8 Tips to Support a Healthy Microbiome and Reduce Chronic Inflammation

Systemic inflammation is intimately connected to our gut health and our microbiome. If we want to lower chronic inflammation, the microbiome is a good place to start.

This is a whole paradigm shift in medicine, and it’s one of the most fascinating things I’ve ever learned. And, it works!

70% of our immune system lies in our guts, just underneath the single cell endothelial layer that makes up all of our digestive tract (affectionately referred to as the “gut” here).

It’s there on purpose. Remember, one of the most important functions of the immune system is to recognize and eliminate foreign invaders and toxins.  The gut, which can be 30 feet in adults, is the greatest exposure to the outside environment.

And if that single cell layer of the digestive tract gets damaged, undigested food particles and bacteria or viruses or other unwanted guests can come across.

If the immune system does not recognize any of these food particles or invaders, it kicks into high gear. It activates genes that call in more troops to help overcome this barrage happening in the gut. And these “troops” are also known as antibodies, T cells, and inflammatory markers that enter the bloodstream and lead to chronic inflammation.

This is why healing for chronic inflammatory conditions, from Alzheimers and autoimmune diseases like lupus and rheumatoid arthritis to heart disease and diabetes starts with a healthy microbiome.

The microbiome encases our entire bodies – think every single surface area, from skin, intestines to lungs and ears. All of it. And most of the time, we’re living symbiotically, where we work together.  

In other words, the 39 trillion bacteria in our guts actually play an important role for us. Since we’re talking about inflammation and the gut microbiome today, we’ll focus on that.

Those bacteria actually help modulate our immune systems, helping “train” the immune cells to recognize “harmless” and “self” from “safe”, “invader”, and toxins/danger.

Through germ-free experiments in animals, we know that without a microbiome, the immune system does not learn this and can over-react, leading to significantly more inflammatory conditions. This is called tolerance, and by creating a healthy balance of bacteria, our immune system learns what’s foreign and dangerous from self and safe.

In addition to helping us with digestion, making necessary vitamins such as B vitamins and vitamin K, and initiating the detoxification process, the microbiome are producing metabolites, which can greatly protect the cells of our gut lining and lower our chronic inflammation. These are known as short-chain fatty acids or SCFAs. These metabolites are post-biotics, and they are possibly even more important than the actual bacteria, with far-reaching functions such as improving metabolism, regulating blood sugar, communicating with our brains, and modulating the immune system.

However, the mcirobiome can also produce harmful metabolites, based on how we eat and live. It can become dysbiotic, and no longer function in a symbiotic state with us. We feel this in symptoms of inflammation. It can also form endotoxins that are absorbed into the bloodstream and promote systemic inflammation, and make instead postbiotics that can be more harmful than helpful, as discussed below.

So, how can we build a healthy microbiome to reduce chronic inflammation and improve our health?

8 Tips to build a healthy microbiome and lower inflammation:

1. Eat more fiber! This cannot be overstated. The bacteria feast on fiber, and if you’re not eating enough of it, they will run out of food, and will actually eat the mucous layer that protects our gut lining.  Fiber is key when it comes to healthy microbiome. The recommended amount is 25g for women and 35 g for men, and even this is low when it comes to the microbiome. And it’s even better to aim for closer to 50g/day or more. Where can you get fiber? It’s found in all plant foods. So, pack your plate with raw and cooked veggies, fresh fruits, legumes, whole grains, and small amount of nuts and seeds – this is just another area where a whole food, plant-based diet can benefit you. And mix it up a bit – diversity is essential when it comes to microbiome function. The beneficial bacteria thrive on diversity of fiber-rich food, and you will reap the benefits.

2. Emphasize prebiotic fiber – Prebiotic fibers are types of fiber that serve as food that promotes the growth of the healthy bacteria in our guts. It has been shown to increase bacterial species of Bifidobacterium and F. prasnitzii, which are beneficial against inflammatory diseases. It has been shown to decrease bacterial endotoxin levels leading to inflammation, and in fact, leads to lower inflammatory markers like C-reactive protein, IL-6, and tumor necrosis factor (TNF). Prebiotic fiber also helps improve metabolic parameters, such as improving insulin sensitivity, lowering cholesterol, TGLs, and increasing HDL cholesterol while lowering fat mass. Plus, they help satiate you and feel full after eating. Some good examples include onions and leeks, asparagus, bananas, oats, and barley, white potatoes (resistant starch), flaxseeds. However, for those who do not yet have a healthy microbiome and get excess gas and bloating, a small amount of a prebiotic fiber supplement can be helpful for all these reasons. A few prebiotics that have been studied for this are partially hydrolyzed guar gum (PHGG), psyllium, beta glucans, acacia, and green banana flour.

3. Think polyphenols. Polyphenols are phytochemicals that serve as prebiotic fiber and antioxidants. They are prebiotics in the sense that 90-95% of them are untouched in the digestion process until they reach the colon, where our microbes transform and activate them into health-promoting metabolites.  There are over 8000 known different polyphenols, each with slightly different functions. They can be found in foods like blueberries, pomegranates, turmeric, cocoa, green and black tea, chili peppers, apples, onions, flax seeds, and sesame seeds.  Their metabolites have been shown to have a strong antioxidant effect, help sensitize insulin, improve metabolic parameters, reduce inflammation, and modulate the immune system, among other effects. They should be a regular part of your diet.

4. Avoid foods that harm the microbiome. What we eat can nourish the healthy bacteria, starve them, or feed the disease-promoting bacteria. For example, eating excess sugar leads to an increase of yeast and provides less fiber to feed the anti-inflammatory and protective ones such as bifidobacteria and lactobacillus. Alcohol has been shown to alter the microbiome, which makes sense when you think that alcohol wipes are used to destroy bacteria and viruses. Imagine what it’s doing to our microbiome. Animal products, such as chicken, meat, eggs lead the bacteria in our microbiome to produce a metabolite called TMAO, which has far-reaching effects and leads to increased cardiovascular disease, weight gain, insulin resistance, and even effects inflammation. Lastly, highly processed foods with food additives and preservatives can be highly damaging to the microbiome. For example, emulsifiers, such as carboxymethylcellulose and polysorbate 80 directly damage the gut microbiota, leading to reduced microbial diversity, increased inflammation contributing to colitis, and obesity in mice.

5. Include fermented foods. Fermented foods have been used for centuries as a preservative. I like to think of it as a way to keep the food chain alive, as it relies on the live bacteria already present in the microbiome of the food, and turns it into something different and delicious by creating the right environment. For example when fermenting cabbage to make sauerkraut, the cabbage is submerged in water, where it has no oxygen, creating an anaerobic environment. The anaerobic bacteria can thrive here, produce acids that lower the pH, and other bacteria will die off in these conditions. This allows bacteria such as Lactobacillus plantarum, which has multiple beneficial effects including improving gut health, reducing gas and bloating, and lowering chronic inflammation, to take over. Some of my favorite fermented foods, which are also high in fiber and prebiotics, are sauerkraut, kimchi, tempeh, miso, and vinegar. A small amount each day can go a long way to improving the diversity and balance in your gut microbiome.

6. Move your body. Exercise actually changes the microbiome, supporting the health-promoting ones. Remarkably, it was shown in mice that exercise led to 40% increase in SCFAs that helped repair the gut integrity and reduced inflammation. Similar findings were found in people, too. Make it a regular part of your life, to move your body every single day. Bonus points if you can get out in nature to do it.

6. Follow your rhythm. Interestingly, both humans and microbiota have circadian rhythms. For example, they oscillate during the day, based on what time you eat and sleep. And it’s known that jet lag and shift work alter the microbiota composition and affect metabolic, inflammatory, and stress-related diseases in people. In order to maximize SCFA – producing bacteria and reduce dysbiosis, try to stick to your circadian rhythm, going to bed at a reasonable time consistently, and eating the same time every day. And even better, keep your eating window to 11 or 12 hours or less. This has been shown to be helpful in relieving symptoms of IBS, inflammatory conditions such as arthritis, and many metabolic parameters such as insulin resistance, blood pressure, cholesterol, and promotes weight loss.

7. Relax and Unwind. The microbiome responds to our thoughts and the state of our bodies and minds. For example, when people feel happy, relaxed, and safe, their microbiome functions in a harmonious way, working in synchrony with each other and with their body functions and circadian rhythm. However, when under chronic stress, which may be perceived or real, the microbiome becomes discombobulated and erratic. This transforms a healthy symbiotic microbiome into a dysbiotic one. Therefore, it becomes essential to practice regular stress modification techniques and actively relax our minds. I like mindfulness – being present in the moment in a nonjudgmental way, meditation, gratitude, deep breathing, yoga, but there are so many great techniques. My best advice is to find what works for you and use it daily.

8. Make sleep a priority. During sleep, our gut wall heals, the microbiome fluctuates to different predominant species at night, hormone levels balance themselves. and the body goes into repair mode. We likely have all felt this effect after an unrestful night of sleep, where we tend to make poorer decisions, have a bigger appetite, and may feel more depressed or anxious. And in fact, evidence from shift workers shows us that poor sleep shifts the microbiome to one that promotes obesity, and is associated with weight gain, increase risk of heart disease, stroke, diabetes, impaired immunity, decreased productivity/concentration, and reduced athletic performance. The bottom line, help promote your own healthy goals by focusing on how to get a good, restorative night of sleep, and your microbiome will work in your favor!

I hope you can see now, that how we eat and how we live affect our health and well-being on so many levels, right down to the trillions of bacteria in our guts. Health starts with healthy living, and we all feel the long-lasting benefits! Start today, and your microbiome will reward you.

-Chris Miller, MD

References:

1. Introduction to the Human Gut Microbiota, Biochemical Journal, June 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433529/
2. ASGE.org
3. Fiber-Fueled, 2020, Dr. Will Bulsiewicz, MD MSCI.
4. Exercise Modifies the Gut Microbiota with Positive Health Effects, Oxid Med Cell Longev, 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357536/
5. Food preservatives linked to obesity and gut disease, Nature 2015. https://www.nature.com/news/food-preservatives-linked-to-obesity-and-gut-disease-1.16984.
6. The microbiotium clock: how gut microbes and circadian rhythms influence health. Neuroscience, April 2020. https://microbiomepost.com/the-microbiota-clock-how-gut-microbes-and-circadian-rhythms-influence-health/
7. The Circadian Code, 2018. Sachin Panda, PhD.