We are trained to think of bacteria as enemies, eliminating them relentlessly with antibiotics. Are we, in our ignorance, destroying an essential part of ourselves? Bacteria may be part of a large plan to keep you well How new is this? Is it for the better? Will it work in real life? Can I use it now? 1 2 3 4 5 Low High Dr Arjun Rajagopalan Medi-culling: 13 May 2015 The microbiome Complex microbial communities within our intestinal tract interact ﬂuidly not only with their The human microbiome Us Them Weight 70 kg 2 - 3 kg Cells/ person 10 trillion 100 trillion Genes 20,000 2 million human host, but also with each other and play important roles in health and disease. They appear to confer both protection from and risk for many chronic illnesses: asthma, allergies, obesity and diabetes. • Two main classes of bacteria populate the human intestinal tract. The ratios of these communities, has changed over the last 30 years, diverging along a path that mirrors global spikes in obesity, diabetes, and other disorders.

Bacteria are part of a large plan to keep you well

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Page 1: Bacteria are part of a large plan to keep you well

We are trained to think of bacteria as enemies, eliminating them relentlessly with antibiotics.

Are we, in our ignorance, destroying an essential part of ourselves?

Bacteria may be part of a large plan to keep you well

How new is this?

Is it for the better?

Will it work in real life?

Can I use it now?

1 2 3 4 5

Low High

Dr Arjun RajagopalanMedi-culling: 13 May 2015

The microbiomeComplex microbial communities within our intestinal tract interact fluidly not only with their

The human microbiome

Us ThemWeight 70 kg 2 - 3 kgCells/ person 10 trillion 100 trillionGenes 20,000 2 million

human host, but also with each other and play important roles in health and disease. They appear to confer both protection from and risk for many chronic illnesses: asthma, allergies, obesity and diabetes.• Two main classes of bacteria populate the human intestinal

tract. The ratios of these communities, has changed over the last 30 years, diverging along a path that mirrors global spikes in obesity, diabetes, and other disorders.

Page 2: Bacteria are part of a large plan to keep you well

Obesity surgery, diabetes and the microbiome: Stomach “bypass” surgery is now commonly offered for those who are in the severely obese weight ranges. The operation seems to change the microbiome in a manner that facilitates weight loss over and above restricting caloric intake. Diabetes comes under good control. It is possible that this benefit might be the consequence of restoring the bacterial environment to a more favourable state.

Antibiotics: prime culprits The rampant (ab)use of antibiotics is the practice where suspicion first falls. They directly alter the composition of bacterial communities in persons who consume the drug, even for short periods. The associations between an altered gut microbiome and long-term health is unproven but a picture does seem to emerge when viewed in light of the exponential increases in obesity and its attendant rise in diabetes along a path that mirrors the availability of antibiotics.

Dr Arjun Rajagopalan

EndNotes

Bacteria: buddies, not bogeys

Medi-culling: 13 May 2015