About Gemma
Dr Gemma has a specialist interest in holistic health, plant based nutrition and lifestyle medicine. Another passion is planetary health, and she has spoken on this topic at a debate at Imperial College, on the 'Rhitrition' Podcast and at the Food 2030 Conference at the European Commission in Brussels. She was also one of the experts featured in the documentary film 'Eating Our Way to Extinction' narrated by Kate Winslet.
As a presenter she has been featured on ITV, Channel 4, Channel 5 and Sky News Sunrise as well as BBC Radio with Gaby Roslin and the Chris Evans Virgin Radio Breakfast Show. She has spoken on many podcasts including The Rich Roll Podcast, ‘Feel Better Live More’ by Dr Rangan Chatterjee, The Deliciously Ella Podcast and Mo Gowdat's 'Slo-Mo' Podcast. She hosted five seasons of 'The Wellness Edit’ podcast with Holland and Barratt which was nominated for Podcast of the Year by the PPA Awards during her tenure. Dr Gemma has written two books - ‘The Plant Power Doctor; a simple prescription for a healthier you’, which became a number one bestseller in Popular Medicine and Green Living and 'Get Well, Stay Well: The Six Healing Health Habits Everyone Should Know' (Ebury, 2024).
Our gut microbiome
Gut health is one of the newest trends in wellness, and you will probably have noticed an explosion of products on the market touted as being good for your gut, or containing ‘gut friendly’ bacteria. The word ‘microbiome’ is also becoming ever more recognised in popular culture, as it relates to our bodies, but what is the significance of having a healthy gut microbiome, and what on earth does this have to do with maintaining healthy skin?
The gut microbiome is a vast array of bacteria, viruses and yes, even parasites, that create an ecosystem within us as unique as our fingerprints, and more numerous than all the stars in our galaxy. Doctors used to think of our gastrointestinal tract as a tube that ran from mouth to bottom, with various pouches (stomach, small and large intestine) responsible for nutrient absorption and waste disposal. Microbes were only ever bad things, that caused diarrhoea and vomiting bugs.
Now we understand that the microbiome has distinct functions that support our health in so many ways. For optimal health researchers agree that it is good for us to have many varieties of beneficial bacteria in our large intestine. Some studies have shown that people with atopic eczema may have a smaller range of gut bugs than those who don’t have eczema. A small number of studies have also found that people with eczema are more likely to have higher or lower amounts of certain types of bacteria in their gut microbiomes than those with a functioning skin barrier.
Why are certain bacterial species so important for our health? They work for us, to break down fibres and plant nutrients that our bodies can use for gut lining strength, to properly absorb nutrients and to prevent infections and autoimmune over-reactivity. How?
Food for our microbial friends
Fibre from foods like fruits, vegetables, peas, beans, lentils, and whole grains are not only healthy for us, but they are also how we actually feed our healthy gut bugs. In return, when these amazing foods are broken down in our intestine by bacteria, substances called ‘short chain fatty acids’ are produced. Or SCFAs for short. These are truly amazing molecules, because they have been shown to help the gut lining remain strong, thus reducing risk of inflammatory bowel disorders, or unwanted exposure to toxins from our environment that pass through our guts. They also have a role to play in protecting the blood brain barrier (therefore protecting our brains too) and amazingly they also have anti-cancer effects, as well as reducing our chances of developing obesity and type 2 diabetes.
The science behind gut and skin health
Interestingly both gut and skin microbes can produce short chain fatty acids. And these short chain fatty acids have powerful calming effects on our immune function. They reduce the cytokine production that takes place in our immune cells (white blood cells such as macrophages and T-cells). This is particularly relevant for eczema which happens as a result of an overactive immune system, which can cause the skin to become dry and itchy. In psoriasis, an increase in the skin cell turnover is the key problem, which causes flaky and crusty patches of scaly skin. This is also mediated by the immune system in a different way. Research is now suggesting that by up-regulating certain short chain fatty acids, and down-regulating others, anti-inflammatory effects can be seen to improve both eczema and psoriasis.
Although this is is a new and exciting area of burgeoning research, what is clear is that eating fibre rich foods acts as the perfect PRE-biotic (food for your microbes) and examples of great prebiotic foods include: onions, bananas, asparagus, legumes like chickpeas and lentils, and whole grains. Meanwhile, eating fermented foods can provide PRO-biotics (beneficial microbes), and examples include yogurt, kimchi, miso and sauerkraut. Eating significant amounts of fermented foods appears to be linked to a lower risk of having eczema as an adult. One study with almost 10,000 participants found that adults who ate a diet high in fermented foods were significantly less likely to have eczema. Supporting these results, a study in Japan showed that the babies of mothers who had eaten natto (fermented soybeans) every day during their pregnancy were less likely to develop eczema than those whose mothers ate it only two to three times per week.
The research
We have much to learn about the optimal strains, formulations and concentrations of probiotics for health. Some formulations will be poor quality, or have low doses, and others will have dead bacteria. This is why, in general, it is good to have a food forward approach when it comes to healthy habits for health.
However, clinical studies are showing through complex immune mechanisms, that the gut microbiome has the ability to affect distant organ systems, including the skin. By modulating microbiome communities, probiotics might be beneficial in the prevention and treatment of inflammatory skin diseases with minimal side effects – in fact, more than 70 clinical studies on food containing microbial ingredients have been conducted to investigate the potential side effects of probiotics and none has shown any adverse effects.
One study found that babies who were given two specific probiotics every day for 6 months were less than half as likely to develop eczema during that time as those who didn’t take the supplements. A powerful review of seven other studies found that children whose mothers took Lactobacilli probiotics during pregnancy had a lower chance of developing eczema between 2 and 7 years of age. But for those who took a blend of other types of probiotic bacteria, there was no less risk of developing eczema. What about for psoriasis?
There is emerging research is coming out all the time, and two recent studies certainly seem to corroborate what Hanna's community has been saying about how much they have improved after trying her probiotic. This study was performed recently on nearly 50 people living with psoriasis. They found the extent and severity of psoriasis was markedly improved, as well as the quality of life for those taking the probiotic. The same researchers published a follow up article in 2022 highlighting that the stud group's blood pressure, pro-inflammatory blood markers (cytokines hs-CRP and IL1-β), and harmful lipoproteins (LPS levels) were all reduced following just 8 weeks of supplementation.
In this ever-expanding and exciting field of research, Hanna decided to take some of the evidence we have so far on supportive microbes for general and skin health as well as other ingredients that support healthy skin, such as co-enzyme Q10, aloe vera, bilberry, ginger, turmeric, hibiscus, zinc and more, to create her very own high strength multi-strain probiotic. Hand-brewed in small batches, teeming with billions of live bacterial strains in liquid form, this tangy, tasty and slightly fizzy formulation has helped her manage her own skin health, and as over 2000 independent reviews have shown, is a bestselling product for Hanna and her team for a reason.
It is rarely one component of our lives and habits that helps us step closer towards optimal health. In focussing on diet, lifestyle, connection with others, skin hydration and a healthy gut microbiome, which as we have learned, is intrinsic to digestive balance, immunity and overall skin health, we can help the skin to heal and thrive from the inside out.
References
I gave you a lot of information and with that, of course, comes the supporting research! Feel free to peruse the following references to what we just spoke about on this page.
Effects of gut microbiome and environment on the development
of eczema in Chinese infants. Medicine. (2020).
https://pubmed.ncbi.nlm.nih.gov/32481318/
Fermented food intake is associated with a reduced likelihood of atopic
dermatitis in an adult population (Korean National Health and Nutrition
Examination Survey 2012–2013). Nutrition Research. (2016).
https://www.sciencedirect.com/science/article/abs/pii/
S0271531715002912
Gut microbiota, probiotics, and their interactions in prevention and
treatment of atopic dermatitis: a review. Frontiers in Immunology. (2021).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317022/
Impact of maternal supplementation with probiotics during pregnancy
on atopic eczema in childhood – a meta-analysis. British Journal of
Nutrition. (2011). https://www.cambridge.org/core/journals/britishjournal-of-nutrition/article/impact-of-maternal-supplementation-withprobiotics-during-pregnancy-on-atopic-eczema-in-childhood-a-metaa
nalysis/0DD5C549F687188AC97E9E1EB10AEEE9
Influence of atopic dermatitis on cow’s milk allergy
in children. Medicina. (2019).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723735/
Maternal intake of Natto, Japan’s traditional fermented soybean food,
during pregnancy and the risk of eczema in Japanese babies. Allergology
International. (2014). https://pubmed.ncbi.nlm.nih.gov/24759553/
Microbiome in the gut-skin axis in atopic dermatitis.
Allergy, Asthma & Immunology Research. (2018).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6021588/
Pathophysiology of atopic dermatitis: Clinical implications.
Allergy and Asthma Proceedings. (2019).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399565/
Probiotics for treating eczema. Cochrane. (2018).
https://www.cochrane.org/CD006135/SKIN_probiotics-treating-eczema
Probiotics in late infancy reduce the incidence of eczema: a
randomized controlled trial. Pediatric Allergy and Immunology. (2019).
https://onlinelibrary.wiley.com/doi/10.1111/pai.13018
Probiotics: What you need to know. (2019)
https://www.nccih.nih.gov/health/probiotics-what-you-need-to-know
Psychoneuroimmunology of psychological stress and atopic
dermatitis: pathophysiologic and therapeutic updates. Acta
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The gut microbiome as a major regulator of the gut-skin axis.
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Buhaș MC, Candrea R, Gavrilaș LI, Miere D, Tătaru A, Boca A, Cătinean A. Transforming Psoriasis Care: Probiotics and Prebiotics as Novel Therapeutic Approaches. Int J Mol Sci. 2023 Jul 7;24(13):11225. PMID: 37446403; PMCID: PMC10342574.
Moludi J., Khedmatgozar H., Saiedi S., Razmi H., Alizadeh M., Ebrahimi B. Probiotic Supplementation Improves Clinical Outcomes and Quality of Life Indicators in Patients with Plaque Psoriasis: A Randomized Double-Blind Clinical Trial. Clin. Nutr. ESPEN. 2021;46:33–39.
Moludi J., Fathollahi P., Khedmatgozar H., Tabrizi F.P.F., Zare A.G., Razmi H., Amirpour M. Probiotics Supplementation Improves Quality of Life, Clinical Symptoms, and Inflammatory Status in Patients With Psoriasis. J. Drugs Dermatol. 2022;21:637–644.