GUT MICROBIOTA AND NUTRITION NEWSLETTER #17
April, 2020
We sincerely hope that as you read this, you're safe and healthy and are taking some time to nourish yourself. Each one of us is dealing with different challenges during this pandemic, but it's a great comfort that we have the opportunity to remain connected and purposeful through our digital community.
In this month's newsletter, we summarize studies on how gut microbiota varies with consumption of fermented foods, and on the health effects of excess salt. We also highlight a publication examining gut microbiota responses to changes in diet and weight. Then we highlight an analysis on probiotics for hypertension, and a review on gut microbial metabolites in type 2 diabetes.
Do feel free to reach out at any time with questions or feedback! We remain physically distant but digitally close.
Natasha and Kristina
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Consumption of Fermented Foods Is Associated with Systematic Differences in the Gut Microbiome and Metabolome
This study examines the gut microbiome of fermented food consumers versus non-consumers involved in the American Gut Project. 16S rRNA amplicon sequencing revealed subtle, but statistically significant, compositional differences in the gut microbiome profiles of fermented food consumers. The consumption of fermented foods was associated with a gut microbiota enriched in microbes known to be derived from fermented foods, including fermented milk products (Lactobacillus acidophilus, Lactobacillus brevis, Lactobacillus kefiranofaciens, Lactobacillus parabuchneri, and Lactobacillus helveticus) and fermented meat (Lactobacillus sakei). Interestingly, the metabolome of fermented food consumers was enriched with conjugated linoleic acid (CLA), known for its beneficial health effects. The increase in CLA was not associated with intake of foods rich in CLA such as dairy, eggs, or meat, but is believed to be associated with microbial production. Further study is required, but the researchers hypothesize the putatively beneficial health effects of fermented foods may be related to CLA production as a result of the microbes found in fermented foods.
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A high-salt diet compromises antibacterial neutrophil responses through hormonal perturbation
Researchers from the University of Bonn have discovered how excess salt intake impairs the immune system in mice and humans. This elegant study found that mice exposed to a high salt diet had an impaired neutrophil response so were less able to rid themselves of ingested bacteria such as Listeria monocytogenes and E. coli. The results were supported by a follow-up study in healthy volunteers consuming 6 grams of sodium in addition to their regular diet (the equivalent of two fast food meals). Researchers collected the subjects' serum and found that the neutrophils did not respond as strongly when exposed to the high salt diet, concluding that a high salt diet could potentially increase vulnerability to bacterial infections.
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Long-term dietary intervention reveals resilience of the gut microbiota despite changes in diet and weight
Researchers from Stanford found that neither baseline microbiome composition nor baseline diversity predicts the degree of weight loss on either a healthy low-carbohydrate (low-carb) or low-fat diet for weight loss. The Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) clinical trial was a year-long dietary intervention study that included 609 generally healthy, nondiabetic participants. Participants lost weight but despite initial taxonomic changes to the microbiota during the first 3 months of the intervention, the microbiota returned to baseline for the remaining 9 months of the study.
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Effects of Probiotics on Patients with Hypertension: a Systematic Review and Meta-Analysis
Do probiotics have any effects on hypertension? This publication concluded that probiotic consumption results in a 4.81 mmHg (95% CI 1.53, 8.09) reduction in systolic blood pressure in individuals with pre-existing hypertension. This systematic review examined 11 studies involving 628 patients. The efficacy of probiotic supplementation was associated with treatment duration, dosage, and the age of subject, but not single versus multiple strain usage. People receiving a treatment for longer than 4 weeks and a dosage of more than 2 × 10(10) CFUs showed a more pronounced reduction in blood pressure. Patients older than 60 years benefited less from probiotic supplementation.
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Metabolites Linking the Gut Microbiome With Risk for Type 2 Diabetes
Microbial metabolites play a complex role in the regulation of host metabolism and maintenance of the gut microbiome, and as a result they have been linked to insulin resistance and type 2 diabetes. This review discusses the key mechanisms of how several important metabolites (e.g., short-chain fatty acids, bile acids, sulfur-containing amino acids, branched-chain amino acids, lipopolysaccharide, etc.) influence the gut microbiome and how they are linked specifically to type 2 diabetes.
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Beyond cough and fever: How common are digestive symptoms in COVID-19 infection?
So much of the focus on COVID-19 has been on severely ill patients with respiratory systems that include coughing, difficulty breathing, and pneumonia. But what about digestive symptoms?
New and emerging research confirms that about 50% of patients wth COVID-19 develop digestive symptoms such as diarrhea, nausea, vomiting, and/or poor appetite (1). In fact, diarrhea was reported as one of the first or only symptoms COVID-19 positive patients experienced. In some cases, digestive symptoms presented before the respiratory symptoms even occurred (2).
Digestive symptoms are common in the general population and can worsen with stress and anxiety. And let’s be honest, who isn’t under a bit of stress in the current situation? So while diarrhea isn’t always indicative of COVID-19 infection, it is definitely a possible symptom of the infection. People who were diagnosed with COVID-19 diarrhea tended to have diarrhea that lasted for an average of 5 days (range 1-14 days), with about 4 stools/day. Stools were loose and, in some cases, watery (1). What appeared to distinguish COVID-19-related diarrhea from “stress” diarrhea is that the patients also had a FEVER (73%). Diarrhea with fever is not just stress and indicates that there could be an infection. (With that said, not all patients that had diarrhea and were COVID-19 positive presented with a fever.)
Is COVID-19 diarrhea an infectious diarrhea? Research looking at the feces of COVID-19 patients found that 53% contained the genetic material of the COVID-19 virus in their stool for up to 5 weeks after respiratory symptoms cleared; however, the active virus was not found (2). It is important to note that this was a study of 9 patients with a mild, uncomplicated course of COVID-19. The verdict is still out as to whether or not COVID-19 can spread via fecal-oral transmission. What is clear, however, is that the virus is shed in feces, in addition to the more frequently discussed fluids like saliva and respiratory secretions. Until further studies are able to confirm that feces are not infectious, it is better to err on the side of caution and treat fecal transmission as a potential risk.
For now, continue physical distancing and meticulous handwashing -- and add bathroom sanitizing to your routine if you or someone in your household is sick or has recently been sick.
Covid-19 is #NotJustCough*
Stay safe, all!
*The #NotJustCough hashtag was coined by Dr. Brennan Spiegel to bring awareness that COVID-19 infection is not just a respiratory condition.
References:
(1) Han, C., Duan C, Zhang S. et al. Digestive Symptoms in COVID-19 Patients with Mild Disease Severity: Clinical Presentation, Stool Viral RNA Testing, and Outcomes. AJG (2020). https://journals.lww.com/ajg/Documents/COVID19_Han_et_al_AJG_Preproof.pdf
(2) Wölfel, R., Corman, V.M., Guggemos, W. et al. Virological assessment of hospitalized patients with COVID 2019. Nature (2020). https://doi.org/10.1038/s41586-020-2196-x
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