The First 1,000 Days of Life: The Link Between Nutrition & the Gut Microbiome

by Rebecca Williams, APD

The first 1,000 days of life, spanning conception to the age of two, are increasingly being recognised as a critical window where a child’s environment, including the impact of nutrition, can significantly influence their long-term risk of non-communicable disease. So much so that research suggests environmental factors in infancy may have a greater impact on disease risk than even genetics or environmental influences later in life⁽¹⁾.  Specifically gut microbial composition and early nutrition have been shown to play a critical role.

Gut microbial composition is unique to every individual and is thought to be strongly influenced by a number of environmental factors, including method of delivery (vaginal or Caesarean section), the mother’s diet, whether a child is breast or formula fed and also the time and method of introduction of solid foods⁽¹⁾. Breast fed infants, for example, are exposed to more than 700 species of bacteria through their mother’s milk, as well as a range of oligosaccharides (prebiotic fibres) which stimulate the growth of beneficial gut bacteria⁽²⁾.

It's been suggested that the establishment of the gut microbiome during the first 1,000 days is important for the development of ‘immune fitness’ and may result in a subsequent reduction of disease risk⁽¹⁾. The link between gut microbiota and health is influenced via short chain fatty acids such as butyrate and acetate - both produced when the gut microbiota ferment (or break down) the prebiotic fibres in our diets⁽⁴⁾. Butyrate is thought to have anti-inflammatory effects, decrease rapid rates rates of cell reproduction and may have an ability to enhance the colonic immune response^{(6, 7)} whilst also appearing to reduce intestinal pH which helps to prevent the growth of harmful bacteria⁽⁸⁾. 

In contrast, a reduction in the diversity and composition of gut microbiota in early life could result in an increased risk of developing non-communicable diseases in later life, including allergic diseases such as asthma, eczema and food allergies, autoimmune diseases such as multiple sclerosis, metabolic disorders including obesity and cardiovascular disease and other immune conditions such as inflammatory bowel disease⁽¹⁾.

A key life stage for infants which also has a significant influence on the colonisation and diversity of gut bacteria during infancy, is the introduction of solid foods:⁽³⁾ foods that contain prebiotic fibres such as fructo-oligosaccharides, galacto-oligosaccharides and resistant starch support the growth and activity of beneficial gut bacteria⁽⁴⁾. Demonstrating the link further, a recent Australian study found that infants could access the benefits of prebiotics at a younger age than previously thought, with babies as young as seven months showing increased microbial diversity following consumption of resistant starch from solid foods⁽⁵⁾.

As outlined in the Infant Feeding Guidelines, solid foods should be introduced at around six months to meet an infant’s increasing nutritional and developmental needs. So in order to positively influence gut bacteria, it's important to ensure they're fed a balanced diet when beginning solid foods - introducing a variety of plant foods such as grains, legumes, fruit and vegetables as their first foods will ensure a varied intake of prebiotic fibres⁽⁹⁾. It's also important to ensure that the introduction of solid foods is complemented with an increase in water intake to prevent issues such as constipation, helping to promote good digestive health.

Emerging research demonstrates the importance of nutrition during the first 1,000 days of life, with this initial period increasingly being recognised as a key influencer for long-term health. Once established in this critical window, the composition of the gut microbiota remains relatively stable throughout our adulthood, but can be altered as a result of bacterial infections, antibiotic treatment and long-term dietary changes.

This evidence suggests that the establishment of a healthy and diverse gut microbiome is essential to promote immune health and reduce risk of chronic disease in later life not only during infancy, but also emphasises the critical role of nutrition on our gut microbiota as we move through all life stages.

To find out more on the benefits of grains and legumes throughout all life stages and for recipes and more, visit our website here.

References

1. Tang M. Abstract: Role of Nutrition in Tolerance Development. Unpublished. 2016.

2.  Rodríguez JM, Murphy K, Stanton C, Ross RP, Kober OI, Juge N, et al. The Composition of the Gut Microbiota Throughout Life, with an Emphasis on Early Life. Microbial Ecology in Health and Disease. 2015;26:10.3402/mehd.v26.26050.

3. Johnson CL, Versalovic J. The Human Microbiome and Its Potential Importance to Pediatrics. Pediatrics. 2012;129(5):950-60.

4. Slavin J. Fiber and Prebiotics: Mechanisms and Health Benefits. Nutrients. 2013;5(4):1417-35.

5. Gopalsamy GL, Christophersen CT, Bird AR, Young G. Abstract: Infants Can Ferment Resistant Starch Shortly After Wearning Which Changes Faecal Metabolite and Microbial Profiles. Unpublished. 2016.

6. Bi Y, Qin N, Yang R. Human microbiota: a neglected "organ" in precision medicine. Infectious Diseases and Translational Medicine. 2015;1(2).

7. Scott KP, Gratz SW, Sheridan PO, Flint HJ, Duncan SH. The influence of diet on the gut microbiota. Pharmacol Res. 2013;69(1):52-60.

8. Flint HJ, Scott KP, Louis P, Duncan SH. The role of the gut microbiota in nutrition and health. Nat Rev Gastroenterol Hepatol. 2012;9(10):577-89.

9. Halmos EP, Christophersen CT, Bird AR, Shepherd SJ, Gibson PR, Muir JG. Diets that Differ in Their FODMAP Content Alter the Colonic Luminal Microenvironment. Gut. 2015;64(1):93-100.

Keeping Our Finger on the Pulse: The Phenomenal Success of the International Year of Pulses

By Alexandra Locke

A recent analysis of research has revealed that 2 out of 3 Australians simply don’t think to include pulses and legumes in their diet¹ and with 2016 being deemed the peak of the fashionable paddock to plate movement - a trend which prioritises local ingredients and whole foods - it seemed only fitting that the United Nations named 2016 as the International Year of Pulses (IYP): a year dedicated to raising public awareness of the humble pulse.

One key objective of IYP was to heighten public awareness of the nutritional benefits of pulses as part of a sustainable agricultural system, moving towards global food security and nutrition - a message which has been supported by both the Grains & Legumes Nutrition Council (GLNC) and Pulse Australia, playing key roles in the promotion of pulses to both industry and consumer audiences. As a result of these communications, pulses are now having their moment in the limelight with many celebrity chefs and foodie influencers adopting their use as a staple ingredient in everyday and high end cuisine.

Moving into 2017, the true impact of IYP is just being revealed, showing that the influence has been felt on a global scale. It’s clear that the hard work that went into planning this momentous year has been worthwhile, raising awareness of pulses and their benefits for both health and environment. 2016 saw a 51% increase in media mentions of pulses in Australia in comparison to 2015², which has helped communicate these messages to a global audience of over 4 billion - a significant achievement given the initial aim was to reach 30-40 million people.

On the back of a record breaking crop in 2016, the raised awareness of pulses presents opportunities to add wider value to Australian pulse crops. Processors and retailers have seen the benefit too, specifically via an increase in canned pulse sales with total pulses seeing positive growth in both value and volume over the last 12 months in Australia, up 0.3% to a total value of $58.3 million and 7.9% to a total of 20 million kg respectively².

A consistent problem that those involved in the pulse industry consistently face, whether grower, manufacturer or retailer and which IYP succeeded in addressing, is public perception that pulses can be difficult to prepare and are limited in both flavour and usability. Pulse advocate and celebrity chef Simon Bryant used IYP’s momentum to help change this consumer perception, with key activities throughout the year including recipe development, alongside demonstrations to help communicate the versatility of pulses.

Alongside growing consumer awareness, manufacturers are now taking advantage of this momentum by looking for increasingly innovative ways to include legumes into their products; including a line of mung bean spreads as a low allergen alternative to nut butters and a range of roasted chickpeas and fava beans as an alternative to traditional snack products. And many other producers have incorporated pulses into snack bars, crackers and energy bites amongst others – clearly opportunities abound for those willing to think outside the box.

Whilst IYP is now officially over, foundations have been set in place to ensure this momentum is continued - Global Pulse Day, an annual celebration on January 18^th will help to maintain public awareness over 2017 and beyond, alongside the continued efforts of all those invested in IYP. The results of 2016 have demonstrated the success that an initiative such as this can have on improving health, sustainability and food diversity on a global scale and the future looks bright to ensure that pulses become an integral and sustainable part of our food chain.

To access a whole host of resources on pulses, including teaching aids, fact sheets and more, visit the Pulses website here. For more recipes and information on the nutritional benefits of pulses visit GLNC's website here.

References

1. 2014. GLNC Consumption & Attitudes Study. Unpublished.
2. 2017: 2016 International Year of Pulses: Australian Outcomes Report. Unpublished.

Should We Still Be Eating Wheat

By Helen Tran, APD

Wheat has featured in the human diet for more than 8,500 years, but more recently the media has led us to question if wheat is good for our health. A recent example of this manipulation of consumer perception is the documentary ‘What’s with Wheat?’ hosted by Australian Nutritionist, Cyndi O’Meara.

But it’s true that wheat isn’t tolerated by a small subset of the population, including those with diagnosed coeliac disease, a wheat allergy or non-coeliac wheat sensitivity, so we’ve taken a look at what the science says for the rest of us.

Does wheat cause a rise in coeliac disease and wheat sensitivity?

It’s suggested that modern wheat varieties created by genetic research, has led to the addition of a ‘new’ protein in wheat called gliadin, which in turn has led to an increase in the number of people with Coeliac disease and wheat sensitivity. But this notion is flawed. All varieties of wheat contain gliadin, including ancient and modern varieties, suggesting that we have always been exposed to gliadin in our diets.^(1,2)

Similarly, results from a study examining data from the 20^th and 21^st centuries in the United States do not support the theory that wheat breeding has caused a rise in gluten content in wheat.⁽³⁾ Another theory is that fructan in wheat has increased, but once again there is no well-designed research to support this. In one study, some ancient wheat species had a higher fructan content than modern wheat species.⁽⁴⁾

Overall, the evidence does not support the notion that modern wheat has a higher gliadin, gluten or fructan content compared to ancient varieties. It may be likely that the rise in coeliac disease and wheat sensitivity in the last 50 years comes from improvements in detection methods and an overwhelming increase in our awareness of how specific foods make us feel.

Does eating wheat lead to obesity and type 2 diabetes?

The relatively recent abundance of wheat products on our supermarket shelves has been identified as one factor responsible for the global increase in incidences of obesity and overweight. Whilst it’s tempting to find a single culprit for this very concerning trend, it is an oversimplification. This assertion overlooks the multiple interacting factors that can contribute to weight gain, including genetics, individual psychology, environment, dietary intake and level of physical activity.^(1,5)

Contrary to this claim, a recent analysis of the Australian National Nutrition Survey found that people who eat the recommended amount of core grain food each day are no more likely to be overweight than those who limit grain foods. Research also shows those people who eat whole grains, including whole grain wheat, have been shown to have the least amount of abdominal fat accumulation compared to those people who eat refined grains or limit all grains.⁽⁶⁾ In fact, eating foods made with whole grain wheat may have positive effects on long term weight management.⁽¹⁾

Currently, there is no clear evidence that wheat (whole grain or refined) is associated with an increased risk of type 2 diabetes. In fact, well-designed studies show that individuals who regularly eat whole grains (most of which are wheat based) are at a reduced risk of developing type 2 diabetes, compared to those who eat the least.^(1,8,9)

The protective effects of whole grain wheat comes from the dietary fibre, vitamins, minerals and phytochemicals it contains. So to reduce our risk of type 2 diabetes, the answer doesn’t lie in cutting out wheat completely, but in choosing whole grain and high fibre wheat foods instead with an aim to increase our intake of whole grains, including whole grain wheat.

Does eating wheat cause inflammation?

It’s been proposed that plant defense proteins called amylase trypsin inhibitors may cause chronic inflammation and activate the immune system^(10-12) but there is currently no evidence which supports this theory.

There is however, mounting evidence to suggest that higher intakes of whole grains may be protective against cardiovascular disease, hypertension, metabolic disorders and specific cancers. ^(13,14) Prebiotic fibres in fibre-rich grains stimulate the production of short chain fatty acids, such as butyrate, that have been shown to enhance the intestinal barrier function.⁽¹⁵⁾

This limited research shows that further research is needed before definitive conclusions can be drawn about the effects of wheat on inflammation.

Does eating wheat change the behaviour of children with Autism Spectrum Disorders?

More and more parents of children with Autism Spectrum Disorders (ASD) are adopting a gluten free diet to manage their child’s behaviour.⁽¹⁶⁾ It’s been hypothesised that children with ASD may have a leaky gut and peptides of gluten in gluten-containing foods could enter the central nervous system. The theory suggests that gluten peptides may intensify brain opioid activity and disrupt normal brain function.⁽¹⁶⁾ Scientific evidence for the leaky gut theory remains inconclusive and evidence to either support or refute the use of a gluten free diet for managing ASD is inadequate.

In the absence of evidence of an effect of gluten on ASD, it is not recommended that children are placed on a gluten-free diet as this diet has been shown to be deficient in nutrients that are important for a child’s growth and development, including B vitamins, iron, zinc and magnesium.

Instead it’s recommended that time and resources would be best spent on more robustly designed interventions.⁽¹⁷⁾ Until more evidence is available, a gluten free diet should only be adopted by children with coeliac disease or wheat sensitivity.

So what’s the bottom line?

Given the evidence, there appears to be no benefit in removing wheat from the diets of the general population. In fact, eating whole grain foods, predominately those that are wheat-based, have been shown to reduce chronic disease risk and are a leading source of essential nutrients in the Australian diet including fibre, B vitamins, iron, magnesium and iodine. Although more research is required to identify the specific link between wheat (whole grain and refined) and health outcomes, it appears that wheat may not negatively affect our health like the many claims that appear consistently in the media.

As such, it’s important not to rely solely on claims appearing in the media but consider the positives and negatives of all available evidence. After all, it’s up to us to make the best decision for our health.

For more information on the multiple benefits of wheat and whole grains, download the GLNC Grains for Health Report here or visit our website for recipes, factsheets and more here.

References

1.    Brouns FJPH, van Buul VJ, Shewry PR. Does wheat make us fat and sick? Journal of Cereal Science. 2013;58(2):209-15.

2.    Prandi B, Tedeschi T, Folloni S, Galaverna G, Sforza S. Peptides from gluten digestion: A comparison between old and modern wheat varieties. Food Research International.

3.    Kasarda DD. Can an increase in celiac disease be attributed to an increase in the gluten content of wheat as a consequence of wheat breeding? Journal of agricultural and food chemistry. 2013;61(6):1155-9.

4.    Ziegler JU, Steiner D, Longin CFH, Würschum T, Schweiggert RM, Carle R. Wheat and the irritable bowel syndrome – FODMAP levels of modern and ancient species and their retention during bread making. Journal of Functional Foods. 2016;25:257-66.

5.    Newell B, Proust K, Dyball R, McManus P. Seeing obesity as a systems problem. New South Wales Public Health Bulletin. 2007;18(12):214-8.

6.    Molenaar EA, Massaro JM, Jacques PF, Pou KM, Ellison RC, Hoffmann U, et al. Association of lifestyle factors with abdominal subcutaneous and visceral adiposity: the Framingham Heart Study. Diabetes care. 2009;32(3):505-10.

7.    Aune D, Norat T, Romundstad P, Vatten LJ. Whole grain and refined grain consumption and the risk of type 2 diabetes: a systematic review and dose–response meta-analysis of cohort studies. European Journal of Epidemiology. 2013;28(11):845-58.

8.    Wu H, Flint AJ, Qi Q, van Dam RM, Sampson LA, Rimm EB, et al. Association Between Dietary Whole Grain Intake and Risk of Mortality: Two Large Prospective Studies in US Men and Women. JAMA Intern Med. 2015.

9.    Kucek LK, Veenstra LD, Amnuaycheewa P, Sorrells ME. A Grounded Guide to Gluten: How Modern Genotypes and Processing Impact Wheat Sensitivity. Comprehensive Reviews in Food Science and Food Safety. 2015;14(3):285-302.

10. Cuccioloni M, Mozzicafreddo M, Ali I, Bonfili L, Cecarini V, Eleuteri AM, et al. Interaction between wheat alpha-amylase/trypsin bi-functional inhibitor and mammalian digestive enzymes: Kinetic, equilibrium and structural characterization of binding. Food chemistry. 2016;213:571-8.

11. Junker Y, Zeissig S, Kim S-J, Barisani D, Wieser H, Leffler DA, et al. Wheat amylase trypsin inhibitors drive intestinal inflammation via activation of toll-like receptor 4. The Journal of experimental medicine. 2012;209(13):2395-408.

12. Jones JM, Peña RJ, Korczak R, Braun HJ. CIMMYT Series on Carbohydrates, Wheat, Grains, and Health: Carbohydrates, Grains, and Wheat in Nutrition and Health: Their Relation to Digestion, Digestive Disorders, Blood Glucose, and Inflammation. Cereal Foods World. 2016;61(1):4-17.

13. Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, et al. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. Bmj. 2016;353.

14. Brahe LK, Astrup A, Larsen LH. Is butyrate the link between diet, intestinal microbiota and obesity-related metabolic diseases? Obesity Reviews. 2013;14(12):950-9.

15. Christison GW, Ivany K. Elimination diets in autism spectrum disorders: any wheat amidst the chaff? Journal of developmental and behavioral pediatrics : JDBP. 2006;27(2 Suppl):S162-S71.

16. Hurwitz S. The Gluten-Free, Casein-Free Diet and Autism: Limited Return on Family Investment. Journal of Early Intervention. 2013;35(1):3-19.