Germs in Your Intestine - Something New in Medicine!

One of the biggest new stories in medicine is the relationship between the gut bacteria, also known as the microbiotome, and your health.

In previous posts I have mentioned how changes in these germs can increase risk for:

• Obesity
• Asthma
• Diabetes
• Ulcerative Colitis and Inflammatory Bowel Disease
• Melanoma

Now more provocative information has been published.

Microbiotome can affect your response to Cancer Chemotherapy:

In an immune therapy for Melanoma, researchers found that only in the presence of a certain gut bacteria would the therapy be able to cure the cancer!

Anthony L. Komaroff, MD Reviewing Snyder A et al., Science 2015 Nov 27; 350:1031

Also, stool transplants (frozen capsules of stool bacteria) has become the most effective treatment for a potentially fatal colon infection (Clostridium).

The medical has been responding to this news - antibiotic use has decreased by about 25% between 2000 and 2011 in the US,

Thomas Glück, MD Reviewing Frenk SM et al., J Antimicrob Chemother 2015 Oct 12

Look for more news as we learn more about the unique relationship between gut microbiotome and disease. One day forms or probiotics will become adjunctive or primary treatment for many diseases!

Too Many C-Sections

Many people think that the US is doing too many Cesarean sections; for many reasons including malpractice concerns, convenience, and financial gain.

But is this reality? What is the appropriate rate?

When looking at smaller numbers we realize that every delivery is different. However, in a recent study, researchers looked at cesarean delivery rates and morbidity and mortality data from 194 World Health Organization member nations from 2005 to 2012. They found that rates of about 19% were associated with the lowest maternal and neonatal mortality. This is counter to the 15% rate many have suggested as ideal.

So how are we doing? Very poorly. In 2013, the CDC reports that 32.3% of all births were by C-section. In Puerto Rico it was 49%; Louisiana, Florida and New Jersey were close at 38%. The best states were Utah, Idaho, Hawaii and Alaska at rates of 22-25%.

In Canada, the rate was 17% in 1995, but has now climbed to 27%.

So yes, we are doing too many C-sections. If you can. check out your doctors record and willingness to allow labor to proceed when the mother and child are not in danger. Not only are many C-section unnecessary, but they are actually harmful to the mother and child!

JAMA, December 1, 2015, Vol 314, No. 21

http://jama.jamanetwork.com/article.aspx?articleid=2473490

"Idiocracy" and The Idiot Box

In 2006 Mike Judge wrote and directed a movie, "Idiocracy" based on a concept that 500 years in the future humanity would have evolved downward towards lower intelligence.

In a recent study, Steven Dubovsky, MD Reviewing Hoang TD et al., JAMA Psychiatry 2015 Dec 2, the researchers discovered that we are dumbing ourselves through our lifestyle.

They reviewed self reports on TV watching and exercise of over 5,000 adults who had been followed for 25 years. After adjusting for factors such as illness and smoking, they found a long-term pattern of low physical activity was associated with significantly slower processing speed. Watching television for >3 hours/day had significant associations with slower processing speed and poorer executive function. Participants with the lowest level of physical activity and the most television watching had the slowest processing speed and worst executive function.

This study began in early adulthood; one can only guess about what effect it is having on our children!

Perhaps less intelligent people watch more TV and exercise less because they are less intelligent. But would you take that chance with your kids?

Screen time should be restricted in children (and adults), and regular exercise strongly encouraged. Next time you go out to dinner count how many people are not on a device - it will be easier than those with their faces in their phones. Perhaps if we don't change soon Mr. Judge's prophesy will become reality!

Environment Health and Good Germs

More studies are beginning to show that our bodies are actually in quite a delicate balance with our environment; and this can easily be destabilized by medical intervention.

We already know that changes in the bacteria, or germs, that grow in our intestines can lead to obesity and autoimmune diseases. As well, there is a severe intestinal infection, known as Clostridia, which results from antibiotic treatment, is best treated by changing the bacteria in our gut (using a "stool transplant" in a frozen prepackaged capsule).

In a recent study, researchers found that children at high risk for asthma (defined as wheezing and positive skin prick tests at age 1 year) had received more courses of antibiotics during their first year of life, were more often born by caesarian section and were more often exclusively formula fed. They found that certain bacteria were less likely to be found in their intestines.

Sci Transl Med 2015 Sep 30; 7:307fs39

In a second, JAMA Pediatr 2015 Nov 9, researchers gave probiotics during the first month of life to a group of infants who had a genetic marker associated with type 1 diabetes. They found that there was a 40% decrease in development of diabetes in these children during the 10 year followup.

The environmental influences of intestinal bacteria are related to breast feeding, as well as normal behavior where children "taste" everything. We have discovered that exposure of babies to "dirt" or things they normally pick up is a normal adaption that actually prevents autoimmune diseases and allergies.

We need to, within reason, allow our babies to be "dirty", try and breast feed for at least 6 months (a year is preferred), and avoid antibiotics unless absolutely necessary. This includes eating foods or meats that have been treated with antibiotics.