A CONVERSATION WITH SCOTT C. ANDERSON, CO-AUTHOR OF ‘THE PSYCHOBIOTIC REVOLUTION’

Louise Macnab

Firstly, thank you for producing such an easily digestible (pun intended) and information rich book on an important topic that we’re very passionate about at JERMS: the relationship between gut health and psychological well-being. As a scientific journalist, what initially drew you to the subject of the gut microbiota and mental health? 

In 2005, I was invited to Ohio to create a laboratory to produce prebiotics for humans and animals. Working with veterinarian Frank Pellegrini, we discovered that horses can get colonic ulcers. I believed that the cause was bacterial imbalance in their hindgut. We created a fecal blood test that allowed us to correlate those ulcers to poor performance. We try not to anthropomorphize, but these horses seemed depressed. In my research, I came across the work of Professor John F. Cryan and Dr. Ted Dinan of University College Cork. They were working on something called psychobiotics – bacteria that could improve mood as well as some antidepressants.

Believing that we were working on the same problem, I called them up. They had read some of my previous writings and we all thought it would make sense to write a book about psychobiotics. I visited them in Ireland and we sealed the deal over a meal of fish and champagne. I count myself as very lucky to meet these giants of research and to work with them on a book for lay people to learn about the amazing secrets of psychobiotics.

The book is called ‘The Psychobiotic Revolution’. Can you explain to us what the term ‘psychobiotic’ means and why it has the potential to revolutionize healthcare?

Psychobiotics include prebiotics and probiotics that improve gut function and lower inflammation that can lead to depression, anxiety and other mental issues. Via the gut-brain axis, these substances can help to address psychological stress and perhaps lower the need for harsh medicines that often have poor efficacy and nasty side effects. 

Psychobiotics will likely not replace the current suite of psychological drugs, but they offer many patients a more holistic approach to dealing with depression and anxiety. They may also play a big role as adjuvants, used in combination with antidepressants and anxiolytics.

Merely recognizing that gut microbes can affect our mind, cognition and mood is a true revolution. The beauty is that the microbiota acts like another organ in our body – but one we have control over. Being able to take charge of our mental health via diet is a remarkable breakthrough.

How do you recognise a healthy microbiota (the community of microbes living in our guts)?

It turns out to be quite difficult to look at a microbiota and determine if it is healthy.

Unhealthy guts are easier to identify, as they are often dominated by one or two species, with much lower diversity. Researchers are starting to realize that diversity is the most important common factor in a good gut – as long as no one species dominates, the microbial communities are better balanced and more resilient to change.

Research suggests a strong connection between low microbiome diversity and modern Western diseases. Can you unpack a little why you think we’re seeing a surge in, for example, autoimmune diseases today?

The hygiene hypothesis says that our lives may actually be a little too clean. In 1989, Dr. David Strachan found that younger siblings had lower rates of eczema and asthma. He proposed that exposure of these youngsters to the microbes of their older siblings was teaching their immune systems to tolerate certain antigens. Studies of farm-raised Amish kids support this finding as well. 

The Western world, however, is at war with germs, with antibacterial soaps and antibiotic overkill.

The impact of refined foods has added to our woes. By extracting fiber from our food – so-called refining – we have disturbed a deal we made with our microbes millennia ago to provide them with sustenance while they protect us from pathogens. As a consequence, beneficial bacteria are suppressed and pathogens bloom, leading to inflammation and the likelihood of autoimmune and other chronic diseases.

The book discusses how to reduce gut-based inflammation as a way to reclaim both physical and mental health. Can you discuss the role that gut inflammation plays in depression and anxiety?

Gut inflammation can lead to “leaky guts” – a loose term that means toxins and bacteria can escape the gut and invade the bloodstream. 

No matter how beneficial microbes might be in the gut, they are nothing but trouble in the blood. Once there, the heart dutifully pumps them to every organ in the body. That includes the brain. Normally, the brain is effectively walled off from the messiness tolerated by the rest of the body by the blood-brain barrier (BBB). 

But when inflammation becomes chronic, the BBB can break down, allowing those toxins and microbes to enter the brain. The immune system is then called upon to come to the rescue, but it is not subtle. There is a lot of collateral damage generated by the immune system as it hunts down microbes.

Stress triggers the release of cortisol, the flight-or-fight drug that is the body’s response to stress. Interestingly, cortisol diminishes the immune response, potentially causing a vicious cycle of increasing inflammation. The longer this goes on, the greater the anxiety and depression of the sufferer.

We have known about the effects of disease on our mental state since the days of Hippocrates. He described liver patients who became anxious and even angry, something we now know as hepatic encephalopathy. In at least some cases, it is caused by pathogenic microbes that produce ammonia. We also know one way to treat this microbial disease: antibiotics. Once treated, these patients can quickly regain their normal personalities.

In the book you explain how a good diet can keep your gut happy, increase your health span, and improve your mood, all at the same time. Is it that simple, can we really eat ourselves happy?

The evidence shows that excess sugar and diminished fiber in our diet is directly related to leaky gut syndrome, inflammation, and chronic disease – including mental disease. Dr. Dinan’s success treating depression and anxiety with psychobiotics is further evidence of the link between an unbalanced microbiota and mental disruptions.

It is hard to avoid the data showing that people consuming a Mediterranean diet are healthier and happier with high fiber and a wide diversity of foods. Fiber feeds beneficial bacteria which then produce butyrate, a short-chain fatty acid that nourishes and heals the gut. Butyrate can also penetrate the BBB where it can promote nerve growth, enhancing cognition and mood. All in all, eating a diet high in fibrous foods like onions, artichokes, asparagus and beans will make your gut healthier, lower inflammation and improve overall health, including mental health.

There’s been a recent realization that there may be no single, one-size-fits-all diet and that differential human responses to dietary inputs may rather be driven by unique host and microbiome features. What’s your opinion on tailored diets and what do you perceive as the main challenges in harnessing the potential of microbiome-informed personalized nutrition?

There are many variables involved in gut health: genes, early exposure, antibiotic use, culture, habits and many more. This makes it difficult to offer useful advice about specific microbes that may be good or bad. Instead, microbes like E. coli, Clostridia, and Streptococcus can be beneficial or pathogenic depending on the rest of their environment. 

Eating fiber works regardless of your specific microbiota. For some people with active gut inflammation like IBD, fiber can cause discomfort and bloating, but for most people it’s a boon. The upshot is that we need to pay strict attention to what we eat, especially foods with fiber, and take note of what works. That complicates things short-term, but in the long run, a diverse microbiota from eating a varied and fiber-rich diet will be excellent for your health.

Can you tell us something that even you were surprised to learn about the gut microbiota when you were writing this book?

The concept that invisible gut microbes can produce neurotransmitters that are identical to those used by our own brains is mind-boggling. 

But extending this idea leads to some amazing theories. Microbes can use this leverage to affect our cravings. This same power can shape our personalities. Microbes may affect who we choose as partners, and an extension of that idea is that microbes may even affect speciation. Some of these ideas are more speculative than others, but the implications are staggering. Microbes play a much larger role in the advance and shape of humanity than we ever thought possible!

What is your hope for the future of microbiome research? Are there any other particular areas you’re personally excited to dig deeper into?

There are so many spin-offs from microbial research! Realizing that microbes can have a powerful effect on our health, our personalities and even our civilization is sobering and empowering. I look forward to future microbial therapies that can treat our epidemic of depression, obesity, diabetes, heart ailments, mental problems and other chronic diseases.

I also expect to find ways to deal with antibiotic resistance, which threatens to undo a century of “miracle” cures for infection. The answer may involve phages, which are viruses that live off (and in) bacteria. The exploration of viruses continues our exploration of the microbiota and is poised for a renaissance. It also bodes well for new solutions for plagues like the coronavirus.

Researchers are learning how to turn bacteria into tiny “doctors” that can analyze their surroundings and then make decisions about which medicines they can release to treat disease. This sounds like sci-fi, but is already up and running in laboratories today.

Scott’s book the Psychobiotic Revolution: Mood, Food and the New Science of the Gut-Brain Connection is available on Amazon 



A CONVERSATION WITH TAMIR BARZILAI, CO-FOUNDER AND CEO OF HONEYCOMB

Louise Macnab

Honeycomb is a revolutionary AI technology helping empower individuals with dietary restrictions in the U.S, Canada and Australia and we’re thrilled to be the first business in the UK to offer it to JERMS customers in our London cafe.

Honeycomb was born out of your own experience living with the digestive condition Ulcerative Colitis – can you share with us the backstory and how that led you to create what Honeycomb is today?

In 2013 I went on my first flight across the Atlantic. Halfway through the flight I knew something was wrong with me – for those who suffer from IBS/IBD, they’ll know exactly what I mean when I say I was very busy going back and forth, up and down the aisles.

To make a long story short, that was the beginning of a mega flare-up – a flare up that put me in the hospital back in Vancouver just over a month later when I got back, 25 pounds lighter than when I left. My mom couldn’t recognize me at the airport, things weren’t looking up!

To fast forward, I had multiple meetings with dietitians to come up with a diet that could get me into remission. Low-FODMAP elimination diet was what I started with, but ultimately it was a tumultuous three-year journey to finally get to the autoimmune nirvana, the magic word called “remission”.

At the time, I was running another company and would frequently have meetings in downtown Vancouver. After every meeting around lunch, I’d end up at Subway. Why Subway? Because despite the negatives, I could at least pick out which ingredients they put in my food. I felt I had some control. 

However, going to Subway everyday wasn’t sustainable for my palette, even though it was indeed reliable. Here we see a problem: I’m in downtown Vancouver, and there are dozens of amazing restaurants and cafes offering so many delicious meals. However, I didn’t know how to discover suitable items without having to call or visit the restaurant and share my dietary needs. 

Not only is it a tedious process, it’s also at times embarrassing to have to play ingredient-tetris with strangers in order to simply find eat lunch. 

At that point I decided to create Honeycomb. What if there was a mobile application that could profile my exact dietary needs, has access to a database of nearby restaurant menu items, and could simply match me up with items suitable for me to eat? So I teamed up with my friend who’s a computer engineer and we got to work!

Developing Artificial Intelligence to help diners with food allergies and specific diets select suitable items from restaurant menus is no mean feat! What were some of the main challenges you initially faced from a technology and development perspective?

From a restaurant perspective, operators don’t have time to manually annotate and fill out super detailed allergen guides and dietary information. Our AI tool saves restaurants hours of grunt work by using our predictive ingredient/diet labelling feature to help annotate their menu items with the valuable dietary information.

For customers, our AI tool works like what you might expect Netflix or YouTube to do when it comes to making personalized recommendations. Honeycomb services both sides of the experience, therefore making it viable to provide an amazing experience for the end user, only recommending food that explicitly suits their dietary needs and preferences, including intolerances and more allergies.

Alright, let’s talk gut health! At JERMS we’re super passionate about normalising the discussion around our bodily functions. As a young guy suffering with a chronic digestive condition, did you ever feel any isolation or embarrassment around it and, if so, how did you deal with it?

Honestly, at first I never wanted to tell anyone because they might see me as weak or inferior in some way. Having gut issues can indeed be very embarrassing.

I would have trouble going out with friends without knowing the plan in advance (I’d have to map out the washrooms) and camping/travelling/hiking was a huge NO for me, which is particularly bad here in British Columbia where everyone wants to hit the outdoors. 

Now that my baseline is pretty much remission, I find it less severe and therefore my social life has recovered to a relatively normal level where I’m not afraid of the consequences. Thankfully, the people around me are supportive and I can be pretty transparent about everything!

Apart from your diet are there any other lifestyle changes you’ve made that have helped you manage your Ulcerative Colitis? 

Yes! It’s always a combination for me. The perfect storm for a flare up is always multi-factored. High stress, not taking medication, not sleeping enough, and having some cheat meals here and there will all contribute to an imminent flare up.

To keep my gut-health in check, I make sure I get enough sleep, mitigate any cheat meals, stay away from alcohol, and get some exercise in at least 3 to 4 times a week to keep the stress down. I always go by the concept of “Eat. Move. Sleep” as a strategy to stay healthy.

And finally, as the founder of a successful start-up, what 3 points of advice would you give to aspiring founders? 

  1. Keep your mission – your grandest vision – as your North Star. Be unshakeable in your dedication to it, and understand that accomplishing it is going to be monumentally difficult. Knowing that will keep you in the game longer.
  2. Be careful who you take advice from. Keep advisors close, listen to the words of your investors, but ultimately, test each idea with rigorous logic and reasoning and do your best to keep bias and ego from creeping in. Do you want to win or do you want to be right?
  3. Be kind to everyone, even if they piss you off. Sometimes people might say the wrong thing or back down from promises they have made. Keep a trail of kindness behind you everywhere you go – don’t burn bridges!  

To learn more about Honeycomb visit www.honeycomb.ai or follow them on socials @honeycomb_app



EXERCISE CAN CHANGE OUR GUT MICROBIOME

Louise Macnab

As if we needed another reason to work out…

Although it’s well established that diet can change the composition of our microbiome (the universe of bacteria living inside every human that’s believed to influence everything from metabolism to mood), recent studies suggest that exercise can alter it too

In one study, higher self-reported physical activity levels were associated with a 22% reduced risk of active Ulcerative Colitis “UC” (chronic digestive condition), and a 10-wk intervention that included moderate exercise improved quality of life in patients with moderately active UC.

Another study investigated the microbiomes of 40 professional international rugby union players compared to control groups of people of similar age with either high or low BMI. It highlighted “significantly greater intestinal microbial diversity among the athletes”.

And in one recent study, Scientists at the University of Illinois at Urbana-Champaign identified significant differences in the gut bacteria of obese and lean individuals who underwent the same endurance training.

The scientists took blood and fecal samples and tested everyone’s aerobic fitness. Then the volunteers began supervised workouts, during which their efforts increased over time from about 30 minutes of easy walking or cycling to about an hour of vigorous jogging or pedaling three times per week.

They were asked not to change their normal diets.

After six weeks, the scientists collected more samples and retested everyone, and then asked the volunteers to stop exercising altogether.

Six weeks later, the tests repeated.

The results showed that the volunteers’ gut bugs had changed throughout the experiment. In particular, they noted widespread increases in certain microbes that can help to produce substances called short-chain fatty acids. These fatty acids are believed to aid in reducing inflammation in the gut and the rest of the body. They also work to fight insulin resistance, a precursor to diabetes, and otherwise bolster our metabolisms.

Significantly, the study’s overall results suggest that even a few weeks of exercise can alter the makeup and function of our gut microbiome – although consistency is key as almost all of the changes in people’s guts reverted to what they had been at the study’s start after six weeks of not doing any exercise.

The above content is provided for informational and educational purposes only and is not a substitute for professional advice or diagnosis and should never be relied upon for specific medical advice.


Sources:

Evans CC, LePard KJ, Kwak JW, et al. Exercise prevents weight gain and alters the gut microbiota in a mouse model of high fat diet-induced obesity. PLoS One. 2014; 9(3):e92193. Allen JM, Miller MEB, Pence BD, et al. Voluntary and forced exercise differentially alters the gut microbiome in C57BL/6J mice. J. Appl. Physiol. 2015; 118(8):1059–66.

 

Morgan XC, Tickle TL, Sokol H, et al. Dysfunction of the intestinal microbiome in inflammatory bowel disease and treatment. Genome Biol. 2012; 13(9):R79.

 

Jones PD, Kappelman MD, Martin CF, Chen W, Sandler RS, Long MD. Exercise decreases risk of future active disease in inflammatory bowel disease patients in remission. Inflamm. Bowel Dis. 2015; 21(5):1063–71.

 

 https://nutrsci.illinois.edu/news/exercise-alters-our-microbiome-one-reason-it’s-so-good-us