Your gut, your microbiome, your health


The microbiome in our gut consists of up to 1,000 different types of bacteria and about 100 trillion cells. As such, it has 10 times as many cells as we have. The development of the microbiome depends on a number of factors: absorption of microorganisms from the mother’s vagina at birth, breast feeding by the mother, what foods a person eats, antibiotic use, and stress and genetic factors. 

A Belgian study recently published in Science magazine is one of the first population-wide studies on the variation of gut bacteria and its links to health, diet and lifestyle. The Flemish Gut Flora Project analyzed human stool samples from 5,000 volunteers over four years. Factors such as transit time, health, diet, medication, gender and age were identified as linked to gut flora composition. Fiber intake was related to a healthy variety of microbes in the gut. While breastfeeding promotes the growth of beneficial bacteria in the gut, whether or not a person was breast-fed as a child did not relate to adult gut microbe variety. This indicates that there is an opportunity later in life to change gut microbe composition with the right diet. The researchers said that their findings may relate to new ways of influencing mental health because of the close connection between the gut and the brain. 

According to a recent study from the Mount Sinai School of Medicine, specific combinations of gut bacteria from mice with “social withdrawal” produce substances that can make normal mice show similar behavior. (Social withdrawal is the mouse equivalent of depression.) Also, similar gut bacteria influence the myelin content of brain cells, potentially affecting demyelinating diseases such as multiple sclerosis. Research in this area has shown that children with multiple sclerosis have been found to have an increase in gut bacteria linked to inflammation. Myelin is a sheath-like material that forms a protective coating around nerve fibers.

Since the gut microbiome can influence the central nervous system and the immune system, it’s important for all of us to feed it well. We know those microbes like plant food with fiber, so go high on 100 percent whole grains, fresh and dried beans of all kinds, vegetables and fruits. If you do this, there is little room left for refined flour and sugars. 

Here’s the good news: there are bacteria in our gut that turn dark chocolate into compounds that have health benefits. Dark chocolate helps restore flexibility to arteries while also preventing white blood cells from sticking to the walls of blood vessels. Try getting unsweetened cocoa powder and carefully adding your own sweetener. I prefer xylitol—it’s actually good for your teeth!


Zika and family planning

In countries where mosquitoes are spreading the Zika virus, it can be terrifying to be pregnant.  Millions of women in Latin America and the Caribbean still have an unmet need for family planning. In several countries where Zika is active—the Dominican Republic, El Salvador, Haiti, Honduras, Nicaragua and Suriname—abortion is a crime, often punishable by long-term imprisonment. Even in countries where abortion is legal in cases of rape, incest or threats to the life or health of the woman, American aid has been blocked by the Helms Amendment. 

This policy was passed as an amendment to the Foreign Assistance Act in 1973 as part of a wave of anti-abortion backlash to the Roe v. Wade Supreme Court decision of the same year. It states, “No foreign assistance funds may be used to pay for the performance of abortion as a method of family planning or to motivate or coerce any person to practice abortions.”

American aid to family planning could be helpful in many developing countries in Latin America, Asia and Africa. Both Hillary Clinton (and Bernie Sanders) have committed to fix Helms after taking the presidential oath of office. President Obama has failed to do so thus far. 

According to Global Planned Parenthood, one in three women in the world will experience violence in her lifetime, many before age 18. In some countries, that figure can be as high as 70 percent. High rates of violence contribute to unintended pregnancy, complications in pregnancy, unsafe abortion and maternal deaths in parts of the world where health systems remain weak and women and communities lack access to quality care.

Rates of gender-based violence are especially high in areas of conflict and crisis, where rape is used as a tool of war, and in displaced communities such as refugee camps. Young women are particularly vulnerable to both violence and unintended pregnancy, which forces many of them to give up school or become mothers before they are ready. Worldwide, there are more than 20 million unsafe abortions every year that lead to millions of injuries and 22,000 deaths.

Here’s some better news. The percentage of pregnancies that are unintended is falling in the United States. Data from the Centers for Disease Control found that the proportion of pregnancies in the United States that were unintended dropped from 51 percent of all pregnancies between 2006 to 2010 to 45 percent between 2009 and 2013. Researchers consider a pregnancy to be unintended if a woman said she never wanted to have a child or did not want to have a child yet.

Here’s a new trend in birth control availability: women are now going to special apps on their phones to ask for the pill or some other hormonal methods without a doctor’s visit. They are interviewed online or by video, and the pills are sent by mail. Planned Parenthood has such an app, called Planned Parenthood Care. Applicants also have a video interview with a doctor or nurse practitioner. The American College of Obstetricians and Gynecologists has approved of making the pill available over the counter, but is concerned that women should see a physician at various times for detection of cancer of the cervix and breast and a general health exam. You can read the story of the new birth control apps in the New York Times’ June 20, 2016 edition.


Sadja Greenwood is a Bolinas resident and a retired physician. Read more of her work at