Q&A: Healthy gut microbiome starts with the ‘right nutrition,’ bacterial diversity
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Low bacterial diversity and Bifidobacterium depletion were associated with severely symptomatic COVID-19 infection in a small subset of patients — a pattern of dysbiosis that may serve as a susceptibility marker for symptomatic severity.
“To fight a virus one needs strong bacteria,” Sabine Hazan, MD, founder and CEO of research genetic sequencing laboratory ProgenaBiome in California, told Healio. “After analyzing thousands of stool samples, I saw markers of diseases in the microbiome.”
In a cross-sectional study, Hazan and colleagues compared gut microbiome diversity and composition in patients with confirmed SARS-CoV-2 infection, who ranged from asymptomatic to severely symptomatic, vs. a group of controls, who were exposed to SARS-CoV-2 but tested negative and remained asymptomatic.
Compared with control individuals (n = 20), participants with severely symptomatic COVID-19 infection (n = 28) had less bacterial diversity, with lower relative abundance of Bifidobacterium, Faecalibacterium and Roseburium. These patients did, however, have an increased abundance of Bacteroides.
“Our data suggest a new area for exploration: If SARS-CoV-2 severity is found to be dependent on the microbiome, then accounting for microbiome differences could reduce variability in outcomes for SARS-CoV-2,” Hazan and colleagues wrote in BMJ Open Gastroenterology.
To further explore the implications of these results, Hazan spoke with Healio about risk factors for an “unbalanced gut,” how to best preserve the gut microbiome and the need for additional research.
Healio: What is the gut microbiome and what role does it play in our susceptibility to illness?
Hazan: It is essentially trillions of bacteria, viruses, fungi and parasites all living together.
They are crucial to our immunity, our digestion, absorption of nutrients — they are crucial for life, in my opinion.
Healio: Does the presence or lack of Bifidobacterium determine whether someone has an “unbalanced gut”?
Hazan: Absolutely, and the more severe cases are the ones who have no Bifidobacterium —people who have cancer, are obese, have autoimmune diseases, chronic Clostridioides difficile infection. Some neurological patients have no Bifidobacterium. Also older adults, because the process of aging includes loss of Bifidobacterium — you are born with a lot of Bifidobacterium and you die with none.
Bifidobacterium is a crucial group of bacteria that are needed for immunity, in my opinion. We are also seeing this in research so far.
Healio: How would someone know whether their gut is unbalanced?
Hazan: What we Ire now developing at ProgenaBiome is an assay that will identify those high-risk markers. It is only available under research protocol right now. The microbiome is very complex and when you start telling patients they have certain bacteria that are high or low, you have to explain it to them. Further validation and data are needed.
Healio: What can people do to correct an imbalance of bacteria in the gut?
Hazan: It is very difficult to correct Bifidobacterium once you have lost it. If you have none, you need to begin taking good probiotics. Unfortunately, the problem with probiotics is they are not regulated. In other words, you need to ask whether it is a live bacteria probiotic or a dead probiotic.
Vitamins are also very important: Vitamins C and D improve your microbiome and, again, the quality of the vitamin is very important.
Then, of course, there is avoiding destruction. For example, drinking a glass of wine helps your Bifidobacterium, but four glasses of wine do not. If you are eating foods that contain antibiotics, like some meat, that does not help your Bifidobacterium. You have to be very sensitive with antibiotics regarding whether you really need it, because though it may treat that bad bacterium, too much has the potential to kill your Bifidobacterium.
Healio: What advice would you give people who want to preserve their gut microbiome?
Hazan: Diet is very important and educating yourself on food is very important. There are many foods people should start eating to improve their gut and the factory that is your colon. We are supposed to be making Bifidobacterium and it starts with the right nutrition.
Physicians should advise their patients to focus on nutrition and improve their fermented food intake.
Healio: What additional research is needed in this area?
Hazan: There is a lot of research needed. Research is needed to determine which foods improve the microbiome and which kill Bifidobacterium. The same research is needed for medications, as well as investigating how long it takes Bifidobacterium to grow back.
It is difficult because a lot of this research is controversial — it is new data and the research is very expensive. We count on doctors for their support in being a part of the research. I feel the microbiome relies on a patient-doctor relationship.
For more information and research on the gut microbiome, visit progenabiome.com.
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