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Episode 1: What’s the Microbiome?

In this three part series, we set the stage for the show with microbiome researcher, Dr. Mahmoud Ghannoum. In this first episode, we define the microbiome and get everyone on the same page before moving on to topic number two: fungus.

There was a time not too long ago when everyone was scared of germs. When scientists discovered bacteria, it set the world ablaze with news about how the microorganisms living in and on us caused disease – and therefore needed to be eradicated at all costs.

Today, we know that’s not true. Microorganisms like bacteria and fungi aren’t always friends, but they’re also commonly not foes either. In fact, researchers like today’s guest, Dr. Mahmoud Ghannoum, have identified thousands of gut organisms that live together and cooperate in ways both good and bad.

The average person could have anywhere from 300-400 species in our digestive tract at any given time, helping us to deal with stress, to act more courageously, or simply, to digest our food.

In this episode, we get very clear on exactly what the microbiome is, where different microbiomes are located around the body, and the exciting horizon of research as this field continues to expand.

If you’ve ever wondered what the microbiome is or what it does, this episode will bring it all into focus and offer some surprising tidbits on how using things like mouthwash could be disastrously squashing your buggy buddies.  

Episode 1 The Microbiome Report by BIOHM Health

Released Dec 6th 2018

In part 1 of our three part series, leading researcher Dr. Mahmoud Ghannoum sets the stage for future microbiome discussions on the show. In this first episode, Dr. Ghannoum explains what the microbiome is, where it’s located, and why it’s so critical to our existence.   

Here’s what you’ll learn in part 1:

What is the Microbiome? [2:00]

Impacts of Antibiotics [8:08]

The exciting future of personalized medicine [15:31]

What came first? Balance or disease? [21:23]

What are PREbiotics? [23:21]

The microbiome. It dictates so much of how we move through the world – from how we digest our food to the mates we choose as we spin around the globe. On this show, we’re investigating how the things we do everyday impacts the bugs of our bodies.

The Microbiome Report is powered by BIOHM Health.

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Full Transcript Below

Welcome to the microbiome report, powered by [inaudible]. I’m your host Andrea Wien, and to kick off the show, we’re starting with a three part series on the basics of the microbiome. In episode one, we’ll dive into what the microbiome is, where it exists around the body, and why it’s important to study. In episode two, we’ll talk about fun. Yes, including specific fungi you may have heard about, such as penicillin and Candida, and an episode three. We’re breaking down info on biofilms and digestive plaque. If you haven’t heard of these things, don’t worry, you’re not alone. My resident expert, Dr mcnutt will be joining me in the studio for this three part series. Dr Cunningham is a professor and the director of the center for Medical Mycology at Case Western Reserve University and university hospitals, Cleveland Medical Center. Dr Graham has spent his entire 40 year career studying fungi. His research has been cited over 19,000 times and he was the first researcher to coin the term microbiome for the fungal colonies that coexists with bacteria around the body. Now, without further ado, let’s jump right in. Dr Graham, thank you so much for coming on the show. Thank you so much.

Speaker 2: 01:19 So in preparation for this show, I asked a bunch of people on facebook and different groups that I’m in about what their questions were about the microbiome and I was shocked because quite a few people said what’s the microbiome they didn’t even know. And I think coming from this field where we’re so entrenched in medicine and science and being on the cutting edge, it’s easy to forget that a lot of the mainstream doesn’t know what the microbiome is. So tell me a little bit about what it is.

Speaker 3: 01:46 Well, first I’m not surprised that some people are not aware of the microbiome in spite of the fact that we have the media. The news these days talk a lot about the microbiome, but anyway, to make a more approachable to people so that they understand what the microbiome they refer. When we talk about microbiome, we are referring to organisms or organisms that live in our body. For example, we all know if you have bacteria as well as fungus in our hats. So that’s all the time we think about it. Oh, there are germs on our hands, but in fact, now recent studies starting to show that these microorganisms, not only in our hands also they exist in our gut. They are in our head, they are in our mouth all over our body. We have these organisms. What’s interesting about the recent studies is that we always are afraid, or at least we used to be afraid of germs, but now what we are learning with the new technologies that are available is that we also have some good organisms that are beneficial bacteria, beneficial fungi that live in our body.

Speaker 2: 02:58 But I think interesting thing

Speaker 3: 03:00 to think about is that there’s not good and bad bacteria. It’s all about the balance between the bacteria and the fungi and everything that’s going on. So candia for example, it’s quite normal to have some level of Candida in your system, but if it overpowers and becomes too much, that’s when the problems come. So talk a little bit about why it’s dangerous to classify things as good or bad. It’s not. It’s like a few takes. If you take a little bit soul, this is good, but if you have a huge amount, any chemical could be bad. It’s the same picture. You can paint with micro organisms, like for example Canada, we did this study. There are about at least 70 percent of the people have candida in their mouth and in their gut, but they have it as a very low level. In other words, they are there. They are happy campers. They’re getting their food from our whatever, whatever side they are present, whether it’s our skin or in the mouth or the gut. The problem becomes an issue is when somebody take, let’s say an antibiotic, if you take an antibiotic, what happens? You are killing the bacteria which keeps Candida under control and this leads to an overgrowth or an increase in number of Canada. Once you have this increase in number, then we start having issues.

Speaker 2: 04:19 We’re going to do a whole episode I know on Candido because it’s such a hot topic right now, but to take a step back, what are some of the major players when we’re talking about bacteria? What are the. What are the ones that are colonizing the god that we see most often in the gut and in the mouth and in any other of the microbiomes of Christ? The body?

Speaker 3: 04:37 Well, again, the recent studies are starting to show that there is a large number of organisms in our body, in the gut, for example, there are thousands of organisms, bacteria of these. When you look at the classification, there are a lot of them which are good and what I mean by going to your absolutely right, like if they increase in number, they could cause a problem, but in general these good bacteria, they help us with our digestion, food digestions and other things, but when we look at what is there that is a wide number, like it could be the good bacteria as I mentioned, like bifidobacterium, lactobacillus, you have other organisms which are really faecalibacterium for example. These are good organisms. For example, faecalibacterium, as I mentioned, it has anti inflammatory activity which champs us. So when you look at our God, in addition to these, some of the organism which we mentioned, we all have other bacteria, which even though if they are present, as you mentioned before, in low numbers they don’t cause trouble, but when they increase in numbers such as equal life, for example, then they become an issue. So in general you have about maybe 300, four, 100 different strains or species in our gut. They live together and they cooperate in good and bad ways.

Speaker 2: 05:59 So I think a lot of people recognize lactobacillus because we see it on yogurt. It’s in a lot of food products that people may have picked up along the way. But when we look at the gut reports coming back at biome, we don’t see a lot of lactobacillus in there. So how is that possible that that one strain that seemingly is everywhere is not in our gut?

Speaker 3: 06:18 The issue is with respect to when you were trying to see what. What is the level of Lactobacillus is? We look at the stools and in the stool, sometimes it shows that there is low abundance of lactobacillus. However, lactobacillus also has ability to adhere or stick to the lining of the gut and that’s why sometimes these, we don’t see it much because it is stuck to the gut lining and when in the stool we don’t see it as much. So this really what that tells you why sometimes you think you don’t have any, but there are as long as there is enough levels where it tells you there is something, some lectures I said less than you are fine.

Speaker 2: 06:58 Okay. And then could the same thing be for a pathogenic strain? That those are also stuck to the gut. And so maybe in a soil sample you wouldn’t see that as much.

Speaker 3: 07:06 Uh, definitely the same could be applied to the pathogenic organisms. And again, we can talk about Canada since it’s my favorite organism. It has a high ability to stick or adhere to tissues. But the problem when you have pathogenic organism and the number is very high, as you say overgrowth. Then in addition to what sticking to the guns, we have enough in the stool that tell us there is a problem.

Speaker 2: 07:33 Why is candy to your favorite?

Speaker 3: 07:35 When I started the study in Canada over 40 years ago and uh, I spent all my lifestyle in Canada, so I love it if you can say you love it.

Speaker 2: 07:46 Do you think that it has a personality if you had to give it a personality?

Speaker 3: 07:49 Oh, definitely. It’s a fun guy just like you. That’s a lot of the time when I give talks, people telling me, Oh, you know, you seem to be happy when you are talking about a fungus. I say, yeah, of course I make my living out of fungus. And they are fun as well.

Speaker 2: 08:08 So you mentioned antibiotics. That’s something that can throw off this balance. You’ve also done some research on things like artificial sweeteners. Can you talk a little bit about how what we’re eating affects what’s going on in our gut?

Speaker 3: 08:20 This is really very important question because again, based on the recent studies, definitely our diet influenced what micro organisms we find or what the Microbiota exist in our gut. For example, if you have too much sugar, you have some organisms love that and they start to increase in number if you like five-year-olds. Exactly. They don’t know when to stop, know, and, and of course the more you give them, the happier they are. That’s why we need to balance what we eat and watch what eat. It’s like, what do we say, Eh, you are what you eat and you have other, for example, organisms, they liked to have fibroids and if you don’t eat fibers in your diet, guess what? The increase in number and that’s why we may start to see some imbalance in there. So that’s a really critical for us now with all this new information to know what we eat and how if we have imbalance, what we need to do to bring it back and maintain it.

Speaker 2: 09:24 Is there a big difference in the type of microbiome someone would need if they were living here in North America and maybe even in different parts of North America at Colorado versus Cleveland versus Miami and then someone who might be living in Africa and living a completely different lifestyle and different foods stuff?

Speaker 3: 09:40 Oh, certainly. I mean, one of the studies that I wanted to do, ones to look at the Microbiota in HIV infected patients and I wanted to do the study use controls in the U, s and in Africa and one of the main issues that came is that it depends on the diet, your diet, which as you know, what people eat in Africa or even what people eat in Texas versus what they eat in Denver. It could be completely different now. One interesting study looked at people who eat European or western style diet and they took a village in Africa and tried to compare what is their Microbiota a Lo and behold, the people living in Africa because they type of food, they eat, you know, that is an all natural. They don’t eat too much meat and this sort of thing. Their microbiota reflected our ancestors. Where as for us here we see different types of organisms or different type of Microbiota, which again, it’s we are feeding them with what we eat and that’s why we have differences. How

Speaker 2: 10:48 tied to our microbiome, and this might be a big jump. I don’t know if the science is there yet, is causing so much of our sickness.

Speaker 3: 10:57 You are absolutely right. We are really living in unexciting time. As far as the microbiome is concerned, we are starting to see a lot of studies published in good studies, in peer review journals where it’s linking different types of diseases with the microbiome. So are we finished yet? I don’t think so. I think within the coming five to 10 years we are going to gain a lot of information and this information is gonna allow us to manage our health differently and not only this ib because of the knowledge that we are accumulating in the microbiome, we may start changing the way we manage our heads and we may follow, for example, preventative measure instead of waiting to get sick to be treated. So I think it’s a wealth of information. Are we there yet? Not yet, but I tell you it’s very exciting and promising.

Speaker 2: 11:51 Yeah, and I think that’s why we want to do this show because there’s so much research coming out every day and so much of it is maybe misreported in the media or overblown and what we’re able to do right now and what we really know about that’s going on in our microbiomes, so I think this show specifically is looking at who’s doing the research and how can we start to implement it in our lives, but it’s trial and error process. Not No one knows a completely how we’re going to be able to balance exactly the microbiome for optimal health.

Speaker 3: 12:23 I agree with you, but the good, again, good news from my point of view is that there is extensive literature and the studies being done and this is starting to help us to rebalance, but we really still need more and more in that direction and we need good studies. We need. You need a good controlled studies. You need to make sure you have. Let’s say if we want to look at a certain disease, how the Microbiota affected you will need to have the disease group and have a good control so that you can compare this and then based on this knowledge and based on their data, it can start to tell you how to really adjust this microbiota toward the best.

Speaker 2: 13:05 You’ve been doing this research for 40 years and I can imagine now that the microbiome has become a hot topic, that more and more researchers are starting to get involved. Where do you still see holes that you would love to be able to see a scientist working on?

Speaker 3: 13:19 I think in my life doing this 40 years, I always find the new ways of like I go to meetings and I think, oh, you know, this is very interesting. So this is where we should go. For example, I can tell you, uh, we, I went to a meeting about 15 years ago and people are talking about the microbiome and they only talking about the bacteria and then I said, but our body has a lot of fungus and that’s why we should look at it. So now we have not just my group, also other groups starting to look and seeing, you know what there is now we have communities of organisms, bacteria, fungus, viruses, as well as parasites. But the question is where do we see this field going? I think we are starting to gain a lot of knowledge about how these organisms work together.

Speaker 3: 14:13 So we spent time at the beginning to know what is there now. We started to know that they will play together, so we need to start the understanding what are the mechanisms that allow them to help each other or inhibit each other. So this is an exciting area. It’s what we call it, poly microbial, which means more than one organism playing together. That’s one area. The other area which I think is going to be very hot and it’s starting to look at it, is these organisms and they are working together whether towards the good or the bad. They secrete these and these metabolites are small chemicals which could affect your buddy. They go into the blood and they start affecting other parts of your body. So this is where another area, now, in addition to this, we really need to harness the knowledge that we have so that we can come out with ways to control the microbiome.

Speaker 3: 15:13 In other words, to maintain it in balanced chip. And this could be from finding probiotics which directed towards a specific organisms in your gut. You need also sometimes maybe new therapeutic approaches, new drugs to maintain this balance. Okay. One thing which I think is going to be excited and a lot of people hear about it these days is about personalized medicine. From my point of view, this is very hot area. We need not only personalized medicine, also we need a personalized nutrition because by what we eat, what it is diet as well as nutritional supplements including vitamins, probiotics, prebiotics is gonna. Allow us to balance back God or Microbiota in our gut. And I think that’s where the excitement is going to be.

Speaker 2: 16:03 He’s very exciting and something I say to my clients all the time, there’s 7 billion people on planet earth and there’s 7 billion different diets that work best for all of us. So I think too, there’s something called psychobiotics that are starting to come out and it’s really how our Microbiota is affecting our mood and that’s something that’s so interesting to me. Learning about how these other organisms can really start to control what’s going on in the mechanisms of our body is so exciting.

Speaker 3: 16:30 I really agree with you. I was in a meeting at, it’s called the American Society for microbiology and one presentation was looking at how the microbiota affect our behavior and it’s amazing how certain micro micro organisms such as bifidobacterium was able by feeding mice, bifidobacterium, it affected their mood. It made them more courageous. It made them less really risk averse. It’s fascinating in this area. I agree with you. This is going to be the cycle. Biotech is going to be bloody exciting area which will allow us to control our mood or stress and otherwise.

Speaker 2: 17:09 So many people have heard of the gut microbiome. They’re familiar with it, they’ve eaten yogurt, they drinking Kombucha, perhaps these things that are very mainstream, but not many people think about the skin microbiome of the mouth, the vagina. Even. So when we’re thinking about how to keep balance in those areas, what are your, what are your thoughts on different microbiomes that are outside of the gut?

Speaker 3: 17:32 When I started working with the microbiome, the first site in our buddy was the oral cavity. So I wanted to see, uh, what is the Microbiota that live in healthy mouth.

Speaker 2: 17:45 It’s a little bit easier to get in there. Yeah,

Speaker 3: 17:46 exactly. Stomach. It’s very easy to collect samples and that’s what really one of the advantages when we started and what we, what we found that in addition to understanding what is enhanced, we looked at HIV infected patients and we found that there is disturbance in the balance. So, and we found reading some organisms that can bring this better. It’s the same way, for example, for people with dental issues, periodontitis or carries and what that bad studies are starting to show that there is imbalance in the oral microbiota. So this is very important to address and people are starting to look at that as well. Now with respect to the vagina, clearly the microbiome plays an important role in this, in health, a women’s health. And this sort of thing. So now people are starting to understand and for long time, for example, what is the imbalance that goes, for example, the thrush and they’re finding that there is, for example, your favorite organism.

Speaker 3: 18:49 Lactobacillus is really less and that’s why some people, the developer thrush due to the fungi and why? Because you have imbalance in the Microbiota. We have less and less and when you have less back to us, unless you have this other organs that we grow and cause trouble. Also we have, you know, the hormones in our body. It could affect also the balance of this organization and in college some of them to grow. So understanding the micro biota both in the oral, the vagina as well as the skin is very important. So I just forgot to talk about the skin because the skin. I’m in, department of Dermatology and we have a lot of interest in understanding what the Microbiota and why. We just published a paper about the gut skin brain connection. It seems there is a relation between the organisms in our gut which could affect our mood, our way we behave as well as what skin live in our skin. For example, what, sorry, what organisms live in our skin. Particularly we are focusing on psoriasis, people with atopic dermatitis, and we are starting to see that not only bacteria has changed. Also fungus is changed and now people are attempting to have a new research to identify how can we rebalance the skin Microbiota as well.

Speaker 2: 20:18 So is that to say then that there’s a connection. If your skin Microbiota is unhealthy, would it be possible to even have healthy mouth and gut microbiomes or is it they’re either all in balance or they’re all out of balance?

Speaker 3: 20:33 This is a very complex question, but I can tell you at least there are studies to show when you have gut imbalance that is concordance with respect to the balance of the Microbiota in the mouth. It data reflect each other because remember when we eat the food or whatever it goes from our mouth count go down into our gut. So there is some connection sometimes if you have imbalance in your mouth, it could be an indicator that you have imbalance in the gut as well. I don’t think a lot of people who studied at the mouth got and the skin so, but I’m sure there are because of the gut skin brain connection or access as we call it. Definitely a change in the gut microbiota will also influence the skin microbiota. But we need more studies in this area.

Speaker 2: 21:23 So you mentioned your HIV patients that you were studying, their microbiomes of their mouth were imbalanced. What came first? The imbalance or the disease?

Speaker 3: 21:35 Honestly, you are difficult. You give a difficult questions because we really don’t know these are these onsets. I think that we don’t know is it? It’s a chicken and egg situation, but at least from my research, if we have an immunity defect or you are immunocompromised compromised in one way or another such as HIV infected patients, you have problem with their immunity. So I want about the is very efficient in controlling germs when we have good immunity. So when you have a deficient immunity, then these organisms, there is nothing to control them. So to me, I would say if you have deficiency in your immunity comes first and then that will lead to the imbalance as well because then there is nothing to control these organisms down.

Speaker 2: 22:24 That makes sense. Okay, great. I was reading the other day about Gut microbiome, I’m sorry, the mouth microbiome and its relation to vasoconstriction and when we eat certain nitrates foods are turned into nitrite and nitric oxide in the blood and so it can actually reduce blood pressure, but if people are using things like mouth washes or maybe chewing tobacco and they’re altering their microbiome of their mouth, perhaps that could have some effect on their internal structure as well.

Speaker 3: 22:55 Definitely. This is again, takes us back to the idea of the metabolites. You know when you have these nights ago and the nitric oxide and this sort of thing. This is good. That’s where we need to start looking at the metabolites because absolutely if we interfere with this balance, we are effecting these metabolites or these little chemicals which could go through the blood and cause issues somewhere else.

Speaker 2: 23:19 Before we end the show, I want to talk just briefly about prebiotics because that’s an area that most people don’t really know much about. They’re starting to hear more about the importance of prebiotics. What are they?

Speaker 3: 23:30 Prebiotics. Unlike probiotics, which are really probiotics are live organisms or which, as we mentioned, lactobacillus for example, the prebiotics are basically fibers. Okay. They are certain fibers which, uh, we can eat and the fibers are important. Why? Because they feed the good bacteria in our gut, which start to help the breakdown of our food to keep the bad bugs, uh, under control. So it’s a type of fibers. Bay Bay basically, which, and also there are different prebiotics and some of them, for example, the men have been shown to be very good prebiotic. So some of them are polysaccharides and,

Speaker 2: 24:20 and I would assume different ones feed different probiotics. So it really is all about if you already have an overabundance of one thing, you might not want to eat that prebiotic that could feed that.

Speaker 3: 24:29 Sure, sure. And that’s why really when you do the report or you understand what is in your on your gut micro organism, do you know where there is balanced or imbalanced and then based on this you are able to use the right five buyer, the right probiotic on the right diet to bring it back into balance and that’s what,

Speaker 2: 24:51 and at least in that area the science is clear for the most part on which bacteria are fed by which things maybe more plant matter, maybe animal fats, etc. So it’s a little bit clearer in that regard of what we’re eating and how that can affect the individual bacteria. Correct?

Speaker 3: 25:08 Correct. We are really getting there to get in there. There are a lot of publiShed work now where it shows if you have imbalanced in certain organisms, like for example, if you have imbalance in bacteria, having prebiotic in particular is very good or fiber. Okay. Also having in vitamin d three, would it be also very good is so yes. Once you know what organisms in your gut, you will be able to select what type of food you need to eat, what type of fibers of prebiotic, probiotic and vitamins to take so that you really restore and maintain your balance.

Speaker 2: 25:45 Dr donna, this has been great. Thank you so much for coming on to set the stage of the microbiome discussion and we look forward to talking to you more about fungi and biofilms and everything else that you’ve been researching. Thank you so much. Thank you very much.

Speaker 1: 26:01 Thanks so much for listening to the show. If you enjoyed what you heard, don’t forget to tune back in next week for episode two of the microbiome report. Until next time, I’m your host, andrea.