Dark Matter: The New Science of the Microbiome

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The sense of revulsion we feel when we’re faced with human excrement (or even just the thought of it) is, in part, a response to the way it looks and smells. But that revulsion is also a psychological reflex, ingrained by potty training and social stigma. This aversion is an important safety mechanism: handwashing and sewer systems prevent the spread of diseases that have killed millions. 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.

Some of these studies are extremely encouraging and offer treatments where few effective medical therapies exist. For example, FMT appears to be a promising treatment for irritable bowel syndrome and a recent study suggests that its benefit can last for many years: 125 patients were randomly assigned to receive either 30g or 60g of faeces from the same donor or a placebo transplant containing their own faeces. Researchers not only found that the FMT improved the symptoms, but there was a lasting benefit three years after it was given. Yet it is only now, as we are beginning to discover the microbiome's enormous potential, that we are realising it is in grave danger, being irrevocably destroyed through the globalisation of our diets, the war on bugs and the industrialised world.I think Dr Kinross is spot on when it comes to the Microbiome being the next very important area for modern medicine to get to grips with. He gives some excellent examples, and some very in depth explanations. Love the story about how animals, and humans can have a poo transplant, which in some cases can save your life. In summary, "Dark Matter: The New Science of the Microbiome" is an enlightening and invaluable resource that I would highly recommend. Whether you're a health professional, a young parent, or simply someone interested in the future of healthcare, this book is a must-read. But what if I told you that faeces was not toxic waste and that it contained the secret to human health? Would you eat it, if your life depended on it? What if it was rebranded as a faecal microbiota transplant (FMT) or, more accurately, a faecal milkshake given through a tube that passes through the nose into the stomach? You could even take it in the form of a capsule – or “crapsule” – if you wanted.

I've long been interested in the microbiome, and have been eagerly awaiting a book that might uncover some of its mysteries. This is that book Heston Blumenthal Our gut microbiome is being badly damaged in our early lives. This not only promotes inflammation and sensitises us to a poor diet, but our microbiomes are less resilient and diverse. That’s why at a population level we’re seeing alarming increases in the risk of colorectal cancer, asthma, allergies, rheumatoid arthritis and other chronic conditions.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 antibiotic addition, industrial food production, the globalisation of our diets and lifestyles, and the destruction of our environment. While an FMT might be a new idea to many of us today, the medical practice of faecal transplant is ancient, and it has been drunk as “yellow soup” since the 4th century AD for the treatment of infective diarrhoea. In 1958 an innovative surgeon, Dr Ben Eiseman, administered faecal enemas to his patients in Denver, Colorado, with severe and recurrent C diff infections. It was remarkably effective, but like all important medical discoveries, this intervention was largely ignored at the time of its first report. 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. Kinross makes it clear that the composition of the microbiome has been implicated in many conditions, but the truth is that this is really nothing new. The great unknowns are the exact mechanisms by which the composition of the microbiome may (and I stress may) be a factor in these conditions, and the science is so young that there simply isn't the evidence to make any definitive claims; given the extreme number of confounders, it's very unlikely we ever will. Spector’s 30-year-long study of 15,000 twins, TwinsUK, and his PREDICT studies have shown that even genetically identical people respond to the same foods very differently (our microbiomes are so variable that twins share only 30% of the same gut microbes). By feeding participants the same meals on different days, he was able to show that responses to the same meals also vary hugely between individuals, influenced by both the microbiome and genetics. This matters, says the ZOE team, because our response to food is linked to our risk of heart disease, type 2 diabetes and obesity, but also because it blows apart the tired and useless mantra “calories in, calories out”, which doesn’t make sense in a world where two people’s blood glucose levels can be hugely different after eating the same slice of cake.