Throughout this whole series, you’ve read of the strong associations between gut dysbiosis’ influence on type 1 diabetes (T1D) and complicating its management.
More importantly, you’re learning of the more common triggers promoting gut dysbiosis.
Today’s post will cover chronic infections and lack of physical activity.
Hop on board and let’s go!
Chronic Infections
In case you haven’t gotten the memo, yet, when it comes to gut issues, the majority of the time it’s rarely a clear-cut understanding of which came first: the inflammatory trigger (chicken) or the gut disorder (egg)?
They both can and do influence each other quite frequently.
This is no different with chronic infections.
In the last post, you learned that antibiotic overuse may impair gut function.
However, its intended purpose is to treat the next dysbiosis trigger, infections.
Infections are a condition when microorganisms invade and compromise tissues they don’t belong to.
Among everything else gut dysbiosis has been associated with, it also increases the likelihood of infections occurring (1).
However, chronic infections are suggested to increase gut dysbiosis risk, as well (2).
(Cue “vicious circle” parade.)
With the immune system likely compromised due to dysbiosis, it should make sense that infection risk may increase.
The more common gut infections usually range from bacterial, fungal, parasitic, or viral (3, 4, 5, 6, 7).
These infections create a favorable environment for pathological gut microbes, leading to conditions like gut dysbiosis and leaky gut (8, 9).
Infections & Type 1 Diabetes
One study found of the 4,748 type 1 diabetics tested, there were almost 4,000 hospitalizations due to infections. Bacterial infections accounted for over 80% of them (10).
Another study suggests that bacterial and/or fungal infections may take part in type 1 diabetes development. While another suggests viral infections may be an influencer, as well (11, 12).
One research proposes that the likelihood of intestinal parasites being present among type 1 and type 2 diabetics is 63% (13).
There’s also evidence suggesting high blood glucose levels may increase infection risk among the diabetic community and vice versa (14, 15).
It’s almost never-ending, isn’t it?
Covid-19 and the Gut
Research shows strong associations between Covid-19 severity and a reduced microbiome composition when compared to those without Covid-19 (16).
It has also been suggested that optimal gut health may very well minimize the impact that Covid-19 may have on an individual (17).
There’s even strong speculation that gut dysbiosis is a likely factor leading to severe Covid symptoms (18).
We heard plenty in the news that the elderly and those with autoimmunity should be more careful during the Covid-19 pandemic.
Whelp…it should make more sense as to why because both of these groups have a greater risk of having intestinal dysbiosis (19, 20).
In addition, the American Diabetes Associations claims a higher risk for more severe viral complications among diabetics whose blood sugars are not well-maintained (21).
This broken record of gut health affecting diabetes continues to have multiple, validating associations individually and globally.
Next, let’s look at physical activity and its effects on our gut microbiome.
Physical Activity
I’ve broken down this physical activity info among three different levels and how these different demands impact gut health:
Too Little
Too Much
Just right
You can make an educated guess that too little activity may influence quite a few health problems, especially if a poor diet is mixed into the equation.
But some of you may also be surprised to know that too much exercise may also hinder your gut health.
Energy Demands 101
First, let’s understand that energy (calories) must be used and burned to perform any physical activity.
From actions as simple as chewing food and getting up from a chair to more complex activities like Crossfit exercises, none of these may be accomplished without the utilization of energy.
This energy comes from proteins, glucose, and fat.
You can think of energy demands as activity demands.
The more activities executed, the more energy is needed to perform these appropriately.
This is important to remember because we will come back to this later in the post.
For now, let’s go over common inflammatory triggers that many adults endure from not enough physical activity.
“Too Little” Activity Effects on the Gut – Research
In this study, researchers state the following actions play a role in the obesity pandemic (21):
-Changes in how and where energy is stored, i.e. significant increases and the quality of certain macronutrients (carbs, proteins, and fats) are likely factors.
-Changes in nutrient metabolism, i.e. not getting the right amounts of nutrients/minerals to perform what the gut and body need them to do. This could be due to malabsorption issues, not consuming enough nutrients, or both.
Too little physical activity may also further enable nutrient metabolism dysfunction (22).
-Decrease in short-chain fatty acid production (due to changes in nutrient metabolism).
-Inflammation, i.e. not enough sleep, physical activity, dense nutrient intake, proper gut health, pleasured activities in response to stress, etc.
The list goes on, but these are the main ones I consider to be more commonly misplaced.
These have been shown to increase inflammatory biomarkers, among those suffering from obesity.
-Antibiotic use, i.e. where have we seen this before (Psst! Part 3!)?
-Misplaced satiety signaling, i.e. the body isn’t being triggered to feel “satisfied” with its meals when it should be. This can lead us to think we aren’t “full” and are still able to consume more when, in actuality, we should stop eating. This is commonly seen in high-carb diets, especially with minimal physical activity.
Many scientists believe that these variables are all able to limit microbial diversity, which can play a significant role in the continued rise of obesity (23).
Now, the majority of these obesity triggers are worsened when minimal activity is added to this mix.
Remember that activity is fueled by energy/calories. But what happens when there is excess energy/caloric consumption, but with no activity?
Especially if the energy consumed is from nutrient-poor foods.
That’s right. A gut punch of inflammation to the gastrointestinal (GI) system!
A large portion of these calories are disproportionately stored as fat or in the blood, raising blood sugars. A lot of times, it’s both!
But why are we talking about obesity? Most type 1 diabetics typically aren’t overweight, right?
If you’ve been reading this whole series of posts, you’ll know what affects our gut health likely:
–alters the gut barrier and immune system function
–compromises the gut’s ability to absorb nutrients properly
–increases blood glucose mismanagement.
So, just because a non-active type 1 diabetic may not look obese doesn’t mean these obese-driving-triggers aren’t taking an ill effect on them.
Various studies come to the same conclusion that if one has a diverse microbiome, the likelihood of obesity and its symptoms are greatly reduced.
And this may occur even with little physical activity. But this is also assuming proper energy/caloric consumption is being executed.
Next, let’s look at what too much exercise may do to the gut microbiome.
“Too Much” Activity Effects on the Gut – Research
There are studies suggesting that forced exercise lowers microbial diversity (24).
Prolonged strenuous activity typically triggers the stress response to occur, which enables the release of cortisol, epinephrine, and norepinephrine.
These hormones and neurotransmitters that reduce blood flow to the abdominal organs and GI system and redirects oxygen to the muscles so that they are better prepared for a potential “fight or flight” response (25).
This chronic loss of blood to the intestine (aka intestinal ischemia) can not only cause severe gut distress but also significantly increase mortality risk (26).
And to no surprise, decreased immune function has been suggested among those who exercise frequently with little to no recovery time, as well (27).
Other symptoms of over-training may include reduced performance, loss of energy, difficulty concentrating, depression, decreased libido, and amenorrhea in females (28, 29, 30, 31).
The “Just Right” Effects of Physical Activity on the Gut – Research
As you’ve been reading, too much and too little physical activity are likely to have negative impacts on our gut integrity, along with other potential health concerns.
This concept follows an inverted U-shape curve.
The physical activity imposed for optimal gut integrity, and overall health for that matter, appears to be right in the middle of the previous two activity levels mentioned.
One study with rugby players showed that they had a more diverse gut flora when compared to controls who were not as active (32).
While another study proposes that physical activity could be a beneficial factor in treating gut dysbiosis (33).
Not only does routine physical activity help diversify the microbiome, but it’s also suggested to help (34, 35, 36, 37, 38, 39, 40):
Exercises, like high-intensity interval training (H.I.I.T.), are even speculated to improve blood glucose for 1 – 3 days among diabetics and non-diabetics (40).
The benefits of a routine exercise regimen have also been seen among conditions like obesity, metabolic syndrome, cancer, osteoporosis, insomnia, depression, and anxiety (41, 42, 43, 44, 45).
My Personal T1D Experience
Given much of what’s on my plate, it’s not uncommon for my basal rates to fluctuate between my weekdays and weekends given the inconsistencies that typically arise.
My weekdays are much more reliable to predict, but my weekends can still present challenges. Especially with my business, family, and children.
Every type 1 diabetic is different, but if my current basal rate happens to not be enough to maintain my blood sugars on a particular day and it goes spiking up (and if the opportunity presents itself), I sometimes will go out in my yard and just start pulling weeds for 5 – 15 minutes.
I’ll do this because I know this physical activity will work a lot faster than the time it will take for my body to respond to injected insulin.
And once synthetic insulin has reached my circulatory system, it will still take approximately 15 to 40+ minutes before it starts taking sugar out of my blood, insulin brand pending.
For me, my insulin will also stay active for approximately 3+ hours post-injection.
For other type 1 diabetics, it may remain active between 3 – 6+ hours.
Whereas my being physically active, for an extremely short period, naturally demands my body to fuel itself for the physical activity at hand, forcing it to take sugar out of my blood at a much more rapid rate in comparison to my insulin correction bolus.
I’ll then recalculate my insulin pump’s basal rate and monitor it diligently to ensure my blood glucose levels are where they need to be.
This is something I’ve learned with my own body and its response to this particular situation over the 20+ years I’ve had type 1 diabetes.
And given how well I know my body responds to this, it has been rather useful.
Although immediate physical activity is not always an option for me to execute whenever these hyperglycemic incidents arise, it’s nice to have it as an option when possible.
The research validating routine physical activity and its effect on increased insulin sensitivity is convincing, as well. (46).
Again, not every type 1 diabetic will respond as I do in this situation.
Some may even respond better, worse, or not at all!
Many hypoglycemic reactions can and do occur with physically active T1Ds.
A type 1 diabetic’s knowledge of their own body’s wiring and how well it responds to many different blood sugar triggers will only empower them and their management.
But they need to make sure they don’t do this alone and that they have a physician assisting them with this at all times.
We’ve all known the health benefits of exercise, but now it may be a little easier to connect the dots as to why!
In part 5 I’ll be discussing potential risks factors that influence early gut microbiome dysfunction.
Summary
- Though your gut health is to improve immune function, if it’s impaired, it can lead to more infection risk. This can then increase gut dysbiosis risk, enabling a vicious circle or a dog chasing its tail effect
- Some research has noted that a large group of type 1 diabetic hospitalizations were due to infections
- Chronically high blood sugars have also been suggested to increase infection risk
- Many people forget our diet should be based on our energy demands due to the foods fueling it accordingly, i.e. the more active one is, the more energy is needed
- Too little activity may lead to a impairment in metabolic, nutritional, gut, inflammatory, and neuroregulatory functions in your body
- Too much activity may reduce your gut bug diversity, increase inflammation and stress response, which can then affect insulin and influence insulin resistance, along with gut and immune dysfunction
- The right amount of activity can improve gut health, increase insulin sensitivity in the skeletomuscular system, reduce chronic inflammation and cardiovascular risk, and improve sleep
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