Ahead of the publication of my new book, Our Future is Biotech, we will be sharing some of the key ideas contained in the book which I hope you might find interesting.
The middle section of the book is all about biotech's potential impact on our health and mental health. A key theme within that is the extent to which a large number of “diseases of modernity” and disorders have risen enormously in the last few decades.
These include diabetes, epilepsy, asthma, inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), debilitating allergies such as hay fever, nut allergies and eczema, and a raft of other autoimmune diseases including rheumatoid arthritis, coeliac disease, myositis and lupus.
Most of us are also more than familiar with the extent to which depression, other mental illnesses, Autism Spectrum Disorder (ASD), and obesity are rising at an alarming rate in many parts of the world.
The book shows how this isn’t just a function of improved rates of diagnosis. When researchers adjust for that factor, these many diseases and disorders of modernity really are significantly on the rise.
Levels of diabetes are up between 10 and 20 times in less than a century. Coeliac disease is 30 or 40 times as common today as it was in the 1950s, and we have seen the rate of asthma grow from about one child per school to a quarter of all children in less than a century. Similarly, peanut allergies trebled in the last decade of the twentieth century, and then doubled again in the five years after.
When it comes to rates of obesity, in the USA in the early 1960s, 13 per cent of the adult population were obese. By 1999 this proportion had more than doubled to 30 per cent. These numbers have continued to rise: Today it is estimated that more than 70 per cent of North American adults are overweight or obese. The same has been seen in many other developed world countries including in the UK and Australia.
In the book, I look at why this has happened and what we might be able to do about it. One of the key themes with respect to that is our increasing understanding of just how important the microbial world has been in all of the above.
Modernity and affluence?
A key clue to a causal relationship here lies in the differing experiences of the growth trajectory of such chronic conditions in the developed world as against in the developing world.
These diseases of modernity are very significantly less prevalent in the developing world than in the developed world. There is a clear correlation between modernity and affluence and the rise of chronic disease. The incidence of diabetes is sixfold higher in Finland compared to the adjacent Karelian republic of Russia, although the genetic background of the population is the same, for example.
Similarly, migration studies have shown that offspring of immigrants coming from a country with a low incidence of a given disease or health condition acquire the same incidence as the host country, as rapidly as the first generation. This is well illustrated by the increasing frequency of diabetes in families of immigrants from Pakistan to the United Kingdom, or the increasing risk of MS in Asian immigrants moving to the United States. The prevalence of systemic lupus is much higher in African Americans compared to West Africans, and rates of ASD far higher in Somali immigrants to the US than in Somalia.
Even within a given country, numerous studies have shown a correlation between wealth and chronic illness. After (poor) East Germany reunified with (wealthy) West Germany in the early 1990s a study showed that the richer West German children were twice as likely to have allergies than their East German compatriots.
Put simply, the more successful a nation state has been at eradicating infectious disease, and the wealthier a given population is, the more of a problem they have with chronic illness. It seems increasingly clear that these are two sides of the same proverbial coin.
Why?
In the book I explain the key causal role of microbes and the microbial world in all of this.
The Human Genome Project has estimated that humans have between 20,000 and 25,000 human genes. Crucially, this is a tiny fraction of the number of genes that are found in our microbiome - that is to say in the trillions of bacteria, viruses and fungi that lurk in us and on us.
As reported in ScienceDaily in 2019, a team of scientists at Harvard Medical School “set out to estimate the size of the universe of microbial genes in the human body”. They found that there were nearly 46 million bacterial genes alone in our microbiome (as against only 20-25,000 of our own human genes as given above)!
In recent years it has become increasingly clear that our microbiome has an extremely important role to play in our health overall. As that Harvard study put it:
“Mounting evidence has revealed the role of [...] microbes as powerful modulators of disease and health [...] linked to development of conditions ranging from [...] dental caries and gut infections to [...] chronic inflammatory bowel disease, diabetes and multiple sclerosis.”
As another clue to just how important our microbiome is for our health – some 80 per cent of our immune system is found in the gut. Crucially, our gut is also where an estimated 95 per cent of our microbiota can be located.
There is a key causal relationship between the quantity and quality of our gut ‘flora’ and the efficient functioning of our immune system and, by extension, our health overall.
Dysbiosis
‘Dysbiosis’ is the term used to describe a compromised or imbalanced microbial community in the human gut. Research conducted over the last several years has implicated dysbiosis in disease after disease, including essentially all of these chronic diseases of modernity as well as cancer, obesity and a wide range of mental health conditions, including depression.
It is also increasingly clear that there is a link between the health of the digestive system and the development of neurological and psychological disorders and a number of other conditions, including, anxiety, schizophrenia and Autism Spectrum Disorder.
When we consider the list of things which cause dysbiosis, we find the causal link between reducing rates of infectious disease and rising chronic illness and can see clearly why those illnesses are so often diseases of affluence and modernity.
Specifically, risk factors for dysbiosis include: a poor diet, including too much sugar (and alcohol) and processed foods; the ‘accidental’ consumption of chemicals such as those commonly found in pesticides and elsewhere in the consumer products of our modern, industrialised world; excessive use of antibiotics, and high levels of stress. As should be abundantly clear from this list, all of these factors correlate with rising development and affluence, particularly the use of antibiotics, for example.
It is becoming abundantly clear that a modern, affluent, excessively sterile and overly medicated lifestyle, particularly when it involves the use of large quantities of antibiotics, can significantly compromise our gut flora and, by extension our immune system and our health. This is highly likely to be one of the key common causal factors leading to the rise in so many chronic health conditions all over the world and in the developed world in particular.
That is the bad news. The good news, however, is that we seem to have finally worked out what the problem is and, increasingly, what we might be able to do about it.
Of course, we don’t want to lose so many of the benefits of modernity and, most particularly, our ability to fight infectious disease with anti-microbials and vaccines. Giving up such things would take us back to a world where hundreds of millions of us might die unnecessarily. Surgery would become prohibitively dangerous, for example.
Equally, however, we don’t want our societies to continue to endure this inexorable rise in diabetes, obesity, depression and so much else besides, which have come as a natural consequence of that modernity and of our use of vaccines and antimicrobials.
Happily, it is highly likely that we will be able to ‘have our cake and eat it’. Part of the reason I believe this to be the case has to do with the fact that the wealthiest within society have shown themselves most able to avoid much of the chronic disease epidemic.
This is because such individuals so often have access to the latest and best health information, the best healthcare, and the freedom in terms of time and money to make the healthiest choices around diet, exercise and supplementation for example.
Economic growth and technological development will make these advantages available to an increasing percentage of the population, just has been the case with every other element of human progress since the Industrial Revolution, whether the radio, car, plane, television, personal computer or smartphone.
If there is one primary solution to so many of these diseases of modernity, it seems likely to lie in our ability to deal with dysbiosis, particularly in our children as their gut flora develops. We need to ensure that our microbiota and our immune systems and those of our children, do not become excessively compromised by these various risk factors of modernity.
Encouragingly, to do that we may need nothing more than better information and a willingness to take consistent action and implement habits which reduce the risk of dysbiosis and the many health problems it can inflict.
For many, repairing a compromised gut microbiome with all that this implies for the effective functioning of their immune system and a reduction in chronic disease, may ‘only’ require better diet and nutrition, supplementation with probiotics and a number of lifestyle choices around things like sugar consumption, sleep, exercise and the ability to deal with stress. At present, too few people have sufficiently good information about such things, but I would argue that this is changing and will likely do so at an exponential rate going forwards, in large part thanks to the biotech and tech industries.
In our next article – we’ll look at these ideals in more detail – particularly when it comes to how we think about diet and the key role played by the microbiome and dysbiosis with respect to obesity.
As a March 2021 article published by Healthline has put it:
‘If there’s one thing the last several decades of nutrition research have proven, it’s that there’s no one-size-fits-all diet. While many factors are at play, one reason certain eating plans work for one person but not another may have to do with our genetics.’
But there is a great deal of evidence by now that it goes much further than genetics alone. Our environment, our genes, our diet and our lifestyle will impact those trillions of bacterial and viral cells in each of us and this, in turn, will impact our health.
If you’d like to make sure that you get the full text on all of the topics above, and so much else besides, please do consider ordering a copy of the book ahead of publication later this month.
...and finally
By the way - if you run a business and would like to bring these ideas to your team, we’d love to hear from you. The publisher can make the book available at competitive discounts when purchased in bulk across both physical and digital formats – and can offer bespoke editions featuring corporate logos, customised covers and even messages from senior management in the “front matter”. If this would be of interest – please do let us know!