Chapter 1. “Plague of Modernity»

I didn't know my father's two sisters. They were born in a small town at the beginning of the last century and did not live to see their second birthday. One of these days, they have a high fever and, probably, there was something else. The situation was so serious that my grandfather went to the prayer house and changed the names of his daughters to deceive the angel of death. None of them helped.

In 1850, one in four children in America died before their first birthday. Deadly epidemics swept through overpopulated cities, where people lived in dark, dirty rooms with stale air and without running water. Cholera, pneumonia, scarlet fever, diphtheria, whooping cough, tuberculosis and smallpox were among the familiar diseases.

Now only six American babies out of a thousand do not live to see the year – this is a significant improvement. Over the past century and a half, both the United States and other developed countries have become much healthier {1}. This was due to improved sanitation, deratization, clean drinking water, pasteurized milk, childhood vaccinations, modern medical procedures (including anesthesia) and, of course, almost seventy years of antibiotics.

In today’s world, children grow up without deformed bones due to lack of vitamin D or “turbid” respiratory tract infection. Almost all women survive childbirth. Eighty-year-old men, having retired, cheerfully run after tennis balls, often, thanks to a metal hip joint.

Yet over the past few decades, despite all the medical advances, something has gone wrong. We are becoming weaker, suffering from a variety of” plague of our time”: obesity, juvenile diabetes, asthma, hay fever, food allergies, gastroesophageal reflux, cancer, celiac disease, Crohn’s disease, ulcerative colitis, autism, eczema. And this is not the whole list. It’s in the papers every day. Most likely, we ourselves, someone from family members or acquaintances suffers from one of these diseases. In contrast to the deadly diseases of the past centuries, which were transient and beat for sure, the above – chronic, they spoil the lives of victims for decades.

The most noticeable is obesity, which is determined by the body mass index (BMI) – the ratio between height and weight of a person. In people with normal weight BMI is 20-25. BMI 25-30 is overweight, over 30 is obesity. Barack Obama, for example, has BMI 23. Most of the presidents of the United States he was less than 27, with the exception of William Howard Taft who once got stuck in the bathtub at the White house. His BMI was 42.

In 1990, about 12% of Americans suffered from this disease. By 2010, the figure was already 30%. When you get to the American airport, supermarket or shopping center, look around and see for yourself.

These numbers are not just disturbing: it is truly shocking that weight gain has not been gradual, for several centuries, but rapidly, in just two decades. Rich fats and sugar food, which is often accused of all mortal sins, was common before. And the third world countries, where new generations are suffering from excess weight, did not make a sudden transition to a diet of Kentucky fried chicken in the American style. Epidemiological studies show that increased intake of high-calorie food, of course, contributes to weight gain, but is not the only cause of the spread of the epidemic of obesity.

In addition, the number of cases of autoimmune diabetes, which begins in childhood and requires insulin injections (type 1 diabetes), doubles every twenty years in industrialized countries. In Finland, where detailed statistics are kept, the incidence has increased by 550% since 1950. And it’s not that we’ve learned how to better diagnose diabetes. This disease has always been fatal, until the 20-ies of the last century did not open insulin. Now, with proper treatment, most children survive. But it’s not the disease that’s changed, it’s us. In addition, type 1 diabetes is now affecting children at an increasingly early age. Once he was diagnosed at an average of nine years, now-at six. Some have seen in three years.

The obesity epidemic is a problem not only in the US, but in the whole world. In 2008, according to the world health organization (who), 1.5 million adults were overweight: more than 200 million men and 300 million women were obese. However, many of them live in developing countries, which are usually associated with hunger rather than overeating.

The increase in the incidence of asthma, chronic inflammation of the respiratory tract is also frightening. In 2009, it suffered every twelfth American (about 25 million-8 % of the population), ten years before – every fourteenth. And 10 % of children in the United States suffer from hoarseness, shortness of breath, shortness of breath and cough. The worst is black-one of them is sick every sixth. The incidence increased by 50 per cent between 2001 and 2009, and did not spare any ethnic group.

Asthma is often caused by external causes: tobacco smoke, mold, air pollution, cockroach garbage, cold, flu. When an attack begins, asthmatics do not have enough air, and if there is no medicine at hand, they are urgently sent to emergency rooms. Even with the best care, they could die, like the son of my doctor colleague.

Everywhere and food allergies. A generation ago, reactions to peanuts were rare. Now in any American kindergarten you can find a “no-nut zone”. More and more children suffer from an immune response to food proteins, which are found not only in nuts, but also in milk, eggs, soy, fish, fruits. Name any product-someone must be contraindicated to eat it. Celiac disease, an Allergy to gluten, the main protein of wheat flour, is also spreading wider. And 10 % of children suffer from hay fever. Eczema, a chronic inflammation of the skin, appears in 15% of children and 2% of adults in the United States. In industrialized countries, the number of children with eczema has tripled in the last thirty years.

These diseases suggest that future generations are faced with never before observed levels of immune dysfunction, as well as with disorders such as autism. This modern” plague”, around which many discussions and disputes, studies my laboratory. However, adults, too, inherited. The number of cases of intestinal inflammation, including Crohn’s disease and ulcerative colitis, is growing, wherever you look.

When I was a medical student, gastroesophageal reflux, which causes heartburn, was not too common. But over the past forty years, the number of cases of this disease has increased significantly, and the cancer that causes this disease – adenocarcinoma of the esophagus – the most rapidly spreading in the United States and in other countries where statistics on this issue. Particularly affected are white men.

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Why all these diseases at the same time struck the developed countries, and now “conquer” and developing, which are being rebuilt in a Western way? Could it be a coincidence? If there are ten “diseases of our time“, they have ten separate causes, right? It seems unlikely to me.

Or maybe there is some single reason for the parallel increase in morbidity? It’s easier to recognize. But what grandiose reason can combine, among other things, asthma, obesity, heartburn, juvenile diabetes and Allergy to a particular product? Too high-calorie diet can explain obesity, but not asthma: many children suffering from it, thin. Air pollution-asthma, but not food allergies…

Various theories have been put forward to explain the reasons:

• lack of sleep makes you fat;
• vaccinations cause autism;
• genetically modified wheat-poison for the gut, etc.

The most popular explanation for the increase in child morbidity is the so – called hygienic hypothesis. The idea is this: the plague of modernity has struck us because we have made the world too pure. As a result, immune systems have become calmer and more vulnerable to false alarms. Many parents are trying to strengthen the immunity of children, getting Pets or arranging tours of the barnyard, or better yet, allowing to eat dirt.

Let me argue. I believe that such measures have no impact on our health. The microbes that are found in the mud have evolved to live in the soil, not in us. And those in domestic and farm animals, too, are not too bound by human evolution. The hygienic hypothesis is misunderstood.

First of all, you need to take a closer look at the microorganisms that live in our bodies, to the huge collections of cooperating and competing microbes, known as microbiomes. In ecology, a biome is a collection of plants and animals found in a particular area, such as a jungle, forest, or coral reef. A huge number of diverse organisms, large and small, interact to form complex support networks. When the main type of biome is gone or is dying, the ecology is suffering. Maybe even collapse.

Every human being has an equally diverse ecosystem that has evolved with us over the millennia. They live in the mouth, intestines, sinuses, ear canal, skin, women – in the vagina. The microbes that make up your microbiome are usually acquired in early childhood; surprisingly, by the age of three, the population of a child is almost the same as that of an adult. They play a critical role for the immune system. In short, it is your microbiome that supports your health. And now he’s disappearing piece by piece.

The causes of this environmental disaster are all around us. For example, excessive use of antibiotics, caesarean section, widespread use of disinfectants and antiseptics. Antibiotic resistance is a big problem in itself: old killers, like tuberculosis, fight them more effectively, and the incidence starts to rise again. For example, Clostridium diffi cule (C). diff), a very dangerous bacteria from the digestive tract, resists several antibiotics, as well as a widespread pathogen – Staphylococcus aureus (methicillin-resistant Staphylococcus aureus), which can be picked up almost everywhere. Too much use of antibiotics only exacerbates the situation.

Of course, resistant pathogens are terrible, but even more dangerous is the loss of diversity in the personal microbiome. This leads to changes in the development of the body, affecting metabolism, immunity and cognitive abilities.

I called this process the “vanishing microbiota“. I don’t think you’ve heard the term before, but I think it’s true. For various reasons, we are losing ancient microbes. It is this alteration, in which we got – the Central theme of the book. I’m willing to assume that the future will only get worse. Unexpected effects were found in internal combustion engines, splitting of the atom, pesticides. There are also abuses of antibiotics and some other medical and quasi-medical practices (such as the use of disinfectants).

If we do not change our behaviour, we have a worse future ahead of us. It’s so dark, like a snowstorm raging over a frozen field, I call it “antibiotic winter.” I don’t want the children of the future to die like my poor aunts. That’s why I’m sounding the alarm.