As nutrition professionals, our top priority is ensuring the health and optimal function of our clients’ digestive processes. An essential aspect of this is achieving balance and diversity in the gut microbiome.
When it comes to the various bacterial species that make up the microbiome, some appear to have a more significant impact than others. Ensuring optimal levels of these individual species – not too low, not too high – can have a far-reaching effect. One of the keystone species of beneficial bacteria is Akkermansia Muciniphila. It has received a lot of attention recently as several studies have connected adequate quantities to optimal body weight and shown it to be protective against Type II Diabetes, as well as severe digestive issues such as Ulcerative Colitis and Crohn’s Disease.
For evaluating the health of the gastrointestinal tract, at the Institute of Restorative Health, we teach the GI-MAP Stool test, which includes assessment of Akkermansia Muciniphila levels. As any Restorative Wellness Practitioner who regularly runs these panels will tell you, this species frequently comes up not only low, but often below detectable levels. This is concerning given its importance and warrants further discussion: What exactly is Akkermansia Muciniphila? Why is it so impactful to our overall health? And what can we do to help it proliferate?
Akkermansia Muciniphila is a commensal gram-negative, strictly anaerobic, non-motile, non-spore-forming, oval-shaped bacterium, and makes up a notable 1-4% of our microbiome. It lives in, and nourishes itself from, the carbon and nitrogen found in the mucosal layer coating our intestinal walls (hence the “Muciniphila” which translates to “mucous loving”). However, rather than degrading the gut lining in the process as one might assume, it enhances mucosal production in the gut and provides protection against leaky gut. We know an intact and healthy gut lining is integral not only to digestive health, but to immune and metabolic health as well.
What’s particularly interesting about Akkermansia Muciniphila is that, unlike most other beneficial bacteria, it doesn’t depend on our diet to feed it. Even when there are no nutrients in the digestive tract, it feeds on the mucin in the mucosal layer, building up a stronger, healthier gut lining in the absence of us “feeding” it.
Akkermansia Muciniphila is typically abundant in children and decreases with age and illness. Restoring it to optimal levels can yield many benefits.
Indeed, research has connected levels of Akkermansia Muciniphila to many functions and health issues:
- Low levels of A. Muciniphila are associated with Crohn’s Disease and Ulcerative Colitis. [https://pubmed.ncbi.nlm.nih.gov/20648002/ and https://pubmed.ncbi.nlm.nih.gov/23385241/ ]
- It has been shown to have a powerful connection to Type II Diabetes, and yields clues as to the role of the microbiome in blood sugar regulation. In fact, this paper [https://academic.oup.com/femspd/article/76/4/fty028/4972761] gives incredibly promising news, connecting A. Muciniphila to improved liver function, a reduction in gluco-toxicity, the alleviation of oxidative stress, and suppression of inflammation, concluding, “Akkermansia Muciniphila might be considered as one of the ideal new probiotics used in the management of type 2 diabetes mellitus in future.” Another study showed A. Muciniphila to improve glucose homeostasis. [https://pubmed.ncbi.nlm.nih.gov/23804561/]
- It reduces the inflammatory burden as a result of a healthy gut lining that is not allowing endotoxins such as lipopolysaccharides to circulate through the bloodstream [https://www.nature.com/articles/srep16643].
- It has been linked to the reversal of liver dysfunction [https://www.nature.com/articles/s41591-019-0495-2]
- Recent studies have connected A. Muciniphila to reduced body weight gain and a lean phenotype [https://pubmed.ncbi.nlm.nih.gov/28249045/]
- It has been shown to reverse atherosclerosis, by improving metabolic endotoxemia-induced inflammation through restoration of the gut barrier. [https://www.ahajournals.org/doi/full/10.1161/circulationaha.115.019645]
- It regulates immune function [https://pubmed.ncbi.nlm.nih.gov/28249045/]
- It fuels the proliferation of other beneficial bacteria species, such as Faecalibacterium prausnitzii, which feeds on the short chain fatty acid acetate that A. Muciniphila produces. F. Prausnitzii in turn converts the acetate produced by the A. Muciniphila into the short-chain fatty acid butyrate, which fuels the cells lining the gut. This process is known as “cross-feeding.” https://pubmed.ncbi.nlm.nih.gov/25118238/
You’re getting the picture, I’m sure, and now understand why Akkermansia Muciniphila is considered a keystone species.
The next question, then, becomes: how do we encourage the growth of Akkermansia Muciniphila? Here are some ideas to get you started:
- Increase the consumption of polyphenol-rich foods, in particular grapes, cranberries, and pomegranate seeds. Cranberries and grapes in particular contain a class of polyphenol called proanthocyanidins, which stimulates the production of mucin, which is what A. Muciniphila loves to eat.
- Eat fatty fish and/or supplement with fish oil. The fatty acids in oily fish have been shown to support A. Muciniphila proliferation [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4598654/]
- Avoid excess alcohol, which significantly lower A. Muciniphila [https://pubmed.ncbi.nlm.nih.gov/28550049/]
- If tolerated digestively, consume prebiotic foods that stimulate the proliferation of Bifidobacterium, which has a synergistic relationship with A. Muciniphila. Fructooligosaccharides (FOS) in particular – present in banana, garlic, asparagus, and onions – support an abundance of bifidobacterium. While you cannot, at this point, supplement with Akkermansia Muciniphila directly, incorporating a supplement that includes bifidobacterium species can support the proliferation of A. Muciniphila indirectly.
Akkermansia Muciniphila is a true rock star commensal bacteria and we are still only at the beginning of understanding all of its many important roles in human physiology and health. When you see it low or below detectable levels on a stool test, take note, and consider these strategies for increasing its proliferation and impact.
References and additional reading:
https://en.wikipedia.org/wiki/Akkermansia_muciniphila
https://pubmed.ncbi.nlm.nih.gov/31599433/
https://www.frontiersin.org/articles/10.3389/fimmu.2017.00850/full#B8
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FAQ
These frequently asked questions expand on the key clinical concepts discussed in this article and provide additional context for practitioners interpreting Akkermansia muciniphila in practice.
What is Akkermansia muciniphila, and why is it considered a keystone microbial species?
Akkermansia muciniphila is a beneficial commensal bacterium that plays a central role in maintaining gut barrier integrity and supporting overall gut health. It typically makes up approximately 1–4% of the gut microbiome and influences digestive, immune, and metabolic function. Because its effects extend beyond its own abundance, it is considered a keystone microbial species.
Why is Akkermansia muciniphila important for overall health?
Akkermansia muciniphila supports the health of the intestinal mucosal layer, which helps maintain barrier function. Research discussed in this article also associates adequate levels with healthy body weight, glucose regulation, immune function, reduced inflammation, liver health, and protection against several chronic diseases.
Where does Akkermansia muciniphila live in the gut?
Akkermansia muciniphila resides within the mucosal layer lining the intestinal wall. It utilizes carbon and nitrogen from mucin while simultaneously stimulating additional mucosal production, helping strengthen rather than degrade the gut barrier.
How is Akkermansia muciniphila different from many other beneficial gut bacteria?
Unlike many beneficial microbes that rely primarily on dietary nutrients, Akkermansia muciniphila feeds on mucin within the intestinal mucus layer. This allows it to remain active even when little food is present in the digestive tract while continuing to support gut barrier integrity.
Why are low levels of Akkermansia muciniphila clinically significant?
Low or undetectable levels may indicate reduced support for the intestinal mucosal barrier. The article highlights research associating lower levels with conditions including Crohn’s disease, ulcerative colitis, type 2 diabetes, liver dysfunction, increased inflammation, and metabolic disturbances.
How can practitioners assess Akkermansia muciniphila levels?
The article describes assessing Akkermansia muciniphila through GI-MAP stool testing. According to the authors’ clinical experience, practitioners frequently observe low or below-detectable levels when interpreting these panels.
How does Akkermansia muciniphila influence inflammation?
Akkermansia muciniphila helps reduce inflammatory burden by supporting a healthy intestinal barrier. A stronger gut lining limits the movement of endotoxins such as lipopolysaccharides into circulation, which may help reduce systemic inflammation.
What is the relationship between Akkermansia muciniphila and metabolic health?
Research cited in the article links Akkermansia muciniphila with improved glucose homeostasis, healthier liver function, reduced oxidative stress, suppression of inflammation, and protection against type 2 diabetes. Studies have also associated higher levels with reduced body weight gain and a lean phenotype.
How does Akkermansia muciniphila interact with other beneficial gut bacteria?
Akkermansia muciniphila supports other beneficial microbes through a process known as cross-feeding. It produces acetate, which Faecalibacterium prausnitzii converts into butyrate, a short-chain fatty acid that fuels cells lining the intestinal tract.
Which foods may help support Akkermansia muciniphila growth?
The article recommends several dietary strategies that may encourage Akkermansia muciniphila proliferation.
These include:
- Polyphenol-rich foods such as grapes, cranberries, and pomegranate seeds
- Fatty fish or fish oil
- Prebiotic foods containing fructooligosaccharides (FOS), including bananas, garlic, asparagus, and onions (when well tolerated)
Can Akkermansia muciniphila be supplemented directly?
According to the article, direct supplementation with Akkermansia muciniphila was not available at the time of publication. However, practitioners may consider supporting its growth indirectly through Bifidobacterium-containing probiotics because of the synergistic relationship between these organisms.
What lifestyle factors may reduce Akkermansia muciniphila levels?
The article identifies excess alcohol intake as a factor associated with lower Akkermansia muciniphila abundance. Reducing excessive alcohol consumption may therefore be one strategy for supporting healthier levels.
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ABOUT THE AUTHOR
Margaret Floyd Barry, FNTP MRHP is owner and Executive Director of the Institute of Restorative Health. She’s a functional nutritionist, author, speaker, educator, and real food advocate. Through years of experience working with the most complex client cases, including reversing her own autoimmune condition, Margaret uses a powerful system for restoring health by addressing the root cause of illness.
Today, Margaret teaches fellow practitioners the same proven system she uses to get her clients life-changing results through the Institute of Restorative Health – a two-year comprehensive functional nutrition certification program for qualified health professionals. Margaret also runs Restorative Corporate Wellness, a team of Restorative Health Practitioners facilitating health transformations with corporate clients. She is the author of Eat Naked and its follow-up cookbook The Naked Foods Cookbook. She’s also the host of the Clinician’s Corner podcast, where she interviews some of the world’s top experts in the fields of functional health and nutrition.
