Safeguarding our Gut Microbiome after the pandemic

-“Doctor…During that homely seclusion, we ate too much junk—feel intoxicated.”

Claire X. is a smart, well-educated, middle-aged lady that, besides pursuing a successful career in the Finance sector, prides herself in taking loving care of her husband and their three children. She has always made sure that they would all eat  a Mediterranean diet save for occasional permissiveness usually on weekends. However, the brutal Social Isolation of the COVID-19 pandemic, which has imploded so many paradigms of our former lives, also compromised their eating.

What used to be the Saturday Night loaded pizza became bi-weekly. Pourquoi pas ? What used to be the rare All the Works-Burger became a regular. Pour quoi pas? What used to be the fab Strawberry Smoothie became a lunch staple. Pour quoi pas?

The unhealthy cloistering with limited social contact not only brought a retinue of Mental Health disorders ranging from Anxiety/Depression to more serious pathologies, but also  had the collateral effect of compromising the safeguards we have been building for decades to improve our lifestyles. We ate food with too much salt, sugar, ultra-processed items. And way too often.

The microbiome is the sum of the bacterial and viral populations that reside inside our bodies, with mostly beneficial effects and some occasional deleterious ones. They are trillions of microorganisms that coexist peacefully in our Digestive System and in other organs, The majority of these organisms are symbiotic, which means that our bodies and these invited guests collaborate to promote our healthy status. In rare occasions they become pathogenic, which means that they promote diseases. A nice report from the Harvard School of Public Health stated: “Each person has an entirely unique network of microbiota that is originally determined by one’s DNA. A person is first exposed to microorganisms as an infant, during delivery in the birth canal ands through the mother’s breast milk. Exactly which microorganisms the infant is exposed to depends solely on the species found in the mother. Later on, environmental exposures and diet can change one’s microbiome to be either beneficial to health or place one at greater risk for disease.”

In order to ensure that we have the right amount and variety of microbiome, we can use the probiotics, which are foods naturally containing them or live active bacteria. It is a multi-billion industry in the USA, which is largely unregulated because they are considered as “mere food” and not drugs, escaping the regulatory enforcement of the Food and Drug Administration (FDA) Even thought the scientific data is still inconclusive, they might have a beneficial effect on younger and older patients.

Food with a high content of fiber can only be broken down in the lower segments of the colon, which means that the release of Short Chain Fatty Acids (SCFA) from the fermentation process will lower the pH of the gut. As a result dangerous bacteria like Clostridium difficile will not find a proper environment to grow and cause harm. Certain foods contain copious amounts of indigestible carbohydrates and fibers such as garlic, leeks, onions, asparagus, artichokes, bananas, beans, oats, barley. They are dubbed as prebiotic because they provide the raw material for the probiotic elements. Taken in excess, they might cause excessive bloating and flatulence.

Note. This image of the Microbiome was taken from Wikimedia Images and originated in the American Gut Project based on the University of California San Diego School of Medicine.

Keeping our bespoke microbiome system in decent shape is also essential to recover form the deleterious effects of the Covid-19 pandemic as there is a direct ink between the clinical status of our Digestive System and the integrity of our Respiratory System. Dr. Tim Spector, professor of Genetic Epidemiology at King’s College in London, UK, wrote in a review: “recent research has shown that the gut microbiome plays an essential role in the body’s immune response to infection and in maintaining overall health. As well as mounting a response to infectious pathogens like coronavirus, a healthy gut microbiome also helps to prevent potentially dangerous immune over-reactions that damage the lungs and other vital organs.” These interactions are not yet fully understood by scientists, but it has been proven that gut bacteria produce many critically needed chemicals and activate the Vitamin A in our food, which helps to regulate the immune system.”

In order to be effective, a microbiome must be diverse; however as we age, that diversity declines. For that very reason, a good diet becomes of paramount importance in the latter stages of our lives. We should eat plenty of fruit, vegetables, nuts, seeds and whole grains, extra virgin oil, lean meat, and fish. We should restrict our intake of salt, sugar, alcohol , carbonated drinks, and sweets. And of course we should eat naturally resourced food with no additives or artificial sweeteners.

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.

Obesity is shifting the Covid-19 infection to younger people

The carelessly hasty re-opening of most places of big public gatherings like bars and restaurants, without a statewide mandate to wear a face mask and to keep social distancing, produced a tragic spike of new Covid-19 infections in the state of Florida. In late March, the state authorities were gloating about the supposedly “mild” and “manageable” number of infected persons in our state, compared to New York. The influx of thousands of tourists fleeing the pandemic in the North and the crowding of beaches and entertaining venues produced a disastrous sanitary picture at present.

One of the associate factors that might have had a critical influence could have been the high incidence of Obesity in young people in Florida and the nation as a whole. S.L. Philip et al studied the state’s adult obesity rate by using the electronic health records (EHRs) available from the statewide clinical data research network called the OneFlorida Clinical Research Consortium—filled with data from claims of more than 12 million patients of the Sunshine State. They found that: “Among the 1,344,015 adults in OneFlorida with HER data and who met inclusion criteria, the obesity rate was 37.1%. Women had higher obesity rates compared with men. Obesity rates varied within racial/ethnic groups, with the highest rate among African-Americans (45.7%)” [i] The Robert Wood Johnson Foundation prepared a report in 2018 called the National Report of Children’s Health where they found that the state of Florida ranked 13th in the nation with their rate of childhood obesity.[ii]

Graselli, Zangrillo and Zanella studied the characteristics and outcomes of 1591 patients infected with Covid-19 that were subsequently admitted to Intensive Care Units (ICUs) in the region of Lombardy in Italy; they found that their median age of 63 years, with only 203 patients (13%) younger than 51 years old.[iii] The initial epidemic outbreak in the province of Wuhan, China, had a similar age prevalence. When the pandemic struck the USA, similar results were expected, especially because, at least initially, the national and state authorities were mistakenly giving a “modicum of assurance” to young segments of the population as they emphasized the higher incidence in patients older than 65 years old and with chronic conditions.

In a recent communication to The Lancet, David A. Kass at al. wrote: “However, as the pandemic hit the Johns Hopkins Hospital in late March 2020, younger patients began to be admitted to our ICU, many of whom were also obese.” Slowly but surely, other professionals started to communicate that obesity was an underappreciated risk factor for the disease. The USA has a general prevalence of 40 % of Obesity in its population, compared to a meagre 6% in China, where the pandemic had started.[iv]

Using the least squares univariate and multivariate linear regression, they studied the data from 265 patients (58% of whom were males) that had been admitted to several major medical centers, including Johns Hopkins, to determine the relationship of body mass index (BMI) and age in patients infected with the SARS-CoV-2 virus. They found an inverse correlation between age and BMI, whereby younger patients admitted to ICUs were more likely to be obese; there were no gender differences. They said that: “Obesity can restrict ventilation by impeding diaphragm excursion, impairs immune response to viral infection, is pro-inflammatory and induces diabetes and oxidant stress to adversely affect cardiovascular function.” [v]

Stay distant. Stay safe. Stay beautiful.

Picture provided by: JoachimKohlerBremen – Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=58168999

What do you think? Please tell us.

Don’t leave me alone.

 

References

[i] S.L. Filipp, M.Cardel, J.Hall et al., Characterization of adult obesity in Florida using the One Florida Clinical Research Consortium, Obesity science Practice 2018 August; 4(4):308-317. Published online 2018 June 15.

[ii] https://rwjf.org

[iii] Graselli G., Zangrillo A., Zanella A. et al., Baseline characteristics and outcomes of 1591 patients infected with SARS-Cov-2 admitted to ICUs in the Lombardy Region, Italy, Journal of the American Medical association (JAMA) 2020; published online April 6, 20202.

[iv] David A. Kass, Priya Duggal, Oscar Cingolani, Obesity could shift sever COVID-19 disease to younger ages, Correspondence, The Lancet, Published online April 30, 2020.

[v] Ibidem as above.