I just spoke at an international microbiome symposium sponsored by the Falk Foundation and organized by Dr. Gerald Holtmann in Brisbane, Australia.
The conference highlighted the rapid progress that is being made in identifying the role of the gut microbes in a wide range of disease areas, including inflammatory bowel diseases, IBS, rheumatoid arthritis, pulmonary disease, liver disease, obesity and depression.
Among the many topics, a presentation by Professor McGuckin about the role of the mucus layer of the gut lining was of particular interest. The mucus layer has many crucial functions ranging from its role as barrier between microbes and gut lining, to being the home and food supply for certain microbes. Stress and an unhealthy diet (high fat and sugar, emulsifiers and artificial sweeteners) can have a detrimental effect on it. In turn, a compromised mucus layer plays a major role in the leakiness of the gut.
I was recently invited by Professor William McCarthy from the UCLA School of Public Health to participate in an Expert Roundtable on Added/Free Sugar at the Luskin Center at UCLA. The meeting was sponsored by the Kaiser Permanente Policy Institute in partnership with the American Heart Association and hosted by Drs. Sue Babey and William McCarthy from the Center for Health Policy Research at UCLA. Kaiser Permanente wants to be a leader in clinical and policy approaches to reducing excess added sugar intake.
A wide range of topics were discussed at the meeting from the detrimental effect of excessive fructose consumption on metabolic health and on fatty liver disease to legislative approaches to reducing population access to sugary beverages. The task to stand up against the powerful lobby behind the farm and food industry (adding sugar and high fructose corn syrup to just about everything we eat) is enormous. However, some companies have become partners in this effort. Jessica Sperling from Dannon (now DanoneWave) gave an excellent example of the laudable efforts this company makes to reduce sugar in dairy products and their example will hopefully be followed by others.
In the last 5 days I spoke at scientific meetings in NYC, New Orleans and UCLA on each of these topics. The growing interest in the topic of brain gut communication by specialists working in very different areas of research would not have been imaginable only a couple of years ago!
Question 1: What do inflammatory bowel diseases (IBD), obesity/food addiction, and depression/anxiety have in common?
Answer: Current research suggests that they are all disorders involving the brain gut microbiome communication. A recent review by Caltech investigators reviews the latest evidence on the topic of brain microbiota communication (https://www.ncbi.nlm.nih.gov/pubmed/27814521)
Question 2: If the gut microbes do play a role in all 3 disorders, are there shared therapies targeted at the brain gut axis?
Answer: Current evidence suggests yes. Both mind based therapies (like mindfulness based stress reduction and cognitive behavioral therapies), as well a diet high in plant based foods and low in animal products (like the Mediterranean diet) are beneficial in all three diseases. Read more about it in The Mind-Gut Connection Book.
Further reading: Sharon G, Sampson TR, Geschwind DH, Mazmanian SK. The Central Nervous System and the Gut Microbiome. Cell. 2016 Nov 3;167(4):915-932. doi: 10.1016/j.cell.2016.10.027.
During my recent trip to Korea, I had a first hand opportunity to experience a food culture which to a large degree is based on fermented foods. While the controlled fermentation of food evolved thousands of years ago as a technique to preserve and store vegetables and fish to be enjoyed fresh months later, there has been a renewed interest in such fermented foods in the US for a totally different reason.
The microorganisms essential for the fermentation process are probiotics, a group of microbes that has become synonymous for gut (and brain) health, and which have shown to have small but significant health benefits in a variety of medical conditions. Hundreds of such probiotic strains, either single organisms or combinations of several strains are marketed on the internet and in stores for their various health benefits, even though such benefits for the great majority of these probiotics have never been tested in a controlled study. After 3 days of enjoying different Korean dishes from breakfast to dinner (up to 30 different fermented side dishes come with every main dish –including mushrooms, cabbage and anchovies), I started to wonder how many live probiotics the average Korean ingests during a year, starting in infancy, a period particularly important for the development of a healthy microbiome.
If our emerging scientific concepts about the benefits of probiotics are correct, shouldn’t we expect a reduced prevalence of such common Western disorders as metabolic syndrome, gastrointestinal disorders, and even brain disorders such as depression, Alzheimer’s or Parkinson’s disease? I will address this question in a future post. However, one thing that is obvious spending only 3 days in Korea, even without looking at population statistics is the fact that there are hardly any obese people to be seen.
But then, there are also major differences in the Korean diet beyond the richness of probiotics. Like most other diets with optimal health benefits (and in contrast to the prevailing Western view that Korean barbeque is the quintessential Korean food), the traditional Korean diet is largely made up from a variety of plant based foods, carbs from the staple food of rice and noodles, in addition to a small amount of seafood and meat. Nearly absent are animal fats and refined sugars. In addition to the health benefits of such a diet, Koreans love all forms of physical exercise including regular walks. Relying on century old traditions, it seems Koreans don’t have to be concerned about the latest diet fads and the benefits of high fat, low carbs and gluten free. Read more about the health benefits of such a diet in The Mind-Gut Connection Book.