Max Roser and Hannah Ritchie (2020) - "Burden of Disease". Published online at OurWorldInData.org. 'https://ourworldindata.org/
Max Roser and Hannah Ritchie (2020) - "Burden of Disease". Published online at OurWorldInData.org. 'https://ourworldindata.org/
Hannah Ritchie and Max Roser (2020) - "Causes of Death". Published online at OurWorldInData.org. 'https://ourworldindata.org/causes-of-death'
Hannah Ritchie and Max Roser (2020) - "Causes of Death". Published online at OurWorldInData.org. 'https://ourworldindata.org/causes-of-death'
DEFECATIONRESIDUES IN DIET
MEALINGESTION
1000
mL
0POSTPRE
Colonic Biomass: Effect of Meals and Diet
MR imaging
•7
MR, magnetic resonance.
Bendezu R, et al. Neurogastroenterol Motil. 2016;28:849-854.
# of genes
Average gene set per individual 590,384
Common (>50% of individuals) 294,110
http://www.hmdb.ca
Fluid TotalMicrobial
origin% Microbial origin
Blood 3158 104 3,3
Saliva 1233 59 4,8
Urine 1976 102 5,2
CSF 450 36 8,0
Breast milk 120 10 8,3
Bile 18 5 27,8
Number of Metabolites Detected in Human Fluids
Rienks et al, Nutrients 2017
McDonald et al, mSystems 2018
Diversity of plants in diet associated with microbiome composition American Gut Project: Microbial sequence and data from 15,096 samples from 11,336 human participants
Gut microbes modulate response toimmunotherapy in melanoma patients
Gopalakrishnan et al, Science 2017
Gut microbes modulate response toimmunotherapy in melanoma patients
Gopalakrishnan et al, Science 2017
Exposure to antibiotics reduces survival in patients onimmunotherapy against epithelial tumors
Routy et al, Science 2017
Palleja et al, Nat Microbiol 2018
Loss of Bacterial Diversity in the Human Gut Microbiome afterAntibiotic Exposure
Oral vancomycin, gentamicin and meropenem from D0 to D4
Palleja et al, Nat Microbiol 2018
Different Recovery Capacities between Strains
Oral vancomycin, gentamicin and meropenem from D0 to D4
Disorders associated with loss of richness/diversity of the gut microbiota:
• Nutrition-related disorders (obesity, type 2 diabetes and the metabolic syndrome)
• Inflammatory bowel diseases (UC and CD)
• Caeliac disease
• Recurrent diarrhoea by C. diff
• Functional bowel disorders
• Systemic complications of decompensated liver disease
• Colo-rectal cancer
• Certain allergies
• Certain mental and neuro-developmental conditions, such as autism spectrum disorders
Loss of microbial richness is a common feature of chronic non-communicable
diseases of modern society
Dysbiosis in IBD
Pascal et al, Gut 2017
Le Chatellier et al, Nature 2013
Stewart et al, Nature 2018
Temporal development of the gut microbiome in early childhood
TEDDY study: The Environmental Determinants of Type 1 Diabetes in the YoungCohort: 8676 children with high-risk HLA-DR-DQ or first-degree relatives of persons with T1D enrolled at birth (from 2004 to 2010)Microbiome study: 12,005 gut microbiome samples from 903 children 3–46 months of age
Gut microbiome in early-onset type 1diabetes from the TEDDY study
Vatanen et al , Nature 2018
Zhao et al, Science 2018
Gut bacteria selectively promoted by dietary fibers alleviatetype 2 diabetes
Zhao et al, Science 2018
Gut bacteria selectively promoted by dietary fibers alleviatetype 2 diabetes
•30 patients complaining of flatulence •20 healthy subjects
Manichanh et al, Gut 2014
Diet-induced Microbiota Changes
Manichanh et al, Gut 2014
Bilophila wadsworthia was found positively correlated with volume of gas
evacuated in patients (r = 0.64; FDR = 0.12) but not in healthy subjects
Bilophila wadsworthia and gas volume
200 400 600
-2
0
2
4
6
8
Volume of gas evacuated
Rela
tive
ab
un
da
nce
Manichanh et al, Gut 2014
Flatulence PatientsBilophila wadsworthia and gas volume
200 400 600
-2
0
2
4
6
8
Rela
tive
ab
un
da
nce
Volume of gas evacuated
Healthy subjects
A Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome
Halmos et al, Gastroenterology 2014
• FODMAPs are poorly absorbed short-chain carbohydrates including fructose, lactose, polyols, fructans, and galacto-oligosaccharides.
• Vegetables, legumes, fruits, nuts, bread and cereals, dairy, honey, fruit juices, etc., may contain FODMAPS.
• Such dietary restrictions are difficult to maintain for long periods
A Diet Low in FODMAPs Alters the Colonic Luminal Microenvironment
Halmos et al, Gut 2015
Bimuno GOS versus low FODMAPs dietin patients with FGD complaining of excessive gas: experimental design
prebiotic GOS + balanced diet
placebo + low-FODMAPs diet
treatment period (4 wk)basal period follow-up (2 wk)
habitual diet habitual diet
Huaman et al, Gastroenterology 2018
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5flatulence pain distension borborygmi bloating
10
0
PREBIOTIC GROUP
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 50
10
flatulence pain distension borborygmi bloating
LOW FODMAPs GROUP
Digestive symptoms
pre-treatment
Huaman et al, Gastroenterology 2018
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5flatulence pain distension borborygmi bloating
***
10
0
PREBIOTIC GROUP
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5
*
*
*
**
0
10
flatulence pain distension borboriymi bloating
LOW FODMAPs GROUP
Digestive symptomspre-treatment treatment
Huaman et al, Gastroenterology 2018
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5flatulence pain distension borborygmi bloating
***
* * *
10
0
PREBIOTIC GROUP
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5
*
*
*
**
+
++*
**
0
10
flatulence pain distension borboriymi bloating
LOW FODMAPs GROUP
Digestive symptomspre-treatment treatment post-treatment
Huaman et al, Gastroenterology 2018
Number of daytime anal gas evacuation
* p<0.05 vs pre-treatment
0
5
10
15
20
1 2 3
*
*
20
0pre treatment post
LOW FODMAPs GROUP
0
5
10
15
20
1 2 3pre treatment post
20
0
PREBIOTIC GROUPPREBIOTIC GROUP
Huaman et al, Gastroenterology 2018
Changes in luminal bacteria during treatment
Huaman et al, Gastroenterology 2018
Functional gut symptoms: treatment strategies
microbiota
RESTRICTED BENEFICIAL
INACTIVITY ADAPTATION
COMPETENCEDYSBIOSIS/ATROPHY
SUBSTRATES IN DIET
• Maintaining gut microbiota diversity is a novel clinical target for health promotion and disease prevention.
• Improving gut species diversity and increasing abundance of fermentative taxa are to be considered as hard endpoints for human trials.
• Probiotics with high anti-oxidant and anti-inflammatory potential, and prebiotics promoting activity and abundance of butyrate producers, are to be developed and tested for their capacity of recovering vulnerable gut microbiotas in industrialized countries.