{"id":11596,"date":"2022-11-18T20:26:01","date_gmt":"2022-11-18T20:26:01","guid":{"rendered":"https:\/\/todaysveterinarynurse.com\/?p=11596"},"modified":"2022-11-18T21:01:07","modified_gmt":"2022-11-18T21:01:07","slug":"nutrition-small-animal-microbiome-and-nutrition","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/nutrition\/small-animal-microbiome-and-nutrition\/","title":{"rendered":"The Microbiome and Nutrition"},"content":{"rendered":"<div class=\"su-spacer\" style=\"height:20px\"><\/div><div class=\"su-note\"  style=\"border-color:#d8d8d8;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><div class=\"su-note-inner su-u-clearfix su-u-trim\" style=\"background-color:#f2f2f2;border-color:#ffffff;color:#333333;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><b>Abstract<\/b><\/p>\n<p>Research is revealing the important effects that the gut microbiome has on a host\u2019s overall health status as it influences the function of organs and physiologic systems. Compounds or metabolites produced by microbial fermentation of certain nutrients in the gastrointestinal (GI) tract play the largest role in these effects. Appropriately altering the digestibility or type of macronutrients in a pet\u2019s diet can positively affect the pet\u2019s GI microbiome, resulting in improved physiological function and health for the animal. Helping pet owners understand new \u201calternative\u201d or innovative first-line testing and treatment options is imperative for improving recovery rates in pets with GI dysbiosis.<br \/>\n<b><\/b><\/p>\n<p><b>Take-Home Points <\/b><\/p>\n<ul>\n<li>Nutrients provide energy for microbes in the GI tract as well as their host.<\/li>\n<li>The health of the GI microbiome is a good indicator of the health status of the host. A healthy microbiome contains many microbial species that can aid in promoting host health.<\/li>\n<li>The GI microbiome is influenced by host factors such as genetics, birth presentation, age, sex, hormonal status, environment, stress, nutrition, and antibiotic use. All of these factors may affect microbiota density and diversity.<\/li>\n<li>Broad-spectrum antibiotic usage causes the most significant change in the GI microbiome with the longest recovery rate.<\/li>\n<li>Host nutrition can alter the diversity and density of the GI microbiome, which may affect the metabolism, protective functions, and structural integrity of the GI tract.<\/li>\n<li>Nutrients that are indigestible by the host are the usual sources of nutrition for the GI microbiome. Fiber is a preferred energy source of many commensal bacteria.<\/li>\n<li>Fecal microbial testing can provide owners with a visual report of what is happening with their pet\u2019s health compared with \u201cnormal\u201d or \u201chealthy\u201d standards.<\/li>\n<li>When recommending probiotics, veterinary nurses should choose products that are species-specific and are supported by species-specific research.<\/div><\/div><\/li>\n<\/ul>\n<p class=\"p1\"><span class=\"s1\">A<\/span><span class=\"s1\">nswering the question \u201cWhy is pet nutrition important?\u201d has evolved over the last few decades. As the benefits of pharmaceutical agents in treating a disease state have long been understood\u2014for example, insulin to balance blood glucose in a diabetic pet or anti-inflammatories to decrease joint pain associated with obesity\u2014so has nutrition become recognized as a fundamental factor in pet health. Increased research into how nutrients provide energy has led to use of a wider variety of ingredient sources in pet food and a more thorough understanding of canine and feline digestive and physiologic requirements. This has enhanced the development of formal nutritional guidelines for macro- and micronutrient requirements for pets and a growing variety of diets. <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Recently, research in pet nutrition has focused on how nutrients are used by both pets and the microbes living in their gastrointestinal (GI) tract, and how microbial metabolism of these nutrients affects the health of the host.<sup>1<\/sup> The newly recognized organ, the GI microbiome, is particularly important, as it contains over 100 trillion types of bacteria, fungi, archaea, and viruses, including microbial genes, that are able to influence multiple host organ systems, such as the neurologic, hepatic, oral, cardiac, integumentary (skin, hair, nails, and glands), and GI systems.<sup>2-4<\/sup> Multiple factors have been identified as playing roles in altering and supporting these microcommunities, including nutrition.<\/span><\/p>\n<h2 class=\"p3\">What is a Healthy GI Microbiome?<\/h2>\n<p class=\"p2\"><span class=\"s1\">The health status of the GI microbiome is a good indicator of the health status of the host. A healthy microbiome contains numerous types of microbiota that assist in multiple health-promoting functions.<sup>5<\/sup> A less diverse microbiome in which only a few species are identified is associated with poor health or a disease state.<sup>5<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Creating a healthy GI microbiome usually starts during the birthing process or soon after birth. Neonates born by vaginal delivery from healthy mothers have an initial exposure to maternal native vaginal microbiota, while those born via cesarean delivery may be initially exposed to the microbiome of the skin or environment. These pioneer microbes help educate and mature the immune system by conditioning the epithelial cells that line the GI tract to decrease their subsequent response to the same types of bacteria, allowing for a future symbiotic relationship.<sup>6<\/sup> Additionally, how and what the neonate is fed can influence exposure to pioneer microbes. Ideally, microbial exposure should be species specific, which is more likely to occur during natural delivery and maternal nursing than during cesarean delivery or artificial nipple or tube feeding. The beneficial microbes that colonize the GI tract are known as commensal microbes.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Continued stabilization of the healthy GI microbiome is influenced by many factors, including host genetics, age, sex, hormonal status, environment, stress, nutrition, and antibiotic exposure.<sup>7<\/sup> These factors all affect microbiota density and diversity. However, <a href=\"https:\/\/todaysveterinarypractice.com\/clinical-pathology\/improving-patient-outcomes-through-antibiotic-stewardship\/\" target=\"_blank\" rel=\"noopener\">broad-spectrum antibiotic usage<\/a> has been identified as causing the most significant shift or change with the longest recovery rate.<sup>8<\/sup> For example, administration of metronidazole and tylosin has been shown to lead to major, long-lasting alterations in the intestinal microbiome.<sup>9<\/sup> This is because beneficial anaerobic bacteria in the microbiome are slower to adjust their <\/span>metabolic process and flourish after antibiotic treatment<span class=\"s1\"> than facultative bacteria (e.g., <i>Escherichia coli), <\/i>which are able to thrive in an anaerobic or aerobic environment. Once these bacteria have flourished, it can be difficult to rebalance the state of the microbiome back to its preantibiotic \u201cnormal\u201d state.<sup>9,10<\/sup><\/span><\/p>\n<h2 class=\"p3\">How Does the GI Microbiome Affect the Host?<\/h2>\n<p class=\"p2\"><span class=\"s1\">Microbes in the GI tract play a role in host health through 3 main functions (<\/span><span class=\"s2\"><b>FIGURE 1<\/b><\/span><span class=\"s1\">). First, they perform or aid in the completion of metabolic functions, primarily through metabolite production. Second, they enhance or perform protective functions by controlling the growth of potential pathogens and influencing the immune system\u2014the GI tract contains 80% of the body\u2019s immune cells, which allows the GI microbiota to influence this system.<sup>8<\/sup> Third, they support the GI tract structure by improving the GI barrier. Each of these functions depends on proper nutrition of both the host and the microbes.<\/span><\/p>\n<div id=\"attachment_11484\" style=\"width: 560px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2022\/11\/Saar_TVNWinter23_Microbiome_Fig1.png\"><img fetchpriority=\"high\" decoding=\"async\" aria-describedby=\"caption-attachment-11484\" class=\" wp-image-11484\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2022\/11\/Saar_TVNWinter23_Microbiome_Fig1.png\" alt=\"\" width=\"550\" height=\"385\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2022\/11\/Saar_TVNWinter23_Microbiome_Fig1.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2022\/11\/Saar_TVNWinter23_Microbiome_Fig1-300x210.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2022\/11\/Saar_TVNWinter23_Microbiome_Fig1-768x538.png 768w\" sizes=\"(max-width: 550px) 100vw, 550px\" \/><\/a><p id=\"caption-attachment-11484\" class=\"wp-caption-text\">Figure 1. The physical and chemical components of an animal\u2019s diet affect the gastrointestinal microbiome and subsequently host health, although the exact mechanisms have yet to be identified. Figure 1 (dog bowl): VectorPlotnikoff\/shutterstock.com<br \/>Used under Creative Commons license (<a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\" target=\"_blank\" rel=\"noopener\">https:\/\/creativecommons.org\/licenses\/by\/4.0<\/a>) from Leeming ER, Louca P, Gibson R,\u00a0Menni C, Spector TD, Le Roy CI.\u00a0The complexities of the diet\u2013microbiome relationship: advances and perspectives.\u00a0<em>Genome Med<\/em>.\u00a02021;13(1):10. doi.org:10.1186\/s13073-020-00813-7<\/p><\/div>\n<h3 class=\"p4\">Metabolite Production and Functions<\/h3>\n<p class=\"p2\"><span class=\"s1\">Metabolites are chemical compounds resulting from metabolic processes. In the GI setting, they are produced by microbes through fermentation of dietary components that cannot be digested in the small intestine. Different types of bacteria prefer different dietary components (known as preferred nutrients), and different components produce different metabolites. Each metabolite has different functions for the host, such as providing energy for cells or other microbiota, assisting with host energy metabolism, and aiding in digestion processes. <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">To flourish and produce necessary metabolites, all commensal microbes require their preferred nutrients.<sup>7<\/sup> For example, <a href=\"https:\/\/todaysveterinarypractice.com\/nutrition\/understanding-types-fiber-clinical-uses\/\" target=\"_blank\" rel=\"noopener\">fiber<\/a> is an important dietary component because it is a preferred nutrient for GI bacteria that produce short-chain fatty acids (SCFAs). SCFAs (butyrate, propionate, and acetate) have multiple beneficial roles, including being energy sources for colonocytes and improving intestinal mucosal barrier functions and glucose metabolism. They also cross the blood\u2013brain barrier to support brain function.<\/span><\/p>\n<h3 class=\"p4\">Dysbiosis<\/h3>\n<p class=\"p2\"><span class=\"s1\">An imbalanced microbiome may lead to a state of dysbiosis. Three types of GI microbiome dysbiosis are commonly identified: (1) overgrowth of a pathogenic type of bacteria, (2) absence of key beneficial bacteria, and (3) decrease in the diversity or number of types of bacteria.<sup>11<\/sup> These types of dysbiosis may be present separately or concurrently. In each case, the imbalance in microbial species affects the type and quantity of metabolites produced by the microbiome, with consequences for the host.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Depending on the type(s) of dysbiosis present, a variety of clinical signs may be observed. Diarrhea is the most commonly identified, but conditions affecting systems and organs other than the GI tract are being identified as correlating with dysbiosis in the GI microbiome. For example, neurologic conditions (e.g., seizure, cognitive dysfunction, anxiety), diabetes, obesity, atopy, and neoplasia have all been associated with a GI microbiome dysbiosis or imbalance.<sup>4,12<\/sup> However, it is still unclear if dysbiosis causes disease, if it is a result of the disease state that perpetuates the condition, or how <\/span>long it takes for signs to appear after dysbiosis develops.<sup>1<\/sup><\/p>\n<h2 class=\"p3\">What is the Role of Nutrition in Treating Dysbiosis?<\/h2>\n<p class=\"p2\"><span class=\"s1\">Veterinary teams can support pets with GI dysbiosis in several ways. One of the most basic is to be aware of all treatment options, including nutritional options, for pets with acute GI or noninfectious conditions in which the GI microbiome may not have been previously considered to play a role, such as atopy, hepatic, and behavior issues. Veterinary professionals should complete a nutritional evaluation for these patients and consider diet as a first-line option. Using 5\u00a0main goals, veterinary teams can simplify how they determine and present their nutritional recommendations. <\/span><\/p>\n<h3 class=\"p4\">1. Determine Appropriate Calorie Goals<\/h3>\n<p class=\"p2\"><span class=\"s1\">Assess the pet\u2019s body condition score (BCS) and muscle condition score (MCS) and calculate the pet\u2019s energy requirement based on its individual needs. If the pet has an ideal BCS (5\/9) and a good MCS, the current diet is likely providing adequate nutrition to meet its basic metabolic needs in its current health state. If the pet is overweight, GI dysbiosis is likely, and a change in diet could aid in improving microbiome diversity. <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Calculating the patient\u2019s specific energy requirements supports a healthy body condition and energy function by ensuring that the pet is not being fed excessive calories. The pet\u2019s resting energy requirement (RER) should be calculated using current body weight in kilograms (BW<sub>kg<\/sub>) and the formula BW<sub>kg<\/sub><sup>0.75<\/sup> \u00d7 70, as this is a more accurate calculation than a linear formula.<sup>13<\/sup> RER can then be multiplied by a factor of 0.8 to 3 (the average range for most pets) depending on the energy needs of the pet. (Note: For more information on body and muscle scoring and resting energy requirement factors, see the article \u201c<a href=\"https:\/\/todaysveterinarynurse.com\/nutrition\/veterinary-energy-calculations-and-proper-caloric-intake\/\" target=\"_blank\" rel=\"noopener\">Energy Calculations: Gauging the Proper Caloric Intake for Patients<\/a>.\u201d<\/span><span class=\"s1\">)<\/span><\/p>\n<h3 class=\"p4\">2. Choose the Diet<\/h3>\n<p class=\"p5\"><span class=\"s1\">Diet recommendations to support the GI microbiome should be based on 3 main principles:<\/span><\/p>\n<ol>\n<li class=\"p6\"><span class=\"s1\">Ensure the diet is complete and balanced and is appropriate for the current life stage of the pet.<\/span><\/li>\n<li class=\"p6\"><span class=\"s1\">Improve macronutrient digestibility. Individual macronutrient (protein, fat, carbohydrate) digestibility percentages may be found in pet food product guides or by contacting the pet food company directly. Protein, fat, and simple or digestible carbohydrates ideally have higher digestibility (80% to 90% is very digestible). Fiber is less digestible by the host but important to the GI microbiome. Diets with a high level of fiber will have an overall lower digestibility percentage even though the protein and fat sources in the diet may be highly digestible.<\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">Alter the percentage of macronutrients. Is the pet on a diet that contains a higher percentage of a single macronutrient? For example, diets high in fat are correlated with a less diverse microbiome, and obesity is known to be a state of low-grade inflammation that corresponds to GI dysbiosis.<sup>14<\/sup> Increasing dietary protein or fiber content and reducing fat content provides more preferred nutrients to appropriate commensal microbiota, allowing them to flourish and correct some diversity imbalances. Adding more fiber may also increase satiety and aid in correcting metabolic derangements, as SCFAs are believed to inhibit the accumulation of fat in adipose tissue.<sup>1<\/sup><\/span><\/li>\n<\/ol>\n<h3 class=\"p4\">3. Create a Feeding Plan<\/h3>\n<p class=\"p2\"><span class=\"s1\">Diet changes should be made gradually. While the generally acknowledged method of switching diets by decreasing the percentage of the existing diet while increasing the percentage of the new diet over several days can be used, a simpler transition plan in which the old diet is stopped and the new diet is started immediately at a lower feeding volume has been successfully used by the author and multiple nutrition clinicians.<sup>8<\/sup> This type of plan is usually recommended for any pet that has not met its minimum energy requirements for 3 days or more and may be at risk for refeeding syndrome. However, it is a viable way to provide a pet\u2019s digestive tract sufficient time to adjust to a change in nutrient profile and to allow the appropriate microbes to flourish and properly ferment the indigestible portion of the diet. <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">This \u201cimmediate\u201d plan starts feeding the new diet only on day 1 at 50% of RER, divided into 4 meals. Each day, the total volume of food is increased by 25% of the energy requirement until the pet\u2019s total energy requirement is met by the new diet. Then, the number of meals per day can be reduced until the pet is fed its daily RER or maintenance energy requirement (MER) in 2 or 3 meals per day (<span class=\"s2\"><b>FIGURE<\/b><\/span><\/span><span class=\"s2\"><b>\u00a02<\/b><\/span><span class=\"s1\">). This plan, which tends to be easier for pet owners to follow, can take anywhere from 4 to 10 days to complete, allowing the GI tract to provide sufficient enzymes for digestion while enabling a smooth microbial shift.<sup>8<\/sup> <\/span><\/p>\n<p><a href=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2022\/11\/Saar_TVNWinter23_Microbiome_Fig2.png\"><img decoding=\"async\" class=\"aligncenter size-full wp-image-11485\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2022\/11\/Saar_TVNWinter23_Microbiome_Fig2.png\" alt=\"\" width=\"936\" height=\"1060\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2022\/11\/Saar_TVNWinter23_Microbiome_Fig2.png 936w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2022\/11\/Saar_TVNWinter23_Microbiome_Fig2-265x300.png 265w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2022\/11\/Saar_TVNWinter23_Microbiome_Fig2-904x1024.png 904w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2022\/11\/Saar_TVNWinter23_Microbiome_Fig2-768x870.png 768w\" sizes=\"(max-width: 936px) 100vw, 936px\" \/><\/a><\/p>\n<h3 class=\"p4\">4. Consider Testing and Supplements<\/h3>\n<p class=\"p2\"><span class=\"s1\">Fecal microbial testing can provide owners with a visual reference for what is happening in their pet\u2019s GI tract compared with a \u201cnormal\u201d range or dysbiosis index. With the GI microbiome\u2019s ability to influence other systems, this test may be a good indicator of imbalance in more than just the GI tract.<sup>3<\/sup> It can also be used in pets with no signs of disease to provide a baseline.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Supplements such as fecal microbiota transplant capsules (as a form of species-specific probiotics<sup>4<\/sup>), <a href=\"https:\/\/todaysveterinarypractice.com\/nutrition\/probiotics-prebiotics-synbiotics-dogs-cats\/\" target=\"_blank\" rel=\"noopener\">prebiotics<\/a>, postbiotics, and bacteriophages are some of the currently available tools to help support the GI microbiome.<sup>1<\/sup> However, all supplements are not created equally. Probiotics for humans may provide bacteria that do not normally reside in a pet\u2019s GI tract or are not as important in their metabolic functions. When recommending products to support the microbiome, it is important to use only those that have been researched and shown to have a species-specific benefit and to ensure that owners understand the importance of this requirement. <\/span><\/p>\n<h3 class=\"p4\">5. Educate Owners<\/h3>\n<p class=\"p2\"><span class=\"s1\">Links to factual sources like the World Small Animal Veterinary Association nutrition tools for pet owners (<\/span><a href=\"http:\/\/wsava.org\/global-guidelines\/global-nutrition-guidelines\" target=\"_blank\" rel=\"noopener\"><span class=\"s2\">wsava.org\/global-guidelines\/global-nutrition-guidelines<\/span><\/a><span class=\"s1\">) and vendor resources are helpful in teaching pet owners about microbiome and nutrition health. Providing owners with reliable information sources allows them to participate more in decisions affecting their pet\u2019s health and improves trust in the veterinary team, strengthening future interactions. <\/span><\/p>\n<h2 class=\"p3\">Summary<\/h2>\n<p class=\"p2\"><span class=\"s1\">The body\u2019s microbiomes are diverse microscopic communities that play a role in the health of their host. Their density and diversity can be altered by various factors, including nutrition, with a less diverse microbiome being correlated with poor health and a richly diverse microbiome reflecting a good health status.<sup>14,15<\/sup> Fecal microbial testing may help identify dysbiosis in pets that are exhibiting clinical signs of disease; it can also be used to obtain a baseline in those that are apparently healthy. Veterinary professionals should be aware of nutrition as a first-line therapy option for pets that may have GI dysbiosis and should complete a nutritional evaluation for every pet. Providing pet owners with sources of factual information from trusted organizations helps them make educated decisions about their pet\u2019s health and builds trust with the veterinary team. <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The body\u2019s microbiomes are diverse microscopic communities that play a role in the health of their host.<\/p>\n","protected":false},"author":236,"featured_media":11486,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":0,"footnotes":""},"categories":[235],"tags":[145],"class_list":["post-11596","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-winter-2023","tag-peer-reviewed","column-nutrition_notes","clinical_topics-nutrition"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 (Yoast SEO v27.4) 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