A synbiotic intervention to improve well-being at work.

Background: There has been extensive research on the effects of probiotics and prebiotics. Research is now examining them in combination (synbiotics), which was done in the present study. There has been no previous research on the effects of synbiotics on wellbeing at work, which was investigated here. Methods: Fourteen participants from a third-sector charity completed the Well-being Process Questionnaire before and after a 6-week intervention involving the consumption of kefir and a prebiotic mixture. Results: The results showed that several aspects of well-being significantly improved after consumption of the synbiotic drink. The participants reported feeling less sleepy during the day and more immersed in their work. They also reported higher life satisfaction and greater flourishing (thriving). Conclusion: This is the first study to demonstrate the benefits of a synbiotic drink for the well-being of workers. Further research with appropriate comparison conditions is required to identify what produces such effects. Including gut microbiome assays will also help determine the underlying biological mechanisms

Trialling a microbiome-targeted dietary intervention in children with ADHD—the rationale and a non-randomised feasibility study

Background Dietary interventions have been previously explored in children with ADHD. Elimination diets and supplementation can produce beneficial behaviour changes, but little is known about the mechanisms mediating change. We propose that these interventions may work, in part, by causing changes in the gut microbiota. A microbiome-targeted dietary intervention was developed, and its feasibility assessed. Methods A non-randomised feasibility study was conducted on nine non-medicated children with ADHD, aged 8–13 years (mean 10.39 years), using a prospective one-group pre-test/post-test design. Participants were recruited from ADHD support groups in London and took part in the 6-week microbiome-targeted dietary intervention, which was specifically designed to impact the composition of gut bacteria. Children were assessed pre- and post-intervention on measures of ADHD symptomatology, cognition, sleep, gut function and stool-sample microbiome analysis. The primary aim was to assess the study completion rate, with secondary aims assessing adherence, adverse events (aiming for no severe and minimal), acceptability and suitability of outcome measures. Results Recruitment proved to be challenging and despite targeting 230 participants directly through support groups, and many more through social media, nine families (of the planned 10) signed up for the trial. The completion rate for the study was excellent at 100%. Exploration of secondary aims revealed that (1) adherence to each aspect of the dietary protocol was very good; (2) two mild adverse events were reported; (3) parents rated the treatment as having good acceptability; (4) data collection and outcome measures were broadly feasible for use in an RCT with a few suggestions recommended; (5) descriptive data for outcome measures is presented and suggests that further exploration of gut microbiota, ADHD symptoms and sleep would be helpful in future research. Conclusions This study provides preliminary evidence for the feasibility of a microbiome-targeted dietary intervention in children with ADHD. Recruitment was challenging, but the diet itself was well-tolerated and adherence was very good. Families wishing to trial this diet may find it an acceptable intervention. However, recruitment, even for this small pilot study, was challenging. Because of the difficulty experienced recruiting participants, future randomised controlled trials may wish to adopt a simpler dietary approach which requires less parental time and engagement, in order to recruit the number of participants required to make meaningful statistical interpretations of efficacy

A randomised controlled trial of the effects of kefir on behaviour, sleep and the microbiome in children with ADHD: study protocol

Introduction: Current interventions for children with ADHD are primarily medication, behavioural therapy and parent-training. However, research suggests dietary manipulations may provide therapeutic benefit for some. There is accumulating evidence that the gut microbiome may be atypical in ADHD and therefore manipulating gut bacteria in such individuals may help alleviate some of the symptoms of this condition. The aim of this study is to explore the effects of supplementation with kefir (a fermented dairy drink) on ADHD symptomatology, sleep, attention and the gut microbiome in children diagnosed with ADHD. Methods and analysis: A six-week randomised, double-blind, placebo-controlled trial in 70 children aged 8-13 years diagnosed with ADHD. Participants will be recruited throughout the UK, through support groups, community groups, schools, social media and word of mouth. Children will be randomised to consume daily either dairy kefir or a placebo dairy drink for six weeks. The primary outcome, ADHD symptomatology, will be measured by The Strengths and Weakness of ADHD-symptoms and Normal-behaviour (SWAN) scale. Secondary outcomes will include gut microbiota composition (using shotgun metagenomic microbiome sequencing), gut symptomatology (The Gastrointestinal Severity Index questionnaire), sleep (using seven-day actigraphy recordings, The Child’s Sleep Habits Questionnaire and Sleep Self Report questionnaire), inattention and impulsivity (with a computerised Go/NoGo test). Assessments will be conducted prior to the intervention and at the end of the intervention. Interaction between time (pre/post-intervention) and group (probiotic/placebo) is to be analysed using a Mixed Model Analysis of Variances (ANOVA). Ethics and dissemination: Ethical approval for the study was granted by St Mary’s University Ethics Committee. Results will be disseminated through peer-reviewed publications, presentations to the scientific community and support groups. Trial Registration: The trial protocol has been prospectively registered with ClinicalTrials.gov: NCT05155696. Registered on 13 December 2021

Harnessing the Power of Microbiome Assessment Tools as Part of Neuroprotective Nutrition and Lifestyle Medicine Interventions

An extensive body of evidence documents the importance of the gut microbiome both in health and in a variety of human diseases. Cell and animal studies describing this relationship abound, whilst clinical studies exploring the associations between changes in gut microbiota and the corresponding metabolites with neurodegeneration in the human brain have only begun to emerge more recently. Further, the findings of such studies are often difficult to translate into simple clinical applications that result in measurable health outcomes. The purpose of this paper is to appraise the literature on a select set of faecal biomarkers from a clinician’s perspective. This practical review aims to examine key physiological processes that influence both gastrointestinal, as well as brain health, and to discuss how tools such as the characterisation of commensal bacteria, the identification of potential opportunistic, pathogenic and parasitic organisms and the quantification of gut microbiome biomarkers and metabolites can help inform clinical decisions of nutrition and lifestyle medicine practitioners

Becoming a professional opinion leader

Findings, discussion and conceptualisation of informal learning in occupational practices

Neuroprotection, aging, and the gut–brain axis: Translating traditional wisdom from the Mediterranean diet into evidence-based clinical applications

Given the multifactorial nature and the complexity of the aging processes, it would be simplistic to assume that the consumption of high levels of single nutrients or specific food items would be able to modulate the many pathways involved therein. Instead a diverse and naturally occurring dietary pattern, such as the Mediterranean diet, provides practitioners with a model that's well documented for its range of beneficial actions on gut, brain, and systemic health. This chapter describes the context of age-related disorders with a specific focus on brain aging. It describes integrative practitioners with an insight as to how this model is a much better fit for ongoing neuroprotection mediated by means of ongoing minimization of genomic instability, sustained protection of genomic integrity and wholefoods. The chapter deals with the use of targeted nutraceuticals, prescribed on the basis of individual requirements

Diet and the microbiome in precision medicine

With the current boom of research interest on the links between diet and the gut microbiome, it is easy to fall under the spell of hyperbolic claims. The one point that shines through clinical research is that diversity of fresh produce is a key contributor to a balanced microbial population, a state known as eubiosis, which contrasts with dysbiosis. Trials assessing the impact of single foods as well as whole diets, on the microbiome, metabolome, and on mental health markers, already provide many clues about how to achieve the best health results

Could food act as personalized medicine for chronic disease?

Based on recent conflicting views on nutritional approaches, are nutrition health professionals meant to wait until key long-term human randomized controlled trials of good methodological quality are published on UK-type populations, a process that could take decades at the current rate. Instead, they could embrace the new ‘omic’ technologies as innovative tools to help personalized nutrition. Based on current findings, a single microbiome test can provide more reliable information about a person’s health than a genome screen and major disruptions are seen in allergy, obesity, colitis and irritable bowel syndrome, diabetes or even cancer. While treating every patient as a research subject, health professionals should see every meal as an opportunity, and every food as a potential drug