Probiotics, Prebiotics and Antibiotics

Do you really need to buy supplements?

I would like to introduce a previous substack on the microbiome in humans.

Also periodic updates in subsequence posts and not even scratching the surface!

So, I am exploring the probiotic industrial complex hype and asking the questions. Are supplements necessary for gut health? Are there alternatives like food that can help? How did going from hunter-gatherer to agrarian to urban/industrial affect the human microbiome? Where is the science?

Human Gut Microbiome Across Different Lifestyles: From Hunter-Gatherers to Urban Populations

This is a Frontiers in Microbiology paper that explores this issue and a good read.

Human lifestyle and its relationship with the human microbiome has been a line of research widely studied. This is because, throughout human history, civilizations have experienced different environments and lifestyles that could have promoted changes in the human microbiome. The comparison between industrialized and non-industrialized human populations in several studies has allowed to observe variation in the microbiome structure due to the population lifestyle. Nevertheless, the lifestyle of human populations is a gradient where several subcategories can be described. Yet, it is not known how these different lifestyles of human populations affect the microbiome structure on a large scale. Therefore, the main goal of this work was the collection and comparison of 16S data from the gut microbiome of populations that have different lifestyles around the world. With the data obtained from 14 studies, it was possible to compare the gut microbiome of 568 individuals that represent populations of hunter-gatherers, agricultural, agropastoral, pastoral, and urban populations. Results showed that industrialized populations present less diversity than those from non-industrialized populations, as has been described before. However, by separating traditional populations into different categories, we were able to observe patterns that cannot be appreciated by encompassing the different traditional lifestyles in a single category. In this sense, we could confirm that different lifestyles exhibit distinct alpha and beta diversity. In particular, the gut microbiome of pastoral and agropastoral populations seems to be more similar to those of urban populations according to beta diversity analysis. Beyond that, beta diversity analyses revealed that bacterial composition reflects the different lifestyles, representing a transition from hunters-gatherers to industrialized populations. Also, we found that certain groups such as Bacteoidaceae, Lanchospiraceae, and Rickenellaceae have been favored in the transition to modern societies, being differentially abundant in urban populations. Thus, we could hypothesize that due to adaptive/ecological processes; multifunctional bacterial groups (e.g., Bacteroidaceae) could be replacing some functions lost in the transition to modern lifestyle.

Of course, lifestyle would include a diet that include ultra processed food, sugar, lack of fiber and antibiotic usage.

You likely seen something about Hadza hunter-gatherers from Tanzania and studies on their lives and that includes the gut microbiome.

Hunter-gatherers in Tanzania have incredibly diverse gut microbiomes

More than a thousand novel microorganism species that inhabit the gut have been discovered in the Hadza hunter-gatherer community in Tanzania. These contribute to a gut microbe diversity that is much greater than that of people in California, showing how industrialisation might have reduced microbiome diversity.

There also studies that address geriatric gut microbiome. https://www.scientificamerican.com/article/gut-bacteria-change-as-you-get-older-and-may-accelerate-aging/

Human microbiome in an intestine. Credit: Getty Images

The Supplement Hype

Let’s not forget weight loss though there is evidence for gut-brain axis interaction for healthy flora.

More on this later Let’s look at some conditions that likely to potentially benefit from pro/prebiotics Tx.

• MRSA/VRE - Antimicrobial resistance (AMR), notably against MRSA and vancomycin-resistant Enterococcus, is a global public health crisis.

This is an in depth look at potential Tx using various Probiotics and Their Bioproducts. Maybe even help with Candida species.

Abstract

Antibiotic resistance is a serious global health problem that poses a threat to the successful treatment of various bacterial infections, especially those caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). Conventional treatment of MRSA and VRE infections is challenging and often requires alternative or combination therapies that may have limited efficacy, higher costs, and/or more adverse effects. Therefore, there is an urgent need to find new strategies to combat antibiotic-resistant bacteria. Probiotics and antimicrobial peptides (AMPs) are two promising approaches that have shown potential benefits in various diseases. Probiotics are live microorganisms that confer health benefits to the host when administered in adequate amounts. AMPs, usually produced with probiotic bacteria, are short amino acid sequences that have broad-spectrum activity against bacteria, fungi, viruses, and parasites. Both probiotics and AMPs can modulate the host immune system, inhibit the growth and adhesion of pathogens, disrupt biofilms, and enhance intestinal barrier function. In this paper, we review the current knowledge on the role of probiotics and AMPs in targeting multi-drug-resistant bacteria, with a focus on MRSA and VRE. In addition, we discuss future directions for the clinical use of probiotics.

Figure 1. Pros and cons of probiotics and AMP use for the treatment of MDR bacterial infections.

There is even a a phase 2, double-blind, randomised, placebo-controlled trial for B subtilis probiotic to be useful for MSRA.

• Clostridioides difficile - In a previous post, I mentioned Clostridioides difficile spores tolerate disinfection with sodium hypochlorite disinfectant and remain viable fomite surfaces in addition to being a common recurring infection. Well, we have an FDA approved Fecal microbiota therapy (FMT) for this. However, there are a few regulatory kinks with this but a start!

I could go on (my spouse is happy to volunteer that I often do) but it’s clear that the Microbiome Revolution is here.

Human microbiome research has progressed in leaps and bounds over the past decades, from pivotal studies begun in the 1970s to the launch of the Human Microbiome Project in 2007. Breakthroughs have laid the groundwork for more recent clinical applications, such as fecal microbiota transplantation (FMT), and advanced techniques to explore new therapeutic pathways. Yet the "microbiome revolution" is just getting started, according to professor Martin J. Blaser, MD, one of the field's pioneers.

• Inflammatory diseases such as inflammatory bowel disease. IE: irritable bowel syndrome - Yes, we are seeing potential benefits but the science is still catching up with this.

• Weight Loss - There is no clear evidence that taking supplements helps with weight loss though widely claimed by the nutraceutical industrial complex. Likely due to unregulated and uncertified “marketers” so your mileage may very. Like a good diet to promote the good germs in your guts may be more beneficial? Certainly reducing refined carbohydrates, sugars and increasing prebiotic food is helpful. More on this below.

• Now should you take probiotics ?

As noted in the link, The "good bacteria" may help healthy people but aren't formally recommended.

Yes, there are a few conditions that could call for taking supplemental probiotics. Such conditions include traveler’s diarrhea, antibiotic induced diarrhea, Necrotizing enterocolitis (NEC), ulcerative colitis (UC) and inflammatory GI conditions.

I don’t know how many companies are offering these supplement but probably dozens. Of course they not regulated nor science based and have potential for harm, so caveat emptor! Always consult your doctor or clinician.

Building a Healthy Gut Microbiome

https://connect.mayoclinic.org/blog/weight-management-1/newsfeed-post/building-a-healthy-gut-microbiome/

• For your CE edutainment…