At the Heart of the Gut

Researchers at the Cleveland Clinic recently announced discovery of a link between Coronary Artery Disease (CAD) and Small Intestine Bacteria Overgrowth (SIBO). According to the Center for Disease Control and Prevention (CDCP), more than 11% of the US population suffer from CAD, while the estimate of the rate of SIBO ranges up to about 20%.  Patients with gastrointestinal disorders such as Irritable Bowel Syndrome (IBS) have a much higher rate of SIBO at about 78%. The researchers believe the link between CAD and SIBO is due to metabolic processes in digestion that produce bacterial byproducts that may cause atherosclerosis, predisposing a patient to CAD.

It’s almost impossible today to read an article or research paper dealing with diet and health without reference being made to the complex system of microorganisms (bacteria, viruses, fungi and archaea) that inhabit our bodies from skin to gut. Known collectively as the Human Biome, the bulk live in the digestive system, starting in the mouth, but concentrated in the intestines. Up to 100 trillion bacteria cells, comprising as many as 500 different microbe species and weighing as much as 4 pounds, may be held within the large intestine at any one time. Our relationship with these intestinal microbes is symbiotic – they depend on us to feed them what they need to thrive and we rely on them to support our immune systems and help us maintain good health. If we feed them the wrong foodstuffs, those high in sugar for example, we encourage the growth of microbes that may damage us.

The US National Institute of Health (NIH) set up the Human Microbiome Project in 2008 to study how changes in the human microbiome influence health and disease. The Project has analyzed many habitats within human bodies and found that even healthy individuals differ remarkably in the microbes that populate their gut, mouth and skin. Diet, environment, genetics and early microbial exposure all play a role in the variation, but much of the diversity remains unexplained. An individual can be characterized by their biome as clearly as by DNA or fingerprint.

Gut microbes are characterized as “good”, “bad” or “neutral”, depending on their effect on the body. The number and type of bacteria that inhabit our bodies change daily, varying with the food we eat, the stress we experience, our sleep patterns and the overall external environment in which we live. Diets high in sugar, animal fats and protein generally have a negative effect on the bacterial population, increasing bad bacteria at the expense of the good. Fermentable foods and those rich in fiber help to keep the populations in balance.

Friendly gut microbes enable synthesis of several important nutrients – vitamin B12, folic acid, Vitamin K, thiamine and biotin – that we are unable to produce alone. They strengthen our immune systems by helping to protect us from harmful bacteria and pathogens. The immune system normally protects us against injury and disease by using inflammation, producing chemicals that in the process help to heal us. But disruptions in the microbial community can sometimes trigger an inflammatory response that works against us, attacking the body’s own healthy tissues.

Early symptoms that the gut microbes are out of balance include bloating, frequent bouts of diarrhea or constipation, gas and pain, heartburn and acid reflux. Persistent chronic inflammation in the gut can lead to forms of colitis as well as various autoimmune diseases such as Irritable Bowel Syndrome (IBS), Rheumatoid Arthritis (RA) and celiac disease. Cleveland Clinic researchers found that patients of all ages with celiac disease were twice as likely as the general population to have CAD. An increased risk of CAD has also been reported in other inflammatory disorders.

For those curious to find out more about the bacteria in or on their bodies, the biotechnology company uBiome, based in San Francisco, offers a service that analyzes biomes of the gut, genitals, nose, mouth or skin. After purchasing a kit ($89 for a single site) that includes swabs and instructions for sampling, the kit is returned to the company and the results sent back to the client in a few weeks. The process is simple and results can be compared with those of other participants.

Appropriate modifications to the diet can change the bacterial population of the gut, and changes can be tracked by using the uBiome service on a regular basis. People suffering from inflammation of the gut could use the information to help identify the causes and change their diet accordingly. If inflammation is reduced, so are the risks of CAD. The auto-immune Paleo diet is one such diet that has proven extremely helpful for sufferers of auto-immune diseases.

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