From the cradle to the grave

There is evidence to suggest that the unique microbiome of each person starts to take shape even while we are still growing in the womb. From birth and throughout life, it continues to develop and evolve, influenced by genetics, as well as environmental factors such as diet, nutrition and exposure to drugs such as antibiotics.

It is estimated that an average adult carries about two kilograms worth of microbes in their gut. In fact, the number of these organisms often outnumber our own cells. Most of the time, we may be carrying more microbial genes than human genes in our bodies. The latter aid in digestion and help produce essential vitamins (such as vitamins B and K) and maintain a healthy gut by preventing overgrowth and invasion by disease-causing microbes. But increasingly, research is finding that there is more to our microbiomes than just promoting gut health: It can impact weight, immunity, mood, behaviour, energy and overall wellness.

Some experts claim that up to 90 percent of diseases can be traced back in some way to the gut and the health of the microbiome. The gut microbiome, and its diversity, has been shown to influence many conditions not traditionally considered microbe related from whether a person develops obesity, heart disease, asthma or diabetes, to neurological conditions such as Parkinsons disease and dementia, to development of cancer, right down to how well we respond to chemotherapy and vaccines.

A new frontier

Microbiome research is an exploding field of science growing at an exponential rate. New knowledge is being added almost daily. The organisms being discovered have names not found in textbooks, being unknowable to us a mere few years ago. Unlike their disease-causing counterparts, they live symbiotically within the host and are not found in clinical specimens. But advances in genetic analysis technology have propelled the exploration of this new frontier of science.

Researchers have now identified more than 10,000 species of microbes living in and on the human body. The next challenge is to tease out and define the apparent associations between the microbiome, health and disease and develop ways to manipulate it to improve health, as we have done with antibiotics and probiotics.

The more diverse, the better

It remains to be defined how exactly the microbiome exerts its health consequences on the host or what makes a healthy microbiome. Experts agree that diversity is a good thing when it comes to gut microbes. The diversity of the travellers we carry appears instrumental in the development of a robust immune system. Association with disease is usually observed when this diversity is reduced or lost. Diet is a major influence on this diversity by dictating the environment in which certain microbes can take up long-term residence within the gut. For example, diets high in saturated fats, which are linked to conditions such as diabetes and heart disease,are also thought to reduce microbial diversity.

How you can influence your microbiome

Here are a few tips to cultivate as much diversity as possible in your gut microbiome:

Increase your fibre intake

Dietary fibre usually comes from plant-based food ingredients that are not broken down by enzymes in the gastrointestinal tract. Most adults should aim to have 25 35 grams of fibre in their diet every day. Fibre supports the growth and diversity of the microbiome and has the added benefits of lowering your risk of heart disease, diabetes and colon cancer.

Eat a wide and seasonal range of fruits, nuts and vegetables

The variety and the types of fibres found within different fruits and vegetables are thought to support different microbial species, thereby contributing to the overall diversity.

Include fermented foods in your diet

Fermented foods such as pickled vegetables, staples of the Burmese dinner tables everywhere, have been shown to be beneficial in improving the diversity of the microbiome and gut function. Other fermented foods include yoghurt, kimchi, soybean-based products such as soy sauce and tempeh.

Avoid artificial sweeteners.

Artificial sweeteners such as saccharin, sucralose or aspartame may be sold as sugar substitutes or are found in sugar-free beverages. These are marketed as a healthier no-calorie alternative to natural sugars, but they have been shown to disrupt the gut microbiome.

Avoid antibiotics and non-essential medicines

Antibiotics may be life-saving when taken for the right reasons. But taken unnecessarily, they indiscriminately wipe out many beneficial microbes, reducing the diversity of the microbiome with effects lasting up to years. Dangerous and pathogenic bacteria may flourish in absence of the microbiome diversity which may result in serious illness. Even non-antibiotic medications may alter gut microbiome by altering the colonic environment so best to play it safe and only take them when necessary.

Dr Thel Khin Hla is a doctor with the Myanmar Oxford Clinical Research Unit in Yangon.

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The travellers within us - Myanmar Times