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Good bacteria: Why I put my poo in the post

“Good bacteria” – what are they, will they make me healthy and how do I get some?

To find out I too..

"Good bacteria" – what are they, will they make me healthy and how do I get some?

To find out I took the unusual , and rather disgusting, step of donating my poo to science.

Microbes live on, and in, all of us and they even outnumber our own human cells.

But their favourite spot – and where they live in incredible numbers – is our digestive system.

That's why I posted my faeces to the British Gut Project for analysis.

"You're not exactly average, but you're not way off the chart either," its director, Prof Tim Spector, tells me.

The bacteria in my stool were studied not with a microscope, but with powerful tools to identify them by their genetic code.

It showed I was missing whole groups of bacteria. One area of concern was my Firmicutes, as I had fewer than other people.

"They're generally the ones that have your beneficial microbes in it, suggesting you've got less general diversity than the average person," Prof Spector told me.

"The less diversity you have, the less healthy your gut. It's not a good thing."

A deeper trawl uncovered I had high levels of Akkermansia, which "is generally seen in people who are lean and healthy". But I was also harbouring those linked with inflammation.

There is growing interest in understanding the health consequences of the microbiome.

The microbiome

  • You're more microbe than human – if you count all the cells in your body, only 43% are human
  • The rest is our microbiome and includes bacteria, viruses, fungi and single-celled archaea.
  • The human genome – the full set of genetic instructions for a human being – is made up of 20,000 instructions called genes.
  • But add all the genes in our microbiome together and the figure comes out between 2 million and 20 million microbial genes.
  • It's known as The Second Genome and is linked to diseases including allergy, obesity, inflammatory bowel disease, Parkinson's, whether cancer drugs work and even depression and autism.

More than half your body is not human

Are "bad" bacteria or too few of the good ones causing disease?

Prof Spector argues the microbiome is the "most important, exciting thing in medicine today" and that "diversity" – having as wide a range of different species as possible – is key.

Clearly I could do with some improvement. So here are the tips I picked up along the way while making The Second Genome series.

Fibre, fibre… fibre

Researchers Eric Alm and Lawrence David have some of the most studied microbiomes on the planet.

They spent a year analysing 548 of their stool samples.

Lawrence David, an assistant professor at the Duke Center for Genomic and Computational Biology, said diet had the biggest influence on the microbiome – and one thing was especially effective.

He says: "One of the leading sets of molecules that people are getting excited about have to do with plants, specifically fibre.

"It's what at least some bacteria in the gut love to eat."

He says plant fibre is likely to benefit most people's microbiome, though he admits the study has just made him feel more guilty about the food he eats.

"I still eat hamburgers and chicken nuggets," he confides.

Fermented foods 'the future'

Fibre is a prebiotic, providing fuel for the microbes that are in our digestive system.

But Dr Paul Cotter, who I met at the University of Cork, is concerned we're not introducing enough new microbes into our bodies.

He told me: "An awful lot of what we eat now are foods within tins or with an awful lot of shelf-life and they have a long shelf-life simply because there are very few, or not any, microbes within them."

His field is fermented foods that bacteria have gone to town on before you eat them.

Fermented foods include well-known favourites, such as cheese and yoghurt, but also the milk drink kefir, a tea called kumbucha and certain cabbage dishes, such as sauerkraut or the Korean kimchi.

BBC Good Food: A guide to fermented foods

Dr Cotter says most people should be thinking of adding fermented foods to their diet as the microbes in them help calibrate the immune system.

He said: "If you're already healthy, the way to go is consume fermented food rather than going for a particular probiotic" – although studies have shown some probiotic products can help prevent necrotising enterocolitis and diarrhoea in some cases.

Listen to The Second Genome on BBC Radio 4.

The next episode airs 11:00 BST Tuesday April 17, repeated 21:00 BST Monday April 23 and on the BBC iPlayer

Fibre and fermented foods are a good rule of thumb, but there is no guarantee they will work for everyone.

Everybody's microbiome is unique, so the spectacular biology they are performing in the gut varies from one person to the next.

Eric Alm, of serial-faeces-monitoring fame and the co-director of the Center for Microbiome Informatics and Therapeutics at MIT, argues dietary advice will have to be more personalised in the future.

He says: "One thing that we're learning is, based on the microbiome, different people may need to consume different diets in order to get the same effect."

Chain reaction

He has studied what different people's microbiomes do with different dietary fibres.

Broadly, fibres are broken down into chemicals called short chain fatty acids.

They can be absorbed by the intestines and have effects throughout the body. It is one of the ways the microbiome is thought to influence our health.

Prof Alm's work showed some people's microbiome was very good at making short chain fatty acids from a dietary fibre called pectin, which is found in apples and oranges.

Other people's needed inulin (found in leeks, asparagus and onions) to make the same short chain fatty acids.

Prof Alm says: "You can imagine a future where if you needed to increase the levels of butyrate (a type of short chain fatty acid) production in the gut, which some people think might be advantageous for diseases like inflammatory bowel disease, you might sequence your microbiome first.

"[Then] figure out what species are there, then take a prebiotic or dietary fibre supplement that matched the microbes you have to produce butyrate."

Follow James on Twitter.

Illustrations: Katie Horwich

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Burkina Faso: Growing Violence Threatens Health Care

Away from the worlds attention, Burkina Faso has been slipping into violence. In less than a year, t..

Away from the worlds attention, Burkina Faso has been slipping into violence. In less than a year, the number of displaced has increased fivefold, from 50,000 last December, to 270,000 in August. As ever, the most vulnerable suffer most: the very young, and the very old.

When Alidou Sawadogos elderly mother fell ill, he faced a long and dangerous journey to get treatment for her.

“When she collapsed, a friend called me,” he explains. “By the time I arrived she was already unconscious. I decided to take her to the health center and luckily someone who had a motorcycle helped me. Because of the violence many people who are sick wait at home and die. Everyone is afraid of taking the road to the health center in Barsalogho.”

Across Burkina Faso, the rising insecurity has forced over a hundred health centers to close, or to limit their work. Half a million people now have little or no access to health care. Dedicated health workers, among them Dr Bertrand Dibli in Barsalogho, are struggling to meet the needs, and to stay safe themselves.

“This is one of the few health centers that isnt closed,” he says. “We dont have enough equipment. And the insecurity has caused huge anxiety among health workers. Even coming here to Barsalogho is a huge challenge because the route is so dangerous.”

The ICRC has been working to support Burkina Fasos health professionals, with medical kits, and vaccination campaigns. During his visit to the country, ICRC President Peter Maurer expressed his concern at the multiple challenges facing Burkina Fasos people.

“We are very concerned,” he said. “Very worried about the upsurge in violence, its a vicious circle that is trapping the civilian population between armed groups.”

“We also see,” Mr Maurer added, “that it is not only the violence that is affecting the country, it is also under development, and climate change. Together with the violence that is obstructing the health services, its an accumulation of factors.”

And so the ICRC – jointly with the Burkinabé Red Cross – is also delivering food to the displaced, and helping to improve access to water supplies. All of this, says nurse Jeanette Kientega, is desperately needed by a population uprooted by conflict, and denied access to basic health care.

“By the time they are able to get here, it is often too late” she says. “Sometimes we can help, but if they have already been ill a long time, it is difficult. We try to do what we can.” (more…)

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World Bank and WHO Statement on Partnership & Deployment of Financing to WHO for Ebola Response in DRC

WASHINGTON, August 23, 2019—The World Bank and the World Health Organization (WHO), along with the G..

WASHINGTON, August 23, 2019—The World Bank and the World Health Organization (WHO), along with the Government and other key partners, are working in close partnership on the Ebola Crisis Response in the Democratic Republic of the Congo (DRC). Central to this partnership is the assessment of the financing needs, and deployment of resources, with the goal to put an end to the current deadly outbreak.

The World Bank is today announcing that US$50 million in funding is to be released to WHO for its lifesaving operational work on the frontlines of the outbreak. The WHO is announcing that this US$50 million in funds will close the financing gap for its emergency health response in DRC through to the end of September 2019, and is calling on other partners to mirror this generous support in order to fund the response through to December.

The funding comprises US$30 million from the Pandemic Emergency Financing Facility (PEF) and US$20 million from the World Bank. The US$50 million in grant funding is part of the larger financial package of approximately US$300 million that the World Bank announced last month to support the fourth Strategic Response Plan for the DRC Ebola outbreak.

“WHO is very grateful for the World Banks support, which fills a critical gap in our immediate needs for Ebola response efforts in DRC, and will enable the heroic workers on the frontlines of this fight to continue their lifesaving work,” said Dr. Tedros Adhanom Ghebreyesus, Director-General, World Health Organization. “We keenly await further funding from other partners to sustain the response through to the end of the year.”

The DRC government, working in collaboration with the World Bank, WHO, and other key partners, has finalized the Fourth Strategic Response Plan (SRP4), which outlines the total resources needed for the DRC Ebola Crisis Response from July to December 2019. The financing announced today is part of the World Banks previously announced financial package of up to US$300 million and covers over half of SRP4s needs, with the remainder requiring additional funding from other donors and partners.

“The World Bank is working closely with WHO, the Government of DRC, and all partners to do everything we can to put an end to the latest Ebola outbreak,” said Annette Dixon, Vice President, Human Development at the World Bank. “The partnership between our organizations and the Government is critical for responding to the emergency as well as rebuilding systems for delivery of basic services and to restoring the trust of communities.”

The Government of DRC requested US$30 million from the PEF Cash Window to be paid directly to WHO. The PEF Steering Body approved the request bringing the PEFs total contribution to fighting Ebola in DRC to US$61.4 million. The PEF is a financing mechanism housed at the World Bank; its Steering Body is co-chaired by the World Bank and WHO, and comprises donor country members from Japan, Germany and Australia. The quick and flexible financing it provides saves lives, by enabling governments and international responders to concentrate on fighting Ebola—not fundraising.

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Borno State launches first Malaria Operational Plan, reawakens fight against malaria

Maiduguri, 13 August 2019 – Following recommendations from malaria interventions in Borno State Nige..

Maiduguri, 13 August 2019 – Following recommendations from malaria interventions in Borno State Nigeria, the Malaria Annual Operational Plan (MAOP) was developed and launched on 08 August 2019 with technical support from the World Health Organization (WHO) and partners. Aligned to the National Malaria Strategic Plan (2014 -2020), MAOP was developed through a broad-based stakeholders workshop involving malaria stakeholders, reviewed on different thematic areas and endorsed by the Commissioner for Health and Permanent Secretary, Borno State Ministry of Health.

Speaking during the launch, the Borno state Malaria Programme Manager, Mr Mala Waziri described the MAOP as the first to be endorsed and disseminated in Borno State. “WHO has made us proud by supporting the first ever Malaria Operational Plan right from development, review, printing to dissemination.”

Dr Ibrahim Kida, the Ministerial Secretary Borno State Ministry of Health and Incident Manager of the state, described the launch as “an historic event as stakeholders across the health sector made commitments to use the document as an implementation guide for all malaria programs”. The plan was also described as an advocacy tool for planning domestic funds mobilization.

The MAOP has seven objectives among which are: provide at least 50% of targeted population with appropriate preventive measures by 2020; ensure that all persons with suspected malaria who seek care are tested with Rapid Diagnostic Test (RDT) or microscopy by 2020 and all persons with confirmed malaria seen in private or public health facilities receive prompt treatment with an effective anti-malarial drug by 2020.

The MAOP will further ensure that at least 50% of the population practice appropriate malaria prevention and management by 2020, ensuring timely availability of appropriate anti-malarial medicines and commodities required for prevention, diagnosis and treatment of malaria in Borno State by 2020.

In addition, it seeks to ensure that all health facilities report on key malaria indicators routinely by 2020 and finally strengthen governance and coordination of all stakeholders for effective program implementation towards an A rating by 2020 on a standardized scorecard. These strategic objectives have specific targets and the MAOP takes into account the humanitarian response.

“Malaria remains a leading cause of poor health in Nigeria. According to the 2018 WHO Malaria Report, 53million cases are recorded annually in Nigeria, roughly 1 in 4 persons is infected with malaria contributing 25% of the global burden,” says Dr Nglass Ini Abasi, WHO Malaria Consultant for the North East.

“Furthermore, 81,640 deaths are recorded annually (9 deaths every hour), which accounts for 19% of global malaria deaths (1 in 5 global malaria deaths) and 45% malaria deaths in West Africa. The Nigeria Malaria Strategic Plan (NMSP) 2014-2020 has a goal to reduce malaria burden to pre-elimination levels and bring malaria-related mortality to zero and WHO is working assiduously with Government to ensure the burden is reduced accordingly.”

Results from WHO’s Early Warning, Alert and Response System (EWARS) week 30 report from 223 sites, (including 32 IDP camps) show that malaria was the leading cause of morbidity and mortality accounting for 35% of cases and 46% of reported deaths. In addition, results from the Nigeria Humanitarian Response Strategy (NHRS 2019-2021) indicate 7.1million people are in dire need of healthcare and 6.2million are targeted for immediate attention.

Despite recent improvements, insecurity remains a challenge limiting access to the functional health facilities. Easily preventable and treatable diseases such as malaria, acute respiratory infection and diarrheal diseases account for the greatest proportion of morbidity and mortality among the vulnerable population. Furthermore, Malaria is endemic in North East Nigeria and the transmission is perennial with a marked seasonal peak from July to November every year. (more…)

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