Obesity, Type 2 Diabetes, and Prebiotics
The Missing Nutrient in Weight Loss
Frank W Jackson MD
Gastroenterologist
Mechanicsburg PA
Our diet and the foods we consume are obviously the most important part of maintaining a healthy weight and preventing and treating type 2 diabetes. Yet, for those of us that struggle, it is by far the most frustrating of all the things we do. There are hundreds of diet books available and just as many programs, pills and TV commercials that promise an easy solution to this most difficult of all problems. In many of these there is precious little or no science to back up the claims. But science is now entering the picture with some remarkable new discoveries concerning gut bacteria, our diets and how they impact our health and well being. As a physician, I am very impressed that this new research has very practical implications for these patients as well.
The Great Awakening
In retrospect it would have seemed so obvious that bacteria are an important part of life and health. Bacteria have been around long before we humans arrived on the scene. However, these bugs were just discovered and grown in Petri dishes in the late 1800s. Of course, the first rush of research was to identify the bad ones that caused disease and death such as pneumonia and tuberculosis. Then along came antibiotics in the middle of the last century. It was thought that infectious disease would end as drug companies rushed to bring out ever more powerful antibiotics to kill these bad bacteria. Of course, with each new drug, some bacteria developed resistance and so it was a never ending chase. The bad bacteria always won the chase, always slowly becoming resistant to each great new antibiotic. The unfortunate legacy of all this information is that all bacteria were bad, even the ones on our hands and in our mouth.
As the new century came upon us, we learned that we and the bacterial environment in which we live in most cases lived harmoniously together. We now know that most bacteria are simply everywhere in nature from the highest mountains to the deepest ocean. More important than that is the fact almost everywhere we look we find that most bacteria produce benefits where they grow. This makes sense. Why would they not produce a benefit? With a benefit, they can keep growing and flourish. And yes, even produce a benefit for the place or for the person where they grow. And that is exactly what science has found.
One simple example is on the surface of the eye. Science shows that there are a variety of bacteria that normally grow on and so protect the surface of your eye. Yes, your tears, fortunately, are not sterile. Otherwise some bad bacteria would grow there. The ones you have keep the bad ones from finding a home. Another example are the bacteria that grow in and protect our mouth. Most importantly of all they also are found in our intestines where many bacteria quietly grow and in so doing create many health benefits for everyone.
The Gut’s Great Bacteria Factory
A tremendous number of bacteria reside in the gut, especially the large bowel or colon. It was just about 20 years ago that we began to understand the health importance of these bacteria. An astounding revolution then occurred in this entire area of gut bacteria and its relationship to the gut, to the body and to the general health of everyone, especially to those with a weight problem. This has occurred because of incredible advances in studying the very genes that reside within bacteria. New genetic probes are now telling us some amazing things about these mostly friendly gut bacteria. There are well over 1000 species of bacteria in the gut, twice the number that we previously thought. Remarkably the total number of bacteria in the colon is over 10 trillion, 10 times the number of cells in our entire body. The most important finding in this new revolutionary field of gut bacteria is that most of these intestinal bugs turn out to be our friends. If they are fed properly by the way we eat, a wide variety of health benefits occur, both for the gut and the body. The colon, in essence, is a true health organ when the large thriving pool of bacteria is of the right mix. The importance of this to those who are overweight, obese, or who have type 2 diabetes has now become clear.
WHAT HAPPENS IN OBESITY AND TYPE 2 DIABETES?
The new research on gut bacteria and the presence of obesity is simply astounding. And this new research has importance for everyone, but especially for those with obesity and type 2 diabetes. In these conditions the colon, where most bacteria live, has a completely different arrangement of bacteria. It is a change that has direct health implications for these people. There is a shift from good types of bacteria which produce health benefits to ones that are not so good, ones that, indeed, cause adverse changes in the colon wall itself.
The good bacteria group is called Bacteriodetes or Good Bacteria for short. The bad group is called the Firmicutes, or the Bad Bacteria. When these latter predominate, changes occur in the wall of the colon. Some bacteria actually move through the bowel wall and invade the colon itself. Normally, this should not happen. Normally, there is a very strong mucous barrier on the inside surface of the colon that prevents this from happening. So this mucous barrier is weakened and leakage can then occur. Beyond this, the tight adhesion between the colon wall cells themselves weakens. A true leaky gut ensues whereby various endotoxins or just plain toxins can move through the bowel wall and likely enter the blood and then reach the liver. There are some medical researchers who feel that this may be a major element in the condition known as a fatty liver. A fatty liver is common in obesity and type 2 diabetes. By itself, a fatty liver may progress to very serious liver disease such as cirrhosis.
The trigger for these changes appears to be the diet. More specifically, when a high meat and saturated fat diet is ingested on a regular basis, there is a shift in the colon bacteria from the Good Bacteria to the Bad Bacteria. As these latter bacteria predominate, increased calories are absorbed through the colon wall. It is important to understand this point clearly. There are a certain number of calories normally produced in the colon by fermentation and the growth of bacteria. However, when the bacteria balance shifts from Good to Bad then there are almost twice as many calories produced by the colon bacteria. Twice as many calories are thereby absorbed. Bad Bacteria in the colon means that more calories seep into your system. This is a major new and now well recognized finding by many researchers.
However, when plant foods are a major part of the diet, then the shift is in the other direction, from the Bad Bacteria to the Good Bacteria. We now know what it is plant food that is so important to the health of the colon and, indeed, to the health of our very bodies. This important and only recently discovered nutrient for our best bacteria is a special type of food fiber. These unique plant fibers are called Prebiotics.
Prebiotics
A prebiotic is not a probiotic. Probiotics are live bacteria found in yogurt, other dairy products and pills. A prebiotic, on the other hand, is a naturally growing plant fiber. These are soluble fibers meaning that they dissolve in water and in so doing nourish the Good Bacteria in the colon. On the other hand, an insoluble fiber, found in wheat and rye, is not fermented by bacteria but rather acts to help form a larger bulkier stool. They do not nourish bacteria. The best researched of the prebiotics are naturally occurring and are called oligofructose and inulin. These two prebiotics, oligofructose and inulin, are the ones that maximally stimulate the Good Bacteria to thrive and dominate in the gut. They are the ones that produce so many health benefits.
These two key prebiotics, oligofructose and inulin, are very widespread in many plants throughout the world. They are present in many foods we humans eat such as wheat, onions, garlic, yams, asparagus, bananas, leeks, chicory root, Jerusalem artichoke and even dandelions. Unfortunately, they are not present in large amounts in many of the foods that humans eat on a regular basis. This is where the problem is. For instance, Prebiotics are not present in French fries or any meat, chicken or even fish. All medical and nutrition experts tell us that we need to be eating from 25 to 35 grams of fiber a day. This means a significant shift in the types of foods we eat. But when this goal is reached on a regular basis, we can be reasonably assured that we are getting enough prebiotic in the diet and that changes are occurring in our gut.
Health Benefits of Prebiotic Fibers
Two major health benefits occur for the overweight and/or type 2 diabetic patient.
Reduced Colon Calorie Absorption
Here is where the new colon and bacteria research is so very surprising and important. We now know that a certain number of calories are generated by bacteria in the colon and are absorbed into the body. What is new is the fact that the calories made and absorbed in an environment of the Bad Bacteria is about twice that of that seen when the Good Bacteria predominate. So, by eating a prebiotic rich diet or even by taking a prebiotic supplement, you can change the makeup of the colon so that fewer calories are absorbed even when eating the same number of total calories. Almost everyone with a weight problem has noted and said that they don’t eat any more than others who are not overweight, but they still can’t lose weight. Now we know why. They are just eating the wrong types of food.
Appetite Hormone Control
New research has shown that your appetite and your sense of fullness are, in part, related to hormones generated in the walls of the gut. These hormones are protein-like substances that enter the blood and then exert an influence on the brain. The hunger hormone is made in the stomach and, of course, helps make one hungry and want to eat. The satiety or fullness hormones are made in the lower bowel and provide a sense of fullness. Prebiotics make these hormones change in the desired direction, providing a drop in the hunger sensation and increase in the sense of fullness. This is just what is desired in the obese and type 2 diabetes person.
There are other now well known health benefits that occur when prebiotics are a major part of the diet. These include:
- Increased absorption of calcium and magnesium through the colon
- Stronger bones
- Enhanced immunity and resistance to intestinal infection
- They may also be some benefit in colon polyps and cancer, and perhaps inflammatory bowel disease as well. Research in these areas is ongoing.
To Sum Things Up
- Remain on your present weight and/or diabetic control program.
- Add extra prebiotic foods and supplements. Our Prebiotin supplement assures you that you are getting the best prebiotic formula available.
- Reduce red meat and saturated fats in the diet. These are the 2 major factors that promote the growth of Bad Bacteria in the colon.
- Significantly increase the amount of plant based foods in the diet. The goal should be 25-35 grams of plant fiber per day, depending on weight and sex.
- Be sure your physician knows of these dietary changes.
- Our Prebiotin supplment significantly reduces the calories you absorb and favorably changes your appetite hormones
References
This is the landmark study that showed that when the gut was dominated by the bad Firmicute group of bacteria that there was a significant increase in calories produced by the colon bacteria and which were then absorbed into the body
This is a huge 2010 review of research on prebiotics by many experts in the field. They list 12 findings on the effects of prebiotics.
- In the colon good bacteria grow and bad ones do not.
- More regular and easier bowel pattern
- Increased calcium and magnesium absorption
- Enhance bone density
- Better appetite control
- Stronger immune system
- Less leaky bowel
- Fewer bowel infections
- Fewer calories produced in the colon
- Reduce colon cancer risk substances (carcinogens)
- May help in the diet control of inflammatory bowel disease
This scientific article reviews the hormones produced in the wall of the gut that have effects on the sensation of appetite and fullness or satiety in the brain. They are related to prebiotics in the foods we eat or otherwise ingest by supplements.
