Mind your Microbiome (and maximise it).

You are home to trillions of bacteria. Before you say ‘Yuck’ and douse yourself in Dettol – Wait!

The BMJ recently released a ‘State of the Art Review’ focusing on the bugs in your gut – termed the ‘gut microbiome’. While we commonly associate bacteria with dirt, illness and infection, medicine has adapted its opinion of our inhabitants to have a softer view. This review suggests bacteria can be helpful; with closely entwined roles in the long term development of our immune system and body composition, to short term regulation of digestion and appetite.

This BMJ review outlines various roles of the microbiome and our physiology. Check it out. Where could this take us?

– Our bacteria release anti-inflammatory substances, such as short chain fatty acids. These may have systemic contributions to inflammation levels in the body. How far could this link go? Could the microbiome contribute to the diagnosis and maintenance of inflammatory and autoimmune diseases such as rheumatoid arthritis?

– The metabolism of the micro-biome is separate to ours. As students we recognise that our endogenous CYP450 enzymes in our liver metabolise substances, including drugs or carcinogens, into alternative forms that either are potentiated or inactivated. Our microbiome also metabolises these substances, including prescription drugs. Will future prescriptions take into account of an individual’s microbiome when assessing efficacy or toxicity of drugs? This provides a VERY exciting field for the future.

– Our bugs eat our food before we do. They’re not stealing our food – they can convert foods that are indigestible by us (e.g. complex fibres like polysaccharides that we lack enzymes for) into molecules we can absorb, such as short chain fatty acids. These short chain fatty acids can be used for energy, influence the behaviour of our immune cells, and contribute to the integrity of our gut lining. A good gut lining means we have a strong barrier between our poo and our blood. This is a fun blog post that goes into your gut barrier a bit further. Good stuff.


How can we enrich our relationship with our bugs?

What to avoid:

Avoid refined and processed carbohydrates. These don’t provide the bacteria with the foods we want to feed them – the indigestible fibres that are provided when eating lots of plants. This means we can ‘starve’ the good bacteria – reducing the variety of bacteria in our gut. Sugar may further contribute to the composition of our gut flora by promoting the growth of yeasts, such as candida.

Don’t eat too often – Whether it’s giving it a chance to allow its enzymes, acid and bile to take effect, or ample opportunity for peristalsis to shift the gut’s contents along, your gut needs time to process the food you put into it. Eating too often may promote incomplete digestion – putting undigested food where it shouldn’t be. This may contribute to SIBO or SIFO (small intestinal bacterial/fungal overgrowth), where your small intestine (which normally has very few bacteria) is over-colonised with bugs. This may harm the lining of the small intestine and prevent absorption of nutrients from your food. Let your belly have a rest – stop eating before 8-9PM and eat breakfast at 7AM.

Be wary of using hand-sanitiser, and watch your antibiotic usage. We need to redefine ‘clean’ – to include an acceptance that part of our health is dependent on our bugs. So although a sterile surgical theatre or disinfected medical equipment are necessary in certain extreme contexts (like preventing bugs getting into an operation wound), we should accept that it is normal for our skin and gut to come into contact with bacteria.


What to do:

Eat a wide variety of vegetables (preferably at every meal)! Besides providing different profiles of micronutrients, the vegetables you eat will provide many of the indigestible fibres. These fibres feed the bacteria in your gut. If you want, some internet bloggers recommend eating vegetables raw and unwashed – possibly contributing to a greater diversity of bacteria. Your choice – do some reading.

Eat fermented foods. When a fermented food like sauerkraut is made, bacteria are allowed to eat and break down the fibres in the cabbage. This process provides the bacteria with the energy to grow. When you eat the sauerkraut, you eat the bacteria. This way of consuming more bacteria is cheap (or free if you make your own sauerkraut), and will contain a wide variety of bacteria. Let’s not forget that there is a huge variety of delicious fermented foods to choose from – starting with yogurt, then swiftly moving to Kefir, Kimchi, Natto, Miso, Tempeh, Kombucha etc.
If you’re asking “What the heck are these?” – You had better get sampling!!
I’ve got this book – which shows how great fermented vegetables can be with a selection of pretty pictures and delicious recipes.

Supplement with probiotics – For some, the thought of fermented cabbage may be all too much. Probiotics (bacteria in a pill) can be a useful option – they have no taste and are small. Easy to pop down the hatch. If you go down these lines – you risk paying lots of money for a product that has not necessarily been proven to work, or not contain any potent bacteria at all! Check out this podcast by Nourish Balance Thrive for context.


This is a striking change in direction.

We are transitioning from a medical dogma where hygiene and the microbe-as-pathogen dogma is king, to one where we appreciate the subtleties of our relationship with bacteria – a field that can only grow stronger and more diverse in the future! (Like our gut microbiomes).

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Who knew feeding your microbiome could taste so good? Chopped tomato and avocado over a base of mixed greens. Liberally season with olive oil, sea salt and pepper and you’ve got a great addition to any meal. #medicineforstudents

Shortlink http://wp.me/p4Kc1Q-hl

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