Ideally, we need to nurture our gut microbiome from birth. I think that this is so important, that it should be a given human right. One of the ways to do this is for women to breastfeed if they can and for children to have all their vaccinations – that way, they’re much less likely to need antibiotics. When used correctly, antibiotics save lives, but overuse causes more harm than good. We also need our children to play outside with other children and to have a diverse diet that is high in fibre and low in saturated fats. Have you made changes in your own life because of what you’ve learnt about our gut microbiome? In this mindblowing book, scientist and surgeon James Kinross explains how the organisms that live within us have helped us evolve, shaped our biology and defined the success of our species. But just as we have discovered this delicate and complex ecosystem within us, it is being irrevocably destroyed through the globalisation of our diets and lifestyles, our addiction to antibiotics, and the destruction of our environment. With dazzling science and fascinating stories spanning from the dawn of humankind to the current race to develop personalised healthcare, and practical advice on how to nurture your microbiome through your diet and lifestyle, this pioneering book will change the way you think about human health forever. I knew the gut microbiome was important to our health and I wanted to focus my future career on understanding how": Meet James Kinross A microbiome refers to all the microscopic organisms within a particular environment, and all of the things that they need to sustain themselves. They exist at lots of different scales and we have them all around, on and inside us. So, for example, our planet has a microbiome and we have microbiomes on our skin and in our lungs and in our gut. Our microbiomes have evolved with us and they change and grow with us over our lifetime. They have an important symbiotic role in our health: they need us to survive, but we need them too. Why is the gut microbiome important?

Our gut microbiome is responsible for educating our immune systems as we grow and for controlling how those immune systems function later in life, as we age. We are just now starting to understand the role our gut microbiome plays in defining our risk of chronic or non-communicable disease and conditions, such as diabetes, arthritis, allergies and cancer. How did you become interested in this area? An urgent investigation into a brave new world in science - the microbiome - and how it could save our health. 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. 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.

Podcast

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? The logistics of preparing an FMT should not be underestimated. Faecal donors have to be found – harder than you might think. Most of us are squeamish about pooing in pots, and we struggle to do it on demand. Some studies use friends and families, others use members of staff, volunteers or “pooled” samples taken from lots of donors mixed together. Eat more omega 3 New research suggests a relationship between gut microbes, omega 3 and brain health And how the biome is affected by your social environment; the brain-gut axis looks to be key to our survival. An Imperial surgeon specialising in the gut microbiome has published a new book to explain why it is important for our health.

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. His recent book, Dark Matter, looks at the role of micro-organisms – harmful and helpful – in our bodies and the impact on our health of their imbalance in our system and in the world around us. In this blog*, Dr James Kinross tells us more and offers some tips. What is a microbiome?Engaging ... [ Dark Matter] stands out in revealing the microbiome through the eyes of a clinician who sees each patient not just as a human, but as a human entwined with a complex, dynamic ecosystem New Scientist

Spector hopes his tests – which don’t just test for microbes, but also assess blood fat and blood glucose responses to specific foods – will change this. “We’re just starting to get to the point where we can suggest individualised foods. This is not just isolated microbiome testing,” he says. “We have trials in place to quantify this, but the initial results are exciting, with nearly everyone reporting weight loss and improved energy levels without any calorie counting or traditional weight loss methods. Previous microbiome tests have been sub-optimal [but the] ZOE approach is completely different: using state of the art sequencing allows us to detect species and strains and find strong associations between these microbes and both foods and health.”Ray was readmitted to St Mary’s critically unwell and was soon diagnosed with Clostridium difficile (C diff) infection (officially, this bacteria has now been renamed Clostridiodes). A “hospital-acquired infection”, this disease is a complication of 20th-century medicine and an unintended consequence of Alexander Fleming’s discovery of penicillin, the first effective mass-produced antibiotic, in 1928. It is a global problem that afflicts 500,000 people in the United States each year and it kills 29,000 of them. 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. I was keen to bring together all the work going on in microbiome science, because it creates such a compelling argument for taking it seriously. It’s not just about the gut: it’s about the human microbiome. 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. If you're a young parent, this book is particularly crucial for you. The gut microbiome plays a significant role in the health of young children, and Kinross provides actionable insights on what can be done to ensure better health for our children in the future.

More than half a century later, the Dutch gastro- enterologist Josbert Keller and his team at the Amsterdam Medical Centre randomised patients with recurrent C diff into three groups. The first group received vancomycin, a wash-out of the colon using a strong laxative, and a faecal transplant. The second had vancomycin and the colonic wash-out, and the third just received vancomycin. The FMT group did so much better than the other two groups that the study had to be stopped early, as it was deemed unethical to continue. 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.

Fermented foods are now thought to be integral to a healthy gut because they provide a vast amount of natural probiotics which can boost immunity and soothe the digestive tract. Johnny Drain is a materials scientist and a chef who believes in the benefits of fermentation, and has looked worldwide for innovations in techniques and flavours. An urgent investigation into the brave new world of the microbiome and how it shapes our lives and health. A very small Italian study using a similar commercial probiotic, Sivomixx, piqued his interest after it suggested acute Covid patients treated with it might be less likely to end up in ICU or to die, and eight times less likely to suffer respiratory failure. Bjarnason is hoping to start a larger study in the next few months. Books» Non-Fiction» Medicine» Other branches of medicine» Pathology» Medical microbiology & virology We're trying to engineer the microbiome to improve cancer therapy. I've got a really great PhD student looking at how bacteria might reduce the adverse side-effects of chemotherapy. The chemotherapy agents we use are toxic to all cells, not just cancer cells. We want to see if the microbiome may have a role in protecting normal cells.