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360 is dedicated to using evidence-based medicine to proactively inform decision-making in our health. Now, more than ever, it is important we utilise peer-reviewed literature to help us navigate the pandemic on a personal level.

We live at a time of great uncertainty. Rules and regulations that affect our daily lives are changing frequently. The future is unsure. There is currently no clear finishing line to many of the challenges we face at home, at work and in society. However, whilst we cannot control all these factors in the outside world, we can take charge of factors impacting our inner world. Personal wellbeing is central here.

Nutrition is one of the many pillars we can address through small impactful lifestyle changes to look after our wellbeing. It is also an emerging area of interest in the successful management of COVID-19.

More specifically, research suggests that improving the health and diversity of the gut microbiome through a diet lower in saturated fat, higher in fibre and including probiotics may be of value in the pandemic because of the impact the gut microbiota in regulating immune tolerance and the lung microbiota.

As the authors of this paper put it:

Gut microbiota diversity and the presence of beneficial microorganisms in the gut may play an important role in determining the course of this disease. Elderly, immune-compromised patients and patients with other co-morbidities like type-2 diabetes, cardiovascular disorders fare poorly in combating Covid-19. It is interesting to note that a general imbalance of gut microbiota called “dysbiosis” is implicated in such patients and the elderly

A recent Research Review looked at the potential impact of the gut microbiome in determining outcomes of COVID-19 infection. The gut microbiota refers to the trillions of microorganisms that live inside the gastrointestinal tract, and collectively it plays a central role in regulating immune and brain function. For a deep review of the topic, this is a very good research paper by leaders in the field.

The current paper, entitled “Potential contribution of beneficial microbes to face the COVID-19 pandemic“, addressed biological mechanisms by which a healthy and diverse gut microbiota appears to be central in successfully regulating our immune responses to COVID-19 and helping to prevent the hyper-inflammatory “cytokine storm”.

The “cytokine storm” has been shown to be a key determinant of outcomes with COVID-19. Therefore, if there are proactive lifestyle medicine tools that can be used to reduce the risk of negative outcomes, it is worthy of note. This research review in question builds on the weight of research from evidence-based medicine and postulates that dysbiosis (an imbalance in the gut microbiota) is a risk factor in COVID-19 outcomes.

Simply put, an unhealthy and imbalanced gut appears to put an individual at greater risk of a “cytokine storm” and pathology within the lungs after infection by SARS-CoV-2. This risk is chiefly caused by the fact that dysbiosis promotes a release of pro-inflammatory cytokines in the gut which impairs the integrity of the lining of the gut, thereby increasing the chances of a cytokine storm within the lungs. The image below illustrates these mechanisms at play:

As you can see in the image there is a gut microbiota and a lung microbiota. An imbalance in the gut microbiota caused by poor diet sets up a chain of pro-inflammatory events in the body that affect the lung microbiota and can contribute to the cytokine storm.

As the authors of the paper postulate:

Dysbiosis in the microbiome may create an inflammatory environment that the coronavirus can exploit. Gut-related inflammatory proteins, cytokines, are amplified by more cytokines when coronavirus hits. The combined inflammation may ignite a “cytokine storm”—a runaway immune reaction that can cause more damage than the virus itself, including multiorgan injury.”

At 360, we have a distinct philosophy in all of our work which is to be proactive and treat the cause, not the symptom. We focus on positively impacting the first domino rather than reactively chasing the fifth.

In this instance, it is important that hospitals use various anti-inflammatory medications to manage the cytokine storm once it hits, but from a preventative medicine standpoint, our interest is in helping people ahead of time prevent the cytokine storm in the first place if they become infected with SARS-CoV-2. The gut is one key piece of the immune resilience matrix in this respect. This is summarised well in a new research paper which concluded:

The gut microbiome can play a crucial role in modulating the immune responses of COVID-19 infected individual, and prevent the damage of vital organs, including lungs. Therefore, re-formulating the gut microbiota may emerge as a new therapeutic target in the disease management of COVID-19 patients employing nutritional therapy, probiotics or fecal microbiota transplantation (using standard guidelines).

As we approach winter, make gut health central to your wellness programme and that of your employees.

Justin Buckthorp

Justin Buckthorp is Founder and CEO of 360 Health & Performance International. He has 20 years of experience healthcare, elite sport and performance coaching, and is passionate about helping others unlock their potential.

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