Diet and the Gut Microbiome Jean Kerver, PhD, MSc, RD March 15, 2018 COMMUNITY CAMPUSES & CLINICAL SITES Jean Kerver, PhD, MSc, RD kerverje@msu.edu 1
Diet and the Gut Microbiome Does the type and amount of bacteria that live in our intestines play a part in our health? This session will provide an overview of the burgeoning research field studying the effects of diet on the human gut microbiome. Learn what makes up our microbiome and how our diet can help improve it, with a special focus on child health outcomes. You ll hear about a national research initiative in this area and how the work connects with public health programming. Learning Objectives List 3 food groups that have been shown to increase the biodiversity of the human gut microbiome. Name 3 child health outcomes that have been associated with a more diverse gut microbiome. Describe a current research initiative exploring the effects of maternal diet on the colonization of the infant gut microbiome. 2
Nutrients what else affects our phenotype? Slide courtesy of Sarah Comstock, PhD What is a microbiome and why do we care? Health outcomes associated with specific or diverse microbiomes Effects of diet changes on the microbiome What makes our microbiomes unique? PEAPOD: A local research initiative exploring the effects of maternal diet on the colonization of the infant gut microbiome CHARM: A statewide pregnancy cohort seeking to determine environmental influences on child health outcomes 3
What IS the human microbiome? Microbiota: the microbial taxa associated with humans Under study since about 1680 using microbiological methods Microbiome: the catalog of these microbes and their genes Term coined in 2001, field is possible because of molecular methods (instead of relying on microbial culturing) The Gut Microbiome Slide courtesy of Sarah Comstock, PhD 4
What do these microbes do? Classically Digest molecules we can t digest Cellulose, other starches Produce vitamins B12, K Cause infectious disease C. difficile, campylobacter, H. pylori State of the art Interact with our immune systems Interact with our brains Modulate our metabolism Prevent infection Cause non-infectious disease Slide courtesy of Sarah Comstock, PhD 9 10 5
Before and After Slide courtesy of Sarah Comstock, PhD Impact of diet on the gut microbiome and human health Singh et al. J Transl Med (2017)15:73 12 6
Impact of dietary protein Singh et al. J Transl Med (2017)15:73 13 Impact of dietary fats Singh et al. J Transl Med (2017)15:73 14 7
Impact of popular diets Singh et al. J Transl Med (2017)15:73 15 Lots of interest in the gut microbiota Easily influenced by diet http://www.nature.com/nature/journa l/vaop/ncurrent/pdf/nature12820.pdf May directly contribute to obesity and other diseases Easier to study now because of next generation sequencing Slide courtesy of Sarah Comstock, PhD 8
The prenatal gut microbiome: are we colonized with bacteria in utero? The fetal gut is not sterile The maternal microbiome changes during pregnancy Bacterial transfer from mother to offspring Multiple maternal sites may contribute to offspring microbiome Walker et al. Pediatr Obes (2017)12S1:3-17 9
Proposed mechanisms of maternal transfer of bacteria to the fetus in utero Walker et al. Pediatr Obes (2017)12S1:3-17 19 Slide courtesy of Sarah Comstock, PhD Castanys-Munoz et al. Adv Nutr (2016)15;7 (2):323-30 20 10
Epigenetic Matters Indrio et al. Front Pediatr (2017)5:178 21 Connections to Health via Metabolites Autism Hsiao E, et al. Cell 2015 Dae-Wook K, et al. Microbiome 2017 Obesity Cassidy-Bushrow, et al. Int J Obes 2017 Atopy/Asthma Fujimura KE, et al. Nat Med 2016 Slide inspired by Susan Lynch, PhD 22 11
Panigrahi et al. Nature (2017) Doi:10.1038/nature23540 23 Probiotic prevents infection in newborns Newborn sepsis results in 1M annual deaths worldwide. RCT of an oral synbiotic (Lactobacillus plantarum plus fructo-oligosaccharide) in rural India, for 7 days, starting on day 2-4 of life N=4,556 infants ( 2000g; 35 wks; healthy) randomly assigned to treatment or placebo. Risk ratio for clinical sepsis by 60 days of age = 0.60, 95% CI 0.48-0.74 D. Tancredi Commentary Nature (20170) Doi:10.1038/nature23540 24 12
25 Acknowledgments Grand Traverse Women s Clinic MSU CHM Traverse City Campus Munson Medical Center Janel Gryc, RN, BSN, MPH Susi Worden Oleson s Foundation Fustini s MSU CHM Christine Johnson, PhD Sarah Comstock, PhD Joseph Gardiner, PhD Nigel Paneth, MD MPH 26 13
Child Health Advances from Research with Mothers What is Child Health Advances from Research with Mothers? Collaboration of Michigan institutions CHARM Objectives Observe mother and child during pregnancy Collect information, including biological materials during pregnancy, birth, and childhood Analyze data to inform causes of health conditions and developmental disorders Partner with others to use findings toward prevention 14
How we chose the hospitals Biostatisticians at UM performed a stratified random sample of all 83 lower peninsula birthing hospitals. Two hospitals were selected (using probability proportional to size) from each of five strata. Strata were quintiles of % A-A births. HOSPITAL LOCATIONS Two in Detroit Two in Detroit Suburbs Southfield Dearborn Two in Ann Arbor One each in Saginaw Traverse City Grand Rapids Sturgis Flint Role of the Prenatal Care Clinic Study Introduction Patient s Consent Urine #1 Blood #1 2 nd Trimester Urine #2 Blood #2 Urine #3 15
Role of the Hospital Participant identification Placenta collection Access to medical records Placenta processing and storage Pregnancy Cohort Timeline Some moms and babies will also provide stool samples so we can assess gut microbiome 16
COMMUNITY CAMPUSES & CLINICAL SITES Jean Kerver, PhD, MSc, RD kerverje@msu.edu 17