Trust their gut: UF Nursing researcher uses body’s microbes to improve health equity for immigrants

By Kyle Chambers

UF College of Nursing Research Assistant Professor Dany Fanfan, PhD, MSN, RN, has a gut feeling about how one population’s health can be affected by a move to the United States.

Thousands of friendly microbes live inside of your stomach and their genetic material makes up what is known as the ‘gut microbiome.’  According to Fanfan, when the type and number of these microbes are ‘in balance,’ they help ensure our health and protect against illnesses.

However, outside forces, such as stress and diet changes, can throw off this delicate environment, leading to long-term negative effects on health and psychological well-being.

Fanfan intends to research how several conditions can impact the gut microbiome in one of the fastest-growing and most-understudied populations in the United States: recent Haitian immigrants.

In a pilot study funded by the National Institute of Nursing Research, a division of the National Institutes of Health, Fanfan will use her background in mental health nursing and her current work on the microbiome to explore connections among stress, lifestyle behaviors, diet, and cultural/socioenvironmental conditions; the gut microbiome; and psychological distress in this group.

“Research has shown that these factors influence both the gut microbiome and levels of psychological distress,” Fanfan said. “We know that certain populations, such as immigrants, are more likely to experience symptoms of distress — such as depression, anxiety, fatigue and pain — at much higher rates than others, but we often fail to identify this distress early enough to head off negative effects to health and wellness.”

By identifying the microbes found in study participants’ stomachs within six months of immigrating to the United States and a follow-up six months later, Fanfan and her team will be able to describe how the gut microbiome changes in this earliest phase of migration. The group will then be able to link these changes in the gut microbiome to both external factors and early symptoms of psychological distress.

“After migrating, Haitian immigrants experience many changes to what are known as social determinants of health, such as diet and physical activity, stress levels, income, education and other outside socioeconomic factors. We expect to find evidence that changes in these social determinants of health are linked to specific changes in the gut microbiome,” Dr. Fanfan said. “We also expect to find links between specific changes in the gut microbiome and levels of psychological distress. “

Research Assistant Professor Dany Fanfan, PhD, MSN, RN

As an example of how these factors can influence the gut microbiome, Fanfan explained that we can determine an immigrant’s level of assimilation to an American diet and lifestyle by trusting their gut.

Western diets, which are high in fat and sugar, can create a drastically different gut microbiome than the diets of an immigrant’s home country. The more ‘westernized’ an immigrant’s gut microbiome becomes, the less variety and number of microbes live in their stomach, leading to negative effects on health.

The researchers hope their study will provide insight into how social determinants of health after migration can impact both the gut microbiome and psychological distress among Haitian immigrants to the United States. According to Fanfan, if these connections can be identified, the gut microbiome may be able to serve as an early, biological warning sign of changes in psychological distress, allowing providers to intervene earlier in order to improve health outcomes.

Because many social determinants of health can be altered through policy changes and specialized care, Fanfan and her team hope this research will also suggest methods that could reduce the negative effects of migration on the gut microbiome and psychological well-being of Haitian immigrants.

“As a first-generation Haitian immigrant myself, I understand that this work is a critical step in reducing health disparities for my community,” Fanfan said. “The knowledge we gain will serve as a foundation in future studies for improving health equity, as well as psychological and physical well-being for Haitian and other immigrant populations nationwide.”

Fanfan will work with primary mentor Debra Lyon of the University of Florida; co-mentors Volker Mai and Connie Mulligan of the University of Florida, in addition to Maureen Groer of the University of South Florida; and collaborators Michael Weaver, Jeanne-Marie Stacciarini and Bruce Stevens of the University of Florida, as well as Fatma Huffman of Florida International University.

Research reported in this publication is supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number K23NR020222. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.