At a recently held industry event around neutraceuticals by Nutrify Today, a health tech company, leading experts came together to speak on health issues, debunk myths and discuss the importance of neutraceuticals in India.
THE WEEK spoke to Dr Prabha Sawant, MD, MISG, FICP, Gastroenterologist, Gleneagles Hospital Parel, about her talk on gut microbiome and its significance in maintaining health and well-being.
Q: Is gut microbiome the ‘Axis Mundi’ of all health issues?
A: Yes, all diseases begin in the gut. It is a rich inner ecological system. We need to promote a healthy and thriving gut. You have nearly 100 trillion diverse bacteria, and 160 species. There are innumerable articles on PubMed. The gut microbiota alteration is responsible for obesity, diabetes, neurological conditions like Parkinson’s, metabolic syndrome, metabolically associated liver disease, autoimmune disease, allergies, and certain skin conditions.
Q: Are there possibilities of a connection between the gut microbiome and Parkinson’s disease or cancer?
A: Yes. Many patients with Parkinson’s have constipation and small intestinal bacterial overgrowth. It’s a neurodegenerative condition. One postulation is that it could be due to gut dysbiosis, which is characterised by a leaky gut and increased intestinal permeability. When intestinal permeability increases, neurotransmitters are also affected, there is neural inflammation, the blood-brain barrier becomes permeable, and patients can have neurodegeneration.
Cancer microbiota also shows a definite link, especially for stomach cancer- H. pylori. There are enough papers to suggest that H. pylori and CA of the stomach have a link. Gut microbiota dysbiosis can initiate cancer, and can give rise to a proliferation of cancer, especially colonic cancer. And it can even influence the cancer therapy.
Q: What are the new therapeutic strategies for addressing problems in the gut microbiome?
A: You have to give the patient enough prebiotics, which are non-digestible fibres beneficial to the gut microbiome, ask the patient to eat whole grains, enough fruits, enough vegetables, limit sugar, limit salts, see that there are enough polyphenols in your diet, have a circadian rhythm between 7.30 am to 7.30 pm, and a strict no to ultra processed food.
Q: Are there ways to further characterise gut microbiomes and their functions?
A: Well, there are ways to characterise the gut microbiome. This is in its infancy. It’s called metagenomics, and there’s vast variability in your gut microbiota. So, it’s a collective genome. There are various gene products within the host. So, you should know which microorganisms are present and relatively abundant in a particular person. You have this human microbiome project. There are various sequencing methods and RNA sequences, and they can form an important bioinformatic tool.
Q: How can children and adults best care for their guts?
A: Well, if it’s a child, see that the child is breastfed at least for the first six months. So, there are increased levels of bifidobacteria. When the child is being weaned off, what diet you give is also important. How was the child born? Was it a vaginal delivery or caesarean section? The gut microbiota will be different, so when the child goes to daycare and is exposed to a certain environment, that also can change the gut microbiota.
Try to avoid sugars in a child, lower salt and sugar intake in the child for at least the first two years of their life. See that the child is not exposed to antibiotics; give only when required. And give the child whole foods after the child starts eating solids, such as whole grains. See that the child has yoghurt, various vegetables, fruits and enough high-quality proteins.
And even in adults, you must see that you follow the circadian rhythm. So, you have to have enough protein in your diet. Start the meal with raw vegetables and salads, then have the protein and carbohydrates.
The Indian diet is mainly carbohydrate rich. So, we must have a balanced diet with enough protein, fewer carbs, and enough polyphenols. Polyphenols contain antioxidants and are present in fruits such as berries, strawberries and spices. And you can also include resistant starch in your diet. That is, rice that is cooked and cooled should be taken. That is resistant starch, green bananas. Also, you should have yoghurt and fermented food and avoid ultra-processed food.