What we do and don't know about gut health
The brain and gut have a strong, two-way communication system Each are essential to the other – studies have found that brain development is abnormal in the absence of the gut microbiome. Gut microbes can produce most of the neurotransmitters found in the human brain, including serotonin, which plays a key role in regulating mood.
However, research hasn’t yet figured out which exact gut bacterium are crucial for brain development.
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Western diet, typically high in animal fat and protein and low in fibre, increases the risk of cancer. The Mediterranean diet is high in fibre and low in red meat and has been likened with anti-inflammatory effects and an improved immune system.
This leads us to the conclusion that gut health, favoured by fibre, is a reason for longevity of people following the Mediterranean diet.
There has been a lot of hype around the health benefits of prebiotics and probiotics in recent years, but while they're increasingly used in treatments including inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis, several reviews suggest there needs to be further research on which strains and dosages are effective. Recent studies have found some people are even immune to probiotics.
Gut microbiota has a major role to play in the health and function of the GI tract, with evidence that conditions such as irritable bowel syndrome (IBS) often coincide with altered microbiota. But it also plays a much wider role in our health, and this is largely determined in the first few years of life.
Antibiotics can dramatically alter our gut microbiota. Many of the genes thought to be fixed in certain bacterial environments can start spreading by overuse of antibiotics, which can put pressure on the resistant genes locked up inside a single bacterial cell, causing them to mobilise.
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Metaphors that scientists use to talk about the microbiome influence scientific understanding and can shape medical treatment. For example, viewing the microbiome as an "organ" or a "part of the immune system."
Some physicians support fecal microbiota transplantation (FMT) - treating the malfunction of the gut microbiome by swallowing a pill full of someone else's poo. It follows the same basic principles as an organ transplant, and the treatment is probably a consequence of understanding the microbiome as an organ.
To think of a microbiome as an organ creates a limited perspective because organs are relatively set. Generally, a heart will develop and remain the same in each person. But a microbiome is not one thing. It's trillions of things and responds to small changes in our diet, environment, and behavior. It works together with the human body in a symbiotic relationship.
Each metaphor can only capture a part of what the microbiome is. We need all the metaphors to understand the complexity of the microbiome and its role in our bodies.