The Mediterranean Diet Can Help Keep Your Gut Happy
By Heather Cruickshank
Trillions of bacteria and other microbes live in the human digestive system. Together, they form a community that's known as the gut microbiota.
Many bacteria in the microbiota play important roles in human health, helping to metabolize food, strengthen intestinal integrity and protect against disease.
To help friendly bacteria in the gut thrive, new research presented at UEG Week 2019 suggests it may help to eat a Mediterranean-style diet that's rich in plant-based foods, including fruits, vegetables, grains, legumes and nuts, as well as fish.
When researchers from the University Medical Center Groningen in The Netherlands assessed the eating habits and gut bacteria of more than 1,400 participants, they found that a Mediterranean-style diet was linked to healthier gut microbiota. It was also associated with lower levels of inflammatory markers in stool.
This points to the role that a plant-rich diet might play in helping to protect against intestinal diseases, including inflammatory bowel disease (IBD).
"Connecting the diet to the gut microbiome gives us more insight into the relation between diet and intestinal disease," Laura Bolte, lead investigator of the study and a dietitian who's currently pursuing an MD and Ph.D. in the field of nutrition, said in a statement.
"The results indicate that diet is likely to become a significant and serious line of treatment or disease management for diseases of the gut — by modulating the gut microbiome," she added.
Mediterranean Diet Might Reduce Inflammation
Four groups of participants took part in Bolte's study, including members of the general population and patients with Crohn's disease, ulcerative colitis (UC) and irritable bowel syndrome (IBS).
Crohn's disease and UC are forms of IBD that involve chronic inflammation in the intestines. IBS is another intestinal disease in which inflammation may play a role.
To identify potential links between diet, gut microbiota and intestinal inflammation, the researchers administered a food frequency questionnaire and collected a stool sample from each participant.
They found multiple links between participants' eating habits, gut microbiota and markers of intestinal inflammation.
A Mediterranean-style diet rich in fruits, vegetables, legumes, grains, nuts and fish was linked to greater abundance of friendly bacteria that help synthesize essential nutrients, produce fuel for cells in the colon, and reduce inflammation. This plant-rich eating pattern was also linked to lower levels of inflammatory markers in the stool.
In comparison, a diet rich in meat, refined sugar, or fast foods was linked to lower levels of friendly gut bacteria and higher levels of inflammatory markers.
"It's not surprising that a diet pattern which has been connected to a lower risk of heart disease, cancer and increased longevity is also associated with beneficial digestive effects," Julie Stefanski, MEd, RDN, a spokesperson for the Academy of Nutrition and Dietetics, told Healthline.
"This study reinforces a growing body of data demonstrating that having a healthy intestine and pinpointing the right mix of bacteria needed for health may be key to tackling many chronic diseases," she added.
More Research Is Needed
This study adds to a large body of research that suggests Mediterranean-style diets and other plant-rich eating patterns have benefits for human health.
"We've known for some time that when you look at it at a country level, populations that take in less red meat and eat a more plant-based diet have lower incidence of inflammatory bowel disease, including Crohn's and colitis," Dr. Arun Swaminath, director of the inflammatory bowel disease program at Lenox Hill Hospital in New York City, told Healthline.
"I think the interesting addition here is that we didn't know why that was true or really understand what the mechanism of that was," he continued, "and the microbiome seems to be at least one of the ways that this association exists."
To learn more about the potential relationship between diet, gut microbiota and intestinal health, more research is needed. In particular, clinical trials are needed to test the links that identified in this cross-sectional study.
"Food frequency questionnaires can have hundreds of variables and microbiota data can have the same," Swaminath explained, "and it's hard to tell whether there's really a meaningful signal or if it's just part of the statistical noise."
"So I think it'll be interesting when we're able to see more of the details of their data and methodology and then reproduce some of this in clinical trials," he continued, "especially if people are put on these diets and we can see how the microbiota change moving forward in time."
To follow up on their study, researchers at the University Medical Center Groningen are planning to conduct a trial to test the effects of a Mediterranean-style plant-rich eating pattern in people with Crohn's disease.
Similar research is also underway in the U.S., where investigators are comparing the effects of a Mediterranean-style diet and an eating pattern known as the Specific Carbohydrate Diet in adults with Crohn's disease.
Expert Guidance May Help
While research on gut microbiota and diet continues, Swaminath and Stefanski encourage patients with IBD to work with qualified health professionals to develop diet plans that works for them.
Some people with Crohn's disease or UC develop strictures or narrowed segments in their intestines, which can make it difficult to pass bulky stools. Such patients might benefit from a low-fiber diet.
But in patients without intestinal strictures, eating more fiber may promote better gut health. A registered dietitian nutritionist can help them learn which types of food might be best for them.
"Certain [foods] and ways of preparing them are better tolerated than others," Stefanski said.
"Working with a [registered dietitian nutritionist] to personalize specific food choices is vital when trying to achieve more plant-based diets," she added.
Reposted with permission from our media associate Healthline.
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From the mythical minotaur to the mule, creatures created from merging two or more distinct organisms – hybrids – have played defining roles in human history and culture. However, not all hybrids are as fantastic as the minotaur or as dependable as the mule; in fact, some of them cause human diseases.
When Looking Through a Microscope Isn’t Close Enough.<p>For the last few years, <a href="http://www.rokaslab.org/" target="_blank">our team at Vanderbilt University</a>, <a href="https://www.researchgate.net/lab/Gustavo-Goldman-Lab" target="_blank">Gustavo Goldman's team at São Paulo University in Brazil</a> and many other collaborators around the world have been collecting samples of fungi from patients infected with different species of <em>Aspergillus</em> molds. One of the species we are particularly interested in is <a href="https://doi.org/10.1006/rwgn.2001.0082" target="_blank"><em>Aspergillus nidulans</em>, a relatively common and generally harmless fungus</a>. Clinical laboratories typically identify the species of <em>Aspergillus</em> causing the infection by examining cultures of the fungi under the microscope. The problem with this approach is that very closely related species of <em>Aspergillus</em> tend to look very similar in their broad morphology or physical appearance when viewing them through a microscope.</p><p>Interested in examining the varying abilities of different <em>A. nidulans</em> strains to cause disease, we decided to analyze their total genetic content, or genomes. What we saw came as a total surprise. We had not collected <em>A. nidulans</em> but <em>Aspergillus latus</em>, a close relative of <em>A. nidulans</em> and, as we were to soon find out, <a href="https://doi.org/10.1016/j.cub.2020.04.071" target="_blank">a hybrid species that evolved through the fusion of the genomes</a> of two other <em>Aspergillus</em> species: <em>Aspergillus spinulosporus</em> and an unknown close relative of <em>Aspergillus quadrilineatus</em>. Thus, we realized not only that these patients harbored infections from an entirely different species than we thought they were, but also that this species was the first ever <em>Aspergillus</em> hybrid known to cause human infections.</p>
Several Different Fungal Hybrids Cause Human Disease.<p>Hybrid fungi that can cause infections in humans are well known to occur in several different lineages of single-celled fungi known as yeasts. Notable examples include multiple different species of <a href="https://doi.org/10.1002/yea.3242" target="_blank">yeast hybrids</a> that cause the human diseases <a href="https://rarediseases.info.nih.gov/diseases/6218/cryptococcosis" target="_blank">cryptococcosis</a> and <a href="https://www.cdc.gov/fungal/diseases/candidiasis/index.html" target="_blank">candidiasis</a>. Although pathogenic yeast hybrids are well known, our discovery that the <em>A. latus</em> pathogen is a hybrid is a first for molds that cause disease in humans.</p>
(Left) Candida yeasts live on parts of the human body. Imbalance of microbes on the body can allow these yeasts, some of which are hybrids, to grow and cause infection. (Right) Cryptococcus yeasts, including ones that are hybrids, can cause life-threatening infections in primarily immunocompromised people. Centers for Disease Control and Prevention<p><a href="https://doi.org/10.1371/journal.ppat.1008315" target="_blank">Why certain <em>Aspergillus</em> species are so deadly</a> while others are harmless remains unknown. This may in part be because <a href="https://doi.org/10.1016/j.fbr.2007.02.007" target="_blank">combinations of traits, rather than individual traits</a>, underlie organisms' ability to cause disease. So why then are hybrids frequently associated with human disease? Hybrids inherit genetic material from both parents, which may result in new combinations of traits. This may make them more similar to one parent in some of their characteristics, reflect both parents in others or may differ from both in the rest. It is precisely this mix and match of traits that hybrids have inherited from their parental species that <a href="https://www.nytimes.com/2010/09/14/science/14creatures.html" target="_blank">facilitates their evolutionary success</a>, including their ability to cause disease.</p>
The Evolutionary Origin of an Aspergillus Hybrid.<p>Multiple evolutionary paths can lead to the emergence of hybrids. One path is through mating, just as the horse and donkey mate to create a mule. Another path is through the merging or fusion of genetic material from cells of different species.</p><p>It is this second path that appears to have been taken by our fungus. <em>A. latus</em> appears to have two of almost everything compared to its parental species: twice the genome size, twice the total number of genes and so on. But unlike other hybrids, which are often sterile like the mule, we found that <em>A. latus</em> is capable of reproducing both asexually and sexually.</p><p>But how distinct were the parents of <em>A. latus</em>? By comparing the parts contributed by each parent in the <em>A. latus</em> genome, we estimate that its parents are approximately 93% genetically similar, which is about as related as we humans are with lemurs. In other words, <em>A. latus</em>, an agent of infectious disease, is the fungal equivalent of a human-lemur hybrid.</p>
How A. Latus Differs From its Parents.<p>Elucidating the identity of closely related fungal pathogens and how they differ from each other in infection-relevant characteristics is a key step toward reducing the burden of fungal disease. For example, we found that <em>A. latus</em> was three times more resistant than <em>A. nidulans</em>, the species it was originally identified as using microscopy-based methods, to one of the most common antifungal drugs, <a href="https://www.drugbank.ca/drugs/DB00520" target="_blank">caspofungin</a>. This result provides a clear example of the potential importance of accurate identification of the <em>Aspergillus</em> pathogen causing an infection.</p><p>We also examined how <em>A. latus</em> and <em>A. nidulans</em> interact with cells from our immune system. We found that immune cells were less efficient at combating <em>A. latus</em> compared to <em>A. nidulans</em>, suggesting the hybrid fungus may be trickier for our immune systems to identify and destroy.</p><p>In the midst of the COVID-19 pandemic, our quest to understand <em>Aspergillus</em> pathogens is becoming more urgent. Growing evidence suggests that <a href="https://doi.org/10.1111/myc.13096" target="_blank">a fraction of COVID-19 patients are also infected with <em>Aspergillus</em>.</a> More worrying is that these <a href="https://doi.org/10.3201/eid2607.201603" target="_blank">secondary <em>Aspergillus</em> infections</a> can worsen the clinical outcomes for those infected with the novel coronavirus. That being said, we stress that little is known about <em>Aspergillus</em> infections in COVID-19 patients due to a lack of systematic testing, and none of the infections identified so far appear to have been caused by hybrids.</p><p>So, when it comes to hybrids, some are fantastic (the minotaur), some are helpful (the mule) and some are dangerous (<em>Aspergillus latus</em>). Understanding more about the biology of <em>Aspergillus latus</em> may help in our understanding of how microbial pathogens arise and how to best prevent and combat their infections.</p>
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