Diabetes, Obesity, Probiotics and Fiber – Bringing It All Together in 3 Steps

In all my years of reading, there have only been a few articles that were truly pivotal. When I first flagged this article I thought it was neat. But the more I thought about it, the more this article resonated with some of the most important chronic diseases of our time.

To understand this article better, I need to give a little background on some very important aspect of our physiology.

1) GLP-1 and its effect on the body

This aspect is so important that every resource for new drug development for treatment of diabetes is focused along this single pathway. It involves hormones called incretins that come from the gut and control our reaction to the foods we eat. They are critical in how well our body responds to our diet and our blood glucose control. It does this by stimulating the insulin producing beta cells of the pancreas to grow in number, respond better to blood sugar elevations and release more insulin. At the same time, GLP-1 improves the way insulin works throughout the body as well as slows gastric emptying, thus allowing the food we eat to get absorbed slower.

The two main incretins in our bodies are Glucagon Like Peptide (GLP-1) and Gastric Inhibitory Peptide (GIP). GLP-1 has a very short life in our bodies-it is broken down by the enzyme DPP-4 in a matter of 1-5 minutes.

From a diabetic drug standpoint, Byetta and Victoza are two brand name drugs that mimic our own GLP-1. Januvia was the first drug to market that stops the enzyme DPP-4 and allows our own GLP-1 to last longer (all the latest drugs all have “gliptan” in their names).

Overall, this approach is THE Holy Grail of diabetes drug development right now. Most of the research studies focus on these pathways.

The increased use of these medications is of concern. Thyroid cancer, immune problems and destruction of the beta cells may be potential long term damaging effects of overuse of these drugs.

2) Antibiotics contribute to obesity, probiotics protect against obesity

The past few years have brought a heightened awareness to the relationship of the bacteria in our gut and the link to obesity. Of course, on the flip side, this means that the use of antibiotics, which destroy the normal, healthy flora of the gut, have been associated with obesity as well.

The need for a good blend of healthy bacteria in our gut is no longer in question. The list of benefits of probiotics have become quite long, although the list of diseases may be significantly shorter if we didn’t destroy them off in the first place.

3) Fiber in our diets is important

When we talk about fiber, we are really talking about 3 different kinds. First is what people think of when they think of fiber. This is insoluble fiber–the roughage that your mom always told you to eat more of. Our bodies cannot digest insoluble fiber, but it does help us by adding bulk to the stool and absorbing toxins present in the gut. Think bran in whole grains and the

Resistant starch is the new player in the field of fiber. We generally think of fiber as not being digestible by our digestive system. However, resistant starch is digested, but it is a slow process resulting in a slow trickle of glucose into our bloodstream, which is easier for our bodies to adapt to. Think beans and bananas.

Soluble fiber is not digestible by our digestive system, but is readily digested by the bacteria in our gut, producing compounds called short chain fatty acids (SCFA). Butyrate is the most notable of these as it is the preferred fuel source for the cells of our colon, leading to a healthier gut with a lower risk of colorectal cancer.

Not that you have a little more background, a recent article in the journal Diabetes will make more sense.

Most of our understanding on what triggers GLP-1 release has been focused on the carbohydrate portion. Research suggests that the main thing that triggers the release of GLP-1 is “sweet” signals, just like the sweet sensation we get on our tongues. That may be changing.

This particular article, although done in rats, finds that short chain fatty acids stimulate the release of GLP-1 from the small intestine. Knowing all the above, contemplate on what this means…

In a healthy, normal weight, non-diabetic person, the soluble fiber taken in the course of a good healthy diet is digested by the healthy bacteria in the gut to short chain fatty acids. These SCFA then cause the release of GLP-1, keeping this person lean and diabetic free.

Contrast this to the unhealthy person so typical of today’s society. Antibiotic use almost from birth. Poor quality diets low in soluble fiber. Artificial sweeteners confusing the “sweet” message our body receives. Obesity and diabetes are almost inevitable.

The take home message is that obesity is not the end result of too many calories in versus calories burned. Our bodies are far more complex than that. Avoiding diabetes and maintaining an ideal weight is a comprehensive approach never to be found in a pill, a supplement or the gym alone.

Read the research article here….. http://diabetes.diabetesjournals.org/content/61/2/364.abstract