A Hidden Reason Women and Men Need Different Gut Health Strategies
Implications of Sex Differences on Gut Bacteria that Influence Obesity, BMI, Fat Mass, and Waist Size
What does gut bacteria have to do with overweight or obesity? A lot actually. It’s been well-established through research that imbalances in beneficial and harmful gut bacteria, called dysbiosis, are correlated with weight gain, overweight and obesity. In fact, the gut microbiome of persons with obesity looks very different from the gut microbiome of persons without obesity. More interestingly, the actual species of bacteria that are either too low or too high are different between males and females with obesity.
That’s right. Different beneficial species are lower and different harmful species are increased in women vs men. AND, there’s sex-specific bacteria differences in species that correlate with fat mass and a larger waist size. We’ll get to the details in a moment.
Factors that Effect Dysbiosis and Obesity
While the gut microbiome plays a key influencing and mediating role for obesity, it is one of many factors that play a role and should not be considered either as 1) the singular factor nor 2) the cause.
It’s not that straightforward. There is no single factor or cause of obesity. And, if you still harbor the belief that it’s as simple as calories-in, calories out (CICO) or willpower, well I have no problem telling you: YOU’RE WRONG. The science, physiology and biochemistry just don’t support that. One of these days I’ll write an article about the pathophysiology of obesity, but today is not that day.
Other factors that influence dysbiosis and weight gain, overweight and obesity include:
Stress
Dietary patterns
Inflammation
Insulin resistance
Physical activity
Environmental exposures
Mental health status
Sleep
Medications and supplements
I’ll call particular attention to the top 5 as these are factors that we can absolutely influence – in fact, we influence them everyday, whether we realize it or not, through the choices we make.
The extra unique aspect of these top 5 is that they all also influence each other. As an example: Stress contributes to inflammation and chronic inflammation contributes to physiological stress responses. This is why tackling one area is a good start, but to see meaningful, long-term shifts in the body, each of them should be addressed – that’s not to say you need to take them all on at once … not at all. In fact, depending on your personal state of health, there’s probably some that are higher priority than others. Starting with the gut and stress management are great places to start because so many other factors are impacted by both.
A quick primer on the gut microbiome
Your body has trillions of microbes in it, and there’s more than one microbiome. These collections of bacteria are found in our large intestine, small intestine, mouth, vagina (for those of us that have them), and skin.
There’s billions of these bacterias in the gut microbiome, which primarily refers to the large intestine but also includes the small intestine. There are a HUGE number of families and species of bacteria; some are beneficial and are commonly called “good” and some are harmful or pathogenic, these are considered “bad.” Your gut bacteria is fed by the food you eat. These bacteria don’t just simply consume the food you consume, they also create waste products, called metabolites. These metabolites can be neurotransmitters and hormones, endotoxins like lipopolysaccharides and TMAO, and other things – what they all have in common, though, is that they tell your body to function in a certain way.
Imbalance or dysbiosis occurs when:
There are reduced beneficial bacteria
An overabundance of harmful bacteria
A lack of diversity of different families and species
There’s no such thing as a perfect or ideal microbiome. There are so many families and species of bacteria that we don’t yet clearly understand what each species does for the body; added to that, no person has the exact same bacterial makeup – your specific combination of types and number of bacteria are as unique to you as your fingerprints … except this would be like fingerprints that are constantly changing. The closest I can come to describing an ideal gut microbiome is: A highly diverse microbiome with more beneficial than harmful bacteria.
There are some families and species of bacteria that probably are familiar to you: Lactobacillus acidophilus (commonly found in yogurt), Lactobacillus rhamnosus GG (one of the most well-studied strains, Streptococcus (there are both harmful and beneficial species in this family), and Akkermansia (this has gotten a LOT of attention in the past 2 years; it’s technically an archaea not a bacteria).
Gut Bacteria and the Microbiome of Women with Obesity
These findings come from a study conducted in Spain on 361 adults with a median age of 44; 70% of the participants were women (I would have preferred to see this more well-balanced). Half of the women had a BMI not associated with obesity (</= 30 kg/m2) with a waist circumference </= 34.64 inches (88 cm) and half had a BMI associated with obesity (> 30 kg/m2) with a waist measurement of >34.64 inches (88 cm).
Both men and women who had obesity had significantly lower levels of Christensenella minuta, a bacterium linked to leanness. Women had an over-abundance of families of bacteria that were predictive of a higher BMI, higher fat mass, and larger waist circumference that included: Prevotella micans, P brevis, and P sacharolitica.
Men, on the other hand, had much higher levels of Parabacteroides helcogenes and Campylobacter canadensis (which were associated with higher BMI, fat mass, and larger waist measurement).
So, I just get a probiotic, right? No
So, here’s the thing, just because we know which species were low, doesn’t mean, you can simply go out and buy a probiotic to supplement it. We would need to see another research study using that specific strain of bacteria to understand if a probiotic supplement would be effective. Plus, unless you know what to look for, there’s no guaranteeing the probiotic you’re buying will actually be beneficial for the problem you’re trying to solve. (Shameless plug for an upcoming post on Probiotics!)
For all of the harmful strains that were too high, the best way to decrease them is to have prebiotic- and fiber-rich foods while also consuming probiotic-rich foods. Prebiotics and fiber are critical pieces because they feed the good bacteria and take away the “parking spaces” for bad bacteria which encourages them to die off.
Depending on your specific health status, additional diet and lifestyle interventions are likely necessary. Your care plan would not only depend on your current state of health, but your age, your cycle, medical history, family history, your job, where you live, your circadian rhythm, sleep, alcohol intake, and more, as well.
References
Obesity-associated gut microbiota and its impact on the metabolome
https://drive.google.com/file/d/18Urmr8fayStxDj1WJ5F3p7ExQnHFeD_i/view
Exploring the Impact of the Gut Microbiome on Obesity and Weight Loss: A Review Article
https://pmc.ncbi.nlm.nih.gov/articles/PMC10368799/
The association of weight loss with changes in the gut microbiota diversity, composition, and intestinal permeability: a systematic review and meta-analysis
https://pmc.ncbi.nlm.nih.gov/articles/PMC8796717/
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