Minggu, 03 Juni 2012
GUT HEALTH AND IMMUNITY
It’s All About the Good Bacteria That Can Help Fight Disease
By Lori Zanteson
The Basics Everything we eat and drink passes through the gut along the gastrointestinal (GI) tract. It seems simple enough, but the tubelike GI tract, lined with a thin, sticky mucous, is embedded with millions of bacteria that live, grow, and metabolize (digesting and absorbing) in what’s considered a complex ecosystem
comprised of both benefi cial and harmful bacteria.
According to A. Venketeshwer Rao, MSc, PhD, professor emeritus in the department of nutritional sciences at the University of Toronto, “It’s the predominance of the benefi cial bacteria referred to as the probiotic bacteria, such as bifi dobacteria and lactic acid bacteria, that ensure good health and prevent diseases
of the gut and other organs in the body.”
Recent evidence, Rao explains, shows a close involvement of gut microfl ora and various aspects of health, such as nutritional status, behavior, and stress response. “[The gut microfl ora] accomplish this via several mechanisms,” Rao says, “but primarily by metabolizing our dietary constituents to either detoxify them or activate them into toxic forms.
A presence of pathogenic bacteria requires a well-functioning and strong immune system to prevent infections. In this way, the nature and composition of the gut microfl ora can infl uence our immune system.” These benefi cial probiotic bacteria do several things that contribute to good health and immunity. As Rao mentioned, their most basic function is to fi ght harmful foreign substances that enter the body by detoxifying them and easing their elimination.
Probiotics can prevent the growth of harmful bacteria, which thrive and grow within a neutral pH environment, by producing organic acids such as acetic and lactic acids that, in turn, lower the pH of the large intestine. This lower pH also prevents the metabolism of cholesterol and bile acids in the colon.
“Since cholesterol and bile metabolites act as cancer-causing agents,” Rao explains, “they can play an important role in the prevention of cancers of the GI tract and other organs as well.” These helpful bacteria, he continues, can even lower serum cholesterol levels along with cardiovascular disease risk by preventing the activity of an enzyme involved in the synthesis of cholesterol.
What Is Gut Health?
While there’s no clear defi nition of gut health other than a general absence of disease or GI issues, “Gut Health: A New Objective in Medicine?” published in the March 2011 issue of BioMed Central Medicine, lists fi ve criteria that provide a positive basis for understanding (see sidebar).1 Intestinal microbiota, or gut fl ora, and the gut barrier determine gut health.
Inside the gut are about 100 trillion live microorganisms that promote normal GI function, protect the body from infection, and regulate metabolism and the mucosal immune system. In fact, they comprise more than 75% of the immune system. Also important is their role in maintaining and protecting the GI barrier.
An intact GI barrier maintains gut health, while a problem with its microbiota composition will affect the body’s defense systems and can create a condition known as leaky gut syndrome, which can compromise gut health and lead to diseases such as infl ammatory breast cancer, obesity, chronic fatigue syndrome, and depression.
Maintaining Gut Health
When it comes to gut health, Kathie Madonna Swift, MS, RD, LDN, coauthor of The Inside Tract: Your Good Gut Guide to Digestive Health, said in the March 21, 2012, webinar “Functional Nutrition and the Gut” that “diet and nutrition therapy should be the fi rst route [to obtaining gut health], not the alternative. In Western medicine, they [prescribe] medicine.” Based on several studies, the current medical focus is on treatment rather than prevention. Several drugs exist to treat acute infl ammatory bowel disease (IBD), for example, but none to prevent it.
The research behind what’s known as the hygiene hypothesis says an imbalance within the gut will impair the gut barrier and increase risk to gut health and of developing disease. Conditions that cause imbalance can be an unbalanced diet but also may be lack of exercise or chronic stress. Recent studies have shown that high dietary fat and high fructose disturb the GI barrier, which can lead to fatty liver disease
and infl ammation.
1 On the other hand, positive changes in the diet have been shown to help prevent major diseases such
as obesity, allergy, and cancer.1 As more research shows the key role that diet and lifestyle play in maintaining gut health and preventing GI diseases, including infection, IBD, and food allergies, Swift says, “We [dietitians] have to be the change agent to make this happen.”
Swift says processed foods and today’s grains vs. ancient grains have a big impact on gut function. To help improve it and prevent disease, she counsels clients to feed gut fl ora by “plant centering the plate” and eating foods that are nutrient dense, high in fi ber, and have a low glycemic load.
As a proponent of the RD’s role in public health, Rao agrees. Dietitians would do well to counsel clients to eat “healthpromoting diets and, in particular, diets that help promote the predominance of the benefi cial bacteria,” he says. Because probiotic bacteria use complex carbohydrates such as dietary fi ber and harmful bacteria use dietary proteins and fats to produce toxins that can damage good health,
Rao suggests a diet that’s a “good source of complex carbohydrates and low in red meats, which are sources of protein and saturated lipids. Good food sources of complex carbohydrates include fruits, vegetables, legumes, and cereals. Another important recommendation is to include foods that are rich sources of antioxidants such as fruits and vegetables.”
Food is central, but supplements can be helpful,” Swift adds. Most notable in supporting gut health are supplements containing probiotics or prebiotics. Though the number of studies is limited, probiotics have been shown to maintain gut health and prevent chronic bowel diseases such as IBD and restore leaky gut. While it’s still premature to recommend these supplements as a preventive measure, current evidence indicates a “strong rationale for using probiotics, possibly also in synergistic combinations with prebiotics, to
maintain gut health.”1
RDs always have understood and counseled clients on the importance of food as preventive medicine and a maintainer of overall health. By recommending a balanced diet, exercise, and strategies to reduce stress as well as prebiotics and probiotics, RDs can support gut health in their practice. Now that medical research is beginning to make that food and guthealth connection, RDs will play a key role in what will hopefully be a shift in focus from treatment of GI disease to prevention.
— Lori Zanteson is a southern California-based food and health
writer whose work has appeared in various publications.
FIVE CRITERIA FOR
A HEALTHY GI TRACT1
Specifi c Signs of Gastrointestinal (GI) Health
• Normal nutritional status and effective absorption of food, water, and minerals
• Regular bowel movement, normal transit time, and no abdominal pain
• Normal stool consistency and rare nausea, vomiting, diarrhea, constipation, and bloating Absence of GI Illness
• No acid peptic disease, gastroesophageal refl ux disease, or other gastric infl ammatory disease
• No enzyme defi ciencies or carbohydrate intolerances
• No infl ammatory bowel disease, celiac disease, or other infl ammatory state
• No colorectal or other GI cancer Normal and Stable Intestinal Microbiota
• No bacterial overgrowth
• Normal composition and vitality of the gut microbiome
• No GI infections or antibiotic-associated diarrhea Effective Immune Status
• Effective GI barrier function, normal mucus production, and no enhanced bacterial
• Normal levels of immunoglobulin A, normal numbers and normal activity of immune cells
• Immune tolerance and no allergy or mucosal hypersensitivity Status of Well-Being
• Normal quality of life
• Qi (ch’i), or positive gut feeling
• Balanced serotonin production and