and Streptococcus thermophillus are also used in the yogurt.
[110] https://www.researchgate.net/profile/Namrata_Iyer; https://www.linkedin.com/in/namrata-iyer-634b564a/
[111] https://www.nature.com/articles/nature11234: In healthy volunteers, “Oral and stool communities were especially diverse in terms of community membership”
[112] Like all healthy ecosystems, richness of microbiota species characterizes the GI microbiome in healthy individuals. Conversely, a loss in species diversity is a common finding in several disease states.
[114] Crop diversification can improve resilience in a variety of ways: by engendering a greater ability to suppress pest outbreaks and dampen pathogen transmission, which may worsen under future climate scenarios, as well as by buffering crop production from the effects of greater climate variability and extreme events.
[115] https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/high-fiber-foods/art-20050948#
[116] Changes in fiber intake positively correlated with next-day abundance changes among 15% of gut microbiota members
[117] Consuming a carbohydrate- or fat-restricted low-calorie diet for a year , or a high-fat and a low-fibre, or low-fat and high-fibre diet for 10 days can induce statistically significant changes in the gut microbiota…
[118] Changes in our diet can rapidly change the gut microbiota. Generally, a high-fibre diet which is low in saturated fat and sugar is associated with a healthier gut microbiome, characterised by a greater diversity of organisms.
[119] animal studies have shown that consuming an unhealthy diet for only three days a week has detrimental effects on the gut microbiota, even when a healthy diet is eaten for the other four days.
[120] Microbiota accessible carbohydrates (MACs) found in dietary fiber, play a key role in shaping this microbial ecosystem…taxa driven to low abundance when dietary MACs are scarce are inefficiently transferred to the next generation and are at increased risk of becoming extinct within an isolated population.
[121] mediterranian diet: the NU-AGE MedDiet is characterised by changes in the consumption pattern of specific dietary components—namely, an increase in the consumption of fibres (vegetables, fruits), carbohydrates (wholegrains), plant proteins (legumes), polyunsaturated fatty acids (fish) and vitamins such as vitamin C (fruits) and a concomitant decrease in the consumption of fats, alcohol, sodium and sugar (sweets). This study took more than 1200 elderly people, and put half on the diet. Those who went on the diet for a year had changes to their gut bugs associated with improved cognition.