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#283 ‒ Gut health & the microbiome: improving and maintaining the microbiome, probiotics, prebiotics, innovative treatments, and more | Colleen Cutcliffe, Ph.D.

Dec 18, 2023 2h 32m 23 insights
<p><a href="https://peterattiamd.com/colleencutcliffe/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=231218-pod-colleencutcliffe&amp;utm_content=231218-pod-colleencutcliffe-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=231218-pod-colleencutcliffe&amp;utm_content=231218-pod-colleencutcliffe-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=231218-pod-colleencutcliffe&amp;utm_content=231218-pod-colleencutcliffe-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>Colleen Cutcliffe is an expert in molecular biology and co-founder of Pendulum Therapeutics, a company working to develop treatments for a variety of diseases by targeting the microbiome. In this episode, Colleen delves into the complexity of the microbiome, how it is tested, and how it changes over time. She explores how probiotics, prebiotics, and postbiotics affect the gut and makes a compelling case that well-developed products have the potential not only to enhance gut health but also to positively influence overall metabolic well-being. Colleen emphasizes the significance of a high-fiber diet in sustaining a thriving gut microbiome, shares insights on minimizing microbiome damage during antibiotic use, provides tips for fostering and preserving a healthy gut, and much more.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>Colleen's background and current focus [4:45];</li> <li>The basics of the microbiome [7:15];</li> <li>The study of the human microbiome [15:15];</li> <li>Categories of bacteria, and the implications on health of the rapid evolution of bacteria [19:45];</li> <li>Methods for measuring and understanding the microbiome, and key indicators of microbiome health [28:30];</li> <li>The important role of fiber for promoting gut health through the production of butyrate [38:30];</li> <li>The case for manipulating gut bacteria via fecal microbiota transplant (FMT) [45:00];</li> <li>Dynamics of the microbiome: the gut-brain connection and how antibiotics, nutrition, stress, and more impact the microbiome's diversity and function [50:15];</li> <li>Factors that influence the vaginal microbiome [55:15];</li> <li>The effect of gut microbes on obesity and challenges with fecal transplants in people [58:45];</li> <li>Beneficial strains of gut bacteria and strains commonly found in probiotics [1:01:15];</li> <li>The difference between a probiotic and prebiotic, and how CFUs are a measure of the "active ingredient" [1:09:45];</li> <li>Considerations about how probiotic strains are produced, and more on the meaning of CFU [1:14:15];</li> <li>Mitigating the effect of antibiotics on the microbiome [1:22:30];</li> <li>What do we know about the effect of artificial sweeteners on the gut microbiome? [1:30:00];</li> <li>Why Akkermansia is a keystone strain with implications for metabolic health and an individual's response to dietary interventions [1:36:15];</li> <li>The essential steps necessary to develop a robust probiotic for optimal health support [1:45:45];</li> <li>How Akkermansia helps control blood glucose, and potential implications of Akkermansia in weight loss, diabetes management, and more [1:48:45];</li> <li>Pendulum Therapeutics' commitment to rigorous product develop [2:06:30];</li> <li>Details about the probiotic "Glucose Control" and other probiotics developed by Pendulum Therapeutics [2:13:00];</li> <li>Further studies of Akkermansia that have been proposed or are underway [2:20:30]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href="https://twitter.com/PeterAttiaMD">Twitter</a>, <a href="https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>
Actionable Insights

1. Acromantia for Glucose Control

For individuals with type 2 diabetes, a multi-strain probiotic formulation including Acromantia mucinophila has been shown to lower A1C by 0.6% and reduce blood glucose spikes by 34% over 90 days. This works by stimulating GLP-1 production and improving gut metabolism.

2. Optimize Post-Antibiotic Diet

Following antibiotic treatment, seize the opportunity to reset your gut microbiome by consuming a diet rich in high-fiber and high-polyphenol foods. Avoid high-fat, high-sugar foods to foster the growth of beneficial microbes.

3. Take Probiotics with Antibiotics

To support gut health during and after antibiotic treatment, consider taking probiotics. Research indicates this practice may help maintain a healthier microbiome by providing a “seeding” effect for beneficial strains, even if some are killed by the antibiotic.

4. Boost Butyrate for Colon Health

Increase butyrate production in your gut, as it is a crucial short-chain fatty acid that serves as the primary energy source for colon cells. Sufficient butyrate levels are linked to good GI health and may reduce the risk of colon cancer.

5. Consume Insoluble Fiber

Increase your intake of insoluble fiber from vegetables and fruits, as it acts as a crucial prebiotic, feeding gut bacteria that metabolize it into short-chain fatty acids like butyrate, essential for gut health.

6. Acromantia for Gut Lining

Ensure sufficient levels of Acromantia in your gut to support the regulation of the mucin layer, which is vital for maintaining a healthy gut lining and preventing conditions such as “leaky gut” and other gastrointestinal issues.

7. Reduce Sugar Cravings with Acromantia

To help manage sugar cravings, consider a probiotic supplement containing Acromantia, as pilot studies indicate it can lead to a significant reduction in food cravings, likely by influencing GLP-1 and satiety.

8. Harness Microbiome Mutability

Understand that your microbiome is highly mutable and can be changed through various factors, offering a significant opportunity to impact your health. Focus on modifiable factors to drive positive changes.

9. Evaluate Probiotics Beyond CFU

Do not solely rely on Colony Forming Units (CFUs) when choosing probiotics, as this metric only counts live, culturable cells and often overlooks the majority of dead cells and their functional contributions (postbiotics). Focus on products with demonstrated efficacy and transparent manufacturing.

10. Screen FMT Donors Carefully

Before undergoing a fecal microbiome transplant (FMT), confirm that the stool donor has been rigorously screened to avoid transmitting pathogens or potentially altering your metabolism negatively, such as inducing obesity.

11. Bank Autologous Stool Sample

To mitigate risks associated with donor stool for potential future needs, consider banking your own stool sample for an autologous fecal microbiome transplant. This could be a smart strategy for gut microbiome reconstitution after events like antibiotic courses.

12. Optimize Fiber Supplement Delivery

If using fiber supplements, choose enteric-coated capsules to ensure the fiber reaches the distal colon, where gut bacteria primarily metabolize it. This targeted delivery may enhance impact and allow for smaller effective doses.

13. Pair Probiotics with Inulin

To improve the colonization of specific probiotic strains in your gut, consider taking them alongside a small amount of prebiotic such as inulin. This provides immediate food for the strains upon capsule dissolution.

14. Maintain Vaginal Acidity

To support a healthy vaginal microbiome and protect against pathogens like yeast, focus on maintaining an acidic environment. This is achieved through the actions of beneficial bacteria like lactobacillus.

15. Diet Affects Vaginal Microbiome

Understand that the foods you consume can impact the composition of your vaginal microbiome. Consider dietary choices that support its health, such as cranberry juice for urinary tract health.

16. Protect Microbiome from Depletion

Be aware that aging, intense stress, and disrupted circadian rhythms (e.g., from travel) can deplete your microbiome’s diversity and function. Women should also note significant changes during menopause.

Recognize that your gut microbiome can influence your food cravings via the gut-brain connection, potentially altering your dietary preferences. This awareness can be a tool for managing eating behaviors.

18. Choose Precision Antibiotics

When possible, discuss with your physician the use of precision antibiotics rather than broad-spectrum options. Broad-spectrum antibiotics can severely deplete your gut microbiome, impacting overall health.

19. Refrigerate Probiotics Properly

Always refrigerate probiotics if the product specifies it, as this is crucial for maintaining the viability of the live bacterial strains. Improper storage can cause the bacteria to die, reducing product efficacy.

20. Keep Acromantia Dry

To preserve the viability of Acromantia probiotics, store them in a dry environment, utilizing desiccant packets if provided. Moisture can reactivate the dormant strains, leading to their death due to oxygen exposure.

21. Comprehensive Microbiome Analysis

For a thorough understanding of your microbiome, utilize shotgun sequencing for strain identification, quantitative PCR for abundance, and longitudinal studies to track changes and functional shifts. This approach provides a more complete picture than a single snapshot.

22. Monitor Microbiome Diversity with Age

Recognize that your gut microbiome’s diversity naturally decreases as you age, which can lead to a loss of key functions. This understanding can inform proactive health strategies.

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