The gut feeling

That several kinds of microbes and parasites are harmful to humans and cause a variety of diseases is a well-known fact. But not all microbes are bad. In many cases, they help in coping with various diseases.

In 2006, Jasper Lawrence, a US-based advertising professional, got himself infected with hookworms to cure his asthma and allergies by walking barefoot through toilets in a village in Cameroon, Africa. When he got back home, he found his condition had gone into “complete remission". In 2007, he founded Autoimmune Therapies, which sold hookworms online. He, however, came under the US Food and Drug Administration agency’s radar. He closed his business and has since moved to the UK. Lawrence’s adventures notwithstanding, the question that arises is: Are microbes really our friends?

From our weight to mood and temperament, it seems that the microflora in the body control everything. In a 2016 study by the University of California, Los Angeles, it was found that women with a certain type of bacteria (bacteroides) had greater volume in the learning, memory and information-processing parts of the brain. The other set of women, with another type of bacteria (prevotella), had more weight in the emotional/sensitive part. However, it must be pointed out that the sample size of the study was quite small: 40 women.

“Just our gut alone contains trillions of microbes," say London-based naturopath and author Nigma Talib over the phone. In her book, Younger Skin Starts In The Gut, Talib writes about balancing the microflora within. “Most of your immune system is located in your gut." Talib says the gut has a bi-directional relationship with the central nervous system, referred to as the gut-brain axis. This allows the gut to send and receive signals to and from the brain. She claims that adding good bacteria such as lactobacillus to the supplement range helped reduce her patients’ anxiety levels. Talib explains that short-chain fatty acids such as butyrates or by-products from fibre digestion were found to increase the levels of the happiness hormone, serotonin.

Microbes have seen a swift rise in popularity—from being enemies to now being sought after. What’s the reason behind this?

Joseph Pizzorno is a naturopath, editor-in-chief, Integrative Medicine and A Clinician’s Journal, and author of the book The Toxin Solution. For him, the importance of microbes is nothing new. “Almost half a century ago, when I was a naturopathic medical student, one of my professors started the class stating, ‘Disease begins in the colon’," says the Seattle-based Pizzorno over email. “They are metabolically active, creating many chemicals—some of which are good for us, like vitamins, while others, like skatoles, are toxic. Unfortunately, the unnecessary fear of bacteria has resulted in the use of antimicrobial chemicals everywhere, even in our food," he says. It would be fair to say, then, that over-sanitization is one of the leading causes behind the rising cases of allergies. “The immune system has evolved to keep microorganisms from colonizing our bodies. When the bacterial, fungal, worm, etc. load is too low, the immune system starts reacting against the normal body constituents," explains Pizzorno.

So what’s the solution?

First, stop using hand sanitizers, antibacterial wipes and household cleansers that promise to wipe out all bacteria, says Pizzorno.

Then, look at your diet. Are you eating foods that feed the right bacteria or kill it? Lovneet Batra, a Delhi-based sports nutritionist who focuses on diets which improve gut health, says, “It’s simple, really—alkaline foods encourage the growth of good bacteria, while the ones that grow in acidic environments are bad for us. It’s all about the environment you’re building in your body," she says. According to her, the inflammatory/acidic foods are sugar, processed foods, packaged cereals, refined carbohydrates, and anything with preservatives, which include market-bought jams, jellies, pickles and preserves.

Batra recommends beginning the day on an alkaline note with coconut water, home-made yogurt and fruits. Pre-packaged breakfast cereals are a bad idea. “On the contrary, dalia (broken wheat) is good because it’s not pre-packaged and acidic." Similarly, she explains that poha (flattened rice) is better than rice crispies, and home-made yogurt has more bacteria than store-bought varieties labelled probiotic. Of course, probiotics (yogurt, kimchi, sauerkraut, kefir, kombucha) are the gold standard for bacterial health, but one must not ignore the role of prebiotics.

“Unlike probiotics that get easily destroyed by stomach acids, prebiotics are fibres that are not easily dissolved and serve as fertilizers or foods for good bacteria," says Batra. Prebiotic foods include raw garlic, raw onions, asparagus, raw leeks, apples, bran, root vegetables and lentils. Also, make sure that you chew your food well, because digestion actually begins in the mouth.

Jumping on the microbes-for-health bandwagon is Seattle-based entrepreneur Naveen Jain. “With research showing that all chronic diseases start in the gut—there was still nothing to really understand what was going on in the gut at a detailed level," says Jain. In 2016, he launched Viome, a wellness start-up that raised $15 million (around Rs97 crore) in venture capital funding in July this year. The start-up analyses the composition of your gut bacteria and metabolism to determine the best diet for you. “This is bringing research from the US government’s Los Alamos Laboratory to look at every single living organism in the gut and what they’re doing to help everyone live a healthier life...," says Jain.

He says that 70% of the immune system is in the gut microbiome, which they can train and balance. “There has been so much research in the past five years to support this, while the medical world is still 20 years behind the science. Chronic diseases and auto-immune diseases (to name a few) are directly linked to the microbiome." On a personal level, analysing his gut bacteria has also helped Jain, who was at one time pre-diabetic. “In response, my doctor recommended that I cut down on carbohydrates and starches, such as potatoes, bread and rice." But, after several weeks of consuming primarily legumes and lentils, his blood glucose levels were static. “As a stool sample analysis later revealed through Viome, I actually needed to eat more carbohydrates, not fewer—once I did this, my health improved." However, this was the case with his own constitution, and cannot be generalized for everyone.

Studies suggest gut microbes are able to put chronic health conditions into remission. It makes sense to not just eat probiotic foods but also pop a daily supplement. Talib and Pizzorno are both of the opinion that a long-term use of a daily probiotic supplement is essential. And this is especially relevant if you work in a high-stress environment, eat out often, or have been on a course of antibiotics.

You know probiotics have really gone mainstream when a leading cosmetic house launches microbiome-friendly skincare. Dior Life is a new range of cosmetics which claims that the creams and cleansers do not kill the good bacteria on the face. “It combines a more ecologically designed product concept with natural ingredients and a revolutionary approach founded on the symbiosis between the skin and the skin’s flora to serve skin hydration and beauty," says Paris-based Édouard Mauvais-Jarvis, environmental director and scientific communication director at Parfums Christian Dior, over email. But does probiotic skincare pack an equal punch? “There are amazing products out there that help balance the skin microflora, but it doesn’t make me jump out of my chair, it’s more like let’s wait and see," says Talib, who also has her own range of probiotic supplements and skincare on online fashion retailer Net-a-Porter.

For me, having suffered from grade IV endometriosis for 10 years, I’m now looking at my chronic condition through the lens of the gut. A specialist in London told me that endometriosis is also an immune disease and the symptoms can be reduced by ensuring healthy gut function. When I thought about it, every attack was accompanied by gastric symptoms. So, after my last surgery, I have changed my diet completely. I take a daily probiotic, have reduced sugar intake, and eat vegetables by the kilo. It’s only been a few months but these days I have no side effects to hormonal pills and injections. I can’t help but think that my diet and probiotics have something to do with it. Maybe it’s a fluke, or maybe it’s my gut instinct.