April 16, 2015


The Good Gut: Taking Control of Your Weight, Your Mood, and Your Long-Term Health. By Justin Sonnenburg, Ph.D., and Erica Sonnenburg, Ph.D. Penguin Press. $27.95.

     Let’s see. There are 168 hours in a week. How many do you think it would take to put into practice all the multifarious suggestions/recommendations of health professionals to exercise a certain way, consume certain things, supplement foods with pharmaceuticals and nutraceuticals and such, and pay particular attention to specific organs of your body, including the brain, heart, stomach, lungs, kidneys, gall bladder, islets of Langerhans, appendix and more? Probably about 168. Never mind per week – that’s per day.

     So, not to take anything away from The Good Gut, but this is a book that joins an astonishingly large coterie of volumes designed to tell people just what is wrong with some particular element of their lives and/or bodies and just what to do to make that particular thing better/healthier/happier. Been there; probably haven’t done that, though, because there is such an unending parade of things to watch and observe and do and not do and pay attention to and ignore and eat and not eat that there is simply no way any reasonably sane person can even try to accommodate all the well-meaning, well-researched, well-thought-out, well-designed prescriptions, proscriptions and descriptions.

     Well, just in case you have spare time (which is what, exactly?) to devote to the microbiota in your intestines, husband-and-wife Stanford University School of Medicine scientists Justin and Erica Sonnenburg have, you will be relieved to hear, something with which to fill it. Actually, your gut is filled already: there are some 10 trillion human cells in the human body, but there are 10 times as many – approximately 100 trillion – bacterial cells in the gut. The premise of The Good Gut is that imbalances in gut bacteria, and mistreatment of the environment in which those bacteria live, lie at the root of a great many diseases and of the rampant obesity now found in the United States and other wealthy countries.

     There is an old saying that when all you have is a hammer, everything looks like a nail. In science, when you are a super-specialist in one field, you tend to develop tunnel vision, through which you can see that the solution to every problem lies in your particular area of expertise. The Sonnenburgs are – surprise! – experts in microbiota. So it is absolutely to be expected that they will trace a great many human ills, if not quite all, to the gut bacteria they have been studying for more than a decade.  They deem the collection of gut bacteria so all-powerful, so crucial to health, that they approvingly discuss a colleague’s actions at the birth of his child by C-section – birth being the time when bacteria first colonize the human gut: “Being keenly aware of the differences that exist between the microbiota of C-section and vaginally delivered children, Rob and his wife took matters into their own hands. Using vaginal swabs from the mother, they inoculated their daughter at multiple body sites to ensure that she was exposed to the bacteria she would have encountered had she gone through the birth canal.”

     This may sound like fanaticism to some (perhaps many) readers, but the Sonnenburgs say it makes good sense in light of the overweening lifelong importance of gut bacteria for whole-body health. They argue that gut bacteria regulate the immune system and our metabolic functions, affecting moods and behavior; thus, when the gut bacteria are the wrong kind or out of balance, we get weight gain, cancer, depression, and such immune-system-related diseases as allergies, eczema, dermatitis, Crohn’s disease, ulcerative colitis and multiple sclerosis. The evils undermining proper gut bacteria types and levels are the familiar ones so avidly condemned by so many researchers who have a particular type of tunnel vision: our dietary choices, our medicine choices (especially antibiotics), and our overall environment (which the Sonnenburgs argue is too sterile to allow proper proliferation of health-improving types of bacteria). Their answer: “Our family consumes microbes regularly, usually in the form of fermented dairy products like yogurt and kefir. When an illness seems imminent, our bacteria consumption increases. …Because of the individual nature of each person’s microbiota and the inability to predict which type and how much probiotic might be helpful and for what conditions, it is important to find probiotics that work well with your microbiota. …It may require a little trial and error with various types of probiotic-containing foods or supplements to find one that agrees best with your system. …In the search for the right probiotic, it is important to systematically try different ones until you find something that seems to work for you.” Now that is a breathtaking argument: management of gut bacteria is crucial, but there is no way to predict what sort of consumption of what sort of item will do what your individual gut bacteria require, and therefore you must have plenty of time to devote to finding the correct health-enhancing foods and/or supplements that are just right for you, and if you cannot find them, you are doing something wrong – certainly you cannot blame the Sonnenburgs.

     Well. It looks as if 168 hours a day devoted to all those can’t-fail-absolutely-true dietary and lifestyle prescriptions will not be enough. No, now you need time for experimentation and rearranging your food choices (being sure not to interfere with other rearrangements made in line with other people’s equally certain and equally crucial recommendations); and in your spare time, of which you had better have plenty, you can worry about “microbiota diversity loss,” which dates back even farther in time than to a child’s birth and initial contact with gut bacteria. This dire circumstance ties to “technological innovation in food processing,” which of course is a bad thing (it is amazing what level of agreement there is among scientists with tunnel vision about how bad technology is, except of course when they use it intensively in their own work). The solution: “A healthy diet coupled with plenty of sleep can synergize to help keep sickness at bay.” Be sure to allot some of that more-than-168-hours-a-day schedule to plenty of sleep, of course unencumbered by worry about diet, gut bacteria, health, technological innovation, or – heaven forfend – the daily vicissitudes of earning a  living, caring for yourself and your family, and otherwise doing anything that is not directly related to an appropriate gut-bacteria focus.

     The non-tunnel-vision reality is that the Sonnenburgs are correct about gut bacteria being important to health, but not to the exclusion of many other physical, mental, psychological and emotional parts of life. Adding huge stress to people’s lives through warning them about yet another bodily process to which they are paying insufficient attention and on which they must focus intensely and immediately is a recipe for mental and psychological overload – and, more to the point, a recipe for failure in the management of that bodily process. The Sonnenburgs make some very good points about gut bacteria and their significance; their concerns about the elderly having compromised microbiota because of long-term antibiotic use and poor institutional diets are particularly cogent and well-presented. And they are to be commended for including a section of menus and recipes at the end of their book – although their count-the-grams-of-fiber approach is a depressing one, and their specific recommendations are at once esoteric and likely to be unappealing to many readers (lunch of “kale salad with chia seeds, pomegranate seeds, and pistachios” one day, then “sandwich on whole wheat bread with fermented cream cheese, smoked salmon, cane artichoke hearts, tomato slices, and capers” the next day).

     Ultimately, what the Sonnenburgs argue in The Good Gut is that everybody should be like them: thinking their way, eating their way, raising a family their way. For families in which the parents are not Stanford University professors (with their commensurate salaries and work flexibility), this is more than a tall order – it is an impossible expectation. The Good Gut would have been much better if the Sonnenburgs had acknowledged that theirs is just the latest in a long line of “treat your body better” books and if they had given specific recommendations on incorporating their ideas into the many, many, many others emerging from scientific research done by other people. Because they chose not to do this, because they decided that their narrow niche provides the one and only health solution that people need, they have created a book that is filled with intriguing research findings and well-meaning arguments, but that will cause most readers – those who do not have 168 hours a day to devote to such things – to feel not as if the book helps them take control of their weight, mood and long-term health, but simply as if they have been punched in the gut.

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