Bulletin No. 1, 2019

Trust Your Gut Diabetes, hypertension and depression persist as pervasive ailments of modern society. The health assumptions we draw seem to push us, almost instinctively, toward the pill cabinet. Prof. Paul K.S. Chan , Associate Director of the Centre for Gut Microbiota Research, suggests otherwise: we must first look inwards before seeking external solutions. Professor Chan is Chairman of the Department of Microbiology at the Faculty of Medicine in CUHK. As an expert in clinical virology and epidemiology, he is one of the foremost researchers in gut microbial function. Rather than adopting the assumption that health issues invariably stem from our own cells, Professor Chan posits the crux is gut bacteria imbalance. While gut bacteria of healthy populations are generally well- balanced, evidence points to a correlation between disease— both mental and physical—and a disrupted gut microbiome. Professor Chan’s 2018 pilot study included over 400 subjects and established five categories for bacterial patterns. It marked the first time categorical differences in gut health emerged and gut microbial profiles were set. Chronological age influences the gut microorganism, though it is just one piece of a multifaceted puzzle. Older individuals may have dissimilar patterns than younger individuals, though to ascribe disparities entirely to age is untoward—diet, lifestyle, and genetics have a say too. Evidence suggests a correlation between gut health and aspects such as sleep quality, mood, blood pressure, mental health, and metabolic syndrome. Even subtle factors such as marital status and mode of birth (cesarean section versus vaginal delivery) revealed correlations. A single individual living alone exhibited a disparate gut microorganism pattern than an intimate partnership co-inhabiting a single household. The dissimilar yet patterned characteristics that distinguish between cesarean section births and vaginal delivery births provides further intrigue—how could a baby’s very first step into the world hold sway in the future of their gut health? Defining reference points for gut health improves the chance for anticipatory, personalized interventions while potentially limiting surprise onsets of disease. ‘Until we can determine what a normal healthy gut pattern looks like, we cannot recommend specific interventions,’ Professor Chan explains. ‘Once we establish this, we can develop predictions regarding health advice.’ Earlier this year in May, Professor Chan sought to establish a gut microbiota data bank specific to Hong Kong. Entitled ‘HKGutMicMap,’ the project focused on determining a baseline pattern of a healthy gut microorganism profile for Hong Kong people. Professor Chan hopes to construct an applicable health target for Hong Kong residents. ‘This research can set the course for medicine in the future,’ adds Professor Chan. ‘With today’s undertakings, future generations can enjoy the progress of research.’ Because of the distinction of gut patterns between populations and geographies, there cannot be a substitute for Hong Kong people. Data from other countries’ research cannot replace this study. Studies from North America and Europe can be useful for other medical fields, though the uniqueness of gut health precludes borrowing data. The field of gut health research remains in its incipient stages, and Prof. Paul K.S. Chan is spearheading these next steps. If progress continues at this rate, administering health interventions on an evidence-based, preemptive basis will be within reach. In the not-so-distant future, treatment plans for cancer, diabetes and other afflictions will trend towards the predictive and prophylactic, rather than the reactive and palliative. To solve our most prevalent diseases we may just need a gut check. Phil Rosen The full article originally appeared in No. 538 of CUHK Newsletter . Scan to read: 27 Trust Your Gut