THE MICROBIOME SUMMIT : The Paradigm Shift
Microbes III: Healing Dysbiosis
Dr. Susan Prescott, MD, PhD & Dr. Alan Logan, ND
In the third video in their series, Dr. Susan Prescott and Dr. Alan Logan talk about healing dysbiosis (reduced microbial diversity). Given that dysbiosis is caused by a number of different factors, reversing dysbiosis requires a multi-pronged approach. In this inspiring video, Drs Prescott and Logan look at the big picture of reversing dysbiosis, providing tips on how to eat to feed your gut microbes (you are what you eat, eats!), the importance of spending time in nature and circadian rhythms.
- Alan:
- Welcome to the University of Toronto’s Microbiome Summit Series. I’m here with Dr. Susan Prescott; Pediatrician, Immunologist. My name is Alan Logan, and it’s wonderful to be here. So, I’d like to say that we are what we eat. Think about those phytochemicals going down into the gut and then transforming the foods, and making them more bioavailable and being delivered to the brain. Being delivered to other target organisms. And all of this happens; as you have pointed out many times. It happens sometimes within days. And you can literally influence these beneficial bacterial metabolites even in a few days of shifting your diet.
- Susan:
- Yes. The studies have shown that you can change if you move from a meat based diet, to a plant based diet and back again there are rapid shifts in your diversity, but even more prominent shifts in the metabolic activity of the bacteria with the production of these anti-inflammatory products which are called, “Short-chain fatty acids.” And they appear to be very important, they are anti-inflammatory, and not just in the locally in the gut to reduce the leakines but they are actually reach into the systemic circulation where they influence our mood. Our appetite. Our level of systemic inflammations. So it’s a way that we can see immediately how we know the benefits sort of a high-fiber diet, but here we can see another mechanism, by which, that is operating. So, and all of this of course is relevant to pregnancy as well, because and what mom eats in pregnancy is going to influence the metabolic activity of the gut bacteria, which then the products of the metabolism cross the placenta to influence the developing fetus in so many different ways.
- Alan:
- It’s true. So, these things when they get metabolized into the phytochemicals. I mean, they are literally making their way. Researchers have take tagged them, they mark and they find out where they go to and it just amazing that they make their way to the brain where they do a lot of wonderful things. In fact, recently scientists have found that these phytochemicals, the ones that are metabolized by microbes could actually potentially have this same type of activity in preventing the breakdown of neurotransmitters and so forth. So, it’s really one; and all of it is really layered on one nutritional story after another. We can talk about phytochemicals, but if you don’t have enough magnesium in your diet you’re intestinal microbe diversity may suffer. If you don’t have enough zinc in your diet, your intestinal microbe diversity might suffer.
- Susan:
- So, what you read really does influence not just the composition of your bacteria, but also the metabolic activity and the availability of nutrients.
- Alan:
- Yeah. And I think that’s really why it’s tough to sort of fix this all with a probiotic pill. I think it’s just very complex. Yes, they provide benefit, but we also need to talk about some other nutritional stories as well about how they may interplay. And I think fermentation is a really wonderful application. It’s a traditional artisanal application. We know that it’s probably much older than this, but we have definitive science showing that at least nine thousand years old and fermentation transforms foods. It also includes live microbes quite often. Or even activated ones that may confirm benefit.
- Susan:
- So, I guess the um the role of fermentation is something that is often underplayed in our dietary pyramids.
- Alan:
- Yeah. Well, if you look at the food guides for most major organizations, certainly, in western UK Canada, Australia, United States. You don’t see inclusions of fermented foods in those pyramids or my plate or whatever it is. And they should because there’s many benefits that come along with it.
- Susan:
- So, I think, we have underscored the importance of nature. Another important thing that for me is seeing nature as an important relationship to food. We know that if children are in nature and they understand where food comes from that actually has a beneficial effect on understanding food, but also understanding where it comes from, and hopefully making healthier eating choices as well. Obviously, today we see that technology in processed foods are really threatening that relationship though. Aren’t they?
- Alan:
- Yes, they are. I mean, the ultra processing of foods and this is now a global epidemic. You see you know nations that are under transition and heading towards so called fully developed nations. They’re being embedded with ultra processed and again, that’s a microbiome story. And when you start doing that are now taken away diversity. This is the thing, it’s all connected.
- Susan:
- It is. Because I guess the food comes out of the ground has microbes on it, and of course, we know that soil microbes influence health. They influence brain and behaviour I believe.
- Alan:
- Yeah. According to a rodent study, so far there is not a lot of human data on this yet. But there is research that’s really remarkable and that is these non-pathogenic or essentially, not harmful microbes that would reside in most soils throughout the world if it’s sort of a wet soil. They have been shown in animal models to reduce stress, to improve cognition; if you will memory recall and to diminish what we can propose to be anxiety, that is if rodents experience anxiety the way we do. But behaviourally they do. So, you start to see the study’s coming out right now and it would indicate that once again there may be hope a decade from now that there would be application for specific psychiatric illnesses. But for now and what we’re concerned about is the loss of contact with, you know, being a kid and being out in the nature and making incidental contact with soil and so forth. What is the fallout from that? Even mentally is now the question for us.
- Susan:
- Yes. Because even on fruits and vegetables there’s sort of bacteria that you encounter there. That don’t even have to be killed. But I mean, a live bacteria that still have an effect when you eat them.
- Alan:
- I think this is a really important point that you’re making right now. A critical point. For example, lactobacillus plantarum. Comes from plants. It comes from plants and is found in nature. It’s found in plants. There are many many studies just on that beneficial microbe alone. In the heat killed form. Where the researchers have intentionally heat and active; it’s not living anymore. But it has profound benefit to the host, and were not even talking about all rodent studies here. There are human studies showing that heat and activated lactobacilli can influence psychological stress in university students. It can influence allergies. It can influence immunity. Meaning, that even a heat killed microbe can help the shift of other microbes.So, it can still be pro-life even though it’s not living.
- Susan:
- Absolutely. So, I guess we have to come back to that basic tenet of where we get our food is important. Do we get it out of the garden or do we get it out off the shelf highly processed? So, I think that’s something that is a challenge for all of us. I’d liked what you said before; but we are what we eat and this transition from the traditional diet and right through to these highly processed foods are less fibre, are less omega-3 fats. More fat. More salt. Less fresh foods. Preservatives. The high temperature, which creates these inflammatory product, which are also driving a lot of the irritation probably in our gut lining as well. This is beginning to affect our health even again very early in life. So, I think we should think about our food as one of the quickest way to change our gut bacteria. And that includes just not what we’re eating, but where we’re getting get from. So, is it from nature and less processed food. So, I think that we need to remember that when we change our gut bacteria, we are in fact changing our genes because they are genetically active genes bacteria.
- Alan:
- That’s the the point. And again, if you think about that and you think about the greater environment itself it all comes back. These are all functional genes, and I’m glad you, really briefly, I’m glad you mentioned the omega-3. Because I think it’s underappreciated that your omega-3 fatty acids status can influence your microbes.
- Susan:
- So, as we change that metabolism we will see flow on effects to our immune function. Our mood. Our appetite and even our insulin and glucose regulation. So, I think one of the big challenges for all of us, everyone listening as well, is to eat real food. To eat fresh. You eat local and start today. And that’s for me one of the best things that we can do.
- Alan:
- Yes. I couldn’t top that advice. I think part of that is also trying to reconnect with nature and understanding our place in it and a great way to do that, especially, for children is community gardening. Academic gardening in schools. And that kind of thing as well.
- Susan:
- Yes. And we’re seeing more of that. Which, is really wonderful because there are so many benefits of community gardens.Not just ah relationship with food and nature but also our relationship with each other.
- Alan:
- Yeah. I mean that’s it. Exactly. There’s a social support network there. Generally speaking, people end up increasing their fruits and vegetable intake. There’s positive mood aspects. There’s many layers to that particular way to connect with nature.
- Susan:
- So, I think one of the main things we should be looking at is trying to simplify our lives in doing things like community gardens.
- Alan:
- Yes, it’s true.
- Susan:
- I really love the quote, “To change the word, you have to change the menu first.” Because I think that it really shows that solutions that have personal, social or economic benefits can have community and much wider benefits as well. It’s all interconnected as you’ve said many times. And I think that we need to understand that healthier food solutions will bring us closer to nature and improve biodiversity and as well.
- Alan:
- I completely agree.
- Susan:
- So, I think one of the other things we should just talk about as we address trying to heal this – the dis-biosphere. Are there wider issues driving this problem. I think that we’ve talked a lot about, individual choices in food and trying to make our own choices about eating healthier, but we also need to address the upstream factors.
- Alan:
- Yes. I completely agree with you, Susan. This is the aspect of the microbiome conversation that does not get nearly enough play in my mind nor yours, as well. You and I like to talk about ecological justice. It’s a sort of a combination of social justice, economic justice, as well right? And environmental justice. But really, ecological justice means, turning down the dial on all those forces that cause dysbiosis in the first place. Like for example, in those neighbourhoods that we discussed before, those individuals that are disadvantaged and are at risk. Greater concentrations of fast food outlets and greater concentrations of bars. Greater concentrations of tobacco outlets. All of these things cause dysbiosis right of the microbes. Greater concentration of environmental pollutants causes dysbiosis of the microbes. Ah, the fact that in disadvantaged communities, the recognition of fast food logos is much higher and it sort of tells you everything you need to know, and that is a story of dysbiosis. It really is. And that is the missing part of the conversation that you and I have been advocates for quite some time.
- Susan:
- And these influences, these dis-biosphere is even affecting us at night time. I mean, we can say that our mental and physical and social community health are – are at risk because we have become progressively a screen culture. We’re away from nature. That’s also affecting gut health.
- Alan:
- When you talk about that screen culture and taking that screen into the nighttime as many of us do now influencing circadian rhythms, that has a detrimental effect of dysbiosis right. It…
- Susan:
- So, it actually, does affect the gut bacteria.
- Alan:
- It does. So, what you’re saying is very true, and in fact, there’s even studies that show that when there are screens around, people tend to snack more and they’re not exactly reaching for the healthiest of snacks. So, all of these things are ripple conversations around it. The fact that we can’t you know no longer see the milky way at night is actually a related conversation because we have too much light at night and that in turn could be another social factor that is influencing the microbiome.
- Susan:
- Soa third of humanity can no longer see the milky way because of light pollution…
- Alan:
- That’s right.
- Susan:
- It’s really quite staggering. And when we stepped back, we can see that when we look at all these forces, whether it’s fast food, smoking or screen time. Tobacco.
- Alan:
- Light at night.
- Susan:
- You know, it’s getting harder and harder for all of us to outrun these unhealthy forces. Isn’t it?
- Alan:
- It really is and I think that’s why I love the microbiome research as a general topic. Because it’s a place where we can become united and recognizing that these forces are really what the issue is.
- Susan:
- And it really is about the economic drivers that really are driving health disparities, social inequality and adding to the environmental degradation and grey space, which you know, we know are fundamental issues in our society today.
- Alan:
- I completely agree. When a soft drink truck pulls up in front of the school, that is a story of dysbiosis. In both its a larger real definition again, for those who might of missed that. It’s life in distress. And also in its microbial sense.
- Susan:
- So, it’s really looking at a crazy world aren’t we? Where we’ve got trucking in on one side, the fast food, the beer, and the cigarettes and on the other side of the equation we’re trucking in the medications, that need to heal the problem and when we’re not really addressing the fundamental and causes in the first place so.
- Alan:
- Yeah. I mean if the listener just sort of step back for a second, close their eyes, imagine that right now there is a juggernaut heading across a Canadian or a US, or an Australian highway, filled with commodities to try to undo what’s been done by other commodities that are heading to the same city filled to the gills with whatever that ultra processed food is or whatever it might be. Or marketing materials that get people to eat those same foods.
- Susan:
- And we know marketing is important; isn’t it? Because it really – even early in life it really is beginning to affect child food choices.
- Alan:
- It really does.And it’s not a mystery anymore. Look, Australian researchers or several months ago showed that according to Bradford Hill criteria, which is used in public health measures. It essentially met all of the criteria for causation. Right. So, what that means is that we’re not speculating that these marketing efforts are tweaking the way these kids eat. No, they’re doing it. The causation is now been established through Bradford Hill criteria.
- Susan:
- Yes. And you really have talked about this as a matter of ecological justice, not just trying to restore what is missing; the green space; the healthy food choices, and the optimism that we used to have, which is being eroded, I think and the biodiversity. I think we need to also look at trying to address the excess.That we’re seeing in our society today.
- Alan:
- Ah exactly. So, there’s a few solutions to fixing the dis-bioshere. One is reconnecting ourselves to the natural environment. And one is also an education effort that sorts of pulls the lens back and says, wait a minute. We can’t talk about the microbiome and not talk about all these other things that are working against it.
- Susan:
- And one of the really important messages here when we look at this in the upstream way is that we’re not blaming individuals. We’re not even blaming communities. We’re actually looking at how the economic ecosystem is functioning to promote dysbiosis.
- Alan:
- I really love that. Because quite often it’s so easy, when you think about maternal health and the importance of microbiome during pregnancy or in very early childhood life it’s so easy to blame mothers. And it’s so inappropriate to do that when every environmental marketing force and driving force is trying to get at them to have ultra processed foods to maintain an unhealthy lifestyle.
- Susan:
- So, I think before we finish, we probably should talk about at least touching on climate change. Because climate change is real and it is affecting human and planetary health so it’s having a flow on effects through all aspects of our environments and obviously it’s part of the dysbiosis’s story, and we’re on a interjectory for vast environmental losses and this really does demand ah urgent advocacy. Doesn’t it?
- Alan:
- It does; and it’s just another way, in which, that microbiome research forces our hand to look at the greater environment and the way it’s changing. Again, although we don’t see microbes with the naked eye they are a critical part of nature, and when we talk about climate change, and when we talk about biodiversity losses and when we talk about environmental degradation. Although we can’t see them and we don’t have an emotional affinity with them and they’re not the Bengal tiger or the Panda. Because we can’t see them and pet them. Right? But they are critical to us and no less important than other species on our earth.
- Susan:
- So, we really need to understand what we’re losing; is what you’re saying? The importance of biodiversity and the natural environment for our health. Our physical health and our mental health, and we really need to have a respect for the natural environment and engender that in our children from a very early age.
- Alan:
- In fact, it’s their right. The United Nations, 1989 Charter says, that children have the right to be supported in their development for; “Respect for the natural environment.” Respect for the natural environment. So, how are we going about doing that? It’s very difficult to bring up children to learn respect for the natural environments. And there go microbes without actually experiencing time in natural environments.
- Susan:
- Really, we are trying to reach our human potential. Mere survival is not enough. I believe it’s been said. A part of this story is not just our constant and previous focus on preventing disease, but really, optimizing and trying to achieve complete wellness, so that we may reach our potential. And obviously, having a healthy environment within us and without us is a key part of that. Isn’t it?
- Alan:
- It is. Within us and without us. It’s exactly right. So, every part of our discussion thus far as we bring it to a close is you can think of the microbes that reside on one little tiny bit of your intestine, right? So, the intestinal villi, which are like a little finger projection as you well know has this little ecosystem with on it and it’s no different than the lessons of the external environment. Diversity is critical and we need to have respect for that and make sure that this conversation is seen through a certainly, through a lab focus, but also through a massive broad lens as sort of seen from the sky if you will.
- Susan:
- Absolutely. And on that note, I think that we really need to remember that we are, all of us, are part of the social and the economic ecosystems, that drive inequality. That drive dysbiosis and we all have the really important role to play in contributing to changing them. But the factors that drive grey space and ecological social inequalities should be as unacceptable to us as tobacco campaigns aimed at children for example.
- Alan:
- Oh, absolutely. That’s really well said; as unacceptable as the tobacco campaign. I love that and it’s true. We should have no time for it.
- Susan:
- Mm-hmm. And I certainly, believe that all of us need to be advocates for long-range vision and long-range vision, and long-term commitments, because our attitudes will influence the policies that impact the generations to follow.
- Alan:
- Yes. And that is where the microbiome discussions sort of where the rubber hits the road for you and I.
- Susan:
- It is.
- Alan:
- About the long-range view.
- Susan:
- I mean here we are and were talking about health, but it really is about the future. About the future of our health. About the health of our world.
- Alan:
- Yes. The health of the planet.
- Susan:
- And I think the microbiome story really shows us that everything is interconnected; doesn’t it?
- Alan:
- Yes. It does. I mean that was the primary theme, now circling back,, our original meeting in 2003 to here as this is presented in 2017. Ah, it’s just a remarkable story that simply underscores it’s all one. It is all connected.
- Susan:
- Yes. That our lifestyle, the environment, our economic systems, diet; our social inequalities is that they all matter and they’re all interconnected. And I really and if we bring it back to the microbiome terminology, it means we all need to work symbiotically to overcome the challenges on our planet today.
- Alan:
- And sort of be united in our efforts to understand, moving forward with nature as opposed to back to nature. That’s the other thing. Our communication, our writings, our messaging, our advocacy is not about going back to nature. It’s not a luddite conversation. It’s not “hey, put your technology away.” It’s actually moving forward with nature. So, your point about moving forward in a symbiotic way into the future with nature is really important and understanding our place within the universe.
- Susan:
- Absolutely, and I guess, I’d like to remember that the beginning is near.
- Alan:
- The beginning is near.
- Susan:
- This is really an exciting adventure and we’ve got a lot a head of us and I just hope that were having an even more exciting conversation in ten years time.
- Alan:
- I hope so too.
- Susan:
- Thank you.
