The role of gut microbiota

Trillions of gut microorganisms impact metabolism and immunity. Dysbiosis, or an imbalance in the gut microbiota, is linked to obesity, diabetes, and autoimmune diseases, highlighting the importance of gut health and lifestyle choices in disease prevention, writes Dr Adarsh C K

The human gut microbiota, a complex community of microorganisms residing in the gastrointestinal tract, plays a crucial role in the development of various diseases, including obesity, diabetes, and autoimmune conditions. The term “gut microbiota” refers to the microbes themselves, while the “microbiome” encompasses all the genetic material of these microorganisms.

Emerging research suggests that disruptions in the gut microbiota, known as dysbiosis, can significantly contribute to disease development. This occurs through a variety of mechanisms, including decreased microbial diversity, changes in energy metabolism, alterations in hormone regulation, and increased inflammation. So how does the gut microbiome influence these conditions?

Obesity & the gut microbiome

• Metabolism regulation: Certain gut bacteria help digest fibre and complex carbohydrates, producing short-chain fatty acids (SCFAs) such as butyrate, acetate, and propionate. SCFAs play a vital role in regulating metabolism, appetite, and fat storage.

• Energy harvesting: An imbalance in the gut microbiome can lead to increased energy extraction from food, contributing to fat accumulation and weight gain. Studies show that people with obesity often have distinct microbial profiles compared to lean individuals.

• Inflammation: Dysbiosis can compromise the gut lining, leading to a “leaky gut.” This allows harmful bacteria and toxins to enter the bloodstream, triggering chronic low-grade inflammation, which is a key factor in obesity.

Diabetes & the gut microbiome

• Glucose regulation: The gut microbiome is crucial in regulating glucose metabolism and insulin sensitivity. Certain bacteria, such as Akkermansia muciniphila, are associated with improved blood sugar control and reduced inflammation.

• SCFA production: SCFAs produced by gut bacteria enhance insulin sensitivity and regulate blood sugar. A decrease in SCFA-producing bacteria can contribute to insulin resistance, raising the risk of type 2 diabetes.

• Gut hormones: The microbiome interacts with gut hormones like GLP-1 and PYY, which regulate appetite and blood sugar levels, influencing diabetes risk.

Autoimmune diseases & the gut microbiome

• Immune system regulation: The gut hosts 70-80% of the body’s immune cells. A balanced microbiome helps train the immune system to distinguish between harmful and harmless substances. Dysbiosis can disrupt this balance, leading to overactive immune responses and autoimmune diseases.

• Leaky gut: Increased intestinal permeability can allow bacteria or food particles to enter the bloodstream, triggering immune reactions. This may contribute to autoimmune conditions like rheumatoid arthritis, lupus, and multiple sclerosis.

• Microbial diversity: A lack of microbial diversity is associated with autoimmune diseases. A diverse microbiome supports immune system balance, while a reduced variety may lead to immune dysregulation and chronic inflammation.

What links the gut microbiome to disease

• Inflammation: Dysbiosis triggers chronic inflammation, a common factor in obesity, diabetes, and autoimmune diseases.

• Metabolic pathways: Gut bacteria influence nutrient metabolism, fat storage, and blood sugar regulation.

• Immune modulation: The microbiome plays an essential role in educating the immune system and maintaining immune tolerance.

Promoting a healthy gut microbiome

• Diet: A diverse, fibre-rich diet (including fruits, vegetables, and whole grains) supports a healthy microbiome. Fermented foods like yoghurt, kefir, kimchi, and sauerkraut provide beneficial probiotics.

• Prebiotics: Foods rich in prebiotics, such as garlic, onions, bananas, and asparagus, help nourish beneficial gut bacteria.

• Probiotics: Taking probiotics can help restore balance to the microbiome, especially after antibiotic use.

• Limit processed foods: A diet high in processed foods and sugar can disrupt the microbiome and promote dysbiosis.

• Stress management: Chronic stress negatively affects gut health. Practices such as mindfulness, yoga, and regular exercise can improve gut function and overall well-being.

• The gut-brain axis: The bidirectional communication between the gut and the brain — further highlights how gut health affects mood, behaviour, and cognitive function, underscoring the importance of a balanced microbiome for overall health.

(The author is a senior consultant in medical gastroenterology, hepatology &  advanced endoscopy.)