Tana Loy
Associate Medical Writer
As it often happens on my drive
home, I hear a snippet of something absolutely fascinating on NPR, usually on Fresh Air with Terry Gross, and when I
get a chance later, I surf the Web for more information. This week was no
exception. On a recent episode, Terry’s guest was Dr. Martin Blaser, the NYU Muriel G. and George W. Singer Professor of Translational
Medicine, director of the Human Microbiome Program at NYU, and the
former president of the Infectious Diseases Society of America. In addition to
his academic positions, Dr. Blaser has appeared on television programs such as
Dr. Oz and has just released a new book, Missing
Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues.
Yes, a nerdy topic to some, but bear with me—and don’t worry, this isn’t a book
review!
Dr. Blaser posits that bacteria, or
rather the lack thereof, are a plausible explanation for the rise of obesity,
asthma, allergies, and even celiac disease, but he also points out that
bacteria may have therapeutic benefits. All of his research on bacteria is
fascinating, especially his study of Heliobacter
pylori, a microbe that has been shown to cause stomach ulcers and even
gastric cancer, but we are going to concentrate on a couple of topics he
covered in the Fresh Air episode that
may prompt us to make different, maybe even better, decisions about our health
now: the proper development of the human microbiome and the addition of
antibiotics to livestock feed.
The National Institutes of Health
describes the microbiome as “the community” of microbes that exist in and on
our bodies. Those horror movies in which a person becomes a host for a foreign
organism are not exactly farfetched. In fact, about 70% to 90% of cells in the
human body are microorganisms!
Most medical writers have a few
topics about which they are passionate, and for me, maternal healthcare is a
topic I love to research and talk about. I am particularly supportive of
breastfeeding (as is the American Academy of Pediatrics) and of medical and
surgical intervention free childbirth (as appropriate) in low-risk, full-term
pregnancies. In fact, abundant microbiologic evidence suggests that vaginal
deliveries and exclusive breastfeeding may be the best ways of ensuring good
health for newborns. Not surprisingly, Mother Nature knows what she is doing.
Your microbiome starts at birth.
Babies in the womb are essentially sterile, but it is during delivery that they
begin to establish their microbiome. In a 2010 study, Dominguez-Bello et al
showed that “vaginally delivered infants acquired bacterial communities
resembling their own mother's vaginal microbiota, dominated by Lactobacillus, Prevotella, or Sneathia spp., and those delivered
by C-section harbored bacterial communities similar to those found on the skin
surface, dominated by Staphylococcus,
Corynebacterium,
and Propionibacterium
spp.” (Proceedings of the National
Academy of Sciences. http://www.pnas.org/content/early/2010/06/08/1002601107.full.pdf+html)
These results have important
implications for the most basic thing a newborn does—eating!
The mother’s microbiome is so
smart, it actually changes during pregnancy. Her birth canal increases
production of lactobacilli, bacteria that, you guessed it, break down milk.
Long story short—baby is born vaginally, baby is coated with microbes
(including lactobacilli), baby “inoculates” mom’s breast with the bacteria, the
bacteria enter the baby’s gut when she starts to eat, and boom! The microbiome
foundation has been set.
The microbiome matures and
undergoes the most development during the first 2 to 3 years of life, and it
quite possibly sets the stage for many aspects of your health for the rest of
your life. Evidence shows that the interruption in the development of the
microbiome (by, for example, fatty foods or inappropriate use of antibiotics)
can affect many aspects of our health and wellness—even our waistlines. We’ll
come back to that later.
Now let’s switch gears to the use
of antibiotics in livestock feed. In the world of diet and nutrition, where the
“eat this, not that” information is constantly changing, you may have heard
that you should consume only some combination of organic, humanely raised,
grass-fed, free-range, hormone- and antibiotic-free all-natural meat or
poultry. I know, I know, I struggle to keep up with the newest studies, too.
But here is the kicker—does the average consumer understand why he or she
should choose antibiotic-free meat?
The explanation that may first come
to mind is that when we consume meat from animals who have received
antibiotics, it increases our resistance to antibiotics, leading to those pesky
“superbugs.” That may be true, but let’s examine this from a different angle.
These animals receive antibiotics not just to prevent illness linked to
production conditions but also to make them grow! In fact, the antibiotics are
given at subtherapeutic levels, meaning that the amount of antibiotic they receive
would not likely have any effect on harmful bacteria. Dr. Blaser explains that
farmers give antibiotics to livestock because they promote growth. So if
farmers are using antibiotics to promote growth in livestock, are the
antibiotics we take making us fatter? Although they may not be the primary
contributor to an increased risk of obesity, they may certainly be a factor.
Dr. Blaser’s lab conducted
experiments on mice to demonstrate what effect bacteria had on obesity. In one
experiment in which mice were raised on both high-calorie food and antibiotics,
the results of the study were dramatic, particularly in female mice. Those mice
gained about twice as much body fat as a control-group of mice that ate the
same food but did not receive antibiotics. Dr. Blaser concluded that for the
female mice, the antibiotic exposure was the switch that converted more of
those extra calories to fat, but the males grew more in terms of both muscle
and fat. He tells the New York Times
that “the observations are consistent with the idea that the modern
high-calorie diet alone is insufficient to explain the obesity epidemic and
that antibiotics could be contributing.”
It is important to note that most
scientists, Dr. Blaser included, believe in the use of antibiotics when appropriate.
He suggests that a breakthrough in medicine will be the development of
rapid-result tests that can detect the exact harmful bacteria that are causing
illness. With these tests, bacteria-specific antibiotics can be prescribed. In
addition, fecal transplantation is emerging as a treatment for dire infections,
such as from Clostridium difficile.
So let’s look at the big picture.
How can Artcraft Health help? Surely, we can’t address all of the points
covered in this article, let alone all of the different ways our microbiome
affects us. But wait, yes. Yes, we can, and it all starts with patient
education.
Many women (and patients in
general) are not offered health information that is easily understood. They
trust their doctors to make the decisions about their bodies, sometimes with
poor outcomes. But what if women were educated to understand the way their
child enters this world can have long-term effects on their baby’s health?
Would this information change their birth plans or health behaviors during
pregnancy, childbirth, and even general pediatric care? For example, rather
than relying on a broad-spectrum antibiotic to treat an ear infection in a
1-year-old, what if we can offer tests that would indicate a specific
antibiotic for targeting the infection?
Going even further, can we campaign
for more research on the effects of antibiotics in livestock feed? The US Food
and Drug Association has already revised their policies on subtherapeutic
antibiotics in feed. As consumers, and patients, should we seek (or better yet,
be given) information from dieticians and primary care providers about the
potential benefits of organic, antibiotic-free meat?
Above all, it is extremely
important to empower patients and consumers to learn how their bodies have
adapted to our modern lifestyle and to understand the repercussions that our
choices have on all aspects of our health. Everyone has the capacity to
understand any information, as long as it is clear, actionable, relevant, and
engaging (CARE™). Artcraft Health understands the needs of patients, and we can
deliver practical and essential health information through our CARE Principles.
From prenatal care to what chicken to choose at the market, AH delivers.
To learn more about the topics
covered in this post, please visit the following sites:
The Human Microbiome Project
http://commonfund.nih.gov/hmp/index
Guardian article on gut bacteria
analysis and sequencing
http://www.theguardian.com/science/2014/feb/11/gut-biology-health-bacteria-future-medicine
How microbes effect the body
http://www.nytimes.com/2010/07/13/science/13micro.html?pagewanted=all
Antibiotics in food animal
production
Childbirth delivery method and
initial microbiota
http://www.pnas.org/content/early/2010/06/08/1002601107.abstract
Modern use and consequences of
antibiotics
http://www.nytimes.com/2014/03/09/opinion/sunday/the-fat-drug.html
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