The Guts of Obesity and Diabetes

Obesity and type 2 diabetes seem to go hand in hand – we are always being told of the rise in both – and that being obese puts you at a greater risk of developing type 2 diabetes.

The temptation is to say – just stop eating the junk – that ‘these people’ must be lazy – must be eating too much and not doing enough exercise. How many times have you seen the guy (it usually is a guy) commenting on an article about obesity “it’s simple – food in must equal energy out or you will get fat!”

Fat and Thin Bronze courtesy Rui Fernandes
Fat and Thin Bronze courtesy Rui Fernandes creative commons

It is not as simple as that! Guy A may eat exactly the same as Guy B – do exactly the same amount of exercise … but  Guy B is Fat and Guy A is Lean.  Ah Ha! Metabolism – people say, Guy A must have a fast metabolism … well, probably not. Generally people’s metabolism is roughly the same if they do the same amount of exercise (excepting certain constant fidgeters) . It seems that Guy A may have a better gut bacteria balance – one that does the right things with the food he has ingested, one that isn’t compromised.

The Western diet – high carbohydrate, high sugar diet – and modern lifestyle – antibiotic treated, c-section opted, bottle-fed by choice, urban-clean living – has created a gut biome that is not as diverse or as balanced as it once was. This is pretty much agreed.

However, recent studies have shown that the balance between two groups of bacteria in the intestine can make all the difference as to what happens to the ‘food in’ side of the equation. There are two groups of bacteria that make up 90% of the gut bacteria – the Bacteriodetes and the Firmicutes.

First take the Bacteriodetes – this bunch of bacteria specialise in breaking down resistant starch plant molecules and fibres into Short Chain Fatty-Acid molecules that the body can use for energy (SCFAs). These short-chain fatty-acid molecules are good for our system, used in intracellular signalling and for creating Adenosine Tri Phosphate (ATP)  as an efficient form of energy, and more recently are indicated in causing colon-cancer cells to kill themselves (autophagy)

The Firmicutes are adept at breaking down carbohydrates and in extracting the greatest amount of calories from them. However they have another effect on our system – they can actually control the way our body uses energy – they do this by using the epi-genetic effect (turning on or off ‘switches’ on our genes) in this case telling our bodies to store energy – to lay down fat! epigenetic mechanism[Epi-genetics is another whole area of fascinating new research – not long ago we all thought we were stuck with whatever our DNA bequeathed us – it is now evident that ‘nurture’ (as in our environment, infections, treatments, food ingested and even the air we breathe) can turn on or off genetic expressions – so that even identical twins who have had different life experiences can end up with a different genetic expression from the same set of DNA]

The guts of naturally lean people (like Guy A) have a much larger proportion of the Bacteriodetes than the Firmicutes. The guts of obese people have a larger proportion of Firmicutes.

Indeed in a experiment where baby ‘humanised’ mice were given gut microbes from one of twin women, (one of whom is obese, the other being lean) then gave the mice the same food and in the same quantity to eat. Those with the microbiome from the obese twin started to put on more weight than those with the microbiome from the lean twin. When checked – their gut bacteria were far less diverse than those of the lean ones. More than this, when they allowed the mice to share a cage the natural behaviour of mice (to eat faeces) resulted in the obese mice eventually becoming lean – having taken in the correct bacteria and created the right balance to become lean (when checked their bacteria diversity had also increased).

Fecal transplants have been used to even out the bacteria in humans too, though mainly used as a treatment for C Difficile, the results have, co-incidentally, been the same.

Then, once visceral fat is being laid down, there is another layer of trouble ahead. Visceral fat cells create their own ‘hormones’ and when in possession of too much visceral fat this can become overwhelming to the system. They suppress the hormone that tells us we are full, they stimulate the brain into wanting MORE sweet and rich food – more than we need – more than we consciously want – by making our brain CRAVE these things – and they cause inflammation – fat-generated cytokines are found in elevated levels in all inflammatory conditions – from  arthritis and heart disease to auto-immune disorders and dementia. (note: you do not have to be overweight or obese to lay down viceral- fat- some people are what is known as TOFI ‘thin outside – fat inside’ and are just as much at risk)

A larger proportion of firmicutes than bacteriodetes is also indicated in increased gut permeability – and so then in inflammation – leading to many other inflammation-triggered diseases.

[It makes me wonder if ‘being fat running in families’ can be partially due to collecting the wrong balance of bacteria at a natural birth, if the mother has an imbalance in her gut-biome – and then this causes a yearning for the wrong foods that starts the vicious cycle – this doesn’t seem to be an area that has been researched as yet]

And what of Diabetes?

It is a given that Obesity and Diabetes are linked. There are more and more obese people – so it follows that we are on the edge of a diabetes explosion too. But what if they are not only consequential – but actually initiated by the same problem – an uneven balance and less-diverse gut biome than we ought to have?

An experiment, carried out by Dr Nieuwdorp in the University of Amsterdam, using fecal transplants showed that insulin sensitivity and the blood-sugar variation was improved when he transplanted fecal material from healthy, lean, non-diabetics  into  diabetic patients.  This was a blind test on 250 people – with the control group being given a fecal transplant of their own bacteria to rule out the placebo effect. To reverse the symptoms of diabetes in this way is a breakthrough as, at the moment, nothing else does this.

Fecal transplants do sound rather drastic, however, the good news is that is is relatively easy to change the gut bacteria – by ingesting probiotics (pills packed with the range of bacteria that we need) or eating the fermented foods that have these naturally in them – PLUS making sure that we eat the type of diet that feeds the bacteria that are better for us to have in abundance (bacteriodetes) rather than those that it is better to have in smaller numbers (firmicutes).

This doesn’t mean that once your gut is populated healthily that one could eat everything and anything and not put on weight, only that on a sensible diet, rich in fibre from plants, well balanced with proteins and good fats it would be possible to be lean – whereas with an unhealthy balance of bacteria it would forever be an uphill struggle.

Has this section been food for thought

Has it raised any questions for you – I may be able to find the answers if you ask

I look forward to hearing your responses …

 

 

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