By Dr. Gabriella Nataloni, Specialist in Internal Medicine at Aventino Medical Group, Rome
Introduction
The gut microbiome is a complex ecosystem that plays a crucial role in regulating metabolic, immune, and cardiovascular health. In internal medicine, the balance of the microbioma is increasingly recognized as a key factor in the prevention and management of chronic diseases, including diabetes, metabolic syndrome, and inflammatory bowel disorders.
“Avoiding unnecessary antibiotics, managing stress, and adopting a balanced diet are fundamental strategies,” explains Dr. Gabriella Nataloni. “Microbiome analysis could become an innovative preventive strategy in personalized medicine, allowing for more targeted treatments for chronic diseases.”
Microbiome and internal medicine: an essential connection
A healthy gut microbioma not only supports digestion but is closely linked to metabolic and cardiovascular health. Recent studies have highlighted that microbiome imbalances may contribute to:
Type 2 diabetes → Imbalances in gut flora can influence insulin resistance.
Hypertension → The microbiome regulates the bioavailability of short-chain fatty acids, which are essential for blood pressure control.
Autoimmune diseases → Gut dysbiosis can trigger chronic inflammatory responses, worsening conditions such as rheumatoid arthritis and lupus.
Liver diseases → The microbiome plays a key role in non-alcoholic fatty liver disease (NAFLD) and other metabolic liver disorders.
Strategies for a healthy microbiome in internal medicine
Adopting a Diet Targeted at Metabolic Regulation
A balanced diet can support gut function and prevent metabolic complications:
Fermented foods (yogurt, kefir, miso) help modulate immune response.
Soluble fiber (oats, legumes, vegetables) reduces inflammation and improves glucose metabolism.
Omega-3 fatty acids (fatty fish, nuts) counteract inflammation linked to gut dysbiosis.
Controlling Medication Use
Certain medications, such as antibiotics and proton pump inhibitors (PPIs), can alter gut flora, reducing microbial diversity. In internal medicine, it is essential to:
Use antibiotics only when strictly necessary.
Supplement with targeted probiotics in patients undergoing prolonged antibiotic therapy.
Avoid excessive use of antacid medications, which can alter gut pH.
Managing Stress and Promoting Sleep
The microbiome is closely connected to the hypothalamic-pituitary-adrenal axis. Stress management techniques, such as meditation and proper sleep hygiene, can reduce gut inflammation and improve cardiovascular health.
Monitoring the Microbiome with Specific Tests
New technologies allow for bacterial composition analysis, identifying imbalances linked to chronic diseases. Microbiome testing could be integrated into internal medicine practice to:
Assess the risk of metabolic syndrome.
Monitor the effectiveness of nutritional and pharmacological therapies.
Prevent functional gastrointestinal disorders.
Frequently Asked Questions (FAQ)
What is the link between the microbiome and insulin resistance?
Recent studies have shown that an altered microbioma can produce pro-inflammatory metabolites that influence insulin sensitivity, increasing the risk of diabetes.
Can antibiotics cause metabolic issues?
Yes. Excessive antibiotic use can disrupt gut flora, reducing beneficial bacteria involved in lipid and glucose metabolism.
What tests can help evaluate the microbiome?
DNA sequencing tests can analyze the microbioma composition and detect imbalances.
Does the microbiome influence cardiovascular health?
Yes. Certain gut bacteria influence the production of compounds that can contribute to atherosclerosis.
How can I improve my microbiome?
Eat a fiber-rich diet
Reduce refined sugar intake
Manage stress through relaxation techniques
Connections with other specialties and institutions
A healthy microbiome is fundamental not only in internal medicine but also in many other medical specialties. At Aventino Medical Group, we collaborate with specialists in:
Gastroenterology → Managing dysbiosis, irritable bowel syndrome, and inflammatory bowel diseases.
Cardiology → Studying the microbiome’s role in cardiovascular disease prevention.
Endocrinology → Exploring the connection between microbioma, diabetes, and metabolism.
Psychiatry → Assessing the microbiome’s impact on mental health and psychological well-being.
Collaborations with leading institutions
To ensure optimal gut health management, we rely on guidelines and research from authoritative scientific institutions, including:
National Institutes of Health (NIH) – www.nih.gov
European Society for Clinical Nutrition and Metabolism (ESPEN) – www.espen.org
Italian Society of Internal Medicine (SIMI) – www.simi.it
World Gastroenterology Organisation (WGO) – www.worldgastroenterology.org
Conclusion
A healthy microbiome is a key element of overall well-being, influencing not only digestion but also metabolic and cardiovascular health. Maintaining a balanced lifestyle, with a diverse diet, stress management, and mindful medication use, can help prevent chronic diseases and support better quality of life.
Understanding the role of the microbiome with the support of specialists can be valuable in assessing one’s health status and adopting personalized prevention strategies.