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The Effectiveness of Diet in the Intervention of Dysbiosis of the Gastrointestinal Microbiota on Inflammatory Disease among Adults B Y CA MI LLE R E D MOND 1 Let’s break that down What is the microbiota? • Microorganisms that live on and in the body • • • • Includes, bacteria, fungi, protozoa, and viruses Consists of between 75 to 200 trillion individual organisms Of 1,000 different species of microorganisms May weigh up to 5 lbs (Hair & Sharpe, 2014) Retrieved December 8, 2015 from https://studentaffairs.duke.edu/blog-entry/how-your-microbiota 2 The function of the microbiota • Vitamin synthesis • Digestion of dietary fiber • Regulation of inflammatory responses (Maslowski & Mackay, 2011) Retrieved December 8, 2015 from http://www.diapedia.org/type-1-diabetes-mellitus/2104723411/microbiome-and-type-1-diabetes 3 Diet • Effects the composition of the gut microbiota • Different human populations have different microbiomes • Contributes to the unique combination of bacteria within an individual (Flint, Duncan, Scott, & Louis, 2007) Retrieved December 8, 2015 from http://livinggreenmag.com/2014/02/25/food-health/heritagepyramids-cultural-cuisines-can-clean-diet/ 4 Diet and Beneficial Bacteria • Complex carbohydrates, dietary fiber, resistant starch • Legumes, whole grains, vegetables • Short chain fatty acids produced by fermentation • • • • • Maintains epithelial barrier function Diminished oxidative DNA damage Regulates inflammation Stimulates immune function Anti-cancer properties (Maslowski & Mackay, 2011) Retrieved December 8, 2015 from http://www.freeendlessinfo.com/wp-content/uploads/2012/11/veggies_f.jpg 5 Diet and Pathogenic Bacteria • Refined foods • Think white: flour, sugar, etc. • Prepared/processed foods • Convenience foods • High Fat, protein rich • Animal products Produces toxic metabolites triggering inflammatory responses (Berg, Kelly, & Farraye, 2012; Begley, Hill, & Gahan, 2006) Retrieved December 8, 2015 from http://www.cwmtafuhb.wales.nhs.uk/preventing-stroke 6 Dysbiosis • Proliferation of pathogenic bacteria • Alters immune function and metabolic activity causing: • Obesity • Insulin resistance • Fatty liver disease • Produces a chronic inflammatory state • Due to increase in bacterial antigens (Amar et al, 2011) Retrieved December 8, 2015 from http://333oee3bik6e1t8q4y139009mcg.wpengine.netdnacdn.com/wpcontent/uploads/2015/06/BacteriaOvergrowthChart.png 7 Prebiotics and Probiotics • Prebiotics • Complex carbohydrates, dietary fiber, resistant starch • Legumes, whole grains, vegetables • Probiotics • Beneficial bacteria • Yogurt, kefir, fermented vegetables, kombucha Prebiotics and probiotics may reverse dysbiosis (Dore & Blottiere, 2015) Retrieved December 8, 2015 from http://sitn.hms.harvard.edu/wp-content/uploads/2015/02/MN-Fig-3.jpg 8 Infancy • Established through the birth process, breast feeding, and the environment • Impacts epigenetic programming of later immunity and of regulation of genes involved in lipid and carbohydrate metabolism • Reaches a stable microbial population by 3 years of age (Yatsunenko et al, 2012) Retrieved December 8, 2015 from http://img.medicalxpress.com/newman/gfx/news/hires/2015/t heinfantgut.jpg 9 Elderly Over the Age of 65 • Malnutrition linked to physiological changes impacting digestion and absorption • Decreased taste and smell • Swallowing difficulties • Masticatory dysfunction • Reduced intestinal motility altering fermentation • Inflammaging • Low grade chronic system inflammation • Contributes to frailty, unhealthy aging, and degenerative disorders (Salazar et al, 2014) Retrieved December 8, 2015 from http://www.nature.com/na ture/journal/v492/n7427_su pp/full/492S14a.html 10 Future Research • Relatively new area of nutritional science • Prebiotics • Effects on composition and function of microbiota • Identify potential benefits on specific disease conditions • Further understanding of the composition, function, and interactions between the microbiota and the host (Brownawell et al, 2012) Retrieved December 8, 2015 from http://www.thebluediamondgallery.com/pictures/resear ch.jpg 11 Education • Understanding the relationship between the microbiota and the host increases our knowledge of disease • Eating a varied, high-fiber diet will support beneficial bacteria • Diet shapes the microbiota impacting health (Giorgetti et al, 2015) Retrieved December 8, 2015 from http://www.thebluediamondgallery.com/pictures/ed ucation.jpg 12 Policy • Prebiotics and probiotics • Health claims not approved by FDA • Nutrient content claims cannot be made because there is no daily value established • Structure/function claims most common (Brownawell et al, 2012) Retrieved December 8, 2015 from http://www.thebluediamondgallery.com/pictures/policy.jpg 13 Intervention • Prebiotics • Complex carbohydrates, dietary fiber, resistant starch • Legumes, whole grains, vegetables • Probiotics • Beneficial bacteria • Yogurt, kefir, fermented vegetables, kombucha Individualized dietary plan (Zhang et al, 2010) Retrieved December 8, 2015 from http://www.frontiersin.org/files/Articles/108740/fmicb-05-00494HTML/image_m/fmicb-05-00494-g002.jpg 14 References • Amar, J., Chabo, C., Waget, A., Klopp, P., Vachoux, C., Bermudez-Humaran, L. G., … Burcelin, R. (2011). Intestinal mucosal adherence and translocation of commensal bacteria at the early onset of type 2 diabetes: Molecular mechanisms and probiotic treatment. EMBO Molecular Medicine, 3(9), 559-572. • Begley, M., Hill, C., & Gahan, C. G. M. (2006). Bile sale hydrolase activity in probiotics. Applied and Environmental Microbiology, 72(3), 17291738. • Berg, A. M., Kelly, C. P., & Farraye, F. A. (2012). Clostridium difficile infection in the inflammatory bowel disease patient. Inflammatory Bowel Disease, 19, 194-204. • Brownawell, A. M., Caers, W., Gibson, G. R., Kendall, W. C., Lewis, K. D., Ringel, Y., & Slavin, J. L. (2012). Prebiotics and the health benefits of fiber: Current regulatory status, future research, and goals. Journal of Nutrition, 142(5), 962-974. • Dore, J. & Blottiere, H. (2015). The influence of diet on the gut microbiota and its consequences for health. Current Opinion in Biotechnology, 32, 195-199. • Flint, H. J., Duncan, S. H., Scott, K. P., & Louis, P. (2007). Interactions and competition within the microbial community of the human colon: Links between diet and health. Environmental Microbiology, 9(5), 1101–1111. • Giorgetti, G., Brandimarte, G., Fabiocchi, F., Ricci, S., Flamini, P., Sandri G., … Tursi, A. (2015). Interactions between innate immunity, microbiota, and probiotics. Journal of Immunology Research, 2015, 1-7. • Hair, M. & Sharpe, J. (2014). Fast facts about the human microbiome. The Center for Ecogenetics and Environmental Health. Retrieved December 8, 2015 from http://depts.washington.edu/ceeh/downloads/FF_Microbiome.pdf • Maslowski, K. M. & Mackay, C. R. (2011). Diet, gut microbiota and immune responses. Nature Immunology, 12(1), 5-9. • Salazar, N., Arboleya, S., Valdes, L., Stanton, C., Ross, P., Ruiz, L., … de los Reyes-Gavilan, C. G. (2014). The human intestinal microbiome at extreme ages of life. Dietary intervention as a way to counteract alterations. Frontiers in Genetics, 5, 1-9. • Yatsunenko, T., Rey, F. E., Manary, M. J., Trehan, I., Dominguez-Bello, M. G., Contreras, M., … Gordon, J. I. (2012). Human gut microbiome viewed across age and geography. Nature, 486(7402), 222-227. • Zhang, C., Zhang, M., Wang, S., Han, R., Cao, Y., Hua, W., … Zhao, L. (2010). Interactions between gut microbiota, host genetics and diet relevant to development of metabolic syndromes in mice. International Society for Microbial Ecology, 2010(4), 232-241. 15