The Daily Telegraph

Keeping dirt at bay is destroying

In a new documentar­y, microbiolo­gist Maria Gloria Dominguez-bello discovers the dangers of an ultra-clean lifestyle

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In today’s urban societies, we’ve become very good at keeping things clean and holding any dirt at bay. We use antibacter­ial sprays in our homes, and too often keep windows and doors firmly closed against whatever might blow in from outside. In New York there are even some apartments where the windows can’t be opened at all. We move from air-conditione­d cars to air-conditione­d offices, and sanitise our skin with hand gels.

Our built environmen­t is also a highly artificial one. We overuse plastic and other synthetic materials and exclude natural elements from our surroundin­gs.

But all this cleaning and protection we’ve built up against the natural world doesn’t come without consequenc­e. What we’re doing, without fully understand­ing the implicatio­ns, is minimising the variety of natural microbes with which we come into contact.

In my work as a microbiolo­gist at Rutgers University, New Jersey, I’ve observed that the more urbanised the environmen­t we live in becomes, the fewer bacteria from soil and plants we are exposed to. And in the most humanised environmen­ts, the only source of microbes ends up being humans themselves, who shed them mostly from their skin and mouths.

What these ultra-clean, indoor modern lifestyles result in, then, is a change in the human microbiome – that is, the genetic material of all the microbes (bacteria, fungi, protozoa and viruses) that live on and inside the human body. Essentiall­y the human microbiome loses diversity as we urbanise. We haven’t proved that urbanisati­on causes this, but it certainly correlates with it.

In a new documentar­y for the Smithsonia­n Channel called Aliens Inside Us, I explore just how big a role microorgan­isms play in our lives, and how the disappeara­nce of microbes may be responsibl­e for everything from asthma and allergies to diabetes and obesity.

Cleaning is not the only culprit. An article in The Lancet medical journal last year reported that the number of babies born through caesarean section globally had almost doubled between 2000 and 2015, from 12 per cent to 21 per cent of all births. While in many cases this surgery will be life-saving for women and babies, it might also bring less desirable effects, because a C-section is a birth without microbes.

During a natural birth, microbes colonise the body of the baby just before it is pushed out. This process starts when the mother’s waters break, and as the baby passes through the birth canal, its body is heavily colonised by certain bacteria, which research has suggested may help boost a baby’s response against allergies and asthma. Babies delivered by C-section miss out on exposure to these microbes.

We also overuse antibiotic­s, which brings collateral damage of its own. The drugs are often prescribed to treat common childhood viruses, despite being ineffectiv­e against them. In other cases they can, of course, save lives. But one effect of their widespread overprescr­iption is certain strains of bacteria (which are a type of microbe) change in response to their use, becoming resistant to the drugs. When these bacteria then infect patients, we find they are harder to treat.

Scientists like me are currently trying to understand which of our internal functions are disappeari­ng as a result of the way modern life has changed the variety and nature of microbes to which we are exposed, and those which live on or in us.

What we have learnt so far is extremely concerning, and the problems start right from birth. By performing more C-sections, limiting skin-to-skin contact with the mother at the start of a child’s life, formula feeding instead of breastfeed­ing and leaving babies to sleep in cots in clean rooms instead of by the side of their mother, we are impairing the transmissi­on of the mother’s bacteria to

We are trading the infectious diseases that used to kill us for new ones

the baby, which has implicatio­ns for the baby’s immune system.

The baby then develops within a built environmen­t, composed of artificial materials layered with synthetic paints. We are still learning about the toxins these materials, including plastic, contain. But we do know they often feature compounds that impact our physiology.

Plastics, for instance, contain compounds that interact with the metabolism of steroids, and steroids are the basis of our hormones. We see effects on the endocrine system as a result – a system that plays a key role in whether you develop diabetes, thyroid disease, growth disorders, sexual dysfunctio­n, and many other hormone-related disorders.

We also have evidence that fungal diversity increases as bacteria decrease. What this means is we are trading the infectious diseases that used to kill us for new ones: immune and metabolic diseases such as type 1 diabetes, an auto-immune disease that destroys the pancreas. This used to be rare and its onset was not until patients were in their teens. It’s no longer rare and occurs in children.

Coeliac disease, asthma and obesity may also be on the rise as a result of our more limited microbial exposure. Some people think even Alzheimer’s

and autism are related to this. There’s enough evidence to suggest that modern auto-immune diseases have a probable underlying cause related to microbes and the education of the immune system.

In combating, or preventing, some of these ill-effects, scientists like me must establish which microbes children need to develop the healthiest immune systems. We also need to know how we can restore the microbiome after it has been impacted by medicines.

In the meantime, what can we do to alleviate some of the potentiall­y damaging effects on our microbiome of the sanitised modern lifestyles we’ve embraced? Reverting to living in the jungle is obviously not an option. But we can learn from those who live in greater harmony with nature about what is missing from our own microbiome. To this end, we visit in the documentar­y a Peruvian village called Checherta and its isolated rural Amazonian community, whose lifestyle is more similar to that of our ancestors. They live in open huts and mostly eat what they gather from their natural environmen­t every day.

They typically go fishing daily, and regularly eat soup made with fish or roots, once or twice a fortnight going hunting. There’s no electricit­y in the huts, so families go to bed early and rise early. They tend to nap in the afternoon, something we rarely have time for in urban societies, and they tend to eat frequently, throughout the day, with very high amounts of fibre and low amounts of fat in their diets.

The Chercherta community lacks modern medicines, so mortality is extremely high. But its members do have much greater diversity in their microbiome, and we can learn a lot from them about what we have lost from our own, and what functions in the body this affects – something we are working on currently.

We can also include some of their healthy practices in our own lifestyles, not only by switching to a high-fibre diet to improve the microbiome, but by exposing ourselves to nature far more, and to soils and plants we might otherwise tend to exclude.

We still don’t understand exactly why, or what are the mechanisms involved, but there’s now a scientific consensus that eating plants and fibres and being exposed to the environmen­t are generally healthy. All of us can live better lives by bringing nature back in. As told to Rosa Silverman

Aliens Inside Us airs on the Smithsonia­n Channel at 9pm on Thursday

We can learn a lot from those who live in greater harmony with nature

 ??  ?? Gut reaction: the human microbiome loses diversity as we urbanise
Gut reaction: the human microbiome loses diversity as we urbanise
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