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By Margaret Mielczarek. When thinking about nutrition and chronic disease, it’s becoming increasingly important to consider the gut – the microbiome – as research is beginning to show it plays a significant role in our overall health. Retail Pharmacy looks at the role of the microbiome in chronic disease prevention and management, and asks: can food really be our medicine? A review article in the journal Nutrients suggests the gut “plays an important role in human health and influences the development of chronic diseases ranging from metabolic disease to gastrointestinal disorders and colorectal cancer”.1 The microbiome and its role in health and immunity “Our gastrointestinal tract is inhabited by more than 100 trillion microorganisms, including viruses, fungi, protozoa and more than 8000 species of known bacteria,” Advanced Accredited Practising Dietitian Dr Tim Crowe said. He adds that while the terms microbiome and microbiota are used interchangeably, the difference between them is: “The microorganisms plus the genes inside them make up the microbiome; the microbiota refers to the actual microorganisms.” Pharmacist, Naturopath and Clinical Nutritionist Vanita Dahia says the “microbiome plays a major role in all diseases”, as supported by “numerous studies”. on the use of Lactobacillus rhamnosus, which is a particular strain of probiotic,” she said, referring to research at the Murdoch Children’s Research Institute. She adds that the team found 80 per cent of children with peanut allergy who received the probiotic strain were able to tolerate peanut after the trial period, compared with four per cent in a placebo group. Peanut allergy is the commonest cause of anaphylaxis, a life-threatening allergic reaction, and one of the commonest causes of death from food allergy. “Now four years on, they’ve done another study that followed up on these kids and it’s been published in The Lancet Child & Adolescent Health,” Ms Dahia said. “They found that there’s still a good reserve against anaphylaxis \\\\\\\[from\\\\\\\] peanuts. “In other words, can you change an allergic response in the gut to a particular food using probiotics? Yes, you can. So, it \\\\\\\[the microbiome\\\\\\\] supports the innate immune system.” Prebiotics, probiotics and the microbiome Conversations around the microbiome and gut health often include topics such as prebiotics and probiotics – both nutritional components known to assist with maintaining the health of the microbiome. “Prebiotics are like fertiliser for our gut because they encourage the growth and activity of beneficial bacteria such as Bifidobacteria and Lactobacillus,” Dr Crowe said. “To keep your gut ecosystem thriving, aim to eat more foods high in different types of fibre, including soluble and insoluble fibre and resistant starch.” Conversely, he says probiotics “add more of the beneficial bacteria in our gut”. Role of the community pharmacist While nutrition counselling is largely the domain of dietitians, community pharmacists have an important role in this space as often the first health professionals a customer will see. “Pharmacists and pharmacy assistants have an important role to play in exploring the different types of over-the-counter probiotics and prebiotic fibre supplements that could benefit a person,” Dr Crowe said. “Such advice, though, doesn’t sit in isolation, as diet and lifestyle changes are the key to long-term gut health, and here a referral to a dietitian for tailored nutrition advice can be appropriate.” References 1. Gunnars K. ‘Does all disease begin in your gut? The surprising truth’. Healthline, 2019. Available at: healthline.com/nutrition/does-all-disease-begin-in- the-gut \\\\\\\[Accessed 3/2/21\\\\\\\]. 2. Hills Jr R, et al. ‘Gut microbiome: Profound implications for diet and disease’. Nutrients 2019; 11: 1613; doi:10.3390/nu11071613 AS SEEN IN RETAIL PHARMACY 43 As seen in the March issue of Retail Pharmacy magazine. CAN FOOD REALLY BE THY MEDICINE? “One study that’s worth noting is one To read the full feature as it appears in the March issue of Retail Pharmacy magazine, visit: retailpharmacymagazine.com.au/magazine RETAIL PHARMACY ASSISTANTS • MAR 2021