July 21, 2016
(+++) THE “WE” WITHIN
The Human Superorganism: How the Microbiome Is Revolutionizing the Pursuit of a Healthy Life. By Rodney Dietert, Ph.D. Dutton. $28.
It has recently become fashionable to regard the human body not as an integrated organism but as a colony of trillions of microorganisms. On that basis, some 90% of human cells are microbial. This is reductio ad minimum if not ad absurdum, but it is not as peculiar or scientifically or philosophically abstruse as it may at first seem to be. The fact that our bodies are populated by trillions of bacteria is not news, nor is it revelatory to state that an appropriate balance of “good” bacteria helps protect us against periodic invasions by “bad” bacteria – and that, indeed, maintaining such a balance is a key to overall health.
A key, not the key. The distinction matters, because stating that microbial balance is the key to health opens the door to any number of scammers, “nutraceutical” peddlers, “probiotics” pushers and others who are only too eager to jump on the latest bandwagon and use it to make all the profits possible before the next big thing comes along.
Rodney Dietert, thankfully, is no peddler or pusher, even if he is a trifle too intense in his advocacy of microbiome balance as the key to living well. Dieter starts from the inarguable premise that despite many decades of advancement in medical technology, nearly two-thirds of deaths today are caused by illness – and particularly by non-communicable diseases (NCDs) such as heart disease, cancer and diabetes. Furthermore, says Dietert, a professor of immunotoxicology at Cornell University, there is an epidemic of non-fatal but nevertheless serious diseases that can also be tied to microbiome disturbance, including celiac disease, psoriasis, asthma, osteoarthritis, autism, depression and many more. All these diseases share an improperly regulated immune system, Dietert argues, and because that is what they have in common, appropriate alteration of our microbiome can return our biological superorganism to health through a rebalancing act that involves treatments such as prebiotics and probiotics.
The problem, Dietert asserts, is that we as a species have spent so much time in recent decades deregulating rather than balancing our microbiome. Here he cites the usual suspects, including antibiotic overuse and insufficient nutritional diversity. We have pushed our bodies into a state of chronic inflammation, says Dietert, and that in turn makes us susceptible to an ever-increasing number of chronic illnesses.
Little of this is really new, although Dietert is to be commended for backing up his assertions with so many citations of responsible research, much of it cutting-edge. The notion that we live symbiotically with helpful bacteria that, for their part, protect us against a host of diseases caused by lack of homeostasis, allows us to imagine a fairly simple rebalancing act that will end the inflammatory response and present us with a holistically healthy future. But of course things are not as simple as that. Pretty much every aspect of modern life needs to be rethought in order to restore microbiome balance, Dietert suggests, ranging from altered birth practices (no more elective C-sections, no excuses for failing to breastfeed) to new approaches to geriatrics. The basic problem, Dietert says, is that in waging war against harmful microorganisms, we have been causing collateral damage to the helpful ones that are crucial to our health – in effect, fighting ourselves and defeating the very elements of our biological makeup that keep us healthy. We have suffered “the loss of a higher order of self-integrity involving our microbiome,” and medical treatments make matters worse insofar as they ignore the preeminent importance of microbiome management.
Dietert veers perilously close to fanaticism as he brings up instance after instance in which a problem, pretty much any problem, is caused by mismanagement of the microbiome. His strong scientific background and research-based arguments prevent his book from sounding entirely like a jeremiad, but there is a certain hectoring tone about his insistence that whatever may be the matter, he, Dietert, knows what the problem is, and what can be done about it. Of course, what can be done differs for every individual, so there is, after all, no easy solution in The Human Superorganism. In fact, Dietert’s insistence on the importance of personalized medicine is right in line with the increasing realization among clinicians that one-size-fits-all treatments really fit almost no one: individual people respond differently to an identical dose of the same medicine given for the same condition, for example. Unfortunately, Dietert’s statement that everyone can benefit from a microbiome makeover (“rebiosis,” he calls it) runs head-on into his statement that “what works wonderfully for one person might not work as well for someone else,” which rather begs the question of how to implement the program that Dietert recommends.
“The bottom line is that even with some uncertainties, more information to come out, and risks greater than zero, there is little reason simply to live with NCDs and treat the end-process with heavy-duty pharmaceuticals while never addressing the root of the problem,” Dietert opines. That certainly makes sense – as does Dietert’s emphasis on exercise and improved nutrition, the latter meaning that “you need to consume a diet that allows the microbes you are installing in your gut to thrive, to have an ecological advantage in you, and to function fully.” Even non-holistic medical practitioners would surely agree with the notion of improving diet and increasing physical activity, although they might not accept the specific terms in which Dietert presents his ideas. In the absence of specificity, however, Dietert’s well-meaning recommendations to reset one’s microbiome in a way that one discovers for oneself after substantial research and experimentation turn into just another of the many “here are the start and finish on a map so you can find your own road” healthcare self-help tomes. Some of what Dietert discusses is exceptionally interesting, especially his research-based assertions and his comments on ways in which he personally has applied his “rebiosis” approach. However, readers looking for the how of microbiome reorientation rather than the why of it will likely be disappointed to learn that the best Dietert can tell them is to figure out what to do on their own.