BALM is a strategy to Support Bowel cancer prevention through nourishing The Gut Microbiome

1. Include Soluble Fibre to “Sweep Out” the Digestive System

Enhancing Butyrate Producers:

• Increased Fibre Variety: The BALM Protocol Bread supports a wider range of beneficial gut bacteria, particularly those that produce butyrate, a short-chain fatty acid important for colon health. Butyrate-producing bacteria like Roseburia and other Firmicutes can be encouraged by the increased availability of various fermentable substrates.
• Fermentation Process: Fermentation helps pre-digest the fibres and makes them more accessible to the gut microbiota, enhancing their bioavailability. This process potentially increases the growth of beneficial bacteria like Lactobacillus, which, although depleted in CRC patients, are generally known to contribute to a healthy gut microbiome.

Reducing Pathogenic Bacteria:

• Competitive Exclusion: The growth of beneficial bacteria supported by diverse and bioavailable fibres can outcompete pathogenic bacteria for nutrients and attachment sites in the gut. For instance, an increased population of health-promoting bacteria could help suppress the growth of harmful bacteria such as Fusobacterium nucleatum, which is enriched in CRC patients.
• Acidic Environment: The fermentation process lowers the pH of the gut environment, which can inhibit the growth of pathogenic bacteria like Enterococcus faecalis and Streptococcus gallolyticus, which prefer less acidic conditions.

General Microbial Balance:

• Enriched Microbiota: The overall increased microbial diversity due to the consumption of wholegrain diverse fermented bread might also help restore balance to the gut microbiome. This balance is crucial, as dysbiosis (imbalance in the microbiota) is often linked to various diseases, including CRC.

Potential Impact on Specific Bacteria Noted in CRC Patients:

• Actinobacteria and other enriched bacteria: While the table mentions their enrichment in CRC patients, their responses to dietary changes can vary. Actinobacteria, often involved in breaking down complex carbohydrates, could potentially be modulated to a beneficial state with a diverse, wholegrain diet.

Bread has great potential to support CRC; however, I want to caution that dietary effects on the microbiome can be highly individual. The impact on CRC patients should complement traditional treatments and possibly play a role in preventing and managing CRC by modulating the gut microbiome. Always consult healthcare providers before making significant dietary changes, especially for individuals with health concerns like CRC.

2. Boost the Diversity of Ingredients to Feed a Diverse Microbiome

• Incorporate a wide variety of grains, seeds, and legumes.
• Aim for 30+ different plants as ingredients across breads.
• Diversity promotes beneficial bacteria and “crowds out” harmful strains like Fusobacterium.

3. Include Probiotic Ingredients to Boost Beneficial Bacteria

• Add live cultures like sourdough starter, yoghurt, and kefir.
• Use specific probiotic strains known to benefit gut health.

4. Increase Antioxidants in Both the Flour and Through Symbiotic Eating

• Select high-antioxidant grains and ingredients.
• Promote symbiotic pairings with bread (berries, leafy greens, tea).

5. Optimise Fermentation Processes

• Use long, slow fermentation to enhance digestibility and nutrient availability.
• Employ sourdough fermentation to lower gluten content and glycaemic index.

6. Reduce Additives and Preservatives

• Explain to your student/patient that baking your own bread will minimise the use of emulsifiers, dough conditioners, and artificial preservatives.
• This is also a better and more natural preservation method (fermentation, refrigeration).

7. Incorporate Targeted Functional Ingredients in the Symbiotic Eating and in the Botanical Blend

• Add omega-3 rich seeds (flax, chia) to reduce inflammation.

Rye and spelt are exceptional grains for reducing bowel cancer risk, thanks to their rich content of prebiotic fibres, bioactive compounds, and native enzymes. By harnessing the power of these grains in the context of the BALM protocol, we can create breads that are not only delicious but also optimally designed to promote gut health, reduce inflammation, and protect against the development of bowel cancer.

Rye is an exceptional grain when it comes to bowel cancer prevention. It’s rich in dietary fibre, particularly arabinoxylan, a type of pentosan that’s abundant in rye. Arabinoxylan is a prebiotic fibre that’s fermented by the beneficial bacteria in your gut, producing short-chain fatty acids (SCFAs) like butyrate. Butyrate is a key player in maintaining the health of your colon lining, regulating inflammation, and even promoting the death of cancer cells. Rye is also a standout source of bioactive compounds, including lignans, alkylresorcinols, and phenolic acids. These phytochemicals have potent antioxidant and anti-inflammatory properties that help protect your cells from oxidative damage and reduce chronic inflammation in the gut, both of which are risk factors for bowel cancer. The high content of enzymes in rye, particularly alpha-amylases and xylanases, contributes to the breakdown of complex carbohydrates into simpler sugars during the breadmaking process. This not only enhances the digestibility of rye bread but also increases the availability of fermentable substrates for your gut bacteria, further boosting the production of beneficial SCFAs.

Spelt, like rye, is a nutritional powerhouse when it comes to reducing bowel cancer risk. It’s an excellent source of resistant starch, a type of fibre that resists digestion in the small intestine and is fermented by the gut bacteria in the colon. This fermentation process yields SCFAs, particularly butyrate, which has been shown to have anti-inflammatory and anti-carcinogenic effects in the gut.

Spelt is also rich in antioxidants, including phenolic compounds like ferulic acid and flavonoids like quercetin. These bioactive compounds help neutralise harmful free radicals and reduce oxidative stress in the colon, which is crucial for preventing DNA damage and cancer development.

Generally, the enzymes in spelt are higher than in conventional flour, and they include beta-amylases and proteases, which play a key role in the bioavailability of the nutrients being made available in the fermentation process. The increased enzymes contribute to the breakdown of complex starches and proteins into simpler, more fermentable compounds, enhancing the bioavailability of beneficial nutrients and increasing the production of SCFAs in the gut.

• Use spices with anti-inflammatory and antioxidant properties (turmeric, ginger)—this could be with the symbiotic eating of fish or with the bread of baked goods.

8. Consider Lifestyle Factors

• Replace red meat consumption with legumes – soup, for example.
• Encourage gentle exercise after eating to stimulate peristalsis.
• Provide guidance on light toasting to avoid acrylamide formation.

9. Personalise Based on Individual History and Microbiome Testing

• Offer higher fibre options for those with low-fibre diets and dysbiosis.
• Use targeted probiotic strains based on individual gut testing.
• Tailor antioxidants to specific needs (immunity, inflammation).

10. Educate and Empower Consumers

• Provide clear labelling and information on personalised bread benefits for manufacturers.
• Offer guidance on freezing bread to increase resistant starch and how to eat bread.
• Integrate personalised bread into an overall bowel cancer prevention lifestyle plan.

11. Collaborate with Healthcare Professionals

• Do not underestimate a collaborative approach. Even if you are a baker, your input can really make a difference when you collaborate, so offer to consult with the gastroenterologists, oncologists, and dieticians with whom your student is working to refine the protocol further.
• Explore the potential for “prescription bread” for high-risk individuals in families.
• Monitor outcomes and adjust the protocol based on emerging research.