Is hygiene mania and poor nutrition causing the microbiome to decline?

There is a surprising amount in the body. Billions of germs roam there. Bacteria, fungi, protozoa: every human being has at least 1000 different species. The tiny microorganisms colonize the intestines, but also the skin, nose, mouth and genitals. This is in no way disgusting or even harmful, as we know today. Rather, these germs, also known as the microbiome, keep us healthy. But there’s a problem.

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“Probably about half of the microbiome has been lost in Western countries,” says Till Strowig, who studies the protective effect of bacteria in the intestinal flora at the Helmholtz Center for Infection Research (HZI) in Braunschweig. The problem that researchers are increasingly pointing to is that many people are becoming more susceptible to disease due to the decline in microorganisms.

A long list of popular ailments is under suspicion. Metabolic disorders, for example, leading to obesity, among other things. Heart and vascular diseases can also be promoted. Also, chronic inflammatory bowel diseases such as Crohn’s disease and autoimmune diseases such as rheumatism. A connection between food allergies and the gut microbiome is also suspected. So why are microorganisms suddenly disappearing?

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Birth, lactation, place of residence: the microbiome develops in childhood

The first five years of life are particularly crucial for the development of the microbiome.

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It is the human being himself who is increasingly pushing the protective germs of his life, going through daily life in a more hygienic, sterile and urban way. On the one hand, this has advantages, as Strowig explains. Bad pathogens like cold, corona, noro and influenza viruses have less chance to spread. But there are also disadvantages: the good microbiome-relevant pathogens no longer come into contact with the human body. Because it depends on the absorption of bacteria from the environment.

Especially in childhood. “The first five years of life in particular are crucial for the development of the microbiome,” explains Strowig. Researchers know that children born by cesarean section develop a different microbiome in the first few months than those born vaginally. When a baby passes through the mother’s birth canal, it ingests a large number of microorganisms for the first time. However, according to data from the Federal Statistical Office, about 30 percent of current births end in caesarean sections.

Till Strowig heads the Microbial Immune Regulation department at the Helmholtz Institute for Infection Research.  His team studies how microbial communities influence infectious diseases and how they can be manipulated to treat disease.

Till Strowig heads the Microbial Immune Regulation department at the Helmholtz Institute for Infection Research. His team studies how microbial communities influence infectious diseases and how they can be manipulated to treat disease.

Is the child breastfed or bottle fed? This also plays a role because breastfeeding transfers bacteria and components that nourish the young microbiome. Sure enough, there is a breakthrough in pre-feed offerings. “But that’s still not quite the same when it comes to developing the microbiome,” Strowig says of the current state of the research.

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How children grow also plays a role. “Anyone who grows up in a super sterile environment is less likely to ingest various natural bacteria,” says Strowig. A little contact with dirt in everyday life? It definitely has health benefits. Do children play with many different friends or always with the same ones in the first years of life? Is your environment heavily sanitized with disinfectants? Are you growing more urban or rural? Do you take antibiotics for a long time? All this helps to decide which microorganisms colonize the body in the first formative period of life.

Better wholegrain than chips: today’s diet lacks fiber

When we eat fiber-rich foods, we give bacteria more substance to grow.

But adults are also involved in the fact that their microbiome is shrinking more and more these days. They eat less fiber than before, which gives the good bacteria in the large intestine very little food. Instead, today’s diet means eating mostly easily digestible foods. “However, many health-promoting bacteria feed on fiber, the components of our food that humans cannot digest well on their own,” Strowig explains. “If we eat foods rich in fiber, we give the bacteria more substance to grow.”

On the contrary, this also means that the more varied and less processed foods you eat, the more bacteria can find their own niche in the body, and the microbiome can be maintained throughout your life. Instead of sweets, fries and frozen pizza, whole grains, nuts, fruits, legumes like chickpeas, vegetables like celery, broccoli or even mushrooms should be on the plate. This is what the German Nutrition Society recommends.

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Destroyed microbiome: fecal donations could help

Because once the microbiome has been destroyed, there is no pill that favors a reset. After all, new therapeutic approaches are on the way. Strowig reports that experiments in which healthy people donate stool samples, which are then transplanted into destroyed gut flora of sick people or administered in capsules, are particularly promising.

Countries like the Netherlands have already had good experiences with this treatment method. Recurrent Clostridioides difficile infections, for example, could be stopped with the help of a stool transplant. This is an acute intestinal inflammation that occurs mainly in older people or during a hospital stay, often after antibiotics have been given. In Germany people doubt even more than in the neighboring country. The treatment is not yet generally recommended, which has something to do with approval guidelines, Strowig reports. Clinical studies on stool transplants have increased but also in this country. Such approaches could also help in the therapy of cancer or diseases of the nervous system.

Beware of stool tests from private providers

You can’t reliably tell with such tests whether this microbiome is good or bad for this person.

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Several private providers on the Internet have now added to the hype surrounding stool transplants. They offer so-called gut microbiome tests. The promise? Anyone submitting a stool sample needs to learn about the exact connections between gut flora and health problems. Sometimes personalized nutritional advice is included. “I don’t recommend doing that,” says scientist Strowig. “You can’t reliably say with such tests whether this microbiome is good or bad for this person.”

To better understand the interaction of bacteria, this is exactly what is still being investigated. Nor has it yet been precisely deciphered which fecal donation with which microorganisms might be particularly suitable for which patient. Therein lies the great challenge: how microorganisms are composed and how they protect each other varies from person to person. Each microbiome is unique.

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