THE GUT MICROBIOME

Jesse Crowley, Dietetic Intern

OUTLINE

Introduction

Properties

Functions

Colonization

Influences

Treatment

OBJECTIVES

Provide overview of colonization of gut

Provide overview of influences on the gut microbiome

Suggest ways the RD can be involved

THE INVISIBLE UNIVERSE OF THE HUMAN MICROBIOME

PROPERTIES

SPECIES

PHYLA

PHYLA & SPECIES

DIVERSITY

FUNCTIONS

METABOLISM

Harvest energy

IN: Carbohydrates, insoluble fiber, probiotics

OUT: SCFAs

5 - 15% of total energy intake

Synthesize vitamins K and B12

IMMUNITY

Suppress inflammatory signaling pathways

Metabolites (SCFAs) suppress cytokine secretion

COLONIZATION

COLONIZATION

In Utero

Delivery

Infant Feeding

IN UTERO

Microorganisms have been found in the placenta, amniotic

fluid and umbilical cord.

The fetus swallows amniotic fluid in utero, beginning to

colonize the developing GI tract.

Infants that are born preterm may not receive the benefit of
this progressive colonization.

DELIVERY MODE

The gut microbiota of the newborn will closely resemble the

microbiota encountered during birth.

Vaginal

Inoculated with the microbiota of the vagina

Caesarian section

Inoculated with the microbiota of the skin

INFANT FEEDING METHOD

Breast milk

Contains up to 600 species of bacteria

Fuel for bacteria, prebiotics - oligosaccharides

Formula

WINDOW OF OPPORTUNITY

3 years of age

AGING

Decreased diversity & frailty

AGING

INFLUENCES

DIET

A diet that is varied and complex is associated with a more

diversified microbiome.

A coevolution occurs between the diet and the microbiota.

American vs Malawian/Amerindian

European vs African

Vegetarian/Vegan vs Omnivorous

STRESS

Whether psychological or physiological, leads to response

Gut microbiota is sensitive to this response

Delivery vehicles for neuroactive compounds?

PHYSIOLOGICAL STRESS - EXERCISE

Habitual exercise and fitness may be beneficial

Anti-inflammatory eect

Suppression of inflammatory cytokines

Abrupt, prolonged or excessive exercise may be detrimental

Produces inflammatory cytokines

Prolonged intestinal hypoperfusion

Intestinal ischemia

Increased intestinal permeability

Bacteria/endotoxin translocation

PHYSIOLOGICAL STRESS - CRITICAL ILLNESS

Redistribution of circulation

Intestinal hypoperfusion

Gut ischemia

Mucosal injury

Bacteria/endotoxin translocation

PSYCHOLOGICAL STRESS

Gut-brain axis

Early life stressors, namely abuse, have been suggested as

important contributor to functional GI disorders.

Stressor

Dysfunctional gut-brain axis

Altered gut microbiome

PHARMACEUTICALS

Proton Pump Inhibitors (PPIs)

Antibiotics

PROTON PUMP INHIBITORS (PPIs)

Associated with SIBO

Lack of acid

Lack of protective eect against pathogenic bacteria

ANTIBIOTICS

Oral and IV

Incorporated into bile

Decreased diversity

Changes include:

Loss of bacterial ligands

Loss of specific bacterial signals

Alterations in metabolites (i.e. SCFAs)

Fosters metabolic environment ideal for C.dicile

TREATMENT

PREBIOTICS

Natural, non-digestible carbohydrates, including:

Bananas

Onions

Garlic

Leeks

Asparagus

Artichokes

Edamame

Whole wheat products

PROBIOTICS

Live culture of good bacteria, including:

Yogurt

Kefir

Aged cheeses

Kimchi

Sauerkraut

Miso

Tempeh

QUESTIONS?

REFERENCES

Cresci GA, Bawden E. Gut Microbiome: What We Do and Don't

Know. Nutr Clin Pract. 2015 Dec;30(6):734-46. doi:
10.1177/0884533615609899.

Borowitz, Stephen. "The Human Microbiome: They Are Us & We

Are Them". 2016. Presentation.

Sekirov I, Russell SL, Antunes LC, Finlay BB. Gut microbiota in

health and disease. Physiol Rev. 2010 Jul;90(3):859-904. doi:
10.1152/physrev.00045.2009.

Newgent J. Prebiotics and Probiotics: Creating a Healthier You.

www.eatright.org 2015. Available at: http://www.eatright.org/
resource/food/vitamins-and-supplements/nutrient-rich-foods/
prebiotics-and-probiotics-the-dynamic-duo. Accessed May 10, 2016.