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1 " Live dirtier, eat cleaner "
― , The Microbiome Solution: A Radical New Way to Heal Your Body from the Inside Out
2 " A glass or two of red wine may be good for your heart but not for your microbiome. Studies show that just one drink per day in women and two in men can induce dysbiosis and bacterial overgrowth. Levels of good bacteria like Lactobacillus fall, while potential pathogens rise, leading to an increase in toxins and other chemicals that can cause inflammation, damage the liver, and increase permeability of the gut. Most of the overgrowth happens in the small intestine and can lead to malnourishment because the excess bacteria consume the nutrients that the small intestine would normally absorb. Some studies report an incidence of small intestinal bacterial overgrowth (SIBO) in alcoholics that’s three times that of the general population. "
3 " Antibiotics aren’t the only cause of dysbiosis. Gastrointestinal infections themselves can deplete the microbiome, and the subsequent decrease in microbial richness can lead to increased susceptibility to disease. Many patients trace the beginnings of their decline in health to an infectious event—from Montezuma’s revenge in Mexico to dysentery on safari in southern Africa to a bout of giardia from contaminated water closer to home. Post-infectious irritable bowel syndrome is a well-described phenomenon, and up to 10 percent of patients with inflammatory bowel disease like Crohn’s and ulcerative colitis point to a significant infectious event that marks the beginning of their illness, particularly if their microbiome was already compromised from prior antibiotic use. "
4 " There are some infections that definitely require antibiotic treatment, but more often the need for antibiotics is a gray area. A study published in the journal Pediatrics found that pediatricians prescribed antibiotics 62 percent of the time when they perceived that parents expected them to be prescribed, and only 7 percent of the time when they thought parents didn’t, suggesting that the need for antibiotics is almost always optional. It’s not just children who are being overtreated. Two out of every three adults who see a health practitioner for cold or flu symptoms are prescribed antibiotics, which 80 percent of the time don’t meet Centers for Disease Control and Prevention (CDC) guidelines for antibiotic therapy. When I ask my patients about previous antibiotic use, they usually respond that they took “a normal amount,” but after I have them add up every prescription, they’re often shocked to realize just how much “normal” really is. "
5 " If we look at a map of the world today, one of the striking observations is that illnesses like Crohn’s disease are common in more developed countries and rare in less developed ones. The hygiene hypothesis accounts for this uneven distribution by suggesting that less childhood exposure to bacteria and parasites in affluent societies like the United States and Europe actually increases susceptibility to disease by suppressing the natural development of the immune system. This concept has also been linked to the rise of many of our chronic ailments: the obesity epidemic, deadly disorders like metabolic syndrome and heart disease, psychiatric conditions like depression, poorly understood afflictions like autism, and even some forms of cancer—and clinical studies have shown significant disturbances in the microbiome in all of them. We spend huge amounts of time making sure we’re clean—scrubbing ourselves with harsh soaps, sanitizing our hands and environment with chemicals, and eliminating any trace of dirt from our homes and lives—but since the evidence suggests that germs may actually be essential for our well-being, it may be time to rethink our approach to cleanliness and hygiene. "
6 " An immune system that doesn’t get up close and personal with enough germs early on is like a kid with overprotective parents, ill equipped to deal with problems when they inevitably happen. Inadequate exposure leads to defects in immune tolerance and a trigger-happy state of heightened activity where essential bacteria, proteins in food, and even parts of our own body (the digestive tract, in the case of IBD) are treated like the enemy and attacked. "
7 " It’s shocking that we still tell teenagers that what they eat doesn’t have any effect on their skin and then subject them to years of antibiotics that can have serious effects on their health. Almost all of the patients I see in my practice with Crohn’s disease and ulcerative colitis have a history of taking antibiotics for acne, and while that doesn’t necessarily prove causation in those particular patients, the medical literature is full of studies that now confirm that antibiotic use, particularly in childhood, is a major risk factor for the development of these diseases. While "