Upgrade to Pro — share decks privately, control downloads, hide ads and more …

Visit 2: Microbiome Immune Connection & Importa...

autoimmune
May 17, 2023
140

Visit 2: Microbiome Immune Connection & Importance of Intestinal pH

discussion of stool pH and ways to improve it

autoimmune

May 17, 2023
Tweet

Transcript

  1. Beneficial/commensal Harmful/opportunistic Balanced gut / Eubiosis Gut permeability Proinflammation Insulin

    resistance Gut/metabolic/cardiovascular health Harmful/opportunistic Beneficial/commensal Gut microbial dysbiosis Gut permeability Gut/systemic inflammation → GI sxs Insulin resistance Adiposity, diabetes, MetS, CVD, NAFLD, NASH, IBD, IBS, etc. Prudent diet & lifestyle, probiotics/prebiotics High-fat/high-sugar diets, sedentary, antibiotic use Dysbiosis
  2. Intestinal pH is crucial for Gut Microbiome  pH stands

    for “power of hydrogen” & is measured on a scale from 0 to 14 – neutral is 7.0 – anything below 7 is considered acidic, and anything above 7 is considered alkaline.  A healthy, optimal pH for the colon is between 5.0 to 6.5, which is considered acidic since it is below the neutral pH of 7.0. At this acidic pH, the growth of pathogens is inhibited. A pH of below 5.0 is potentially concerning. Stool pH is relevant to a variety of GI symptoms and issues.  Potentially problematic species such as E. coli, Bacteroides, and Desulfovibrio and yeast species such as Candida begin to proliferate when the pH starts to rise above 7.0.
  3. How fast can stool pH change?  Studies show that

    increasing levels of fiber in the diet can rapidly decrease the pH within just a couple of weeks  In one study, people who doubled their fiber intake from 17 g to 34 g per day experienced a progressive drop in stool pH over a mere 2 weeks.  Goldilocks level for pH – not too high or too low (usually problem is too high) although in those with diarrhea it can become too low due to loss of beneficial acids S.B. Naaeder, D.F. Evans, and E.Q. Archampong, “Effect of Chronic Dietary Fibre Supplementation on Colonic pH on Healthy Volunteers,” West African Journal of Medicine 17, no. 3 (July-September 1998): 165-167
  4. Strongly affects cancer risk  Studies also show that higher

    stool pH above 7.5 is associated with increased risk of colon cancer, likely due to the production of carcinogenic compounds  A process called protein putrefaction, where bacteria break down protein to form harmful compounds, occurs much more at alkaline pH.  At higher pH pathobiont bacteria (bacteria that can be either harmless or harmful at certain times) such as Bacteroides, E. coli and Clostridia ferment proteins to produce amines, indoles, and ammonia, which have negative effects on gut permeability, inflammation and motility.
  5. Improves mineral absorption  An acidic pH is critical for

    absorbing certain minerals such as calcium and iron. Their absorption declines when the pH starts getting into the alkaline range.  So, maintaining this acidic pH is crucial to maintaining healthy absorption and optimal digestive function, preventing dysbiosis, and preventing colon cancer.
  6. Infant Microbiome deteriorating  Unfortunately, stool pH in the infant

    gut microbiome worldwide has been steadily increasing from 1926 through current times, from an average of 5.0 up to 6.5, likely as a result of decline in beneficial keystone SCFA producing species such as bifidobacteria.  There has been a corresponding rise in dysbiosis seen in the infant microbiome during this time  Dysbiosis in infant microbiota has been linked to long-term health implications such as higher risk of developing autoimmune disorders, chronic inflammation, asthma, and other immune-mediated diseases.
  7. How to maintain optimal stool pH  One of the

    biggest contributors to healthy pH are short chain fatty acids, which are produced by our healthy bacteria. The most important and well-known of these SCFAs is butyrate, which has several beneficial properties.  As we discussed, butyrate is the primary fuel for the intestinal cells, reduces G.I. and systemic inflammation, promotes normal intestinal permeability, has anti-cancer effects, improves the gut-brain axis and can even heal “leaky brain”, an impaired blood-brain barrier.
  8. Prebiotic plant fibers  The best way to increase production

    of short chain fatty acids is a high- fiber diet with a diverse blend of plenty of plant fiber, which will be used by the good bacteria to produce SCFAs.  Your bacteria use the fibers in these prebiotic foods to produce short- chain fatty acids.
  9. Additional fiber options  Do keep in mind that the

    lab usually has a normal range of 7.0-7.5 for stool pH, but optimal is 5.5-6.5  Two fibers have the effect of increasing the production of short-chain fatty acids, and thereby acidifying the intestine and lowering its pH.
  10. Additional Prebiotics • For additional Prebiotics, the options are either

    taking either psyllium husk or Partially Hydrolyzed Guar Gum (to help with constipation or diarrhea and to acidify the intestine) • Both fibers have the effect of increasing the production of short-chain fatty acids, which result in acidifying the intestine and lowering its pH. © 2023 Sutter Health. For informational purposes only.
  11. Psyllium • Psyllium has been shown to help raise the

    levels of three groups of beneficial bacteria known to produce butyrate: o Lachnospira o Roseburia o Faecalibacterium © 2023 Sutter Health. For informational purposes only.
  12. Psyllium • Psyllium has major systemic benefits, including: o reducing

    cholesterol o lowering blood pressure o increasing satiety o supporting weight loss o potentially alleviating IBS symptoms © 2023 Sutter Health. For informational purposes only.
  13. Partially Hydrolyzed Guar Gum (PHGG) • Increases levels of keystone

    species such as: o Fecalibacterium o Bifidobacteria o Bacteroides • Boosts the production of short-chain fatty acids such as: o Butyrate o Acetate © 2023 Sutter Health. For informational purposes only.
  14. • Has shown additional systemic benefits such as: • regulating

    blood sugars by slowing the uptake of glucose from the intestine • promoting satiety • lowering cholesterol levels. • My preferred form of PHGG is a product called SunFiber®, and there are various brands that contain this product, such as Tomorrow’s Nutrition and Perfect Pass. © 2023 Sutter Health. For informational purposes only. Partially Hydrolyzed Guar Gum (PHGG)
  15. Levels are increased by polyphenols, inulin, and arabinoxylans: • Polyphenols

    – green tea, beans, red wine and kiwi • Inulin – Jerusalem artichoke, jicama, chicory, onion, garlic, asparagus and leek • Arabinoxylans – rye, barley, rice, oat and sorghum 20 Prebiotic Foods That Support your microbiome including Faecalibacterium Prausnitzii
  16. Fermented foods  Fermented foods contain organic acids such as

    lactic acid and acetic acid that contribute to maintaining the healthy acidity in the colon.  Vinegar is defined by its content of acetic acid; consuming fermented foods that contain vinegar (or ACV) delivers the acetic acid to the intestine, where it helps keep pH at a healthy low level.
  17. Follow-up  Stool pH will be ordered at the Sutter

    lab or Quest Diagnostics if you typically use that lab (message me if you do not want to do this test for any reason)  Pick up collection container from the Sutter lab (order will be placed electronically today)  Return the collection container after stool sample collection  Any questions?