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The GUT – Where Bacteria and Immune System Meet

Gut health refers to the balance of microorganisms that live in the digestive tract. Looking after the health of the gut and maintaining the right balance of these microorganisms is vital for physical and mental health.

A healthy gut contributes to

  • A strong immune system
  • Heart health
  • Brain health
  • Improved mood
  • Healthy sleep
  • Effective digestion
  • It may help prevent cancer
  • And autoimmune diseases

These bacteria, yeasts, and viruses, of which there are around 100 trillion, are also called the “gut microbiome” or “gut flora.”

Many microbes are beneficial for human health, and some are even essential. For maintaining the gut microflora, conscious addition of probiotic and prebiotic foods is essential.

Hence, here have given out certain guidelines that can help you combat the problems of Gut health during COVID-19 lockdown. 

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Guidelines To Improve Gut Health: 

  • Include homemade curd and buttermilk twice a day. 
  • Include fermented foods like idli, dosa, dhokla more frequently. 
  • Add variety to the diet by incorporating other fermented recipes like Sauerkraut, pickled vegetables, kanji, ambali, etc.
  • Have balanced meals including whole grains, germinated pulses, fruits, salads. Add flavour to meals by specifically adding garlic, onions, flaxseed chutney. 
  • Include rice and brown rice-based recipes more often as they help in improving the gut health. 
  • Take cereal-pulse combination recipes like khichadi, oats moong dal upma, etc more often. 
  • Minimize the intake of refined and processed foods like while bread, white pasta and other maida preparations. 
  • Include a good amount of fiber in the diet by taking oats, salads, sprouts in meals. 
  • Probiotic supplements like Velgut, Darolac, vibact can be included for 1 month. 
  • Limit fats and simple sugars; avoid deep-fried foods, butter, and saturated fats, sugary drinks, sugary foods to maintain good gut health. 
  • Avoid alcohol, artificial sweeteners, food additives, food preservatives to preserve the good bacteria in your gut.

Protection Of Pulmonary Tissue:

Angiotensin converting enzyme 2 (ACE2) has been reported as the entry point into human cells for some coronaviruses, including SARS-CoV and COVID-19. The devil COVID-19 is rising over us with accompanying adverse effects on several important organs predominantly the lungs. Intra and extra pulmonary expression of ACE2 can be the possible reason for this.

However, the gut is the biggest immune organ and its ACE2-mediated effects on immune and neural systems might impact pulmonary functions. Thus, the small intestine is the most abundant source of ACE2 and has been linked with microbiota. 

Moreover, regulation of ACE2 is critical in situations like COVID-19. To do that, engineered microbial consortia (EMC) can be used. EMC can modify human microbiome (especially gut microbiome) and help human cells to fight against diseases as deadly as COVID-19.

Gut Microbiome Activates Vitamin A

The fine details of the interactions between the gut microbiome and the immune system are not fully understood. But there seems to be a link between the makeup of the microbiome and inflammation – one of the hallmarks of the immune response.

Gut bacteria produce many beneficial chemicals and also activate vitamin A in food, which helps to regulate the immune system.

Therapeutic Treatment Claim By An US Company

San Diego /PR News wire /Persephone Bio-sciences Inc., a biotechnology company that designs micro-bio-me therapeutics and diagnostics to promote normal immune function in order to prevent and fight disease, recently announced that it is developing an immune-boosting micro-bio-me therapeutic to help prevent and fight the novel coronavirus (SARS- CoV-2) as well as a potential stool-based diagnostic designed to help predict which patients are of at highest risk for developing severe complications and mortality from COVID-19.[1]

“Recent reports from China suggest that COVID-19 is strongly linked to the gastrointestinal tract and that there is some correlation between severe patient response to the disease and imbalanced or damaged gut microbiomes,” said Stephanie Culler, CEO and co-founder of Persephone Biosciences. “We noted these findings because our research is centred around the microbiome, making our therapeutic discovery platform immediately relevant in the fight against SARS-CoV-2.” 

Gut Health And Diabetes

It is found that probiotic supplementation for 12 weeks had beneficial effects on glycemic control, HDL- cholesterol, total-/HDL-cholesterol ratio, biomarkers of inflammation and oxidative stress in diabetic patients with CHD.[2]

A study showed a significant decrease in FPG level and increase in HDL by multi-strain probiotic supplements in within group comparison; though, further studies are needed to confirm results. [3]

Gut Health And Elderly

Probiotics (usually lactobacilli and bifidobacteria) and prebiotics (non-digestible oligosaccharides) have been shown to be useful in preventing certain disease conditions as well as possibly promoting specific aspects of health.

In the present review, the evidence from clinical trials for benefits from probiotics and prebiotics to elderly populations is presented and discussed, specifically in respect of three common conditions found in the elderly. Both probiotics and prebiotics may be helpful in malnutrition, particularly in lactose intolerance and calcium absorption, and in constipation.

 Probiotics have been shown clearly to boost immunity in the elderly, but the clinical significance of this remains to be clarified. These results are encouraging, and further large-scale studies seem justified to establish the place of probiotic and prebiotic supplements in elderly subjects.[4]

Gut Health And Menopause:

The research suggests that the intervention of optimum level of probiotic supplementation along with some nutraceuticals improved the climacteric symptoms and vaginal health status by altering the microbiota. [5]

Gut Health And Gout

There is ample clinical and epidemiological evidence supporting the role of prebiotics and probiotics in reducing uric acid levels in serum, though the mechanisms remain elusive.

Probiotics can influence the bioavailability of the uric acid precursor, namely purine and its breakdown products inosine and guanosine, which could influence clinical uric acid profiles. [6]

Gut Health And PCOS 

Overall, the co-administration of probiotic and selenium for 12 weeks to women with PCOS had beneficial effects on mental health parameters, serum total testosterone, hirsutism, hs-CRP, TAC, GSH and MDA levels. [7]

The finding provides evidence that daily probiotic consumption has beneficial effects on decreasing Fasting Blood Insulin, TG, and VLDL-C, and increasing the Quantitative Insulin Sensitivity Check Index (QUICKI) score in PCOS patients. [8]

Gut Health And Hypertension

An increasing number of clinical trials supporting the probiotic-dependent attenuation of hypertension and hypercholesterolemia could provide immense support for the application of such cultures to improve cardiovascular health. Hence, dietary intervention to correct gut microbiota could be an innovative nutritional therapeutic strategy for hypertension.

The knowledge obtained on probiotic potential against CVDs is still at infancy stage and current findings suggest that hypotensive effects of probiotics are very promising and worth exploring to promote cardiovascular health.[9]

Gut Health And Thyroid:

The gut microbiota has important effects on human health and disease. It is an altered composition of the gut microbiota was identified as a factor contributing to Hashimoto’s Thyroiditis and Grave’s Disease. The microbiota may influence Iodine uptake and enterohepatic cycling of thyroid hormones.[10]

Prebiotics

Prebiotics act as food for the probiotics and help the good bacteria in the gut to grow. An article by Dr. Jagmeet Madan enlists the sources of whole grains as prebiotics.[11]

Sources: 

Whole grains, garlic, onions, raw banana, oats, apples, flaxseeds, pulses, fruits. 

  • Germinated pulses act as better prebiotics. 
  • Brown rice is a better source of prebiotics than wheat – can be opted more often. 
  • Combination of cereals and pulses like in khichadi proved to be a better source of prebiotics. 
  • Fiber supplements like inulin, FOS also help in improving the gut microflora. 

Prebiotic Supplements: 

Many inulin and FOS containing prebiotic supplements are available. Myfy, Fitofy, 100% Inulin, somavit are few examples that can be suggested.

Probiotic Supplements:

OTC – Velgut, Darolac, Vibact. 

While adding supplements, please check the for the following:

  • Suitability to the client 
  • Adding anything new with caution and for a short period of time. 
  • Bacteria-derived probiotics should be separated from antibiotics by at least two hours. 
  • Live cultures are not recommended for those with serious medical conditions, for example those who are severely immunosuppressed, have pancreatitis, are in the ICU, have melaena, have a central venous catheter, infants with short bowel syndrome, or to patients with open wounds following major surgery; unless under a doctor’s care. 
  • Pregnant or breastfeeding women should consult their doctor before taking certain live cultures. [12]

Probiotic Recipes

1. Sauerkraut:

Ingredients:

  • 2kg very firm, pale green or white cabbage (any leathery outer leaves removed), cored 
  • 3 tbsp coarse crystal rock salt (or 6 tbsp flaky rock salt) 
  • 1 tsp caraway seeds 
  • 1 tsp peppercorns 

Method –

  • Thoroughly wash a large tub or bowl, then rinse with boiling water. Make sure that your hands, and everything else coming into contact with the cabbage, are clean. It is wise to use a container that will fit the softened cabbage, allowing several inches of room at the top to avoid overflow. 
  • Shred the cabbage thinly. Layer the cabbage and the salt in the tub or bowl. Massage the salt into the cabbage for 5 mins, wait for 5 mins, then repeat. You should end up with a much-reduced volume of cabbage sitting in its own brine. Mix in the caraway seeds and the peppercorns. 
  • Cover the surface of the cabbage entirely with a sheet of cling film, then press out all the air bubbles from below. Weigh the cabbage down using a couple of heavy plates, or other weights that fit your bowl, and cover as much of the cabbage as possible. The level of the brine will rise to cover the cabbage a little. Cover the tub with its lid (or more cling film) and leave it in a dark place at a cool room temperature (about 18-20C) for at least 5 days but for maximum flavour leave the cabbage to ferment for anywhere between 2-6 weeks (or until the bubbling subsides). 
  • Check the cabbage every day or so, releasing any gases that have built up as it ferments, and give the cabbage a stir to release the bubbles. If any scum forms, remove it, rinse the weights in boiling water and replace the cling film. You should see bubbles appearing within the cabbage, and possibly some foam on the top of the brine. It’s important to keep it at an even, cool room temperature – too cool and the ferment will take longer than you’d like, too warm and the sauerkraut may become mouldy or ferment too quickly, leading to a less than perfect result. 
  • The cabbage will become increasingly sour the longer its fermented, so taste it now and again. When you like the flavour, transfer it to smaller sterilised jars and keep it in the fridge for up to 6 months. 

2. Carrot Kanji

Ingredients: 

  • 250 gm carrots-preferably the dark variety (called kaali gajar) 
  • 6 cups water 
  • 3 Tbsp powdered mustard seeds 
  • 2 Tbsp salt

Method: 

  • Peel the carrots, and cut them into 7cm/3″ pieces, not too thin (about finger size). 
  • Boil the water and add the carrots to it. 
  • When the water comes to a boil again, shut off the heat and leave to cool. 
  • Add salt and mustard powder, and transfer it into a jar with a lid, and keep this in the sun, to mature.
  • In sunny weather, it takes 3-4 days for the taste of the mustard to become strong. Do not keep the jar in the sun, after it is ready.

3. Pickled Vegetables 

Ingredients: 

  • 1⁄2 medium cauliflower, florets cut into small, bite- sized pieces 
  • 2 medium carrots, cut on a sharp diagonal into 1⁄8” thin rounds 
  • 1 small white or yellow onion, sliced into very thin rounds 
  • 2 chillies, sliced into thin rounds 
  • 6 garlic cloves, quartered 
  • Plain white vinegar or apple cider vinegar – 1 cup
  • Water – 1 cup
  • Salt – 1 tablespoon
  • Honey – 1 1⁄2 tablespoon
  • Leaf – 1 bay
  • Oregano – 1 teaspoon
  • Freshly ground black pepper 

Method

  • Pack the cauliflower, carrots, onion, jalapeños and garlic into a quarter-sized wide-mouth mason jar. Place the jar in the sink since you will be pouring hot liquid into it soon. 
  • In a medium saucepan, combine the vinegar, water, salt, honey, bay leaf, oregano and a generous amount of freshly ground black pepper. Bring the mixture to a simmer over high heat, then carefully pour the hot vinegar mixture into the jar. You should have enough to completely submerge the vegetables (and maybe a little extra). Tuck the bay leaf into the side of the jar. 
  • Let the pickles cool to room temperature (about 1 1⁄2 hours) before gently tapping the jar to remove air bubbles. The pickles should be pretty well pickled and ready to consume at this point. If you are not eating them right away, securely fasten the lid and refrigerate for up to a month. 

Important:

Always follow pickle recipes exactly. Altering quantities—especially those of vinegar, vegetables, and salt—can lead to the spread of spoilage-causing bacteria.

Scrupulously clean all cooking utensils in hot, soapy water. Rinse thoroughly. 

Use stainless-steel, glass, or ceramic bowls. For pots and pans, use stainless steel, heat proof glass, or hard-anodised aluminium. 

Avoid containers and utensils made of copper, iron, zinc, or brass (these materials may react with acid and salt). 

3. Kambu Ragi Koozh / Ambali (fermented, vegan, gluten-free)

Ingredients: 

  • Whole kambu or Bajra – 1 cup 
  • Ragi flour – 1.5 cups 
  • Water for cooking – 4.5 – 5 cups 
  • Salt to taste 
  • Chopped onion (Optional)

Method: 

  • Soak the whole kambu or bajra for an hour. Rinse and let it air-dry for a couple of hours. 
  • Then use a mixer and grind to a coarse rava/broken grain consistency. Add water to the broken kambu.
  • Add the ragi flour and mix well. Set aside till it ferments. Overnight does the trick. 
  • Boil the water, add salt and add the fermented grain mixture to it. Keep some more water aside. 
  • In case the porridge becomes too thick, add water as required. Allow it to cook till it thickens and flour gels together. Set aside till it cools completely. 
  • Koozh can be eaten in a couple of ways. Thick koozh can be eaten as one would eat paddy/millet rice. Serve it with sambar and poriyal or however it is you eat your rice. 
  • Alternately, once the koozh has completely cooled down, it can be diluted with water so it is a more flowing porridge and chopped raw onion can be added to it. This is pretty much a complete food in itself.

4. Turmeric Root & Mango Ginger Pickle in Lemon Juice

Ingredients 

  • 150 gms Fresh Mango Ginger 
  • 150 gms Fresh Turmeric Root 
  • 1/3 Cup Lemon Juice (~5 Large Lemons)
  • 4-5 Green Chillies (optional) 
  • 1/2 tsp Salt

Method

  • Using a few drops of oil, grease your palms. This prevents the turmeric root from staining your palms. 
  • Peel and chop the turmeric & mango ginger into thin slices. You can also julienne them. Cut the green chillies into 1/2′′ pieces. 
  • Add the mango ginger slices, turmeric root slices, green chillies, lemon juice and salt to a clean, dry, airtight glass bottle. Use a spoon and mix well. Close the bottle and let the pickle rest for 2 days. [13]

Conclusion

With most other health conditions, Gut health is one of the concerns and easily taken care of. Immunity has been playing a major role among people who are getting recovered from the COVID-19 attack. Hence Gut health during COVID-19 is something we have to be taking measures for since it comprises more than 75% of the Immune System.

The guidelines mentioned above not only helps people with poor gut health but people in general without any other medical conditions.

‘Gut health is the key to overall health’- says Kris Carr. This is indeed true. Have you ever felt uneasy after having a healthy meal? Never! While this is the time when our body has to get stronger and healthy to fight against the deadly COVID-19, it is our need in hour to practice a healthy lifestyle.

We have given out guidelines to be practised for most other health conditions including Gut health during COVID-19 pandemic. Do hover on those articles and share them with people who you believe will be helped. Also, contact us for any queries regarding your concerns with dealing during COVID-19.