Gut microbiota

I recently wrote about the adverse effects of artificial sweeteners. One of those effects is that they disrupt gut microbiota (intestinal bacteria) balance and diversity.[1] You really don’t want to mess with your healthy gut organisms and I’ll tell you why a bit later in this report. Let’s look at disruptors of healthy gut microbiota and also the connection scientists have found between gut microbiota and most all body systems.

Importance of a healthy gut microbiota[2]

Your gut bacteria produce a variety of nutrients. They produce short-chain fatty acids, B vitamins, and vitamin K. The bacteria actually interact with epithelial and subepithelial cell receptors and even release cellular factors known to influence your metabolism. As you will see later in this report, they play roles in the pathogenesis of metabolic syndrome, diabetes, non-alcoholic fatty liver disease, cognition, and more, that extends well beyond just bacteria for digestion in the gut.

Disruptors of gut bacterial balance

There are a few disrupters to mention. Aspartame, sucralose and saccharin have been shown to disrupt the balance of gut microbiota. Researchers found that the artificial sweeteners acesulfame potassium, saccharin and sucralose have a major impact on healthy bacterial growth.[3] Researchers began to discover this when fecal transplant experiments (microbiota from artificial sweetener-consuming hosts are transferred into germ-free mice) proved that this disruption is transferable. Moreover, it resulted in impaired glucose tolerance (diabetes).[4]

Antibiotics are also known to disrupt the gut microbiota.[5] For example, even short-term antibiotic treatment is known to shift the healthy gut microbiota to create a long-term dysbiotic condition that promotes the development and aggravation of various diseases.

In one study, healthy volunteers who were treated for up to 1 week with antibiotics reported symptoms of adverse effects of bacterial flora which persisted 6 to 24 months after treatment. They were found to have a dramatic loss in diversity, increased antibiotic-resistant strains, and upregulation of antibiotic resistance genes.[6]

Apparently, antibiotics drive intestinal environment changes that proliferate even virulent gut pathogens. Unfortunately, even one single dose of Clindamycin (antibiotic) has been shown[7] to induce profound changes in the gut microbiota of mice even to consequently confer long-lasting susceptibility to C. difficile infection. I’ll share more about Clostridium difficile intestinal infection in my next article.

This shift in gut microbiota from antibiotics is linked to a number of illnesses. For example, surveys on thousands of children show a link between the use of antibiotics in the first year of life and asthma development by 6 to 7 years of age.[8]

What else disrupts your gut microbiota? We know that genetics do, and possibly the mode of delivery at birth and method of infant feeding. Also, the use of many other medications (not just antibiotics) play a role. The foods you eat probably play the biggest role here. I’ll address that in my next report.

Gut microbiota impacts most body systems

The bacteria that inhabit your body impacts your health and disease far more than we were every taught in college. Just go online to and search for “gut microbiota” and you’ll find more than 25,000 scientific articles. You quickly come to learn that intestinal bacteria impact virtually all systems in the body. But how?

Apparently, your gut microbiota influences essential bodily functions such as digestion, energy metabolism, and even inflammation. These organisms somehow modulate multiple hormone (endocrine), nervous system (neural), and immune system functions in our body.[9]

There may exist a gut microbiota signature that promotes intestinal inflammation and subsequent systemic low-grade inflammation, which in turn promotes the development of insulin resistance and type 2 diabetes.[10] According to these[11] authors, “Over the past 10 years, data from different sources have established a causal link between the intestinal microbiota and obesity/insulin resistance."

Gut microbiota contributes to the development of atherosclerosis or heart disease.[12] [13] [14]

Gut microbiota influences bone health too. The emerging field of the gut-brain-bone axis is showing that the microbiota of the gut drives bone physiology via regulation of key hormones (hormones that are originally made in the brain).[15]

In my next article I’d like to take a closer look at the foods that play the biggest role in gut microbiota health. I’ll also share some astounding facts about Clostridium difficile intestinal infection, which the Centers for Disease Control and Prevention (CDC) says is the most common hospital infection in the U.S., causes half a million infections and even kills 15,000 people yearly.

To a healthy gut microbiota and long life,

Michael Cutler, M.D.


[1] Nettleton JE, Reimer RA, Shearer J. Reshaping the gut microbiota: Impact of low calorie sweeteners and the link to insulin resistance? Physiol Behav. 2016 Oct 1;164(Pt B):488-493. Review. PubMed PMID: 27090230.

[2] Ramakrishna BS. Role of the gut microbiota in human nutrition and metabolism. J Gastroenterol Hepatol. 2013 Dec;28 Suppl 4:9-17. Review. PubMed PMID: 24251697.

[3] Wang QP, Browman D, Herzog H, Neely GG. Non-nutritive sweeteners possess a bacteriostatic effect and alter gut microbiota in mice. PLoS One. 2018 Jul 5;13(7):e0199080. PMID: 29975731.

[4] Nettleton JE, Reimer RA, Shearer J. Reshaping the gut microbiota: Impact of low-calorie sweeteners and the link to insulin resistance? Physiol Behav. 2016 Oct 1;164(Pt B):488-493. Review. PubMed PMID: 27090230.

[5] Hathaway-Schrader JD, Steinkamp HM, Chavez MB, Poulides NA, Kirkpatrick JE, Chew ME, Huang E, Alekseyenko AV, Aguirre JI, Novince CM. Antibiotic Perturbation of Gut Microbiota Dysregulates Osteoimmune Cross Talk in Postpubertal Skeletal Development. Am J Pathol. 2019 Feb;189(2):370-390. PubMed PMID: 30660331.

[6] Jernberg C, Löfmark S, Edlund C, Jansson JK. Long-term ecological impacts of antibiotic administration on the human intestinal microbiota. ISME J. 2007 May;1(1):56-66. PubMed PMID: 18043614.

[7] Buffie CG, Jarchum I, Equinda M, Lipuma L, Gobourne A, Viale A, Ubeda C, Xavier J, Pamer EG. Profound alterations of intestinal microbiota following a single dose of clindamycin results in sustained susceptibility to Clostridium difficile-induced colitis. Infect Immun. 2012 Jan;80(1):62-73. PubMed PMID: 22006564.

[8] Kozyrskyj AL, Ernst P, Becker AB. Increased risk of childhood asthma from antibiotic use in early life. Chest. 2007 Jun;131(6):1753-9. PubMed PMID: 17413050.

[9] Lange K, Buerger M, Stallmach A, Bruns T. Effects of Antibiotics on Gut Microbiota. Dig Dis. 2016;34(3):260-8. PubMed PMID: 27028893.

[10] Wen L, Duffy A. Factors Influencing the Gut Microbiota, Inflammation, and Type 2 Diabetes. J Nutr. 2017 Jul;147(7):1468S-1475S. Review. PubMed PMID: 28615382.

[11] Saad MJ, Santos A, Prada PO. Linking Gut Microbiota and Inflammation to Obesity and Insulin Resistance. Physiology (Bethesda). 2016 Jul;31(4):283-93. Review. PubMed PMID: 27252163.

[12] Miele L, Giorgio V, Alberelli MA, De Candia E, Gasbarrini A, Grieco A. Impact of Gut Microbiota on Obesity, Diabetes, and Cardiovascular Disease Risk. Curr Cardiol Rep. 2015 Dec;17(12):120. Review. PubMed PMID: 26497040.

[13] Koeth RA, et al. Intestinal microbiota metabolism of L-carnitine, a nutrient in red meat, promotes atherosclerosis. Nat Med. 2013 May;19(5):576-85. PubMed PMID: 23563705.

[14] Wang Z, Klipfell E, Bennett BJ, et al. Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease. Nature. 2011 Apr 7;472(7341):57-63. PubMed PMID: 21475195.

[15] Quach D, Britton RA. Gut Microbiota and Bone Health. Adv Exp Med Biol. 2017;1033:47-58. Review. PubMed PMID: 29101651.

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