Dirt is Good - The Advantage of Germs for Your Child’s Developing Immune System, by Jack Gilbert and Rob Knight, with Sandra Blakeslee
Nina Vinot
Symbiologist - teaming with probiotic players to upscale your strains and supporting farmers with soil and plant microbes | Bacterial blogger | ?? Born at 351 ppm (CO2)
Dirt is Good is written to the attention of parents who want to take informed decisions in raising their kids, taking into account the latest science on practices with an effect on the microbiome, and the impacts that dysbiosis can have on health.
This is both an easy read and a rigorous approach, in most cases citing the references, allowing for potential checking and deepening.
The authors are also parents making choices for their kid’s health. For instance, Rob and Amanda were faced with a breastmilk issue, not having enough milk for their baby girl. They went to a pasteurized human milk bank, but quickly found that spending 1000 $ a week on milk was not sustainable – and the pasteurization doesn’t allow this breast milk to maintain the benefits of antibodies and probiotics presence. In addition, not all breast milk banks screen for antibiotic use. Rob and Amanda ended up using formula and integrating with small quantities of breast milk. It’s also good for breastfeeding mothers on antibiotics to know that, according to the authors, the first minutes of nursing let less antibiotics go through.
From pregnancy to diet and environmental considerations, Rob and Jack provide pragmatic, valuable, well-established advice, usually endorsed by medical authorities, and I praise their providing the reference to the US probiotic guide, listing independently evaluated, scientifically-supported probiotics available in the US (and in Canada). The authors absolutely recommend L. rhamnosus GG in diarrhea, but also mention a study in which increasing doses of GG for 18 months solved peanut allergy in 80% of the kids. Besides, a supplementation in pregnancy and the 6 first months of life with this strain halved the risk of eczema for up to 5 years.
Interestingly, the American Academy of Pediatrics recently changed its recommendation from avoiding potentially allergenic foods to introducing them early. It all fits together with the hygiene hypothesis, or “Old Friends” hypothesis, the idea that a lack of microbial exposure increases allergies and immune disorders. Practical advice on managing “microbiomental” exposure includes getting a dog or an outdoor cat, which reduces by 13% the risk of asthma (though of course the decision of caring for a pet for many years should be taken on different grounds), bringing plants in the house, opening the windows and airing the house regularly, washing the dishes by hand, using mild detergents free from triclosan, etc. In fact, dirt is so good that “the reflex babies seem to have for putting things into their mouths may have evolved to increase their early life exposure”.
Still linked to hygiene and microbial exposure, a great question raised is the one of water: if bottled-water contains BPA but tap water contains chlorine, what are the stakes? No risks were described with public water fountains in the developed World, while the authors claim you’d need to drink significant quantities of tap water for the chlorine to have an effect on the microbiome (except in Hong Kong, which I can personally confirm). Too bad the references are missing for this assertion, since no safe dose of chlorine was determined, to my knowledge, taking into account “microbiomental” effects. Conversely, Willis et al. published in 2018 a large study in 1500 Spanish adolescents and found the tap water composition was related to important changes of the oral microbiota.
The authors vision of probiotics is in favor of specific bacteria selected to help in specific conditions. “Clinical probiotics will be provided in concert with clinical prebiotics. This will revolutionize the impact of these products”. While I believe that not only Live Biotherapeutic Products (LBPs) are useful – probiotics benefits have also been demonstrated in healthy kids and healthy adults, for example with decreased prevalence and severity of respiratory tract infections and less antibiotic intake – I agree that probiotics specificity is an added-value, and that the future of allergy management should combine oral challenge and probiotics administration.
A last point I’d like to give credit to: although Rob and Jack are cofounders of the American Gut project, they don’t oversell results of microbiota testing. “Right now, it’s extremely difficult to draw specific conclusions from much of the microbiome data that are available from American Gut and other such companies. In fact it would be unethical to make claims unless we were really sure to be correct.” Such results are useful for research and can give hints of issues, like when Jack, who got arthritis after a diet, found a surge in sugar-eating Bacteroides in his samples, and understood he was eating too much candy bars, which tend to be pro-inflammatory. He stopped and solved his joint pain within 3 weeks, which would have been difficult without his extensive microbiome knowledge.
Dirt is Good is definitely a recommended read if you look for practical, science-based advice, especially for kids’ health, and the Q&A format makes it easy to go directly to your own questions.
Natural Birth Specialist, Creator, Designer, Builder, Musician, Healer
5 年We live on a 20acre property with horses, cows, goats, a dog, a cat and a chicken. There are rabbits and wild ducks everywhere and plenty of poo on the ground. My children where born and have grown up here and as parents we have never restricted their activities. They even swim in the dams that the livestock drink out of. Rarely, if ever, do we use antibiotics. There was a time while the kids were in primary school that there was a massive outbreak of chicken pox. Almost the entire school of 250 kids succumbed to it, even those who had been immunised. Our two sailed through without a sign of it, even though they are not immunised, which we actively chose not to do. While we may not fully understand it as a western society, nature holds the key. Everything exists in a harmonious balance. The key is to harmonise with it. You only have to look at indigenous cultures. Most had no resistance to the diseases that urbanised populations brought to them, and yet they lived so intimately with and in nature. The natural environment is not going to destroy us, it protects us.
Adult Care Management, Benefits Design, Speaker
5 年For most the summer, my mom allowed me, my sister and brother to run around without shoes, inside and out. ?We helped her dig in the garden. ?When we were little, we made mud pies in the backyard. ?As an adult, my sister can count the times she has used an antibiotic on one hand. ?We are meant to be in nature, not just because it is beautiful, but because there are real health benefits. ?
National School of Public Health at Ministry of Health
5 年I was born in a village in Greece, but, my parents were overprotective and would not allow me to play in dirt, etc. I was always sick. My cousin, who played in the dirt, was never sick. Finally, even the pediatrician got fed up and asked my parents " Don't you have dirt in your village? Doesn't your child go outside to play? Please, let your child get dirty so her immune system can develop!!!" I was rarely sick after that!!!