Presentation given at the AMEN Australia 2018 annual conference held in Adelaide, Australia, www.amenaustralia.org.

AMEN Australia 2018: Healing, Surviving, Thriving

<p>Presentation given at the AMEN Australia 2018 annual conference held in Adelaide, Australia, www.amenaustralia.org.</p>

<p>Free sharing permitted under the Creative Commons <a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/us/">BY-NC-ND 3.0 (US)</a> license.</p>

Adventist Medical Evangelism Network Australia

Justin Jackson

Gut Microbiome and Health

I'm excited to be talking on the gut microbiome this morning and I'm excited about our God.

Our God is an amazing God and the way that he has created this world is absolutely amazing.

And really when you start to look at nature, This quote really came home to me from the quarterly review of biology, December 2012.

And it says, the discovery of symbiosis throughout the animal kingdom is fundamentally transforming the classical conception of an insular individuality in 1 in which interactive relationships among species blur the boundaries of the organism and obscures the notion of essential identity.

Now, I think we do have an essential identity, but I also think that we are symbiotic.

And I'm gonna come back to this point as I conclude this talk and really focus on perhaps some of the spiritual lessons that the gut microbiome teaches us.

We're going to move quickly, but I want to introduce to you the Hawaiian bobtail squid that emerges at night to forage.

And the reason that it glows is it has a bacteria inside it called Vibrio fischeri that lives in its light organ.

And it's not actually the squid that glows, it's the bacteria that glows.

And this bacteria is important for the squid's immune system.

And in fact, if this bacteria wasn't in the squid, the squid's light organ would not develop.

And so you can see here in this diagram from a paper on the squid that the relationship begins on the underside of the newborn squid where mucous-lined fields are beating hairs, the cilia draw the bacteria in close, and then when the Vibrio fischeri touches the squid, it actually sends a cascade, switches on a cascade of genes, squid genes, that produce a cocktail of antimicrobials, which allow the Vibrio fischeri to live there but create a completely inhospitable environment for other microbes.

Not only that, these cascade of genes then release enzymes which break down the squid's mucus and it attracts more of the Bivrio fischeri.

It takes just 5 bacteria to trigger these changes within it.

And then you know there's a whole process.

I'm not going to go into the into the details this morning but Inside You is a process just as amazing as that and the human body is estimated to have 30 trillion human cells colonized by 40 trillion microorganisms and primarily the gut, the skin and the oral cavity.

90% of bacteria belong to just 2 phyla, the firmicutes and the bacteroides.

And again, we will perhaps start by touching on some of the science.

And similar to the squid, These bacteria are essential to synthesise vitamins.

They protect us against opportunistic pathogens.

They harvest nutrients, as we saw in the quiz last night, that the Japanese have, that Bacteroides plebeius that digests the seaweed in the Japanese gut.

It sets our metabolic rate, as we'll discover.

Traditionally, it was thought that the newborn was born with a sterile gut, but now we know that there is actually a prenatal gut microbiome from what the mother eats and travelling via the various routes there that you see in this paper, just released last year.

Now a key concept is that we do not dine alone.

So when you eat, you're actually feeding trillions of bacteria in your gut.

And I say to my kids, if there was a horse in the paddock and you put out a carcass there your horse would die off pretty quickly whereas if you had a lion in the paddock it'd do just fine on that sort of a diet.

If you feed your horse oats, then it'll be fine in the paddock.

And if you feed your bacteria, you will select out the kinds of bacteria that you want in your gut by what you feed them.

Now before we move down into the intestine, I just want to start out with this pretty neat way that we actually get our nitrous oxide in part.

And so green leafy vegetables, particularly spinach, have huge amounts of nitrate in them.

So if you follow it through from number 1 there, As it goes into your circulation, what actually happens is your salivary glands will concentrate the nitrate 20-fold, re-excrete it into your mouth, and the anaerobic bacteria there will then convert the nitrate to nitrite.

So if you use alcoholic mouthwashes, I would suggest stopping.

The other fascinating thing is that if you have the right acidity in your stomach, which is not aided by a proton pump inhibitor.

And there's great studies on this, not only affecting stomach acidity, but the gut microbiome as a whole.

The low stomach acid will then turn the nitrite to nitric oxide.

And then in this incredible interaction, it then gets absorbed.

So you sort of go from the vegetable to the system to the mouth, back into the stomach, back into the circulation.

And green leafy vegetables or beet juice is another very high nitrate compound that's been extensively studied.

It'll lower your blood pressure by 10 mils of mercury.

It'll improve the function of blood vessels.

For the runners this morning Trevor, Tash and Neil and Co.

Will increase your VO2 max in a pretty remarkable way, 15% increase in time to exhaustion.

But as we move down into the gut, we discover again that we don't dine alone.

And this was perhaps a landmark paper from 2010 that demonstrated striking differences between the children in essentially an agrarian environment, a plant-based diet in Africa, and European children eating a Western diet.

And I want you to look there at this 53% of their gut made up of a bacteria, Prevotella, that loves digesting plant-based material.

And then another 20% made up of this Xylana bacteria, which also loves digesting cellulose and plant material.

So this is what their gut looks like and I hope that's what your gut looks like as well.

In contrast, These red and blue bugs here are bile-loving bugs that form when we eat a diet, a Western diet.

This has been demonstrated many, many times.

So the 2 species there that if you just stick them in your head, Prevotella, contrasted with bacteroides.

Another paper from the subsequent year, which really demonstrated the same thing in a different population.

And so you can see there that the authors write the bacteroides enterotype was highly associated with animal protein, a variety of amino acids and saturated fats, which suggest that meat consumption, as in a Western diet, characterised this enterotype.

In contrast, they say the Prevotella enterotype was associated with low values for these groups, but high values for carbohydrates, simple sugars, indicating association with a carbohydrate-based diet more typical of agrarian societies.

So going back to our African children of Bikini Fasale, what do they actually eat?

And you can see here, this is photos from that paper that I quoted a few slides back.

You can see that they grow their produce locally, that their diet consists basically of millet and sorghum.

It's a high complex carbohydrate diet and so that's what they feed their bacteria and that's what will grow up in their gut.

So the Prevotella actually ferment the plant polysaccharides as we've discussed, but they produce high levels of short-chain fatty acids, which feed the lining of your gut and they improve the tight junctions between the cells to reduce toxin leak.

And I want to show you here that from this same paper that the short chain fatty acids in these African children were drastically increased compared to the European children.

Now this paper was published last year with this beautiful diagram here.

You can see the intestinal epithelial cells and the tight junctions between those cells, which I've highlighted with red circles, the bacteria on the outside and the immune system on the inside.

And you can see here the opposite, a disrupted intestinal layer, where the tight junctions have gone and the bacteria are actually getting inside the gut.

A landmark paper from Nedgem this year actually demonstrated that Enterococcus gallinarium was found in the livers of SLE patients, which has been shown to induce the double-stranded DNA formation in mice from essentially this process.

So you can see that the bacteria leak through your system and cause many of the diseases that characterized our Western world.

So this is just commenting on cancer as well, particularly colon cancer.

I'm just going to focus briefly on obesity and I want you to contrast for those doctors in the audience, Enterobacter is a pretty nasty bug that we often see infecting our patients.

This particular person, his gut microbiome was made up of 35% of this single species.

What they did with him, they put him on a essentially, it was a Chinese diet, but it was a plant-based whole grains diet for 23 weeks.

They discovered that with this single intervention, they got rid of that bacteria without antibiotics and without anything else.

And he lost, I think, about 50 kilograms of weight.

So he was a very big man, about, there we go, 51.4 kilograms.

His blood sugar returned to normal and his blood pressure returned to normal.

As a proof of concept, they took that enterobacter out and they stuck it in a mouse.

And the mouse developed the phenotype of the person.

This study's been replicated many times over in different ways.

I've seen this work with Clostridium difficile, and in the interest of time I won't go into that, but you can offer patients antibiotics, you can offer them a faecal transplant, or you can offer them diet.

And I had 1 person who said, I will take the diet option.

I don't want anyone else's poo put in me.

And he was able to cure his Clostridium difficile by essentially feeding the right bacteria.

And So you can see here that the toxins leak and the bacteria themselves leak into the body and result in this inflammatory state.

And the inflammatory state is well associated with many diseases, Parkinson's, Alzheimer's, multiple sclerosis, obesity, diabetes, cancer, inflammatory bowel disease, and many others.

So mice with no microbiome will stay thin if you feed them a high-fat, high-sugar diet.

Now we'll come to why it's a good idea to have bacteria in your gut in a sec.

So it's the same mice and the same diet but it's a different gut microbiome.

And if you take the bugs out, this is another study that's essentially proving the same concept.

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