Gut Microbiome Health, Fecal Transplants, and the Impact of Western Diet

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• Western Diet and Gut Bacteria Changes
• Hygiene Hypothesis Explained
• Fecal Transplant Treatment Applications
• Circadian Rhythms and Bacterial Jet Lag
• Future of Microbiome Research
• Full Transcript

Western Diet and Gut Bacteria Changes

Dr. Simon Robson, MD, details how the modern Western diet fundamentally changes gut bacteria composition. Highly processed foods and saturated fats disrupt the delicate balance of the intestinal microbiome. Dr. Simon Robson, MD, explains that artificial fertilizers, a product of modern agriculture, introduce fixed nitrogen into our food supply. This change in nutrition, while supporting population growth, contributes to overnutrition and associated diseases.

These dietary shifts are not limited to Western nations. Dr. Anton Titov, MD, notes that obesity and "Western diet" type diseases are now prevalent in the developing world. The alteration of food components, including gluten and non-gluten parts of grains, is a significant factor in this global health shift.

Hygiene Hypothesis Explained

The hygiene hypothesis offers a compelling explanation for the increase in autoimmune and allergic conditions. Dr. Anton Titov, MD, references a study comparing Finnish children and children from North West Russia. Genetically similar populations showed dramatically different asthma rates and IgE immunoglobulin levels. Finnish children, living in a cleaner environment, had higher allergy indicators and asthma rates.

Dr. Simon Robson, MD, connects this concept to gastrointestinal diseases. He states that a lack of microbial exposure might cause the immune system to attack the body itself. This mechanism is implicated in the rising incidence of inflammatory bowel disease, Crohn's disease, and ulcerative colitis.

Fecal Transplant Treatment Applications

Fecal microbiota transplantation (FMT) is a groundbreaking treatment for restoring gut health. Dr. Simon Robson, MD, confirms its remarkable efficacy, particularly for Clostridium difficile infection. FMT achieves a success rate of approximately 90% for C. diff, often requiring just a single treatment.

The procedure involves transferring stool from a healthy donor to a patient's colon during a colonoscopy. Dr. Robson's work at Harvard involves using FMT to treat more complex conditions like inflammatory bowel disease. While short-term results are very good, these conditions often require repeated microbiome corrections. This cheap treatment modality represents a significant advance in managing difficult gastrointestinal diseases.

Circadian Rhythms and Bacterial Jet Lag

Gut bacteria possess their own internal circadian rhythms, a fascinating area of research highlighted by Dr. Simon Robson, MD. These bacterial circadian programs are driven primarily by patterns of food intake, not light exposure. When a person travels across time zones, their body adjusts to the new day-night cycle.

However, the microbiome experiences its own form of jet lag. Dr. Simon Robson, MD, explains that the bacteria can be out of sync by six to eight hours. It takes time for the gut's bacterial community to reset its rhythms to align with the new feeding schedule in the different time zone.

Future of Microbiome Research

The potential applications of microbiome research extend far beyond current treatments. Dr. Simon Robson, MD, points to fascinating experiments where fecal transplants transferred obesity or leanness between mice. This research suggests microbiome correction could play a future role in managing metabolic conditions like obesity in humans.

Dr. Anton Titov, MD, emphasizes the importance of this field for developing new and inexpensive treatments. Understanding the intricate relationship between diet, gut bacteria, and health opens doors to novel therapeutic strategies for a wide range of autoimmune and inflammatory diseases.

Full Transcript

Dr. Anton Titov, MD: Western diet changes gut bacteria. Fecal transplantation therapy is increasingly used to restore the balance of intestinal flora. How is fecal microbiota transplantation used in the treatment of inflammatory bowel disease, Crohn's disease, and ulcerative colitis?

Western diet leads to autoimmune intestinal disease. Gut bacteria have their own circadian rhythms. Western diet changes gut bacteria.

Dr. Simon Robson, MD: Fecal transplantation therapy is an effective treatment for Clostridium difficile infection. Fecal microbiota transfer can also treat ulcerative colitis.

Fecal microbiota transplantation (FMT or fecal transplantation) can also treat Crohn's disease. The hygiene hypothesis explains why ulcerative colitis and other autoimmune diseases increase in incidence. Western diet changes gut bacteria in adults and adolescents. That is why fecal transplantation therapy is needed for more patients with autoimmune diseases.

Medical second opinion helps to make sure ulcerative colitis and Crohn's disease diagnosis is correct and complete. Medical second opinion also helps to choose the best treatment for ulcerative colitis.

Stool transplant for Clostridium difficile has been very effective on the first attempt. Fecal transplantation might also play a role in obesity and autoimmune disease.

Dr. Anton Titov, MD: How to change gut bacteria to lose weight?

Fecal transplants might be helpful to restore the balance of the gut microbiome. This is why understanding intestinal bacteria is important for medicine and can lead to new and inexpensive treatments. Western diet changes gut bacteria because of highly processed food and saturated fats.

Ulcerative colitis patients can benefit from fecal transplantation therapy. Western diet changes gut bacteria. Fecal transplantation in ulcerative colitis. Fecal microbiota transfer.

Dr. Simon Robson, MD: This was previously discussed. Alteration of gluten and non-gluten components in grains by radiation and selection is only one change in modern food.

Other changes are nitrogen fixation and fertilizers. High energy from oil is used to make fertilizers. Probably 20% to 30% of nitrogen in our bodies comes from artificial fixation of nitrogen in fertilizer.

Artificial process to fix nitrogen and make fertilizers allows much better nutrition. This fuels population growth in the developing world. World population increased from 3 to 7 billion. Overnutrition is a problem in the developing world.

Dr. Anton Titov, MD: Many patients are overweight and obese. Many patients with obesity in the developing world now suffer from "Western diet" type of disease.

We discussed the theme of excess nutrition and Western diet with Dr. Robert Lustig from the University of California in San Francisco. We also discussed increasing asthma prevalence in Western society with Dr. Esteban Burchard in San Francisco.

Hygiene hypothesis is perhaps an explanation for increasing asthma in children in Western society. There was a research study that looked at immunoglobulin (IgE) levels in children with asthma in Finland and in the North West of Russia.

These populations are similar genetically and demographically. Asthma rates in Finnish children increased dramatically over the last 50 years. But asthma rates in children in the North West of Russia stayed at a similar level.

Levels of allergy indicators (IgE immunoglobulin level) in Finnish children were found to be higher than in children who lived in the North West of Russia. Hygiene hypothesis could offer an explanation of the increase in asthma in Finnish children.

Lifestyle in Finland improved dramatically in the last 50 years. Children in Finland live in a cleaner environment compared with children in Russia.

Dr. Anton Titov, MD: The immune system of Finnish children could attack its own body. This can result in asthma.

Dr. Simon Robson, MD: It is interesting. We mentioned celiac disease. Changes in microbiome are changes in gut bacteria composition and ratios. This might predispose patients to gluten sensitivity.

There is also inflammatory bowel disease, Crohn's disease, ulcerative colitis. There is a genetic predisposition because these diseases run in families.

But there also might be alterations in the immune response and inflammation in autoimmune diseases. There were also changes in the microbiome of patients with inflammatory bowel disease, Crohn's disease, and ulcerative colitis.

Dr. Anton Titov, MD: Hygiene hypothesis probably explains some of the pathologic changes in these diseases.

Dr. Simon Robson, MD: We worked with Dr. Allan Moss, MD at Harvard Institute of Translational Immunology. We study how to change the microbiome in patients with inflammatory bowel disease.

We treated patients with inflammatory bowel disease by fecal transplantation (FMT, Fecal Microbiota Transfer). This is a cheap treatment. You take fecal mass (stool) from a healthy patient.

Patient with inflammatory bowel disease then has a colonoscopy. Fecal transfer from a healthy patient is introduced to the patient's gut during colonoscopy. We had very good short-term results with fecal transplantation.

It is also called fecal microbiota transplantation, FMT. Fecal transfer from a healthy patient corrected the microbiome in patients with inflammatory bowel disease.

Dr. Anton Titov, MD: Fecal transplants are used to treat Clostridium difficile colitis (C. diff colitis).

Dr. Simon Robson, MD: Yes, fecal transplants are used to treat C. diff colitis. Fecal transfer is very effective in C. diff infection. Treatment of C. diff with fecal transplant is effective in 90% of cases.

Often just one fecal microbiota transfer is needed. But inflammatory bowel disease is more complicated. Often we need to repeat correction of the microbiome by fecal transplantation.

But you are right, C. diff treatment with fecal transplant works magically. I find it interesting. With the experiments, you can create obesity in mice. You can treat obese mice by transfer of microbiome via fecal transplantation.

Dr. Anton Titov, MD: Mice lose weight or gain weight depending on the composition of their microbiome.

Dr. Simon Robson, MD: This is wonderful new research. There is a lot to learn about microbiome correction and fecal microbiota transfers, FMT.

Jet lag is well known. There is a medical article in the journal "Cell". Scientists studied jet lag and circadian rhythms in bacteria in the gut and in bile. Bacteria in intestines (gut) and in bile have their own bacterial circadian rhythms.

Bacterial circadian programs change with jet lag. In jet lag, your body adjusts to a new day-night cycle. But it is dark in the colon.

But bacterial circadian programs are driven by regular food intake. Food intake patterns change in a new location. Bacteria are jet-lagged by 6 to 8 hours. It takes some time for the microbiome and gut bacteria to also reset itself.

Bacterial circadian programs drive bacterial jet-lag after travel.

Dr. Anton Titov, MD: I will make sure that I synchronize my bacterial circadian rhythms to the new time zone.

Dr. Simon Robson, MD: Your jet-lagged bacteria will appreciate it very much! I certainly hope so.

Dr. Anton Titov, MD: Western diet changes gut bacteria. Fecal transplantation. Video interview with a leading gastroenterologist. Fecal transplants for obesity? Hygiene hypothesis.