There's no doubt that when the hottest topics in medicine for 2014 are compiled, the microbiome will be on everybody's short list. This mass of bacteria has fascinated the nation and filled headlines. The fact that we have perhaps 100 trillion bacteria living in our bodies, estimated to be 10 times the number of cells in our body; the fact that our bacteria weigh at least 5 pounds; the fact that the Human Microbiome Project is completing an analysis of every bacteria in test subjects; all have become almost matter of fact.
For most of my years of practice, the gut and the heart seemed remote. However, the view that systems of the body don't function alone, but interact in a complex, interconnected web — the foundation of functional medicine — has gained favor. In the last few years I've recommended foods and supplements containing probiotics to my heart patients, and the science is demonstrating important benefits to support this.
Here are seven conditions probiotics may help improve:
1. Congestive heart failure
In a study about to be published, 20 patients with this serious disorder were treated with S. boulardii-containing supplements or placebo. Improvements in heart function and a reduction in cholesterol and inflammatory markers were seen in the group treated with probiotics.
2. High cholesterol levels
A number of studies indicate that one of the benefits of a healthier GI tract is a lower blood cholesterol level. A recent analysis of the published data found important support for this observation, and I've seen similar improvements in patients I have treated.
3. Low vitamin D levels
4. Blood pressure
An analysis of nine studies using probiotics found a reduction in blood pressure compared to placebo. This was particularly true when therapy was continued for over eight weeks with more potent preparations.
5. Diabetes mellitus
Although more studies are needed, improved glucose control and lower measures of inflammation have been seen when probiotics are administered to patients with diabetes.
I spend a fair amount of time counseling cardiac patients on measures to manage anxiety and use adaptogens and other nutraceuticals. Data are highlighting the role of the gut in neural pathways to the brain impacting mood and psychological state. Preliminary studies indicate improved mood in subjects given probiotics.
I see the obesity epidemic in my clinic every day, and excess weight identifies individuals at higher risk for diabetes, hypertension, and heart disease. Early work suggests that probiotics may make weight loss and management more successful.
It has long been said that the way to a man's heart is through his stomach, and that somewhat dated truth may be prophetic. The updated version is "through his or her microbiome."
It's becoming clear that optimal heart health requires optimal GI health, with avoidance of unnecessary antibiotics by prescription and from food sources, along with avoiding excesses of alcohol, sugar, trans fats, and perhaps genetically modified foods. Leighton Meester offered the advice to "Follow your gut and your heart. You'll almost always make the right choice." In my cardiology clinic it now appears that the advice is pretty much the same.
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