Our microbiota undergoes the most prominent deviations during infancy and old age and, interestingly, our immune health is also in its weakest and most vulnerable during these two critical stages of life.¹ Increasing evidence indicates that the composition of the intestinal flora can affect the rate at which we age, and that changes in gut flora predict the lifespan of humans.²  Ageing is a highly complex process affecting a wide array of physiological, genomic, metabolic, and immunological functions.³ Research suggests that the gut microbiota may be associated with age-related inflammation and chronic health conditions, and hence could be used as a novel treatment strategy in the future to ameliorate the ageing process.⁴

The age-dependent relationship between host and gut microbiota is influenced by many factors including diet and lifestyle changes, and changes in gut physiology, such as gastric motility disorders, achlorhydria, and degenerative changes in the enteric nervous system. Reduced integrity of intestinal epithelium in old age could instigate more leakage of gut bacteria in the systemic circulation eventually leading to an increased antigenic load and systemic immune activation which might represent a hallmark of old-age ailments including chronic inflammation, autoimmune disorders, liver disease, metabolic, cardiovascular and neurological conditions.⁵

One of the main age-related changes in the gut microbiota is a decline in microbial diversity. Microbiome changes as we age are also characterised by a loss of genes for short-chain fatty acid production, an overall decrease in the saccharolytic potential, while proteolytic functions are more abundant, and an increase in "pathobionts", i.e. opportunistic pro-inflammatory bacteria generally present in the adult gut ecosystem in low numbers.6 Prebiotics and probiotics can significantly improve the health of the elderly by shaping the gut microbiota in a favourable manner and hence reducing the inflammatory response and improving the adaptive immune response to improve immunosenescence.² Direct regulation of the microbiota may also result in increased degradation of non-digestible carbohydrates, enhancement of antioxidant activity, production of B vitamins and conjugated linoleic acids, regulation of host fat deposition and metabolism, prevention of insulin resistance, and improved maintenance of mucosal barrier integrity and immune homeostasis.⁷

Bacterial targets for anti-ageing drugs are mainly Bifidobacteria and butyrate-producing colon bacteria. Butyrate has many functions, such as preventing metabolic endotoxemia, enhancing mitochondrial activity, and regulating epigenetic processes by inhibiting histone deacetylase activity. As such, butyrate-producing bacteria offer a therapeutic potential in age-related diseases.²

The mechanisms by which the gut microbiome may favourably influence host aging are now being intensively studied while exploring safe and effective approaches (such as dietary therapies including probiotics, fibre ingredients, nutraceuticals and others) to improve/restore gut eubiosis for better health. While it remains unknown if gut dysbiosis is a cause or consequence of aging and senescence-associated inflammatory disorders; it has been hinted that gut microbiota homeostasis is crucial for healthy aging and hence restoration of this homeostasis might be supportive for human longevity.

These findings highlight the need for practitioners to consider the beneficial role of pre- and probiotic supplementation as part of an overall plan in supporting the health of aging patients, especially those experiencing any degree of dysbiosis.

Practitioners should consider the following supportive approaches:

• Prescribe a multi-strain probiotic that contains multiple Bifidobacterium species to provide natural microbial diversity and support gastrointestinal health.
• Consider adjunct support with high dose glutamine in combination with a prebiotic (i.e. inulin, Larch arabinogalactans, pectin, kiwi fruit) to prevent local gut inflammation and permeability to support structural integrity and function of the gastrointestinal tract in patients with compromised digestive function.
• Focus on the importance of diet in all patients
  • If overweight or obese, implementation of calorie restriction and/or a high fibre Mediterranean-style diet.
  • Encourage a diet rich in anti-inflammatory foods such as oily fish, fruits, vegetables, nuts and seeds and limit pro-inflammatory foods such as sugary drinks, refined carbohydrates, trans fats and processed meats.
  • Encourage increased dietary intake of foods rich in antioxidants such as resveratrol and/or other polyphenol compounds.8,9 Examples include, herbs, spices, nuts, seeds, dark berries, olives and dark chocolate.
• Educate patients on lifestyle habits that negatively affect gastrointestinal health, such alcohol, cigarette smoking, eating on the run or when stressed, and not chewing their food adequately.

 

References

1. Nagpal, R., et al., Gut microbiome and aging: Physiological and mechanistic insights. Nutr Healthy Aging, 2018. 4(4): p. 267-285.
2. Lu, M. and Z. Wang, Linking gut microbiota to aging process: a new target for anti-aging. Food Sci Human Wellness, 2018. 7(2): p. 111-119.
3. Lopez-Otin, C., et al., The hallmarks of aging. Cell, 2013. 153(6): p. 1194-217.
4. Buford, T.W., Trust your gut: the gut microbiome in age-related inflammation, health, and disease. Microbiome, 2017. 5(1): p. 80.
5. Nagpal, R., et al., Gut microbiota in health and disease: an overview focused on metabolic inflammation. Benef Microbes, 2016. 7(2): p. 181-94.
6. Rampelli, S., et al., Functional metagenomic profiling of intestinal microbiome in extreme ageing. Aging (Albany NY), 2013. 5(12): p. 902-12.
7. Patel, R. and H.L. DuPont, New Approaches for Bacteriotherapy: Prebiotics, New-Generation Probiotics, and Synbiotics. Clinical Infectious Diseases, 2015. 60(suppl_2): p. S108-S121.
8. Cardona, F., et al., Benefits of polyphenols on gut microbiota and implications in human health. J Nutr Biochem, 2013. 24(8): p. 1415-22.
9. Hu, Y., et al., The Bidirectional Interactions between Resveratrol and Gut Microbiota: An Insight into Oxidative Stress and Inflammatory Bowel Disease Therapy. Biomed Res Int, 2019. 2019: p. 5403761.

The information contained within is intended to be used as an educational tool and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.