Wednesday, May 15, 2013

The Microbes Within: How They Shape Our Lives And Influence Our Health, Blogging From The 2013 Nutrition And Health Conference In Seattle, Washington With Justin Sonnenburg

The microbes within greatly influence our health.

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Great Conference
I’m flying home now as the 2013 Health and Nutrition Conference in Seattle has ended. After attending over 20 amazing talks over the past 3 days, my mind is flooded with things I want to share with you. I already blogged about Dr. Weil’s Anti-Inflammatory Diet and Dr. Naiman’s insight into sleep, dreams and nutrition. But before I return to my normal life of recipe development and preparing to launch my ebook, I have to write about the most mind-blowing presentation of the entire conference given by Justin Sonnenburg from Stanford University’s School of Medicine. It’s not terribly appetizing so I would not suggest reading this during dinner, but this information has far reaching implications and can truly change how you think about yourself, your diet and your health.

We're Just a Bag of Germs
Dr. Sonnenburg talked about the role of intestinal microbiota with respect to health and disease.  Sounds pretty dry, right? But it’s anything but. It turns out that we are literally a walking carrier of microbes. There are an enormous number of these little guys living on our skin, in our mouths and mostly in our gut. Their cells outnumber our own cells by 10 to 1. They have 100 times the number of genes than we do so from a genetic standpoint, we are 99% microbial. Now it may not be obvious when you look in the mirror, but in fact we are just a bag of germs! 

Now don’t get completely freaked out. You’ve been hosting these microbiota your entire life and they influence many of our life functions in a BIG way! They can affect our metabolism, our immune function, how we harvest energy and nutrients from our food, how we metabolize drugs - they can even contribute to irritable bowel or obesity (OK, you are definitely partners in that one!). The microbiota profile of the Western world, influenced by our highly processed food and agricultural practices, may be the reason for the increased cases of certain food sensitivities, autoimmune diseases, asthma, type 2 diabetes and cardiovascular disease. 

Our Microbiota
Let’s talk a bit more about the microbiota. Most of them live in our intestines. There are 500 to 1,000 bacterial species: 90% of whom, in the Western culture, are Bacteroidetes and Firmicutes. Other cultures have different species and varying amounts of diversity. Now if you were to look at a cross section of the intestines, you would see villi that are covered with mucous (I told you not to read this before dinner). The mucous is covered with carbs which feed our microbiota. What we eat determines what they are and how happy they are. Since they affect so many facets of human biology, we want these guys to be as happy as possible. Besides, if you don’t eat polysaccharide-rich, high fiber foods, the microbiota will start to eat your mucosal lining

How They Get Here
So how do these microbiota end up in our bodies and what determines which types are most prevalent? Full colonization of your gut happens over the first 3 years of life. It begins at birth when the baby is exposed to the mother’s vaginal and intestinal microbes. When babies are born by Caesarean, however, they do not acquire these critical microbes. In fact, their microbiota profile more closely resembles that of the parents’ skin which may prevent their immune systems from developing properly. With one third of all births in the U.S. being delivered surgically, this could explain the high incidence of food sensitivities, allergies, asthma and autoimmune problems.

Mother’s milk then allows the microbiota to flourish. It contains human milk oligosaccharides (HMO’s). These HMO’s are indigestible by the baby but these prebiotics help seed the bifido bacteria in the child’s intestinal tract. They also attract other microbes needed as the baby weans to solid foods. Baby formulas that do not contain prebiotics, (and the early ones certainly did not), will not support the growth of these important microbes as effectively as good old mother’s milk. Luckily, breastfeeding rates are increasing.

Effect of Diet
Even if a person has developed beautiful and healthy microbiota, it’s important to feed and nurture them. Unfortunately the Western diet, agricultural practices and common medical protocols have a very detrimental affect on them.

Gut microbiota live on polysaccharides. They thrive on high-fiber foods so a plant-rich diet of vegetables, fruits, whole grains, nuts and seeds would make them happy. A diet rich in highly-processed foods would not. Diet is a major driver and as we went from hunters to an agricultural community to one that consumed highly process foods, our microbiota have changed dramatically. The goods news is that microbiota can respond and change if you change your diet. 

Danger to the Microbes
Antibiotics can cause the microbiota population to plummet. They can recolonize but it becomes more difficult with repeated use. Antibiotics disrupt the efficiency of the intestinal ecosystem and allow pathogens to be introduced and take hold. This can lead to inflammation and a host of medical issues. Besides the antibiotics given to us by our doctors, we are exposed to them via our food supply. In severe cases of microbial devastation or antibiotic resistance, fecal transplants may be done. This procedure implants fecal material from a healthy host donor into a recipient thus recolonizing the recipient with microbiota. This has been used to successfully treat C. difficile infections. This procedure can have many other applications.

Dr. Sonnenburg, after examining the pictures of colons post colonoscopy, noted that the preparatory procedure pretty much wipes the intestines clean. He was in no way suggesting that people avoid this potentially life-saving procedure but it made me think that perhaps doctors should be much more proactive in advising their patients to re-colonize afterwards with probiotics and prebiotics. 

Your health care practitioner might recommend a  high quality probiotic after a colonoscopy or course of antibiotics.
I met the people from Bio-K at the conference. This probiotic can be found in the refrigerated section of whole foods.

The Implications
The implications of this work is far reaching. These microbiota play a tremendous role in our health. Their genetic content is far more adaptable and resilient than ours. Our microbiota's collective genes, or microbiome, like that of our human genome, will become a significant factor on how we will be treated for disease in the future. (Already there are companies, like uBiome, who will map your personal microbiome) We will someday use this data to predict and treat disease.  Perhaps the combination of our human genome with our microbiome mapping with allow a specific diet to be designed for us for optimal health. What amazing therapeutic potential! The possibilities are endless and I have thought of practically nothing else since hearing this lecture. 

Can We Take Action Now?
What can we do now?
There are more questions than answers at this point but there are some things we can do. 
* Make friends with your microbes. In fact I’ve given mine a name: The Mobies. It just popped into my mind and stuck. 
* When you eat and shop from now on, ask yourself, “would The Mobies (or whatever yours are named) like this?” This might be a great way to get your kids to eat veggies. They love bugs so the thought of feeding their own personally named internal bugs might be fun for them!
* Eat a plant-rich, fiber-rich diet. See my posting on High Fiber Foods.
* Avoid highly-processed food and foods with additives.
* To provide friends for your microbes, eat more fermented foods like raw sauerkraut, fresh barrel pickles, yogurt (they have some good non-dairy ones now) and kimchee. 
* Use antibiotics sparingly. 
* If you are pregnant, opt for a natural birth if possible and breast-feed your baby for as long as you can.
* After getting a colonoscopy, ask the advice of a naturopath or herbalist on the best way to recolonize your gut.
* Get a little dirty.

Eat plenty of fermented foods like raw sauerkraut or fermented vegetable salads found in the refrigerated section of your health food store.

Get Dirty
Let me explain my last comment about getting a little dirty. Our society has become germaphobes. To quote one of the brilliant speakers at the conference, Dr. Tieraona Low Dog, “we have to stop treating our environment like it’s out to get us”. In light of Dr. Sonnenburg’s talk, this makes a lot of sense. We use antibiotics at the drop of a hat, we use hand sanitizers, we use chlorine washes for our lettuce, we processes the life out of our foods, we boil our babies’ pacifiers. It’s a miracle that we have any microbial life in our bodies at all! 

More Reading
Michael Pollan weighed in on this subject yesterday with an excellent article in the New York Times, "Some of My Best Friends Are Germs"

This is a fascinating and far reaching topic and you will be reading a lot more about it in the future. All the recipes in this blog are microbe friendly - just ask The Mobies!

1 comment:

Kamal S. Prasad said...

Great article! I recently found out that 3 pounds of bacteria make up the weight of an average human. You might also be interested in this: From the website " The Human Food Project is an effort to understand modern disease against the back drop of our ancestral/microbial past. Through a better understanding of human ecology at different time scales, the coevolution of us and the trillions of microbes that live on and in our bodies is likely to open new doors to understanding."