Microbiome as a Modifiable Organ System | Eugene Chang | 240

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Episode Summary: Dr. Eugene Chang talks about the microbiome’s role as a vital organ, the impacts of antibiotics and Western diets on microbial health, and strategies for restoring a damaged microbiome through diet and fecal microbial transplants. They delve into microbiome dysbiosis, its links to modern diseases, and Chang’s research on personalized microbiome interventions.

About the guest: Eugene Chang, MD is a physician-scientist and Professor of Medicine at the University of Chicago, specializing in gastroenterology. His research focuses on the gut microbiome as a vital organ influencing metabolic and immune health.

Discussion Points:

• The gut microbiome is a vital organ, acquired early in life, that supports metabolic and immune functions, but can be disrupted by antibiotics, leading to diseases like C. difficile colitis.
• Western diets, high in saturated fats and low in fiber, contribute to microbiome dysbiosis, linked to modern conditions like inflammatory bowel diseases, obesity, and allergies.
• Microbiome health is better assessed by functional markers (e.g., short-chain fatty acid production) than taxonomic diversity, as diversity varies widely among healthy individuals.
• A patient with severe food intolerance due to antibiotic-induced microbiome damage was treated over 50 weeks with a tailored diet, restoring healthy microbiome function.
• Different dietary fibers (e.g., beans vs. seaweed) are metabolized at varying rates, affecting gut health; fermented foods like kefir can bypass digestion issues.
• Diet can rapidly reshape the microbiome within 24-48 hours, but severe dysbiosis may require microbial transplants if key microbes are extinct.
• Chang’s research shows a high-fiber, low-fat diet outperforms fecal microbial transplants in restoring microbiome resilience in mice post-antibiotics.
• Future microbiome medicine may involve personalized “omni microbial transplants” targeting both small and large intestines for comprehensive restoration.

Related episode:

• M&M 203: Metagenomics, Microbiome Transmission, Gut Microbiome in Health & Disease | Nicola Segata

*Not medical advice.

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