Latest news with #microbiome
BBC News
16 hours ago
- Health
- BBC News
Microbiome: First bacteria we meet can keep us out of hospital
The first bacteria our bodies meet – in the hours after we're born – could protect us from dangerous infections, UK scientists have shown, for the first time, that good bacteria seem to halve the risk of young children being admitted to hospital with lung researchers said it was a "phenomenal" finding and could lead to therapies that boost good bacteria in early encounters with microbes are thought to be crucial in how our immune system come out of the womb sterile, but this doesn't last for long. All the nooks and crannies of the human body become home to a world of microbial life, known as the microbiome. Researchers at University College London and the Sanger Institute investigated the earliest stages in our body's colonisation by bacteria, fungi and collected stool samples from 1,082 newborns in the first week of life. The team then performed a massive genetic analysis on all the DNA in the samples to work out exactly which species were present and how common they were in each then tracked what happened to those babies, using hospital data, for the next two years. One particular early inhabitant of the human body, Bifidobacterium longum, seemed to have a protective 4% of babies with this species would spend a night in hospital with a lung infection over the next two years. Babies with different starter-bacteria were two-to-three times more likely to need to stay in is the first data to show the formation of the microbiome affects the risk of infection."I think it's really phenomenal. It's amazing to be able to show this. I'm excited," Prof Nigel Field, from UCL, told the BBC. How are these bacteria doing it? The most likely culprit for children ending up in hospital is respiratory syncytial virus (RSV), but what joins the dots between this and B. longum?That is the "million dollar question" for Prof know B. longum starts off digesting breast milk which both contains food for the baby and encourages good bacteria. The exact details have not yet been worked out, but either the bacteria themselves or the compounds they make by digesting food are interacting with the immune system "and are influencing the way in which the immune system matures and is able to recognise friend from foe," according to Prof protective bacteria were found only in babies that came into the world via a vaginal delivery rather than a caesarean. Even then they were not discovered after every vaginal researchers say their findings do not justify the practice of vaginal seeding, where some new parents smear babies with a swab taken from the vagina. The good bacteria seem to be coming from the end of the mother's digestive system, an idea known in the field as the "first lick"."I feel pretty confident in saying that vaginal seeding is not a good thing," said Prof the long-term ambition is to come up with microbial therapies – like a probiotic yogurt – that could be given to babies to set their microbiomes on a healthy Louise Kenny, from the University of Liverpool and a consultant obstetrician and gynaecologist, said: "A caesarean section is often a life-saving procedure, and can be the right choice for a woman and her baby."She said that while the benefit was seen only in babies born vaginally, it was not in every child born that way so "further research is needed to create a full, nuanced picture".
Al Arabiya
a day ago
- Health
- Al Arabiya
‘The Second Brain': Why gut health is the key to mental clarity, wellbeing
The gut's influence extends far beyond digestion – affecting everything from immunity and inflammation to focus, mood, and mental clarity. This interconnectedness is driving a wave of innovation in personalized health, and at the center of it is Bioniq, a supplement company using data to turn gut health into a foundation for mental and physical performance. The importance of gut health 'Gut health has become a focal point in personalized health because it's now widely understood that the gut plays a central role in overall well-being – it affects everything from immunity and energy levels to mental health and inflammation. It's often called the 'second brain' for a reason,' said Oliver Motisi, Chief Product Officer at Bioniq, in an interview with Al Arabiya English. Trillions of bacteria live in the human digestive tract, forming the gut microbiome. These microbes influence hormone production, metabolize nutrients, regulate immune cells, and even produce up to 95 percent of the body's serotonin – one of the brain's key mood stabilizers. When the gut microbiome is imbalanced, inflammation can rise and communication between the brain and body can break down. 'At Bioniq, we don't look at gut health in isolation. Instead, we integrate it into a broader, data-driven understanding of each individual's biology,' Motisi said. 'Our approach is grounded in blood biomarker analysis, so if we see signs of inflammation, nutrient malabsorption or deficiencies linked to gut function, that's where we start.' The gut-brain axis Each personalized supplement formula is designed with precision and built on a prebiotic fiber base to support both nutrient absorption and microbiome diversity. 'Our goal is to support the body as a whole, with gut health as a critical part of the full system, guided by real data, not guesswork.' The company is especially focused on the bidirectional communication between the gut and brain – what scientists call the gut-brain axis. This channel involves the central and enteric nervous systems and uses neural, hormonal and immune signals to send constant updates between the two organs. 'We now know that changes in gut microbiota can significantly impact cognitive performance, mood and emotional resilience,' Motisi explained. 'That's because the gut and brain are deeply interconnected through the gut-brain axis – a communication pathway that includes neural, hormonal and immune signals.' Mental health symptoms like brain fog, anxiety, and fatigue are often early signs of imbalances in the gut. When the balance of bacteria in the gut is disturbed, it can interfere with the production and signaling of brain chemicals such as serotonin, dopamine and gamma-aminobutyric acid (GABA). For example, low levels of beneficial gut bacteria may reduce serotonin production, which can contribute to anxiety or low mood. Imbalances can also trigger low-grade inflammation, which has been linked to cognitive issues like brain fog and difficulty concentrating. Fatigue may result from poor nutrient absorption in the gut, especially when the body lacks key vitamins and minerals like B12, magnesium or iron. In some cases, individuals with irritable bowel syndrome (IBS) or other digestive conditions also report increased symptoms of stress, anxiety or depression – highlighting how gut health and mental health are often very much intertwined. Micronutrients Micronutrients play a major role in gut-brain health, Motisi explained. 'Micronutrients play a foundational role in how our brains function – they're the building blocks behind everything from memory and focus to mood and resilience,' he said. 'Take magnesium, for example – it's essential for neurotransmitter function and managing stress. Elements like zinc and selenium support processes related to mental clarity and immune health.' Tailored ingredients To address these imbalances that people may have, Bioniq creates custom supplement blends with ingredients tailored to target brain and body together. 'When it comes to cognitive function, that can mean including targeted ingredients like magnesium, omega-3s, adaptogens, and more to help boost clarity, focus, and mental performance.' What sets Bioniq apart in a crowded supplement market is its deep reliance on data. 'Since our founding in 2019, Bioniq has built one of the largest databases of its kind, drawing from over 300,000 individuals and more than 6 million biochemical data points,' Motisi said. 'Our patented algorithm cross-references users' health quiz responses with real-world blood test results to create a truly personalized formulation.' Looking ahead, Motisi sees blood-based biomarkers – particularly those linked to inflammation – reshaping how brain and mental health are tracked and treated. 'I believe the future of brain health will be increasingly defined by how we interpret inflammatory markers, hormonal balance, and metabolic health together, rather than in isolation.' For conditions like anxiety or even neurodegenerative diseases, Motisi said he sees tremendous promise. 'By tailoring supplementation based on an individual's specific biomarkers, we can target these root causes more precisely,' he said.
National Post
2 days ago
- Health
- National Post
Evvy Launches Women's Complete Probiotic, Delivering Advanced 3-in-1 Microbiome Support for Gut, Urinary, & Vaginal Health
Article content Developed by the scientists behind Evvy's Vaginal Microbiome Test, the unique formulation offers targeted support for women's interconnected microbiomes Article content Article content NEW YORK — Evvy, the precision women's health company, today announces the launch of its latest innovation: Evvy Women's Complete Probiotic. This once-daily supplement delivers advanced 3-in-1 microbiome support for gut, vaginal and urinary health — backed by science and uniquely formulated for women. Article content Unlike most probiotics that target just one area of health, Evvy Women's Complete Probiotic is designed to support the full microbiome ecosystem that shapes a woman's wellbeing. The probiotic includes: Article content Clinically-studied Lactobacillus strains to promote healthy bacteria, support yeast balance, and reduce bloating Patented delayed-release capsules that increase survivability of probiotic strains through the GI tract Postbiotics and Vitamins D & E to support immunity and gut barrier integrity Article content 'At Evvy, our research across over 50,000 women has shown just how deeply interconnected the gut, urinary, and vaginal microbiomes are — yet most products continue to treat them in isolation,' said Pita Navarro, Co-founder and Chief Science Officer at Evvy. 'That's why we created a formulation that finally reflects the science: a single research-backed capsule that supports the full picture of women's microbiome health.' Article content The launch of the Women's Complete Probiotic builds on Evvy's pioneering vaginal healthcare platform, which includes the world's first at-home Vaginal Microbiome Test powered by metagenomic sequencing, as well as precision prescription treatments. Informed by insights from the largest real-world dataset on the vaginal microbiome, Evvy Women's Complete Probiotic is designed as a proactive daily essential for supporting gut, urinary, and vaginal health. Article content About Evvy: Article content Founded in 2021, Evvy is closing the gender health gap by leveraging overlooked female biomarkers, starting with the vaginal microbiome. The company offers the world's first Vaginal Microbiome Test powered by metagenomic sequencing, analyzing over 700 microbes with a single, at-home swab — including those related to bacterial vaginosis, yeast infections, fertility outcomes, and more. Evvy's care platform also includes precision treatment pathways from licensed clinicians and 1:1 health coaching. Through their test and care platform, Evvy has built the world's largest dataset on the vaginal microbiome, and they are leveraging this novel data to improve outcomes across women's health. Article content Article content Article content Article content Contacts Article content Article content Article content
Yahoo
5 days ago
- Health
- Yahoo
This Type of Fiber Could Have Weight Loss Benefits Similar to Ozempic
Research on the microbes living in our digestive tract has triggered a 'revolution' in nutritional science. In the last few years, dietary fiber has become the "new protein", leading to it being added to foods in abundance to feed our gut's microbiome and boost our health. However, a study on mice published in 2024 suggests not all fiber supplements are equally beneficial. A form that is readily found in oats and barley, called beta-glucan, can control blood sugar and assist in weight loss among mice fed a high-fat diet. According to researchers at the University of Arizona (UA) and the University of Vienna it was the only type of fiber supplement they tested that decreased a mouse's fat content and body weight within 18 weeks. Other fibers they considered, including wheat dextrin, pectin, resistant starch, and cellulose, had no such effect, despite shifting the makeup of the mouse microbiome significantly compared to mice fed no fiber supplements. "We know that fiber is important and beneficial; the problem is that there are so many different types of fiber," explained biomedical scientist Frank Duca from UA in July. "We wanted to know what kind of fiber would be most beneficial for weight loss and improvements in glucose homeostasis so that we can inform the community, the consumer, and then also inform the agricultural industry." Dietary fibers are the main source of energy for bacteria living in our guts, and yet less than 5 percent of people in the US consume the recommended 25–30 grams (0.9–1 ounce) of fiber a day. To make up for this, fiber supplements and 'invisible fiber'-infused foods are growing in popularity. But fibers are extremely diverse, so which do we choose? Some fibers, like oat beta-glucans and wheat dextrin, are water-soluble, meaning they are easily fermented by gut bacteria. Others, like cellulose and resistant starch, are less soluble or insoluble, meaning they stick to other materials to form stool. Until now, writes biomedical scientist Elizabeth Howard from UA and her colleagues, "there is no study that has investigated the role of various fibers in one cohort." To make up for this, the current study tested several forms of fiber in one cohort of mice. Only beta-glucan was found to increase the number of Ileibacterium found in the mouse intestine. Other studies on mice have linked this bacterium to weight loss. Sure enough, long before the 10-week marker, mice fed beta-glucan showed reduced body weight and body fat content compared to mice fed other forms of fiber. The findings align with another recent study by Duca, which fed barley flour, rich in beta-glucan, to rodents. Even though the rats continued eating just as much of their high-fat diet as before, their energy expenditure increased and they lost weight anyway. A similar outcome was observed in mice fed beta-glucan in the new study. These animals also showed increased concentrations of butyrate in their guts, which is a metabolite made when microbes break down fiber. Butyrate induces the release of glucagon-like peptide-1 (GLP-1), which is the natural protein that synthetic drugs like Ozempic mimic to stimulate insulin release. "Part of the benefits of consuming dietary fiber is through the release of GLP-1 and other gut peptides that regulate appetite and body weight," said Duca. "However, we don't think that's all of the effect. We think that there are other beneficial things that butyrate could be doing that are not gut peptide related, such as improving gut barrier health and targeting peripheral organs like the liver." Far more research is needed before these results can be extended to humans, but the findings suggest that some fibers may be better suited to weight loss and insulin control than others. The study was published in the Journal of Nutrition. An earlier version of this article was published in July 2024. Study Reveals Plague's Evolutionary Hack to Survive 3 Pandemics One Key Way of Consuming Sugar Could Spike Your Diabetes Risk Parasite Infecting Up to 50% of People Can Decapitate Human Sperm
Medscape
22-05-2025
- Health
- Medscape
Episode 2: HS, Microbiomes, and Whole-Body Healing
This transcript has been edited for clarity. For more episodes, download the Medscape app or subscribe to the podcast on Apple Podcasts, Spotify, or your preferred podcast provider. Ginette A. Okoye, MD: Hello. I am Dr Ginette Okoye. Welcome to the Medscape InDiscussion podcast series on hidradenitis suppurativa (HS). Today we'll discuss the gut and skin microbiome and how they relate to HS with our guest, Dr Tamia Harris-Tryon. Dr Harris-Tryon is an associate professor in the departments of dermatology and immunology at UT Southwestern Medical Center in Dallas, Texas. Her research focuses on how the immune system, the microbiome, and the skin barrier all work together or sometimes against each other in chronic skin conditions such as HS. Thank you for joining us today, Dr Harris-Tryon, and welcome to the Medscape InDiscussion podcast. Tamia Harris-Tryon, MD, PhD: Thanks so much, Ginette. Okoye: I have been excited for this conversation today because certainly there's increasing interest in the role of the gut and skin microbiome and skin diseases, and this interest isn't just among healthcare professionals — it's among our patients, too. Our patients are taking probiotics, especially those who are more interested in holistic care and those who are on antibiotics. I would love for us to try to empower dermatologists and other healthcare providers to understand the science here so we can help our patients make informed decisions about this aspect of their care. Thank you for being willing to guide us through that conversation. Why don't we start by you telling us your connection to HS? Harris-Tryon: My connection to HS pre-dates my connection to the microbiome. I trained at Hopkins in dermatology. Dr Okoye was my attending, and we saw a lot of patients with HS in the practice there. I think what struck me is how much suffering there was and how little knowledge there was concerning what was causing all these festering wounds in the armpit. We were putting people on biologics, but only one third of people were responding to them. These are some of the best medicines we have. Some people would respond, but even then, I would call the response partial. People weren't going back to their normal lives and a normal high quality of life. They were still suffering. It became clear that we needed to learn significantly more about HS and try to make a difference in our patients' lives. Okoye: Absolutely. I agree with that. Do you see patients with HS now? And how do you work in your research on the microbiome into your care of these patients? Harris-Tryon: I spend about 80% of my time running my basic science lab. The focus is on the skin microbiome and the immune system. But when I am in clinic, I see patients at both our public hospital and also in my private practice. I see patients with HS, and when I see those patients with HS, what I want to impart to them is that this is a whole-body condition, and that if we can do things to strengthen their immune system through modifying behaviors in their life, we can make a meaningful impact in their disease. Every medicine I prescribe — I still prescribe a lot of medicines — they'll all work significantly better if we can also make some changes in lifestyle management, smoking cessation, nutrition practices, and increasing physical activity in their daily lives. If we can do those things all together in concert and take an integrated approach to their health, we'll make significant gains and get people, hopefully, into durable remission with their HS, and they can go back to a high quality of life every day. Okoye: I love that goal. You mentioned an integrative approach. How do you manage that with your patients? Harris-Tryon: The way that I approach a lot of integrative health questions now with my patients with HS is to help them understand that the skin microbiome is out of balance. In HS, bacteria are growing and existing in people's armpits and groins, buttocks, and under the breast, which we never see in patients who don't have HS. The lens that I take toward it is, how do we get that balance restored? One of the first things we talk about is diet. Diet is such a hot-button issue. It can be so sensitive for people. I focus more on things we can add back into the diet. And then some major things that we need to take away. The one major thing I say that we should reduce is high-sugar foods. In medicine, we also often call these 'high glycemic index foods' — sweetened juices, sodas, things like that, and sweetened tea here in the south. We love our sweet tea. To partner with my patients, I often say we don't have to get rid of those entirely. Cut back sugary drinks to maybe once a day if you're having them many, many times a day. And then if you're having a sweetened drink once every day, maybe cut them back to once a week. We talk about risk reduction, and sugar is the first place I start. In partnering with that, too, when people are thinking about diet, they're often thinking about restriction. I also try to emphasize that we can add some yummy things back in. What's your favorite vegetable that you enjoy eating? Maybe being intentional about adding those to the diet every day. If they're already there every day, maybe we can add them to every meal. And placing sweet drinks as a dessert and as a treat after a meal, not as the main focus of your nutrition, and understanding that skin and nutrition go hand in hand. The last piece is also fats in the diet. Modern diets are sometimes low in fats. I emphasize that the skin is the largest organ of the human body. It needs a lot of fats to function optimally. Making sure you get those nutrients is going to make a good impact in the skin. Okoye: It must be a different conversation to have a quote-unquote diet conversation with a patient, where you're saying, you can have more fat. I think that's a nice way of having what could be a fraught conversation. Your nutrition recommendations are related to your thoughts and research about the microbiome. Let's take a step back and teach us a little bit about the microbiome and how it relates to those recommendations. Harris-Tryon: I was fortunate to do my postdoctoral fellowship in a gut microbiome lab here at UT Southwestern, Lora Hooper's lab. If you're in a gut microbiome lab, you start to realize that microbiome in the gut and nutrients in the diet, they go hand in hand. Every time you consume something, your body's going to do some of the work of digesting that food and extracting the nutrients from that food. But the microbes are also doing their part. The easiest example is fiber in the diet. If you have any plant-based food, you have a salad today, or even if you have wilted spinach today, cooked vegetables, our body can't digest all of that spinach. We just don't have the enzymes to do that. And that's not bad. It doesn't limit us because in our small intestine and the large intestine, we have a series of microbes that can do the digestion for us. They can digest plant polysaccharides, the big fiber molecules. There are species of bacteria that do that work very well, way better than we do. When you give those microbes the food that they need, they grow and expand. The populations that digest fiber expand. It turns out that the microbes that digest fiber make all sorts of small molecules that are highly beneficial for our immune system, our brain, and our skin. Those things working together in concert help strengthen our immune system and help it help strengthen our skin barrier. Okoye: These bacteria, do they exist from birth, or do they change depending on what you eat throughout your lifetime? Can you change them? Can you adjust your microbiome? Harris-Tryon: It's been shown in mouse studies and human studies, large population studies from all over the globe, that what you eat will drive your microbiome. Some of the original studies were done in groups of human populations that shift their diet significantly with seasons. During the seasons when you had a high fiber-rich diet, your gut microbiome expands to be full of microbes that digest that food. During the seasons when you don't eat that same nutrient, those microbes go down, and the microbes that metabolize what you are now eating will go up. We know that's true, and it happens over weeks, not over months. It can happen even faster, too. If you change your diet and microbial communities, we expect to see a shift in the gut. To answer your second question, babies are somewhat sterile at birth. Their skin microbiome gets colonized by their method of delivery. If you're born vaginally vs by C-section, the baby's gut gets populated again. If you are getting breast milk, that's going to tune you to have a certain microbiome. Formulas, which we've tuned over time to be a lot like breast milk, are going to have an impact on the microbes that respond to that nutrient early in life. Okoye: Are there data showing the types of microbes that tend to occur in patients with HS in terms of the gut and the skin? Harris-Tryon: Yes, there have been some papers. It hasn't been entirely definitive what microbes are associated with HS in the gut, but we know that there are decreases in fiber-fermenting microbes. We know that in the populations that tend to get HS, we see fewer of those fiber-fermenting bacteria. Okoye: So that's what's driving your recommendation to increase fiber, vegetable, and fruit intake in patients with HS. Harris-Tryon: Yes, increasing vegetables and fruits and lowering the sugars. Every single interaction you have in your life will have a tuning effect on the microbiome. For example, we know that our HS patients smoke more. We know that there are specific species, such as Porphyromonas species, that are more associated with smoking. These links are known. It's diet, and also other exposures such as smoking, that have a big impact on the oral microbiome. Microbes that grow in your mouth will also impact microbes that end up in your gut. Okoye: How does a high sugar diet affect the microbiome? Harris-Tryon: I think it's twofold. If you have a high-sugar diet, you also probably have a low-fiber diet. It's the two things together. We don't exactly know the mechanisms, but if you have high sugars, you'll get high amounts of insulin. We know as dermatologists that we see a lot of rashes that come downstream of that. My lab is trying to dissect some of these questions right now on the bench. What exactly is changing? I have less data for that, and fewer direct links to the microbiome. That is part of my practice as a physician and clinical experience. If I lower those sugars, patients do better. Okoye: And there are lots of other good reasons to decrease sugar in the diet anyway. Harris-Tryon: I emphasize that to my patients for acne and HS, this is the organ we can see. But all these changes, we have decades of medical literature saying that this is good for your heart, your liver, your kidneys. It's very affirming for me as a physician to be able to motivate people to make whole-health system changes to their life that impact the organ they can see every day, which is their skin. Okoye: When you talk to patients in a nonjudgmental, relationship-affirming way, they will often identify those foods themselves as foods that tend to flare their disease. This is fantastic. I think it will help inform some of our conversations with patients, so we are not just arbitrarily saying decrease sugar, increase fiber, have more fruits and vegetables, but we can explain to them why. Especially if they are showing interest in more integrative care or they're asking about dietary changes or probiotics. Harris-Tryon: I've had so many patients who say, my HS was terrible. I decided to drop my soda consumption every single day and my skin cleared up. When they come with those stories, it's very affirming to me that this practice is something people get a lot of benefit from. Okoye: I think it's important to note that this is part of the practice. So yes, we can still treat with antibiotics, we could still treat with biologics, but why not also incorporate this into our care? It'll help the patient's overall health. When I think about foods, I always think about the impact of public health factors that we know impact food choices. What are your thoughts on public health interventions or systemic interventions that we, as a field, should think about for patients with HS when it comes to their microbiome? Harris-Tryon: I think on a systems basis, this is critically important. We have a lot of data on what makes populations thrive and healthier. This includes access to nutrient-dense foods that are affordable and accessible. They've done some studies to show that it's not necessarily more expensive to have a diet that has nutrient-dense foods, but access is an issue. How do people access the grocery store? How do you physically get to that grocery store so that you can get the groceries that you need? That's a major issue here in Dallas. Our food pantries are helping to fill some of that gap with a lot of education and a lot of access to food. 'Food is medicine' programs are allowing physicians to shift their practice so that you can start prescribing foods, so that we can write prescriptions for foods that we know are nutrient-dense and fiber-rich, that can have an impact on health. I think that's a major one. I was fortunate to be at this meeting last week, talking about heart health. The American Heart Association has talked about all of these different metrics that help with hypertension. Many of those help with other things too that we see in dermatology. Making sure our patients know that sleep and stress are going to modify their immune system and gut microbiome, and disease. Allowing people to live in walkable, safe communities so that they can get the exercise that they need and the steps that they need, because that is also a component of how you optimize metabolism, which ends up having a big impact, a positive impact, on skin. All these issues are systems issues. They're public health issues. Addressing them will help with HS. Again, to come back to smoking, whatever we can do to encourage smoking cessation is also going to allow all the medicines we prescribe for HS to work better. It is so clear that patients who smoke are at a higher risk of developing HS. All these are big public health interventions we can make to have an impact on our patients. Okoye: So, at a systems level, zooming out, there is work to be done. Clearly, you already led with the things that we could do one-on-one with patients to help them and ultimately their families. Because often we see women of childbearing age with HS. They may be preparing food for their children and their family. We could have an exponential impact that way. Harris-Tryon: One other thing I try to encourage my patients to do is to use less packaged foods; they're foods of convenience. They are part of everyone's diet, but I think it's just being conscious of that. Foods that are shelf-stable, by definition, are missing some nutrients that we need to make them shelf-stable. Some nutrients we need aren't shelf-stable. I have that conversation as well with my patients. Okoye: What are your thoughts on probiotics? Do you think they have a role in the management of HS and other inflammatory conditions? Harris-Tryon: We talked about my stepwise approach. First, cut back on the sugars. Next, focus a lot on what we need to add back those fibers, fats, and healthy proteins. I always say, if people still want to talk about it, then we move on to probiotics. My approach to probiotics is also supported by a lot of other microbiome scientists, who focus on fermented foods. There are so many fermented foods that are ancient in human history, and we know that a lot of the microbes in those foods are beneficial to all aspects of human health. If you take yogurt, probably the most easily and readily available fermented food, it often has Lactobacillus species in it. Those are beneficial microbes. And they make a lot of products that are good for the immune system. They often also have Bifidobacterium species in them. We know that when you're eating the fermented food, in the case of yogurt, you're getting the live microbes. If you turn over any container of yogurt at your grocery store, they will list the live active cultures. They'll actually list the species that are in there. These foods are also approved by the US Food and Drug Administration. We've had them in our history as humans for millennia, so we know they're safe. We know that humans have been eating them with benefit for a long time, and they're also well-controlled. We know what active species are in them. So, for all those reasons, I think it's great to start with a fermented food such as yogurt. You can eat other foods that are ancient, such as kimchi, sauerkraut, kefir, yogurt drinks, all these foods, we know are full of microbes that have now been shown with all of our scientific tools to be very beneficial. But for millennia, humans have been eating them. Okoye: Our ancestors already knew. Are there any other fermented foods we could mention? Harris-Tryon: Ginette, you and I are both from the Caribbean region. My family's from Guyana. We have drinks such as fly, mauby, and ginger beer. Those are just from the region my family happens to be from. I know in West Africa, even their fufu and these other pounded grains, they have to be fermented. My lab is full of people from all over the world, and so I often ask questions about their fermented food practices. Bamboo shoots are often fermented in many parts of the world. Some of the people in my lab point out that dosa dough is fermented. I didn't know that, and I love dosa. The dough is made and then left overnight to ferment. I'm not sure what species are in that. I was saying we should study that in the lab. I do think one thing that microbiome has helped me align with is, how you feel is important. If you eat some of these things and your stomach or your digestion is upset, you don't have to eat things just because they're fermented. I think it is important to center on how you feel after you eat, and that's also what microbiome science has helped me understand. Thinking about the skin, too — if your skin reacts negatively after a few days of something, move away from it. And if your digestion reacts negatively after a few days, move away from it. I can't tolerate a lot of fermented drinks if I drink too much of them. I don't drink too many fermented drinks if they have too much gas in them, too much carbon dioxide. Many other fermented foods, I tolerate well. There have been so many fermented foods throughout human history. Remember to always align with how you feel after you consume something. Okoye: I think that's important to follow up on those recommendations to patients, so they don't feel like they failed. For example, I tried kombucha, and I felt terrible. Okay, then try something else. And I think it's always nice to tell people to think about their people — where are from, and what have they been eating for millennia? Harris-Tryon: Yes. A beneficial diet is the Mediterranean diet. One way that you can understand how the Mediterranean diet might be used differently throughout the world is through the website They've created food pyramids that reflect Mediterranean-style diets, not just from the Mediterranean, but from the African continent, Asia, and the Americas, so that everybody can have access to that. Okoye: This has been fascinating. Do you have any parting words for us? Harris-Tryon: Your skin is telling you something about your health, is probably my parting word. It shouldn't be itchy. It shouldn't be inflamed. It shouldn't be red. It does need care, but that care doesn't always involve a 15-step, highly astringent regimen that's expensive. I think it involves taking care of your body through making mindful choices of what you're ingesting. Get good movement several times a week; the body needs that for its metabolism. As dermatologists, we love a great moisturizer for a reason because the skin needs lipids, both in the diet, and if your skin is dry, you want to add a little bit more lipid to it. If you feel like your skin is oily, then you can shift away from that, too. But I do think trying to find a skin balance where your skin is not inflamed is an important part of health. Okoye: Today, we've talked to Dr Harris Tryon about the gut microbiome in HS. Some key takeaways from my perspective include the fact that what you eat changes your gut microbiome, and that change can happen within days or weeks. And that encouraging our patients to have a higher fiber, lower sugar diet can sway their microbiome toward the types of bugs that we believe are more beneficial for inflammation in the skin. Thank you for joining us. Please take a moment to download the Medscape app to listen and subscribe to this podcast series on Hidradenitis Suppurativa. This is Dr Ginette Okoye for the Medscape InDiscussion podcast. 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