Saturday, April 23, 2011

Fermented Asian Food and Gut Dysbiosis 101

Flexibility = Adaptability

This gentleman was kind enough to let me take his photo by the West Lake in Huangzhou. His pose lasted longer than the time we had to hang out! I especially loved his timeless smile and ageless grace.

Fermented Foods of China

Quest for Fermented Food

In our first leg of our vacation in China, my husband and I had dinner with fellow blogger and fermentation fan Seth Roberts at his choice, a Yunnan restaurant which specialized in regional dishes. Wasn't difficult to track down dishes with fermented condiments or fermented flavors. Most traditional ethnicities incorporate fermented foods in daily meals from dawn to twilight no matter where you are on planet earth. (everywhere except the land of McDonalds, Velveeta doesn't count!)

From top to bottom:
-- roasted duck with fermented bean paste (I think, I can't recall now!)
--deep fried insects (grub have microbiota which ferment but *ugggh* the veggie oils)
--fish with fermented black bean sauce
--yak milk yogurt, fermented sweeten rice wine dessert w/tapioca balls, tea with milk (tea leaves fermented)
--(not shown) B-E-E-R, fermented grains (it aint that bad, no?)


Exploring the Benefits of Fermentation

Our gut microbiome is primarily responsible for fermenting our undigested food. Under pathologic circumstances, fermentation happens where it is not supposed to, e.g. the stomach, small bowel or in our blood stream.

Below Jiménez describes the benefits and distinct role our gut microbiome plays in our health, longevity and maintenance. Some experts even propose that our gut microbiome fucntions as an neuro-endocrine organ. I would strongly concur. It is transplantable like any other organ and is so indisposable that we cannot live without it. When it goes awry in function, like any other organ, a host of chronic illnesses and disorders ensue -- obesity, autoimmune diseases, cancer, mental conditions/crankiness, infertility, heart disease, etc.

Table IV Primary Functions of Intestinal Microflora (per Jiménez) (free PDF)
I. Planktonic microflora --> METABOLIC

(a) To ferment indigestible substrates (fiber, extruded cells and endogenous mucus)

(b) To favor the growth of beneficial intestinal microflora
----(i) Improves lactose digestion----(ii) Modulates intsetinal gas production
----(iii) Increases genesis of short-chain fatty acids --> intraluminal acidication --> increases intestinal transit
----(iv) Increases the absorption of Ca, Fe, and Mg----(v) Synthesizes vitamins: K, folic acid, biotin, B12

II. Mucosa-associated microbiota (MAM)

(a) Protective
----(i) Barrier effect + bacteriocin synthesis --> prevention of invasion by exogenous pathogens
----(ii) Maintenance of intestinal permeability --> prevents bacterial translocation and systemic infection (e.g. PREVENTION OF POOP IN THE BLOOD STREAM)

(b) Trophic
----(i) Controls epithelial cell proliferation and differentiation of intestinal mucosa
----(ii) Maintains new cell growth in intestinal epithelial crypts
----(iii) Of the intestinal immune system: cells and serum (immunoglobulins)


Rev Esp Enferm Dig. 2009 Aug;101(8):553-64.
Treatment of irritable bowel syndrome with probiotics. An etiopathogenic approach at last?
Bixquert Jiménez M.
Irritable bowel syndrome (IBS) is the most common functional digestive disorder, and may affect 11-20% of the adult population in industrialized countries. In accordance with Rome III criteria (2006) IBS involves abdominal pain and bowel habit disturbance, which are not explained by structural or biochemical abnormalities. Several hypotheses attempt to account for the pathophysiology of IBS, but the etiology still remains uncertain or obscure, perhaps multifactorial. Abnormalities in colonic microflora have recently been suggested in such patients, as has abnormal small-intestine bacterial overgrowth (SIBO), or in particular a significant reduction in the amount of intraluminal Bifidobacteria or Lactobacilli, with consequences like the production of colonic gas, and motility or sensitivity disturbances of the intestinal tract. The disorder is difficult to treat, and the wide spectrum of non-drug and drug treatments shows our ignorance about the cause of the condition. Newer drugs, both pro- and anti-serotonin, have failed to show long-term efficacy or have been withdrawn due to concerns about harmful effects. Recent research has provided increasing support for the idea that disturbances of intestinal microbiota occur in patients with IBS, and that such abnormalities may contribute to IBS symptoms. Studies in Scandinavian countries in the last ten years emphasize the role of probiotics in the modulation of intestinal microbiota, and as a consequence in the regulation of the motility and hypersensitivity of the digestive tract. Although results between studies are difficult to compare because of differences in study design, probiotic dose, strain, and duration of therapy, some studies show symptom improvement. Lactobacilli are found among the normal bacterial flora of the gastrointestinal tract, and Lactobacillus plantarum (Lp) is one of the species frequently isolated from the human mucosa, which is capable of surviving the low pH of the stomach and duodenum, resisting the effect of bile acids in the upper small intestine when ingested, and temporarily colonizing the gastrointestinal tract by binding to the intestinal and colonic mucosa. Concurrent with colonization by Lp there is a decrease in bacterial groups with gas-producing ability, such as Veillonella spp. and Clostridia spp. Evidence has now accumulated to suggest the efficacy of certain probiotics like Lp299v, which may be capable of bringing about a significant reduction in pain, abdominal distension and flatulence, while increasing health-related quality of life in IBS.

Int J Mol Sci. 2009 Aug 27;10(9):3755-75. Free PDFThe improvement of hypertension by probiotics: effects on cholesterol, diabetes, renin, and phytoestrogens.
Lye HS, Kuan CY, Ewe JA, Fung WY, Liong MT.
Probiotics are live organisms that are primarily used to improve gastrointestinal disorders such as diarrhea, irritable bowel syndrome, constipation, lactose intolerance, and to inhibit the excessive proliferation of pathogenic intestinal bacteria. However, recent studies have suggested that probiotics could have beneficial effects beyond gastrointestinal health, as they were found to improve certain metabolic disorders such as hypertension. Hypertension is caused by various factors and the predominant causes include an increase in cholesterol levels, incidence of diabetes, inconsistent modulation of renin and imbalanced sexual hormones. This review discusses the antihypertensive roles of probiotics via the improvement and/or treatment of lipid profiles, modulation of insulin resistance and sensitivity, the modulation of renin levels and also the conversion of bioactive phytoestrogens as an alternative replacement of sexual hormones such as estrogen and progesterone.