Author: Dr Ken McGrath

23 April 2020

 

 

Why are nutrition professionals uniquely placed to leverage advanced knowledge of the gut microbiome in practice?

Everyone’s gut microbiome is unique. A growing body of evidence links the organisms in our gut with various health and disease states, making now the time to look deeper at these connections.

As a healthcare professional, guiding your patient on their health journey using a personalised approach is key, and delving into their unique gut microbiome is a valuable tool in practice.

The past decade has seen advancements in the technology used to look at the organisms in our gut, leading to more powerful microbiome analysis. Microba’s co-founders, Professors Phil Hugenholtz (The University of Queensland) and Gene Tyson (Queensland University of Technology) were able to open up world-leading microbiome analysis to healthcare professionals right here in Australia.

 

What does gut microbiome analysis tell you?

Healthcare professionals understand the power of information, and the value of testing to better understand what is going on with their patient. Gut microbiome analysis using metagenomic sequencing, provides in-depth information to empower practitioners to assess, improve, and monitor their patient’s gut health.

• Assess, to understand your patient’s current condition and what challenges they face

• Improve their gut health through targeted diet and lifestyle interventions that aim to nurture specific beneficial microbes in your patient’s gut

• Monitor their gut microbiome to ensure the patient is on track and achieves their goals.

This leads to efficiency in your clinic to make evidence-based decisions and move forward managing your patient without the guesswork.

 

Why use metagenomics?

There are many different kinds of stool tests, and each looks at a different aspect of gut health. Examples include the national bowel cancer screening test (which detects haemoglobin from blood in the stool), or tests that search for specific bacteria or parasites (like pathogen screens, or microscopy). These use methods that give you a specific answer, but don’t take into account the entire microbiome.

Current research indicates that a patient’s whole microbial population should be taken into account when assessing the health of a patient’s gut, rather than targeting a subset of organisms.

Exploratory tests on the other hand, look at the community of bacteria living in the gut microbiome and what their role is. This is done via DNA sequencing. There are two main types of DNA sequencing tests available currently – 16S sequencing and shotgun-metagenomic sequencing.

16S sequencing looks at a small piece of a single gene found within bacteria and then predicts the types of bacteria that may be present. This region is typically 10,000 times smaller than the entire bacterial genome. The resolution attainable using such a small fragment of DNA is limited, and so the information is generally about groups of bacteria present and the method is unable to tell you much about the function of the organisms.

The best way to explore the gut microbiome is through metagenomic sequencing, as this method analyses all of the DNA from the microorganisms in a sample. Through metagenomics, all of the genetic information present in a sample is sequenced. This provides the highest-resolution view of the gut microbiome, including detailed information about which bacteria are living in a person’s gut (species), what they are able to do (metabolic potential), and what foods their microbes need as fuel (prebiotics). In addition, it can provide you with information on how these elements are connected to major systems of your patient’s body and health. As a healthcare professional, you are supported to use the information in a patient’s report and use your expertise to set a plan for improving their overall health into the future.

 

What value does this kind of testing bring to you in practice?

Modern practitioners are well placed to utilise gut microbiome analysis in practice, and assist their patients with evidence-based approaches to improving gut health. There are many insights in a metagenomics report that can inform your clinical decision making, from looking at what metabolites your patient’s gut microbiome is producing, to which prebiotics will best fuel the good bacteria in their gut.

Here are examples of insights from the report that are valuable in clinical practice:

• Gut microbiome diversity level – the level of diversity in your patient’s gut is important, and can show overgrowth of certain bacteria present in the gut microbiome. Practitioners can use this information to inform dietary interventions and consider a more diverse diet to boost microbial diversity.
• Human DNA abundance – normally, human DNA is at very low levels in stool. If this is elevated, it can be an indicator of inflammation or more serious GI concerns and warrants further testing.
• Fibre digestion potential – the patient’s ability to digest fibre can inform dietary intervention

Another key aspect of Microba’s microbiome report is understanding your patient’s ability to produce metabolites that impact their health. These metabolites can interact with our immune, metabolic and nervous systems and have been linked to many health conditions. Some metabolites promote good health and some promote poor health. Understanding the potential of your patient’s gut microbiome to produce different metabolites can provide insight into how the gut microbiome may be contributing to their overall health.

Here are three examples of key metabolites in the Microba report:

• Butyrate – a key Short Chain Fatty Acid (SCFA) your gut cells require for regular function. Low levels of butyrate production are considered unhealthy, and can contribute to inflammation and other negative consequences. This result can inform dietary interventions such as increasing resistant starch intake, which is a precursor for butyrate production.
• Trimethylamine (TMA) – high levels are linked to cardiometabolic disease, and so this can indicate increased risk of several health issues and inform dietary intervention.
• Lipopolysaccharide – this inflammatory compound is produced by certain types of bacteria, causes systemic issues and absorption is increased in the presence of saturated fats. A high potential can inform dietary interventions.

 

Where to from here?

There is a vast amount of information that can be found and utilised in practice from a gut microbiome analysis, but how do you maximise the value of such a tool? The first step is having a deeper understanding of gut microbiome analysis and interpreting a report. Any healthcare professional passionate about using technology in practice and expanding their offerings to patients can do this.

In addition to the online course you’ve undertaken with Microba, there is a dedicated Healthcare Support Team who can assist you in using the reports and discuss aspects of your patient’s reports in a 1-on-1 call. There are also clinical resources  for healthcare professionals to access various supporting guides. The Healthcare Portal also includes video guides and interesting articles and blogs for healthcare professionals.

How could gut microbiome analysis enhance your practice? With the term ‘gut health’ being a buzzword across the globe, interest in what makes a healthy gut and what people can eat to keep their insides healthy is increasing rapidly. There has never been a better time to capitalise on this growing interest and utilise a tool such as gut microbiome analysis to not only attract new clients, but also enhance your offerings for your current clients. Speak to the Healthcare Team today about how you can use Microba’s analysis in your practice.