“We are more bacterial than human”, is the observation of Dr. Jean-Paul David, endocrinologist and passionate about new discoveries in terms of intestinal flora. He was particularly interested in the relationship between microbiota and metabolic syndrome.
The waistline is the best marker of a person’s metabolic state. The metabolic syndrome is no longer defined solely by overweight but by various associated parameters: excessive abdominal girth, hypertriglyceridemia, lowered HDL cholesterol or the presence of antihypertensive treatment, increased blood pressure and / or hyperglycemia. If three factors are present, we can speak of metabolic syndrome. A person can therefore present a metabolic syndrome without being obese, with the consequence of inflammation perceived by a biological increase of the CRPultra-sensit marker, oxidative stress and an anomaly of the intestinal barrier which has become hyperpermeable. The cells that store fat are not inert, they participate in inflammation. In addition, we now know that the flora plays a major role in this syndrome.
Each of us has 100,000,000,000 germs, which is 400 times more genetic information than our own genome provides. The researchers observed less bacterial diversity in obese subjects than in healthy subjects. The flora of the obese is poorer. The flora is involved in particular in the metabolism of fibers, B vitamins and certain immune factors such as immunomodulins; it activates the production of mucus or glycocalyx, inducer of tolerance; it regulates hepatic lipogenesis and the activity of adipocytes. We recently discovered a bacterium called Akkermensia muciniphila that we now know universally correlated with weight, it is very little present in obese and very present in healthy subjects. A large ingestion of sugars, saturated fats or alcohol promotes the development of so-called gram-bacteria, responsible for an increase in intestinal hyperpermeability which, through immune reactions, generates inflammation and increases endotoxins . Dr Cani, a specialist in intestinal flora, presents it as a full-fledged metabolic organ, involved in the synthesis of fatty acids, in the metabolism of the liver, and contributing to the storage and oxidation of fats. Other factors that can lead to intestinal hyperpermeability are fasting, trauma, infections such as gastroenteritis, chemo and radiation therapy, emotional stress and obesity.
A new player has been discovered, it is the endocanabionoid system which, if it is stimulated in particular by stress, triggers an increase in food intake at the same time as intestinal hyperpermeability. Stress increases intestinal hyperpermeability, this has been seen and proven; it increases the presence of a large number of bacteria in the intestinal lymph nodes, which also confirms the infectious theory of obesity; stress increases enzymatic reactions and oxidative stress, as the name suggests. Stress decreases the immune agents of the intestinal wall, Iga, surface immunoglobulins, at the same time as it increases cortisol, all interesting markers to evaluate during a metabolic syndrome. More and more obvious links are being established between the endocannabinoid system, the pancreas which secretes insulin, the muscle which seeks glucose, the liver which synthesizes fat and adipose tissue, the intestine and the microbiota. The intestine-brain axis is better and better understood: we now know that an unbalanced intestinal flora will divert tryptophan, a precursor of serotonin, a neurotransmitter of good humor, in a loop, generating less well- be and more metabolic imbalance.
A patient suffering from the metabolic syndrome will benefit from the following treatment: a work-up including: search for lipid abnormalities; blood sugar; Uric acid ; creatinine clearance Cokroft MRDR; VS and CRP us; K; TSH; SGOT SGPT GGT; calcium protidemia; vitamin D ; liver function and abdominal ultrasound; ferritin; TSH; ECG. The clinical examination will be attentive to the size, weight, abdominal perimeter, hepatomegaly, abdominal sensitivity, blood pressure, pulse, periodontal condition, skin condition (acne, stretch marks , yeast infection).
It will be improved by a Mediterranean diet rich in plants, minerals, trace elements, vitamins, polyphenols, by good fats, by a good supply of vegetable fibers and quality proteins, without forgetting omega 3, by sports sessions. weekly and stress management, if applicable.
Article written by Raissa Blankoff, naturopath-aromatherapist, www.naturoparis.com
