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Your body hosts trillions of bacteria, viruses, and fungi, collectively known as the microbiome. While some bacteria are linked to disease, many play essential roles in supporting your immune system, heart health, weight management, and overall well-being. This article delves into the significance of the gut microbiome and its impact on health.
Interestingly, bacterial cells outnumber human cells in the body, with approximately 40 trillion bacterial cells compared to 30 trillion human cells. With up to 1,000 species of bacteria present in the gut, each plays a distinct role. While most bacteria contribute positively to health, some can be harmful. Together, these microbes weigh around 1–2 kilograms, functioning almost like an additional organ essential for overall well-being.
The relationship between humans and microbes has evolved over millions of years, with the gut microbiome playing a crucial role from birth. Initial exposure to microbes occurs during birth, and some evidence suggests that exposure begins in the womb. As the microbiome diversifies, it starts influencing key bodily functions:
Digestion of breast milk: Beneficial bacteria like Bifidobacteria help break down essential sugars in breast milk, supporting infant growth.
Fiber digestion: Some bacteria process fiber into short-chain fatty acids, which contribute to gut health and reduce risks of obesity, diabetes, and heart disease.
Immune system regulation: The gut microbiome interacts with immune cells, influencing how the body responds to infections.
Brain health: Emerging research suggests a link between the gut microbiome and brain function, potentially affecting mental health and neurological processes.
An imbalance between beneficial and harmful microbes, known as gut dysbiosis, may contribute to weight gain. Studies on identical twins—one with obesity and the other without—suggest that microbiome composition plays a role in body weight independent of genetics. Additionally, animal studies indicate that gut bacteria can influence weight gain, even when calorie intake remains constant.
Probiotics, beneficial bacteria found in supplements and certain foods, can help restore gut balance and support weight loss, though their effects may be modest.
The gut microbiome plays a vital role in preventing and managing conditions like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Imbalances in gut bacteria may lead to bloating, cramps, and digestive issues. On the other hand, beneficial bacteria like Bifidobacteria and Lactobacilli help strengthen the intestinal lining, reducing the risk of gut-related disorders.
Research suggests that the gut microbiome influences heart health by affecting cholesterol levels and blood pressure. Certain harmful bacteria produce trimethylamine N-oxide (TMAO), a compound linked to blocked arteries and heart disease. However, probiotics, particularly those containing Lactobacilli, may help reduce cholesterol levels and promote cardiovascular health.
The gut microbiome also plays a role in regulating blood sugar levels. Research on infants genetically predisposed to type 1 diabetes indicates that gut microbiome diversity declines before disease onset. Furthermore, individual variations in gut bacteria may explain why people experience different blood sugar responses to the same foods.
The gut is physically connected to the brain through nerves, and certain bacteria help produce neurotransmitters like serotonin, which influence mood and mental health. Studies indicate that people with mental health disorders often have different gut bacteria compared to those without such conditions. Additionally, some probiotics have shown promise in alleviating symptoms of depression and anxiety.
Maintaining a balanced gut microbiome is crucial for overall health. Here are some strategies to support gut health:
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It is a common belief that metabolic dysfunction-associated steatotic liver disease (MASLD)—formerly known as non-alcoholic fatty liver disease (NAFLD)—is primarily associated with diet, sedentary lifestyles, and obesity. However, there are other factors as well that affect this aspect. Post-menopausal women experience a significantly higher incidence and faster progression of fatty liver disease, even when maintaining a stable body weight.
In Pre-menopausal women, estrogen plays a central role in metabolism by promoting healthy fat accumulation in subcutaneous tissue (below the skin) rather than around internal organs; it also increases insulin sensitivity and suppresses liver inflammation.
After menopause, when estrogen levels drop, this protective function is lost; there is redistribution of fat leading to more fat accumulation around internal organs, including the liver, thus leading to increased chances of NAFLD and also increasing insulin resistance. Needless to say, with age, our metabolic rate also goes down, which also plays a role in this.
The important part lies not only in understanding the above but in going further in early detection and prevention of menopause associated NAFLD. As we know, fatty liver is a silent disease and often does not cause any signs and symptoms till a very advanced stage.
First and foremost is to change lifestyle with advancing age, changing both the dietary habits and physical activity. Regular screening and monitoring are warranted with blood tests, routine metabolic panels, keeping a tab on weight, sugar, and cholesterol levels, and a basic ultrasound of the abdomen. For someone already diagnosed with second or third stage fatty liver, a simple non-invasive FibroScan can help monitor and assess the response to treatment.
Coming to the treatment part of NAFLD in post-menopausal women, being primarily a lifestyle disease, the core of management also lies in managing lifestyle. Medicines are available for treating and controlling NAFLD in conjunction with lifestyle management. Hormone replacement therapy (HRT), when initiated early in post-menopausal women for symptomatic relief, may offer secondary benefits by maintaining metabolic health. However, HRT should always be initiated after proper evaluation and expert guidance.
NAFLD is a silent epidemic and primarily a lifestyle disease; knowing about it and knowing the triggering and precipitating factors helps with understanding and prevention better. Menopause, being a natural biological phenomenon in every female’s life, makes it essential for us to know how it affects our liver health and overall health as well.
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Being aware of personal and family cancer risk may be a critical component in women's knowledge and empowerment to make appropriate screening, prevention and treatment decisions.
Cancer treatment is fast evolving. Doctors are now focusing more on the person than the location or type of cancer and are considering the personal attributes of the patient and the disease. Genetic/genomic testing can complement this and can offer something more that could inform personalised cancer care.
Genetic testing screens for changes in the genes that could be passed down from parents. Some genetic mutations passed down from parents can make a woman more likely to get breast or ovarian cancer.
Having such a genetic change does not mean that a woman will develop cancer. This information will help her and her doctor discuss screening, monitoring and preventive action (if applicable) to reduce her risk.
This information may be useful for family members who could be at risk and should talk to their health care provider about their own risk.
There is a difference between genetic testing and genomic testing. Genetic testing is usually performed on blood or saliva to look for inherited changes or genetic predisposition. Genomic testing is usually performed on the tumour or blood to identify its molecular features to enable better understanding of its biology and biomarkers.
Cancer is not one disease and even two patients with the same type of cancer can have different biological characteristics, which can help doctors decide on the treatment and options that may be suitable for an individual patient.
Genomic testing could help to pinpoint features of a tumour that can be used to consider particular targeted treatments or other methods. But not all of them will be suitable or available to all patients based on the results of testing.
For women, knowing their family history and discussing any concerns with a doctor can be an important starting point. Genetic or genomic testing should not be done simply because it is available. A specialist may recommend testing based on factors such as family history, age at diagnosis and the type of cancer involved.
It is also important to understand test results correctly. Genetic counselling and discussions with an oncology specialist can help women understand what their results mean and what they do not mean.
Ultimately, genetic and genomic testing is not about predicting the future with certainty. It is about giving patients and doctors more information to make better-informed decisions.
As cancer care moves towards greater personalisation, the freedom to know your risk can become a powerful part of taking control of your health—helping women move from fear and uncertainty towards awareness, informed choices and personalised care.
(Dr. Jyoti Wadhwa, Principal Lead, Medical & Precision Oncology, Apollo Athenaa Women’s Cancer Center)
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World Mosquito Day, observed on August 20, raises awareness about mosquito-borne diseases such as dengue, malaria, Zika, yellow fever, and chikungunya and the health risks they pose.
Among these diseases, dengue remains a major public health concern, affecting people across regions worldwide throughout the year.
Also read: India’s First Approved Dengue Vaccine: Takeda’s QDENGA Protects Against All Four Virus Serotypes
Dengue is typically associated with high fever, joint pain, and low platelet counts. However, severe dengue can affect the kidneys and lead to acute kidney injury (AKI).
Speaking to HealthandMe, nephrologists said kidney problems may not always cause symptoms early on, making monitoring particularly important in severe dengue.
Dr. Anupam Roy, Additional Director - Nephrology and Kidney Transplant, Aakash Healthcare Multi-Speciality Hospital, Dwarka, said that recovering from dengue requires careful fluid management, particularly in severe cases.
It is because the kidneys regulate fluids and electrolytes, and changes in circulation caused by dengue can temporarily disrupt their function.
Fever, vomiting, and poor fluid intake can cause dehydration, while severe dengue can cause plasma leakage. Both too little and too much fluid can create problems, making medical supervision important. In hospital, healthcare professionals monitor urine output and signs of dehydration, particularly in patients with complications or underlying health conditions.
After the acute phase, patients should gradually resume eating and drinking according to medical advice. Excessive fluid intake and self-medication should be avoided, particularly when medicines could place additional stress on the kidneys.
“So, it is the quantity issue that must be tackled,” Dr. Roy said.
According to Dr. Manoj Arora, Consultant Nephrologist, NephroPlus, a network of dialysis centers, warning signs include:
Some symptoms can overlap with severe dengue, including continuous vomiting, severe stomach pain, and bleeding.
Kidney injury is more likely in people with severe dengue or shock. Older people and those with diabetes, hypertension, obesity, or existing kidney problems may also face higher risk.
Seek medical attention for a drastic reduction in urine, new swelling, blood in the urine, worsening breathlessness, confusion, or continuous vomiting.
In hospitalized patients, monitoring is important when creatinine rises, electrolyte levels fluctuate — particularly potassium — or urine output continues to change.
Early recognition and appropriate management are key. Doctors may monitor:
Do not self-medicate or increase fluid intake without medical advice, particularly during severe dengue.
Reducing mosquito exposure and preventing mosquito breeding can help lower the risk of dengue.
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