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Gut Microbiome and Health

Sensible use of prebiotics and probiotics superadded with good
sleep and positive healthy attitude can ensure better life

Lt. Gen. (Retd) Mahmud Ahmad Akhtar Former Surgeon General Pakistan Army

Preventive Medicine – Promotion of Health

It is well-known now that the pillars of healthy life-style (physical and mental) are healthy plant base diet, eating enough vegetables and fruits, regular exercise, a good night sleep and staying hydrated. All of these things also support the gut microbiome, all the microbes that live in the digestive tract. But there are some extras to consider if you want to optimize your gut health.

Prof. Maj. Gen. Muhammad Aslam and Mr. Shaukat Ali Jawaid photographed with Lt. Gen. (Retd) Mahmud Ahmed Akhtar former Surgeon General of Pakistan Army on whom they called on August 7th 2024 to enquire about his health.

It is widely accepted among those who study the gut microbiome, that a healthy gut is one that contains diverse range of microbes and has an effective gut barrier (the lining between intestine and blood stream). Diet has probably the biggest influence on your gut health said Rosie Young, Marl am, Gomal el Din and Yong Yee working at the Quad rum Institute in the UK. Diet, high in fiber, unsaturated fatty acids (found in fatty fish and nuts) and polyphenols (chemicals found in plants) will promote a healthy gut, while those high in saturated fats additive (such as E numbers) and sugar can harm gut health. So, avoid eating a lot of ultra-processed food.

In Pakistan sugar, saturated fats and other ultra-processed foods are consumed a lot, resulting in epidemic of metabolic disorders like diabetes, hyper/dyslipidemia, atherosclerosis, hypertension, heart attacks, strokes, fatty liver, cirrhosis, renal failures, carcinomas and mental disorders. Some species of gut microbes have been linked to higher rates of depression. Serotonin, the chemical in brain which regulates mood has strong gut connection. Only 5 percent of your body’s serotonin is made in the brain and the rest is made, stored and active in the gut, said Dr. Naidoo, author of the new book “This is your brain on Food”.

Nutritional psychiatrists say food should not replace other treatments for mental health including therapies and prescription drugs, but food should not be ignored either. A number of studies have suggested that dietary changes can lead to meaningful improvements in mood and mental well-being. Hippocrates, the father of medicine said “Food is health- health is food”. About 20 percent we eat goes to brain effects.

Emulsifiers, a common additive in ultra-processed food have been found to cause intestinal inflammation and a leaky gut. The most common ones to look out on packaging are lecithin, guar or Xanthan gum and mono and triglycerides. These additives are also common in protein supplements whose popularity has been steadily increasing since the early 2000, especially among the gym-goers looking to bulk-up. It has become a big business in Pakistan, adversely affecting the health of young people. The government should ban these to promote health and save lives.

Prebiotics and Probiotics

It would be unreasonable and unrealistic to tell you to avoid food with additives, but trying to limit consumption while increasing your consumption of pre-biotic and pro-biotic foods; could protect your gut. Dietary fiber is a good example of a pre-biotic which is defined as a non-digestible food ingredient that can stimulate the growth of good bacteria in the colon. As the main food of your gut microbes, it is important to consume enough if you want your microbiome to flourish. The expert guidelines suggest around 30 grams of fiber a day for adults and 15-25 grams a day for children depending on their age.

Most pre-biotics come from plant foods. So, getting a high diversity of plant products in our diet will keep gut healthy. The latest recommendation is to include 30 plant species in diet per week. It is not hard to achieve. To be kept in mind, that good quality of coffee and dark chocolate counts. Incorporating several of them in meals will improve overall quality of daily diets. Leafy greens are called foundations of health because they are cheap, versatile and they have a high ratio of nutrients to calories. Kale, spinach, arugula, collard, beet greens and chard are great sources of fiber, folate and Vitamin A and C. You can make salads, add green to soups, stews, stir fries and smoothies or turn them into pesto. Adding a small serving of sea-weed (the leafy green of the sea) to your plate once a week is a source of iodine, fiber, zinc and additional polynutrients. The more colorful your plate is, the better it is for your physical and mental health. The compounds in brightly coloured fruits and vegetable like red peppers, blueberries, broccoli and eggplants can affect inflammation, memory, sleep, mood and cardio-vascular organs.

Sea Food

Sardines, oyster, mussels, salmon and cod are sources of long-chain fatty acids that are essential for brain and cardio-vascular health. Sea food is also a good source of Vitamin-12, Selenium, Iron, Zinc and Proteins. If you do not like to eat fish, alternately, chia seed, flax seeds and sea vegetables are good source of Omega-3.

Nuts and Seeds

Nuts and seeds including cashews, almond, walnuts and pumpkin seeds are great snacks. They can also be added to stir-fry dishes and salads. Black and red beans, lentils and legumes can also be added to soups, salads, and stews or enjoyed as a meal or a side dish. Nut butter also counts.

Spices and Herbs

Spices not only make food taste better, but studies also suggest that certain spices may lead to a balance of gut microbes, reduce inflammation (physical health) and improve memory (mental health). Turmeric’s active ingredient, crewmen, may have benefits for attention span and over all cognition. Other spices like cinnamon, rosemary, sage, saffron and ginger also have their benefits.

Fermented Foods

Fermented foods are made by combining milk, vegetables or other raw ingredients with micro-organisms like yeast and bacteria. Studies have found that fermented foods can improve the diversity of gut microbiome, lower inflammation and improve health. These include yogurt, cheese, sauerkraut, kimchi, fermented soy products, kefir (a fermented milk beverage), kombucha (a fermented drink made with tea) etc. Kimchi a traditional Korean side dish of fermented cabbage and radish fermented soy products such as tempeh and miso, some types of apple cider vinegar that not only support the healthy balance of gut bacteria but provide good source of fibers, vitamins and other nutrients. To get most benefits from these products, look for those in the fridge section labelled as containing live cultures, or live bacteria with minimal ingredients and no heating or pasteurization processing.

Fasting can also improve your gut health by repairing gut lining and reducing inflammation. People who regularly eat dark chocolate have a 70 percent reduced risk of depressive symptoms, according to a large USA government survey of nearly 14,000 adults. The same effect was not seen in those who ate a lot of milk chocolate. Dark chocolates are packed flavonoids including epicatechin but milk chocolates and candy bars are so processed that they do not have much epicatechin left in them.

Medication and The Microbiome

Medications can directly and indirectly affect the gut microbiome. Misuse of anti-microbial particularly broad-spectrum will kill not only harmful but also beneficial ones too. These can be associated with gastrointestinal problems and also decreased immunity, especially after prolonged use.

In Pakistan, drugs are misused on large scale causing serious anti-microbial resistance problems due to being sold without any valid prescription, lack of quality medical education due to the absence of specialty of clinical pharmacology and clinical therapeutic and opening of a large number of medical institutions having sub-par quality medical teachers. Sadly, our political leaders and power-hungry bureaucrats, who are in power since very long are in denial. Pakistan has not only worse parameters in this region but also in the world.

Although, you may not have much say over medications, there are a few strategies to support your gut during and after your medications. Staying healthy, prioritizing good sleep and managing stress level is also important but also intake of both pre-biotic and pro-biotic may at times lessen the blow of medication on your microbiome.

It is always recommended to check with your doctor before introducing a pro-biotic supplement. In the rare case, it may not be suitable alongside the treatment. Microbiome research is continuously shedding new light on intricate connections between microbes that live in our gut and our well-being.

The essence of this write-uip is that we may have sensible use of prebiotics and probiotics superadded with good sleep and positive healthy attitude to have a better life.

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