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gut flora

Anxiety, Antibiotics And Gut Flora

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IS YOUR ANXIETY / STRESS CAUSED BY ANTIBIOTICS?

It would not be the first time that I’ve posted about just how important the bacteria in our gut is.  I just hope that you understand just how critically important the presence of friendly bacteria in our gut is.  This is exponentially more important as newborns, infants, toddlers and young adults.  The negative consequences of not having the right balance of bacteria are too numerous to mention, but this article points out one you may not think of.  Given the fact that the gut actually produces a large chunk of the body’s neurotransmitters (it is frequently referred to at the “second brain”) it is understandable that altered gut flora has been linked to weight gain and now anxiety.  Although this is a mouse study, it would do us well to pay attention to the results.

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Can Bacteria Make You Skinny? Or Antibiotics Fatten You Up?

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If only it were that simple, but physiology rarely is. But this does not mean you can’t use this info on probiotics and weight gain to your advantage.

Out of all the topics I’ve covered in the past 13 years and some 2500 blog posts, there are a few that stand out.  Vitamin D, exercise, diabetes prevention, chronic migraine relief. Probiotics, or those beneficial little buggers that should be present in your gut, is also way up on this list.

That is because the research on probiotics is everywhere across multiple specialties and any number of disease states. Many times I do not flag interesting journal articles on probiotics because I sound like such a darn broken record. So why am I doing it again? Certainly not boredom–I’ve got 20 other articles in my inbox for blog fodder. Maybe it’s because, at times, the evidence for a particular benefit becomes so overwhelming that it needs to be said again.

We are clearly at that point when it comes to probiotics and regulation of body weight.

The problem is that it is not a matter of having obese people add in some probiotics and “Viola!” They wake up skinny. The reality is that having the right blend of healthy bacteria in your gut seems to help set the tone for your body weight over a lifetime. This begins from birth. I recently had a patient with a 4 month old infant tell me that her pediatrician actually recommended probiotics, but that she should start after 6 months.

Well intentioned, but off base by 6 months. Passage through the womb begins the process and nursing continues the exposure of the newborn and infant to bacteria. Waiting for 6 months in a formula fed baby is just WAY too long to wait. This could potentially make the difference between a lifetime of being at an ideal weight versus this child fighting his weight for the rest of his life. Needless to say, I stressed how important it was not to wait 6 months.

As this particular article points out, the details on the process still are not ironed out.  Frankly, given the difference in everyone’s physiology and the hundreds of species of bacteria that are present in the gut, I don’t think we’ll ever get the specifics.

Besides this study, here are some previous blog articles looking at the relationship between probiotics and weight:

  1. Can antibiotics make you fat?
  2. Can the wrong gut bacteria make us fatter?

The take home message is twofold.  First, the use of antibiotics for non-life threatening situations needs to go away. Nothing will destroy the delicate balance of the bacteria in your gut faster than antibiotics.  Second, supplementation of probiotics intermittently is not a bad idea. This concept is particularly important for newborns, infants, toddlers and children.

My general recommendations are as follows:

  • Teens and Adults: 20 billion cfu / day taken one or two weeks per month.
  • Infants and toddlers: 5-10 billion cfu / day at least several days per week.
  • Preschoolers and elementary kids: 10-20 billion cfu several days per week.

While these recommendations vary greatly based on the individual situation, it is a good place to start.

Can Antibiotics Make You Fat?

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There are all kinds of concerns running around with antibiotic resistant bugs. Headlines lately are claiming that the era of antibiotics is coming to an end and soon we will have nothing left to combat our infectious diseases. Rarely, if ever, do I hear the real story highlighted in the media or in the medical literature.

I firmly believe that the rampant use of antibiotics in our newborns, infants and toddlers is wreaking massive havoc on our short term and long term health. I can think of few things as devastating to the immune system than destroying or disrupting the development of the appropriate intestinal flora that begins the second that baby hits the birth canal.

It is difficult for me to describe how important healthy, normal bacterial flora is. There just are not the words to convey everything that the presence of the right blend of bacteria in your gut does for your health. The short list can include:

  1. Develops tolerance in the immune system so it attacks what it should (bacteria, viruses) and and doesn’t attack what it shouldn’t (our own tissues).
  2. Forms a layer along the entire gastrointestinal tract that breaks down harmful toxins to keep them from being absorbed.
  3. It curbs inflammation in the gut, leading to a stable membrane that improves absorption of nutrients and minerals.
  4. It produces natural antibiotics that keep disease-causing bacteria and yeast at bay.
  5. It allows for the proper hormonal messages to be sent to the rest of the body–the gut is considered the 2nd brain.  Would you want your first brain getting all screwed up as bad as your gut?

As I’ve mentioned, the list is long and can get very, very complex. The research backing these statements up includes published journal articles numbering well into the thousands if not tens of thousands. There is NO LONGER any valid excuse for a pediatrician or family practice doctor to write a prescription to an infant or toddler unless it is literally life-threatening. The damage is just too great.

If you think I’m a little to strong on this topic, consider a single study linking the development of an incredibly serious autoimmune condition of the gut. The use of antibiotics in the first year of life increased the risk of developing inflammatory bowel disease 551%. Yes, 551%.

This is merely the tip of the iceberg, but it clearly shows that antibiotics have a massive potential to completely screw up our immune system. And yet I can’t begin to tell you how many patients come in on a daily or weekly basis that were given antibiotics for things like an upper respiratory tract infection, for which there is no evidence that antibiotics should be used. On the contrary, probiotics have been shown to lower the risk of upper respiratory tract infections. This could, ironically, mean that antibiotics will actually make an upper respiratory condition worse.

All of this brings me to this particular article. This is not the first time there have been suggestions that the bacteria in our gut can lead to obesity. In this article, researchers looked at how the alteration of the gut bacteria in mice could play a role in markers of inflammation and diabetes (specifically fasting blood glucose, plasma TNFα and triglyceride levels).

One group was given the antibiotic vancomycin and the other was given a probiotic that was known to produce an antibacterial compound naturally (referred to as bacteriocin-producing Lactobacillus). While the researchers found that the vancomycin group had positive changes and the Lactobacillus group did not, I’m pretty sure this doesn’t mean that we should all run out and get a prescription for vancomycin in lieu of your lap band surgery.

What it clearly suggests is that destruction of certain bacteria in the gut led to an alteration of the way the body was responding in regards to diabetes and inflammation. To me, this would mean that, not setting up the scenario of the obesity-promoting bacteria in the first place (which leads us back to the antibiotics in infants and toddler scenario) is critical.

In the Hospital? On Antibiotics? Prevent C diff Colitis with This

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Clostridium difficile. Nasty stuff. In someone not completely healthy, C diff colitis can kill from the near uncontrollable diarrhea that results.

Otherwise known as C diff, this bacteria is in the Clostridium family.  Siblings you may recognize in this family include Clostridium botulinum (botulism) and Clostridium tetani (tetanus).  Understand that the botulism toxin is one of the most potent toxins on the planet.  A mere thimbleful would be enough to wipe out the entire planet (and yes–this is the same stuff used in Botox–go figure).

C. diff infections occur when antibiotics destroy the normal, protective flora of the intestinal tract and this potentially deadly bacteria can now gain a foothold in the lining of your gut.  As it thrives, it produces toxins that severely irritate the entire GI tract, resulting in diarrhea that can be very difficult to control.  C diff colitis traditionally occurred only in the hospital setting (called hospital-acquired) following the use of broad spectrum antibiotics.  Since this occurs in a population that in which there was already something wrong (they were in the hospital, after all), this can be a very dangerous situation.

That was then, and this is now.  We are seeing an increasing number of community-acquired C diff colitis cases, when people are becoming infected with Clostridium difficile without ever having been in the hospital.  This is a consequence of indiscriminate use of antibiotics in humans and livestock, coupled with lack of recommendations for probiotics to follow up every course of antibiotics.

So what do we do about it?  You guessed it–probiotics.

But, just in case you don’t want to take my word for it, this particular study looked at 20 clinical trials on whether or not probiotics could help prevent or lower the risk of C diff colitis (specifically termed Clostridium difficile–associated diarrhea, or CDAD).   Here’s what they found:

  1. Probiotics reduced the incidence of C. diff colitis by 66%. (Tweet this)
  2. Using probiotics as a preventative, probiotic prophylaxis would prevent 33 episodes per 1000 persons (keep in mind that statins prevent 11 heart attacks per 1,000).
  3. Adverse events in probiotics occurred in 9.3% of patients, compared with 12.6% of control patients.

So across a large number of studies, probiotics clearly lowered the risk of C diff colitis.  No quite an elimination, but a 66% lower risk is not trivial.  Overall, treating everyone on antibiotics with probiotics is a more powerful intervention than is treating patients with statins to prevent a heart attack.  Let’s see if probiotic supplementation to prevent antibiotic associated diarrhea becomes standard practice…

Based on this information, do you think it should be the standard of care for physicians to recommend probiotics along with antibiotics?

 

REASONS TO AVOID ARTIFICIAL SWEETENERS – (02-23-09)

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Sucrose activates human taste pathways differently from artificial sweetener.

As if there weren’t enough reasons to avoid artificial sweeteners already. It still amazes me how well they have permeated our society, and, even more frightening, is how readily our children have taken to their use. It is obvious from a common sense standpoint that putting artificial sweeteners into everything has done nothing to curb our growing rates of diabetes and obesity, and one could strongly argue that they have, in fact, contributed to the increasing incidence.

Altering gut flora, altering our appetite, blunting the thermogenic effect of eating… And now, we see that they affect an unconscious region of our brain that table sugar does not. Personally, I prefer to know what regions of my brain I’m stimulating when I eat.

Read entire article here

COULD ANTIBIOTICS IN CHILDHOOD CONTRIBUTE TO OBESITY?

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Metabolic activity of the enteric microbiota influences the fatty acid composition of murine and porcine liver and adipose tissues

Have I mentioned, by any chance, that the gut flora may have some type of microscopic role in human health.  And that by destroying this flora with antibiotics or not even getting it in the first place (C-section, mom having been on antibiotics) might be a bad thing?

My mind is not what it used to be, but I’m pretty sure I’ve mentioned it once or twice.  Maybe even three times.  With a little ginko, I might even remember 50 or so times….  So, looking at this article, could antibiotics in childhood contribute to obesity?

Read entire article here

COULD ANTIBIOTICS LEAD TO OBESITY?

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There should be no shock to find out just how vitally important having the correct balance of bacteria in our gut is.  The list of conditions that probioitics have shown an effect on is quite a long one.  But this study really looks from a different angle.

The link between bacteria in our gut and obesity is not a newly studied one.  The links between dysbiosis (unhealthy composition of bacteria in our gut) and obesity seems to strengthen with each study.  This particular study goes even further.

Keep in mind that this is a rat study.  The researchers performed a Roux-en-Y gastric bypass on one group and looked at what happened to the rats.  The list is quite long.

First, there was a definate, strong change in the bacteria of the gut.  What this means, we don’t know just yet, but it strongly suggests that there are ties between obesity, bariatric sugery and the bacteria in our gut.  Maybe the changes associated with the surgery, which lead to weight loss, led to the bacterial change.  But does the bacterial change lead to the weight loss?  We don’t have the answer yet, but since it is well established that the metabolic changes that occur after bariatric surgery occur long before weight loss, this may be a logical progression.

It also raises the important question about whether our heavy reliance on both C-sections and antibiotics may not be contributing to the obesity epidemic.  Certainly there are other factors, but we can’t ignore the importance of a healthy gut flora.

Read more…

CAN THE WRONG GUT BACTERIA MAKE US FATTER??

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This is not the first time I’ve gone on a rant about the importance of having a healthy blend of bacteria in the gut on all kinds of chronic disease.  And the fact that wanton antibiotic use (especiallly in our infants and children) decimates a healthy gut and poor lifestyle choices do the same.  Stress can change our gut flora from healthy to unhealthy in a matter of hours.

Our gut contains hundreds and hundreds of little critters.  Bacteria dominate but also coexist with yeasts.  Despite what some promote (Candida diets, antibiotics, etc..), you can never completely eradicate anything in the gut.  Consider our gut like the Taliban underground hideouts in Afghanistan-too many places to hide to wipe them all out.

So consider our gut as more of the most important game of “kind of the hill” you will play.  Probiotic supplementation, good blend of soluble and insoluble fiber, exercise and low stress all help to keep the good guys on top of the hill.

This line of research indicated in this particular study is jaw droppingly fascinating.  Basically, the bacteria in our gut differs if we are obese or lean.  The obese person’s bacteria is more effective at harvesting calories for the person.  This means that more of the calories we eat get absorbed and have the potential to get stored as fat. 

Furthermore, as lean people consumed more calories, the bacteria quickly adapted towards the “obesigenic” side and helped the person absorb more calories.

Very powerful information.  Consider this information the next time a pediatrician wants to put your infant or child on antibiotics for a simple ear infection, Strept throat (yes–I said Strept throat!!) or an upper respiratory tract infection.

http://www.ajcn.org/content/94/1/58.abstract