Why the microbiome--our rich inner ecosystem of microorganisms--may hold the keys to human health.
We are at the dawn of a new scientific revolution. Our understanding of how to treat and prevent diseases has been transformed by knowledge of the microbiome--the rich ecosystem of microorganisms that is in and on every human. These microbial hitchhikers may hold the keys to human health. In Gut Feelings , Alessio Fasano and Susie Flaherty show why we must go beyond the older, myopic view of microorganisms as our enemies to a broader understanding of the microbiome as a parallel civilization that we need to understand, respect, and engage with for the benefit of our own health.
This is a very technical book and it took me a good 3 months to read it, a little bit at a time.
Here is one section I highlighted and it is a good representation of what you're in for if you decide to read this book: "The creation of novel biological computational models and a clear path to move from microbiome association to causation are essential steps in providing a mechanistic approach to gain insights into the development of noninfectious, chronic inflammatory diseases and possible targets for personalized interventions or disease prevention. This can only be done if studies focused on the microbiome are placed in the context of the biological ecosystems in which we live and interface each day."
We know that microbiome composition is associated with various diseases but that doesn't necessarily mean that changing the microbiome composition will cure the disease. This can't be deduced in the lab... i.e. we need human studies that make sense. Because the microbiome of each individual is, well, individual, it's hard to put together a one size fits all study that will satisfy the pharmaceutical companies and the FDA (my words, not the author's). One strain that works particularly well for one individual may not work for another.
The author presents 5 elements that lead to chronic inflammation, a serious problem in the west and a problem of aging. This includes, genetic predisposition, environmental factors, loss of gut barrier function, hyper-belligerent immune system, and an unbalanced microbiome. We can't just blame our genes if all of these things are factors. In the last chapter, these things come up again as the author talks about inflammaging as one of the factors at play in aging.
Another thing I made note of is that people respond differently to cancer treatments based on their microbiome composition. Given how destructive current cancer treatments are, it would be nice to be able to take a sample of the microbiome and measure it to see how effective said treatment might be before even attempting it.
As a nutritionist, I appreciate that the author recognizes how much cheaper it would be to implement healthy nutrition habits over the huge cost of drugs currently prescribed. However this statement made me a little sad: "With the appreciation that diet is the most influential factor shaping our gut microbiome, and that dysbiosis can be associated with a variety of chronic inflammatory diseases, more affluent people are now moving away from junk food and making healthier food choices." This implies that regular every day people are still sitting in line at the fast food restaurants and eating junk food. The thing is that eating healthy doesn't have to be expensive, it just requires more time, something that regular every day people do not have in our modern society.
The author is careful to note, more than once, that longitudinal studies are needed before we can begin to understand all of the many factors at play. Right now we can associate certain microbiome compositions with disease but that does not prove causation.
If you are familiar with terms such as dysbiosis, the blood brain barrier, pathogenesis and epigenetics then you may like this book. Otherwise, you might find yourself spending a lot of time looking up definitions.
This is an informative and interesting book from the first page to the last. The microbiome has become a popular research topic over the past several years, but I have never come across such a thoughtful and well-researched body of work on the subject. In fact, Gut Feelings: The Microbiome and Our Health is so chuck full of information, readers may want to take their time reading through it. I had no idea just how much I didn't know until I read this book. If you have more than a casual interest in the science of the microbiome, this book is for you.
This is a comprehensive book on the current status of microbiome research. It starts with a broader context on the microbial world and then it explores the multiple facets of microbiome (structure, role, influence over health/disease, research methodologies and future directions). Alessio Fasano is a leading expert in the microbiome domain and his own research has brought a significant contribution to it. The book has a lot of technical parts and scientific rigour, but it is an interesting read even for someone without a biology background. After reading it, I am definitely enthusiastic of future developments in microbiome research.
The human microbiome is a fascinating subject. As authors of this book write in the preface, we are on the threshold of a new scientific revolution. The more we know about bacteria, viruses, archaea, and fungi living in our body, the more it changes our approach to diseases, immunity, and even our identity as a species. And this book brings all the newest knowledge on this subject, with a review of the latest studies and theories. You will find here also fascinating insights from the leading scientists in this field and the history of many important discoveries.
However, this is not a popular science book – for most parts, it reads more like a textbook, and authors themselves admit – only half-joking – that you need some perseverance to finish it. But if you are interested in this subject, you won't find a more definitive study.
Thanks to the publisher, The MIT Press, and NetGalley for the advance copy of this book.
First of all, kudos to the authors for their diligence and research in putting this book together. It is a dense science-filled book, not for the faint of heart. They show that basically every disease whether autoimmune, neurodegenerative and even cancer are linked to a dysbiosis of our microbiota. They highlight lots of promising technologies using AI and deep learning, although they mention it in the book I think that what is an essential take-home message is that we’re eating junk food and compromising our microbiota. The first step is to eat whole natural plant-based foods so that our microbiota can thrive and provide us with good health.
Discover why the microbiome might possess the answers to human health with the book ‘Gut Feelings.’
In the intricate riddle of human health, there is a very important player that many do not notice – the microbiome. This vast community of microorganisms has a profound influence on various aspects of our health. From digestive processes to immune responses, and even impacting mental health, the microbiome’s significance is undeniable.
In this review, we will delve into the pages of ‘Gut Feelings’ by Alessio Fasano, a book that uncovers the potential of the microbiome to revolutionise how we perceive health and disease.
Author’s background
Alessio Fasano, a renowned pediatric gastroenterologist and scientist, leads the Center for Celiac Research at MassGeneral Hospital for Children (MGHfC) in Boston.
Established in 1996, the centre focuses on research, clinical expertise, and advocacy for gluten-related disorders like celiac disease. Trained in Italy, Dr. Fasano founded the Pediatric Gastroenterology and Nutrition division at the University of Maryland. He discovered the prevalence of celiac disease in the US, and his research identified ‘zonulin,’ tied to autoimmune diseases.
What is the book about?
‘Gut Feelings’ by Alessio Fasano explores the world of the microbiome – a community of tiny organisms living inside and interacting with our bodies. The book highlights how this field could revolutionise our approach to staying healthy and preventing diseases.
The book is divided into three main sections, each offering unique insights:
I. The Wisdom of a Microscopic Species: This section delves into the evolutionary biology of microorganisms, explaining their adaptability and highlighting the importance of our ancestral microbiome. It explores factors influencing the human microbiome’s development, decoding the connections between our genetic makeup and the intricate microbial ecosystem.
II. The Microbiome’s Role in Disease: The authors discuss the crucial role of the microbiome in various health conditions. They elaborate on the connections between the microbiome and gut inflammatory disorders, obesity, autoimmunity, neurological and behavioural disorders, environmental enteropathy, and even cancer. This section underscores the profound influence of the microbiome on our overall well-being.
III. Manipulating the Microbiome to Maintain Health: The book explores strategies for leveraging the microbiome to support health and prevent diseases. The authors delve into innovative approaches, such as utilising microbiome composition for disease prediction and interception.
Key takeaways from ‘Gut Feelings’
1.The role of microbiome in the development and treatment of diseases
The human microbiome’s central role in disease spans various conditions, including inflammatory diseases like irritable bowel syndrome (IBS) and allergies, where microbiome composition and function are pivotal. IBS highlights the intricate interplay between genetics, triggers, and altered gut barriers. Allergies connect early microorganism exposure with dysbiosis, intestinal permeability, and immune responses, influencing the balance between tolerance and reactions. Diverse studies reveal complex interconnections among microbiota, immunity, and clinical outcomes, offering potential therapeutic directions.
Gut microbiome imbalance has also been linked to obesity and metabolic shifts. Investigations into type 1 diabetes (T1D) indicate microbiome changes, notably the Firmicutes/Bacteroidetes ratio, preceding T1D, emphasising genetics, environment, and microbiome interaction.
What is more, recent studies spotlight the gut microbiome’s significance in cancer immunotherapy, especially with checkpoint inhibitors, revealing dysbiosis-induced inefficacy and linking responder microbiota with improved outcomes, highlighting the potential for personalised anticancer treatments.
2.The unique gut-brain connection
The relationship between the human microbiome and our brain’s health is a fascinating discovery that is changing how we think about our bodies. Imagine there’s a connection between our gut and brain that’s controlled by tiny microorganisms in our gut – this connection is called the gut-brain axis. These microbes communicate with our brain and affect how it develops and works. They can even impact our mood, memory, and other brain functions. This discovery is a big deal because it shows that our gut health is closely linked to our brain health. These microbes can influence how our brain grows, how it works, and even how we feel. It’s like they’re sending messages back and forth between our gut and brain. This is important because it could help us understand and treat conditions like autism, anxiety, and even diseases like Parkinson’s. It also highlights how our diet plays a role in keeping both our gut and brain healthy.
3.Autism and microbiome connection
Autism Spectrum Disorder (ASD) is a complex disease characterised by communication difficulties, social obstacles, and repetitive behaviours. While increased awareness and better diagnoses contribute to the growing cases of ASD, environmental factors are becoming more recognised as key triggers. ASD’s complexity leads to different treatment results, highlighting the need for personalised approaches based on specific biomarkers. In this intricate landscape, the gut microbiome’s role and its potential links to the brain open up new avenues for investigation.
The author cites research that shows that children with ASD often face gut and immune issues. The GEMMA (Genome, Environment, Microbiome, and Metabolome in Autism) study reveals the connections between genes, environment, gut health, and ASD. GEMMA’s pursuit promises not only insights into ASD’s origins but also the potential for personalised treatment approaches that could reshape how we understand and address this complex condition.
Strengths and weaknesses, according to readers’ reviews
Strengths: • Offers a wealth of information and up-to-date research on the microbiome. • Covers the microbiome from various perspectives and includes interviews with various experts in the field, providing a well-rounded view of the subject. • Presents scientific concepts while remaining engaging for those with a general understanding of diseases and pathophysiology.
Weaknesses: • While the book offers a wealth of references and research, it might not fulfil readers’ hopes of finding actionable insights or advice. • The book’s use of technical language and jargon might make it feel like a textbook, especially for readers who are not familiar with the subject.
Best quotes from ‘Gut Feelings’
“Besides a high intake of sodium, all the other listed risk factors linked to deaths and DALYs globally (low intake of whole grains, fruits, nuts and seeds, vegetables, fibers, and legumes) have a proved negative impact on gut microbiome composition and function and favor dysbiosis and inflammation.”
“There is now growing evidence suggesting that the gut microbiome and its metabolites participate in the formation of the BBB, and myelination, neurogenesis, and microglia maturation, from the prenatal period to senility. The microbiota can influence neuroinflammation by modulating microglia and astrocytes. Animal models suggest that the microglia, defined as “the immune system of the brain,” remain in an immature status if animals develop under germ-free conditions, but they can be rescued by the administration of SCFAs.”
Final takeaway
‘Gut Feelings’ by Alessio Fasano delves into the fascinating world of the microbiome and its profound impact on human health. Through the author’s expertise as a renowned pediatric gastroenterologist and scientist, the book uncovers the intricate connections between our genetic makeup, brain health, disease prevention and susceptibility, and the complex microbial ecosystem that resides within us.
This book is a must-read for anyone seeking a deeper understanding of the microbiome’s pivotal role in human health and the future of disease prevention and treatment.
I voluntarily read and reviewed an advance copy of this book from the publisher via NetGalley. All thoughts and opinions are my own.
It's good and very informative, however, it reads a lot like a textbook, and sometimes it made me feel bored and uninterested because of the constant usage of jargon and technical words. I still think this is a great book to read to know more about the gut, it is just not what I expected from it. I go into this wanting to read about the subject matter that I'm studying, but in a different tone (basically, I'm tired of reading my textbooks and handouts over and over again). But this one just reads like another textbook, so that's on me for setting up my expectation that way.
A well-researched and well-presented summary of current research on the human microbiome and its relationship to many aspects of our overall health and well-being.
Fasano's account is non-prescriptive and straightforward. We learn about the microbiome throughout human evolution, in traditional cultures, and in today's world. If you don't have a basic understanding of human (or mammalian) physiology, this could be hard going. For those of us with a solid background in biology, this presents a nice overview and good starting point to further investigation through the medical literature.
a key subject for human health and for human evolution
Full of information and data on the recent and ongoing research in the subject of microbiome. Yet, it is dense and difficult to follow for general public.
Extremely in-depth and technical, even as someone who is a graduating microbiology major in college. I did like how the book was broken up and especially the ending, a great summary with a look ahead to what the microbiome can help
My study of microbiology led me to this book and on the microbiome because I wanted to understand how much of our bodies is comprised of other life forms. Frankly, it could have been a much shorter book as there lots of repetition. I had hoped the various tiny critters be they bacteria, fungi or virus would get more space and discussion but that wasn't the focus of this book.
The basic argument is that only since the Human Genome project which then launched the Human Microbiome project, do we now know how vitally important our microbiome is to our overall health. The list of diseases and conditions mentioned in the book are so many, it seems like it would be easier to just list the ones that aren't impacted by our microbiome. One of the core redundancies is that the mechanisms that operate in our microbiome appear to be very similar so the book ends saying the same thing again and again just replacing the name of the disease. To be fair, the book is very thorough in reviewing all the studies that make the case. They are probably sparing the reader the scientific details that would be over my head had they tried to explain the differences. As it is, the book contains lots of unfamiliar scientific terms and doesn't include a glossary.
I will say that the repetition wasn't completely wasted because it made the microbiome and its properties and operations more familiar to me. It also made me super aware of how I should feed myself a variety of foods as the authors make it clear that the heavy processed food diet of too many Americans doesn't produce a health microbiome.
The other is the biological and historical context for the microbiome, what we know about it, and why we care.
At various points the research is in the foreground of the telling, and at other points it is in the background.
For me, having no education in molecular biology, the context was of more interest, but anyone working in medicine might prefer the research parts. I didn’t understand some of the acronyms myself.
I am grateful that the authors wrote this book and made it available to us. Thank you!
Definitely textbook, not pop sci approach, with latest research (useful) but I just read/skimmed through a few chapters of interest and didn't get real actionable steps, which I kinda hoped I'd find despite other reviews suggesting otherwise. Not found. I think it's good source of references. Not the book I wanted it to be, though.
Interesting read, but hard to follow sometimes. Although I worked in science for a while, so I am no stranger to more technical writing in health, I still found it difficult to read. Nonetheless, if you are interested in the topic, I recommend giving it a go.
Though the book was somewhat repetitive and unnecessarily long, the content is both comprehensive and important. I did enjoy the epilogue, which discusses aspirational workup, prevention and therapy for manifestations of dysbiosis.
Although the content is tantalizing, the writing style is incredibly prolix. Authors, please heed to the advice of Kevin from the TV show The Office: Why waste time say lot word when few word do trick?
The fascinating story of cutting edge medical research. Well worth the time of anyone interested in hard science, in particular our gut biome and ecosystem.