Here are key takeaways from an episode of Kentucky Health discussing the intestinal microbiome, with guests Sara Police, Ph.D., assistant professor and associate director of graduate studies, Dept. of Pharmacology and Nutritional Sciences at the University of Kentucky College of Medicine; and Jessica Houlihan, MPH, MSPAS, PA-C, a physician’s assistant in the Dept. of Pediatrics at the University of Kentucky Children’s Hospital who also works with the Dept. of Dietetics and Human Nutrition at the University of Kentucky.
The Importance of a Healthy Microbiome
“The intestinal microbiome is basically all of the friendly bacteria that is in our gut,” Police says. “When you think of bacteria, I think a lot of people might have this misconception that ‘Oh, this is a germ, this is bad, it needs to be eliminated so that I can stay healthy.’ But actually, the microbiome especially is important to keep us healthy.”
Police says a healthy intestinal microbiome helps regulate digestion and overall intestinal function. It also bolsters a person’s immune system and even affects mood and cognition.
Keeping the intestinal microbiome healthy is individualized – each person has his or her own blend of bacteria that needs to be fortified. Over the past several years, probiotics have grown in popularity among people dealing with gastrointestinal issues. These live micro-organisms sold in grocery stores are advertised heavily as key supplements to the existing bacteria in the microbiome. But Houlihan advises folks to change their diet first before considering probiotics.
Emphasizing fruits and vegetables is the best thing a person can do for their intestinal microbiome, she says. According to Houlihan, there has been a lot of research into the efficacy of probiotics, with inconsistent findings. On the other hand, whole foods contain what she calls “prebiotics” that are essential to gut health.
Fiber is the most essential prebiotic, according to Houlihan. “I try to encourage my patients and other consumers to eat fruits and vegetables,” she says. “They have a very rich source of a combination of fibers in them naturally.”
Police says that at a conference she attended about a year ago, several scientists found a connection between having a diverse diet and a diverse and healthy microbiome. “The more diverse types of vegetables you can incorporate into your diet, then the more diverse your microbiome is, and that actually leads to greater health benefits…. They even had a number – try to get 30 different fruits and vegetables a month.”
If a person already follows a healthy and diverse diet and still feels the need to take a probiotic supplement, Police advises to focus on the number of different bacterial strands in the product. “There’s so many bacteria in our gut that a lower dose could be like spitting in the ocean and not really making a difference,” she says. “So it depends on your age and what you’re taking it for, and a conversation with a health care practitioner would be helpful around that.”
Using Food as a Solution to Health Challenges
In fall 2019, the University of Kentucky launched over 20 online programs, and one of them is a graduate certificate in applied nutrition and culinary medicine. The degree was created to address what Police says is a deficit of nutrition education in medical schools.
Culinary medicine is a relatively new field, Houlihan says. It’s an evidence-based field, she explains, which differentiates it from eating plans that may be more oriented toward losing weight. “This is really looking at the evidence behind food as a prevention and a treatment for disease,” she says. “It blends that science with the art of cooking.”
In her own classes, Houlihan and students will look at a particular disease and the scientific research behind it, and then determine what types of food can help prevent the disease and/or treat it. An example of this is cardiovascular disease, a leading cause of death in Kentucky.
“There are several foods that have been linked to improved cardiovascular health or cardio-metabolic health,” Houlihan says. “How do we prepare dishes or give patients recipes or talk to them about this that will help with this care?” One popular recipe she prepares in class is a vegetable stir fry that uses spices from different cuisines to emphasize flavor. The overall goal is to create meals that achieve a synthesis of health benefits and, as she says, “crave-ability.”
Selecting and Preparing Foods for Maximum Benefit
Eating better does not mean laboring for an extended amount of time preparing foods or spending a lot of money, Houlihan says: “Not one eating pattern or diet is right for everyone.”
For example, both Houlihan and Police debunk the notion that frozen and canned foods are far less beneficial to microbiome health than fresh food. “Frozen foods are picked and processed at their moment of ripeness, so they have a lot of health benefits,” Houlihan says. Canned foods are also good, but Houlihan cautions people to be cognizant of artificial ingredients and/or added sodium that may be present in higher levels.
As noted above, fruits and vegetables are the most important staples of a microbiome-healthy diet. To get the recommended amount, Houlihan suggests mixing frozen, canned, and fresh products, relying more on the former two options during winter months if needed. “Celebrating what’s in season, and not lamenting what’s not,” she says.
She adds that people can always diversify their diet through experimenting, putting frozen fruits and vegetables in smoothies, stir fry, salads, and other meals.
Red meat should be limited in most diet plans, and Police says that’s no different with regard to the microbiome. The key metric to look at is the amount of unsaturated fat vs. saturated fat in the meat, she says.
“We know that bacteria have different functions in the gut according to nutritional sciences research studies, and that is based on what type of fat that is in a protein,” she explains. “We tend to see more pro-inflammatory outcomes with saturated fat vs. fish oil, which is unsaturated.”
Both guests have high praise for the popular Mediterranean diet. “With the Mediterranean diet you tend to see a lot of olive oil,” Police says, “a lot of nuts, fish, a lot of fresh vegetables and lean meats, some red wine – these are some of the staples. What you don’t tend to see is a lot of fried food.” Food preparation is central to the Mediterranean diet, she explains. Sautéing and roasting are common, which can elevate flavors in the food while avoiding the high calories that accompany frying in oil.