Evidence for the health benefits of consuming more live microbes

New study shows lower weight and better overall health in those who consume more live microorganisms daily
New study shows lower weight and better overall health in those who consume more live microorganisms daily

Safe live microorganisms are found in a variety of foods we eat every day, from yogurt and other fermented foods, to raw fruits and vegetables. Despite the widespread idea that these mixtures of live microbes contribute to health, convincing evidence linking live dietary microbes to health benefits has been lacking.

new study provides some of the first real-world evidence that higher consumption of live microbes may promote health. A group of scientists led by the International Scientific Association for Probiotics and Prebiotics (ISAPP) classified over 9,000 individual foods listed in the US National Health and Nutrition Examination Survey (NHANES) into three categories based on their abundance of live microbes, and then used NHANES participants’ reported food intake to quantify the food they ate that contained medium or high levels of microbes. Then they determined how these intakes correlated with various markers of health such as blood pressure and weight.

The scientists found that increased consumption of live microbes in the diet was linked with multiple measurements of better health: more favorable blood pressure, better blood glucose and insulin, lower inflammation, as well as lower waist circumference and body mass index. This established that those who consumed higher quantities of live dietary microbes showed tangible, if modest, health benefits.

While the scientific approach did not allow researchers to conclude that the live dietary microorganisms directly caused the health benefits, the results are consistent with plausible arguments that dietary exposure to live microorganisms in general could benefit health by increasing the diversity of microbes in the gut or by supporting immune function. In the past century, a reduction in the amount of fermented foods in the diet and increased consumption of processed foods has led to a dramatic reduction in the number of microbes most people consume on a daily basis. This trend may be reversing, however, since the dietary data used in the study showed that US adults have gradually increased their live microbe consumption over the 18-year study period. This may bode well for the health of the population.

This study built on two previous published papers, here and here, which conducted the preliminary work necessary to make this assessment of live dietary microbes and health.

”Although the dose-response associations we found were relatively modest, it was notable that these estimated benefits applied to several plausible and important health outcomes and were robust to adjustment for available confounders, including body mass index,” says co-lead author Prof. Dan Tancredi, PhD, of University of California – Davis. “More research that extends these findings to other populations and research that uses study designs that permit stronger causal claims is needed, especially given the potential benefits that might be available by simply substituting into the diet more foods that have safe live microbes.”

ISAPP Executive Science Officer Mary Ellen Sanders, PhD, points out the research focused not just on probiotics, but on all microbes in foods, including environmental microbes associated with raw fruits and vegetables as well as lactic acid bacteria associated with fermented foods. Thus, the study differs from probiotic research, which focuses on microbes defined to the strain level, specific dose and proven health benefits.

Co-first author Prof. Colin Hill, PhD, of University College Cork, Ireland, says it’s possible that dietary advice of the future could include a recommendation for the daily consumption of high levels of live dietary microbes. “Those foods with high levels of microbes (fermented foods, raw vegetables and fruits) are all nutritionally valuable parts of a healthy and diverse diet,” he says. “Secondly, these same foods could be providing an additional, hitherto unrecognised, health benefit due to live microbes themselves that enter the gut and interact with the host microbiome, immune system and even the enteric nervous system”.

Dim lights before bedtime to reduce risk of gestational diabetes

Pregnant women who had greater light exposure three hours before sleep were more likely to develop gestational diabetes
Pregnant women who had greater light exposure three hours before sleep were more likely to develop gestational diabetes

  • Gestational diabetes mellitus is a common pregnancy complication with significant health risks for both mother and offspring
  • Gestational diabetes is rising fast and is now 7.8% of all births in U.S.
  • Mother with gestational diabetes has increased risk of diabetes, heart disease and dementia; offspring more likely to have obesity and hypertensio

CHICAGO — Pregnant persons should dim the lights in their home and turn off or at least dim their screens (computer monitors and smartphones) a few hours before bedtime to reduce the risk of gestational diabetes mellitus, a new Northwestern Medicine study shows.

Women who developed gestational diabetes mellitus in the multi-site study had greater light exposure in the three hours before sleep onset. They did not differ in their light exposure during daytime or sleep or in their activity levels compared to those who did not develop it. 

“Our study suggests that light exposure before bedtime may be an under-recognized yet easily modifiable risk factor of gestational diabetes,” said lead study author Dr. Minjee Kim, assistant professor of neurology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine neurologist. 

Growing evidence suggests exposure to light at night before bedtime may be linked to impaired glucose regulation in non-pregnant adults. However, little is known about the effect of evening light exposure during pregnancy on the risk of developing gestational diabetes, a common pregnancy complication with significant health implications for both mother and offspring. 

This is believed to be one of the first multi-site studies to examine light exposure before sleep on the risk of developing gestational diabetes. 

The study will be published March 10 in the American Journal of Obstetrics and Gynecology Maternal Fetal Medicine. 

Gestational diabetes rise is ‘alarming’ 

Gestational diabetes is on the rise in the U.S. and globally. About 4.5% of first-time pregnant women with a baby born between 2011 and 2013 developed gestational diabetes, which has been increasing on average 3.4% per three-year period until 2019. In 2020, the rate of gestational diabetes was 7.8% of all births in the U.S.  

“It’s alarming,” Kim said. “Gestational diabetes is known to increase obstetric complications, and the mother’s risk of diabetes, heart disease and dementia. The offspring also are more likely to have obesity and hypertension as they grow up.” 

Data show that women who have gestational diabetes are nearly 10 times more likely to develop type 2 diabetes mellitus compared to those do not have glucose issues during pregnancy, Kim said. 

Bright light exposure prior to sleep can come from bright lights in your home and from devices like TVs, computers and smartphones.

 “We don’t think about the potential harm of keeping the environment bright from the moment we wake up until we go to bed,” Kim said. “But it should be pretty dim for several hours before we go to bed. We probably don’t need that much light for whatever we do routinely in the evening.”

Scientists don’t know which source of bright light causes the problem, but it might all add up, Kim said. 

“Try to reduce whatever light is in your environment in those three hours before you go to bed,” Kim said. “It’s best not to use your computer or phone during this period. But if you have to use them, keep the screens as dim as possible,” Kim said, suggesting people use the night light option and turn off the blue light. 

If pregnant persons develop gestational diabetes with the first pregnancy, they are more likely to have it with the next pregnancy. 

Pre-sleep light exposure increases heart rate and may lead to abdominal obesity, insulin resistance, increased blood pressure

Pre-sleep light exposure may affect glucose metabolism through sympathetic overactivity, meaning the heart rate goes up before bed when it should go down. “It seems there is inappropriate activation of the fight or flight response when it is time to rest,” Kim said. 

Data shows the sympathetic overactivity may lead to cardiometabolic disease, which is a cluster of conditions including abdominal obesity, insulin resistance, increased blood pressure and an imbalance of lipids, all leading to cardiovascular disease. 

The study of 741 women in their second trimester was conducted at eight clinical U.S. sites between 2011 and 2013. The participants’ light exposure was measured by an actigraph worn on their wrists. The women were measured during the second trimester of pregnancy, the time when they receive routine screening for gestational diabetes.

After adjusting separately for age, BMI, race/ethnicity, education, commercial insurance, employment schedule, season, sleep duration, sleep midpoint, sleep regularity index, and daytime light exposure, pre-sleep light exposure remained significantly associated with gestational diabetes.

The growing rate of gestational diabetes has been partially attributed to increasing body mass index and the older age of pregnant persons. 

“But even after adjusting for BMI and age, gestational diabetes is still rising,” Kim said. “We have a lot to prove, but my personal worry is that light may be silently contributing to this problem without most people realizing the potential harm.”

Losing body weight and exercising also reduce the risk of developing gestational diabetes, which are important but take some effort.

Turning down lights is an easy modification

“Turning down the lights is an easy modification you can make,” Kim said. 

“Now I’m the light police at home,” Kim said. “I see all this light I never thought about before. I try to dim the light as much as possible. Just for evening activities such as dinner and bathing the kids, you don’t need bright light.”  

“This study highlights the importance of reducing light exposure in the hours before bedtime” said senior author Kathryn Reid, research professor of neurology at Feinberg.

The naturally occurring peptide may tackle obesity-related conditions’ ‘root cause’.

Naturally occurring peptide may tackle the ‘root cause’ of obesity-related conditions
Naturally occurring peptide may tackle the ‘root cause’ of obesity-related conditions

Research shows that a peptide (small protein) called PEPITEM could provide a revolutionary approach to reducing the risk of type 2 diabetes and other obesity-related diseases such as hepatic steatosis (fatty liver). 

The researchers used an animal model of obesity to investigate whether PEPITEM, delivered by a slow-release pump, could prevent or reverse the effects that a high fat diet has on the pancreas.  Excitingly, the results showed that administration of PEPITEM significantly reduced the enlargement of insulin-producing cells in the pancreas and also significantly reduced immune cell migration into various tissues. 

The research team was led by Dr Helen MCGettrick and Dr Asif Iqbal from the University of Birmingham’s Institute of Inflammation and Ageing and Institute of Cardiovascular Sciences.  Dr McGettrick said: “We have found a new therapeutic approach that could provide new drugs to tackle the root cause of obesity-related conditions by preventing the damage caused by systemic inflammation.

PEPITEM was first identified in 2015 by Birmingham researchers who described its role in the adiponectin-PEPITEM pathway, which is involved in controlling the onset and severity of auto-immune and chronic inflammatory diseases. 

Obesity causes complex and dramatic changes in metabolism in adipose (fat) tissue, damage to the pancreas, reduced insulin sensitivity and eventually the hyperglycaemia that underpins type 2 diabetes.  It also causes a low-level inflammatory response across the boyd, encouraging white blood cells to enter into many tissues including the visceral adipose tissue (fat stored deep inside the body wrapped around the organs, including the liver and gut) and peritoneal cavity (a thin membrane that encompasses the gut). 

The latest research, published in Clinical and Experimental Immunology, shows that the adiponectin-PEPITEM pathway also connects obesity, the low-level inflammatory response that is driven by it, and changes in the pancreas that precede diabetes. 

The results showed that dosing with PEPITEM while the mice were on a high fat diet significantly reduced the enlargement of insulin-producing beta cells in the pancreas and the number of white blood cells in the visceral adipose tissue and peritoneal cavity, compared to controls. 

The researchers also looked at the potential of PEPITEM to reverse the changes brought on by obesity, by feeding the animals a high fat diet prior to treating with PEPITEM.  Excitingly, they saw similar results.  Dr Asif Iqbal commented: “Until now we have understood very little about how the inflammation that accompanies obesity drives pathology.  These results show us that PEPITEM can both prevent and reverse the impact that obesity has on metabolism.  The next stage is to translate these exciting results into therapeutics that can be used in humans.”

Professor Ed Rainger from Birmingham’s Institute of Cardiovascular Sciences led the team that first identified PEPITEM.  He commented: “We are all very excited about these latest results.  PEPITEM is a naturally occurring peptide.  We have already shown it has effects on several organs and now for the first time, we have shown that PEPITEM is effective

Scientists unearth potential new therapeutic targets for inflammatory diseases such as Lupus

Scientists working in the School of Biochemistry and Immunology in the Trinity Biomedical Sciences Institute at Trinity College Dublin have made an important breakthrough in understanding what goes wrong in our bodies during the progression of inflammatory diseases and – in doing so – unearthed a potential new therapeutic target.

The scientists have found that an enzyme called Fumarate Hydratase is repressed in macrophages, a frontline inflammatory cell type implicated in a range of diseases including Lupus, Arthritis, Sepsis and COVID-19. 

Professor Luke O’Neill, Professor of Biochemistry at Trinity is the lead author of the research article that has just been published in leading international journal, Nature. He said:

“No-one has made a link from Fumarate Hydratase to inflammatory macrophages before and we feel that this process might be targetable to treat debilitating diseases like Lupus, which is a nasty autoimmune disease that damages several parts of the body including the skin, kidneys and joints.” 

Joint first-author Christian Peace added: 

“We have made an important link between Fumarate Hydratase and immune proteins called cytokines that mediate inflammatory diseases. We found that when Fumarate Hydratase is repressed, RNA is released from mitochondria which can bind to key proteins ‘MDA5’ and ‘TLR7’ and trigger the release of cytokines, thereby worsening inflammation. This process could potentially be targeted therapeutically.”

Fumarate Hydratase was shown to be repressed in a model of sepsis, an often-fatal systemic inflammatory condition that can happen during bacterial and viral infections. Similarly, in blood samples from patients with Lupus, Fumarate Hydratase was dramatically decreased. 

“Restoring Fumarate Hydratase in these diseases or targeting MDA5 or TLR7 therefore presents an exciting prospect for badly needed new anti-inflammatory therapies,” said Prof O’Neill.

Excitingly, this newly published work is accompanied by another publication by a group led by Professor Christian Frezza, now at the University of Cologne, and Dr Julien Prudent at the MRC Mitochondrial Biology Unit (MBU), who have made similar findings in the context of kidney cancer. 

“Because the system can go wrong in certain types of cancer, the scope of any potential therapeutic target could be widened beyond inflammation,” added Prof O’Neill

Genetic and socioeconomic factors affect the risk of type 2 diabetes and obesity.

Study’s findings have implications for both precision medicine and public health
Study’s findings have implications for both precision medicine and public health


New research led by investigators at Massachusetts General Hospital (MGH), a founding member of Mass General Brigham (MGB), indicates that socioeconomic and genetic factors likely interact in an additive way to affect people’s risks of developing obesity and type 2 diabetes. The findings, published in Diabetes Care, suggest that interventions to improve socioeconomic deprivation may decrease metabolic diseases at the individual and community levels, especially among people with concomitant high genetic risk.

Genetic and socioeconomic factors—one intrinsic and unmodifiable and one extrinsic and potentially modifiable—have both been shown to increase the risk of metabolic diseases, but the relative contributions of the two and the degree to which they may interact to impact a person’s risk are poorly understood. To investigate, scientists examined the independent and additive effects of genetic and socioeconomic risk in 26,737 and 223,843 participants of European genetic ancestry from the Mass General Brigham Biobank and the UK Biobank, respectively, as well as in 3,468 and 7,459 participants of non-European ancestry in the respective biobanks.
The team examined individuals’ genetic data at millions of points across the genome and information related to education, income, and employment from their area of residence. Because educational attainment had the strongest association with type 2 diabetes and obesity out of all area-level socioeconomic variables examined, this was used as the primary socioeconomic risk measure.

Results indicated that people in the highest quintile of both genetic and socioeconomic risk had a more than seven-fold higher prevalence of type 2 diabetes (22.2% vs. 3.1%) and a more than three-fold higher prevalence of obesity (69.0% vs. 20.9%) compared with those in the combined lowest risk quintiles.

There was a significant positive interaction between genetic and socioeconomic risk on an additive scale.  This suggests that the absolute increase in metabolic disease prevalence with unfavorable socioeconomic risk was much greater for those at higher genetic risk than for those at lower genetic risk. For example, adverse area-level socioeconomic risk was associated with increased type 2 diabetes prevalence across the spectrum of genetic risk, but the absolute increase in prevalence was greatest in those at highest genetic risk: +9.2% in the highest genetic risk quintile vs. +1.7% in the lowest genetic risk quintile. Overall, the additive effects of genetic and socioeconomic factors accounted for 13.2% and 16.7% of type 2 diabetes and obesity prevalence, respectively.

“We believe that this research calls for a whole-person approach to metabolic disease prevention and that public health interventions may be most impactful if targeted to those who also have elevated genetic risk,” says lead author Sara Cromer, MD, an Endocrinologist in the Department of Medicine at MGH and an Instructor at Harvard Medical School. “The next steps in this research include expanding models to include more risk factors (such as lifestyle factors and behaviors), improving models for individuals of non-European ancestry, exploring the predictive value of area-level socioeconomic measures in diverse populations, and examining the gene–socioeconomic status interplay in regards to other outcomes.”

Senior author Miriam Udler, MD, PhD, an endocrinologist the department of Medicine at MGH, an investigator in the MGH Center for Genomic Medicine, and an assistant professor at Harvard Medical School, adds that the study highlights not only the high prevalence of metabolic disease among individuals with both genetic and socioeconomic risk factors, but also that genetic risk for these diseases is not deterministic. “People at high genetic risk who live in low-risk socioeconomic regions have similar rates of type 2 diabetes and obesity as those with low genetic risk living in certain socioeconomic risk regions,” she says. “More research is needed to understand exactly why this is.”