You Can Improve the Health of Your Microbiome
Food, Water, Activity, Relationships, and Environment Change Your Microbiome
Last week, we discussed what our gut microbiomes are and the many aspects of health they influence. I’m sure as you read that article many of you thought, “Ok, this is pretty interesting, but how do I actually make my gut microbiome healthier?” At least that’s what I thought as I researched. So, I wanted to gather the best information I could find about building a healthy microbiome.
How Can You Support Your Microbiome?
Probiotics
Probiotic foods include fermented foods like kefir, yogurt with live active cultures, pickled vegetables, tempeh, kombucha tea, kimchi, miso, and sauerkraut. Probiotic supplements exist, but there is not clear evidence that they are beneficial.
Some of the known benefits of probiotic foods and drinks:
Relieves lactose intolerance
Increases helpful bacteria in the gut
Stimulates immunity
Decreases inflammatory and allergic reactions
Decreases cholesterol levels
Prevents colon cancer
Decreases severity of eczema
Decreases severity of Crohn’s disease
Decreases severity of diarrhea
Decreases severity of constipation
Decreases severity of yeast infections
Decreases severity of urinary tract infections
Competes with bacteria that cause disease to prevent them from causing problems
Indigestible fiber
Foods that increase the amount of short-chain fatty acids in the body (a good thing), are sometimes called prebiotics because they feed the “good bacteria” in the gut. These foods include:
Inulin, which is found in dandelion root, dandelion greens, burdock root, chicory root, dried garlic, Jerusalem artichoke, dried onions, and leeks.
Resistant starches, which are difficult to digest and arrive intact in the colon. These starches function like dietary fiber. Because they are not broken down in the small intestine, they also don’t release glucose (sugar) into the bloodstream. Legumes are one of the best sources of resistant starch. Interestingly, cooling cooked beans for 24 hours allows some of the starches to recrystalize (increases from about 4 to 6%). Canned beans are similar to cooled beans. Cooked beans have 4-5 times as much resistant starch as white bread and potatoes.
Other foods that are rich in these indigestible carbohydrates include: garlic, onions, leeks, asparagus, Jerusalem artichokes, dandelion greens, bananas, and seaweed.
Whole grains like wheat, oats, and barley are also good sources of prebiotic fiber.
High intake of prebiotic fiber can increase intestinal gas and bloating. Soaking beans and grains can relieve this somewhat. If you have irritable bowel syndrome or other digestive sensitivities, it is wise to try foods in small amounts. If you tolerate a small amount, you can gradually increase it.
Most people are eating much less fiber than our bodies need and our ancestors used to. This leaves the microbiome with less of the nourishment it/they need.
Mediterranean Diet
A lot of Mediterranean Diet recipes in the popular media focus on pasta. This is near the complete opposite of what was actually eaten in the Mediterranean when this diet was studied. There were no refined carbohydrates there at that time. It was primarily vegetables, with a lot of lentils, beans, and nuts. Fruit and whole grains were also a major part of it. Many American sources of whole grains like whole wheat breads and pastas are quite processed so to me, it is less clear that they are beneficial than whole grains like bulgur wheat or barley. It included a moderate amount of yogurt and natural cheese, very little red meat and sugar.
It was based on studying what the people of Crete, Greece, and Southern Italy ate that allowed people who lived in relative poverty to live longer than affluent people in other places. Ultimately, I think what we learn from the Mediterranean diet is the importance of fresh, local foods, lots of cooked greens, minimal sugar, and essentially no processed food. In fact, though the Mediterranean diet has been the most studies, traditional diets from many regions of the world, such as Norway and Japan have similar health benefits. Specifically, these benefits have been seen with regards to mental health, which as we will discuss in more detail next week, is intimately connected to the microbiome.
A research study found that at baseline patients who had obesity, high blood pressure, high blood sugar and/or high triglycerides (metabolic syndrome) had less diversity of “good” bacteria compared to the control group who did not have metabolic syndrome. After 2 years of consuming the Mediterranean diet, they found partially restored populations of good bacteria in the gut.
In addition, total protein consumption also increases the diversity of bacteria and the production of short-chain fatty acids. You’ll notice that beans, legumes, nuts, fish, yogurt, and cheese are all included in this style of diet. And I wouldn’t be the Nettle Witch if I didn’t let you know that nettles are the most protein-rich greens out there.
Minimize Ultra-processed Foods
The composition of the microbial communities in the gut can change within hours to days after a change in the host diet. Ultra-processed foods and sugary foods increase low-grade inflammation and stress intestinal microbes. Examples of ultra-processed foods include:
Soda and artificial fruit drinks
Sweetened yogurt
Packaged snacks like cookies or chips
Candy
Cake mixes
Mass-produced bread and buns
Margarine
Breakfast cereals
Energy bars
Energy drinks
Instant soups, ramens, noodles
Chicken nuggets or fish sticks
Ready to heat meals/TV dinners
If you’re like me, you may wonder, “What foods are left that my children will eat?”
I find this chart, from Healthline, a helpful tool to help us aim for progress rather than perfection in improving the quality of the food we eat.
Increase Water Consumption and Consider Where Your Water Comes From
In a single study, the source of water had as much of an impact on the diversity of gut microbiome species as the diet type, frequency of alcohol consumption, and the frequency of exercise. People who drank well water had more diversity of species in their gut microbiome compared to those who drank bottled, city, or filtered water. In that study, the amount of water consumed also correlated to differences in gut microbes, but those who drank less water were less likely to exercise and more likely to drink sugary beverages as well.
Another study showed that the daily dose of sodium in the water also decreased the diversity of the gut microbiome. Population studies show that the source, chemical, and biological composition of water have significant impacts on the diversity of gut microbes.
The volume of water in the colon influences microbes because it impacts the acidity of the environment and how quickly material moves through the intestines. Water restriction increased the overall bacterial counts in the intestines, including species related to inflammation of the colon. Bacteria were also more likely to be able to enter the gut wall in the water-restricted
Exercise
Within the last decade, research has shown that exercise improves both the quantity and quality of bacteria within the gut. These changes in the microbiome may, at least in part, explain the benefits to GI function, mood, and brain activity that we see because of exercise. Athletes also experienced higher enzymatic activity in several pathways that led to more short-chain fatty acids. In addition, there was a strong correlation between aerobic fitness, as measured by VO2Max, and production of short-chain fatty acids, meaning that more aerobically fit people produce more short-chain fatty acids.
Interestingly, in animal studies, one research study, in which mice were forced to run on the wheel, the mice experienced changes in their gut microbes that were similar to eating a high-fat diet (in other words, it was less healthy afterward). However, in a different study, in which wheel running was voluntary, the gut microbiome became healthier. I interpret this to mean that the stress of compulsory exercise is not beneficial.
Researchers studied human gut microbiomes before and after running a half-marathon and found that after a single, high-endurance event there are improvements in the diversity of species of healthy bacteria in the gut. Other researchers studied people as they participated in a 6-week exercise program. They also found improved diversity of bacteria and increased short-chain fatty acid production. However, one other human study on exercise and the gut microbiome did not notice a change in the microbiome over the course of an 8 week training plan.
Other forms of exercise can also be beneficial to the microbiome. Researchers found that a 9-day yoga retreat with vegetarian diet increased species of bacteria known to improve the barrier function of the gut, the immune function of the gut, and the gut’s communication with the brain.
Time in Nature
The health benefits to humans of time spent in nature are many and numerous. Improvement of the diversity of species and function of the gut microbiome is one of those benefits. In a study of preschool students in Hong Kong, they found that children who participated in an outdoor learning program had a greater diversity of bacteria, a decrease of a harmful type of bacteria, and maintained serotonin levels, while the control group experienced decreased levels. The children also experienced improved social behaviors, but it is unclear if this is related to the gut microbiome or other benefits of nature exposure.
An additional study of Finnish kindergarteners observed children playing in dirt from the forest floor, they were compared to children who played in urban play environments and a grass, soil, planted area, typical of nature schools in the area. The children rotated between these environments for the 28 day study. Those who played in the forest floor dirt were found to have a greater diversity of “good” microbes on both the skin and the gut. There was also an increase in immunity markers, which suggests a decrease in risk of diseases like Crohn’s disease, ulcerative colitis, and rheumatoid arthritis. This study suggests that even short term exposures to wild, natural environments modify our gut microbes and our immune systems.
Another study found that rubbing people’s hands with dirt and plant material increased the diversity of the microbes in the gut and on the skin.
Especially interesting, is that even if you can’t get to nature, there are some benefits of bringing nature to you. Placing a spider plant into a room for 6 months caused a significant increase in the diversity and number of beneficial plant bacteria.
Time with Other People
Animal research on the impact of socialization on gut microbes has found that social interactions influence the gut microbes through a variety of types of physical contact. In humans, there is some evidence that living together influences the gut microbiome. People who were married or living with a partner had more microbial diversity than people who live alone.
Interestingly, an increase in social interactions with relatives and friends increased the diversity of gut microbes, but did so for people who lived alone substantially more than for people who lived with a partner. In addition, participants had microbiomes that were more similar to their spouse’s than their sibling’s microbiome. This suggests that environmental factors are much more predictive of the composition of the microbiome than genetic factors or even many early life exposures. It appears the quality of these relationships also influences the impact on the microbiome. Those who had closer relationships with their spouses or siblings had more similar gut microbiomes and increased diversity and richness of species.
Another study found, “The frequency with which people spend time together, including how often they share meals or how they greet each other — whether with handshakes, hugs, or kisses — was also associated with an increase in microbial sharing.”
Minimize Antibiotic Use
In 2011, in the US, 260 million courses of antibiotics were prescribed. On average, children receive 3 courses of antibiotics by the time they are 2, then 10 by the time they are 10, and 17 by the time they are in their late teens. In Sweden antibiotic prescription rates are 60% lower than in the US. The reality of current medical practice is that it is highly unlikely that all of them are necessary, in fact the CDC estimates that half of all antibiotic prescriptions are unnecessary.
Multiple studies on mice and humans show that alterations in the gut microbiome early in life due to antibiotics increase the likelihood of developing a range of immune and metabolic disorders including asthma, allergies, type 2 diabetes, and obesity.
Minimize Pesticide Use
The impact of pesticides (herbicides, insecticides, and fungicides) are just starting to be studied, in part, because, until recently, they were considered safe for home and farm use. The creation of “Round-Up Ready” crops (crops that have been genetically modified to tolerate the herbicide Glyphosate, aka Round-Up) has led to very high concentrations of glyphosate beyond their target plants, remaining in our soil and water. In fact, one study of European soils, found that 80% of the over 300 fields that were studied were contaminated with pesticide residues. Glyphosate and the compounds it makes as it breaks down, have also been found in fruits and vegetables. These chemicals can enter our bodies through our lungs, our intestines, or our skin.
Pesticides can have directly toxic effects on microbes. Glyphosate inhibits enzyme activity of some gut microbes. Triazine can disrupt cell membranes of some fungi. Pesticides can also act indirectly, changing the gut conditions to favor the growth of some types of bacteria over others, which can lead to an imbalance of gut microbes. This causes decreased movement of the intestines and decreased strength of the barrier function of the gut and around the brain.
From: https://www.nature.com/articles/s41396-023-01450-9
Vaginal Birth when Safe
C-section has a long-term impact on the diversity of species in a baby’s gut microbiome.
C-sections are essential and life-saving in certain circumstances, but they are used far beyond those situations. One way to reduce the likelihood of an unnecessary C-section is to work with a midwife for a low-risk, uncomplicated pregnancy. For low-risk mothers, working with a midwife in the hospital-setting reduced the likelihood of having a C-section by 30% in first time mothers and 40% for mothers who had previously given birth. C-section birth increases the risk for asthma, eczema, and good allergies. It also increases the likelihood of obesity.
Breastfeed
Bifidobacterium infantis is one of the first types of bacteria to grow in the human microbiome. Human infants cannot make the enzymes needed to break down the complex sugars in breast milk. B. infantis makes these enzymes, as do other Bifidobacterium and Lactobacillus species. The breakdown of these sugars into short-chain fatty acids is key to incorporating nutrients into the body, immune, and hormone-related activities throughout the gut. These short-chain fatty acids are also key to helping an infant’s body recognize and tolerate helpful bacteria in the gut.
Final Reflections
What stands out to me most as I learn about the gut microbiome are two things. First, the things that are most beneficial to our gut microbiomes are typically very beneficial to almost all other aspects of our health as well. The second, is that many of the barriers to achieving health through a healthy microbiome lie beyond the realm of individual responsibility. For example, dysfunction within the medical system directly impacts how many antibiotic prescriptions are written and how many C-sections are performed. Dysfunction within our corporate or government policies regarding how much time is allowed for postpartum leave directly impacts the likelihood someone will be able to successfully continue breastfeeding. The quality of our water is related much more to industry than individual practices. The cost of healthy, local food is often prohibitive for many families unless you have the time and/or space to grow your own. We can certainly positively influence our health by adjusting our habits in beneficial directions AND we all benefit when our systems set us up for success.
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You’re right to highlight that so many solutions require systemic action. Individual choices matter, but the playing field is rarely level. Our microbiomes reflect the cumulative impact of community policy, food systems, medical norms, and even urban design as much as what we consciously put in our mouths. I’ve seen this firsthand in families struggling for access to fresh food, or parents doing everything “right” but up against an overload of environmental chemicals.