Gut Health Revolution: How Probiotics Could Be a Key to Weight Loss

WORDS LIYANA TAN ABDULLAH & DR NURUL HUDA RAZALLI

FEATURED EXPERTS

LIYANA TAN ABDULLAH
BSc Applied Chemistry UM
Student of Master Clinical Nutrition
Universiti Kebangsaan Malaysia
DR NURUL HUDA RAZALLI
Senior Lecturer
Dietetic Programme
Centre for Healthy Ageing and Wellness (H-CARE)
Faculty of Health Sciences
Universiti Kebangsaan Malaysia (UKM)
GETTING TO KNOW PROBIOTICS BETTER
  • Probiotics are live bacteria and yeasts that are beneficial for your health, especially your digestive system. Often referred to as ‘good’ or ‘helpful’ bacteria, they help keep your gut healthy.
  • Probiotics are naturally found in your body, but they can also be ingested through certain foods and supplements.
  • Probiotic products contain selective, beneficial types of microbes to add to the populations already living in your body.
  • They are crucial in maintaining a balanced gut microbiota, the community of microorganisms living in the intestines. The human gut is home to trillions of bacteria, a complex ecosystem that plays a vital role in digesting food, synthesizing nutrients, and defending against pathogens. Probiotics contribute to this ecosystem by enhancing its function and restoring its natural balance when it has been disrupted.
  • Some studies suggest that certain probiotics may aid in weight loss by influencing metabolism and fat storage.
PROBIOTIC PRODUCTS IN THE MARKET
  • Many probiotics are oral supplements designed to be ingested into your gastrointestinal tract.
  • Others are topical products that you can apply to your skin or to the mucous membranes inside your body cavities, like your nose or genitals. These are all places where beneficial microbes commonly live.
  • You can also obtain probiotics from your natural food. Yes, tempeh, yogurt, kefir, kimchi, sourdough bread, and other usually fermented foods are probiotic-rich.
THE LINK BETWEEN PROBIOTICS & OBESITY

Variation in the composition of the gut microbiota results in health deterioration due to the mechanisms they employ to maintain appropriate homeostasis, including immune system modification, metabolic signaling, endocrine signaling, neuronal signaling, and epigenetics.

The condition is closely linked to various metabolic disorders, including elevated cholesterol levels, type 2 diabetes, heart and vascular diseases, and osteoporosis.

Consequently, addressing obesity through prevention and treatment is crucial, more so with the integration of innovative scientific approaches and technologies like artificial intelligence.

Probiotics, regarded by the WHO and FAO in 2002 as beneficial live microorganisms that confer health benefits when consumed in adequate amounts, are a testament to this.

They positively affect the host by establishing themselves within the human body and altering the microbial composition at specific sites. By modulating the mucosal and systemic immune functions or adjusting the intestinal microbiota balance, they facilitate nutrient absorption and intestinal health, offering health-promoting effects whether as single or mixed microorganisms with a defined composition.

The connection between gut health and obesity has become a focal point of modern medical research. Studies suggest that the composition of gut microbiota in obese individuals differs significantly from that of healthy individuals, indicating a potential link between gut microbes and obesity.

Probiotics interact with the host through pattern recognition receptors in intestinal cells, such as Toll-like receptors, and these can play multiple roles in the individual’s body.

The mechanisms of action of probiotics associated with obesity control may be modulation of endogenous microbiota functions that affect interaction with the host, competitive exclusion of pathogens, improved epithelial barrier function and other innate immune responses, modulation of fat absorption and excretion, reduced endotoxemia and inflammation, and modulation of numerous genes involved in hepatic lipogenesis or lipolysis in adipose tissue.

Gut Microbiota and Body Weight Regulation

Research shows that certain strains of gut bacteria are more prevalent in individuals who are obese compared to those who are not. These bacteria may influence weight by affecting the body’s metabolism, increasing energy extraction from food, and altering the way fat is stored in the body.

Probiotics and Weight Loss

Research indicates that specific probiotic strains could be effective for weight loss in obese individuals.

Some studies have found that introducing specific probiotic strains such as Hafnia alvei can help reduce body weight and body mass index (BMI) in obese individuals.

Probiotics may aid weight loss by improving the balance of the gut microbiota, reducing inflammation, and influencing hormones and proteins related to appetite and fat storage.

Prebiotics and Synergistic Effects

Prebiotics, non-digestible fibers that feed beneficial gut bacteria, can also play a role in managing obesity. When combined with probiotics, prebiotics can enhance the growth and activity of healthy gut bacteria, leading to improved gut health and potentially contributing to weight loss.

HOW CAN OUR GUT MICROBIOTA BECOME UNBALANCED?
External Factors

Diet, drug intake, and lifestyle habits—smoking, alcohol intake, and disrupted sleeping habits—which can easily influence the bacterial communities in the gut.

Bacterial Metabolites from the Gut

These metabolites, such as SCFAs, gamma-aminobutyric acid (GABA), and tryptophan, have a substantial influence on the regulation of the gut-brain axis.

For example, even a short-term (5-days) consumption of diets composed entirely of animal or plant products alters the microbial community structure, affecting microbial gene expression among individuals.

Fermentable dietary fibre, prebiotics, and probiotic-based diets contribute to the proliferation of SCFA-producing bacteria, which might influence gut-brain communication and brain function directly or indirectly through immune, endocrine, vagal, and other humoral pathways.

THE CHALLENGES IN USING DIET AS A MEANS TO ACHIEVE & MAINTAIN BALANCED GUT MICROBIOTA

Firstly, individual variability plays a significant role. The gut microbiota is highly personal and can be influenced by genetics, age, diet, lifestyle, and even antibiotic use.

This variability means that what works for one person may not work for another, making personalized nutrition and probiotic supplementation strategies necessary.

Furthermore, modern lifestyles and diets often work against the maintenance of a healthy gut microbiota. Processed foods, high sugar consumption, and the overuse of antibiotics can disrupt the delicate balance of gut bacteria, making it difficult to restore or maintain a healthy gut environment.

Additionally, stress and lack of sleep can also negatively affect gut health, adding another layer of complexity to managing gut microbiota.

Lastly, the current regulatory environment regarding probiotics and dietary supplements can be a challenge for consumers. The market is flooded with products claiming to support gut health, but not all of these products are effective or safe. The lack of stringent regulation and standardized testing protocols makes it challenging for individuals to make informed choices about the probiotics and prebiotics they choose to incorporate into their diets.

WHAT CAN WE DO TO MAINTAIN A HEALTHY GUT MICROBIOTA?

Beyond diet and supplementation, holistic approaches that encompass emotional well-being and physical activities play a crucial role in maintaining a balanced gut microbiota.

Healthy Food and Physical Activities

Use the Malaysian Healthy Plate as simple yet effective guide to help you balance your meals on a 10-inch plate.

Imagine dividing your plate into 4 parts.

  • One quarter is dedicated to carbohydrates like rice, noodles, bread, grains, or tubers, ensuring you have the energy to power through your day.
  • The next quarter is reserved for proteins such as fish, poultry, meat, or legumes, supporting muscle repair and growth.
  • The remaining half is where colourful vegetables and fruits come in, flooding your body with essential vitamins, minerals, and fiber.
Healthy Emotional Well-being
  • Practice activites that promote emotional well-being, such as mindfulness, meditation, adequate sleep, and stress management techniques.

Through a comprehensive approach that includes healthy eating, exercise, and stress reduction, individuals can support their gut microbiota’s balance, thereby enhancing their overall health and well-being.

References:

  1. Coradduzza, D., Sedda, S., Cruciani, S., De Miglio, M. R., Ventura, C., Nivoli, A., & Maioli, M. (2023). Age-related cognitive decline, focus on microbiome: A systematic review and meta-analysis. International journal of molecular sciences, 24(4), 3756. https://doi.org/10.3390/ijms24043756
  2. Dalile, B., Van Oudenhove, L., Vervliet, B., & Verbeke, K. (2019). The role of short-chain fatty acids in microbiota-gut-brain communication. Nature reviews gastroenterology & hepatology, 16(8), 461-478. https://doi.org/10.1038/s41575-019-0157-3
  3. Déchelotte, P., Breton, J., Trotin-Picolo, C., Grube, B., Erlenbeck, C., Bothe, G., Fetissov, S. O., & Lambert, G. (2021). The probiotic strain H. alvei HA4597® improves weight loss in overweight subjects under moderate hypocaloric diet: A proof-of-concept, multicenter randomized, double-blind placebo-controlled study. Nutrients, 13(6), 1902. https://doi.org/10.3390/nu13061902
  4. Jokela, M., Virtanen, M., Batty, G. D., & Kivimäki, M. (2016). Inflammation and specific symptoms of depression. JAMA Psychiatry, 73(1), 87-88. https://doi.org/10.1001/jamapsychiatry.2015.1977
  5. Luoto, R., Kalliomäki, M., Laitinen, K., & Isolauri, E. (2010). The impact of perinatal probiotic intervention on the development of overweight and obesity: Follow-up study from birth to 10 years. International journal of obesity, 34(10), 1531-1537. https://doi.org/10.1038/ijo.2010.50
  6. National Center for Complementary and Integrative Health. (2019, August). Probiotics: What you need to know. https://www.nccih.nih.gov/health/probiotics-what-you-need-to-know
  7. Zhang, J., Mu, J., Li, X., & Zhao, X. (2022). Relationship between probiotics and obesity: A review of recent research. Food science and technology, 42, e47621. https://doi.org/10.1590/fst.47621

Concerned about Food Additives & Food Safety? You Should Read This!

WORDS TI MEI JUN & DR NURUL HUDA RAZALLI

FEATURED EXPERTS

TI MEI JUN
Student of Master Clinical Nutrition
Faculty of Health Sciences
Universiti Kebangsaan Malaysia (UKM)
DR NURUL HUDA RAZALLI
Senior Lecturer
Dietetic Programme
Centre for Healthy Ageing and Wellness (H-CARE)
Faculty of Health Sciences
Universiti Kebangsaan Malaysia (UKM)

More than 200 diseases, ranging from cancer to diarrhoea, are brought on by contaminated food that contains dangerous bacteria, viruses, parasites or chemical.

Malaysia had an incidence of 60 cases of food and water borne disease per 100,000 people, with 56% being food poisoning.

Hence, food safety is crucial to ensure that food, when prepared or consumed in accordance with its intended usage, would not harm consumers.

4 FACTS THAT WE SHOULD KNOW ABOUT FOOD ADDITIVES
  1. According to Codex Alimentarius Commission—also known as the ‘Food Code’ published by the Food and Agriculture Organization of the United Nations (FAO) and World Health Organization—any substance that is not typically used as an ingredient in food or consumed as food on its own is considered a food additives, regardless of its nutritional value.
  2. Food additives are added to processed foods to serve several functions, most prominently the prevention of food spoilage, improvements in flavour or texture and other desired qualities, and the provision of certain colours and flavours.
  3. Food additives are applied in the production and processing of almost all food types.
  4. Only specific foods may have food additives added to them, and only to the extent allowed by the Food Regulations of 1985.
EXAMPLES OF COMMON FOOD ADDITIVES
Soybean To maintain food consistency
Beet A colouring agent
Tartazine A colouring agent
Aspartame An artificial sweetener
Monosodium glutamate (MSG) A flavour enhancer
Lecithin Thickening and stabilizing agent
Guar gum Thickening and stabilizing agent
Benzoic acid A preservative
Sorbic acid A preservative
5 TIPS FOR CONSUMERS TO REDUCE EXPOSURE TO HARMFUL ADDITIVES
  1. People with allergies or sensitivity to certain food ingredients should closely read labels when shopping for processed foods.
  2. Buy fresh and whole food to minimize exposure of food additives and contaminants.
  3. Proper storage and handling of food materials are crucial to prevent contamination. Wash and peel foods, such as apples and eggs, to remove dirt and pesticides.
  4. Purchase food from stalls that demonstrate good hygiene practices, such as covering and properly packaging their food.
  5. Buy food that is prepared fresh upon ordering, rather than food that was cooked earlier and not maintained at the appropriate temperature.

References:

  1.  Halim, N. R. A., Mutalib, S. A., Ghani, M. A., & Hashim, H. (2024). Food safety regulations implementation and their impact on food security level in Malaysia: A review. International food research journal, 31(1), 20-31. https://doi.org/10.47836/ifrj.31.1.02
  2. Laganà, P., Avventuroso, E., Romano, G., Gioffré, M. E., Patanè, P., Parisi, S., Moscato, U., & Delia, S. (2017). The Codex Alimentarius and the European legislation on food additives. In P. Laganà, E. Avventuroso, G. Romano, M. E. Gioffré, P. Patanè, S. Parisi, U. Moscato, & S. Delia (Eds.), Chemistry and hygiene of food additives (pp. 23-32). Springer International Publishing.
  3. Lalani, A., Pouyani, N., Askari, A., Tavajohi, S., Akbari, S., & Jafarzadeh, E. (2024). Food additives, benefits, and side effects: A review article. Journal of chemical health risks, 1(1), 1. https://doi.org/10.22034/jchr.2023.1967340.1619
  4. Liang, X. (2023). Impact of food additives in ultra-processed food on human health. Theoretical and natural science, 6, 437-444. http://dx.doi.org/10.54254/2753-8818/6/20230321
  5. Ukwo, S., Udo, I., & Ndaeyo, N. (2022). Food additives: Overview of related safety concerns. Food science & nutrition research, 5(1), 1-10. http://dx.doi.org/10.33425/2641-4295.1052

Food for All: Modifying Food Texture for People With Dysphagia

WORDS AINUL SYAFIQAH MOHD AZAHARI & DR NURUL HUDA RAZALLI

FEATURED EXPERTS
AINUL SYAFIQAH MOHD AZAHARI
Nutritionist and Student of Master Clinical Nutrition
Faculty of Health Sciences
Universiti Kebangsaan Malaysia
DR NURUL HUDA RAZALLI
Dietetic Programme
Centre for Healthy Ageing and Wellness (H-CARE)
Faculty of Health Sciences
Universiti Kebangsaan Malaysia

DYSPHAGIA: IT MEANS DIFFICULTIES IN SWALLOWING FOODS & LIQUIDS

  • Dysphagia comes from  Greek word ‘dys’, which means difficulties, and ‘phagia’, which means swallowing.
  • Medically, dysphagia is a term for swallowing difficulties. Someone with dysphagia takes more time and effort to move food or liquid from their mouth down to their stomach.
  • Episodes of dysphagia can be intermittent or progressive.
IT IS A SYMPTOM FOR MANY MEDICAL CONDITIONS
  • In adults, dysphagia is very common in adult that has a history of stroke, dementia, Alzheimer’s disease, neck cancers, and gastroesophageal reflux disease (GERD).
  • It could also be present in children with attention deficit hyperactivity disorder (ADHD), autism, Down syndrome, and cerebral palsy.
  • Dysphagia can also be a sign that there are some issues with the many nerves and muscles that are involved in swallowing activities.
YOU MAY HAVE DYSPHAGIA IF YOU EXPERIENCE THE FOLLOWING
  • Persistent drooling of saliva
  • Coughing or choking when eating or drinking
  • Bringing food back up, sometimes through the nose
  • Feeling as though food is stuck in your throat or chest
  • Being unable to chew food properly
PEOPLE WITH DYSPHAGIA FACE ISSUES THAT CAN JEOPARDIZE THEIR HEALTH & WELL-BEING

Choking and lung infection

Individuals with dysphagia are susceptible to choking. Due to difficulties in swallowing normally, consumed foods or liquids can accidentally enter the airway into the lungs. This could result in aspiration pneumonia, often known as a lung infection and can be fatal.

Poor nutrition intake
  • The prevalence of malnutrition among people with dysphagia is reported to be anywhere between 3% and 29%, which is quite a high number.
  • Malnutrition leaves people with dysphagia more vulnerable to diseases, should they not receive enough essential nutrients for optimal body function.
  • Muscle wasting, underweight, and stunting could be other issues that arise. Hence, people with dysphagia needs to be aware of any weight loss, hair loss, feeling of coldness, and fatigue as these are the early symptoms of malnutrition.
Loss of appetite and fear of mealtimes
  • People with dysphagia often lose their appetite in conjunction with their reduced swallowing ability.
  • They might develop some degree of “laziness” when it comes to drinking more often, which may lead to dehydration.
  • Because their eating experiences can be difficult, uncomfortable, and unpleasant, they may develop anxiety during mealtimes.
Inability to talk fluently
  • Dysphagia can hinder one’s ability to talk fluently and, combined with difficulties in eating, may cause the affected person to experience low self-esteem and lead to self-isolation.
  • The decrease in social engagement will give a negative impact in the person’s quality of life.
  • Thus, social support from their carer, family members, and close friends are crucial. A little extra kindness and help will give a huge impact in their life and sometimes even touch their heart.
Proper nutrition management for people with dysphagia involves providing adequate nutrients through modification of food texture and fluid consistency.

We need to also keep an eye out for symptoms of dehydration such as dry mouth or tongue, thirst, headache, and lethargy. 

Also, be alert to any unexplained weight loss, hair loss, feeling of coldness and fatigue—these could be early symptoms of malnutrition.
IF YOU ARE WORRIED THAT YOU OR SOMEONE CLOSE TO YOU HAVE DYSPHAGIA

Consult a speech language pathologist, a healthcare professional trained to diagnose dysphagia, for a proper diagnosis.

People with dysphagia can consult with dietitians for their nutritional concerns or if they want to assess their nutritional adequacy.

TIPS FOR INDIVIDUALS WITH DYSPHAGIA TO ACHIEVE GOOD NUTRITION

Understand the extent of one’s dysphagia

Discuss with the speech language pathologist and other relevant healthcare professionals on the degree of swallowing ability in the person with dysphagia.

Refer to the International Dysphagia Diet Standardization Initiative (IDDSI) Framework

This guideline has seven levels. Flow test, spoon tilt, and fork drips are used as measurement methods to determine each level.

Click to view a larger and clearer image.

Further information can be obtained from the IDDSI website (link opens in a new tab).

Modify foods into certain textures 

For more detailed information on how to modify the textures of various foods, you can refer to this page on the IDDSI website (link opens in a new tab).

  • While modifying the textures of foods into appropriate textures, take into consideration the nutritional content (carbohydrates, protein, fat, as well as vitamin and minerals). Daily meals should provide all the nutrients to improve the person’s nutritional status.
  • Always choose softer food options if texture modification is not possible. For example, choose papaya instead of apple, and ‘soften’ a dish with gravy.
  • Add special thickening powder to watery liquids. This thickening allows for easier swallowing.
Useful tips for eating
  • Have the person with dysphagia sit upright to prevent choking.
  • Have them tilt their heads to prevent liquids from going into their air passage.
  • Encourage the person to take smaller bites, and give enough time to chew the food thoroughly.
  • If small pieces of food or liquid are stuck, have them cough a little.

Dysphagia is a journey of eating experience that may switch an individual’s life 360 degree. Hence support and motivation play an important role in the management of one’s dysphagia.

References:

  1. O’Rourke, F., Vickers, K., Upton, C., & Chan, D. (2014). Swallowing and oropharyngeal dysphagia. Clinical medicine (London, England), 14(2), 196–199. https://doi.org/10.7861/clinmedicine.14-2-196
  2. Shaheen, N. A., Alqahtani, A. A., Assiri, H., Alkhodair, R., & Hussein, M. A. (2018). Public knowledge of dehydration and fluid intake practices: Variation by participants’ characteristics. BMC public health, 18(1), 1346. https://doi.org/10.1186/s12889-018-6252-5
  3. Ueshima, J., Momosaki, R., Shimizu, A., Motokawa, K., Sonoi, M., Shirai, Y., Uno, C., Kokura, Y., Shimizu, M., Nishiyama, A., Moriyama, D., Yamamoto, K., & Sakai, K. (2021). Nutritional assessment in adult patients with dysphagia: A scoping review. Nutrients, 13(3), 778. https://doi.org/10.3390/nu13030778
  4. World Health Organization. (n.d.). Fact sheets – malnutrition. https://www.who.int/news-room/fact-sheets/detail/malnutrition