Full Transcript Microbiome, Fiber, and Plant-Based Health 0:00 "Fecal Transplants for Ulcerative Colitis, MS, Depression, Bipolar, and Alcoholism" 0:11 Plant-based foods and the microbiome 0:13 in the preservation of health and prevention of disease. 0:17 We have evidence that high-fiber, plant-based diets can prevent 0:19 many different common diseases, maybe through the effect 0:23 that these diets have on the composition and metabolic activity 0:26 of our microbiome, the bacteria in our gut. 0:30 Good gut bugs in our colon eat the plant residues and 0:32 spit out health-promoting and cancer-suppressing metabolites. 0:36 Like fiber is metabolized to short-chain fatty acids, 0:39 which have profound 0:40 anti-inflammatory, anti-cancer properties. 0:43 And we have special fiber-feeding microbes that chew through 0:45 the plant cell walls and release all the anti-inflammatory, 0:48 antioxidant, and anticancer goodies inside. 0:51 So, how many whole plant foods do we have to eat? 0:56 All the evidence points to a physiological need 0:59 for about 50 grams of fiber a day, 1:01 which is what is contained in the traditional African diet 1:05 and is associated with the prevention of common Western chronic diseases. 1:09 This is up to twice the recommended minimum 1:12 and three times the current intake in the United States.
Fecal Transplants for C. diff and Ulcerative Colitis 1:15 How can you prove the microbiome is involved though? 1:19 Fecal transplantation -- stool transplants. 1:23 One man's trash, another man's treasure. 1:27 Currently, donor fecal microbiota transplantation is the optimum 1:32 therapeutic approach for recurrent Clostridium difficile infection. 1:37 C. diff is today considered the most common hospital-acquired cause 1:40 of diarrhea. It's a life-threatening infection that can rear its ugly head 1:45 when your good gut bugs have been wiped out by antibiotics. 1:49 So to get rid of it, all we need are more good gut bugs, 1:52 which can be provided by a healthy donor 1:55 through the infusion of a liquid suspension of the donor's stool. 1:59 We are winning with poo. 2:04 Fecal transplants have proven their worth in the management 2:07 of recurrent C. diff diarrhea, with cure rates up to 90%. 2:11 Because of this success, fecal transplants have been suggested 2:14 as a potential treatment in other gastrointestinal diseases. 2:18 For example, the inflammatory bowel disease known as ulcerative colitis. 2:22 There have been four randomized controlled trials, 2:24 and fecal transplants appear to nearly double clinical remission rates. 2:28 But what about non-gastrointestinal disorders? 2:34 Here's a case study of a series of fecal transplants 2:36 for multiple sclerosis (MS). 2:39 The patient experienced improvements in their microbiome, 2:41 more of those fiber-feeding anti-inflammatory bacteria. 2:44 And there was a significant increase in the levels of brain derived 2:48 neurotrophic factor, which is suggested to play
MS and the Role of Gut Bugs 2:50 a neuroprotective role in MS, as well as 2:54 both subjective and objective evidence of improved walking, 2:58 which was the patient's primary MS symptom. 3:01 Now, to give the new fiber feeders something to chew on, 3:04 the patient was put on a high fiber diet, which is great. 3:07 But just putting people on a plant-based diet alone may help, 3:10 stool transplants or not, 3:13 since standard Western diets promote dysbiosis, 3:15 a bad bug gut imbalance, and neuroinflammation in MS, 3:20 while plant-based high-fiber diets decrease MS risks. 3:24 Randomized, placebo-controlled trials will be needed to tease that out, 3:28 but in the meanwhile we can certainly build up good gut bugs 3:31 the old-fashioned way by eating fiber-rich whole plant foods. 3:36 What about fecal transplants for depression? 3:39 Interest in the gut microbiome and its role in health has exploded 3:43 just in the last few years. Does any of this have relevance in psychiatry? 3:48 Maybe so. Several studies demonstrate microbiome differences 3:52 between depressed persons and non-depressed persons. 3:55 And after all, an imbalance in neurotransmitters is implicated 3:59 in the cause of depression, 4:01 and the gut microbiome is known to synthesize large quantities 4:04 of these same neuroactive substances, like serotonin and dopamine.
Depression, Bipolar Disorder, and Stool Transplants 4:09 And there's a major information highway from the gut to the brain 4:11 called the vagus nerve that could potentially alter mood states. 4:15 Early fecal transplants were delivered from the bottom up, 4:19 through colonoscopy, but now 4:20 we have crapsules -- encapsulated feces to make it easier to swap stool. 4:28 Here's a case report of a 79-year-old woman who suffered a tragedy 4:31 and subsequently lost her appetite, became introverted, drowsy, 4:35 and stayed in bed all day, 4:37 wasting away 55 pounds over the next six months. 4:40 She was hospitalized for depression and prescribed 4:42 multiple anti-depressant drugs, but to no avail. 4:46 So, what the heck, they stopped the drugs and tried a fecal transplant. 4:51 The stool donor was her own 6-year-old great-grandson, 4:55 who had a good appetite, an outgoing personality, 4:57 and a disciplinary stool -- I don't even know what that means. 5:04 Four days after the fecal transplant, she started feeling better, 5:07 and by two weeks she was frankly euphoric. 5:10 She was able to go back home, 5:11 and within six weeks all was back to normal. 5:16 What about a fecal transplant for bipolar disorder? 5:20 The poor woman was in and out of psych hospitals with manic depression 5:23 until she got a fecal transplant with stool from her husband -- 5:27 that 's romantic -- 5:28 and within six months she was symptom free. 5:32 This case report was published in 2020, so symptom free for years, 5:36 no longer on medication, and has lost more than 70 pounds to boot, 5:40 either because she got slim hubby stool or just being off her psych meds. 5:46 She went from being functionally disabled 5:48 to running a small business and has published two books. 5:52 What about alcohol dependence? Alcoholism has traditionally 5:56 been considered exclusively a brain disorder, but, hey, 5:59 all these other psychiatric syndromes seem to have links to the gut. 6:03 So they compared the guts of alcoholics to nonalcoholics, 6:05 and they found that some alcohol-dependent subjects 6:08 developed gut leakiness, 6:10 which was associated with higher alcohol craving. 6:13 Okay, but maybe instead of the gut issues somehow 6:16 leading to alcohol cravings, the alcohol led to the gut issues. 6:20 Alcohol may have a toxic effect on the gut wall, but both groups 6:23 were consuming the same amount of alcohol at the time, 6:26 so maybe there is some kind of gut connection after all. 6:30 This was the study that blew people's minds.
Alcohol Use Disorder and Fecal Microbiota Transplant 6:34 The transplant of feces from alcoholics 6:36 into mice induced an alcohol preference. 6:40 These were mice without any previous contact with alcohol, 6:43 all of a sudden spontaneously preferring alcohol. 6:46 Normally mice don't really like alcohol, 6:48 but feed them some feces from an alcoholic human, 6:52 and they do a 180-degree switch. 6:56 So wait. Are you saying that gut bugs can determine alcohol craving? 7:00 There's only one way to find out, and that's put it to the test. 7:05 A randomized, double-blind, clinical trial of fecal microbiota transplant 7:10 for alcohol use disorder, 7:12 which is the current clinical term for alcoholism. 7:15 They took alcoholics with liver cirrhosis 7:17 and active problem drinking and randomized them 7:19 to get either a placebo enema or a fecal transplant enema. 7:24 And within two weeks, alcohol cravings reduced significantly 7:29 in 90% of the fecal transplant cases 7:31 versus just 30% in placebo cases. 7:34 And this was validated by pee tests showing that they were drinking 7:38 significantly less too, 7:39 with improved cognition and psychosocial quality of life. 7:44 Now this is all still just experimental, 7:47 and not without potential downsides. 7:48 Yes, they're working on ways to make stool transplants more palatable. 7:53 On balance, they've largely been found to be safe, 7:59 though there have been cases of bad bugs being transferred 8:01 from donors, even a fatal case. 8:05 And there's even a theoretical risk you could be transplanted 8:09 with cancer cells, making it 8:11 the gift that keeps on giving, but in a bad way.
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