What do you think of when you hear the term “gut health?” Everything from what we eat and drink and our lifestyle choices to whether we overuse antibiotics affects what is called our microbiome, which in turn, impacts our immune system.
The microbiome is a compilation of all the microbes and bacteria in our stomachs, on our skin, around our mouth and in our nose, that help determine our overall health. Keeping our microbiomes healthy and in balance helps lower the risk of illnesses, including cancers.
Husband-and-wife team Dr. Martin Blaser, the Henry Rutgers Chair of the Human Microbiome and professor of Medicine and Pathology & Laboratory Medicine at Robert Wood Johnson Medical School; and Dr. Maria Gloria Dominguez-Bello, also a Henry Rutgers Professor of Microbiome and Health in the Departments of Biochemistry and Microbiology & Anthropology at Rutgers University, are researching the microbiome and their work has been featured in a documentary.
They’re also researching babies’ microbiomes through New Jersey, studying how factors like being born by C-section or not being breastfed affect the development of children.
Here, Drs. Blaser and Dominguez-Bello share why we need to be aware of our microbiome and how this emerging field of science and medicine is trying to heal the human body.
New Jersey Family: What is the microbiome?
Dr. Martin Blaser: The microbiome is all the microbes that live in and on the human body in places like the intestinal tract, the mouth, the nose, the ears, the vagina, the skin, and any place where there’s a surface. The gut is the major location of the microbiome, and the gut has connections to all parts of the body: to the brain, to the heart, to the liver, and the reproductive system. It’s all linked, and scientists are trying to figure out the linkages.
There’s evidence that in our modern age, our microbiome is different from that of our ancestors. We have evidence that we’ve lost about half of our gut microbiome diversity. We’re living well, but we’re concerned that certain diseases are rising, diseases that were never a big problem before, like asthma, food allergies, obesity, certain kinds of diabetes and autism.
NJF: What is causing the microbiome to change?
Dr. Blaser: Babies always used to be born vaginally. Now in the United States, about 1 in 3 babies is born by C-section. They miss the passage through the birth canal, and that’s when the microbiome gets established in babies.
Babies always used to be breastfed, and now, there’s much less breastfeeding than there used to be. Breast milk has important nutrients for the microbiome.
Dr. Maria Gloria Dominguez-Bello: Every time we use antibiotics, metabolic development and immune development are at risk of being altered, which can increase disease risks. Antibiotics impact the gut microbiome, which can cause obesity. This has been shown in animals; farmers are using antibiotics to feed their animals, because they grow bigger faster, and they can sell them earlier.
There may also be a correlation between behavioral diseases, like ADH or autism and the microbiome, and this is something actively being investigated by scientists, including us. We are collaborating with neuroscientist Emmanuel DiCicco-Bloom and looking at the effect of C-section birth, and antibiotics on mouse brain proteins and gene expression.
NJF: What are the links between the microbiome and illnesses?
Dr. Blaser: When people have a disease, it changes their microbiome. Think about it as a population of green and red and white organisms, and there’s some mixture of them in every person. When you have a disease, you’re going to change the representation of those colors in the mix, and that can impact the way our bodies work.
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NJF: How does this relate to cancer specifically?
Dr. Blaser: If somebody has cancer and you develop treatments that affect the microbiome, can you change the course of the cancer? We already know that in part the answer is “yes.”
For example, there are a group of drugs used in cancer treatment called immune checkpoint inhibitors. These are drugs that unleash the immune response to fight against cancer, and they’re pretty good drugs, but they have some limitations. It was recently found that if you alter the microbiome, you can make those drugs work better and have better results in treating cancer. This is a very good example of how affecting the microbiome can change your health outcome in people who are ill.
There’s another very good example. There’s a disease of the intestine called C. diff infection. This is an infection that often happens when people take antibiotics. What’s found is that when they have C. diff infection, their microbiome is markedly abnormal. About 20 years ago, scientists found that if you give people a fecal transplant– meaning you give them normal feces, either orally or rectally– you can cure their disease. That’s a remarkable concept that giving somebody poop is going to make them better.
We are interested in the fact that estrogens, the important hormones especially in women, circulate through the intestine. As part of their metabolism, they go through the intestine. The microbiome has a role in regulating estrogen levels in the body. We’re studying that because there are several estrogen-related cancers, like breast, ovarian, uterine or endometrial cancer. That’s a very active area of research.
Dr. Dominguez-Bello: There’s a big study from 30 years of data on nurses in the United States who develop breast cancer. They see that those who develop breast cancer were exposed to more antibiotics. This does not mean that antibiotic use is a cause of cancer, but it does tell us that there may be a relationship between the two.
Colon cancer is also associated with high antibiotic use in early life.
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NJF: What are some dietary rules to keep your gut healthy?
Dr. Blaser: High-fiber foods, which are what our ancestors used to eat, are good. So, recommendation number one is fiber. Recommendation two is fiber. Recommendation three is fiber.
Recommendation four is: to make your food as diverse as possible. That means plant-based food. Each plant is chemically different, and those chemicals are food for the microbiome. If you give someone bread, cake, etc., it’s all the same ingredients. Meats are all generally the same. But spinach is different from carrots, is different from tomatoes, is different from apples, etc.
Dr. Dominguez-Bello: We need very little or no processed foods. I understand that we love ice cream and we love bread, but the point is to make them a very minor part of the diet and to fill your diet with natural products.
And we need exercise. It’s not natural to be sitting eight hours a day. Walking is probably the most natural thing humans evolved to do, but sports, yoga, and keeping the body in shape are crucial for health. There is a field of research about how exercise changes the microbiome as well.
NJF: What’s the real scoop on probiotics?
Dr. Blaser: I can’t make a statement about probiotics except to say that they’re generally safe, but also generally untested. I’ve been eating yogurt every day for 50 years to get naturally occurring probiotics.
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NJF: Why is it important to protect your kids’ microbiome health?
Dr. Dominguez-Bello: We are concerned about the link between the microbiome and health problems such as asthma and food allergies. The New Jersey Kids Study follows a cohort of babies from birth to see their microbiome maturation trajectories as children develop, and their future health.
We recruit pregnant moms because we know that in utero, the maternal microbiome affects the baby. For example, if the mother takes antibiotics during pregnancy, that will affect the baby’s microbiome after birth. Babies start to develop their microbiome during birthm when they leave the utero and cross the birth canal, heavily colonized by beneficial bacteria that will be boosted by maternal milk.
Then the first microbes the baby acquires talk to the immune system, the metabolic system, and the brain which are developing. It is a delicate dance choreography that if perturbed, has developmental consequences.
It is a long project because we must wait about five years to start seeing whether we can observe increased asthma, or allergies, etc.
For more information, an independent film based on Drs. Blaser and Dominguez-Bello’s work called “The Invisible Extinction” (theinvisibleextinction.com) is available to watch on Amazon, Apple, iTunes and Vimeo. You can view the trailer using the password “microbe”.
Maria Gloria Dominguez-Bello is a Henry Rutgers Professor of Microbiome and Health in the Departments of Biochemistry and Microbiology & Anthropology at Rutgers University in New Brunswick. She is the president of The Microbiota Vault; and a Fellow for the Canadian Institute for Advanced Research (CIFAR).
Martin J. Blaser, M.D., is the Henry Rutgers Chair of the Human Microbiome and Professor of Medicine and Pathology & Laboratory Medicine at Robert Wood Johnson Medical School. He is the director of the Center for Advanced Biotechnology and Medicine at Rutgers University.
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