When our bodies are overweight or we eat a very poor diet, then our gut bacteria often become imbalanced, which can lead to weaknesses in the gut barrier allowing toxins (lipopolysaccharides) to enter the blood stream. This can cause low grade inflammation, which is linked to the development of insulin resistance and T2D. Increasing the beneficial bacteria in our gut via our diet (consuming fiber and a wide range of fruits and vegetables) or by taking a prebiotic/probiotic can help to correct this balance and repair the damage.
One interesting bacteria that is currently being studied as a new probiotic is Akermansia mucinophilia, which has been shown to have a causal relationship with hypertension, premature aging, inflammation, autism, cancer and diabetes (1). Low levels of this bacteria are found in people with pre-T2D and newly diagnosed T2D, whereas individuals with a more favourable metabolic status show high levels (2). In studies, those with higher levels demonstrated a greater improvement in glucose control, blood lipids and body composition after dieting (compare to those with low levels) (3).
A. muciniphilia acts by breaking down mucins in our guts and converting them into short-chain fatty acids, especially acetate. Acetate is used by other beneficial bacteria like Firmicutes to make butyric acid, which may promote β cells to secrete insulin and then regulate blood sugar (4). A. muciniphilia is also beneficial in an inactive state, where patients who received the pasteurised bacteria for a period of 12 weeks found an increase in insulin sensitivity, a decrease in total cholesterol and LDL-cholesterol and a reduction in body weight and fat mass (5). There were also no reported side effects like flatulence or bloating (5), which can be an initial issue with traditional probiotics. Whilst it is still early days this bacteria, with its multiple health-promoting effects, may well be an important next-generation beneficial microbe in the treatment of metabolic illnesses (5).
References
1. Li Z, Hu G, Zhu L et al. Study of growth, metabolism, and morphology of Akkermansia muciniphila with an in vitro advanced bionic intestinal reactor. BMC Microbiol 2021;21:61.
2. Brunkwell L, Orho-Melander M. The gut microbiome as a target for prevention and treatment of hyperglycaemia in type 2 diabetes: from current human evidence to future possibilities. Diabetologia 2017;60:943-951.
3. Dao M, Everard A, Aron-Wisnewsky J, et al Akkermansia muciniphila and improved metabolic health during a dietary intervention in obesity: relationship with gut microbiome richness and ecology. Gut 2016;65:426-436.
4. Sanna S, van Zuydam N, Mahajan A et al. Causal relationships among the gut microbiome, short-chain fatty acids and metabolic diseases. Nat Genet. 2019;51(4):600–5.
5. Depommier C, Everard A, Druart C et al. Supplementation with Akkermansia muciniphila in overweight and obese human volunteers: a proof-of-concept exploratory study. Nat Med 2019;25:1096–1103.
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