Why Vita Biosa?

Why Vita Biosa?

By Cliff Harvey PhD, DipFit, DipNat

Why is Gut Health Important?

The gut is the gateway to the body that allows us to take in nutrients from food while keeping out pathogens and harmful chemicals that can cause disease and ill-health and the impact of gut health on immunity, inflammation, and neural and overall health is now becoming very well known. Disturbances to the balance of ‘good’ and ‘bad’ microbes in the gut (dysbiosis) can affect both nourishment and growth and conditions ranging from metabolic states like obesity and type 2 diabetes,1 functional gut disorders,2 inflammatory conditions,3-7 cardiovascular disease, and mental health challenges.8-17 The gut microbiome also has a specific, bidirectional relationship with hunger, satiety, inflammation and immunity, all of which interplay with the spectrum of health conditions including the metabolic disorders of obesity, metabolic syndrome, and diabetes.1, 3, 18, 19 The gut microbiome also has an interplay with sleep and stress, cofactors for the development of diabetes, obesity, mental health challenges, and other health conditions (More information on gut health can be found at cliffharvey.com/?s=gut+health)

What are ‘Synbiotics’?

Synbiotics are foods or supplements that combine probiotics and prebiotics (and sometimes post-biotics). The term derives from the synergy of these components, i.e., synergistic biotics. In common usage, the term synbiotic refers to products that include isolated probiotics in combination with prebiotics and to ‘live’ foods and beverages (such as Vita Biosa) that contain pre-, pro-, and postbiotics in an ‘ecosystem’ in which there is fuel substrate (prebiotics) for live organisms (probiotics) which in turn produce organic acids and short-chain fatty acids that are beneficial to the health of the microbiome and the host animal (post-biotics).

What is the microbiome?

Before looking into what the various biotics are, it’s important to understand common terms like microbiome and microbiota.

The microbiome is the community of microbes found in the body. Technically, the microbiome refers to collective genomes of these microbes with microbiota used to describe the communities of microbes, but these terms are often used interchangeably. In common usage, microbiome refers to the community of bacteria in the gut, but it also includes other microbes like fungi, protozoa, and viruses and there is also distinct microbiota of the skin, oral cavity, and other surfaces.

What are prebiotics?

Prebiotics feed (beneficial) microbes in the gut. Usually, these are various sugars, fibres and resistant starches that feed particular varieties of bacteria (or in some cases beneficial yeasts).

What are probiotics?

Probiotics are microbes (usually bacteria but also some yeasts) that can be taken in supplemental form and are purported to improve the balance of the microbiome.

What are postbiotics?

Postbiotics are chemicals produced by bacteria (like probiotic bacteria) that have additional benefits to the microbiota and systemic health. They are also known as organic acids and include short-chain fatty acids which feed cells of the digestive wall, other bacteria, and can be absorbed by the body for use as fuel (i.e., acetic acid, butyric acid, and lactic acid). These and other chemicals produced by bacteria in the gut also act as messengers that provide a ‘metabolic interaction’ between the host (you) and the microbiota and digestive environment.20

Short-chain fatty acids

Short-chain fatty acids have carbon chains between two and five in length. These fatty acids include acetic acid (C:2), propionic acid (C:3), butyric acid (C:4), and valeric acid (C:5). Short-chain fatty acids, especially butyric acid, are used extensively as fuel by intestinal epithelial cells.21 Fatty-acid chain length also affects the absorption of fats. Shorter chain fats do not require ‘bundling’ with micelles and chylomicrons for absorption and transport and so escape the usual route of absorption into the lymph, and later deposition into the bloodstream (via the subclavian vein) and instead, are far more likely to be absorbed into the hepatic portal vein and transported to the liver where they can be easily converted to ketone bodies,22-27 also a source of fuel for most tissue in the body.

Acetic acid

Acetic acid is a two-carbon short-chain fatty acid. It comprises 4-20% of vinegar, which has been demonstrated to improve postprandial insulin sensitivity in healthy and diabetic people and improve glycaemic responses to meals.28-30

Butyric acid

Butyric acid (butyrate) is a four-carbon, short-chain fatty acid found in the milk of ruminants and is present in small amounts in many dairy foods (the term butyrate comes from the same root as ‘butter’). Butyrate in humans is primarily produced by microbial intestinal fermentation of dietary fibre and resistant starches. Much of this is absorbed and used directly by colonocytes, with most of the remainder absorbed into the hepatic portal vein, and transported to the liver and converted into ketone bodies.26, 27 A small amount is absorbed directly from the large colon and enters systemic circulation, to be used directly by peripheral tissue.26 Butyrate inhibits inflammation and intestinal cancers, decreases oxidative stress, and promotes satiety.31, 32 Thus, it serves an important role in preserving the health of the colon, microbiota, and general and systemic health.

Vita Biosa contains organic acids, including lactic acid, acetic acid, and lesser amounts of butyric acid.

[Image reference33]

General Health Effects of Synbiotics

Synbiotics significantly increase gut levels of beneficial Bifidobacteria.34 Their use decreases inflammatory markers, especially tumour necrosis factor-α (TNF-α) and creactive protein (CRP) (in both healthy and disease states),35, 36 malondialdehyde (MDA),37, 38 and also reduces liver enzymes in non-alcoholic fatty-liver disease (NAFLD),39 The greatest improvements in inflammatory markers are seen in inflammatory bowel diseases (IBDs), arthritis, and NAFLD.35 Synbiotic supplementation may also increase total antioxidant capacity,37, 38 the antioxidants superoxide dismutase and nitric oxide,38 and have been clearly demonstrated to increase the key endogenous antioxidant glutathione.37, 38, 40 Supplementation also significantly reduces levels of gut-derived endotoxins41 which are implicated in cardiovascular and other diseases. Synbiotic supplementation may also reduce body mass42 cholesterol, triglycerides, LDLcholesterol, and increase HDL-cholesterol compared to placebo.43 These effects are most pronounced when synbiotics are supplemented for more than 8 weeks.43 A moderate reduction in fasting blood glucose (of around 0.2 mmol/L) has been observed in trials, however, this effect is greater with supplements containing multiple bacterial strains (~0.3 mmol/L reduction), and in people with blood glucose levels higher than 7 mmol/L, for which there is a significant and clinically meaningful reduction of around 0.7 mmol/L.44 Synbiotics might also have a role in modulating inappropriate gut permeability (commonly called ‘leaky gut’). The gut wall is permeable by nature to allow for greater or lesser ingress of nutrients into the system. The amount of permeability shifts constantly and is influenced by many factors. Increased intestinal permeability which may be inappropriate for optimal immune, allergy, and inflammatory modulation is influenced by diet and lifestyle factors, especially the gliadin protein (a component of gluten) and by small intestinal bacterial overgrowth and dysbiosis.45 Therefore, our diet and lifestyle, including factors like a typical Western-style diet high in gluten-containing ultra-refined foods, sugar, and other factors like stress and lack of movement (which affect gut motility) are likely to play a role in ‘leaky gut’ and resultant immunological and inflammatory challenges. A primary modulator of intestinal permeability is the protein zonulin. Synbiotic supplementation reduces zonulin levels,46 and so, might play a role in reducing excessive intestinal permeability and might even help to reduce muscle wasting by reducing intestinal permeability. A 2021 review by Krimpen and colleagues found that Lactobacillus and Bifidobacterium reduce muscle wasting in mice and that there is an association between gut permeability and muscle mass. Thus, they proposed that some interaction of lactate, butyrate, and reduced inflammation from probiotic or synbiotic supplementation might help to prevent muscle wasting.47

Condition-Specific

Effects of Synbiotic Supplementation Synbiotic supplementation is a relatively new concept (when compared to supplementing with pre- and probiotics) that has a large body of emerging research on its potential uses for health.

Synbiotics in critical illness and surgery

Synbiotics and probiotics increase levels of the beneficial short-chain fatty acids acetic acid, butyric acid, and propionic acid, and reduce c-reactive protein and interleukin-6. They have been shown to reduce surgery-related complications including abdominal distention, diarrhoea, pneumonia, sepsis, surgery site and urinary tract infection, and reduce the duration of antibiotic therapy, postoperative pyrexia, time of fluid introduction, time-to-solid diet, and duration of hospital stay.48-55 It has been concluded that perioperative synbiotics “clearly reduce infection after liver surgery”.56 A 2016 review which compared the effects of synbiotics and probiotics found that there was a greater improvement in infection rates in studies of probiotics compared to those conducted on synbiotics, however, the authors noted there was limited clinical data available at the time for synbtioics.57

Metabolic disorders 

Prediabetes & non-alcoholic fatty liver disease Reviews of randomised controlled trials have shown that synbiotic supplementation can improve body mass, blood glucose, insulin, LDL and total cholesterol, triglycerides, inflammatory markers c-reactive protein and tumour necrosis factor-alpha (TNF-α), and liver enzymes alanine transaminase and aspartate transaminase58 and GGT59 levels among patients with non-alcoholic fatty liver disease (NAFLD). 58, 60, 61

Diabetes

Synbiotics supplementation significantly improves fasting blood glucose, insulin, HOMAIR, insulin sensitivity (QUICKI) and triglycerides, V-LDL, LDL, HDL and total cholesterol.62- 64 Synbiotic supplementation also reduces the inflammatory markers TNF-α, malondialdehyde, and c-reactive protein in people with diabetes65, 66 while also increasing total antioxidant capacity and glutathione.66

Obesity

Synbiotic supplementation is known to reduce fasting insulin and triglyceride levels, an effect also observed in people with obesity.67A meta-analysis of 23 randomized trials indicated that supplementation with synbiotics can decrease body weight and waist circumference.68 A 2019 review also found that while no significant effects from probiotic or synbiotic supplementation were observed for metabolic and anthropometric markers in children and teens, sub-group analysis revealed a significant reduction in body mass index (BMI) z-score in the synbiotic supplemented groups.69 Similarly, another review and meta-analysis from the same year found no difference in body weight or BMI but a significant reduction in waist circumference.70 The most recent review in this area included here (from 2020) found significant reductions in BMI, total body fat, waist circumference, and waist height ratio71 (an important indicator of metabolic health and disease risk).

Blood pressure

Synbiotics have been shown to reduce systolic blood pressure by around 3 mmHg and blood pressure reducing effects were greater with longer-term supplementation (i.e., > 12 weeks) and in younger people.72

Respiratory infections

Overall, synbiotic interventions reduce the incidence rate of respiratory infections by ~16%. Subgroup analysis also suggested more prominent effects of synbiotics among adults than infants and children.73

Asthma

In a review of 11 randomised trials including over 1600 children, while no association was found between probiotic use and asthma risk, a significant reduction in asthma risk was observed in those taking pre- or synbiotics.74

Pneumonia

Network meta-analysis has shown that synbiotics, especially Bifidobacterium longum + Lactobacillus bulgaricus + Streptococcus thermophiles, B. longum + L. bulgaricus + S. thermophiles and Lactobacillus rhamnosus were superior to placebo in preventing ventilator-assisted pneumonia. Analysis was performed to rank the treatments, finding that the most efficacious treatment for preventing pneumonia of this type was B. longum + L. bulgaricus + S. thermophiles.75 Note: Bifidobacterium longum, Lactobacillus rhamnosus, and Streptococcus thermophilus are found in Vita Biosa)

Pancreatitis

Patients treated with pro-, pre-, or synbiotics had significantly shorter hospital stays and a lower risk of organ failure compared to control.76

Cancer

Both probiotics and synbiotics might help prevent colorectal cancer, likely through mechanisms including modulating the intestinal microbiota, reducing inflammation, inducing apoptosis and inhibiting cancer cell growth, modulation of immune responses and cell proliferation, enhanced intestinal barrier function, modulation of oxidative stress, and production of anti-carcinogenic compounds in the gut.77 Synbiotics also have a positive effect on diarrhoea, symptomatic intestinal obstructions, surgical infections and pneumonia in cancer patients undergoing colorectal resection.78

Pregnancy

Synbiotic supplementation might reduce anxiety in perinatal women.79 Synbiotic supplementation also reduces insulin and improves insulin homeostasis in pregnant women,80 and in those with gestational diabetes reduces inflammation, improves antioxidant capacity, and reduces insulin and very-low-density lipoprotein. Supplementation during pregnancy was also associated with reduced risk of hyperbilirubinemia in the newborn and improved birth weight.81

Mental health

Synbiotics may modulate depression and anxiety but at this time, the research is inconclusive and pro- and synbiotics might affect mental health conditions in a strainspecific manner.82

Irritable bowel syndrome

Synbiotics significantly improve global IBS scores compared to placebo.83

Chronic kidney disease

Synbiotic supplementation significantly reduces inflammatory markers CRP and MDA55, 84 while increasing the antioxidant glutathione in chronic kidney disease patients, as compared to placebo. Subgroup analyses showed that other key factors, such as the duration of intervention, participants’ baseline body mass index (BMI), type of intervention, and age, had an effect of microbial therapies on outcomes.84 Synbiotics might also reduce total cholesterol, fasting blood glucose, and improve insulin sensitivity.55

Pancreatitis

Use of pre-, pro-, and synbiotics shorten the length of hospital stay in severe acute pancreatitis.85

Autism spectrum disorder

A 2021 review by Tan and colleagues concluded that at this time results from the extant research do not support that probiotics are beneficial for ASD but that synbiotics appear to be effective in reducing some behavioural symptoms of ASD.86

Autoimmune conditions

Overall, pro- and synbiotic therapies have been shown to reduce inflammatory markers (CRP, IL-6, TNF-a, MDA) and improve insulin homeostasis in people with autoimmune conditions.87

Inflammatory bowel diseases

Pro-, pre-, and synbiotics increase Bifidobacteria and can improve remission rates and reduce disease activity in ulcerative colitis. Synbiotics appear to be more effective than either pre- or probiotics.88 Synbiotics also significantly improve endoscopic and histological scores, clinical disease activity, c-reactive protein, intestinal microbiota, bowel habits and levels of mRNA, TNF-a, interleukin1a, interleukin-10 and modulates pro- and anti-inflammatory colonic cytokines.89

Polycystic ovary syndrome

Pro-, and synbiotic supplementation reduce insulin and triglycerides,90 free androgens and the inflammatory marker MDA, and increases sex hormone-binding globulin and nitric oxide in women with PCOS.91 Effects on fasting blood glucose, HOMA-IR, c-reactive protein, and total testosterone were previously thought to be equivocal,90, 92 but metaanalysis published in 2020 and 2021 suggest improvement in insulin and insulin homeostasis.93, 94 In a 2018 review it was noted that although significant, the reduction in triglycerides was negligible.90 However, this amounted to a reduction of ~0.2 mmol/L, which is clinically meaningful. Subgroup analysis has also suggested that probiotics are associated with greater reductions in testosterone and post-prandial glucose while synbiotics resulted in a more pronounced reduction in fasting blood insulin.93

Diarrhoea

Treatment with pro- or synbiotics significantly reduces the duration of diarrhoea,95, 96 hospitalisations,95 and hospital stay-length96 in severe cases of diarrhoea in children.

Stomach ulcers

Helicobacter pylori overgrowth is commonly implicated as either causal or comorbid with gastric ulcers. Synbiotics might help to reduce complications of stomach ulcers by improving H. pylori eradication rates and reducing adverse events of antibiotic therapy.97

Cognition

Early studies in elderly people with cognitive decline suggest that pro- and synbiotics might improve cognition.98

Eczema

A meta-analysis of 6 randomised controlled trials found significant reductions in the clinical severity of atopic eczema in children when mixed bacteria were used and by children over 1 year of age.99

Health Effects of Herbs Contained in Vita Biosa

Anise

Anise (Pimpinella anisum) is traditionally used as a carminative, primarily to reduce flatulence. Modern research has demonstrated the antifungal and antioxidant properties of anise.100

Basil

Basil (Ocimum basilicum) has traditionally been used to aid kidney problems, earache, menstrual irregularities, arthritis, anorexia, treatment of fevers, colds, and malaria. Pharmacological evidence suggests potential roles for basil as an anti-cancer, radioprotective, anti-microbial, anti-inflammatory, immunomodulatory, anti-diabetic, antipyretic, anti-arthritic, and antioxidant herb.101, 102

Fenugreek

Fenugreek (Trigonella foenum-graecum) is widely purported to be antidiabetic, anticarcinogenic, anti-inflammatory, hypocholesterolaemic, antioxidant, and immunomodulating.103, 104 Many of its benefits are thought to be due to the free-radical scavenging activity of chemicals from the herb and tumour inhibition via induction of apoptosis, tumour suppressor gene, and inhibition of tumour necrosis factor-α.105 Fenugreek supplementation significantly improves fasting blood glucose and HbA1c, cholesterol, LDL and HDL cholesterol, and triglyceride levels.106-108 There is also evidence that it might help to improve neurological disorders, possibly as a result of its hypolipidaemic, hypoglycaemic, antioxidant, and immunomodulatory effects.109

Dill

Dill (Anethum graveolens) is a common culinary herb used throughout Eurasia. Reviews suggest the dill can promote significant improvements in triglycerides, HDL, total, and LDL-cholesterol and insulin sensitivity.110, 111

Fennel

Fennel (Foeniculum vulgare) is a herb traditionally used to help treat female hormonal issues, including those related to dysmenorrhea and menstrual pain. Reviews of the evidence show that fennel might be as effective as pain medication for reducing pain in primary dysmenorrhea,112 and can help to treat other menstrual symptoms.113

Elderberry

Elder (Sambucus spp.) have been traditionally used to help prevent colds and respiratory infections. While elderberry may not reduce the risk of developing the common cold, it may reduce the duration and severity and adverse events arising from colds and influenza.114

Ginger

Ginger (Zingiber officinale) is one of the most studied medicines in the herbal materia medica. It has a long history of use in traditional medicine for pain and diabetes treatment.115 It has been demonstrated to possess anti-inflammatory, antioxidant, antitumour, and anti-ulcer effects,116 and it is suggested that it might help to reduce the effects of ageing.117 A recent comprehensive review of the effects of ginger on human health suggested that improvements in nausea and vomiting in pregnancy, inflammation, metabolic syndromes, digestive function, and colorectal cancer markers were consistently supported by the research.118 Also generally supported by the research is the traditional use of ginger for pain reduction with the weight of evidence suggesting that ginger improves delayed onset muscle soreness, osteoarthritic pain, migraine, and menstrual pain.119 Ginger also reduces MDA,120-122 TNF-α and c-reactive protein,120, 123, 124 and increases glutathione and total antioxidant capacity,120, 122 supporting its use as an antiinflammatory and antioxidant. Studies also suggest that ginger can reduce both systolic and diastolic blood pressure.125 Systolic blood pressure is reduced by ~6mmHg,125 an effect larger than that from drastic sodium reduction.126 Ginger supplementation improves HbA1c compared to placebo in people with type 2 diabetes,115 and reduces body weight, waist-to-hip ratio, and fasting glucose and improves insulin sensitivity and HDL-cholesterol in people over ‘normal’ weight ranges or with obesity.127 Ginger (at doses of around 1500mg per day) has anti-nausea effects,116 and is effective for reducing post-surgery nausea.128, 129 Ginger is also purported to help protect against environmental challenges to health such as heavy metals, pesticides, pollutants, and radio- and chemotherapy.130

Angelica

Angelica archangelica L. have anti-inflammatory and antioxidant properties.131 Emerging evidence suggests that the herb might offer cognitive and neuroprotective effects.132

Liquorice root

Liquorice (Glycyrrhiza glabra) root has traditionally been used as a nervine tonic to help combat fatigue and treat lung diseases, arthritis, kidney diseases, eczema, heart diseases, gastric ulcer, low blood pressure, allergies, liver toxicity, and certain microbial infections.133 Pharmacological evidence suggests that compounds from liquorice have a range of antimicrobial and antiviral, anti-inflammatory, antioxidant, antidiabetic, anticancer, anti-depressive, and neuroprotective activities.134, 135 A 2018 review of the available evidence also found that liquorice use is associated with reduced body weight and BMI.136 Liquorice might also help to improve markers of nonalcoholic fatty liver disease also reduced by probiotics,137 suggesting a plausible synergistic role for liquorice in a synbiotic supplement. In high doses, liquorice is known to cause hypertension and hyperkalaemia.138, 139 Low dose liquorice taken chronically is associated with increased blood pressure (but not hyperkalaemia or changes in diuretic hormones).140

Oregano

Oregano (Origanum cretici Linne) is a common culinary herb traditionally also used as an anti-microbial. It contains several compounds (esp. thymol and carvacrol) which have demonstrated microbial activity against pathogenic bacteria and yeasts.141, 142

Peppermint

Peppermint (Mentha × piperita) has been traditionally used to treat fever, colds, digestive issues, mouth and throat infections, and as an antimicrobial, antiviral, and antiinflammatory herb.143 Various effects are suggested by emerging evidence including application as an antimicrobial, antioxidant, anti-inflammatory, anti-cancer, and antidiabetic.143 The primary use for peppermint though is due to its tonic effects on the muscular and digestive systems. For example, in treating muscle spasms and irritable bowel syndrome,144 and reducing spasticity of the colon (i.e., during colon surgery145).

Parsley

Parsley (Petroselinum crispum) has a long tradition of use in the treatment of urinary tract disorders. In vitro and in vivo studies demonstrate that parsley may have diuretic, hypolipidaemic, hypoglycaemic, hypotensive, antioxidant, anti-inflammatory and antiplatelet effects.146

Chamomile

Roman chamomile (Matricaria recutita L.) is traditionally used as a calming herb and for sleep promotion. It has also been used to aid recovery from respiratory tract infections. It is known to have antibacterial and antifungal, anti-inflammatory, and antioxidant properties.147

Rosemary

Rosemary (Rosmarinus officinalis L.) is a common culinary and medicinal herb. Several studies have reported that rosemary extracts (and constituents including carnosic acid, rosmarinic acid, and carnosol) show biological activities such as neuroprotective, hepatoprotective, antifungal, insecticide, anti-cancer, antioxidant, anti-mutagenic, antiviral and antibacterial.148-151The protective effects of rosemary and its components are thought to be mediated through different mechanisms such as the inhibition of oxidative stress and reduction of inflammatory mediators.151

Studies also suggest that rosemary could help to improve cognition and alertness.152, 153 Mechanistic research demonstrates anticholinesterase, cholinergic, antioxidant, antiamyloid, neuroprotective and anti-inflammatory actions which are thought to result in the effects seen in improving cognition.153

Concerning the global COVID pandemic, a molecular review has suggested a hypothesis that rosemary might help to protect against COVID-19 and other systemic cytokine storm associated conditions by inhibiting the production of pro-inflammatory cytokines, inhibiting infiltration of immune cells to inflamed sites, and positively impacting the gut microbiome. Additionally, carnosic acid can penetrate the blood-brain-barrier and act against free radicals and might help to reduce ischaemia and neurodegeneration in the brain.154

Sage

Sage (Salvia officinalis) has a long history of use as an aid to mental acuity. Modern research is beginning to elucidate the effects of various species of sage (Salvia spp.) on neurotoxicity, neurogenesis (via BDNF and other neurotrophins), antioxidant capacity, inflammation, and functional outcomes of depression, anxiety, and improved cognition.155 Randomised controlled trials have demonstrated improvements in mood and cognition (memory and attention) from both acute and chronic use of sage.155 A 2019 review has also highlighted promising effects on cardiovascular health with studies to date showing reductions in total and LDL-cholesterol and triglycerides and improved HDL-cholesterol levels following sage administration.156

Nettle

Nettle (Urtica dioica) has been used in various traditional systems of medicines since ancient times especially for joint pain, arthritis, prostate problems and as a general health tonic and especially for blood sugar regulation. Its roots and leaves contain a wide variety of bioactive constituents with hypoglycaemic, anti-inflammatory, antioxidant, hypolipidaemic, anticarcinogenic and antiviral activity.157 A review of trials up to 2019 found a significant reduction in fasting blood glucose among those using nettle compared to controls.158

Thyme

Thyme (Thymus vulgaris) plant is a member of the mint family commonly used as a culinary and medicinal herb. Several chemicals from thyme such as carvacrol and thymol have been well-studied and have been identified as antioxidant, anti-oxidative and anti-inflammatory substances with neuroprotective, hepatoprotective and renoprotective effects.159 Thyme is being studied for potential antidiabetic, anti- Alzheimer's, cardio, neuro and hepatoprotective, anti-osteoporosis, sedative, immunomodulatory, antioxidant, anti-tyrosinase, antinociceptive, gastroprotective, anticonvulsant, antihypertensive, antidepressant, anti-amnesia, and anti-helminthic properties.160

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