The gut microbiome is the community of viruses, bacteria, and fungi living in the large intestine. Some evidence suggests that the gut microbiome, more specifically microbial dysbiosis, may be linked with the pathophysiology of diabetes, and it has been suggested that influencing the microbiome through probiotic consumption could help reduce insulin resistance and improve blood glucose management (Zhang et al. 2021)6. However, further research is required to examine the extent to which and how the microbiome directly impacts diabetes.
Dietary fibre is found in plant-based foods, and its roles include supporting digestive health and preventing constipation. There is evidence that eating plenty of fibre helps reduce our risk of type 2 diabetes (The British Dietetic Association 2021)4. Fibre is key considering gut health and increasing the number of good bacteria in the gut, and as an additional benefit, higher fibre foods generally have a lower glycaemic index than lower fibre foods, and they also help increase satiety between meals.
Lower glycaemic index foods are broken down into glucose more slowly, helping improve post-meal glucose management, which is especially relevant for those with type 2 diabetes and individuals at higher risk of developing it. However, it is essential to consider that the larger a carbohydrate portion, the greater the impact on post-meal glucose levels so it is important to consider portion size alongside glycaemic index where blood glucose levels are concerned.
Probiotics are living bacteria and yeasts, often promoted to offer health benefits through influencing the balance and diversity of beneficial gut microorganisms. Some individuals choose to take probiotic supplements, with an ever-growing number of different forms appearing on the market. The benefits of fermented foods have also become an area of growing interest, with some fermented foods, such as specifically-labelled types of yogurts, containing live strains of microorganisms.
However, a food qualifies as a ‘probiotic’ only if the live microorganism has demonstrable health benefits and the strain is clearly defined (Marco et al. 2021)5. Fermented foods such as tempeh and kimchi can contain other bioactive compounds which can support beneficial gut bacteria, and although extensive further research is required, Randomised Controlled Trials have demonstrated that fermented foods can impact gut microbiome composition (Marco et al. 2021).
The role of prebiotics is important (prebiotics are specific types of dietary fibres), as these ‘feed’ good gut bacteria, supporting them to grow and thrive (The British Dietetic Association 2022)5. Dietary variety remains key, and consuming a range of wholegrains, fruits, and vegetables can provide prebiotic fibres which help diversify the microbiome. However, more evidence is needed into the impact of prebiotics on the microbiome, and into how influencing the microbiome benefits human health in general (Holscher 2017)2.
Research has suggested that individuals’ intake of unsaturated fats can affect systemic inflammation, with these healthy fats also being beneficial for blood glucose management. Omega-3 polyunsaturated fatty acids, for example, can positively alter the gut microbiome, by influencing its composition. This occurs through influencing the growth of different types of gut bacteria, thus reducing the inflammatory reaction linked to systemic inflammation (Fu et al. 2021)1.
DHA Omega-3 fatty acids are found in oily fish, and some plant-based foods, such as chia seeds, walnuts, and flaxseeds, contain ALA Omega-3 fatty acids. It is known that type 2 diabetes is characterised by low-grade systemic inflammation, although the clinical relevance of this is still to be examined further. Evidence also exists suggesting that reducing saturated fat intake and increasing unsaturated fatty acid intake can aid with improved glycaemic control and reduced insulin resistance in individuals with type 2 diabetes. For the general population, similar benefits have been demonstrated, supporting existing dietary recommendations (Imamura et al. 2016)3.
We must consider that blood glucose levels are influenced by many different factors, aside from diet, and the extent to which the microbiome directly impacts individuals’ risk of developing diabetes and glucose management requires more evidence. This suggests more research into the direct relationship between diabetes and gut health is needed.
Including a variety of plants within the diet ensures a range of different fibre types is consumed, supporting gut microbiome diversity. Opting for lower Glycaemic Index carbohydrates, for example, swapping white bread and pasta for brown bread and wholemeal pasta, are simple swaps. Maintaining basic helpful habits remains essential (including drinking plenty of sugar-free fluid, regularly exercising, cooking with healthy fats, and including vegetables with meals), for looking after our gut and overall health.
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