Dark Matter: The New Science of the Microbiome

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Spector’s 30-year-long study of 15,000 twins, TwinsUK, and his PREDICT studies have shown that even genetically identical people respond to the same foods very differently (our microbiomes are so variable that twins share only 30% of the same gut microbes). By feeding participants the same meals on different days, he was able to show that responses to the same meals also vary hugely between individuals, influenced by both the microbiome and genetics. This matters, says the ZOE team, because our response to food is linked to our risk of heart disease, type 2 diabetes and obesity, but also because it blows apart the tired and useless mantra “calories in, calories out”, which doesn’t make sense in a world where two people’s blood glucose levels can be hugely different after eating the same slice of cake. A fountain of knowledge and sense in an overwhelming world of science Rhiannon Lambert, Registered Nutritionist and Sunday Times Bestselling Author

While an FMT might be a new idea to many of us today, the medical practice of faecal transplant is ancient, and it has been drunk as “yellow soup” since the 4th century AD for the treatment of infective diarrhoea. In 1958 an innovative surgeon, Dr Ben Eiseman, administered faecal enemas to his patients in Denver, Colorado, with severe and recurrent C diff infections. It was remarkably effective, but like all important medical discoveries, this intervention was largely ignored at the time of its first report. I first understood what the microbiome was when I started my PhD in 2005 and it became obvious to me that this has to be an important part in the story of human health and happiness. These microbes are there for a reason, they're not there by accident. This is an evolutionary partnership, and if we're getting more cancer or chronic disease in the gut, they have to be part of the story. Microbes have been used as therapy and cancer treatment for hundreds of years – but they’ve been ignored by mainstream science. I knew the gut microbiome was important to our health and I wanted to focus my future career on understanding how. What role does diet play in the gut microbiome? Dr Ben Mullish, a clinical scientist at Imperial College London, was running a trial of FMT in patients with C diff infections. Ray was so unwell that Dr Mullish offered him the treatment. Heather understood that there are good and bad bugs and advised her husband to go ahead with it, but Ray was not having it. The idea of taking another human’s faeces was just too much for him, and he refused. Three days later, however, he had deteriorated so much that there was no other choice. Ray consented to the trial. Absolutely! I am mainly vegetarian now. I’ve deleted all my food takeaway apps and I cook food from scratch as much as possible. I’m careful about what I buy and knowing where my food comes from. So, if I eat meat, for example, I want to know about its provenance and that no antibiotics were used in its production. I also try to eat more socially and family meal-times are really important for me. When we’re touching and sharing different plates, we are exposed to each other’s microbes. We need that exposure to keep our systems in balance.

The human microbiome represents the most important new therapeutic target that we have for treating the greatest threats to human life in the 21st century and for preventing future pandemics of pathogens. This was not only important for Ray – it is critical for all of us: without a stable and diverse microbiome, we may well lose our minds. Behind all this is a simple message: microbes are not the enemy. Eat more fibre Most of us eat only half the recommended 30g a day. But start slowly – our guts don’t like rapid change The final frontier for gut microbiome exploration is its relationship with our brains, something the new fields of nutritional psychiatry and psychobiotics are digging into. We already know the gut has its own nervous system, the enteric nervous system, and contains 100m neurons. We also know the gut-brain axis, via the vagus nerve, shoots neurotransmitters produced within the gut around the body and to the brain, which is why Cryan’s lab has studied the impact of particular bacteria on sleep and how certain types of fibre can improve complex cognitive processes. What I particularly loved about this book is its strong scientific foundation. Kinross, a world-leading microbiome scientist and surgeon, offers a wealth of relevant insights drawn from his personal experience and over two decades in the field. The book serves as a much-needed, up-to-date summary of what is going on in this rapidly developing area of study.

We are also running a long-term study to help us understand the evolution of the microbiome in very early life and its importance for influencing your risk of disease later in life. This involves following two cohorts of children from birth and studying how their gut microbiome evolves as they grow up in varying circumstances. What prompted you to write your book, Dark Matter?Kinross makes it clear that the composition of the microbiome has been implicated in many conditions, but the truth is that this is really nothing new. The great unknowns are the exact mechanisms by which the composition of the microbiome may (and I stress may) be a factor in these conditions, and the science is so young that there simply isn't the evidence to make any definitive claims; given the extreme number of confounders, it's very unlikely we ever will. In this ground-breaking book, surgeon and expert on the microbiome, James Kinross, takes us on a guided tour of our extraordinary inner universe, showing how our relationship with microbes may hold the key to why we are increasingly succumbing to diseases and conditions such as cancer, Alzheimer's, autoimmune conditions and allergies. He highlights how hyperglobalization and our addiction to antibiotics has transformed our internal ecosystems and why this matters so much to our future health and happiness. My general hypothesis is that we are experiencing a fundamental change in the type, number and function of micro-organisms that live within us in the developed world. That has happened over a very short timeframe and the reason for that is not just about diet and food. It’s also about our rapidly changing environment (particularly urbanised environments), which we call the exposome, and the fact that we are now taking lots of medicines, especially antibiotics. Clearly diet is a major driver too and in America and Europe, we now eat a kind of globalised, processed, white, gloopy diet which is very low in plant-based fibres and very high in animal fats and refined sugars.

Dietary and lifestyle changes in westernised societies which seemed a good, convenient, palatable (and, boy oh boy, profitable) idea at the time now emerge as causes of a mass of chronic diseases and damaging health conditions. You and people near you have almost certainly got some. There’s a lot of science in the book to support my hypothesis. It’s for anyone who is interested in how we can improve our health and who wants to understand why we get disease and how to prevent it, so I have tried to make it easy to understand. Love the story about how animals, and humans can have a poo transplant, which in some cases can save your life. But what if I told you that faeces was not toxic waste and that it contained the secret to human health? Would you eat it, if your life depended on it? What if it was rebranded as a faecal microbiota transplant (FMT) or, more accurately, a faecal milkshake given through a tube that passes through the nose into the stomach? You could even take it in the form of a capsule – or “crapsule” – if you wanted.Books» Non-Fiction» Medicine» Pre-clinical medicine: basic sciences» Physiology» Biomechanics, human kinetics We compared these diets to those in Sub-Saharan Africa where rural communities have very high-fibre, plant-based diets. They eat meat very rarely, and when they do, it is very lean. They exercise a lot and live in social communities, where they farm together, cook together and share plates of food. So, they exchange and share microbes through lots of different routes. As a result, they have a much more diverse and resilient population of gut micro-organisms than we do. And how the biome is affected by your social environment; the brain-gut axis looks to be key to our survival. Eat more omega 3 New research suggests a relationship between gut microbes, omega 3 and brain health