Understanding disease through gut microbiome


By Aly Cohen MD, FACR

Image credit: Shumilov Ludmila. CC BY 2.0 via Unsplash.

The gut microbiome, composed of various fungi, viruses, and bacteria, is a vital part of the human host. Taking centre stage, with regard to understanding disease and what causes chronic medical conditions and symptoms, the gut microbiome can play a significant role in the intestinal immune system and inflammation.


Research is being carried out to better understand how changes to the gut microbiome can modulate disease. Epigenetic changes are thought to occur in response to a wide variety of factors, including weight, physical activity, nutrition, and environmental and emotional exposures. The microbiome can affect these factors, and vice-versa. Low-molecular-weight substances produced by the gut microbiota can interact with the cellular environment, affecting the signaling pathways and gene expression that regulate cell death, inflammation, and differentiation. It is nearly impossible to have a discussion on genetics and health and not include the gut microbiome. Understanding the gut microbiome and its interaction with the epigenome and diseases will help physicians to improve disease prevention and treatment.


Changing the diet to include more healthy foods, such as fiber, fruits, and vegetables, can intervene in the process by cultivating a more favorable gut microbiome. This has implications for management of a wide variety of conditions, including obesity, diabetes, heart disease, allergy, and autoimmune disorders. The gut microbiota can produce substances such as vitamins that are favorable to health, but they can also produce harmful substances such as toxic metabolites. The mucous barrier of the intestinal tract works together with a diverse microbiome to favor a strong proportion of beneficial bacteria and to keep the harmful bacteria from causing disease. A healthy diet (read this freely available chapter) is an excellent way of maintaining a robust and diverse microbiome.


Eating an appropriate diet and avoiding certain types of environmental exposures can improve the composition of the gut microbiome, thereby modulating inflammation and the incidence of certain diseases and conditions. Understanding these influences on the gut microbiota is a key concept that can help guide clinicians when counseling patients about following a healthy diet and lifestyle.

Aly Cohen MD, FACR  is a board-certified rheumatologist and integrative medicine physician, as well as an environmental health specialist.  In 2011 Dr. Cohen founded her practice, Integrative Rheumatology Associates P.C., which focuses on both traditional western medical management of rheumatologic ailments, as well as integrative options for total “wellness”, such as biofeedback, acupuncture, cognitive therapy, diet and exercise counseling, environmental toxin counseling, smoking cessation, stress management and sleep evaluations.


She shares practical tips on reducing exposure to everyday chemicals and radiation on her website, TheSmartHuman.com and on Facebook: The Smart Human, Twitter, and Instagram: @TheSmartHuman


Her new book, Integrative Environmental Medicine, is now available in print and online.


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