Ask the Expert: Dr. Emeran Mayer on Butyrate, Akkermansia muciniphila, and More

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Ask the Expert: Dr. Emeran Mayer on Butyrate, Akkermansia muciniphila, and More

In our Ask the Expert series, we sit down with renowned science and medical professionals to get their insights into how to stay healthy.

In our third edition of "Ask the Expert," Pendulum CEO and co-founder Colleen Cutcliffe chatted with Dr. Emeran Mayer, who is a gastroenterologist, neuroscientist, and distinguished research professor in the Departments of Medicine, Physiology, and Psychiatry at the David Geffen School of Medicine at UCLA.

Dr. Mayer is one of the pioneers ofand leading researchers inthe role of mind-brain-gut interactions in health and chronic disease.

Dr. Mayer has also made major scientific contributions to the area of basic and translational enteric neurobiology, with wide-ranging applications in clinical gastrointestinal diseases and disorders.  

What are some specific nutrients that are vital for proper gut function? 

When we talk about gut health, we think about what goes on in the end of the small intestine and in the colon. That’s where the majority of our gut microbes live.

The processes that are going on in these regions of the gut have turned out to be very crucial toward many functions in our bodies.  

What’s important for the health of this part of our digestive tract are the nutrients targeted at the gut microbiota.

When we eat a meal, the majority of the macronutrients are rapidly absorbed into our small intestine. We don't really have to worry about this unless we have malabsorption. What we do have to worry about, however, is that fewer and fewer componentsor proportionsof what we eat get down to the microbiota and nurture microbes.

The most important part of this are these microbiota accessible carbohydrates (MACs)also referred to as dietary fiber. These are all the molecules that are not absorbed in the small intestine that move down into the realm of the microbiome where they are being metabolizedmany of them into short chain fatty acids. They play a major role in maintaining the health of that system.

What role does butyrate play in glucose control for people with Type 2 diabetes? 

Butyrate is one of the short-chain fatty acids. I like to refer to short-chain fatty acids as the "main currency" in the microbial world. 

We have so many different cell types that all interact with each other. Interestingly, short-chain fatty acids are a major influencer in maintaining proper functioning of this complex system.

Within the gut, butyrate receptors can be found in a wide range of  epithelial, endocrine, immune, and nerve cells.

Because of the ubiquitous expression of these short-chain-fatty-acid receptors on various gut cells, butyrate has a wide range of homeostatic effects on gut function.

Tell us about this new strain, Akkermansia muciniphila, and why everyone should know about it.

In both clinical and research studies, Akkermansia muciniphila has been implicated to be a major regulator of the mucus layer that plays an essential part of the gut-barrier function. 

The most important link Akkermansia muciniphila has to our gut health is related to its role in optimizing the balance of our gut-mucus layer. That mucus layer essentially is the main barrier between the microbial universe inside of us, both the good and the bad microbes and the gut-associated immune system.

Akkermansia muciniphila strains can live off the complex carbohydrate molecules that are making up the mucus layer. 

There are other microbes that have been implicated in the role of the mucus layer, but I think the greatest attention has been focused on the Akkermansia muciniphila strains. 

What can people do to maintain a healthy gut microbiome

A healthy diet is at the top of the priorities list.

I think the most important and easiest thing you can do is pay attention to the needs of your gut microbiotaand not so much to the needs that we have as the hosts.

Discussions about the "right diet" have focused on how much protein, sugar, or fat is good for you, which is all not terribly relevant for the gut microbes. 

What is relevant, however, is these microbiota-targeted components of foodsuch as fiber, microbiota accessible carbohydrates (MACs), and polyphenols.

There is still debate about the important benefits of diets like ketogenic, paleo, and low-carb. When thinking about a diet that might be right for you and your health goals, I would say the most important thing to think about is that a largely plant-based diet has the highest amountand highest variationof beneficial food components for the gut microbes.

Importantly, the greater variety of fruits and vegetables the better it is for your gut microbes. 

What makes Pendulum Glucose Control different from every other probiotic out there?

There have been a lot of probiotics out there that claim to have various health benefits.

The majority of these probiotics, however, contain generic probiotic strainssuch as lactobacillus and bifidobacteriathat have never been designed for a particular health benefit.

Pendulum Glucose Control is different. 

Pendulum Glucose Control is a combination of 5 microbial strains (including an Akkermansia muciniphila strain) and an Inulin prebiotic.

Pendulum Glucose Control has been specifically developed to help with the management of A1C and post-meal blood-glucose spikes, and has even been tested in animal models and confirmed in a randomized controlled clinical trial.

How do you differentiate good probiotics from bad probiotics?

That's a very difficult question.

If you go on the Internet or if you talk to people that promote probiotics, they usually say that their probiotic is the best. They will tell you that their probiotic has the greatest number of colony-forming units, and that it has the largest number of microbial strains.

These are unvalidated measurements or indicators for the benefits of a probiotic. It has never been evaluated that the combination is more beneficial if you take one one strainas opposed to 15 strains.

Personally, I am very skeptical of claims that companies make about these probiotic products. The biggest problem with many of these products is that they don't have scientifically demonstrated health benefits in humans.

The criteria that I would use is solid. You need to conduct high-quality, controlled, and randomized clinical studies of a probiotic where patients taking the product have demonstrated a measurable, objective benefit.

Pendulum has done just that!

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