Drugs, bugs and environment…

It’s always fascinating to see how trends come and go especially in the world of health and medicine. Don’t get me wrong, I love science but it can get a bit reductionist sometimes and miss the wood for the trees.

We have all seen and heard this in regards to the development of drug therapies that follow on from the observation that certain complex organic compounds can influence health. Problems often follow once the active agent has been isolated and purified. While the reduction of a complex organic compound to it’s principle ingredients may lead to significant drug developments it all comes at a price in the form of side effects and adverse reactions. Accurate and reliable figures are difficult to find, but one authoritative paper reported that adverse drug reactions accounted for 6.5% of all hospital admissions with a cost to the NHS of £446 million. These figures related to 2004 statistics and were published in the 2011 report. One can only shudder to think how the numbers read today. Understandably, given the sheer number of people talking medication in the UK reactions and side effects are bound to happen but these figures do raise an eyebrow!

In the natural health world we also need to be aware of the effect of environment on the body and it’s inner processes. Only comparatively recently has the science of epigenetics become a buzzword, helping to explain the apparent impact of environment on the functioning of the human genome. In a nutshell, a gene may express itself and perform function A in one environment and function B in another. In this context, the term environment can be wide-ranging; geographical, biochemical, nutritional and even psychological. Epigenetics helps underpins the ability of genes to adapt to change, but some of the changes may not always be of obvious benefit to us. To really understand the impact of environment and genes on health we need to turn our attention to the engrossing study of Evolutionary or Darwinian Medicine; may that’s subject for a future blog post.

Focusing a little closer to home, new data is emerging that may force us to rethink how we recommend certain supplements in light of the emerging field of enterotyping. As it’s name suggests, your enterotype reflects your specific gut bacteria type. This is dependant on your internal ecosystem that, in turn, is influenced and can be changed by your diet. The data from studies so far indicate that there are three dominant gut bacteria species; Bacteroides, Ruminococcus and Prevotella. The research has revealed that those who consume higher amounts of meat and saturated fats tend to have a Bacteroides enterotype while those who ate more carbohydrates displayed a Prevotella enterotype. A , Ruminococcus enterotype appeared to dominate in people who drank more alcohol. While a diet change has been shown to cause a shift in a persons gut bug population in the short-term (over 10 days or so) a real change in the actual enterotype can only be expected with a long-term diet change. The reason enterotyping might influence what we eventually recommend regarding supplements follows neatly on from a study that indicated an adverse cardiovascular effect associated with L-carnitine found in red meat. Cutting a long story short, the red meat L-carnitine has been implicated as being responsible for higher rates of atherosclerosis. After delving into the many reasons why this may be so, the researchers suggested that this effect was related to the persons enterotype. Because the red meat eaters naturally have the Bacteroides enterotype and this enterotype appears to be associated with an L-carnitine metabolic mechanism that may lead to atherosclerosis it is suggested that it is the enterotype not the L-cernitine that plays a key role. The metabolic marker associated with the theorised atherosclerotic effects of red meat L-carnitine breakdown was not observed to be elevated in vegans who typically displayed the Prevotella enterotype.

May be, in time, there will be further validation of the influence of our enterotype on health. May be this will include the effects of our enterotype on the metabolism of foods and possibly specific drugs and supplements. How ever you look at it, this type of research helps to keep our eyes open to the influence of environment (internal and external) and it’s effect on our health and well-being. Although this work is still at the experimental stage it does support the well-trodden quote Louis Pasteur is famed to have uttered from his death bed; “It’s the terrain, not the germ.”

By Marcus Webb

Holistic health expert and author
Marcus Webb ND is the technical director of Hadley Wood Healthcare (www.hhcproducts.co.uk) and serves on the editorial board of the peer-reviewed open access publication, the Natural Medicine Journal. He is also on the medical advisory board of Fibromyalgia (UK)