Polyphenols, Akkermansia, Your Immune System, and You

Written by Dr. Ben Reebs on January 16, 2023

In the world of integrative medicine, we are often introduced to new strains of gut bacteria that appear to play specific health roles in the body. (1)

The new kid on the block, in the probiotic world, is Akkermansia, a species that is regularly tested by integrative medicine practitioners on comprehensive stool tests. (2)

Akkermansia appears to play an important role in our metabolic health, and though correlation does not mean causation, adequate amounts of this commensal appear to be necessary for regulating our blood sugars properly. (3) Hence, not having enough Akkermansia could be a risk factor for conditions where insulin resistance plays an important etiological role, such as in diabetes or PCOS. (4)

So how do we balance our Akkermansia, if we are low? Well, there are several probiotics that contain Akkermansia but perhaps the most effective way is to consume adequate amounts of specific prebiotics called polyphenols. (5, 6)


The key to the health of our gut microbiota is the food that our gut consumes, which completely depends on the foods that we consume. These foods which nourish our microbiome are called prebiotics. Prebiotics are substrates which selectively metabolize and confer a health benefit to their host. (7) In other words, prebiotics feed probiotics so that they can properly function in our microbiome.

Polyphenols as Prebiotics

Some well-known prebiotics include inulin (a non-digestible carbohydrate), fructooligosacchardies and galactooligosaccharides. (8) But recently polyphenols have received considerable attention as viable prebiotics. They appear to help the commensal probiotics in our gut thrive. In other words, the Hippocratic axiom, You are what you eat, can be updated to, You are what you eat ate.

Polyphenols, which are also classified as a type of antioxidant, are plant metabolites in fruit and vegetables. (9) In biochemistry, a phenolic compound contains two or more aromatic rings with two or more hydroxyl groups.

Making sure that polyphenols are a part of our diet makes dysbiosis much less likely to occur. (10)

The Gut-Brain Axis and Dysbiosis

There’s something called the gut-brain axis, a bidirectional communication system between the nervous system of our gut (enteric nervous system), and our central nervous system and brain. (11)

Though the term dysbiosis has become less and less helpful, its hallmarks include the loss of microbial diversity, a reduction in beneficial microbe populations, and an overgrowth of pathogenic bacteria (known as pathobionts). (12)

Polyphenols from Dark Berries

So what kinds of polyphenols appear to feed our Akkermansia best? Well, the answer lies in the dark berries which contain the highest amount of polyphenols, such as elderberry and blackcurrant. (13)

This could even be partly why elderberry is so excellent for the common cold. Because 70 to 80% of our immune cells reside in our gut, our intestinal microbiota play a crucial role in our susceptibility to infection.

Another interesting fact is that because Akkermansia appears to play another role in the regulation of our blood sugars, then it appears that consuming dark berries is good for our metabolic health. (14)


It appears that eating plenty of dark berries can provide a jolt to our immune health as well as provide nourishment to our microbiome, both lowering inflammation and modulating our metabolic health. Pretty cool.


  1. Almeida, A., Mitchell, A. L., Boland, M., Forster, S. C., Gloor, G. B., Tarkowska, A., Lawley, T. D., & Finn, R. D. (2019). A new genomic blueprint of the human gut microbiota. Nature568(7753), 499–504. https://doi.org/10.1038/s41586-019-0965-1
  2. Rodríguez-Daza, M. C., & de Vos, W. M. (2022). Polyphenols as Drivers of a Homeostatic Gut Microecology and Immuno-Metabolic Traits of Akkermansia muciniphila: From Mouse to Man. International journal of molecular sciences24(1), 45. https://doi.org/10.3390/ijms24010045
  3. Zhou, Q., Pang, G., Zhang, Z., Yuan, H., Chen, C., Zhang, N., Yang, Z., & Sun, L. (2021). Association Between Gut Akkermansia and Metabolic Syndrome is Dose-Dependent and Affected by Microbial Interactions: A Cross-Sectional Study. Diabetes, metabolic syndrome and obesity : targets and therapy14, 2177–2188. https://doi.org/10.2147/DMSO.S311388
  4. Hasani, A., Ebrahimzadeh, S., Hemmati, F., Khabbaz, A., Hasani, A., & Gholizadeh, P. (2021). The role of Akkermansia muciniphila in obesity, diabetes and atherosclerosis. Journal of medical microbiology70(10), 10.1099/jmm.0.001435. https://doi.org/10.1099/jmm.0.001435
  5. Anhê, F. F., Pilon, G., Roy, D., Desjardins, Y., Levy, E., & Marette, A. (2016). Triggering Akkermansia with dietary polyphenols: A new weapon to combat the metabolic syndrome?. Gut microbes7(2), 146–153. https://doi.org/10.1080/19490976.2016.1142036
  6. Lordan, C., Thapa, D., Ross, R. P., & Cotter, P. D. (2020). Potential for enriching next-generation health-promoting gut bacteria through prebiotics and other dietary components. Gut microbes11(1), 1–20. https://doi.org/10.1080/19490976.2019.1613124
  7. You, S., Ma, Y., Yan, B., Pei, W., Wu, Q., Ding, C., & Huang, C. (2022). The promotion mechanism of prebiotics for probiotics: A review. Frontiers in nutrition9, 1000517. https://doi.org/10.3389/fnut.2022.1000517
  8. Davani-Davari, D., Negahdaripour, M., Karimzadeh, I., Seifan, M., Mohkam, M., Masoumi, S. J., Berenjian, A., & Ghasemi, Y. (2019). Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods (Basel, Switzerland)8(3), 92. https://doi.org/10.3390/foods8030092
  9. Plamada, D., & Vodnar, D. C. (2021). Polyphenols-Gut Microbiota Interrelationship: A Transition to a New Generation of Prebiotics. Nutrients14(1), 137. https://doi.org/10.3390/nu14010137
  10. Kumar Singh, A., Cabral, C., Kumar, R., Ganguly, R., Kumar Rana, H., Gupta, A., Rosaria Lauro, M., Carbone, C., Reis, F., & Pandey, A. K. (2019). Beneficial Effects of Dietary Polyphenols on Gut Microbiota and Strategies to Improve Delivery Efficiency. Nutrients11(9), 2216. https://doi.org/10.3390/nu11092216
  11. Mayer, E. A., Nance, K., & Chen, S. (2022). The Gut-Brain Axis. Annual review of medicine73, 439–453. https://doi.org/10.1146/annurev-med-042320-014032
  12. Carter C. S. (2021). A "Gut Feeling" to Create a 10th Hallmark of Aging. The journals of gerontology. Series A, Biological sciences and medical sciences76(11), 1891–1894. https://doi.org/10.1093/gerona/glab191
  13. Reider, S., Watschinger, C., Längle, J., Pachmann, U., Przysiecki, N., Pfister, A., Zollner, A., Tilg, H., Plattner, S., & Moschen, A. R. (2022). Short- and Long-Term Effects of a Prebiotic Intervention with Polyphenols Extracted from European Black Elderberry-Sustained Expansion of Akkermansia spp. Journal of personalized medicine12(9), 1479. https://doi.org/10.3390/jpm12091479
  14. Shih, C. T., Yeh, Y. T., Lin, C. C., Yang, L. Y., & Chiang, C. P. (2020). Akkermansia muciniphila is Negatively Correlated with Hemoglobin A1c in Refractory Diabetes. Microorganisms8(9), 1360. https://doi.org/10.3390/microorganisms8091360

Article written by Dr. Ben Reebs

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