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'Good Health Is All About Gut Health'

Dr Nageshwar Reddy is a renowned gastroenterologist and chairman of the Asian Institute of Gastroenterology and AIG Hospitals, Hyderabad. He was a recipient of the Padma Shri Award in 2002. In an exclusive interview, Dr Reddy unravels the intricate relationship between gut health and sanitation and the role of bacteria in human life

'Good Health Is All About Gut Health'
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What is new in the gut health discourse?

When discussing health, it is commonly thought that the food we eat is digested by various enzymes in the intestines, absorbed into the body and distributed to organs such as the liver, brain and heart. Good digestion and enzymes lead to good gut health, allowing for efficient nutrient absorption. This concept has existed for many years, but recent discoveries have revealed a missing puzzle piece. We now know that the third factor in gut health and digestion is the presence of bacteria in the gut. This was not recognised until about 10 years ago, and it plays a crucial role in our overall health.

In our intestines, from the mouth to the stomach, the small intestine and the large intestine, a large variety of bacteria, fungi and viruses constitute the gut microbiome. We are 10% human and 90% microbiome. Our gut bacteria control our health.No two people have the same gut bacteria. Therefore, we can assess whether someone has a healthy or unhealthy gut by analysing their gut bacteria.

How does poor hygiene and sanitation in early childhood impact gut health?

The bacteria in our gut play a crucial role in gut health. Interestingly, the type of bacteria in our hearts is determined mainly during our early childhood. Three factors are responsible for this. Firstly, the way we are born, whether it is through vaginal delivery or caesarean delivery, can effect the bacteria we are exposed to. Vaginal delivery exposes us to healthy bacteria, while caesarean delivery does not. Secondly, the duration of breastfeeding also plays a role in determining the bacteria in our gut. Babies who have been breastfed for a more extended period, say six months, tend to have a healthier bacteria profile.

However, harmful bacteria are prevalent without breastfeeding, early weaning or bottle feeding. And the third important thing is antibiotics. If we use too many antibiotics in children, the bacteria change and become destructive.

Many diseases, including metabolic and mental health issues and liver problems, are influenced by the bacteria in our body cells

But what is gut hygiene?

There are two types of bacteria: good and evil. So, there is a constant fight in the body between excellent and harmful bacteria. Even in an average person, 10% of the bacteria are bad. And because of this ongoing battle, the good bacteria can suffer the harmful bacteria.

Maintaining good gut hygiene is essential for health. A healthy gut contains about 90% good bacteria. However, when the proportion of harmful bacteria increases to 30% or 40%, it indicates poor gut hygiene. Various factors, such as sanitation, water quality and food sources, contribute to an unhealthy gut. Consuming contaminated food or certain foods, like red meat, can also adversely affect gut bacteria. Even if red meat is not contaminated, it changes the composition of bacteria in the stomach, increasing the proportion of harmful bacteria that try to break down the heart, resulting in a higher percentage of harmful bacteria.

Maintaining good hygiene standards is crucial for keeping our gut healthy. The type of food we eat, the quality of water we consume and our exposure to environmental factors, such as smoking and alcohol, can all impact the bacteria in our gut. In addition to eating clean and nutritious food and drinking safe water, regular exercise and avoiding smoking and alcohol can help keep our gut bacteria healthy. It is important to remember that even our lifestyle choices can influence the bacteria in our gut.

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Good gut bacteria play a crucial role in overall health. Firstly, they produce antibodies that help combat harmful bacteria, enhancing the immune system. Secondly, these beneficial bacteria process various chemicals from consumed foods, affecting different body parts.

For instance, gut bacteria can convert almond components into substances like tryptophan and serotonin, which are transported to the brain, aiding activity. Thus, it is not solely the brain functioning independently but a collaborative interaction between gut bacteria and the nutrients they process.

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Illustration: Shutterstock

Which diseases can be checked if you take care of gut health?

Your digestive system relies on your enzymes and the enzymes produced by the bacteria in your gut. This is why it is essential to prioritise gut health. Maintaining a healthy weight and metabolism is also crucial for good gut health.

If your bacteria become harmful, they can lead to the development of a bad liver, which is known as non-alcoholic fatty liver disease (NAFLD). It is a paradoxical term, as the person affected is not consuming alcohol. NAFLD is often blamed on factors such as lack of exercise and overconsumption of fatty foods. However, the primary cause of NAFLD is the bacteria in the gut that produce alcohol. This condition is also known as auto-brewery syndrome.

Many diseases, including metabolic and mental health issues and liver problems, are influenced by the bacteria in our body cells. These bacteria can also impact the production of substances like Vitamin B12, essential for our body. If there is a deficiency of bacteria-producing B12, one can experience symptoms like tingling and numbness in their fingers and hands, fatigue, lethargy and mental exhaustion. This type of illness is quite common in such individuals.

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How would you sum up the role of diet in gut hygiene?

In an experiment, doctors were divided into two groups: one group followed a conventional diet, and the other group followed a Mediterranean diet rich in olive oil, vegetables, fruits, nuts and fish. After a month, the doctors on the Mediterranean diet saw notable changes in their gut microbiome, leading to weight loss, decreased liver fat and stabilised blood pressure levels. Enhancing this diet with prebiotic-rich foods, which feed the gut bacteria, can further amplify these health benefits.

Embracing this dietary change can significantly bolster overall well-being. The effectiveness of this intervention is multiplied by incorporating prebiotic foods, which are converted into beneficial substances by the bacteria. By adopting this intervention, we can improve our overall health.

Maintaining good gut hygiene improves gut health and reduces liver diseases, inflammatory bowel diseases, diarrhoea and other related conditions

What is your research experience about how improving gut health reduces the prevalence of some diseases?

Our research findings indicate that maintaining good gut hygiene improves gut health and reduces liver diseases, inflammatory bowel diseases, diarrhoea and other related conditions. Additionally, by taking the necessary steps, we can also lower the incidence of hypertension and non-communicable liver diseases (NCLDs). The latter have become a significant concern worldwide, including in India, where it was previously underestimated. Interestingly, certain types of bacteria in the gut could lead to diabetes. By altering the gut bacteria, one can potentially manage diabetes without any medication.

What about young mothers?

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It is essential to consider the issue of feeding children in our country, as it can lead to problems related to cleaning and hygiene.

In many villages, there is limited access to clean running water, which can pose a challenge when cleaning feeding bottles and utensils. Due to water scarcity, some people repeatedly wash with the same water, leading to the growth of harmful bacteria.

To maintain good gut hygiene, following ideal practices and having access to clean drinking water and proper sanitation facilities like toilets are essential. Open defecation can lead to contamination of other sources of food and can adversely affect not only humans but also animals. Therefore, it is necessary to consider various factors that impact our daily lives, including natural elements and the availability of resources, to ensure good health and hygiene.

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