Respiratory, gastrointestinal and neurodevelopmental complications: preterm birth (sidenote: Preterm birth birth before 37 completed weeks of gestation. There are sub-categories of preterm birth, based on gestational age:
- extremely preterm (less than 28 weeks);
- very preterm (between 28 and 32 weeks);
- moderate to late preterm (between 32 and 37 weeks). Source: WHO ) is the main cause of neonatal morbidity and mortality. The vaginal microbiota seems to be involved, but the underlying mechanisms remain poorly understood. This flora can change rapidly during gestation, due to hormonal changes, genital infections, antibiotics, etc. A team of researchers and clinicians from the states of New York and Virginia tracked the genome of the vaginal microbiota of 175 American women throughout their pregnancies (40 of whom subsequently experienced spontaneous preterm delivery, and 135 of whom delivered at full term).

Higher genetic diversity

The study shows that the two types of pregnancy differ in terms of vaginal microbiota composition: certain bacterial species of the Lactobacillus genus, such as L. helveticus, L. crispatus, L. gasseri and L. jensenii, are associated with full-term pregnancies, while Megasphaera genomosp, Gardnerella spp. and Atopobium vaginae are linked to preterm births.
Another finding is that the genetic diversity of the vaginal microbiota is higher in the first half of pregnancies that end preterm, due to Gardnerella species. More precisely, the nucleotide diversity (sidenote: Nucleotide diversity number of nucleotide differences for a given sequence for 2 individuals (here 2 bacteria) randomly selected in the population. ) of Gardnerella spp. increases at the start of pregnancies that end preterm - peaking at around 13 weeks of gestation, then returning to its initial value at around 20 weeks of gestation - whereas it remains stable in pregnancies that are carried to term. The genetic diversity of Gardnerella spp. during the first half of pregnancy therefore appears to affect pregnancy outcomes and could perhaps be used as a biomarker for the early diagnosis of preterm birth.

An adaptive evolution of Gardnerella

But how can we explain this peak in Gardnerella nucleotide diversity? Compared to other bacteria, Gardnerella shows a 1.5-fold higher growth rate at the start of pregnancy, more frequent genetic recombination (sidenote: Genetic recombination exchange of genetic information (DNA or RNA fragments in the case of certain viruses) to create new genetic combinations and thus new genomes, ensuring genetic admixture and the maintenance of a diversity that enables adaptation to any change in the environment. ) and greater selection of mutations that benefit this bacterium (and increased elimination of deleterious mutations).
Antibiotics and other xenobiotics are thought to be involved. In fact, the more diversified gene pool of G. swidsinskii seems to correspond to an adaptation to drugs, confirming a previously suggested effect of xenobiotics in the vaginal environment; and vaginal microbiota associated with preterm birth exhibit higher antibiotic resistance potential (sidenote: increased presence of phage-borne antibiotic resistance genes. ) .

From vaginal microbiota to the host

Genomic variation in vaginal bacteria is therefore believed to affect the host’s phenotypes (including pregnancy outcomes). However, the authors do not rule out another explanation, even if they consider it unlikely: the associations between microbial genetic diversity and pregnancy outcomes could also result from unmeasured confounding factors (drugs, chemical compounds, etc.) that might act on both variables.

According to the International Microbiota Observatory, more than 9 out of 10 (95%) people who repeatedly benefited from information from their healthcare professional had adopted specific behaviors to maintain a balanced microbiota. What about antibiotics? Well, according to the same study, only 1 in 3 patients said their healthcare professional had informed them that taking antibiotics could upset their microbiota balance. Because information provided by healthcare professionals is a game-changing vector of behavior, during the WAAW 2024 (18-24th November), the Biocodex Microbiota Institute sheds the light on the key role played by physician regarding information about the impact of antibiotics on microbiota and health.

Train the physicians: pass it on to their patients.

Engaging healthcare professionals (antibiotics prescribers) with tailor-made content.  During the WAAW campaign, Biocodex Microbiota Institute federates its physicians ‘community with two “hub” pages gathering all physicians’ tools (thematic folder, accredited training on dysbiosis and the impact of antibiotics, infographics to share with their patients, news, experts ‘interviews…).
 

Raising awareness of the impact of antibiotics on microbiota remains important. This two “hub” pages aim to provide physicians quick and ready-to-use material to improve their patients understanding of the importance of using antibiotics prudently.

Educate the lay public:  you can take action!

Hailed as one of the greatest medical advances of the 20th century, antibiotics have saved millions of lives. Today, they pose serious public health challenges: their excessive and inappropriate use leads to the emergence of numerous resistances, which, in the long term, could eventually make them ineffective. Moreover, they also can damage the microbiota by inducing a dysbiosis. For the lay public, the Institute investigates this ambivalence role with one “hub” page gathering all content on the impact of antibiotics on microbiota. 
 

From subsidiaries to the Biocodex Microbiota Institute passing through Beauvais manufacturing site, all Biocodex’s collaborators get involved!

For the WAAW campaign 2023, Biocodex Microbiota Institute website homepage, X, Facebook and LinkedIn accounts have turned blue. The Institute’s social networks are not the only ones… the Biocodex 9-hectare manufacturing and logistics center in Beauvais, near Paris, joined the color campaign by wearing blue during WAAW event. More than 30 spotlights have been placed to offer visitors and Biocodex collaborators a blue scenography. From November 18 to 24, the Institute invites Biocodex’s collaborators all over the world to join the campaign on social media thanks to a blue stamp they can put on LinkedIn.

#GoBlueForAMR.
 

BMI 23.49

According to the International Microbiota Observatory, more than 9 out of 10 (95%) people who repeatedly benefited from information from their healthcare professional had adopted specific behaviors to maintain a balanced microbiota. What about antibiotics? Well, according to the same study, only 1 in 3 patients said their healthcare professional had informed them that taking antibiotics could upset their microbiota balance. Because information provided by healthcare professionals is a game-changing vector of behavior, during the WAAW 2024 (18-24th November), the Biocodex Microbiota Institute sheds the light on the key role played by physician regarding information about the impact of antibiotics on microbiota and health.

Train the physicians: pass it on to their patients.

Engaging healthcare professionals (antibiotics prescribers) with tailor-made content.  During the WAAW campaign, Biocodex Microbiota Institute federates its physicians ‘community with two “hub” pages gathering all physicians’ tools (thematic folder, accredited training on dysbiosis and the impact of antibiotics, infographics to share with their patients, news, experts ‘interviews…).
 

Raising awareness of the impact of antibiotics on microbiota remains important. This two “hub” pages aim to provide physicians quick and ready-to-use material to improve their patients understanding of the importance of using antibiotics prudently.

Educate the lay public:  you can take action!

Hailed as one of the greatest medical advances of the 20th century, antibiotics have saved millions of lives. Today, they pose serious public health challenges: their excessive and inappropriate use leads to the emergence of numerous resistances, which, in the long term, could eventually make them ineffective. Moreover, they also can damage the microbiota by inducing a dysbiosis. For the lay public, the Institute investigates this ambivalence role with one “hub” page gathering all content on the impact of antibiotics on microbiota. 
 

From subsidiaries to the Biocodex Microbiota Institute passing through Beauvais manufacturing site, all Biocodex’s collaborators get involved!

For the WAAW campaign 2023, Biocodex Microbiota Institute website homepage, X, Facebook and LinkedIn accounts have turned blue. The Institute’s social networks are not the only ones… the Biocodex 9-hectare manufacturing and logistics center in Beauvais, near Paris, joined the color campaign by wearing blue during WAAW event. More than 30 spotlights have been placed to offer visitors and Biocodex collaborators a blue scenography. From November 18 to 24, the Institute invites Biocodex’s collaborators all over the world to join the campaign on social media thanks to a blue stamp they can put on LinkedIn.

#GoBlueForAMR.
 

Cesarean section (C-section) is a common mode of delivery worldwide. The global C-section rate remains at 21%, varying widely from 0.6% to 58.1% across regions. However, C-section delivery has been associated with an increased risk of adverse health outcomes, including autoimmune and metabolic disorders, altered gut microbiota and even neurodevelopmental disorders in infants ¹. Emerging research points to Vaginal Microbiota Transfer (VMT) as a prospective intervention to ameliorate the gut microbiota maturation and neurodevelopment in C-section babies. However, we are still debating on its safety and effectiveness.

How does VMT work? 

Two hours before the C-section, a wet gauze with sterile saline is placed in the lower vagina of women having a C-section. This gauze remains in situ for roughly an hour, and it’s removed 30 minutes before the administration of prophylactic antibiotics in preparation for the C-section delivery.

Immediately following birth, a trained nurse puts the vaginal gauze in contact with the newborn. The gauze is passed on their lips, face, chest, arms, legs, genitals, and bottom. Then, the nurse wipes their back. It takes about 15 seconds. The babies don't get a bath for 12 hours ².

What about VMT’s safety and effectiveness? 

A new research published in Cell Host & Microbes conducted a triple-blind randomized controlled trial to assess the safety and efficacy of VMT in improving neurodevelopment, gut microbiota, and metabolome of C-section babies ². The study enrolled 76 pregnant women that were scheduled for C-sections.

The newborns were randomly assigned to the VMT (n = 35) or control (n = 41) group. The neurodevelopment of the newborns was assessed with the Ages and Stages Questionnaire (ASQ-3) at 6 months of age, their gut microbiota and metabolomes were also analyzed. An additional 33 pregnant women planned for vaginal delivery were also included for comparison. 

In contrast to FMT (fecal microbiota transplantation), which is not advisable for DIY attempts and carries substantial risks, VMT stands out as a less perilous medical procedure that can be readily taught to delivery nurses and midwives. Healthcare professionals should consider VMT as a potential intervention to improve the gut microbiome and neurodevelopment of cesarean-born infants.

Do you feel more beautiful, healthier, and attractive when tanned? Unfortunately, your skin microbiota does not agree... And neither does your health!

So concludes a study ¹ on a group of 4 men and 17 women from Northern Europe who spent at least a week on vacation basking in the sun.

The day before their departure, the researchers took a skin sample from the most tanned part of the participants’ forearms in order to analyze the composition of their skin microbiota. They repeated this the day after the participants’ return (D1), 28 days later (D28), and then after 84 days (D84). 

To determine their phototype and changes in their tans, the scientists also measured the color of the skin on their “posteriors” (low exposure to sun) and forearms, both before and after sun exposure.

To each their own sun exposure...

The results?

Firstly, it was possible to classify the volunteers into three groups:

• The “tanning enthusiasts”, who spent a lot of time in the sun during their vacations;
• The “already tanned”, who had tanned skin before departure and kept it that way;
• The “wary”, who were minimally tanned before leaving and managed to protect themselves from the sun.

The researchers went on to report that in all the volunteers, three major bacterial phyla – Actinobacteria, Proteobacteria, and Firmicutes – accounted for 95% of all microorganisms.

However, on D1, just after returning from vacation, the “tanning enthusiasts” and the “already tanned” showed a skin microbiota depleted in Proteobacteria. 

While this reduction in diversity disappeared over time, and was non-existent by D28, the finding is important.

Potentially harmful changes in skin microbiota

Changes in the Proteobacteria content of the skin microbiota have already been observed in people suffering from psoriasis, eczema, and ​​diabetic foot ulcers.

Studies have also shown that a higher skin density of Proteobacteria is associated with better protection against allergy-related skin inflammation. 

These data therefore suggest that a Proteobacteria imbalance in the skin of those who tend to expose themselves to a lot of sun may lead to a deterioration in health.

Admittedly, this study has a number of limitations (small number of volunteers, women overrepresented, only indirect measurement of sun exposure, etc.) and its findings need to be confirmed by larger-scale studies. 

However, it does open up the possibility of one day using products based on certain beneficial bacteria (probiotics) to limit the deterioration of the skin microbiota during sun exposure.

Over the past decade, the therapeutic arsenal available to treat advanced melanoma has grown. Despite this, half of patients receive no benefit from anti-PD-1 immunotherapy. Combination therapy using anti-PD-1 (sidenote: Anti-PD-1 immunotherapy based on immune checkpoint inhibitors that target the PD-1 checkpoint, reversing the deactivation by the tumor of the recognition system associated with the PD-1 protein present on the surface of T lymphocytes. The immune system’s effectiveness against tumor cells is thus restored. ) and anti-CTLA-4 (sidenote: Anti-CTLA-4 immune checkpoint inhibitor that targets the CTLA-4 checkpoint ) improves response rates, but is associated with immune-related adverse events (irAEs). The gut microbiota regulates the immune system. So what about combining anti-PD-1 with fecal microbiota transplantation (FMT)? This option was explored in a multicenter phase I trial involving 20 patients (sidenote: aged 48 to 90 (average age of 75.5 years), including 12 men (60%) ) with unresectable or metastatic melanoma who had not previously received anti-PD-1 treatment. They received oral FMT (capsules) from a healthy donor (sidenote: three healthy male donors (average age of 35 years) provided the feces used for 4, 7, and 9 patients, respectively ) , followed seven days later by a first cycle of anti-PD-1 (sidenote: nivolumab or pembrolizumab ) .

Comparable safety

The trial’s primary endpoint was safety. FMT induced at most grade 1 or 2 adverse events (diarrhea, flatulence, etc.) in 8 patients (40%). Following anti-PD-1, 17 patients (85%) showed side effects, including 5 patients (25%) with grade 3 irAEs (2 arthritis, 1 fatigue, 1 pneumonia, 1 nephritis) which required temporary discontinuation of treatment. Compared with anti-PD-1 alone (79.5%-93.2% irAEs in phase III clinical trials, including 13.3%-34.0% grade 3-5 irAEs), combined treatment with FMT and anti-PD-1 did not increase the incidence of these events.

Potentially improved response

In terms of efficacy, the objective response rate of 65% (13 patients) was satisfactory and higher than that of anti-PD-1 alone (54%-63% in randomized phase III trials), although the small sample size and absence of a control group (anti-PD-1 only) limit interpretation of the results. The respective donor had no apparent effect on the outcome.

Long-term changes in gut microbiota

Regular sampling of the patients’ stools (sidenote: at baseline, immediately before anti-PD-1, then 1 month and 3 months after anti-PD-1 ) shows that the diversity of recipients’ gut microbiota only increases after FMT. In terms of composition, one week after FMT, the microbiota of all recipients more closely resembled those of their respective donors. However, this similarity subsequently regressed in future non-responders but increased in responders. 

One month after FMT, the flora of responders was enriched in immunogenic bacteria (sidenote: Ruminococcus, Eubacterium ramuleus, and Faecalibacterium ) and depleted in deleterious bacteria (sidenote: Clostridium methylpentosum, Enterocloster aldensis, Erysipelatoclostridium ramosum, and Enterocloster clostridioformis ) .

An effect on T lymphocytes?

The study also showed changes in patients’ plasma metabolites, with an increase in primary and secondary bile acids. After FMT, certain T lymphocytes (ICOS+CD8+) increased in the peripheral blood of responders only.

Lastly, mouse models treated with antibiotics prior to FMT confirm the role of FMT in increasing anti-PD-1 efficacy.

Asthma, allergic rhinitis, food allergies, and atopic dermatitis are often studied on their own, despite having many similar mechanisms (inflammatory responses, immunoglobulin E). Could something else they have in common be the gut microbiota, which matures in parallel with the infant immune system? To find out, data from 1,115 children included in the vast CHILD (sidenote: https://childstudy.ca/ ) longitudinal study were used: 592 children diagnosed with one or more allergic disorders after the age of 5, and 523 children with no signs of allergic sensitization. Regression analysis revealed several risk factors, such as male gender, paternal or maternal history, and antibiotic use before the age of one. Breastfeeding up to six months of age and Caucasian ethnicity appear to be protective.

Less mature gut microbiota

An analysis of stool samples collected at three months and one year of age revealed a delay in microbiota diversification in the children who subsequently developed allergies. Whereas control children had age-appropriate gut flora at age one, future allergic children showed a delay in the maturation of their microbiota. Less maturation of the microbiota at age one seems to be associated with an increased risk of allergic disorders at age five, regardless of the allergy.

Gut microbiota dysbiosis

A gut dysbiosis at age one also characterizes future allergic children: depleted levels of four bacterial species that produce short-chain fatty acids (butyrate-producing Anaerostipes hadrus, Fusicatenibacter saccharivorans and Eubacterium hallii, and acetate-producing Blautia wexlerae) and an increased abundance of five bacteria generally considered pathogenic (Eggerthella lenta, Escherichia coli, Enterococcus faecalis, Clostridium innocuum, and Tyzzerella nexilis). Enrichment in C. innocuum and T. nexilis is correlated with antibiotic use; the abundance of C. innocuum, E. lenta, E. faecalis, and T. nexilis depends on whether or not the baby is breast-fed at six months; while the abundance of C. innocuum and E. lenta is correlated with paternal atopy, and so on.

Metabolites to predict or prevent?

In parallel, the researchers identified 11 metabolic pathways significantly altered in at least two of the allergy diagnoses: nine deleterious pathways correlated mainly with E. coli, while two protective pathways were linked to the bacteria B. wexlerae, F. saccharivorans, A. hadrus, and E. hallii.
A metabolite analysis led to associations with age predicted by the gut microbiota: elevated trace amines (phenylethylamine, tryptamine, and tyramine) promoted inflammation and reduced butyrate production. Thus, the association between altered microbiota maturation and allergies at age five appears to be mediated by these metabolites, which may represent first-choice targets for predicting and/or preventing the development of pediatric allergies.

On their fifth birthday, some of the thousands of Canadian children participating in the vast CHILD (sidenote: https://childstudy.ca/ ) study, which has followed these children since birth, were diagnosed with allergies such as:

• atopic dermatitis
• asthma
• allergic rhinitis
• and/or food allergies.

Since their medical records and stool samples collected at three months and one year were carefully preserved as part of the study, the researchers were able to investigate whether there were any warning signs. As it turns out, there appears to be one warning sign universal to all four allergies: the gut microbiota.

Delayed diversity and dysbiosis

Asthma, eczema, food allergies, and hay fever – whatever the allergy –, all future allergy sufferers had a gut microbiota that was insufficiently diversified at age one, as if they were much younger than their birth certs suggested. In addition to this lack of maturity, the microbiota of the future allergy sufferers presented a dysbiosis: four beneficial bacterial species were depleted, while five species generally considered pathogenic were present in excess.

Suspected mechanisms

This early imbalance may explain the lower production of beneficial short-chain fatty acids (SCFAs) (sidenote: Short chain fatty acids (SCFA) Short chain fatty acids (SCFA) are a source of energy (fuel) for an individual’s cells. They interact with the immune system and are involved in communication between the intestine and the brain. Silva YP, Bernardi A, Frozza RL. The Role of Short-Chain Fatty Acids From Gut Microbiota in Gut-Brain Communication. Front Endocrinol (Lausanne). 2020;11:25. ) and the overproduction of inflammatory molecules. In turn, this leads to the subsequent development of allergies... but also gives hope of one day reversing these allergies by correcting gut dysbiosis. 

Not everyone is equal when it comes to allergies

In the meantime, bear in mind another result of the study: when it comes to allergies, our children are not all equal. Boys are more affected, as are children whose fathers and/or mothers suffer from allergies, and those who were prescribed antibiotics before age one. Conversely, breastfeeding up to six months protects against allergies, as does Caucasian ethnicity. While screening the origin or health record of any future spouse may be out of the question, breastfeeding should be encouraged and antibiotics used with the utmost care and only on prescription.

Biocodex Microbiota Institute: who are we ?

200+ professionals

More than 230 researchers and healthcare professionals across diverse disciplines have been collaborating with the Biocodex Microbiota Institute since its creation in 2017. All together, we join forces and skills to advance microbiota research (gut microbiota but also vaginal, skin, lung…) and raise awareness about its crucial role.

At Biocodex headquarters, the Institute is a team of 7 professionals in science, communications, digital, social networks, etc. with complementary profiles, all experts in their fields. Discover them!

Biographies of the Biocodex Microbiota Institute's team

Former journalist, with 15 years of experience in health communication, Olivier coordinates all of the Institute's activities and oversees the microbiota team. He is specifically responsible for press and public relations of the Biocodex Microbiota Institute.

Fan of rugby and French literature (yes the two are compatible!), this natural-born storyteller turns complex scientific concepts into simple words.

His mission? Making microbiota science accessible to everyone and turn the Institute as a « media reflex » when it comes to microbiota.

The solution provider, always optimistic & no short of ideas, her motto: “there are no failures, only lessons to be learned”.

She has worked in a variety of professional field, jumping from finance to real estate and find her way in the healthcare area. She is the Social Media Manager, working on the Social Media strategy to create a strong microbiota community.

For her, Microbiota is an essential player for a better health.

She is the guardian of the Institute's digital ecosystem. With 7 years of experience in Digital Marketing, she ensures that the site is well referenced, always evolving, and pampers our online communities. She oversees the creation and monitoring of KPIs, so that the whole team can steer the Institute in the best possible direction. Her motto: “Look at the sun, the shadow will be behind you”. She is organized, optimistic and often has a powerful/crazy idea up her sleeve.

For her, Microbiota is THE future of healthcare.

With a deep-rooted passion for science and over 17 years of experience, Emilie holds a PhD in microbiology. Her journey has transitioned from academic research to industrial research within the pharmaceutical industry. Outside of her scientific endeavors, Emilie is an avid yoga practitioner and has a fervent passion for science fiction and fantasy literature.

As the team's microbiome science explorer, she ensures the scientific veracity of the Biocodex Microbiota Institute's content. Known for her curiosity and ability to demystify complex scientific concepts, her motto, "Unlocking the microbial mysteries for global well-being," reflects her dedication to enhancing health through the power of the microbiota.

The Scientific Guardian of the Institute. Her motto "Science must be accessible to everyone". With 10 years of experience in academic research within healthcare and scientific valorization in the industry, Elodie has developed a strong consumer-oriented approach.  Passionate and curious, she transforms research related to the microbiota into engaging and informative content for the general public.

For her, Microbiota is a global health solution and a game changer regarding personalized treatments.

News here and there, every week brings new updates just for you, and in all languages – made possible in part thanks to Clémence. Her calmness inspires confidence and prevents stress during rush times.

Her motto: 'Choose a job you love, and you won't have to work a single day in your life!' This is what she has chosen by balancing these two professions at the Microbiota Institute and in her practice as a Naturopath.

For her, Microbiota is the key to all the answers that science is waiting for. It still requires patience for it to reveal its secrets. In the meantime, taking care of it is essential!

After an initial career in the sciences, Amina, now a work-study student in commerce, management and marketing, has returned to her first vocation: digital marketing.

At the Institute, she has found the perfect balance between her scientific interests and her digital communication skills. In particular, she is responsible for implementing content on the Institute's website, managing site updates, and managing the monthly newsletter for healthcare professionals and the general public. And when she has a little time left over, she contributes to the creation of videos for the Institute.

Joining the Biocodex Microbiota Institute gives her the opportunity to contribute to the promotion of this essential health organ.  

BMI 24.04

Diabetes mellitus (sidenote: Diabetes mellitus Chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Over time, diabetes can damage blood vessels in the heart, eyes, kidneys and nerves. ) is all about sugar, and more specifically, blood sugar levels (glycemia (sidenote: Glycemia Blood sugar level. ) ). The aim is to avoid peaks (i.e., hyperglycemia) following meals. In healthy individuals, insulin (sidenote: Insulin Hormone produced by the pancreas tasked with lowering blood sugar levels to around 1 g/L.  ) regulates blood sugar levels at around 1 g/L. In diabetic patients, the body fails in this regard, either because the pancreas does not produce enough insulin (type I diabetes mellitus), or because the body resists insulin’s commands (type II diabetes mellitus). The gut microbiota appears to be involved in the insulin resistance observed in type II diabetes, but the mechanisms involved remain unclear. Or rather “remained” unclear, since a study published in the prestigious journal Nature has shed some light on the subject.

Micro-sugars promote insulin resistance

The researchers concluded that the richer our stools are in certain molecules, the greater our resistance to insulin. The feces of insulin-resistant volunteers contained far more carbohydrates (sidenote: Carbohydrates A family of macronutrients that includes sugars (i.e., simple carbohydrates), which often have a sweet taste and include glucose, fructose, galactose, maltose, lactose, and sucrose; and starches (i.e., complex carbohydrates). ) , particularly tiny sugars (sidenote: Sugars Fructose, galactose, mannose and xylose. ) produced by bacteria. These micro-sugars are far from harmless. They promote fat accumulation, stimulate our immune system to the point of causing inflammation (admittedly mild, but prolonged and harmful), and ultimately lead to insulin resistance.

The bacteria involved

Two types of bacteria seem to be involved:

• bacteria of the Lachnospiraceae family, which are associated with a higher production of these tiny sugars and insulin resistance; and
• Bacteroidales (Bacteroides, Alistipes, and Flavonifractor), which reduce levels of these sugars and insulin resistance.

A direct effect of the “friendly” Bacteroidales has even been measured in test tubes, where they devour the micro-sugars. The most gluttonous? The bacterial species Alistipes indistinctus consumes the widest variety of micro-sugars. It also works in obese mice, where a pinch of A. indistinctus lowers the amount of micro-sugars in mice’s stools, lowers blood sugar levels, and makes the mice more sensitive to insulin.