Professor Jack Gilbert on why we should all be fascinated by the wonders of our gut microbiome Middling Along

The biology nerd in me is so happy about this one! Joining me this time is Professor Jack Gilbert from the University of California San Diego: in 2023 he gave the Annual Lecture at the British Menopause Society conference, which is how his work came to my attention (via our Managing the Menopause Clinical Lead - also my sister-in-law - Dr Beth Thomas). 
 
In the course of this wide-ranging conversation that focuses on our gut microbiome we cover:
why understanding the interaction of our sex hormones with the microbiome is a burgeoning area of science and how everything in the body is connected in series of complex feedback cycles; 
The key role of decreasing oestrogen in inflammation: leading to depression, anxiety, aches and pains, and gastrointestinal issues;
How our microbiome changes pre- to post-menopause (post-menopause the female microbiome tends to look much more like it would in men);
The important of butyrate and why a healthy gut barrier is so important;
Why we should consider ‘priming’ the body to consume fibre with fermented foods;
The long-term chronic health implications of not getting enough dietary fibre, which are often not felt immediately but accumulate over decades;
How fecal transplants are being used to repopulate the gut microbiome - early studies have shown promise in menopause symptom treatment but more research is needed;
That HRT appears to ‘rescue’ gut dysbiosis (reduce inflammatory bacteria, more balanced microbiome);
The Hypothalamic-Pituitary-Adrenal (HPA) axis (aka how your body senses stress): - cortisol keeps you alert and anxious, but the system can be hijacked by inflammatory bacteria, neuroinflammation triggers the HPA axis causing elevated anxiety, i.e. there is no reason to be anxious but the body is on high alert;
Why acetominophen (paracetamol) can cause liver cirrhosis with excessive consumption in certain people;
How antibiotics wipe out other useful bugs that keep resistant strains under check, and how ‘problem’ strains thrive on high sugar and high saturated fat (and why your diet in the run up to an operation could make a huge difference);
Exposure to microbes in nature and the potential impacts of bacteria in soil that have an antidepressant effect;
‘Gut feelings’: how the state of our gut can impact our decision-making abilities, and that changes in microbiome can impact how hungry we are, our propensity to snack, and even our choice choice of snacks…eg sugar cravings;
How 80% of serotonin is made in gut, but that it is actually a  serotonin precursor that can pass out of the gut into the body to then be made into serotonin by other cells - although the relationships between levels of serotonin in the gut and the brain is not currently understood. 
 
Listen to the end to find out about the research study that Professor Gilbert would  most like to run if he had no constraints! 
 
You can find our more about Professor Jack Gilbert’s work at:
https://gilbertlab.ucsd.edu/ 
You can also find us over on Instagram https://www.instagram.com/middlingalong_podcast/ and you can listen to past episodes at https://middlingalong.com  
 
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