Microbiota in Infancy, Health & Disease: Nestle

Speaker: Dr. Bhaskar Raju - MD DM (Gastro) MNAMS, Formerly Head of Department, Department of Pediatric Gastroenterology, Institute of Child Health & Professor of Pediatrics Madras Medical College Presented at: Nestlé Nutrition Institute Symposium, Kolkata

Summary

This presentation talks about the symbiotic relationship with germs through human evolution. Our obsession over germs causing disease has led to high disturbance with our intestinal flora leading to several diseases. Dr. Bhaskar talks about the acquisition of flora among the babies after vaginal and caesarean delivery. He elaborates the factors that influence establishment of infantile microbiota. He enlists the critical windows in development of microbiota and their teachings and also emphasizes the importance of breast milk in providing good flora to the baby. The presentation explains various functions of microbiota. He iterates that, good microbiota are indispensable for healthy living.

Some basic facts about the microbiota are that average human body has ten to the power of 13 cells and 10 times the number of organisms residing in it. At least 500 different species exist, though 99% of organisms come from 40 to 50 species only. The combined metabolic activities of these organisms are equal to any organ in the body; they are also referred to as the “Forgotten organ”. The organisms weigh about 2 Kgs and they and their residue constitute 60% of dry weight of the human faeces. There are 3 basic functions of microbiota. Protective functions like pathogen displacement, nutrient competition, receptor competition, production of antimicrobial factors and lactic acid. The structural functions are barrier functions, induction of IgA, tight junction integrity and immune/tolerance development. Metabolic functions are to produce Met dietary carcinogens, to facilitate ion absorption and to synthesise vitamin biotin folate. Some functions of intestinal flora is that they synthesise vitamin B12, they metabolise undigested food, they are vestige of GI tract flora of cattle and other mammals where they have major digestive functions.

Some advices to keep the microbiota presence in a new born infant are, discourage vigorous post-delivery antiseptic baths. Encourage early rooming in. Encourage close skin to skin contact between baby & mother. Organise Breast feeds as early as possible. Arrange early discharge away from hospital environment. Microbiota is highly useful in prevention of allergy/atopy.

Obesity is definitely linked to a shift in gut microbial ecology. The western diet results in a dramatic decrease in diversity with a bloom in a single lineage of firmucutes. This bloom encodes genes for metabolizing simple sugars found in the western diet, generating short chain fatty acids that could be absorbed by the host. Short chain fatty acids produced in abundance in the colon end up fat. Microbial-mammalian co-habitation goes back millions of years. Humans have disturbed that stable state in the last 100 years. Normal vaginal delivery and breast feeding cause good microbiota to flourish. Altered flora is responsible for many modern day diseases. Good microbiota is indispensable for health and deserves to be nourished and preserved.