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 Healthy Gut, Healthy You
An introduction to gut health
Presented by
Claudia Graetsch-Vasquez, RDN, CDCES/CDE
Las dispositivas están disponibles en español si las solicita.

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 Our Talk
The content in this presentation is not intended to
be a substitute for professional medical advice,
Today
diagnosis, or treatment. Always seek the advice of
your physician or other qualified health provider
with any questions you may have regarding a
medical condition.
 The impact of “The Gut”

on health

Bischoff, 2011
What is the Gut Microbiome?

• The collective DNA of our gut microbes

⚬ Bacteria, viruses, protozoa, fungi
⚬ "Second genome"
• Most densely populated and diverse microbiota in
the human body
⚬ 100 trillion micro-organisms, 160+ species
⚬ Mainly located in large intestine
• Expands the host's physiological potential
⚬ Extend digestive capabilities
⚬ Prime the immune system
⚬ Produce vitamins
⚬ Degrade xenobiotics
⚬ Resist colonization by pathogens
⚬ Produce energy for the gut wall from undigested food
What influences the Gut Microbiome?
Mode of infant delivery & feeding
• C-section vs. vagina delivery
• Breast fed vs. formula fed
Aging process
• Reduced diversity, more instances of antibiotics use
Diet composition
• High-fat Western diet: decreases lactic acid bacteria. High unsaturated fat intake
increases LAB.
Geography
• Diet, food supply plays a role
Medications
• Antibiotics, PPIs
Stress
• Responds to stress-related chemical release, influence response to infection
Genetics?
• Only minor role (1.9-8.1% of microbiome is heritable)
• Certain phyla more heritable
7 Things you can do for your gut health

1. Lower your stress level

2. Get enough Sleep
3. Eat slowly
4. Stay hydrated
5. Check for food intolerances
6. Change your diet
7. Take a pre/pro/postbiotic
 • "Live micro-organisms which,
when administered in
adequate amounts, confer a
health benefit on the host" ­
WHO
What are • Ilya Ilyich Mechnikov
suggested microbial ingestion
Probiotics improved host health in 1907
⚬ Lactic-acid-producing bacteria
strains in yogurt enhance
longevity

• Most widely used LAB strains

with probiotic effects:
⚬ Bifidobacterium
⚬ Enterococcus
⚬ Lactobacillus
 Evidence exists that probiotics:
• Reduce inflammation and oxidative stress
• Reinforce intestinal barrier integrity
• Develop and modulate immune function
⚬ Promising treatment for allergies, gut &
respiratory infections, IBS, UC, infant colic
• Synthesize vitamins
Benefit of Bifidobacteria specifically associated
with improved health:
Probiotics • Inhibits pathogenic bacteria growth
• Produces digestive enzymes
• Represses activities of rotaviruses
• Restores microbial integrity following abx
therapy
Increased proportion of Bifidobacteria and
Lactobacilli represent a "healthier" microbial
composition
 No evidence for use for healthy
individuals
⚬ C. diff, IBS, UC, atopic dermatitis
⚬ Some research suggests it stimulates a normal
immune system
Regulation is very limited
⚬ Some risk for opportunistic infections
Supplementing
Probiotics are not "one size fits all," must
Probiotics be targeted
Do the probiotics survive?
⚬ Mixed results
⚬ Bacteria in stool, not in intestines
Is food better than supplementing?
⚬ Food may lead to greater bacterial diversity
 Produce
Fermented veggies & fruit (sauerkraut, kimchi,
pickles, beets, carrots)

Dairy
Kefir (and vegan kefir), yogurt (including some
vegan yogurts), sour cream, buttermilk
Sources of Proteins
Probiotics Natto, tempeh

Beverages, etc.
Kombucha, kefir water, beet kvass, fermented
condiments

Note: Must contain live and active

cultures.
Do not cook. Must be refrigerated.
 • "Food" for probiotics
• " A s u bst rate t h at i s s e l e c t i ve l y u t i l i ze d by
h o st m i c ro o rga n i s m s co nfe r r i n g a h e a l t h
b e n ef i t " - I SA P P
⚬ Fermentation results in specific changes in
the composition and/or activity of the GI What are
microbiota
Prebiotics
• Prebiotics are types of fiber found in
vegetables, fruits and legumes.
• We cannot digest these types of fiber, but
the good gut bacteria can digest them.
• Increase proportion of Bifidobacteria
and Lactobacilli
• Increase stool bulk & frequency
⚬ Fermentation leads to increased bacterial
mass and osmotic water-binding capacity
⚬ Improved transit time
Benefit of
• Reduce symptoms of GI discomfort Prebiotics
• Inulin-type fructans most studied
⚬ Reduces appetite, improves glucose tolerance
(5-8g daily)
⚬ Artichoke, asparagus, chicory, onions
⚬ Functional foods (protein bars, powders)

• Potential effect on colon cancer risk

Vegetables
Asparagus, dandelion greens, eggplant, endive,
raddichio, garlic, leeks, onion, sunchokes,
jicama, yacon

Fruits
Avocado, apples, bananas, pears, berries
Sources of
Dairy
Kefir, yogurt, milk, some cheese Prebiotics
Starches
Beans, legumes, peas, oats, wheat, barley
cooked and cooled potatoes

Other
Honey, chicory root
 • "Synergistic mixtures of probiotics and
prebiotics that beneficially affect the host
by improving the survival and coloniztion
of live beneficial microorganism in the GI
tract of the host." -WHO
• Health benefits claimed:
⚬ Increased lactobacilli and bifidobacteria
What are ⚬ Improvement of liver function
⚬ Improvement of immunomodulating ability
Synbiotics ⚬ Prevention of bacterial transolaction

• Proposed as therapeutic agents for:

⚬ Constipation
⚬ Lowering high fasting blood glucose levels
⚬ Reducing risk of post-op sepsis
• Functional bioactive compounds
produced during fermentation which
may be used to promote health
⚬ Short-chain fatty acids (SCFA), microbial cell
fractions, functional proteins, etc.
• Proposed health effects of other -iotics What are
rely on postbiotic production
• Can have direct effect on immune Postbiotics
system & functioning of gut
microbiota:
⚬ Inhibit growth of pathogens by lowering pH
⚬ Provide energy for colonocytes
⚬ Enhance intestinal barrier function
⚬ Anti-tumor and anti-inflammatory effects
⚬ Improve peristalsis and transit time
SMOOTHIE
with kefir or kefir water with banana and
berries

YO G U R T PA R FA I T Ideas for
Greek or vegan yogurt with berries, nuts,
and seeds or muesli Breakfast

OMELET
with kimchi or sauerkraut and onions,
asparagus, etc.
STIR FRY
Bok choy, eggplant, quinoa, salmon, and kimchi

Ideas for
P R O B I O T I C TA C O S
Baked tempeh, avocado, tortillas, and Lunch and
fermented sauerkraut
Dinner
SALAD OR POWERBOWL
Homemade ranch dressing made with kefir or
miso on whole grains + greens + veggies
Dietary Components of

Gut Health
 • High fat diet (40% of calories) induces
unfavorable changes:
⚬ Decreased bacteria that produce SCFA
⚬ Increased fecal concentrations of long-chain
(saturated) fatty acids
• Lower fat diet induces favorable changes:
⚬ Increased butyrate-producing & anti-
inflammatory bacteria
Dietary ⚬ Enhanced protein degradation by gut microbiota

Fat • High unsaturated fat intake associated

with increased LAB such as Bifidobacteria
• Keto diet associated with reduced mass &
diversity
• Lower fat diets (i.e. vegetarian) associated
with higher bacterial diversity
 • Whole grains promote beneficial bacterial
growth
• Diets high in carbohydrate, fiber, and
plant-based protein associated with:
⚬ High levels of SFCA
⚬ Less Firmicutes, more Bacteroidetes
Carbs & ⚬ Microbiota of children from EU vs. rural African
village showed profound differences
Fiber
• Low carbohydrate intake associated with
⚬ Lower levels of fecal SCFAs
⚬ Decreased bacterial number

• Evidence that SCFA from whole grain

fermentation may influence satiety
 • Animal protein-based diets:
⚬ Increased bile-tolerant microorganisms
⚬ Lower levels of CHO fermentation

• E. coli and Enterobacteriacea do not thrive

in vegan/vegetarian diets
⚬ Higher in carbohydrates, lower pH
Protein • WHO: processed meat "carcinogenic to
humans," consumption of red meat
"probably carcinogenic to humans."
⚬ Processed meat: Salting , curing , fermenting ,
smoking , etc.
⚬ Red meat: beef, veal, pork, lamb, mutton,
horse, goat
 Polyphenols
• Tea phenolics repressed growth of pathogenic
bacteria (including C. diff ), less severely
affected Bifidobacterium and Lactobacillus
spp.
Other Dietary • Stimulate the production of SCFA by gut
Factors bacteria

Artificial Sweeteners
• Excessive intake may induce glucose
intolerance by altering gut microbiome
 Eat a diverse diet
• Supports a more diversified microbiome
• Avoid fads & fasting

Focus on fiber (25-38+ grams/day)

Include plenty of plant-based foods
• Associated with microbial enrichment, protective
The elements, and satiety
Bottom Line
Avoid high fat, high animal protein diets
• Associated with more pathogenic, less beneficial
bacteria

Reduce Intake of artificial sweeteners and added

sugars
• May alter microbiome

Include Regular Physical Activity

• Increases number of beneficial gut bacteria
Resources

https://www.eatright.org/

https://www.myplate.gov/

https://health.usnews.com/best-diet

https://ods.od.nih.gov/factsheets/list-all/

https://www.heart.org/ (healthy living)

https://www.cspinet.org/ (nutrition action)

Resources

U.S. Probiotic guide:

• https://usprobioticguide.com/

Books:
• Tamara Duker Freuman, MS, RD - "The Bloated Belly Whisperer" helping identify the many
possible causes of gas, bloating, diarrhea and constipation and helping patients achieve
symptom control and improved quality of life. And, “REGULAR”, addresses the many
causes of—and treatments for— bowel irregularity.

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References
Cresci GA, Bawden E. The Gut Microbiome: What we do and don't know.Nutr Clin Pract. 2015;30(6):734-746.
Kolida S, Gibson GR. Prebiotic capacity of inulin-type fructans. J Nutr. 2007;137(11):2503S-2506S.
Brown-Riggs C. The gut microbiota - Is it a novel contributor to the obesity and diabetes epidemic? Today's Dietitian.
2014;16(11):22.
Gomes AC, Bueno AA, de Souza RGM, Mota JP. Gut microbiota, probiotics and diabetes. Nutrition Journal. 2014;13:60.
Binns N. International Life Sciences Institute. Probiotics, Prebiotics and the Gut Microbiota. https://ilsi.org/europe/wp­
content/uploads/sites/3/2016/05/Prebiotics-Probiotics.pdf. Accessed 6 June 2020.
Kootte RS, Vrieze A, Holleman F, et al. The therapeutic potential of manipulating gut microbiota in obesity and type 2
diabetes mellitus. Diabetes Obes Metab. 2012:14(2):112-120.
Kurilshikov A, Wijmenga C, Fu J, Zhernakova A. Host genetics and gut microbiome: challenges and perspectives. Trends
Immunol. 2017;38(9):633-647.
Rothschild D, Weissbrod O, Barkan E, et al. Environment dominates over host genetics in shaping human gut
microbiota. Nature. 2018;555(7695):210-215.
Turpin W, Espin-Garcia O, Xu W, et al. Association of host genome with intestinal microbial composition in a large, healthy
cohort. Nat Genet. 2016;48(11):1413-1417.
Dennett C. Shaping the gut microbiota. Today's Dietitian. 2018;20(8):16.
References
Iizumi T, Battaglia T, Ruiz V, Perez Perez GI. Gut microbiome and antibiotics. Arch Med Res. 2017;48(8):727-734.
Plaza-Diaz J, Ruiz-Ojeda FJ, Vilchez-Padial LM, et al. Evdience of the anti-inflammatory effects of probiotics and
synbiotics in intestinal chronic diseases. Nutrients. 2017;9(555):1-19.
Vandenplas Y, Zakharova I, Dmitrieva Y. Oligosaccharides in infant formula: More evidence to validate the role of
prebiotics. Br J Nutr. 2015;113(9):1339-44.
Dietitians in Integrative and Functional Medicine. "Probiotics and prebiotics: What you need to know." Academy
of Nutrition and Dietetics. 2018. https://integrativerd.org/wp-content/uploads/2018/07/DIFM-Probiotic-and-
Prebiotic-Handout-FINAL2018.pdf
Bischoff SC. 'Gut health': a new objective in medicine? BMC Medicine. 2011;9(24):1-14.
Zanteson L. Gut health and immunity - It's all about the good bacteria that can help fight disease. Today's
Dietitian. 2012;14(6):58.
Harvard School of Public Health. "Who report says eating processed read meat is carcinogenic: Understanding
the findings." The Nutrition Source. Published 3 November 2015.
https://www.hsph.harvard.edu/nutritionsource/2015/11/03/report-says-eating-processed-meat-is-carcinogenic-
understanding-the-findings/
Wan Y, Wang F, Yuan J, et al. Effects of dietary fat on gut microbiota and faecal metabolites, and their
relationship with cardiometabolic risk factors: a 6-month randomised controlled-feeding
trial. Gut. 2019:68:1417-1429.
Becker SL, Chiang E, Platinga A, et al. Effect of stevia on the gut mcirobiota and glucose tolerance in a murine
model of diet-induced obesity. FEMS Microbiology Ecology. 2020;96(6).
References
Suez J, Korem T, Zilberman-Schapria G, et al. Non-caloric artificial sweeteners and teh microbiome: Findings and
challenges. Gut Microbes. 2015;6(2):149-55.
Heiman ML, Greenway FL. A healthy gastrointestinal microbiome is dependent on dietary diversity. Mol Metab.
2016;5(5):317-320.
De Filippo C, Cavalieri D, Di Paola M. Impact of diet in shaping gut microbiota revealed by a comparitive study in
children from Europe and rural Africa. Proc Natl Acad Sci USA. 2010;107(133):14691-14696.
Martínez I, Lattimer JM, Hubach KL, et al. Gut Microbiome Composition Is Linked to Whole Grain-Induced
Immunological Improvements. ISME J. 2013;7(2):269-80.
Cooper DN, Martin RJ, Keim NL. Does whole grain consumption alter gut microbiota and satiety? Healthcare.
2015;3(2):364-392.
Pelto L, Isolauri E, Lilius EM, et al. Probiotic bacteria down-regulate the milk-induced inflammatory response in milk-
hypersensitive subjects but have an immunostimulatory effect in healthy subjects. Clin Exp Allergy. 1998;28(12):1474-9.
Becker K. "Gut check". Bostonia. 1 February 2018. https://www.bu.edu/bostonia/winter-spring18/do-probiotics-work/
Pandey KR, Naik SR, Vakil BV. Probiotics, prebiotics, and synbiotics- a review. J Food Sci Technol. 2015;52(12):7577-87.
Swidsinski A, Dorffel Y, Loening-Bauke V, et al. Reduced mas and diversity of teh colonic microbiome in patients with
Mutliple Sclerosis and their improvement with ketogenic diet. Front Microbiol. 2017;8:1141.
Wan Y, Wang F, Yuan J, et al. Effects of dietary fat on gut microbiota and faecal metabolites, and their relationship with
cardiometabolic risk factors: a 6-month randomised controlled-feeding trial. Gut. 2019;68:1417-1429.
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Upcoming Wellness Webinar

Healthy Habits for Life

Wednesday December 13, 2023*

12pm-12:45pm pacific time

*2nd Wednesday

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 THANK YOU FOR YOUR TIME TODAY!

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