DayTwo’s landmark research with Mayo Clinic has shown that we each have a unique response to food. While one person might experience a spike in blood sugar from eating a bowl of oatmeal for breakfast, another may not have any reaction at all. And a small modification, such as adding a handful of almonds could eliminate the spike entirely and make it safer for someone to eat without the risk of severe health conditions. In clinical terms it’s known as precision nutrition and it’s replacing traditional interventions for metabolic disease (diabetes, prediabetes, clinical obesity, NAFLD) with payers and employers.


In fact, DayTwo’s proprietary algorithm IDA™ (Integrated Dietary Algorithm)  can predict an individual’s response to food before they eat it, such as using gut microbiome profiling and other anthropometrics.


Understanding Emotional Health Through The Gut Microbiome


What is lesser known, is the relationship between the microbiome and our emotional health. Not only does the microbiome have a powerful influence on glycemic response, it also has a powerful influence on our emotions. 


Biologically speaking, there’s an extremely intense relationship between the gut, brain and microbiome axis. A very dynamic, interconnected system where the microbiome, which is the diverse and voluminous bugs in your gut—literally trillions—produce specific molecules that interact with the gut itself. The gut’s response is to produce a different set of molecules. All of these molecules can have an effect on the central, autonomic nervous system which controls movement of the gut including what it secretes. Overall, this mini-ecosystem is hormonal, neurologic and immunologic. So the part of our system which controls glycemic response is also related to neuronal, immunologic and neuroendocrine systems. 


The Relationship Between Diabetes & Depression


Many studies have shown that diabetes and depression often go hand-in-hand. Naturally, when dealing with an extremely trying, chronic condition it’s fair to assume this creates a general feeling of malaise and intrinsic sadness, particularly since traditional interventions typically have a limited impact on impacting the underlying disease. However, the explanation is considerably more scientific and involves—you guessed it—the microbiome.


Being depressed essentially changes your microbiome. Firstly, the autonomic nervous system which controls visceral functions including digestion is connected to the immune system. The immune system affects the modulation of cortisol, part of the pituitary adrenal axis, which leads to anti-inflammatory cells and increased cytokines—immunomodulating agents that stimulate or suppress the immune system and help the body to fight infection or other diseases. This causes the GI tract to decrease immune activity which in turn decreases overall microbial diversity. Plus, GI symptoms can occur which create stress and can add to the depressive condition. This is why people with depression typically experience constipation. It’s also the reason they eat differently and why they have discomfort, which actually makes them eat more. And it often leads to a worsening of metabolic disease such as diabetes. 


On the other hand, it also works in the reverse, where alterations in the microbiome produce molecules that can cause depression. The vagus nerve induces behavioral changes in the brain, through the entire nervous system and the hypothalamic pituitary adrenal access. All of these factors work together to create various chemicals, neurologic signals and hormones that increase depression when your microbiome changes.


Predicting The Future Of Emotional Wellbeing


To summarize, there is a biological cycle where changes in depression can cause changes to the gut and in the gut microbiome diversity, which in turn leads to increased depression. For many, it’s a vicious cycle. In fact, it can be extremely challenging to treat diabetes without understanding how it interacts with both the microbiome and with depression. And when they present together, studies have found that treating the depression first can lead to the best chances of successfully alleviating both conditions. An approach that is partly psychological and physiologic through the pathways described.


What’s so exciting about this scientific discovery is how many clinical possibilities can come from understanding the gut microbiome. In the same way that blood glucose can be predicted by an analysis of the gut microbiome, so too can the risk of depression and depressive response from certain foods and combinations of foods. So, as employers think about intervention for mental health and metabolic disease, a solution such as DayTwo’s precision nutrition care model can impact 50%+ of an employee population.


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