Probiotics, Omega 3s and Chronic Inflammation: Part 1

As I am always on the lookout for things we can do now, I was particularly interested in reading a new paper just published in the journal Nutrients which reviewed what we know about using probiotics together with omega-3 fatty acids to reduce chronic low-grade inflammation – the bane of modern industrialized societies.[i]  My regular readers know only-too-well that such inflammation is associated with an enormous variety of chronic illnesses ranging from heart disease to cancer to autoimmune diseases to depression to obesity to Parkinson’s disease, and so many more.  This paper was so rich in information that I’m going to split up my summary into two parts, so that I can fit everything in.

We know, of course, that inflammation has been linked to alterations in the bacterial microbiome by a variety of mechanisms including the release of lipopolysaccharides (LPS), which are toxins produced by gram-negative bacteria and are linked to the development of everything from impaired epithelial barrier function (i.e. leaky gut) to obesity to diabetes.  In a vicious cycle, LPS causes an increase in immune activation as it makes its way through the leaky gut, leading to a continual proinflammatory state, which further impairs gut barrier function.  This increase in circulating proinflammatory molecules is observed in a many chronically ill patient groups, as well as those with obesity and in the aging (inflammaging, which I’ve written about before as well, like here).

What can be done?  Well, of course, diet is key:  avoiding proinflammatory foods (i.e. foods high in unhealthy saturated fats, sugar, salt, etc.) and eating more anti-inflammatory foods (fruit and veggies, whole grains, etc.) is mandatory.  In fact, “…dietary changes have been estimated to explain as much as half of the structural variations in microbiota composition.”  But, as this article states, there are certain nutritional factors that are important to normal immune functioning and could greatly benefit immune regulation:  “In particular, probiotic bacteria, prebiotic fiber, and omega -3 fatty acids have been suggested to serve as positive modulators of this nutrition-inflammation coalition. These dietary components interact with bacterial organisms in the gut, modulating the release of metabolites that signal to a variety of bodily systems (e.g., the immune system).”

So what does the research tell us as of today?  (I’m trying to hit all the high points in this post and the next!)

The Gut-Brain Axis and Health:

1. Psychological stress is a “…potent modifier of inflammation in the gut by increasing intestinal epithelial permeability, adversely affecting immune regulation and influencing the enteric microflora.” (That’s a big UH OH for me.)   Chronic stress causes a decrease in Bacteroides and Clostridum, which leads in turn to increased inflammation.
2. “Several studies have observed a relationship between dysbiosis and increased susceptibility to psychiatric and neurologic pathologies…including Alzheimer’s disease, Parkinson’s disease, and stroke, and psychiatric disease such as anxiety disorders, depression, and autism.”
3. Bacteria getting out of the gut through an impaired intestinal barrier has been shown to contribute to the development of major depressive disorders. Dysbiosis is linked to alterations in tryptophan (an amino acid, the precursor to serotonin) metabolism. The subsequent reduction in serotonin levels is observed in those with depression. There is now a “robust body of evidence” that probiotics have a positive effect on depression, driven by an increased availability of serotonin as well as a reduction in inflammation.

The bacterial microbiome and Immune Modulation via Probiotics, Prebiotics and Omega 3s:

1. In a randomized controlled study (RCA), healthy women were given Bifidobacterium animalis Lactis, Streptoccocus thermophiles, Lactobacillus bulgaricus, and Lactococcus lactis subsp. Lactis twice daily for 4 weeks.  They showed positive changes in brain activity and emotional regulation.
2. “Another RCT conducted in adults with major depressive disorder reported that 8 weeks of administering Lactobacillus acidophilus and Lactobacillus casei combined with Bifidobacterium bifidum significantly reduced depressive symptoms in relation to placebo.” This combination of probiotics also significantly reduced metabolic, inflammatory, and oxidative stress biomarkers in the blood.
3. Diets high in prebiotics are linked to increased microbiota diversity. And how’s this for interesting:  how quickly a particular prebiotic fiber is metabolized affects where in the colon it has its beneficial effect.  Thus, different fibers may be more or less important for people depending on what their guts/health issues look like.
4. Omega 3 fatty acids are also anti-inflammatory and can make their way into the brain, especially the frontal, parietal and occipital lobes. This is very dose dependent:  it takes higher doses to get into the brain.

In my next post on this article, specific details about Lactobacillus, Bifidobacterium, combinations of  them…and combining them with omega 3s.

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[i] Hutchinson, A.N.; Tingö, L.; Brummer, R.J. The Potential Effects of Probiotics and ω-3 Fatty Acids on Chronic Low-Grade Inflammation. Nutrients 2020, 12, 2402.