BHS 323 Writing Assignment #9

Prompt: List and describe as many changes in human behaviors as you can think of that contribute to decreased exposure to microbes.

  • Exposure to the outdoors- Spending your childhood indoors vs playing outside, getting dirty, exposure to bodies of natural water would likely decrease your exposure to microbes.
  • Exposure to pets and other animals– Growing up in a home rich with animals, especially those who live outdoors, and having exposure to animal saliva, cleaning animal pens, eating chicken eggs, drinking unpasteurized milk will likely increase your exposure to microbes. Growing up with no pets or animal exposure (or even indoor cats/dogs) would probably decrease your exposure to microbes.
  • Taking antibiotics-As we have learned, this will decrease exposure to microbes and decrease richness of microbes already present in the gut.
  • Eating processed, sugar-rich foods-Instead of eating pre- and probiotic rich foods, eating processed foods will decrease your exposure to microbes.
  • Home daycare as a child vs. public daycare– Growing up in your home environment without exposure to other children will likely decrease your exposure to microbes.
  • Homeschooling vs. public school-Similar to above, attending a public school with children from all backgrounds will likely increase your exposure to microbes, while being homeschooled will decrease your exposure.
  • Not breastfeeding your child-There is a decrease in microbial exposure that comes with formula or bottle feeding an infant.
  • Your work environment-Your work environment could increase or decrease your exposure to microbes depending on where you work. An office setting in your own cubicle will likely provide less exposure to microbes than say, working out in a forest or working with animals.
  • Food source-Where your food is grown and if it was treated with antibiotics is a factor that could increase or decrease microbial exposure. If your food is store-bought, treated with RoundUp or other pesticides, it is likely not going to expose you to as many microbes as if you ate homegrown, organic foods.

BHS 323 Writing Assignment #8

Prompt: Free write. This writing exercise is designed to help you begin to think about a topic you are interested in pursuing for your final essay project in the course. 

5 minute free write #1

I am interested in the role that diet plays in our gut microbiome. Nutrition is very interesting to me and especially the long term effects of a particular diet on all aspects of the body (endocrine, neurological, etc.). The ways in which the gut microbiome is affected by what we eat or ingest that can hurt or harm the microbes. I would like to know more about leaky gut syndrome and the other systemic effects caused by disruption to the gut microbiome. I am also interested in the role that pesticides (antibiotics) have played in our microbiome, if there has been a change nationally in our microbiome with the addition of more processed foods, RoundUp, etc coming into our diets. How we can eat specific foods to target good gut bacteria proliferation and reduce foods that are harmful. I know some things about leaky gut and believe it is somewhat related to the microbiome and partially related to breakdown or inflammation in the gut lining that increases systemic inflammation. Systemic inflammation as a result from dysbiosis in the gut is also something I would like to learn more about. I know there is a big correlation with neurological diseases like parkinson’s and alzheimer’s, which would be interesting to take a look at.

5 minute free write #2

I know that “Leaky gut syndrome” is caused by inflammation in the gut that causes microbes to “leak” into systemic tissues, which usually triggers inflammation and an immune response. It would be interesting to learn more about what can be done to counteract this and if there is any correlation to autoimmune diseases. Working in dermatology, I have exposure to patients with skin components of some autoimmune diseases and I know that diet can play a large role in that. It would be interesting to see if there was a microbial component to autoimmune diseases characterized by inflammation that was maybe caused by leaky gut. Is leaky gut something that can be reversed? I know there are a number of “bad” microbes that feed on simple sugars and processed foods, so eliminating inflammatory carbohydrates can be beneficial for many people. It would be interesting to look at a diet protocol for patients with lots of inflammation or immune conditions. Is systemic inflammation typically caused by the foods we eat? There is a lot of hype about “inflammation” right now and all of the “trendy” things we can do to decrease inflammation. I would like to know which microbes specifically are targeted by sugary foods and maybe lead to increased inflammation or leaky gut syndrome.

Reflection

I think that writing my final paper on a particular anti-inflammatory diet protocol would be very interesting. If I could find research that talks about foods to increase “good” gut microbial communities or foods to eliminate that are more inflammatory or lead to proliferation of bacteria that contribute to inflammation in the gut or even systemically, that would be very interesting. I am drawn to nutrition, its role in our lives, and finding ways to improve our diet to increase longevity and health. I will look at information that is out there and look into more of what leaky gut syndrome is caused by (if it is a symptom of microbial dysbiosis) and see what I can find!

BHS 323 Writing Assignment #7

Prompt: List and describe potential factors that the mother or the infant could be exposed to that could influence the colonization of the microbial community in the newborn infant (in positive or negative ways).

  • Diet of mother-The diet of the mother controls which microbial communities are present in her gut, mouth, and vagina. Her diet also determines whether or not she will develop gestational diabetes during pregnancy.
  • Antibiotics taken by mother-If the mother takes antibiotics during her pregnancy (or prior to becoming pregnant), it is likely she has some level of dysbiosis that could affect the future microbial communities of her unborn baby.
  • Pre-/Probiotics taken by mother-If the mother takes pre-or probiotics prior to- or during pregnancy, this could help to retain or enhance her already present microbial communities.
  • How baby is born-If the baby is born vaginally, they will be colonized with bacteria from the mother’s vagina. If the baby is born via c-section, the baby will be colonized with bacteria from the mother’s skin. One way is not necessarily “better”, but vaginal births are the most “natural” birth method, so I would guess babies are exposed to more diversity of microbes if they are born vaginally vs via c-section.
  • If baby is breastfed or bottle fed-If the baby is breastfed, they are coming into microbes on the mother’s skin and in her milk, which would help to enhance colonization of microbial communities.
  • Hospital environment-The environment in which the baby is born could definitely contribute to the baby’s microbial communities, either in a positive or negative way depending on which microbes were present in the room, if the baby were born in an operating room vs being a home birth.
  • Home environment-Similar to the hospital environment, if a newborn baby comes home to a house with pets or other siblings, they will likely be exposed to a much different set of microbes than a home with no animals. A home in the city vs out in the country could change the microbial communities present too.

BHS 323 Writing Assignment #6

Prompt: Describe your personal philosophy about how and when you have taken, or would take, antibiotics. What experiences or prior knowledge do you have that shaped that personal philosophy?

I have taken antibiotics a handful of times for minor surgery precautions (wisdom teeth), staph infections of the skin, as a treatment for acne and most recently, for rosacea, facial redness caused by inflammation.

I believe that there is a time and place for antibiotics. In the case of surgeries, I think it is a necessary precaution. Infections in your mouth or near organs can be life-threatening. If it was recommended that I take antibiotics prior to, or after, a surgical procedure, I would certainly do it.

For the staph infections, topical agents such as prescription Mupirocin ointment can be used as a primary method of treating the staph (as long as it hasn’t spread or become too aggravated). This would be a way to avoid oral antibiotics with a good cure rate. I would make the change from oral to topical antibiotics to preserve my gut flora in the future.

As a teenager, acne is often treated primarily with Doxycycline 100-200mg daily. I took Doxy for several months about 10 years ago and it certainly helped to clear my skin. This is not something I would ever consider doing again, and if I had the choice to go back and avoid the Doxy, I certainly would. Because this was not crucial to my health and they are other treatment options available, I don’t think taking antibiotics for acne is a great option.

Finally, low-dose, long-term antibiotics for skin conditions such as rosacea is actually a very common treatment. For this, it’s usually a 40mg daily dose of Doxycycline that you basically take….forever. A dermatologist will tell you that taking 40mg is not an antibacterial dose, it is only an anti-inflammatory one. Even so, I don’t think I would ever take a chronic antibiotic knowing what I know now about how my gut microbiome is impacted by their use.

BHS 323 Writing Assignment #5

Prompt: What choices do you make in terms of food/nutrition/product use and consumption that may have an impact on your microbial communities? Consider choices that are intentional, and choices that are perhaps non-intentional.

I think a lot about gut health and the impact that foods have on my body long after eating them. I started eating a low carbohydrate diet almost 3 years ago. For me, low-carb meant entering ketosis and lots of anti-inflammatory processes. I started following this diet mainly as an experiment to see how it would make me feel and what impact it would have on my body. By doing so, I started eating far less fiber (no rice, bread, grains, etc) and far less sugar. I noticed that my digestive issues were lessening. I felt less bloated and had less digestive pain.

I have continued a lower-carbohydrate diet due to its effect on how I feel. I know I am eating less sugar and processed foods than I would be eating a “normal” diet. I try to avoid foods containing excess sugar or inflammatory proteins to avoid proliferation of bacteria that feed off of such foods. I have tried to start implementing more fermented foods into my diet such as sauerkraut, pickled vegetables, and I regularly drink kombucha. I don’t take any probiotic supplements as I have yet to see evidence that I really believe supports the notion that purchasing these expensive supplements will increase gut microbial communities. I do eat cheese, but usually steer clear of yogurt and kefir due to all the added sugars.

These are all intentional choices. I try to be very intentional with the foods I am selecting to eat and don’t have too many unintentional food choices that could affect my gut microbial communities.

BHS 323 Writing Assignment #4

Prompt: Choose one of the primary research or clinical trial articles that was in your reference list for your midterm audience essay, and write a rhetorical precis on the article.

(1) David L. Suskind, MD, Mitchell J. Brittnacher, PhD, Ghassan Wahbeh, MD, Michele L. Shaffer, PhD,Hillary S. Hayden, PhD,Xuan Qin, PhD, Namita Singh, MD, Christopher J. Damman, MD, Kyle R. Hager, Heather Nielson, and Samuel I. Miller, MD, from the Department of Pediatrics, Division of Gastroenterology with Seattle Children’s Hospital with the University of Washington in an original, clinical trial entitled “Fecal Microbial Transplant Effect on Clinical Outcomes and Fecal Microbiome in Active Crohn’s Disease” (2015) demonstrates that changing the fecal dysbiosis of patients with CD can promote a decrease in intestinal inflammation. (2) Suskind et al. provides evidence that FMT is a potentially therapeutic option for patients with CD by looking at 9 patients with mild-to-moderate symptoms and measuring decreases in symptoms as defined by the Pediatric Crohn’s Disease Activity Index. (3) The purpose of this study is to describe the ability of patients with CD to show improvement and regression of disease with fecal microbial transplant in order to assess the safety and efficacy of FMT in patients with CD. (4) Suskind et al. establishes a scholarly relationship in medical academia within the University of Washington and Seattle Children’s Hospital as well as other gastrointestinal specialty centers throughout the country. 

Reference

Suskind DL, Brittnacher MJ, Wahbeh G, Shaffer ML, Hayden HS, Qin X, Singh N, Damman CJ, Hager KR, Nielson H, Miller SI. 2015. Fecal Microbial Transplant Effect on Clinical Outcomes and Fecal Microbiome in Active Crohn’s Disease. Inflammatory bowel disease 21: 556-563.

BHS 323 Writing Assignment #3

Prompt: Brainstorm a list of behaviors that an individual could engage in that could cause changes to a gut microbial community. For each behavior you list, discuss how that behavior could change the microbial community, and what potential health impacts (beneficial, detrimental, neutral) that change could be for the individual’s health.

  1. Supplementation with prebiotics or probiotics. Probiotics and prebiotics work to foster an environment in which bacteria thrive. This would promote bacterial activity and would likely be beneficial to an individual’s health.
  2. Eating fermented foods. Fermented foods contain a wealth of bacteria and other organisms that work to do the fermentation. If the microbes living on the food can make it to your gut, they would increase the amount and diversify the bacteria in your gut. I think some bacteria would not survive your gastric juices, and make it to your gut. Fermented foods would either have a beneficial or neutral change to your health.
  3. Taking a short course of strong antibiotics for an acute illness or infection. Antibiotics are known for disrupting and killing off gut bacteria, both good and bad. Any decrease in number of good bacteria in your gut is not a good thing. This would damage microbial communities and is detrimental to your health.
  4. Taking long-term low-dose antibiotics for chronic conditions such as rosacea. I am actually not fully sure how this would impact microbial communities. Research suggests that taking low dose antibiotics (such as 40mg of Doxycycline) daily for extended periods of time decreases inflammation and does not harm microbial communities. I think it probably has an overall neutral effect, because decreasing inflammation in the body is a good thing, but any antibiotics long term seems harmful to good bacteria in your gut.
  5. Eating a diet high in sugar. Sugar can feed many bacteria that are harmful in your gut, making their numbers increase and leaving less room for “good” bacteria. This would lead to a detrimental effect in your overall health through a proliferation of bacteria in your gut. High sugar diets are also inflammatory, which can lead to “leaky gut syndrome” in which gut walls are penetrated, therefore disturbing the existing gut microbiome.
  6. Eating a diet high in fiber. Fiber is typically crucial for a healthy gut. It is slow or non-digestible, and many times, the gut bacteria feed off of the fiber present in the gut. I would think a diet high in fiber would increase communities of bacteria in the gut, which would increase overall health.
  7. Eating an anti-inflammatory diet. I know there are many health benefits associated with anti-inflammatory diets, but I’m not exactly sure the effect that would be had specifically on the gut microbiome. Usually diets high in sugar are more inflammatory, and diets high in fiber and good fats are less inflammatory, leading me to believe that an anti-inflammatory diet would be good for gut bacteria and would increase your overall health.
  8. Eating artificial sweeteners. Again, I assume artificial sweeteners are horrible for your gut and body overall. I can’t image that these chemical compounds used to simulate sugar are good for your gut bacteria. It would make sense that this would be overall harmful to one’s health.
  9. Taking chronic proton pump inhibitors. Proton pump inhibitors (such as Prilosec, or omeprazole) have a cumulative chronic inflammatory effect on the body. This would make them harmful to gut bacteria, and detrimental to overall health.
  10. Taking chronic NSAIDS. NSAIDS (such as ibuprofen) have a cumulative chronic inflammatory effect on the body and stomach if used for extended periods of time. I’m not sure how this would affect the gut bacteria, but chronic inflammation is harmful, so it would likely decrease the bacteria that are present, making them harmful to your health.
  11. Exposure to external factors such as dirt, animals, nature, public places. Microbes are present in communities in so many different places. Exposure to natural microbes found on plants, in the dirt, on animals, in pet saliva, and other public places throughout a lifetime likely diversity the bacteria found in the gut. 
  12. Being born via c-section or vaginally. Although this is not something the individuals themselves have control of, a mother often has some degree of control over how she will have a baby. Knowing that babies are exposed to more microbes when born through the vaginal canal, it might be beneficial to a baby’s health to make a birth plan that involves being born vaginally.
  13. Being breastfeed vs bottle fed with formula. Similar to above, a baby doesn’t have much choice in their method of feeding, but a mother, or parent (if able) has the choice whether to attempt to breastfeed their baby or use formulas and bottles. Exposure to a mother’s breastmilk probably exposes the baby to additional microbes that they might not get without breastmilk exposure. If true, this would probably increase the health of the baby.

BHS 323 Writing Assignment #2

Prompt: As a healthcare professional, a colleague asks your opinion as to which HPV strains should be covered in a new treatment. Based on your reading from the Sarid and Gao 2011 article, what would your recommendation be, and when should the treatment be administered? What evidence supports your opinion? Keep in mind a cost/benefit analysis, as the cost of developing a vaccine for each strain can get very pricey!

HPV, which is associated with carcinoma of the cervix, vulva, vagina, penis, anus, oral cavity, oropharynx, and tonsils was discovered in 1983. The current Gardasil vaccine helps to prevent HPV in individuals aged 9-45 caused by 9 strains (6,11,16,18,31,33,45,52, and 58). The CDC recommends that boys and girls at age 11 or 12 should receive the Gardasil vaccination.

If a new vaccine were being created today, I would consider adding strains 16, 18, 31 and 35 due to the fact that these 4 strains account for ~80% of cervical cancer in women. Including cost as a factor for my decision, I would target my treatment at the cancer-causing strains, rather than the prevention of anogenital warts. I think the treatment should be given around or before age 11 or 12 similar to CDC guidelines due to sexual contact being the main route of transmission of anogenital HPV and most children are not sexually active around age 11. I would focus the majority of expense on education and primary prevention of HPV rather than adding more strains to the vaccination. If adolescents have better education on prevention of HPV and safe sexual practices, there would be less need for a vaccine with many strains.

BHS 323 Writing Assignment #1

Prompt: List as many human non-infectious diseases that you can think of that are influenced by microorganisms.  

I just finished reading “The Longevity Paradox: How to Die Young at a Ripe Old Age” by Dr. Stephen Gundry and it sparked a huge interest in the gut microbiome as a whole. It was amazing to me to see how microorganisms in our bodies are responsible for nearly every single non-infectious disease humans can be affected by. From metabolic disorders (diabetes), heart disease, cancers, digestive diseases (such as IBS or Crohn’s) and other autoimmune diseases (MS, Rheumatoid Arthritis, Psoriasis, Lupus) to neurologic conditions (Alzheimer’s) and chronic inflammation, the list goes on and on.

Both from the book, and the intro lecture on the history of microorganisms and human health, it was interesting for me to learn about just how all of these diseases are linked to our microbiome and how much things have changed in the last 120 years. Dr. Gundry mentioned the changes that have occurred in the last 100 years that have contributed to a decline in microbiome health including increased antibiotic resistance and chronic inflammation in our bodies causing “leaky gut” syndrome. It will be interesting to me to see if/how these subjects will be discussed in this class and I look forward to hearing about the other connections between the microorganisms in our bodies and chronic, non-infectious health conditions.