Episode 65: How to Support Your Child’s Gut Health with Panuya Athithan
In this episode, we chatted with Panuya Athithan. Panuya is a Ph.D. student at the University of Guelph. She works in the lab of Dr. Emma Allen-Vercoe, studying the gut microbiome of infants, children and adults. We spoke to her about kids gut health, and the ways parents can support their child’s gut health.
Find the resources discussed in the episode here: Probiotic Guide Canada, Clinical Guide to Probiotic Products Available in Canada
Find Panuya on Instagram @panuya14, or on LinkedIn at Panuya Athithan.
Transcription:
Healthy Habits, Happy Homes Podcast
Season 7, Episode 66
Guest: Panuya Athithan
Marciane (0:05)
Hello, welcome to the Healthy Habits Happy Home podcast hosted by the Guelph Family Health Study.
Tamara (0:14)
If you’re interested in the most recent research and helpful tips for healthy, balanced living for you and your family, then this podcast is for you. In each episode, we will bring you topics that are important to your growing family and guests who will share their expertise and experience with you.
Marciane (0:31)
Our quick tips will help your family build healthy habits for a happy home.
Marciane (0: 41)
Welcome to Season Seven of the Healthy Habits Happy Homes podcast.
Tamara (0:46)
Seven seasons, can you believe it?
Marciane (0:48)
I can’t! That’s a while.
Tamara (0:50)
I know, it’s a lot of seasons, and it’s already, this is our third season together as co-hosts Time honestly just flies.
Marciane (0:57)
Wow, oh my gosh.
Tamara (0:59)
Time flies when you’re having fun.
Marciane (1:00)
Honestly, honestly. Tamara and I are so thrilled to be back and we’re also excited to introduce a new member to our podcast team, Ingrid. She’s our podcast manager who’s been working hard behind the scenes to keep us on track and she’s also managing the Guelph Family Health Study social media page.
Tamara (1:19)
Yeah, we’re so excited to have Ingrid join the team. She’s definitely been doing an amazing job of keeping us on track and keeping our social media page looking great as well. So, we’re really, really looking forward to working on this season with her.
Marciane (1:31)
Absolutely. Well, before we dive into the season, how was your summer? Anything new you want to share?
Tamara (1:37)
Yeah, my summer was really, really good. I feel like it went by too fast as it always does.
But academically, I’m still doing my PhD. I’ve been working on a lot of data analysis this summer, a lot of writing. So there’s a lot of projects that are wrapping up, which is really exciting. And, so, this semester is also going to be focusing on continuing to wrap up those projects. I’m also taking a course this semester, which I’m really excited about. I’m learning more about implementation science. So, that’s really cool. And then personally, this summer was actually really exciting for me because I got married.
Marciane (2:13)
Yay!!!! I was there. It was beautiful.
Tamara ( 2:16)
Of course, you were there. It was, yeah, it really was just incredible. So, that was really nice. We got to go on a beautiful honeymoon. So, it was a very, very special summer. How about you? I know that you also have some exciting updates to share, Marciane.
Marciane ( 2:31)
Okay, well, before I get into that, I got a new job. And, so, I’m the executive director of a non-profit here in Guelph called the Learning Disabilities Association of Wellington County. And, we offer free and low cost programming to anyone who is impacted by learning disabilities or ADHD. And, so, we’re really, I’m really excited to be in this role. I’m learning a lot, but it’s really cool to see the impact that we’re able to have in such a short amount of time.
Like, it’ll be a year in December. And, you’re right, time really does fly. I don’t understand how it’s almost a year already.
Tamara (3:07)
That’s incredible.
Marciane (3:09)
And, then, yeah, personally, I got married, too.
Tamara (3:14)
And, I was also there and it was incredible.
Marciane (3:17)
Thank you. So, yeah, things are like looking up, but it is weird. It’s weird to be married and feel like, “Oh, wow, we’re adult adults now. And this is real, but very, very exciting.”
Tamara ( 3:32)
Yeah, definitely. It’s honestly been such a whirlwind of exciting changes.
Obviously, it was a great summer for us both. I’m really excited to be kind of doing this new life chapter. And, we’re kind of along for the ride together, which is really nice as well.
And, we get to continue working together, too, which makes me very happy. We’ve got an amazing season ahead for the podcast. We’ve got some episodes covering everything from gut health to financial literacy, ultra-processed foods, and so much more. So, you definitely won’t want to miss it. Be sure to stay tuned.
Marciane (4:05)
And, without further ado, let’s get into our season premiere.
Today, we’re excited to have Panuya Athithan join us. Panuya is a PhD student in the Department of Molecular and Cellular Biology at the University of Guelph. She studies infant, child, and adult gut microbiomes and how breast milk sugars impact the composition and bacteria at these different life stages.
She also studies how these sugars may play a protective role in the development of Type 1 Diabetes in infants. We are excited to have her on to discuss children’s gut health today. Welcome.
Panuya (4:41)
Hi, thanks for having me.
Marciane (4:45)
We’re really excited for this conversation. To get us started, can you tell us a bit about yourself, your current role, and how your education and experiences led you to where you are now?
Panuya (4:54)
Yeah, for sure. So, I am currently a PhD student in Dr. Emma Allen-Vercoe’s lab in the Molecular and Cellular Biology Department at the University of Guelph. I’m currently studying how, like you guys said earlier, how breast milk, but specifically human milk oligosaccharides, which are complex sugars found in breast milk, affects the composition of the infant gut microbiome, but also how it affects bacteria found in adults and how we might be able to use that as potentially a supplement or as maybe like a prebiotic or some therapeutic for adults dealing with gut-related issues and diseases. And, how I got into this is I did my undergrad at the University of Waterloo in Biomedical Science and I did a fourth-year research project in Dr. Laura Hug’s lab who does environmental microbiology.
And, before that, I wasn’t too keen on microbiology or didn’t really like it that much. But, after being in her lab for a whole year, I actually truly enjoyed it, but, I realized I didn’t really want to work with soil and groundwater for the rest of my career. So, I was super interested in infant health and women’s health. I knew I wanted to do microbiology related to all of that. So, I looked around and came across Emma’s lab, reached out to her. She was more than happy to take me on as a student back in the fall of 2022.
So, I took her offer and I joined her lab initially as a master’s student. Earlier this year, I wanted to continue working in her lab and continue on this project. So. I asked to switch into the PhD program.
And, so, I’ll be here for a couple more years continuing my project on human microbiota saccharides.
Tamara (6:30)
So, that’s super cool. That’s really interesting.
I feel like you’ve had a really cool journey so far that’s led you here today. And, I mean, especially, you know, gut health and the gut microbiome, like, those have been buzzwords for like a while now. I feel like I’ve heard so much about it and I feel like the science world is talking a lot about these things.
So, we’re really excited to have you here, today. But, can you just explain a little bit what the gut microbiome is and what it’s made up of?
Panuya (6:52)
Yeah, for sure. So, gut microbiome is actually found in the colon and it’s made up of all the microorganisms in your gut. So, bacteria, fungi, eukaryotes, archaea. And, it’s also made up of like the genetic makeup. So, the microbes genes, their metabolites, so, like amino acids, short chain fatty acids, any sort of structural elements from the bacteria and, as well, as the environmental conditions found in the gut.
So, that’s what the gut microbiome is. Typically, you’ll hear people use gut microbiome and gut microbiota interchangeably. However, there are differences between the two words.
So, gut microbiota just is all of the microorganisms found in the colon and in the gastrointestinal tract. But, the microbiome includes everything else. So, it’s all the microorganisms plus their genes and the functions and the environment of the gut microbiome.
So, just to clarify that, you know, going forward in the podcast and also for anyone who’s interested, they’re often used together because people sometimes assume they mean the same thing, but not necessarily.
Marciane (7:57)
No, that makes sense. Thanks for explaining it.
It’s like one of those terms you hear all the time. And, then, when someone’s like, what does that mean? You’re like, uh, and then you just repeat the word. So that’s helpful.
Panuya (8:07)
Yeah, no worries.
Tamara (8:08)
Yeah, that’s so true. I had no idea that there was a difference between those two either.
So, I’m like, thank you for clarifying that because it seems like an important distinction that should be made.
Marciane (8:16)
How is the gut microbiome established?
Panuyna (8:18)
So, it’s usually established in three stages. The first stage is the developmental phase, which is usually from birth to about 14 months, zero to 14 months. It’s where all the initial colonization of the microbes occur. And, there’s usually several factors that can influence this, but the two biggest ones are the mode of delivery and feeding methods early in life. So, for mode of delivery, it could be whether a baby was born vaginally or versus C-section.
And, so, babies that are born vaginally are exposed to their mom’s vaginal microbiome, their fecal microbiome, as well as their skin microbiome. So, they’re exposed to a ton of different environments and a ton of different microbes. So, that gives them an opportunity to have a lot of different bacteria try to colonize their gut microbiome starting from birth.
Whereas C-section babies, they are only exposed to their mom’s skin microbiome and as well as typical bacteria that’s found in operating rooms. That’s something that’s common if you culture bacteria found early from babies that are just born, you’ll find a lot of bacteria that are typically found in operating rooms. So, those are the two kind of environments that C-section babies are exposed to.
Quite a bit less exposure in terms of a variety of different bacteria, but, that is one of the differences early in life. And, the second one that’s one of the biggest influences is feeding mode. So, whether a baby is breastfed or formula fed, because babies that are breastfed tend to have gut microbes that are able to metabolize and digest a lot of the different components of breast milk. And, so, that helps them have like a certain select few microbes early in life that can help degrade all of those different components and then help establish a colony early in life. Whereas, infant formula, that formula doesn’t really have a lot of the components like breast milk does, especially for human milk oligosaccharides. I call them HMOs. That’s not really found in infant formula. They’re very difficult to synthetically make. Whereas, like we make them as humans, but you can’t really make them in the lab.
Very few structures of HMOs can be made. So, very few are added into infant formula. And, so, some of the two differences there where babies that are breastfed will have very different bacteria from babies that are formula fed.
And, then, also their mode of delivery also makes an impact on that.
And, then, the second stage is the transitional phase, which occurs from about 15 months to about the age of two, around the age of two. And, this is usually when there’s a lot of changes in their microbial composition in the gut, because this is when babies are about to be weaned off of breast milk or infant formula and starting to transition into eating more whole foods.
So, this transition causes a transition in bacteria as well in their gut microbiomes. It transitions from bacteria that primarily metabolizes, you know, simple sugars found in breast milk or formula to bacteria that can now metabolize complex carbohydrates, lipids and proteins found in whole foods. And, you see, kind of, a shift in a more increased diversity in bacteria in their microbiomes because now they’re eating a bunch of different types of food as opposed to just milk.
And, then, the last stage is a stabilization phase. And, this occurs usually around the age of three and onwards. So, at this stage, the gut microbiota adopts a more like adult-like composition.
And, typically, the gut microbiota is established by the age of three and is quite stable. So, you can see here, there is quite a bit of a critical period here in developing the gut microbiome and establishing it early in life, through feeding practices, diet, and just the environment in order to set up children with healthy guts for their long-term health. And, that’s not to say, like, maturation, the gut microbiome doesn’t occur after the age of three, definitely changes in microbial composition and shifts can occur, you know, through antibiotic use or sicknesses or health-related issues that happen later in life.
But typically, for most part, the gut microbiome is quite established by the age of three and is pretty stable going forward.
Tamara (12:20)
This is fascinating. I’m learning so much already.
The way that you explained that was so clear. And, I can imagine based on how important these early years are in the establishment of the gut microbiome, that the gut microbiome would have an influence on a person’s overall health. So, could you maybe just comment on whether or not the gut microbiome does influence a person’s overall health? And, why is it so important during childhood?
Panuya (12:43)
Yeah, for sure. Absolutely, the gut microbiome does influence a person’s overall health. So, the gut microbiota is able to deliver nutrients, vitamins, and minerals and other bioactive compounds by metabolizing the dietary components that make it to the colon. So, they are able to use these vitamins and minerals and carry out other biological processes in the body or in the gut that are important for maintaining overall health.
And, also, the gut microbiota plays a significant role in regulating the immune system. So, it can sometimes regulate inflammatory responses to respond to foreign invaders or even potential pathogens in the gut microbiome and also try to prevent them from colonizing so that they’re not disrupting the composition of the gut microbiome. And, it especially plays an important role in infancy and childhood because the gut microbiota plays a role in developing the immune system.
So, it helps to prime immune responses and, kind of, expose the immune system to various different bacteria and show them there are harmless bacteria that we shouldn’t be responding to and prime some of the immune cells to be able to detect foreign invaders or even harmful substances in the gut microbiome and then be able to combat that when they do encounter that and try to remove that from the gut. And, lastly, it also plays a role in just maintaining a strong intestinal epithelial barrier. So, that’s kind of like the walls of cells separating the contents of the colon from the rest of the internal environment.
And, so, the gut microbiota helps with secreting a mucus layer which helps trap harmful compounds and other harmful bacteria and prevents the intestinal barrier from becoming inflamed by these foreign compounds and invaders.
Marciane (14:28)
That’s really cool. I think it’s one thing to know generally how important the gut is but then when you break it down, it’s like, oh my goodness, it does so much for us.
I wanted to ask, what role does the gut microbiome play in a child’s long-term health and how it might affect them throughout their life?
Panuyna (14:49)
Yeah, for sure. So, firstly, a gut microbiome is high in diversity or what we would call beneficial bacteria. And, I put beneficial in quotes because we don’t actually know what’s good bacteria and what’s a bad bacteria but based on science: some are more prone to providing us with more short-term fatty acids and immune acids and don’t cause as much inflammatory responses.
So, they’ve been coined as a term as beneficial bacteria but those bacteria help with absorption of nutrients and help remove waste products. So, this helps with preventing digestive problems such as constipation or diarrhea later in life, just, like, general breakdown of components that make it into the colon. And, then, the gut microbiome also helps play a role in body weight management.
So, these bacteria contain genes and metabolic pathways that are able to control lipid uptake and metabolize other components that make it. So, the combination of absorbing nutrients, removing waste but also helping to maintain body weight management helps to promote the growth of the child’s body and help them also maintain an appropriate body weight ensure that children have the nutrients that they need to grow and thrive later in life. And, like I mentioned earlier, the gut microbiome is pretty instrumental in the development of the immune system in early years.
And, so, like I said, they train different immune cells to recognize harmful substances so that in the case of an infection or a pathogenic bacteria start to try to colonize their gut microbiome later in life. You know, their immune system has already been primed and trained to detect those things and try to make a response as quick as they can. So, they can try to get rid of that and not cause too much of an issue in their gut microbiome.
And, then overall, like, establishing a healthy and stable gut microbiome early in life can be essential for their long-term health later in life as the accumulation of all of these things right now helps to decrease the risk of developing chronic and metabolic diseases, like obesity, Type 2 diabetes or even just other gut-related issues that might occur later in life.
Tamara ( 16:50)
Wow, that’s really interesting. Our gut, like Marcianne, like you just said, too, like, wow, like our gut does so much. We got to take care of our guts. There has been a lot of recent popular discussion, too, that I’ve seen about how, you know, our gut health and the gut microbiome influences all aspects of our health, but particularly mental health. How does this conversation apply to children if it does in any way?
Panuyna (17:12)
Yeah, that’s a really good question.
I think this is quite a bit of a new field that people are looking to. People have obviously looked into gut-brain access. That’s kind of a well-established field, but specifically looking at mental health disorders and cognitive disorders, like, how does the gut microbiome play a role in that? And, there’s definitely certainly a link between the two.
So, the gut microbiome and the brain are essentially linked through something called a gut-brain access. And, this is basically where the gut and the brain are communicating with each other. And, so, because of that, they influence each other’s function.
So, what happens in the brain and what happens in the gut? And, specifically talking about the gut microbiome, there are certain bacteria in our microbiome that actually produce neurotransmitters. So, for example, like serotonin, dopamine, or GABA, which are all related and involved in regulating mood or decreasing sensory overload, helping with, like, motivation and satisfaction, also just regulating regular everyday body functions like sleep, which is quite important for all of our mental health. So, the gut microbiome is actually responsible for 90% of the serotonin produced in our body, which is important for a lot of our just general bodily functions, like I mentioned, like, sleep earlier.
And, so the release of these transmitters could potentially suppress or reduce symptoms of stress, anxiety, and depression. But like I said, there is more research that needs to be done in kind of correlating the two and seeing if there is any association between all the neurotransmitters in our gut also influencing our mental health. There have been some studies recently on investigating like gut microbial composition in children with, like, various mental health disorders, specifically anxiety and depression.
And, typically what these studies have found is that these children with these disorders usually have lower microbial diversity and have shifts toward bacteria that tend to cause inflammation in their intestinal tract. So, as a result, there are changes in their levels of neurotransmitters that can be released into their gut that potentially could be causing some of these issues or some of the symptoms that they’re dealing with. And, there’s also changes in short chain fatty acid concentrations and other bioactive compounds that are just important for maintaining biological processes.
And, so, all of these things could potentially contribute and maintain some of these mental health disorders and their symptoms. However, the correlation association of the gut microbiome to the development or maintenance of mental health disorder still needs to be better investigated and better understood on how the gut and the brain are influencing each other in the terms of mental health disorders. And, whether or not other factors like diet and chronic diseases are also at play here because they very well might be, but it’s hard to decipher what exactly is causing all of those issues or whether or not it’s a compilation of all of them that are contributing to all these mental health issues and disorders.
So, it’ll be exciting to see where this research goes and to see what comes out of this field to help us better understand how our bacteria is affecting our mental health.
Tamara (20:14)
Yeah, definitely. It’s super fascinating, actually, just like learning about all of this.
It certainly seems like an area to watch, like, very new, but like a lot is happening in this field. And, I feel like even just like anecdotally, like as adults, like, Marciane and I always joke before we have like a presentation or something that we’re like nervous for, we’re like, “oh, the nervous tummy is like hitting.” And, so, that’s always like our little thing.
It is interesting to hear more about like the science and how that actually is working in our bodies. Like, it’s really cool.
Marciane (20:39)
Yeah, I feel like overall, just it’ll be cool to see what the research says, you know, down the line, but, just in general, like when you’re regular and kind of feeling good in your tummy, I feel better.Like I could think I’m happier versus like the opposite. [laughter]
Tamara (20:57)
It’s so true. The mind-gut connection is like really, yeah.
Marciane (21:01)
Given your focus on breast milk and its impact on the gut microbiome, could you tell us what the current research says about any differences in the microbiomes of children who are breastfed versus those who are formula fed or received a combination of both?
Panuya (21:18)
For sure. And, I think this is probably my favourite question that I’ve been asked so far. Based on a lot of research that has been done and, you know, research that’s ongoing that have looked into the impacts of breastfeeding versus formula feeding versus a combination of both, there are differences in the gut microbiome depending on what your mode of feeding is and how that affects their compositions.
So, formula-fed infants tend to have a higher microbial diversity early in life. So, starting in infancy and resemble a more adult-like gut microbiome earlier in life. And, you might think, “oh, this is great. Like, I have higher microbial diversity as a baby and that’s wonderful.” But, that’s not always the case. Because, like I said, we have very critical years to establish that gut microbiome.
And, there are certain functions that need to be maintained and developed like our immune system and, kind of, establish a foundation for a gut microbiome before we can move on to more diverse microbial composition. And, so, infants that receive a combination of both breast milk and formula have gut microbiomes that resemble more of what they’re receiving. So, sometimes babies aren’t always fed, you know, 50-50 of breast milk and infant formula.
Sometimes they’re mostly fed one and supplemented with another. It depends on what their diets are based on their breast milk and formula fed. But, so, if they’re drinking more breast milk than formula, then their gut microbiome would resemble more of a baby that’s breastfed because they’re utilizing more of those components found in the breast milk versus what’s more in the formula.
And, then, for breastfed infants, they tend to have lower microbial diversity compared to formula-fed infants and have gut microbiomes that are typically dominated by a group of bacteria called bifidobacteria. And, that’s because the large component of breast milk is made of sugars, like I said, HMOs. And, HMOs act as prebiotics in the infant gut microbiome.
So, they enter the colon as whole. They don’t get digested early on. And, so, they act as prebiotics and food for all of these gut microbes in our microbiome.
And, they provide the infant with tons of benefits early in life. So, the gut microbial composition in infancy, if you are breastfed, is heavily influenced by the bacteria that can utilize these HMOs and can break them down. Because, if you can’t break them down, you won’t be able to colonize in the gut microbiome.
But, if you are able to utilize all of those sugars, then you can establish yourself, grow in abundance, and become more of a player in your gut microbiome. So, that’s why bifidobacterium is one of the most predominant members in the infant gut. And, also why there’s lower microbial diversity because not a lot of bacteria early in life can utilize those specific HMOs.
And, so, you know, even in my research, and in Emma’s lab, another PhD student and I have also found that HMOs extracted from donated breast milk are not only able to increase the growth of bacteria, but they’re also able to inhibit growth of other bacteria, sometimes pathogenic, sometimes bacteria that we call pathobionts. So, they’re bacteria that everyone has and it’s found in our gut microbiomes. I mean, they don’t cause any harm until they’re under a certain circumstance or scenario in the gut microbiome where they can have the ability to cause harm in the intestinal tract.
And, so, along with like microbial composition differences, there’s also differences in metabolites found in the gut microbiome. For example, the higher concentrations of short chain fatty acids like acetate and butyrate found in the infant gut that is breastfed. And, this helps to build immune system and feed other bacteria in the microbiome and also prevent pathogenic bacteria from colonizing the intestinal tract.
So, although there is lower diversity in the gut in early life in breastfed infants, that doesn’t necessarily mean it’s a bad thing. And, it’s probably what babies need at that point in their life, just to help them establish themselves when they enter this world, give them a bit time to, you know, not deal with a lot of things, just deal with a few bacteria, bit of help their immune system develop and then move on afterwards.
I’m also not one here to say, you know, breast milk is better than formula.
Obviously, there are differences. But, at the end of the day, a fed baby is what’s best. And, so, you have to do what’s best for you and your baby.
However, it is important to consider that there are differences in terms of composition of the gut microbiome in infancy. And, like, how we talked about earlier, you want to set up your children for success later in life, in terms of their long-term health into adulthood. So, these are some of the ways that the differences are and how that might impact their long-term health and microbial composition into adulthood.
Tamara (26:05)
Yeah, definitely. And, I mean, yeah, I agree like fed is best. And, there’s so many decisions that go into, you know, how someone chooses to feed their baby.
And, it’s, you know, so much more complex than what we’re talking about today, too. It’s just like an array of choices that go into that. But, it is interesting to hear about, you know, when we are talking about gut health, it’s interesting to hear about what some of those differences are in the gut.
I just had a question about something. I was just curious, based on the research and what you’ve found, does what’s mom eating, like, if they are, you know, breastfeeding or chest feeding, does that influence the infant’s diversity of the gut microbiome or anything like that?
Panuyna ( 26:41)
Yeah, for sure. So, it’s actually, this is kind of a new-ish field.
So, the breast milk microbiome, there’s people looking into, does the breast milk itself have bacteria in it? Or, is it, you know, the bacteria in our mammary glands or the tissues that are being transferred from the breast to the infant as they drink the breast milk. And, there are bacteria found in the breast milk itself and also found in the tissue and in the mammary glands. So, that obviously could influence the infant gut microbiome.
But, like I said, it’s quite a new field. And, obviously, there will probably be more research to see how breast milk itself, plus the bacteria that’s coming from the breast milk and the bacteria that’s already colonizing the infant, how all of that plays together. And, if, you know, if there’s similarities between all of them, or if there’s differences between, you know, what makes it through and what can actually colonize versus what can’t.
Tamara (27:35)
Yeah, that’s super interesting.
Marciane (27:37)
I am taking so many notes right now. I just feel like I’m learning so much.
It’s just, it’s so interesting because I feel like you’re sharing so much from the perspective of just, you know, things I can take in just as an individual about gut health, but, then also, like, thinking about my childhood. And, then, even in the future, wanting to be a mom and like all these different things. And, so I love it.
And, I also appreciate how in you being so informative, you’re also just reminding parents that like a fed baby is a happy baby, you know, as long as they’re getting fed. And, even the way that they come into the world, you know, whether it’s through vaginal or C-section, it’s like, we’re not saying one is better. It’s just, you’re exposed to different things.
And, I think that’s really cool, as well, because we know that there is like this, you know, molecular world and we’re always like, you know, in contact with different bacteria and things like that, but it’s not something on our minds every single day. But, to be reminded that that’s around us and it really does affect our health is, it’s just so cool. I’m nerding out.
It’s awesome. [laughter]
Panuyna (28:48)
I love that.
Tamara (28:50)
Science is really so cool. Can we just take a moment to appreciate that?
Panuyna (28:54)
It is cool. There are little bugs in our tummy that do a lot for us.
Tamara (28:57)
Yeah. You don’t ever think about or probably appreciate. Yeah, exactly. I’m definitely having a whole new appreciation for those bugs in my tummy for sure.
And with that, so in your research, when are supplemented probiotics helpful? And what does the current research say about their use in children?
Panuyna ( 29:12)
So, current research on probiotic supplementation in childhood mostly focuses on using it as an intervention for children that are already experiencing gut-related issues or diseases. Typically, you know, inflammatory bowel syndrome, so IBS, infantile colic, or even antibiotic-induced diarrhea. Yeah, I also had colic as a baby, so I don’t know if I was given probiotics or not.I’d have to ask my mom, but, yeah. And, then, also sometimes for eczema, as well. And, so, that’s typically when probiotics are used or that’s what the current research says.
There are not a lot of studies done on probiotic supplementation in healthy children or a healthy children cohort who have no gut issues, so, it’s difficult to say if all children should be supplementing a probiotic early in life regardless of whether or not they have gut-related issues. There are some studies that have looked at probiotic consumption in preschool children and they found that there were modest effects, you know, very minimal differences at the end of their intervention of using probiotics, but, also these effects didn’t last once they had stopped taking the probiotic supplementation. So, I think that’s something to consider. One: that there wasn’t a lot of changes in their composition; and two: they didn’t last as long as they thought they or as long as, you know, general public thinks that’s, you know, it’s one to take probiotics, it probably lasts a while, but that’s not the case, especially in children or preschool children. So, more research definitely needs to be done on this section on when children could be supplemented with probiotics and what’s good for them. But, there are, you know, many recommendations in the literature that suggest incorporate more fermented foods into the diet rather than solely relying on probiotic supplementation.
So, that could be just an alternative that parents use, instead of, you know, using supplements, they could just broaden their diet and add more foods into it.
Tamara 31:05)
Yeah, that is really interesting, especially the eczema part is interesting to me too, because I am a current eczema sufferer. So, I’m like, maybe I should get on a probiotic actually, that’s not a bad idea.
But, it’s it seems like for children, you know, that don’t have gut related issues, that perhaps it’s maybe not necessarily necessary to take these supplements. And, maybe, like, a food first approach seems a bit more appropriate and effective. And, given that you kind of mentioned a little bit about like fermented foods and stuff, are there more effective ways to increase the good bacteria in the gut that’s a bit more consistent and sustainable than supplements.
So, you mentioned fermented foods, maybe just like giving us a few examples, or if there’s any other foods, maybe that parents should think about incorporating.
Panuya (31:45)
Yeah, for sure. So, fermented foods are definitely one of the more sustainable ways to increase microbial diversity in gut.
Now, there have been tons of studies that have shown fermented foods can change the composition of the gut microbiome and boost its diversity. So, some examples could be fermented foods are probably kefir, kimchi, and then yogurts that can be included into the diet. And, also, through the fermentation of these products, you know, metabolites and other products are produced, and that are also beneficial to the gut microbiome that already exists.
And, so, to all of our microbes that exist, and, so it serves as bioactive compounds that can be broken down and used by our microbes that already exist, but, then also come in as well through the diet that we’re eating. And, then, another diet related tip could be just increasing the amount of fibre that is consumed, makes a huge difference in our overall gut health, because it provides bacteria with different sources of food and different components. So, that helps to decrease diversity and metabolizing these components into bioactive products that can be later used in different biological processes, or even like feeding other microbes in our gut microbiome that can’t break these down, but could probably eat some of the more smaller components once these larger ones are broken down.
Tamara (32:59)
Yeah, for sure. I feel like as a dietitian, like, fibre, like, most of us don’t get enough fibre, right? And, fibre is so important. It plays so many roles in our bodies.
I feel like I spent a lot of time when I was counselling patients as a dietitian talking about fibre, and I’m like, yes, it’s so important. We all need to get more fibre.
Pranuya (33:20)
Yeah, the Western gut really lacks fibre. So, you know, any way to get in some fibre into your diet would be wonderful.
Marciane (33:25)
Very true. As we’re talking about, you know, probiotics and all of this, it’s amazing, and it’s great. But, what comes to mind is like, oh, is too much, you know, too much of anything, can it become problematic? So, is it possible to overdo it when trying to improve your gut health, such as consuming too many probiotics? And, how might that impact a child’s body?
Panuya (33:51)
Yeah, so although there isn’t quite a definitive answer to this question, I think the general rule would be everything in moderation would be a good one to follow. So, sometimes actually consuming too much probiotics can cause bloating, nausea, or even an upset stomach. So, there’s just generic common symptoms that could happen.
However, in a more like niche topic, there are some research out there that suggests providing too much probiotics to immunocompromised children could actually cause infections in those children. So, like, sometimes a high amount of bacteria that’s not able to colonize the gut microbiome, or somehow finds its way into the blood, and leaks into the blood and enters the system can actually cause blood infections, you know, because these children are immunocompromised, they are unable to fight those infections off and have much more difficult time. So, you know, being careful about, you know, the dosage of probiotics that you’re taking, also just consulting your medical professionals to see if this is what you should be doing, or if there’s something else that you should be taking.
But, yeah, overall, I think it’s important to try and supplement your diet with foods like fibre, fermented foods, instead of relying on probiotics to do that for you.
Marciane (35:05)
No, that’s so true. And, I think, you know, we’ve said it so many times before, please talk to a registered dietitian, please talk to your physicians, like, you know, talk to the professionals, because, you know, now I’m even learning about, you know, what it’s like being immunocompromised and things like that, like my partner is.
And, so it’s like, okay, there’s different things that might be great for my body, but how can it affect his, you know, and so just being careful, especially since these are buzzwords, and there’s so many advertisements where it’s like good bacteria, bad bacteria, this is what you should do for your gut. And, it’s just, like, always flashing in front of us, we can think we’re being helpful, but it can be harmful if we don’t do it, you know, wisely. So, just always consult professionals.
Panuya (35:53)
Yeah, actually, speaking about like all these buzzwords, and there’s so many different options, you know, my supervisor Emma’s actually let me know about a resource that I’ve used for, you know, as long as I’ve been in her lab, and, you know, recommended it to family and friends, but just called the Canadian Probiotic Guide. And, essentially, it’s just this guide, not certified, but, you know, the most promising probiotics that can be used. It’s not just supplements, you know, they have like yogurts that have active cultures in it, like, maybe this is good for just general health, but, they also have it broken down to like adults, like this is what you can take if you have, you know, IBS, IBD, you know, ulcerative colitis, Crohn’s disease.
And, like, these are the types of probiotics that are available over the counter that you can go buy, if you are experiencing these symptoms. They also have something for children, as well. And they also indicate, you know, if there’s infant formula that are approved in Canada, that have probiotics added to it, or even prebiotics, dietary fibres added to it to help the infant gut microbiome. And, they also have a list of like functional foods. And, all this is based off like clinical studies that have shown that these bacteria with these specific strains actually are effective in making a difference in the gut microbiome and alleviating symptoms if there is a gut issue, because it’s one thing to say, you know, a probiotic has lactobacillus, but there’s so many strains and species of lactobacillus, and not all of them act the same way and do the same thing. So, a probiotic really needs to list like what is the exact strain that they’re incorporating into their probiotic? And, does that exact strain do what they’re saying or alleviate the symptoms or help the symptoms that they’re trying to do? So, that guide is kind of consolidate all that info. So it’s not overwhelming for the general public. So, you can just access that, if you’re curious.
Tamara (37:37)
Yeah, that’s a really useful resource. I actually think I have that app. I’m pretty sure I have that app on my phone. Like this rings a bell, but we’ll definitely link that in the podcast description as well so that our listeners can find that easily.You know, I think it’s just everything we’ve talked about, too. It really is just kind of like everything in moderation. Like it always comes back to that.
And, I think like something that’s important to mention, too, is that probiotics are really expensive. Like, they are very expensive. And, to be honest, it seems like in this context, in this population, we’re talking about kids specifically here, there’s not a ton of research to suggest that they’re effective.
So, maybe just like implementing that food-first approach, you know, increasing our intake of some of those fermented foods, like you talked about like the yogurt and high fibre foods and things like that can really go a long way instead of, you know, be helpful to on the wallet. I mean, because probiotics are very costly.
What practical steps can parents take to support their child’s gut microbiome?
Pranuya (38:32)
Yeah, kind of, just going over what we said, but incorporating high amounts of fibre into their diets is probably one of the most important steps that can be made.
Like we said earlier, Western diets tend to have low fibre intake and high intakes of fats and sugars and processed food. And, so, individuals who consume low fibre diets tend to have decreased microbial diversity. So, adding fibre into the diet can increase the diversity and richness of the gut microbiome and also provide gut microbes with different products for fermentation and intestinal tract.
And, that just helps, you know, produce more short chain fatty acids and other metabolic compounds that can be used in other processes or to even help build the immune system or help feed other microbes in our gut microbiome so that we can increase its diversity. Trying to increase the amount of, like, fruits and veggies that are eaten, trying to incorporate more like whole grains, quinoa, or adding lentils, beans, or even adding different seeds like chia seeds are some ways to easily add fibre into your diet and help support the gut microbiome. I think the next tip would also just is related to diet, but like we said, decrease the amount of processed foods that are consumed.
Food additives, high sugar intake, and highly processed foods tend to decrease diversity, but they also shift the gut microbiome composition to bacteria that are more prone to triggering inflammation in the intestinal tract. And, so, limiting the amount of exposure to these foods while also increasing fibre intake would really help in developing and maintaining a diverse gut microbiota. Another tip would just be to try as much as possible to avoid excessive use of antibiotics.
So, obviously antibiotics is useful and is needed, and I’m not a medical professional by any means, but you know, research has shown that antibiotic exposure, especially to broad spectrum antibiotics, you know, ones that don’t target specific bacteria, but that are just generic, actually significantly decreases the abundance of important and commensal gut microbes, which then causes a loss of metabolic functions. And, so, this environment of decreased diversity and abundance also provides an opportunity for pathogenic bacteria that might have been living low in your gut microbiome now have the chance to exploit this environment and proliferate and try to take over as much space as they can. And, that could cause further gut issues and diseases later down the line.
So, making sure you’re consulting your healthcare professionals and ensuring, you know, the use of antibiotics every time is absolutely necessary, or if there’s other steps that can be taken prior to jumping to that step.
And, then, I think the last tip or some practical step to take would be, there’s some research that’s shown that exercise might also improve microbial diversity. So, lactic acid is produced during aerobic activities, and the gut microbes can actually use this to make other short chain fatty acids or to feed it into other metabolic processes in the gut to ride food for other microbes and to just sustain a healthy environment.
So, exercise increases all of these metabolites and just helps promote microbial growth and diversity. But yeah, those are some practical steps that you could incorporate into your daily routines.
Marciane (41:37)
I love all of those. It’s funny, like, as you were talking, I was like, all of this just sounds so familiar. “Where did I hear this from?” Oh, yeah, my mom, like she’s, like, “eat your fruits and veggies, eat your yogurt, go for a walk, like all these things,” you know, I feel, like, as scientists, it’s so cool, because we get to know, like, more in depth, you know, like, the nitty gritty of how things work. But a lot of it is kind of like going back to the basics.
It’s just now we know maybe why going back to those things is so useful. So I just thought that was funny. I was like, “Oh, yeah, I’ve heard all this before. Where did I hear this?”
Panuya (42:15)
Oh, yeah, you don’t think it’s quite that simple, but it is at the end of the day, it doesn’t require a lot to help your gut microbiome, just very simple steps that you can try to incorporate.
Tamara (42:28)
Absolutely. It’s great, too, because it’s like, it’s not just for kids, right? Like, these are things that we can do as adults, as well. Like, it’s, yeah, it’s really helpful.
Marciane (42:34)
So, are there any symptoms or signs that parents should watch out for that might indicate that their child’s gut health needs attention?
Panuya (42:41)
Yeah, so typically, the current literature out there suggests any constant or consistent constipation, diarrhea, or abdominal pain could be some indicators of a disruption to the children’s gut health. So, this is probably when you want to seek medical attention and should be involved to determine like what the issue could possibly be.
And, if there’s changes that could be made, potentially to diet, I mean, they’re sensitive to certain components of their diet, or something else is going on, and they need treatment. But, I think, yeah, those are some of the typical symptoms that might indicate something’s going on with your child’s gut health.
Tamara (42:25)
Yeah, for sure. These are important signs and symptoms to take note of. And, if you notice anything, you know, out of the ordinary, it’s a good time to get in touch with your primary health care physician and go from there.
So, to close out the podcast, we like to give families three practical take home tips.
Considering the topics we’ve discussed today, what are three tips that can be shared with our listeners to help them maintain or improve their child’s gut health?
Panuya (43:48)
So, before I start listing my tips, I just want to reiterate, I’m not a medical professional or registered dietitian. But, I am basing these tips off of all the current clinical studies, trials and research that’s out there. But, based on the research, I guess, my first tip would be to, and we’ve emphasized this a lot, is try to incorporate as much fibre as you can into your diet, because it really does help promote microbial diversity in the gut and really just helps your metabolic processes in the gut, as well.
So, that would be my first tip. The second tip would be to try and avoid as much processed food as you can. Typically, if you can’t understand a lot of the labels in the ingredients section on something that you’re picking up, it probably isn’t the best thing for you and your gut microbes. It probably has a lot of additives in it that gut microbes can take advantage of and especially, pathogenic bacteria take advantage of and try to grow in their gut microbiome.
And, then, lastly, my third tip is to try and add as much movement and exercise as you can into your routine, because research has shown that it can contribute to increasing diversity and just help maintain overall health of your gut microbiome and just keep it stable and consistent. So, hopefully, following these tips and everything we talked about today can help improve children’s gut health, but also just adult gut health as well, and set them up for success for their long-term health.
Tamara (45:15)
Awesome. Thank you so much. Again, as a dietician, I love the focus on fibre.
We got to get that fibre. Thank you so, so much, Panuya, for taking the time to chat with us about children’s gut health and for sharing your knowledge and expertise with us on the Healthy Habits, Happy Homes podcast.
Panuya (45:18)
Thank you so much for having me. This was very fun.
Marciane (42:21)
You provided such helpful and lovely tips, and we hope our listeners can take away some of these useful tips that you’ve shared. We’ll see you all next time.