Apples and cardiovascular health: is the gut microbiota a core consideration?

There is now considerable scientific evidence that a diet rich in fruits and vegetables can improve human health and protect against chronic diseases. However, it is not clear whether different fruits and vegetables have distinct beneficial effects. Apples are among the most frequently consumed fruits and a rich source of polyphenols and fiber. A major proportion of the bioactive components in apples, including the high molecular weight polyphenols, escape absorption in the upper gastrointestinal tract and reach the large intestine relatively intact. There, they can be converted by the colonic microbiota to bioavailable and biologically active compounds with systemic effects, in addition to modulating microbial composition. Epidemiological studies have identified associations between frequent apple consumption and reduced risk of chronic diseases such as cardiovascular disease. Human and animal intervention studies demonstrate beneficial effects on lipid metabolism, vascular function and inflammation but only a few studies have attempted to link these mechanistically with the gut microbiota. This review will focus on the reciprocal interaction between apple components and the gut microbiota, the potential link to cardiovascular health and the possible mechanisms of action.

Neonatal environment exerts a sustained influence on the development of the intestinal microbiota and metabolic phenotype

The postnatal environment, including factors such as weaning and acquisition of the gut microbiota, has been causally linked to the development of later immunological diseases such as allergy and autoimmunity, and has also been associated with a predisposition to metabolic disorders. We show that the very early-life environment influences the development of both the gut microbiota and host metabolic phenotype in a porcine model of human infants. Farmpiglets were nursed by their mothers for 1 day, before removal to highly controlled, individual isolators where they received formula milk until weaning at 21 days. The experiment was repeated, to create two batches, which differed only in minor environmental fluctuations during the first day. At day 1 after birth, metabolic profiling of serum by 1H nuclear magnetic resonance spectroscopy demonstrated significant, systemic, inter-batch variation which persisted until weaning. However, the urinary metabolic profiles demonstrated that significant inter-batch effects on 3-hydroxyisovalerate, trimethylamine-N-oxide and mannitol persisted beyond weaning to at least 35 days. Batch effects were linked to significant differences in the composition of colonic microbiota at 35 days, determined by 16 S pyrosequencing. Different weaning diets modulated both the microbiota and metabolic phenotype independently of the persistent batch effects. We demonstrate that the environment during the first day of life influences development of the microbiota and metabolic phenotype and thus should be taken into account when interrogating experimental outcomes. In addition, we suggest that intervention at this early time could provide ‘metabolic rescue’ for at-risk infants who have undergone aberrant patterns of initial intestinal colonisation.

Influence of galacto-oligosaccharide mixture (B-GOS) on gut microbiota, immune parameters and metabonomics in elderly persons

It is recognised that ageing induces various changes to the human colonic microbiota. Most relevant is a reduction in bifidobacteria, which is a health-positive genus. Prebiotics, such as galacto-oligosaccharides (GOS), are dietary ingredients that selectively fortify beneficial gut microbial groups. Therefore, they have the potential to reverse the age-related decline in bifidobacteria and modulate associated health parameters. We assessed the effect of GOS mixture (Bimuno (B-GOS)) on gut microbiota, markers of immune function and metabolites in forty elderly (age 65-80 years) volunteers in a randomised, double-blind, placebo (maltodextrin)-controlled, cross-over study. The intervention periods consisted of 10 weeks with daily doses of 5·5 g/d with a 4-week washout period in between. Blood and faecal samples were collected for the analyses of faecal bacterial populations and immune and metabolic biomarkers. B-GOS consumption led to significant increases in bacteroides and bifidobacteria, the latter correlating with increased lactic acid in faecal waters. Higher IL-10, IL-8, natural killer cell activity and C-reactive protein and lower IL-1β were also observed. Administration of B-GOS to elderly volunteers may be useful in positively affecting the microbiota and some markers of immune function associated with ageing.

Impact of palm date consumption on microbiota growth and large intestinal health: a randomised, controlled, cross-over, human intervention study

The reported inverse association between the intake of plant-based foods and a reduction in the prevalence of colorectal cancer may be partly mediated by interactions between insoluble fibre and (poly)phenols and the intestinal microbiota. In the present study, we assessed the impact of palm date consumption, rich in both polyphenols and fibre, on the growth of colonic microbiota and markers of colon cancer risk in a randomised, controlled, cross-over human intervention study. A total of twenty-two healthy human volunteers were randomly assigned to either a control group (maltodextrin-dextrose, 37·1 g) or an intervention group (seven dates, approximately 50 g). Each arm was of 21 d duration and was separated by a 14-d washout period in a cross-over manner. Changes in the growth of microbiota were assessed by fluorescence in situ hybridisation analysis, whereas SCFA levels were assessed using HPLC. Further, ammonia concentrations, faecal water genotoxicity and anti-proliferation ability were also assessed using different assays, which included cell work and the Comet assay. Accordingly, dietary intakes, anthropometric measurements and bowel movement assessment were also carried out. Although the consumption of dates did not induce significant changes in the growth of select bacterial groups or SCFA, there were significant increases in bowel movements and stool frequency (P<0·01; n 21) and significant reductions in stool ammonia concentration (P<0·05; n 21) after consumption of dates, relative to baseline. Furthermore, date fruit intake significantly reduced genotoxicity in human faecal water relative to control (P<0·01; n 21). Our data indicate that consumption of date fruit may reduce colon cancer risk without inducing changes in the microbiota.

Prebiotic potential of a maize-based soluble fibre and impact of dose on the human gut microbiota

Dietary management of the human gut microbiota towards a more beneficial composition is one approach that may improve host health. To date, a large number of human intervention studies have demonstrated that dietary consumption of certain food products can result in significant changes in the composition of the gut microbiota i.e. the prebiotic concept. Thus the prebiotic effect is now established as a dietary approach to increase beneficial gut bacteria and it has been associated with modulation of health biomarkers and modulation of the immune system. Promitor™ Soluble Corn Fibre (SCF) is a well-known maize-derived source of dietary fibre with potential selective fermentation properties. Our aim was to determine the optimum prebiotic dose of tolerance, desired changes to microbiota and fermentation of SCF in healthy adult subjects. A double-blind, randomised, parallel study was completed where volunteers (n = 8/treatment group) consumed 8, 14 or 21 g from SCF (6, 12 and 18 g/fibre delivered respectively) over 14-d. Over the range of doses studied, SCF was well tolerated Numbers of bifidobacteria were significantly higher for the 6 g/fibre/day compared to 12g and 18g/fibre delivered/day (mean 9.25 and 9.73 Log10 cells/g fresh faeces in the pre-treatment and treatment periods respectively). Such a numerical change of 0.5 Log10 bifidobacteria/g fresh faeces is consistent with those changes observed for inulin-type fructans, which are recognised prebiotics. A possible prebiotic effect of SCF was therefore demonstrated by its stimulation of bifidobacteria numbers in the overall gut microbiota during a short-term intervention.

Impact of increasing fruit and vegetables and flavonoid intake on the human gut microbiota

Epidemiological studies have shown protective effects of fruits and vegetables (F&V) in lowering the risk of developing cardiovascular diseases (CVD) and cancers. Plant-derived dietary fibre (non-digestible polysaccharides) and/or flavonoids may mediate the observed protective effects particularly through their interaction with the gut microbiota. The aim of this study was to assess the impact of fruit and vegetable (F&V) intake on gut microbiota, with an emphasis on the role of flavonoids, and further to explore relationships between microbiota and factors associated with CVD risk. In the study, a parallel design with 3 study groups, participants in the two intervention groups representing high-flavonoid (HF) and low flavonoid (LF) intakes were asked to increase their daily F&V intake by 2, 4 and 6 portions for a duration of 6 weeks each, while a third (control) group continued with their habitual diet. Faecal samples were collected at baseline and after each dose from 122 subjects. Faecal bacteria enumeration was performed by fluorescence in situ hybridisation (FISH). Correlations of dietary components, flavonoid intake and markers of CVD with bacterial numbers were also performed. A significant dose X treatment interaction was only found for Clostidium leptum-Ruminococcus bromii/flavefaciens with a significant increase after intake of 6 additional portions in the LF group. Correlation analysis of the data from all 122 subjects independent from dietary intervention indicated an inhibitory role of F&V intake, flavonoid content and sugars against the growth of potentially pathogenic clostridia. Additionally, we observed associations between certain bacterial populations and CVD risk factors including plasma TNF-α, plasma lipids and BMI/waist circumference.

The gut microbiota: a major player in the toxicity of environmental pollutants?

Exposure to environmental chemicals has been linked to various health disorders, including obesity, type 2 diabetes, cancer and dysregulation of the immune and reproductive systems, whereas the gastrointestinal microbiota critically contributes to a variety of host metabolic and immune functions. We aimed to evaluate the bidirectional relationship between gut bacteria and environmental pollutants and to assess the toxicological relevance of the bacteria–xenobiotic interplay for the host. We examined studies using isolated bacteria, faecal or caecal suspensions—germ-free or antibiotic-treated animals—as well as animals reassociated with a microbiota exposed to environmental chemicals. The literature indicates that gut microbes have an extensive capacity to metabolise environmental chemicals that can be classified in five core enzymatic families (azoreductases, nitroreductases, β-glucuronidases, sulfatases and β-lyases) unequivocally involved in the metabolism of >30 environmental contaminants. There is clear evidence that bacteria-dependent metabolism of pollutants modulates the toxicity for the host. Conversely, environmental contaminants from various chemical families have been shown to alter the composition and/or the metabolic activity of the gastrointestinal bacteria, which may be an important factor contributing to shape an individual’s microbiotype. The physiological consequences of these alterations have not been studied in details but pollutant-induced alterations of the gut bacteria are likely to contribute to their toxicity. In conclusion, there is a body of evidence suggesting that gut microbiota are a major, yet underestimated element that must be considered to fully evaluate the toxicity of environmental contaminants.

Use of the DNA Checkerboard hybridization method for detection and quantitation of Candida species in oral microbiota

The DNA Checkerboard method enables the simultaneous identification of distinct microorganisms in a large number of samples and employs up to 45 whole genomic DNA probes to gram-negative and gram-positive bacterial species present in subgingival biofilms. Collectively, they account for 55%-60% of the bacteria in subgingival biofilms. In this study, we present the DNA Checkerboard hybridization as an alternative method for the detection and quantitation of Candida species in oral cavities. Our results reveal that DNA Checkerboard is sensitive enough and constitutes a powerful and appropriate method for detecting and quantifying Candida species found in the oral cavity.

Exploring Bacterial Diversity of Endodontic Microbiota by Cloning and Sequencing 16S rRNA

Introduction: The characterization of microbial communities infecting the endodontic system in each clinical condition may help on the establishment of a correct prognosis and distinct strategies of treatment. The purpose of this study was to determine the bacterial diversity in primary endodontic infections by 16S ribosomal-RNA (rRNA) sequence analysis. Methods: Samples from root canals of untreated asymptomatic teeth (n = 12) exhibiting periapical lesions were obtained, 165 rRNA bacterial genomic libraries were constructed and sequenced, and bacterial diversity was estimated. Results: A total of 489 clones were analyzed (mean, 40.7 +/- 8.0 clones per sample). Seventy phylotypes were identified of which six were novel phylotypes belonging to the family Ruminococcaceae. The mean number of taxa per canal was 10.0, ranging from 3 to 21 per sample; 65.7% of the cloned sequences represented phylotypes for which no cultivated isolates have been reported. The most prevalent taxa were Atopobium rimae (50.0%), Dialister invisus, Pre-votella oris, Pseudoramibacter alactolyticus, and Tannerella forsythia (33.3%). Conclusions: Although several key species predominate in endodontic samples of asymptomatic cases with periapical lesions, the primary endodontic infection is characterized by a wide bacterial diversity, which is mostly represented by members of the phylum Firmicutes belonging to the class Clostridia followed by the phylum Bacteroidetes. (J Ended 2011;37:922-926)

Quantificação do número de AgNORs em células descamadas da mucosa bucal e sua relação com tamanho do núcleo em indivíiduos fumantes

A citopatologia bucal é um método de diagnóstico baseado em células obtidas por raspagem. Com a finalidade de constatar quantitativamente as alterações celulares ocasionadas pelo fumo em mucosa bucal clinicamente normal, durante a Campanha de Combate ao Câncer de Novo Hamburgo/RS de 2000, foram selecionados todos os indivíduos homens, fumantes e não-fumantes, acima de 40 anos e sem lesão bucal aparente. O processo de seleção resultou em um total de 13 fumantes e 9 não-fumantes. Os sítios bucais estudados foram: vermelhão do lábio inferior, porção anterior do soalho bucal e borda da língua. De cada sítio estudado foram obtidos dois esfregaços, sendo o primeiro submetido à técnica de impregnação pela prata (AgNORs) para avaliação quantitativa via IMAGELAB® e o segundo ao método de Papanicolaou Modificado para confirmação de normalidade. Através do teste estatístico Mann-Whitney (p=0,05) foram obtidos os seguintes resultados: (1) em soalho, o número de AgNORs por núcleo foi superior em fumantes comparado ao grupo não-fumantes; (2) em língua, a relação núcleo/citoplasma em fumantes é maior em comparação aos não-fumantes; (3) em lábio, o grupo com média acima de 3 AgNORs/núcleo apresentou área nuclear maior. Considerando que cada sítio possui comportamento específico frente às injúrias ocasionadas pelo fumo, concluímos que as referências quantitativas de relação núcleo/citoplasma e número de AgNORs/núcleo são eficazes para o controle de alterações celulares prévias à lesão bucal visível.

Percepções, conhecimentos, comportamentos e representações sociais de saúde e doença bucal de adolescentes

Esta pesquisa teve como objetivo avaliar as percepções, as representações, os conhecimentos e os comportamentos relacionados com a saúde bucal dos adolescentes alunos de escolas públicas de dois bairros de Porto Alegre para averiguar a possibilidade de participação dos jovens como multiplicadores de saúde no programa docente-assistencial realizado pela Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul. Os adolescentes foram avaliados através de dois instrumentos de pesquisa: um questionário e grupos focais que permitiram uma abordagem mais ampla e profunda do tema proposto. Os adolescentes que participaram desta pesquisa foram voluntários e constituíram uma amostra selecionada e intencional em que a representatividade estatística não pode ser considerada. Os resultados mostram que eles manifestam comportamentos que se contrapõe aos bons conhecimentos que possuem a respeito dos cuidados relacionados com a saúde bucal e que a motivação para realizá-los está vinculada com a sociabilização. Demonstraram disponibilidade para transferir seus conhecimentos através de meios interessantes e divertidos, como jogos e encenações teatrais.

Agentes comunitários de saúde : discurso e prática em saúde bucal coletiva

Esta pesquisa tem como objetivo descrever o que agentes comunitários de saúde da cidade de Porto Alegre sabem em relação à saúde bucal e como colocam em prática esse saber. Partindo de um histórico recente do sistema público de atenção à saúde no Brasil, são resumidas duas estratégias de atenção primária à saúde - a saúde comunitária e a saúde da família. A seguir, são enfocados os trabalhadores em saúde coletiva, especificamente em termos de trabalho interdisciplinar e em relação à sua formação e capacitação. Os agentes comunitários de saúde são então apresentados por um breve histórico da profissão, o desempenho de sua função nas equipes de saúde e junto às comunidades, sua capacitação técnica e seu papel em relação às ações em saúde bucal. A discussão está baseada em entrevistas realizadas com agentes comunitários de saúde, buscando caracterizar sua origem, expectativas, condições de trabalho e satisfação com as mesmas. Finalmente, aspectos relativos à saúde bucal são apresentados e relacionados aos demais. Ao final da pesquisa foi elaborada uma proposta de capacitação em saúde bucal para essa categoria profissional.

Capacidade funcional, função manual, higiene bucal e sua relação com odontogeriatria

O crescimento da população idosa é um fenômeno mundial. Os profissionais da Odontologia enfrentarão um novo desafio, uma vez que a condição de saúde bucal dos idosos é precária. Investigar os fatores relacionados à saúde bucal permitirá intervir no processo saúde-doença de forma mais eficaz. A higiene bucal é um fator local primordial na saúde bucal de todos os indivíduos. Em virtude do processo de envelhecimento ser agravado por certas condições predisponentes, os idosos tendem a perder a capacidade funcional para as atividades diárias. Sendo a higiene bucal uma atividade diária, acredita-se que também é afetada pela capacidade funcional. Desta forma, o presente estudo procurou avaliar, em pessoas idosas, a relação entre higiene bucal e capacidade funcional, principalmente no que tange a função manual. Índices de placa para dentes e próteses, uma escala de atividades da vida diária, teste de conhecimento, teste cognitivo e testes de função manual foram aplicados, em um grupo de idosos institucionalizados de Porto Alegre. A associação com o padrão de higiene bucal foi avaliada através de estudo de correlação e pela comparação de médias através do Teste t de Student Associações significativas foram observadas entre a escala de atividades da vida diária, função manual, estado cognitivo e conhecimento com medidas de higiene bucal. O presente estudo procurou contribuir para o melhor entendimento do processo saúde-doença no idoso, ao suscitar possíveis ligações e determinações até então pouco exploradas. Desta forma, será possível aprimorar as ferramentas de diagnóstico, buscando adequar planos de tratamento às reais necessidades de cada indivíduo, o que proporcionaria melhor qualidade de vida aos idosos.