EP.310/ What are short-chain fatty acids and why do they matter for Endo?
Short chain fatty acids are types of gut friendly fats that are produced when good bacteria in our large intestine eats fibre. So, when healthy bacteria eat let’s say, beans, it will ferment our food, and create gas. Along with that gas, it creates short chain fatty acids.
Short chain fatty acids are one of the key reasons gut health is so important to our overall wellbeing.
Number one is that they are the primary source of food/fuel for the cells in our large intestine. They therefore help to keep our gut barrier intact and strong. When this barrier weakens and holes start to form between our cells, food particles, bacteria and toxins from gram-negative bacteria known as lipopolyscharrides (otherwise known as LPS) can leak through the gut into our blood stream and the surrounding pelvic area.
I’m going to come back to why that’s so important soon, but let’s quickly break down gram-negative bacteria and LPS. We have two types of bacteria in our guts, gram-negative and gram-positive. They differ structurally, with one of the key differences being that the outer later, the cell wall of gram-negative bacteria, are made from lipopolysaccharides. These LPS shed off, especially when bacteria die and are particularly toxic and are very relevant to endo, which you’ll come to learn about soon.
SCFA acids also play a significant role in calming inflammation and regulating our immune system. Essentially, they have an anti-inflammatory effect and stop the immune system from going into overdrive, as a result, healthy levels of SCFA can prevent certain inflammatory diseases.
The problem is, people with endo may be low in short chain fatty acids.
So let’s look at that a bit closer. Research has shown that people with endo have microbiome changes in the gut, including less of the types of bacteria that produce short chain fatty acids, and more of the types of bacteria that release lipopolysaccharides, including some pathogens, which essentially means harmful bacteria.
So, what’s the problem here?
Less SCFA means a weaker intestinal barrier, so we’re less protected from those LPS escaping into our blood stream and our pelvic cavity.
Additionally, as I just said, we tend to have higher levels of LPS producing bacteria, as well as higher levels of LPS in our blood, and our pelvic cavity, than people without endo. This indicates that these gram-negative and pathogenic bacteria, and LPS, are making their way from the gut and into the pelvic area, either through leaky gut and/or through bowel movements, which can sometimes allow for bacteria to spread to the genital tract.
This is a big issue because as I said, LPS are toxic and they trigger a significant inflammatory reaction from the immune system when they escape through the intestinal barrier. Specifically, they activate two inflammatory pathways (let’s just call them reactions) that increase certain types of immune cells called cytokines, which directly help endo to grow.
Remember, I said earlier that SCFA help to calm and regulate the immune system. People with endo tend to have a dysregulated immune system, which is not very good at cleaning up endo, and is in fact, so in overdrive, that it’s excessive inflammatory reactions actually help endo to grow.
The good news is, research shows, in multiple studies, that short chain fatty acids actually inhibit these inflammatory pathways, and a specific short chain fatty acid, called butyrate, is particularly effective at reducing these reactions to LPS. In fact, in animal studies, treatment with butyrate slowed down endometriosis growth.
Another benefit of increasing your short chain fatty acids is that they actually help fight off harmful bacteria whilst increasing healthy and beneficial bacteria. Remember, people with endo have less of the good types of bacteria and higher levels of gram-negative and pathogenic bacteria, which just continues this inflammatory cycle.
The research is so promising, that the microbiome and SCFA are being explored as markers for the disease, and are opening up new treatment avenues.
So, what can we do to increase short chain fatty acids?
The number one change we can make in our every day lives is to eat more plant-based dietary fibre.
Indigestible fibre that makes it to the large intestine, is what your good bacteria will feed off, and will increase the production of short chain fatty acids. This isn’t a one off thing, this is about a long-term change of eating more plant foods that are rich in the types of fibre that good bacteria love.
Just eating more beans, fruit and veg will cover a lot of your bases, but foods like psyllium husk, lentils, cooked and cooled potatoes and rice, uncooked oats, onion, garlic, apples, bananas, chicory root syrup and whole grains can really help.
Now, if you’re freaking out because foods like onion, garlic and apples trigger your endo belly, don’t worry. I’m going to do more episodes on this topic and how to increase SCFA without causing you more bloating with certain foods and tools. I also have a short chain fatty acid boosting smoothie coming out on my Instagram this week, so be sure to check that out.
For now, focus on increasing the plant foods you do tolerate, especially from this list and it’s worth noting - you may be able to tolerate some of these foods in smaller sizes, so experiment and we’ll dive deeper into this topic in upcoming episodes.
Show notes
https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233627/
https://www.nature.com/articles/s41598-018-30114-4#:~:text=Probiotic treatment also significantly enhanced,SCFAs in the gut48.
https://www.healthline.com/nutrition/short-chain-fatty-acids-101#TOC_TITLE_HDR_9
https://monashfodmap.com/blog/dietary-fibre-series-resistant-starch/
https://biosignaling.biomedcentral.com/articles/10.1186/s12964-023-01219-9
https://zoe.com/learn/what-are-short-chain-fatty-acids
https://journals.lww.com/ajg/fulltext/2008/09001/wheat_dextrin,_psyllium,_and_inulin_produce.449.aspx#:~:text=Wheat Dextrin, Psyllium, and Inulin,and Gas Volumes In Vitro
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Produced by Chris Robson