As I said in our article a couple of weeks ago, ahead of the publication of, Our Future is Biotech, we will be sharing some key ideas from the book which I hope you might find interesting and possibly even helpful for your health and mental health too.
A key theme in the book is the structural investment opportunity in biotech and the enormous real wealth creation I believe is coming from the industry, but there is also a great deal about health and healthcare as you might expect, a key element of which is the focus of today's email.
In our last article, we published a piece focused on why so many "diseases of modernity" are on the rise.
As I explained - a key theme in my new book 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, and a raft of other autoimmune diseases including rheumatoid arthritis, coeliac disease, myositis and lupus. Depression, many other mental illnesses, Autism Spectrum Disorder (ASD), and obesity have all risen enormously in recent decades too.
Increasingly, the research is showing that a key causal factor in all of this, which, so far at least, has been given insufficient focus by healthcare systems and clinicians alike, is the crucial role played by the bacteria and viruses we each carry; the role played by our “microbiome”.
We have considerably more bacterial and viral genes, cells and particles in us and on us than human cells and genes. As I mentioned in that last piece, we are each host to tens of millions of bacterial genes as compared to only 20,000-25,000 human genes.
In terms of cells: For some decades, researchers estimated that there were about ten times as many bacterial cells as human cells in our bodies. More recent research has updated this, and it is now estimated that we carry approaching forty trillion bacterial cells and tens of trillions more viral particles over and above “only” thirty trillion or so human cells.
The latest research is showing that this reality is incredibly important for our health. So many of these diseases of modernity are on the rise because of the extent to which we have altered the composition of our microbiome over a century or more.
1,000 times more bacteria than us...
These ideas become particularly compelling when you consider that there is around one thousand times the biomass of bacteria on our planet than of human beings. As I say in the book:
“Even with a population of around 8 billion of us, it has been estimated that human beings make up only approximately 0.1 per cent of all the biomass on earth. Bacteria, on the other hand, comprise fully 12.8 per cent. People sum to only 0.06 gigatonnes of the biomass of life. Bacteria total more than 70. They are more than one thousand times more consequential in terms of life on earth than we are, and this is even before we consider fungi and archaea which comprise another 19 gigatonnes.”
It seems increasingly likely that many of the biggest problems we currently confront as a species may have quite a bit to do with our impact on that microbial biomass, particularly since the Agricultural and Industrial Revolutions, and their impact on us in turn.
In the book, I spend some time looking at how this reality goes a long way to explaining why there can be such conflicting and confusing advice about “the right” diet.
Crucially, our biome, virome and genome are highly differentiated and incredibly personal to each of us. This is why, as a March 2021 article published by Healthline puts 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.”
It is becoming increasingly clear that our genome has an important role to play in diet and, in reverse, our diet may affect our genome, too.
This is the focus of the emerging field of ‘nutritional genomics’. The field is split into ‘nutrigenomics’ and ‘nutrigenetics’. Joanna Janus of the PHG Foundation at the University of Cambridge explains:
"Nutrigenomics assesses how nutrition affects genome regulation. Nutrigenetics investigates specific genetic variants that regulate nutritional processes."
Put simply – our genetic make-up can impact our ability to assimilate nutrition, and the quality of our nutrition, particularly over long periods of time, can impact the functioning of our genes. There is a circular relationship.
The idea that our genes might affect our relationship with food has been around for several decades. It was initially not taken particularly seriously by the medical or scientific establishments. There were many slightly fringe, self-proclaimed nutrition ‘experts’ touting one diet or other based on this broad worldview. Relatively well-known examples include diets based on your blood type which were particularly popular in the 1990s with proponents selling many millions of books on the subject.
The basic thesis was that certain blood type groups respond better to a vegetarian diet and others to a diet heavier in meat and fish. Over thousands of years of evolution, proponents of this thesis suggested, human beings in different parts of the world adapted to their surroundings and ‘optimised’ genetically to the foods that were most readily available to them in their immediate vicinity. One of those genetic adaptations, they argued, was their blood type.
Northern Europeans and hunter gatherers tended to have a high protein diet given how much fish and meat they consumed as a natural function of the way they lived and of their environment. The implication was that such people would then be ‘healthier’ consuming that diet, given they had adapted to it over thousands of years. People in primarily agrarian societies who secured the majority of their calories from plants and grains, in places like the Indian sub-continent for example, would be better served by a vegetarian or vegan diet.
Many scientists and clinicians have subsequently found fault with the blood-type thesis specifically, based on the analysis of large datasets, and suggested that there is little or no scientific evidence to support eating based on your blood type.
However, even if the blood-type diet may have been on the wrong track, by now there seems little question that the complex interplay between your genetic make-up and your diet will certainly be consequential for your health and for working out which diet is ‘right’ for you.
Other memes which have emerged around a genetic basis for diet include ideas such as the supposed remarkable health of certain ethnic groups, particularly those still ‘living as they always have’ – a dangerous and simplistic idea.
Two particular examples of this which are often cited and seem to have entered our collective consciousness over time are the Maasai in East Africa and the Inuit peoples of northern Canada, Greenland and Alaska.
Countless articles and more than a few compelling-sounding television documentaries have highlighted the fact that both of these two peoples consume diets which are very high in fat and protein and relatively low in vegetables or fruits, yet they exhibit much lower rates of the illnesses those of us in the developing world invariably assume would result from such a diet. Such findings are often used by proponents of high protein, high fat diets such as the Atkins or ‘carnivore’ diets to support their position.
Carnivores versus vegetarians...
At the other end of the argument, advocates of vegetarian or vegan diets have their own examples of remarkably healthy peoples to point to. Well-known examples include the Okinawans in southern Japan and the rural Chinese. As a 2009 study of the Okinawans by Craig Willcox and colleagues has put it, they ‘are known for their long average life expectancy, high numbers of centenarians, and accompanying low risk of age-associated diseases’.
That same study highlights the fact that the Okinawan diet is ‘vegetable and fruit heavy (therefore phytonutrient and antioxidant rich) but reduced in meat’.
Another famous piece of research was conducted in the 1980s by academics from Cornell and Oxford universities working with the Chinese Academy of Preventive medicine. According to the Center for Nutrition Studies, that study:
“…embarked upon one of the most comprehensive nutritional studies ever undertaken known as the China Project. China at that time presented researchers with a unique opportunity. The Chinese population tended to live in the same area all their lives and to consume the same diets unique to each region. Their diets (low in fat and high in dietary fiber and plant material) also were in stark contrast to the rich diets of the Western countries. The truly plant-based nature of the rural Chinese diet gave researchers a chance to compare plant-based diets with animal-based diets.”
The study came down heavily in favour of plant-based nutrition.
‘The evidence’ from the Maasai and the Inuit and ‘the evidence’ from the Okinawans or rural Chinese go some way to explaining why it is possible to find numerous books which ‘scientifically prove’ that if you want to maximise your chances of being healthy you should almost certainly be vegetarian or vegan and plenty of others which ‘scientifically prove’ that you should do the precise opposite, fill yourself full of meat and fat and limit your intake of carbohydrates.
How can there be such confusing and conflicting advice?
In recent years, the science suggests that the answer is actually relatively simple: there is a key missing link – a factor that hasn’t been given sufficient consideration.
Crucially, few of the analyses of these diets have taken account of the role played by bacteria and viruses – of the biome, virome and, to a certain extent, of the genome too when it comes to our diets, either sufficiently or at all.
Scientists have become increasingly interested in the role played by our genes when it comes to diet, as we have seen.
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 cells and viral particles in each of us and this, in turn, will impact our health. As reported in ScienceDaily, a 2019 University of Pennsylvania study found:
"Our microbiome [...] reflects the way we live. If we own a pet, we likely share microbes with them. If we eat meat, the microbiome in our intestines may look different from that of a vegan."
If we grow up on a farm, our microbiome will be fundamentally different from that of someone who grows up in the centre of Manhattan. If we grow up in southern Japan, it will be very different to what it might be had we grown up inside the Arctic Circle.
Crucially, our biome then has a fundamental role to play in how we assimilate nutrients – in how we react to food. The fact that people in Okinawa, Alaska and Tanzania can consume such wildly different diets yet still have lower rates of all sorts of Western diseases is a function of this reality.
These peoples have different health outcomes on different diets partly because they are different genetically, but arguably more important than that, because they have different microbes – inside them and also around them in their environments – and the same is very likely true of all of us.
Our diet and our genes are important, but arguably even more so is the complex interplay of such things with the composition of our microbiome.
In our next article – we’ll look at these ideas in more detail and the key role played by the microbiome and "dysbiosis" with respect to obesity.
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!