GUT MICROBIOTA AND NUTRITION NEWSLETTER #21
August, 2020
Dear Friends,
A number of great review papers have been published lately, and we'd like to share some of our favourites with you in this newsletter! See below for reviews on B-vitamins, the gut barrier, dietary patterns and metabolites, fat soluble vitamins and the gut microbiota, and the prebiotic nature of human milk oligosaccharides. We're also sharing an interesting systematic review on how the gut microbiota is affected by parenteral nutrition versus enteral nutrition.
This month's big news in the probiotics / prebiotics world is the publication of the international scientific consensus definition of 'synbiotics'. Find the paper in Nature Reviews Gastroenterology & Hepatology below.
Until next time -- stay safe!
Natasha and Kristina
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Functional Roles of B‐Vitamins in the Gut and Gut Microbiome
When you see a list of the functions of the gut microbiota, "synthesis of B-vitamins" is usually prominent. But the metabolism of B-vitamins is enormously complex. This review article gets into the details: how some B-vitamins are absorbed in the small intestine; how excess B-vitamins make it down to the colon; how the gut microbiota in the colon synthesize additional B-vitamins; and how these synthesized B-vitamins have important functions, both for the host and for gut microbial ecology.
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Impact of diet and the bacterial microbiome on the mucous barrier and immune disorders
In humans, good health depends (in part) on mucous. That is, the layer of mucous that lines the interior of the gut, which prevents microbes from leaking out of the gut and into systemic circulation, disrupting the functioning of the immune system. In fact, some major immune/metabolic conditions (obesity, diabetes, inflammatory bowel disease and others) are linked to this breakdown of the gut barrier. Here’s some reading on the relationship between the mucous barrier, diet, and gut microbiota -- including how a diet high in fat (at least, high in certain fats) makes the mucous barrier more permeable through alterations in gut microbiota.
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Dietary Components, Microbial Metabolites and Human Health: Reading between the Lines
Ultimately, tracking the precise health effects of diet may come down to the metabolites produced by a person's gut microbiota. This nice review goes through different macronutrient substrates in the diet (everything from inulin to milk), specifying which metabolites they are associated with and what activity those metabolites are predicted to have. Then the authors zoom out to the metabolites associated with different dietary patterns: the Mediterranean diet, the paleo diet, and others.
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Metabolic and functional interplay between gut microbiota and fat-soluble vitamins
Fat soluble vitamins -- A, D, E, and K -- are those that are absorbed when taken with a source of lipids, and are stored in the body for a longer period of time because they are kept in the body's fat and liver. This review covers what we know about fats, the gut microbiota, and fat soluble vitamins. The authors describe how all three of these components interact to influence immune function and gastrointestinal physiology.
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Human milk oligosaccharides: Shaping the infant gut microbiota and supporting health
Human milk is full of complex carbohydrates called human milk oligosaccharides (HMOs) -- which have recently become available in some commercial infant formulas. This review paper details the effects of HMOs on the health of the infant, and what's known about the mechanisms. Scientists have found HMOs do not provide direct nutritional value to the infant; instead, they function as prebiotics, promoting the growth of beneficial bacteria in the infant gut and conferring some health effects indirectly.
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Nutrition Support and the Gastrointestinal Microbiota: A Systematic Review
Clinically, you may have reasons to recommend either parenteral nutrition (PN) or enteral nutrition (EN) to your clients / patients. This systematic review looked at the effects of these two interventions on the gut microbiota, and found more deviation from the 'normal' state with PN compared to EN: that is, PN was associated with a lower diversity microbiota and higher Proteobacteria.
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The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of synbiotics
You may have heard the word "synbiotic" used to refer to a combination of a probiotic and a prebiotic. But this definition lacked scientific precision, making it difficult to know what evidence was necessary to prove that a synbiotic product conferred a health benefit. Hot off the press, check out the international scientific consensus definition of synbiotics, co-authored by a global panel of scientific experts. (Read the highlights, along with an infographic on the new definition, in this article from the International Scientific Association for Probiotics & Prebiotics.)
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NATASHA'S PRACTICE TIP:
Saturated Fat: Pass me the Butter!

I was pleased to see the recent state of the art review in the Journal of the American College of Cardiology supporting a reassessment of the current guidelines to limit saturated fatty acid (SFA) intake to less than 10% of total calories. I highly recommend this read! Mounting evidence shows no association between SFA consumption and increased risk of cardiovascular disease (CVD), diabetes or mortality. But why is there such great resistance to changing national guidelines and recommendations?
As a dietitian myself, it seemed the recommendation to reduce SFA intake was dogma, well rooted in science and the one nutrient I thought scientists had figured out. It was not until I started my PhD studies, examining the impact of specific fats on inflammation and the microbiome, that I realized there was way more to this story and that perhaps we do not understand SFA, let alone all fats, as much as we originally thought. Trust me I was skeptical, as I had my own biases around fat. Little did I know that the evidence that shaped my biases was generated circa 1980. Well, it is 2020 -- and as nutrition science continues to evolve and recommendations continue to be updated, SFA are in the spotlight again.
What changed my mind and why do I care?
- I have sifted through a number of systematic reviews that continue to come to the conclusion that there is no evidence for the association between SFA and increased CVD risk. In some cases, as for insulin resistance and stroke, SFA have shown protective effects.
- As I continue to study the impact of specific types of dietary fat on metabolism, inflammation and the microbiome, it is clear that -- much like carbohydrates -- fats are a heterogenous group and the types of fat we consume matter. I have seen in my own research that milk fat has very different effects on inflammation, glucose tolerance and the microbiome than coconut oil. Each fat works through a different inflammatory pathway, stimulating the growth of different microbes and ultimately impacting the host in different ways.
- In my own work, I see differences in intestinal permeability (aka “leaky gut”) between omega-6 fatty acids and SFA. SFA intake results in improved intestinal permeability.
- I see an increased need to look at the bigger picture of our diets – we need to learn from our previous mistakes. Focusing too much on one nutrient has led us down the wrong path. The advocacy for a reduction in total fat consumption, including SFA, without recommending the type or quality of fat led to excess intake of refined carbohydrates and added sugar, which, as we now know, can actually increase the risk of cardiometabolic diseases. We also saw the recommendation to replace SFA with vegetable oils – unfortunately, again without specifying which type of oil. And now we realize a diet rich in omega-6 is pro-inflammatory.
I fully support Astrup et al.’s recommendation to refocus our thinking around specific guidelines for SFA intake to discussions around incorporation of specific foods that contain SFA to create healthy eating patterns.
Reference:
Astrup A, Magkos F, Bier DM, et al. Saturated Fats and Health: A Reassessment and Proposal for Food-Based Recommendations: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020;76(7):844-857. doi:10.1016/j.jacc.2020.05.077
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