Bread and the microbiome: a personal matter

Reference T. Korem, D. Zeevi, N. Zmora et al. Bread influences clinical parameters and induces intestinal microbiom-associated personal glycemic reactions. Cell metabolism. 2017; 25 (6): 1243-1253. Draft randomized crossover study participants twenty healthy participants, 9 men and 11 women between the ages of 18 and 70. Study parameters rated the participants in 2 groups. A group consumed industrially manufactured white bread with sourdough saccharomyces cerevisiae (baker's yeast), the other traditionally ground whole grain-sauer dough bread (the study did not indicate which organisms contained the sourdough). The participants of each group consumed bread every morning in a lot of 50 g of available carbohydrates, plus additional consumption of this type of bread ...

20. Oktober 2022

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reference

t. Korem, D. Zeevi, N. Zmora et al. Bread influences clinical parameters and induces intestinal microbiom-associated personal glycemic reactions. cell metabolism . 2017; 25 (6): 1243-1253.

draft

randomized crossover study

participant

Twenty healthy participants, 9 men and 11 women between the ages of 18 and 70.

study parameters evaluated

The participants were randomized in 2 groups. A group consumed industrially manufactured white bread with sourdough saccharomyces cerevisiae (baker's yeast), the other traditionally ground whole grain-sauer dough bread (the study did not indicate which organisms the sourdough contained). The participants of each group consumed bread every morning in a lot of 50 g of available carbohydrates, plus additional consumption of this type of bread as you wish during the day. The participants were instructed not to take other wheat products during this time. After a two -week laundry phase, the groups changed for another week.

primary result measurements

glucose metabolism (quantified by oral glucose tolerance test) and wax glucose level; The secondary result parameters included blood chemistry, thyroid stimulating hormone (TSH), lipid and blood pressure. The chair was collected on days 1, 6, 20 and 27 and analyzed on the occurrence of microbial species.

important knowledge

In the primary target parameters, no significant difference between the consumption of conventional white bread and wholemeal dough bread was found overall. In fact, a large interpersonal variability in the postprandial glucose friction (PPGR) was found on the two types of bread - 10 participants had a lower glycemic reaction to white bread and 10 had a lower reaction to sourdough.

practice implications

Although the sample size and duration are low, this study is fascinating because it examines the relationship between the composition of the microbiome and the glycemic reaction. While overall there was no significant difference in the glycemic reaction to the white bread compared to the wholemeal dough bread, there were interpersonal differences. Some people consistently had a higher glycemic reaction to white, some on sourdough. When the composition of the chair flora was analyzed, the microbioma of each individual was predictive for its glycemic reaction. In addition, the microbioma remained relatively constant during the entire test period, regardless of the type of bread the person ate.

Earlier studies have shown that several factors influence PPGR for bread products. For example, damping bread instead of baking it, for example, lowers its glycemic index. The structure of the bread itself can also influence the glycemic reaction: A study showed that compact products such as flatbread and noodles showed a lower pattern glucose and insulin reaction compared to bread. ^{1 For a long time, the porosity and thus the glycemic index. Features and grains such as inulin, oat fibers and rye flour to traditional wheat bread can also reduce the glycemic reaction. ^{3-5 The data about whether sourdough reduces the glycemic reaction compared to yeast bread are mixed. While all of this is very useful information for the advice of patients, how they can eat healthy to support a healthy blood sugar level, this study opens up the opportunity to bring our advice one step further into the field of individualization.}}

This new understanding of the microbiome offers doctors the opportunity to use data from stool samples from patients to individualize their nutritional and nutritional supplement.

The connection between the intestinal microbiota and blood sugar regulation, including the metabolic syndrome and type 2 diabetes, has become increasingly clear in recent years. The presence of certain bacteria in the intestine seems to be associated with increased inflammation, obesity and insulin resistance, while others are associated with reduced inflammation and a reduced metabolic balance.

An article from 2015 in diabetology Notes: " lactobacilli species, on the other hand, correlate positively with soberly glucose and glycosylated hemoglobin (HBA1C) levels Clostridium species correlate negatively with soberglukose, hba1c- Insulin mirrors. (Phylum bacteroides) and bacterium Lachnospiraceae 3_1_46faa (class Clostridien). In a rat study Lachnospiraceae it was also found that they contribute to the outbreak of type 2 diabetes.

This new understanding of the microbiome offers doctors the opportunity to use data from stool samples from patients to individualize their nutrition and nutritional supplement plan. Unfortunately, however, only a few of us are currently able to maintain complete microbioma studies with relative frequency, and the tools for interpreting this data in a clinically relevant manner are not yet available in a large scale. On the other hand, the blood sugar control is not only predicted by the presence or lack of certain species - it is related to the composition of the microbiome as a whole. A reduced genetic diversity in the microbiota and a general decrease in butyrat-producing bacteria are also associated with an increased occurrence of metabolic disorders. ^{7:10 Against this background it is a less discouraging task to help people understand how they can eat in their environment and live in a way that increases the exposure to many different microorganisms Relevant, which hopes to improve his glucose tolerance.}

We are not yet able to customize our nutritional plans on people's microbioma, but we have good tools to increase its genetic diversity. While the intestinal flora remained largely the same for every person during this study, other studies have naturally shown dietary changes that promote the growth of different types of bacteria. It has been shown that prebiotics reduce postprandial and sober glucose and improve insulin sensitivity. ^{10 For example, it was found that melanoidins, the product of the Maillard reaction, occurs when strength and protein are baked and the tanned components of the bread crusts, reduces, which promotes, which promotes inflammation, and increase bifidobacteria, which can improve glucose tolerance. ^{11-13 It has also been shown that inulin and other polysaccharides such as fructotoligosaccharides increase the production of bifidobacteria.}}

The other good news is that a general dietary supplement with commercially available probiotic formulations and fermented foods can also positively influence blood sugar. Meta-analyzes of studies on people with type 2 diabetes and metabolic syndrome have shown that patients who were supplemented with probiotics (not in more detail) had both a lower sober blood sugar and a lower HBA value. Insulin sensitivity increases and reduced inflammation. Interestingly, a meta -analysis showed that the effects of fermented dairy products were greater than with stems capsized, which indicates that the greater variety of bacteria in food sources are preferred. ^{18.11 This supports the idea that a greater variety is better for blood sugar control. In order to go further with this idea, several studies have proposed chair transplantation as another practical therapy for diabetes.}

While the primary measurements of this study showed no significant overall difference in the glycemic reaction to the various types of bread, the data from the microbiome of each person was used to predict the individual reaction. This gives us a new factor that we have to take into account when we help patients control their blood sugar. If we look at the balance and diversity of the intestinal flora, we can continue to individualize the treatment to help patients improve and maintain metabolic health.

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