Microbes Target the Sweet Spot

As obesity and diabetes numbers soar across the globe, public health departments are looking for answers beyond the “fast food, slow lifestyle” cause.
Microbes may be part of the problem. In chronic diseases, a dysbiosis—imbalance of the gut microbial ecosystem—often exists. Whereas the disease itself may lead to a microbial mess, it is also believed that the opposite may be true: dysbiosis may be a cause of diabetes and obesity.
Finnish researchers Mikael Knip and Heli Siljander at Helsinki University Hospital looked at the evidence. Their work appears as Effects of Probiotics on Glycemic Control and Inflammation in Type 2 Diabetes Mellitus: A Randomized, Double-Blind, Placebo-controlled Study.

Type 1 diabetes:

Prediabetic children have decreased microbial diversity as well as reduced community stability when matched with children not showing antibodies or biomarkers of the disease.
Antibody-positive children showed:
• More Bacteroidetes
• Fewer butyrate-producing bacteria

Obesity:

• Alterations in gut microbes
• Efficient in harvesting energy
• More Firmicutes
• Decreased Bacteroidetes
• Reduced butyrate-producing bacteria

Type 2 Diabetes:
• Decreased diversity
• Reduced butyrate-producing bacteria in the gut
• Change in inflammatory activity
• Change in insulin resistance

The question: what to do with this information to benefit health.
Diet itself can have a profound impact. High fiber foods or indigestible carbohydrates called prebiotics may reset the microbiome.

Use of probiotics can alter the system and reduce the risk of obesity and diabetes. This is ironic because in Finland where supplementation with probiotics is high, the incidence of Type 1 diabetes is the world’s highest.
Reseeding the entire gut with fecal transplants works well with infestation by toxins such as Clostridium difficile and may eventually be effective in diabetics. Initial research shows improved insulin sensitivity. One 2015 study from Brazil showed reduced hemoglobin A1C (average blood sugar over 2-3 months) when a group of Type 2 diabetics were given milk fermented with strains of Lactobacillus acidophilus and Bifidobacterium lactis. Inflammatory markers also decreased
Take-away message?
Eat lots of fermented foods: yogurt, buttermilk, kefir and the like. Increase those foods needed to feed them. Prebiotics are available in whole grains, fruits and vegetables. Take a supplement.

We need all the help we can get.

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Must-read opinion piece–and “most e-mailed” March 9, 2014)– by Pagan Kennedy about the history of antibiotic use in our feed animals and how it relates to obesity appears in New York Times here. For more on antibiotics and fat, skip to Chapter 9 (Pumped Up:Food Additives And Obesity) in Globesity:10 Things You Didn’t Know Were Making You Fat.

No Pain, More Gain Later with Caesarean Section

Babies born by caesarean section may be more likely to be fat as adults.

A recent review of the literature found that the odds of overweight and obesity were 20 percent greater in these types of births than those delivered vaginally. The 2014 study appears here in PLOS ONE.

Earlier research in Brazil  based on data on a group followed from 1978 and reported in 2011, also found obesity higher in the surgical group than in the labor-intensive birth group. (15% vs 10%).

Microbes may be the difference. A mother’s unique set imprints the baby as it emerges through the birth canal. But if the newborn takes a shortcut out of the tummy as in a caesarean section, it misses out on the magic and instead mops up the bacteria of the doctor or nurse or whoever else is working the room. Certain microbes may lead to obesity by harvesting more energy from food, making more fat cells and by triggering inflammation. Germ warfare indeed.

C-sections disturb the natural order.

Now compare obesity rates with caesarean section numbers. Both have soared in the last few decades, nearly in tandem. Rates have nearly doubled for both in some countries over that time period.

One in three mothers in the United States now gives birth this way.

In China, an astonishing 60% are delivered surgically while Brazil posts a 47% rate, according to recent reports.

The World Health Organization recommends that only 15% of births be caesarean; it should be done only when mother or child is at risk with complications. Too often, they are performed as a convenience for the mother or doctor, with little thought to the implications of the choice. The miracle of a birth of a new being produced by the perfect storm of biological and hormonal changes deserves better. Just because we can make an appointment on our smartphones for a C-section as easily as a pedicure, doesn’t mean we’re getting smarter.

The fallout from doing so may show up on the scales years later, making good health elusive.