DAY ONE MODULE 4 Brad Leech

Functional Dysbiosis: The Food as Medicine Approach Saturday 04 | 11:50am Abstract Functional dysbiosis is characterised by an imbalance or dysfunction of the microbial ecosystem in the gut, resulting in metabolites that fall outside the healthy range. While dysbiosis is a commonly used term, it does not provide context to the specific health and function of each person's microbiome, as the combination of species present in the gut is unique to each individual. Therefore, to effectively treat functional dysbiosis, a comprehensive assessment of microbial metabolites is necessary. ​ In the past, antimicrobial herbs have been used to treat dysbiosis. However, with the advancement of microbiome sequencing technology, this approach has shown these interventions to be inferior to other food-based compounds. Supporting the microbial ecosystem with whole foods, targeted prebiotics and foods rich in polyphenols can effectively treat functional dysbiosis by restoring a healthy balance of functions in the gut microbiome. Each type of functional dysbiosis is unique and requires a personalised treatment strategy. ​ Clinicians should follow the A.I.M approach, which involves assessing the microbiome, implementing personalised treatments, and monitoring progress. By taking a personalised, targeted approach to treating functional dysbiosis, patients can experience significant improvements in their gut health and overall wellbeing. Targeted food-as-medicine interventions for the microbiome require a deep understanding of microbial metabolites and their impact on health. By identifying which microbial metabolites are outside the healthy range, clinicians can develop personalised treatment plans that address the specific imbalances present in the gut microbiome. Prebiotics and polyphenols have been shown to be effective in restoring a healthy balance of functions in the gut microbiome by selectively promoting the growth of beneficial bacteria and suppressing harmful bacteria. 00:00 Introduction: Dr Brad Leech and the Gut Microbiome 00:48 Overview: Gut Health and Functional Dysbiosis 01:25 Why Gut Health Matters 02:03 Audience Discussion: Recommendations for Dysbiosis 02:46 Top 3 Recommendations for Gut Health 03:10 Microbial Diversity, Eating the Rainbow and Whole Foods 04:48 The Growing Prevalence of Gut Disorders 05:55 The Gut-Brain Axis and Systemic Health 06:27 Assessing Gut Function Beyond the Microbiome 07:20 Understanding the Gut Microbiome and Microbial Diversity 09:33 Dietary Fibre and Microbial Fuel Sources 10:10 Microbial Metabolites: Butyrate, Acetate and Propionate 11:54 Functional Dysbiosis: A More Targeted Clinical Approach 13:12 Methane, Gut Motility and Constipation 13:59 Lipopolysaccharides (LPS) and Inflammation 14:43 Carnitine, TMAO and Cardiovascular Risk 16:32 Beta-Glucuronidase and Estrogen Metabolism 17:46 Food as Medicine: Causes of Functional Dysbiosis 18:19 Supplements, NAC and Hydrogen Sulfide 19:05 Antimicrobials and Their Effects on the Gut Microbiome 20:38 Symptoms and Clinical Signs of Functional Dysbiosis 21:05 Pathogens vs Pathobionts: Understanding the Difference 22:26 Recognising Pathogenic Gut Infections 23:25 Microbial Metabolites and Pathobionts 24:40 The AIM Approach: Assess, Implement and Monitor 25:33 Butyrate, Acetate and Hydrogen Sulfide 26:26 Low Butyrate: Intestinal Permeability and Inflammation 26:46 Beta-Glucans to Support Butyrate Production 27:05 Practical Ways to Increase Beta-Glucans 28:40 Resistant Starch and Butyrate Production 28:55 Green Banana Flour, Cooled Potatoes and Legumes 29:46 Choosing the Right Fibre for Individual Patients 30:21 Resistant Starch, Methane and Constipation 30:57 Fibre Tolerance and FODMAP Considerations 31:33 Indole-3-Propionic Acid (IPA) and Gut Health 32:09 Ellagic Acid, Polyphenols and Microbial Metabolites 32:31 Pomegranate Extract and IPA: Research Findings 33:09 Ellagic Acid-Rich Foods for Clinical Practice 33:49 Fresh vs Frozen Berries 34:14 Practical Dietary Strategies: Berries, Nuts and Seeds 35:14 Eating the Rainbow and Cardiovascular Health 35:54 Personalising Treatment for Functional Dysbiosis 36:18 Patient-Reported Outcome Measures and Clinical Monitoring 37:22 Key Takeaways: Food as Medicine and Individualised Care 37:54 Closing Remarks