We now know the trillions of bacteria living within our gut, referred to as the gut microbiome, preform a wealth of vital functions for our bodies, from vitamin production, aiding digestion, toxin removal and indeed, education of our immune system. With respect to gut bacteria, maintaining a high level of bacterial diversity is key. A loss of diversity results in a physiological change within our gut that can initiate or perpetuate common infections and inflammation. We also know that the diversity of the gut microbiome can decrease with age and frailty, both important factors in COVID-19 infections.
The easiest way to increase microbiome diversity is eat a varied diet, focusing on increasing fibre intake, seasonal fruit and vegetables, fermented foods and limiting processed sugary foods. There is much debate on the efficacy of pre and probiotic supplements and their influence on the immune system via modulation of the gut microbiome. A recent meta-analysis suggests probiotic use in children may be associated with reduced antibiotic prescribing in the context of respiratory tract infections, which is in keeping with 2015 Cochrane review on the same topic. However, the quality of the evidence feeding these meta-analyses is low or very low and therefore more robust studies are needed before any specific supplementation could be recommended. Of course, antimicrobial stewardship remains a vital component of preserving the diversity of the gut microbiome. It’s never been more important to mind your microbes.
Christopher Rooney, Versus Arthritis Clinical Research Fellow, University of Leeds, Hon. Specialty Registrar in Medical Microbiology, Leeds Teaching Hospitals Trust, @DrCRooney
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