|
The Role of the Microbiome and Gut Health in Maintaining Host Health
Brandon Lundell, DC, APC, DABCI, IFMCP, Dipl. Ac., NE, CAC
September 16, 2020
11 AM PST
Relative number and diversity of human microbiome is associate with almost all aspects of health – from aging, immune, hormones, metabolic function, mental health and more. In this webinar, Dr. Lundell will dive deep into how the microbiome and gut health effect these areas and what can be done to influence total body health through GI assessments.
|
Wellness Wednesday Webinar
Beyond the Basics: Comprehensive Neurotransmitter Primer
By: Ruth Hobson, ND
October 7, 2020
Review the anatomy and physiology of neurotransmitter function. Discover the role of neurotransmitters; what is known and what is yet to be understood. Explore, via assessing metabolites, how enzyme function may be contributing to neurotransmitter imbalance and a patient’s symptom picture.
|
|
|
|
Expansion of Visceral Adiposity and Cardiometabolic Disorders
|
By David Quig, PhD | September 15, 2020
|
In 2018 the C.D.C. reported that in the U.S. 60% of adults and 20% of children and adolescents were obese or overweight (BMI>25). Early small scale polling suggests that COVID-19 induced restrictions and lifestyle challenges may contribute to further expansion of the adiposity epidemic. Excess visceral adiposity (VAT) has a central role in the pathogenesis of cardiometabolic disorders, including metabolic syndrome (MetS) and coronary artery disease (CAD). Gastrointestinal (GI) dysbiosis associated with excessive VAT and insulin resistance has been partially characterized, and linked causally to metabolic disruption. Research-based laboratory testing is available to help clinicians better identify and monitor the GI dysbiosis and serum-based cardiometabolic risk factors associated with prevalent unhealthy lifestyles.
Macrophages amass in VAT and release pro-inflammatory cytokines and reactive oxygen species that result in systemic low-grade inflammation, disrupted adipokine metabolism and insulin resistance. Low-level systemic elevations of gut-derived bacterial lipopolysaccharides (LPS) augment infiltration and activation of macrophages, and accentuate the release of pro-inflammatory cytokines. Intestinal barrier disruption and high abundance of LPS-rich Proteobacteria (phylum), Enterobacteriaceae (family), and Shigella and Escherichia (genera) are common with inflammatory conditions such as obesity and type-2 diabetes mellitus. In contrast, normally abundant Faecalibacterium prausnitzii, Bifidobacterium spp., Eubacterium rectale and Akkermansia muciniphila are diminished, which begets increased inflammation and intestinal permeability.
Gastrointestinal eubiosis provides short-chain fatty acids (SCFA) that regulate several aspects of host metabolism related to adiposity and MetS. Butyrate and propionate stimulate the release of glucagon like peptide-1 (GLP-1) from enteroendocrine L-cells. GLP-1 regulates post-prandial glycemic control and satiety, and attenuates LPS-induced inflammatory pathways in VAT. Butyrate and acetate stimulate β-oxidation of fatty acids, and the secretion of copious mucins that constitute the critical mucus barrier. The status of colonic SCFAs can be indirectly assessed via a stool specimen.
Obesity is associated with clustering of cardiometabolic risk factors including dysglycemia and dyslipoproteinemia, low-grade inflammation, and renal dysfunction. Beyond a mainstay lipid profile, lipoprotein related cardiometabolic risk factors include non-HDL cholesterol, the levels and ratios of apolipoproteins A-I and B, and the specific LDL culprits oxidized LDL, small dense LDL, and lipoprotein(a). The activity of macrophage-derived lipoprotein-associated phospholipase A2 (PLAC) provides important information regarding vascular inflammation and plaque instability; concomitantly elevated PLAC and CRP are associated with greater risk for coronary and stroke events. Adiponectin is an abundant adipocyte-derived adipokine that imparts anti-inflammatory, ant-oxidative, antidiabetic, and vascular protective effects. Excess VAT is associated with low levels of serum adiponectin and higher levels of opposing leptin. A high leptin to adiponectin ratio coupled with elevated hsCRP is a strong risk factor for CAD. Beyond HbA1C, an abnormally low serum level of 1,5-anhydroglucitol (GlycomarkTM) provides an indication of daily hyperglycemic episodes over the past two weeks. Postprandial hyperglycemia appears to be independently associated with CAD and renal damage in type 2 diabetics. The serum level of cystatin C is an excellent, inversely related indicator of glomerular filtration.
Comprehensive stool analysis inclusive of a highly focused dysbiosis test, and serum-based metabolic biomarkers provide objective assessment of important physiological changes that may be associated with expansive VAT and cardiometabolic disorders.
|
References
Wang J, Chen W-D and Wang Y-D. The Relationship between gut microbiota and inflammatory diseases: The role of macrophages. Front Microbiol (2020)11:1065. https://doi.org/10.3389/fmicb.2020.01065
Forbes JD, Chen C Y, Knox NC et al. A comparative study of the gut microbiota in immune-mediated inflammatory diseases-does a common dysbiosis exist? Microbiome (2018)6:221. https://doi.org/10.1186/s40168-018-0603-4
Mcnabney SM and Henagan TM. Short chain fatty acids in colon and peripheral tissues: A focus on butyrate, colon cancer, obesity and insulin resistance. Nutrients (2017)9:1348 https://doi.org/10.3390/nu9121348
Casen C, Vebo HC, Sekelja M et al. Deviations in human gut microbiota: a novel diagnostic test for determining dysbiosis in patients with IBS or IBD. Alimen Pharmacol Ther (2015)42:71-83 https://doi.org/10.1111/apt.13236
Kim WJ and Park C. 1,5-Anhydroglucitol in diabetes mellitus. Endocrine (2013)43: 33–40 https://doi.org/10.1007/s12020-012-9760-6
|
|
|
|
|
|
|
Disclaimer: All information given about health conditions, treatment, products, and dosages are for educational purposes only and do not constitute medical advice.
|
|
|
|
|
|
