Avoiding sugary foods while taking a course of antibiotics might help protect the diversity of your gut microbiome. The array of bacteria in the gut plays a crucial role in supporting our digestion and our physical and mental health. But this diverse community can be disrupted by antibiotics, leading to digestive problems, fatigue and flare-ups of skin conditions.
Stopping such disruption is particularly important for people with cancer, because greater gut microbiome diversity has been linked to better survival rates. To dig into this issue, Jonathan Peled at the Memorial Sloan Kettering Cancer Center in New York and his colleagues have studied 158 people with blood cancers. The participants were hospitalised for several weeks as they had chemotherapy to knock out their immune systems before an infusion of stem cells.
To prevent potential infections, each person took at least one type of antibiotic. How ancient superbugs could help us fight antibiotic resistance The researchers monitored changes in the participants’ gut microbiomes by analysing stool samples. Crucially, they also knew exactly what people had eaten, and when they had eaten it.
Each time a participant ordered a meal from the hospital kitchen, between 12 days before the stem-cell transplant and 49 days after, the food tray arrived with a questionnaire for recording the amount of each item they consumed. We know the recipe and the standard serving size and the nutritional information of each ingredient. I think this is the closest anyone has ever come to precisely recording everything that goes in and linking it to what comes out.” The researchers recorded more than 40,000 food items, creating a dataset with a level of detail that is rarely possible in nutrition research.
When they scoured it for patterns, they found that people who consumed more high-sugar foods while taking antibiotics ended up with a less diverse microbiome. Having antibiotics in the 48 hours before the collection of a stool sample was linked to a drop in microbiome diversity. This varied from person to person, but for every 100-gram increase in consumption of food or drink that was high in sugar (equivalent to one large milkshake) during that time, that drop in total bacterial diversity was on average 24 per cent greater.
The combination of a sugary diet and antibiotic treatment also led to increased numbers of Enterococcus faecium bacteria, which can act as pathogens and cause severe hospital-acquired infections. The sugar in the gut exacerbates problems caused by the antibiotics, says team member Jonas Schluter at NYU Langone Health in New York. By wiping out many gut bacteria, the antibiotics disrupt the balance of the microbiome, leaving a few “last man standing” strains that aren’t necessarily the most beneficial to our health.
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