Habe hier ein paar schöne Notizen aus einem Interview mit Jason Hawrelak gefunden. Habe hier schon einiges von ihm gepostet, ich finde seinen Zugang sehr spannend und er gibt viel brauchbare Information weiter. Er ist bereits seit 18 Jahren in dem Bereich tätig und seine Warteliste beträgt 1,5 Jahre! Was ich spannend finde, ist dass er aufgrund seiner langjährigen Praxis mit Patienten sehr konkrete Erfahrungswerte hat, wie man das Mikrobiom beeinflusst und wie es "zusammengesetzt sein soll". Das haben wir bereits diskutiert und es kann sich bestenfalls um Richtwerte handeln, da so viele individuelle Faktoren ins Spiel kommen. Aber er motiviert die Erfahrungswerte in diesem Interview sehr schön, beispielsweise warum so ein starker Fokus auf Buttersäure-Produzenten gelegt werden sollte:
Die Notizen sind von diesem Interview. Obwohl viele Themen bekannt sind und das Interview etwas langsam beginnt, ergibt sich ein wirklich gutes Gespräch mit viel Information:
https://www.youtube.com/watch?v=zwuJd2EK7Rw
Hier eine Zusammenfassung (auf Englisch, nicht von mir):
1) ubiome looks at bacterial DNA. That means is picks up what known to exist. If we don’t know yet about a species then this will not get picked up.
2) “Wellness match score” doesn’t mean much. It is a Ubiome derived score.
3). Diversity is key. Jason likes to see an 85 to 90 percentile score for diversity. Diversity takes into account genera present as well as the spread of these also. Are you dominated by 1, 2 or 3 species and how many genera are there. So it’s about genera spread and genera richness
4) some species bounce back after antibiotics but some becomes extinct.
5) Once a species becomes extinct, can’t bring it back. You can feed ones on the edge of extinction though.
6) he first looks at phylum rank. He always looks at proteobacteria levels. All bacteria in this category contain lipopolysaccharides which produce endotoxemia. They are proinflammatory. Can vary from 0.05% to 25% (25% is the highest he has seen). Has a huge impact on inflammatory train a person is dealing with. If high that’s a problem because of the endotoxins. Typically this is at 4 to 5% in westerners. The test result he was looking at was around 1.5% and he said this was very very good.
7) then he looks at genus level data. This tells us the most about diversity. This is what genera makeup in bulk. People who take antibiotics, antibiotic cocktails or chemo, their bacteroides may be at 60 to 75% of ecosystem. That’s not good. Look for a good spread at genus level. He likes to see bacteroides at 20% mark. Top four species are usually bacteroides, faecalbacterium, bloutia, and roseburia. In the test reviewed in the podcast, amounts were: bacteroides 20.75%, faecalbacterium 15:01%, blautia 12.58%, roseburia 6.77%. Blautia and roseburia are two of the key butyrate producing microbes in the gastrointestinal tract and butyrate is the most important and far reaching SCFA’s that’s produced in the gut. Butyrate has a healing affect in the colon and small intestine, helps improve blood sugar regulation, helps improve mitochondrial function, decreases inflammation in the brain. Butyrate is an amazing substance. Some people will have 50 to 60% of ecosystem comprised of butyrate producers while others will have 8 to 10% (way below normal) and that has a huge impact on their health and well being and impact on the disease state they are presenting with.
8) pseudobutyrivibrio and subdoligranulum are also butyrate producers as well as faecalbacterium.
9) F prausnatzi and faecalbacterium are the dominant species he sees in healthy more diverse ecosystems. And higher bacteroides are associated with lower diversity scores. Those that have bacteroides at 30%, 40%, 50%, 60% plus you will generally see a lower diversity score.
10) Faecalbacterium is also a key butyrate producer but it also produces other anti inflammatory gut healing compounds so it has additional gut healing effects beyond what we know about blautia and roseburia.
11) Firmicutes vs Bacteroidettes Ratio - subsequent research has found no connection between this ratio and body weight. So he suggests ignore this ratio as it is not supported by current data. He says Ubiome is still stuck on old research about ratio connection to body weight.
12) Akkermansia - Data is consistent around Akkermansia. He said Akkermansia is one of those species that is sadly and not infrequently extinct in some of this patients guts due to prolonged restrictive diets and antibiotic usage as well. Average Akkermansia in healthy people is between 1% to 3% (microbiologist Kiran Krishnan has said range is between 5% to 10%). In those situations where you want to work in metabolism and weight, etc. then you work on increasing Akkermansia. Also the markers for weight and gut health are diversity. Lower diversity = more metabolic issues.
13) The presence of Bifidobacteria is pivotal for gut integrity and for preventing bacterial endotoxins from getting into your system but also for overall health and improved mood, etc. He said in some people it’s actually extinct. In the person he reviewed in the podcast, it was .08% so very low. He said in those with higher antibiotic usage it is actually gone from ecosystem. Ideal is between 2.5% to 5%. If it is there even in very small amounts, you can bring it up.
14) Other things to look at on Ubiome - the below detectable threshold is around 0.01%. When species is less than that amount usually won’t show up on test result. Once you feed species, it will get picked up by the test assuming it is not extinct. Another thing to consider is that there are a number of species where we have no idea what role they play. We just know they are there (because technology allows us to identify them) but have not yet figured out what role they play or what % they should represent. So most species in the genus list are like that at this time. So he focuses on species we do know as key players associated with better health outcomes along with the ones we know are detrimental and produce by products that are harmful. This includes Desulfovibrio and Bilophila. Both these are key hydrogen sulfide gas producers. Hydrogen sulfide gas is a byproduct that only a small number of species can produce and a small amount of it is fine however when you get above a certain point it causes gut inflammation and more importantly visceral hypersensitivity. For those who have IBS, this is often a key driver in IBS patients and the level of these species is often high.
15) Core aspect is working on diversity. All researchers agree that focusing on diversity is the most important aspect. So you should work on nourishing up those species that are below the detectable threshold. Some species are flexible with their food - they will eat some protein, some bile, different ranges of fibers. Those tend to survive restrictive diets very well but other species have very selective food requirements.
16) Methane producing bacteria can be found under downloads (CSV file) and search manually for methanobrevibacter smithii.
17) increase diversity - do this with plant based foods for those species that have a more niche diet requirement. This will include a rainbow of food colors and wide spectrum of plant fibers. This feeds species in the colon and will feed the widest spectrum of species. This is a key way of improving diversity and diversity score.
18) so how to increase diversity when sensitive or reactive to many foods - try to find cause/reason and work on that so that diet can be expanded. Causes can be leaky gut and use Ubiome test to determine what microbes are contributing to damage and what microbes are absent) along with a thorough case history. What lined up to create current situation.
19) ideally eat 40 or more plant based foods. Don’t get fixated on quantity. For example, 1 tbsp of red lentils is fine (you can count this as a food) but anything less than 1 tsp, don’t count but above that yes. There is nothing magical about the number 40. This is a stretch but doable. Clinically this is what he finds makes a difference.
20) Red Foods are high in polyphenols. They feed akkermansia. Akkermansia likes red polyphenols from different food sources.
21) . Repairing damaged gut - is FMT an option for SIBO? His answer was no it’s not an option for SIBO treatment. Maybe post SIBO for a severely disturbed ecosystem caused by past history of antibiotic use. Always try to restore an ecosystem first and see what happens.
22) Fermented/cultured foods for gut health - there is an overstatement of their impact from a reseeding/repopulating aspect. If you look at an ecosystem from ubiome test vs ecosystem from fermented foods, they do not look the same don’t necessarily share things in common. You are not putting things in that are lacking. They just don’t permanently colonize. You get a temporary improvement of diversity no doubt. For an ecosystem severely damaged by antibiotics, another 10 species or so from fermented foods can be helpful.
