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3 Obesity and Diabetes surgery


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    News article by Dr Abhishek Katakwar published in Deccan Chronicle (Date 21 january 2018) Our complete gastrointestinal tract is lined with microbes collectively called the microbiome, which includes bacteria, fungi, and even viruses. Though it sounds weird and even unhealthy, gut bacteria perform many important functions in the body, including aiding the immune system, producing the feel-good brain chemical serotonin, making energy available to the body from the food we eat, and disposing of foreign substances and toxins, though we always have a mixture of good and bad bacteria, sometimes the bad guys get the upper hand, causing an imbalance in gut bacteria, and can cause severe health problems than just stomach pain, gas, bloating, or diarrhea. Because 60-80% of our immune system is located in our gut, gut imbalances have been linked to obesity, hormonal imbalances, autoimmune diseases, diabetes, chronic fatigue, fibromyalgia, anxiety, depression, eczema, and other chronic health problems. You will be surprised to know that human gastrointestinal microbiota is a complex ecosystem of approximately 300 to 500 bacterial species, comprising nearly 2 million genes (the microbiome). Indeed, the number of bacteria within the gut is approximately 10 times that of all of the cells in the human body. At birth, the entire intestinal tract is sterile; the infant’s gut is first colonized by maternal and environmental bacteria during birth and continues to be populated through feeding and other contacts. Factors known to influence colonization include gestational age, mode of delivery (vaginal birth vs assisted delivery), diet (breast milk vs formula), level of sanitation, and exposure to antibiotics. by the age of 2.5 years, the microbiota fully resembles the microbiota of an adult in terms of composition. In humans, the composition of the flora is influenced not only by age but also by diet and socioeconomic conditions. In a study published in 2012 in “Nature” (high indexed journal) the interaction of diet and age was demonstrated, firstly, by a close relationship between diet and microbiota composition in the subjects and, secondly, by interactions between diet, the microbiota, and health status. It also concluded that non-digestible or undigested components (Fibre) of the diet may contribute substantially to bacterial metabolism; for example, much of the increase in stool volume resulting from the ingestion of dietary fibre is based on an augmentation of bacterial mass. Most recently, qualitative changes in the microbiota have been invoked in the pathogenesis of a global epidemic: obesity. It has been postulated that a shift in the composition of the flora toward a population dominated by bacteria that are more avid extractors of absorbable nutrients, which are then available for assimilation by the host could play a major role in obesity. Also there are enough evidence to support the hypothesis that the endogenous intestinal microflora plays a crucial role in the pathogenesis of Inflammatory bowel diseases and its variants and related disorders. Most Western populations over-consume highly refined, omnivorous diets of poor nutritional quality. Those diets are energy dense, high in animal protein, total and saturated fats, and simple sugars but low in fruits, vegetables and other plant-based foods. Consequently, they are typically low in dietary fibre, non starch polysaccharides in general and resistant starch in particular. Cross-sectional studies have shown some evidence that Western-style diets are associated with gut microbial populations that are typified by a Bacteroides enterotype (bad gut bacteria) whereas traditional diets rich in plant polysaccharides are associated with a Prevotella enterotype (good gut bacteria). Obesity is associated with an increased fecal Bacteroidetes:Firmicutes ratio relative to lean subjects. Replacing a habitual Western diet with one high in fiber elicited rapid (within 24 h) and marked alterations in fecal microbiota composition, although the changes were insufficient to produce a broad switch from Bacteroides to Prevotella enterotype.  One mechanism by which fiber promotes and maintains bowel health is through increasing digesta mass. Incompletely fermented fiber (e.g., insoluble non starch polysaccharides such as cellulose), increases digesta mass primarily through its physical presence and ability to adsorb water. An increase in digesta mass dilutes toxins, reduces intracolonic pressure, shortens transit time and increases defecation frequency. Fibers can also increase fecal mass to a lesser degree by stimulating fermentation, which leads to bacterial proliferation and increased biomass. Prebiotics are dietary substrates that selectively promote proliferation and/or activity of “beneficial” bacteria indigenous to the colon. The concept, first published by Gibson and Roberfroid in 1995, has been refined and redefined on several occasions. Prebiotics are defined currently as “selectively fermented ingredients that result in specific changes, in the composition and/or activity in the GI microbiota, thus conferring benefit(s) upon host health”. Dr Abhishek katakwar, Bariatric & amp; Metabolic surgeon from Asian Institute of Gastroenterology quote “Your body is a Temple. You are what you eat. Do not eat processed food, junk foods, filth, or disease carrying food, animals, or rodents. Some people say of these foods, ‘well, it tastes good;. Most of the foods today that statically cause sickness, cancer, and disease all taste good;s well seasoned and prepared poison. This is why so many people are sick; mentally, emotionally, physically, and spiritually; because of being hooked to poison, instead of being hooked on the truth and to real foods that heal and provide you with good health and wellness.
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