More than 2,000 years ago, Hippocrates , the father of modern medicine suggested that all disease begins in the gut. The significance of gut health in overall human well-being has been a focal topic in medicine for centuries. Notably, the ancient physician Hippocrates, who lived in the 4th century BCE, famously stated that “poor digestion is the source of all evil” and that “death resides in the intestines.” While past studies predominantly concentrated on harmful gut bacteria, contemporary research is increasingly exploring the vital role of gut microbes in maintaining balance (homeostasis) and their involvement in disease development (pathogenesis). This shift highlights the integral connection between gut microbiota and health.

The intricate balance of the human microbiota is a pivotal contributor to our overall health. Understanding the critical distinction between eubiosis a state of healthy microbiota and dysbiosis, which entails an imbalance in microbial communities, is essential for optimising nutrition and promoting well-being. In this article, we will explore the factors influencing our microbiota composition, the physiological significance of maintaining a eubiotic state, and the nutrition-related strategies that can help restore balance.

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Understanding the Microbiota

The composition of our microbiota is shaped by an interplay of host genotype, environmental factors, and dietary habits. The signalling molecules and metabolic products generated by these microbial communities are integral in influencing various intestinal functions, including digestion, motility, permeability, and energy harvest. What’s more, these microbial components can enter systemic circulation, potentially impacting the functionality of organs such as the brain, liver, and pancreas.

The landmark observations by Hippocrates in ancient history, stating that “death is in the bowels,” alongside Ali Metchnikoff’s assertion that “most diseases begin in the digestive tract,” emphasise the necessity of maintaining a healthy microbial ecosystem. A gut microbiota in a state of eubiosis is characterised by a predominance of beneficial bacterial species, particularly from the Firmicutes and Bacteroides phyla, and a minimal presence of pathogenic strains. Conversely, dysbiosis arises when these beneficial bacteria cannot adequately manage populations of harmful bacteria.

Human Virome

It is important to keep in mind that microbial ecosystems encompass not only bacteria, but also viruses, bacteriophages, and fungi, all of which play a vital role in maintaining balance. Metagenomic studies have revealed that a diverse array of viruses, many of which are unique to each person, regularly inhabit our bodies. The category of human viruses includes both eukaryotic and prokaryotic varieties. Eukaryotic viruses can significantly impact human health, while viruses that infect prokaryotes may also influence health by altering the structure and function of bacterial communities. Thus, defining the virome is crucial for understanding how microbial networks affect human health and disease. More research is needed to further explore the virome’s effects on human health, immunity, and responses to co-infections. Recent findings indicate that “Influenza virus infection of intestinal cells increases the exposure of galactose and mannose on the cell surface, which significantly enhances bacterial adherence, regardless of their own adhesive capabilities, suggesting that influenza virus infection may pose an additional risk factor.”

The Physiological Importance of Eubiosis

Several factors can disrupt the delicate balance of our intestinal microbiota, including lifestyle choices, antibiotic treatments, and pathogenic infections. The detrimental consequences of antibiotic treatment, for instance, are well-documented, revealing that such interventions can precipitate antibiotic-associated diarrhoea due to the proliferation of opportunistic pathogens like Clostridium difficile.

Dysbiosis has been linked to the pathogenesis of numerous diseases, encompassing both intestinal conditions—such as irritable bowel syndrome and inflammatory bowel disease—and extra-intestinal issues like obesity and metabolic disorders. For instance, notable research indicates that dysbiosis is implicated in the development of type 2 diabetes mellitus (DM2) through mechanisms such as reduced glucose tolerance and increased insulin resistance. In contrast, eubiosis is associated with enhanced glucose metabolism and increased insulin sensitivity, potentially lowering the risk of diabetes-related complications.

Common Symptoms of Dysbiosis

• Bad Breath (Halitosis): Persistent foul odor from the mouth.
• Digestive Issues: Such as upset stomach, nausea, constipation, or diarrhea.
• Urinary Difficulties: Trouble urinating.
• Itching: Sensations in the vaginal or rectal areas.
• Bloating: Distension and discomfort in the abdomen.
• Chest Pain: Discomfort in the chest area.
• Skin Reactions: Including rashes or redness.
• Fatigue: Ongoing tiredness that doesn’t improve with rest.
• Cognitive Issues: Difficulty thinking clearly or concentrating.
• Mental Health Concerns: Including anxiety and depression.

How Is Dysbiosis Diagnosed?

A proper diagnosis of dysbiosis typically involves a comprehensive evaluation by your healthcare provider, including a review of your medical history and an assessment of your symptoms. The specialist may recommend one or more of the following diagnostic tests:

Organic Acids Test

• This test requires a urine sample collected. The laboratory will analyze the presence of specific organic acids produced by bacteria. Abnormal levels can indicate a microbial imbalance.

Comprehensive Digestive Stool Analysis (CDSA)

• In this test, your healthcare provider will provide you with a special kit to collect a stool sample at home. You will return this sample for laboratory analysis, which will identify the types and levels of bacteria, yeasts, and fungi present, helping diagnose imbalances or overgrowth.

Hydrogen Breath Test

• This non-invasive test involves consuming a sugar solution and then breathing into a special device. The breath sample is analyzed for gases indicating bacterial activity. This test is particularly useful for diagnosing Small Intestinal Bacterial Overgrowth (SIBO).

Biopsy

• In cases of active infection, your healthcare provider may take a small sample of tissue or bacteria to identify the bacterial species responsible for the infection.

Nutritional Strategies to Suport Eubiosis

Promoting a balanced gut microbiota can be achieved through specific dietary interventions that support beneficial bacterial growth. The following prebiotics have shown promising results in improving microbial composition and aiding glycaemic control in individuals with DM2:

1. Inulin: Recommended daily intake of 2 to 12 grams. Sources include onions, Jerusalem artichokes, chicory, dark chocolate (85% cocoa), and agave.
2. Resistant Starch: Recommended intake of 10 to 15 grams per day. Found in foods such as potatoes, green bananas, and black beans.
3. Fructooligosaccharides (FOS): Suggested intake of 12.5 to 20 grams daily. Present in chicory, asparagus, artichokes, and onions.
4. Galactooligosaccharides (GOS): Recommended daily intake of 2 to 10 grams. Found in legumes such as beans and lentils.
5. Peptidic Oligosaccharides: Suggested intake of 30 grams per day. Found in olives, citrus fruits, apples, and potato pulp.
6. Polyphenols: Suggested intake of 1 to 2 grams daily. Found in chocolate, berries, and quinoa.
7. Beta-Glucans: Present in oats and barley.

Restoring Gut Microbiome Health

Restoring a healthy gut microbiome has become clinically significant, with methods such as targeted dietary interventions, the use of pre- and probiotics, and emerging therapies like faecal microbiota transplantation (FMT) showing promise in treating various disorders. Personalised approaches that consider individual microbiota profiles will be pivotal in implementing effective therapeutic strategies.

Maintaining an eubiotic condition within the intestinal ecosystem is integral to optimising health, and detrimental impacts on the microbiota can arise from lifestyle choices, dietary habits, and external factors. Therefore, cultivating a holistic understanding of our microbial community and its interactions is paramount for promoting health and preventing disease.

My Thoughts:

Unlocking the intricacies of human health reveals that restoring a compromised gut microbiome requires time and multifaceted approaches. Effective gut microbiome restoration depends significantly on targeted dietary choices, but is also greatly influenced by factors such as exercise, hydration, sleep, and overall lifestyle habits. When searching for qualified professionals specializing in gut microbiome health, mental health, and dysbiosis, it is crucial to find practitioners who are research-driven and stay up-to-date with the latest scientific advancements in intestinal health. Prioritizing expert guidance can lead to improved gut health outcomes and enhance mental well-being, making it essential to seek knowledgeable and reputable specialists in the field.