00:00:00.000]
[00:00:50.097]
[laughing and shouting]
[00:00:53.272]
[00:01:01.909]
- [All] Let them eat dirt!
[00:01:04.501]
[00:01:08.364]
- When I think of dirt,
[00:01:09.480]
I think that it's going to be full of germs.
[00:01:11.920]
- I would say I'm probably somewhere towards
[00:01:15.790]
a conservative clean freak.
[00:01:18.953]
[00:01:20.240]
- When I was a kid it was sort of like
[00:01:21.820]
constant vigilance against what people put in their mouth,
[00:01:25.890]
washing hands, don't touch this, that's dirty,
[00:01:28.340]
- I remember learning about microbes
[00:01:29.770]
in a 7th grade science class
[00:01:31.520]
and they taught us that microbes were germs
[00:01:35.370]
and that they were essentially bad for your health.
[00:01:37.543]
[00:01:38.601]
- [TV Announcer] We like to keep the things
[00:01:40.260]
that we own as clean as we can.
[00:01:42.750]
That's why Dan is cleaning his bike.
[00:01:45.350]
It looks much better now, but his hands don't.
[00:01:48.760]
Now they need cleaning.
[00:01:50.800]
Dan washes up, because for one thing,
[00:01:53.240]
the soap and water are washing away microbes.
[00:01:56.118]
[otherwordly sound effect]
[00:01:58.711]
- Microbes, microbes [laughs].
[00:02:02.208]
Um, I don't think about microbes, nope.
[00:02:04.753]
[00:02:06.310]
- As parents, we all just want to keep our kids safe.
[00:02:09.220]
I don't think we ever stop worrying about them.
[00:02:11.910]
But some of the trickiest worries
[00:02:13.690]
are about things we can't even see.
[00:02:16.032]
- [TV Announcer] We like to keep the things that we own
[00:02:18.184]
as clean as we can.
[00:02:19.820]
Dan washes up because dirty hands
[00:02:21.910]
don't look very good.
[00:02:23.110]
- Before the internet, that's how we learned
[00:02:25.190]
about important issues.
[00:02:26.530]
Have you learned anything? - Nope.
[00:02:29.570]
- Well what were they trying to tell you?
[00:02:31.727]
[laughing]
[00:02:33.040]
- Dan needs to wash his hands because his hands are dirty.
[00:02:38.040]
[00:02:38.890]
- Definitely old school, so what does modern science
[00:02:42.338]
tell us about germs and microbes?
[00:02:45.676]
[energetic string music]
[00:02:47.820]
- [Brett] Microbes are everywhere.
[00:02:49.840]
They're in deep sea vents
[00:02:51.140]
way under the sea at high pressures.
[00:02:53.183]
[00:02:54.130]
They're in lakes a thousand feet under the ice.
[00:02:56.553]
[00:02:57.980]
They've been here long before we were
[00:02:59.830]
[00:03:01.030]
and they've built this world as we know it
[00:03:03.130]
[00:03:05.140]
and contributed to all the life forms we see around us.
[00:03:07.890]
[00:03:08.990]
- Microbes are actually part of our physiology.
[00:03:11.953]
[00:03:13.440]
The way we developed, the way our organs
[00:03:15.800]
and our systems develop in our body depend
[00:03:18.130]
not only on functions that are encoded
[00:03:21.810]
or produced by our genes, they're reliant on our microbes.
[00:03:25.663]
[00:03:28.340]
- [Brett] There's at least as many microbes
[00:03:29.690]
in and on us as there are human cells.
[00:03:31.753]
[00:03:32.680]
They're so numerous that they outnumber
[00:03:34.127]
the number of stars in the galaxy.
[00:03:35.753]
[00:03:37.860]
- We all have around 35 to 40 trillion
[00:03:40.510]
bacterial cells alone inside our bodies.
[00:03:42.903]
[00:03:43.870]
Most of them reside in our intestine,
[00:03:45.890]
and they play a fundamental role
[00:03:47.720]
in how our bodies develop and how they function,
[00:03:50.980]
everything from producing little chemicals
[00:03:53.050]
that your body needs,
[00:03:54.550]
all the way through to fighting off other pathogens--
[00:03:57.370]
other dangerous bacteria or dangerous viruses
[00:04:00.540]
which you would otherwise be susceptible to.
[00:04:02.840]
- We and our microbes, it's not just two separate things.
[00:04:05.920]
It's just like another organ that we have.
[00:04:08.166]
[00:04:09.074]
- [Jack] Microbes can produce chemicals
[00:04:10.380]
which actually affect how our brains develop
[00:04:12.490]
and even how we behave. [baby crying]
[00:04:15.777]
"Hangry" may be a real thing.
[00:04:17.800]
We know that microbes can play a role
[00:04:19.380]
in diabetes, in obesity, in asthma and food allergies.
[00:04:23.843]
[00:04:27.784]
- In the last 50 years, we've seen an incredible decrease
[00:04:30.843]
in the amount of infectious diseases--
[00:04:32.810]
measles, mumps, tuberculosis, hepatitis.
[00:04:35.893]
That's great.
[00:04:37.220]
But in the same time frame, we've seen
[00:04:39.460]
almost an equal increase in the number
[00:04:42.200]
of autoimmune diseases, allergies, asthma,
[00:04:45.670]
diabetes, intestinal disorders, and obesity.
[00:04:49.113]
[00:04:50.451]
[waves lapping]
[00:04:53.118]
[00:04:55.803]
- My brother and my sister had very severe, chronic asthma,
[00:04:58.670]
the type that does not get controlled easily.
[00:05:01.210]
You almost have to put them in a cocoon
[00:05:03.140]
to prevent them from getting sick.
[00:05:05.800]
They can almost stop breathing
[00:05:07.400]
or you can see them changing color
[00:05:09.310]
due to the lack of oxygen.
[00:05:11.799]
[00:05:13.557]
[gentle piano music]
[00:05:16.307]
[00:05:22.130]
- When I see Ziair in an attack, sometimes I can't think
[00:05:27.130]
[00:05:27.815]
because I'm trying to think of what to do.
[00:05:30.520]
And there's nothing to do other than
[00:05:32.550]
just give him the three medications that they give him,
[00:05:36.032]
and if that seems not to be working
[00:05:37.821]
I feel scared.
[00:05:39.153]
[00:05:41.830]
- I try not to think too much about the fears,
[00:05:43.906]
but they're there.
[00:05:45.295]
[00:05:47.870]
- He is 12 weeks, I want him to be healthy
[00:05:51.310]
and grow up to be whatever he wants to be.
[00:05:53.633]
[00:05:57.352]
- There's only about a hundred different kinds of bacteria
[00:05:59.310]
that actually cause bacterial infections,
[00:06:02.130]
yet we have thousands of different species
[00:06:03.920]
in and on us, living on our bodies.
[00:06:06.255]
They help our brain develop, they help our gut develop,
[00:06:08.900]
they help our immune system develop,
[00:06:10.970]
and when you take them out of the equation
[00:06:12.730]
we realize this doesn't happen.
[00:06:14.280]
[00:06:15.350]
Then we started to see this rise in obesity
[00:06:17.620]
and allergies and asthma and autism and ADHD
[00:06:20.720]
and, y'know, you pick your disease.
[00:06:22.303]
[00:06:25.940]
- But how could microorganisms that live in your gut
[00:06:28.500]
affect your odds of developing asthma,
[00:06:30.840]
which is a disease of the lungs,
[00:06:33.081]
or diabetes, which is a blood sugar disorder?
[00:06:36.650]
In the next 50 minutes, we're gonna talk to families,
[00:06:39.510]
researchers and scientists to try and figure out
[00:06:42.660]
what's harming our microbiome,
[00:06:44.910]
and what we can do to reverse this dangerous trend.
[00:06:48.453]
[00:06:49.540]
But first, a quick biology primer.
[00:06:52.243]
[00:06:53.150]
A microbe is basically any living thing
[00:06:55.540]
that's too small to see without a microscope.
[00:06:58.330]
That includes protozoa, viruses, fungi, and bacteria.
[00:07:03.330]
[00:07:03.670]
Microbes are the oldest and most successful
[00:07:05.930]
life forms on earth.
[00:07:07.320]
And we've evolved with them, in a deeply complex
[00:07:10.410]
symbiotic relationship.
[00:07:11.943]
[00:07:13.060]
Microbes train our immune systems,
[00:07:15.283]
help us digest our food, and even help us fight disease.
[00:07:19.773]
[00:07:21.660]
Without microbes producing vitamin K for example,
[00:07:25.290]
our blood wouldn't coagulate
[00:07:27.170]
and we'd pretty much all bleed to death.
[00:07:30.060]
Yuck!
[00:07:30.893]
[00:07:32.606]
- It turns out that you and I
[00:07:33.470]
are basically genetically identical.
[00:07:34.840]
We're 99.99% of the chromosome the same between us, right?
[00:07:39.140]
And all humans are like that.
[00:07:40.550]
What's different is their microbes.
[00:07:42.322]
[jaunty orchestral music]
[00:07:45.380]
What we're finding is that we're actually
[00:07:47.320]
not being very good to our microbes.
[00:07:49.662]
[00:07:52.880]
Ironically, our grandparents had much better microbes
[00:07:55.412]
than we do now.
[00:07:56.420]
[00:07:58.832]
- And how do we know what kind of microbes
[00:08:00.970]
people had a hundred years ago?
[00:08:02.520]
[00:08:04.218]
Mostly from the guts of World War I soldiers
[00:08:06.597]
buried in permafrost.
[00:08:08.820]
And even further back, from frozen Viking latrines.
[00:08:13.300]
The microbes in these samples
[00:08:14.420]
are totally different from what are found
[00:08:16.140]
in modern European populations today.
[00:08:18.693]
[00:08:19.670]
- [Marie-Claire] In the past century or two,
[00:08:21.330]
we really have been cleaning up the world,
[00:08:23.710]
and there's been really drastic changes
[00:08:25.780]
not only in the type and the number of microbes
[00:08:28.390]
that we get to live with,
[00:08:30.091]
but also the consequences in our bodies.
[00:08:32.743]
[00:08:35.250]
- We're missing these essential microbes
[00:08:36.900]
that we need just to live normally.
[00:08:38.943]
- And that leads to disease? - Yep.
[00:08:40.560]
There's a lot of data indicating that this does.
[00:08:42.750]
You can take mice that don't have any microbes.
[00:08:44.670]
Their brains don't develop normally,
[00:08:46.060]
their immune system does not develop normally,
[00:08:47.840]
their gut doesn't develop normally.
[00:08:49.640]
And what we're now realizing
[00:08:51.210]
is that many of these diseases have screwed up microbes,
[00:08:54.240]
and in several cases we're showing
[00:08:55.990]
that the screwed up microbe
[00:08:57.420]
is actually contributing to the disease.
[00:09:00.753]
[00:09:09.070]
- So what happened?
[00:09:10.800]
If the rise of so many modern diseases
[00:09:13.140]
stems from our kids' missing microbes--
[00:09:15.620]
the ones that our grandparents all had--
[00:09:18.696]
where'd they go?
[00:09:20.597]
[blocks crashing] [all laughing]
[00:09:24.264]
[00:09:25.564]
[upbeat instrumental music]
[00:09:28.380]
- In this one generation, in about 30 years,
[00:09:30.890]
the rates of asthma have quadrupled.
[00:09:34.120]
That's huge, huge numbers.
[00:09:36.370]
And it can't just be genetics,
[00:09:37.780]
because my mom's genes aren't particularly different
[00:09:41.110]
from my genes.
[00:09:42.385]
So it's something about the environment
[00:09:44.093]
that kids are growing up in today.
[00:09:46.790]
- [Marie-Claire] We're depriving our bodies
[00:09:48.710]
of this healthy exposure to microbes,
[00:09:50.840]
especially when we're young.
[00:09:52.783]
[00:09:54.160]
- [Becky] Dr. Marie-Claire Arrieta
[00:09:55.400]
is looking at how microbiomes in different cultures
[00:09:58.400]
can lead to different health outcomes.
[00:10:01.150]
In Ecuador, for example, she studied a community
[00:10:03.660]
where part of the population got clean drinking water,
[00:10:06.520]
and part did not.
[00:10:07.803]
[00:10:10.850]
- People that had potable, clean water in their homes
[00:10:14.740]
had a higher risk of asthma,
[00:10:17.150]
and that really surprised us
[00:10:18.810]
because it possibly showed that it is really
[00:10:21.340]
that microbial environment around the type of water
[00:10:25.410]
that they're drinking and other exposures
[00:10:28.000]
that are driving this risk.
[00:10:30.523]
[00:10:31.450]
Now of course we want clean water
[00:10:33.095]
because we need to avoid infectious diseases,
[00:10:35.630]
they're quite dangerous-- but we want both.
[00:10:38.940]
We want clean water, but we also want lower risk.
[00:10:42.240]
[00:10:44.700]
- [Becky] Now, along with Dr. Cecilia Ximenez
[00:10:47.210]
of The National Autonomous University of Mexico,
[00:10:50.110]
she's looking at microbiome-related health outcomes
[00:10:53.310]
of kids in Xoxocotla, Mexico.
[00:10:55.583]
[00:10:58.560]
- Whether it is a tropical forest
[00:11:00.620]
or the arctic tundra or our gut microbiome,
[00:11:04.320]
one of the critical aspects in ecosystems
[00:11:07.320]
is this concept known as diversity.
[00:11:09.913]
[00:11:13.510]
Even from early ages, the microbiomes here
[00:11:16.330]
start a lot more diverse.
[00:11:18.263]
[00:11:19.280]
With the process of industrialization,
[00:11:21.450]
we seem to have lost about a third of the diversity
[00:11:25.100]
in our microbiome.
[00:11:26.457]
And that's pretty huge.
[00:11:27.723]
[00:11:29.020]
These kids, just like kids in North America,
[00:11:31.710]
will play a lot with other kids,
[00:11:33.220]
but they may do it in a different way here.
[00:11:35.740]
They may be bare feet when they're kicking around a ball
[00:11:38.990]
and they're also more exposed to animals--
[00:11:40.810]
and not just your average cat or dog,
[00:11:42.830]
they have goats and chickens and cows
[00:11:46.150]
and pigs, even, around where they live.
[00:11:48.803]
[00:11:49.710]
I mean, these kids eat peanuts in preschool
[00:11:52.360]
as a healthy snack.
[00:11:54.180]
It's a very different way of growing up,
[00:11:56.840]
and we can learn a lot from diversity
[00:11:59.470]
and other components of the microbiome
[00:12:01.130]
and their immune system.
[00:12:02.373]
[00:12:04.864]
[speaking in Spanish dialect]
[00:12:08.531]
[00:12:44.356]
[chiming instrumental music]
[00:12:46.730]
- Even though they are at a socioeconomic disadvantage,
[00:12:49.920]
for all intents and purposes
[00:12:51.360]
these are healthy children.
[00:12:53.510]
However, their microbiome is completely different
[00:12:56.050]
to the microbiome in North American children
[00:12:59.160]
and also in other Western countries.
[00:13:02.265]
[00:13:04.580]
In Mexico, the rates of asthma and immune diseases
[00:13:07.287]
like allergies or autoimmune disease
[00:13:09.914]
are down in comparison to the rates
[00:13:12.910]
that we're seeing in the more developed world.
[00:13:15.210]
[00:13:19.500]
- [Becky] Yet even within the more developed world,
[00:13:22.230]
lifestyle differences can profoundly affect
[00:13:24.610]
the variety of microbes that live on and in our children,
[00:13:28.620]
which in turn can significantly impact their health.
[00:13:31.523]
[00:13:33.900]
- We're no longer dying in our millions
[00:13:35.630]
from pathogenic infections thanks to vaccines,
[00:13:38.250]
thanks to public health works.
[00:13:39.780]
However, removing that exposure overall
[00:13:42.413]
may have led to our bodies now becoming
[00:13:45.000]
over-sensitized to the rest of the world.
[00:13:47.103]
[00:13:49.360]
We've known for many years that the rate of asthma
[00:13:51.400]
can be higher in the urban communities, in the cities,
[00:13:54.140]
than it is in the rural communities,
[00:13:56.560]
which we put down to the fact
[00:13:57.700]
that people in urban environments
[00:13:58.930]
are being exposed to more pollution
[00:14:00.840]
in the environments around them.
[00:14:02.440]
[00:14:03.900]
When we first started exploring the Amish populations,
[00:14:06.340]
we noticed that that population of people
[00:14:08.650]
had a very low rate of asthma--
[00:14:09.941]
almost 3% or 4%--
[00:14:11.616]
compared to the average for the United States
[00:14:13.730]
which is around 7% to 8%.
[00:14:15.403]
[00:14:16.450]
We also noticed a sister population to the Amish
[00:14:18.930]
called the Hutterites.
[00:14:20.160]
Both these populations have adopted
[00:14:21.850]
a technology-free lifestyle.
[00:14:23.460]
But the Hutterites had almost 25% asthma
[00:14:26.248]
in their population.
[00:14:28.000]
Genetically, the Amish and the Hutterites
[00:14:30.510]
are the same people.
[00:14:31.690]
They drink unpasteurized milk,
[00:14:33.530]
they eat unpasteurized cheese.
[00:14:35.200]
They live this ultimate foodie lifestyle, almost.
[00:14:38.430]
However, the major difference between them
[00:14:40.335]
is that the Amish live on their farms.
[00:14:42.550]
Their front door is 50 feet from the barn door.
[00:14:45.200]
The kids, before school and after school,
[00:14:47.470]
are working in that farming environment.
[00:14:49.940]
The Hutterites don't.
[00:14:51.400]
The men get in their buggy in the morning,
[00:14:52.880]
drive out to the farm, change into work clothes,
[00:14:55.080]
work on the farm all day, drive home.
[00:14:57.110]
And so the children living at home
[00:14:59.390]
have no exposure to that farming environment.
[00:15:01.560]
They have 25% asthma in their population
[00:15:04.000]
compared to the Amish, who are living and working
[00:15:06.500]
on the farm all the time,
[00:15:07.540]
who have 4% or 5% asthma in their population.
[00:15:10.223]
[00:15:13.100]
- That's powerful evidence.
[00:15:14.970]
Unfortunately, we can't all keep a cow in our front yard.
[00:15:18.153]
[00:15:21.990]
So I've been wondering about my family.
[00:15:24.380]
What do our microbiomes look like?
[00:15:26.380]
I mean, I've chosen to raise my kids here in the suburbs.
[00:15:29.510]
How do our microbes compare to those
[00:15:32.060]
of families from less-developed nations,
[00:15:34.230]
or even farm families right here in the U.S.?
[00:15:37.047]
[00:15:39.090]
There are a number of different companies
[00:15:41.240]
that provide test kits to do just that--
[00:15:44.110]
find out what microbes are in our guts.
[00:15:47.360]
But here's the thing.
[00:15:48.650]
You know how we test for that?
[00:15:50.230]
- Your poop. [laughing]
[00:15:52.840]
- It's for science. - Yay!
[00:15:55.403]
- It's disgusting, yay. [laughing]
[00:15:59.070]
- You just swab a piece of used toilet paper
[00:16:02.130]
and put the sample into the vial that they provide.
[00:16:05.983]
[00:16:07.978]
I'll spare you watching this part.
[00:16:10.926]
[00:16:14.310]
A few weeks later, I get back the results,
[00:16:16.570]
and call up Dr. Arrieta to help me understand them.
[00:16:19.483]
[00:16:21.211]
- Hi. - Hey Claire, how are you?
[00:16:22.836]
- Good.
[00:16:23.669]
How are you? - I'm great.
[00:16:24.880]
I'm really curious, are my family's microbes normal
[00:16:29.210]
or are they close to what used to be normal?
[00:16:32.140]
- Great question.
[00:16:33.178]
You and your kiddos
[00:16:34.411]
have the prototypic North America microbiome...
[00:16:37.790]
- Is that good or bad? - It's different.
[00:16:40.700]
We're now at a time where we can only talk
[00:16:43.668]
in terms of "associated with."
[00:16:46.257]
We do not know if that particular bug
[00:16:48.656]
is going to cause diabetes later on, or obesity later on.
[00:16:52.880]
We're still not there yet, but we can associate it.
[00:16:56.600]
- So my son, Finn, has asthma.
[00:16:58.600]
Is there any benefit in taking him to visit a farm?
[00:17:02.467]
- Unfortunately, no.
[00:17:03.690]
I mean, you're thinking of just packing it up
[00:17:05.550]
and moving to a farm hoping
[00:17:07.220]
that his asthma is going to get better?
[00:17:08.879]
No.
[00:17:09.712]
In fact, it would probably get worse.
[00:17:11.810]
At the same time, we do know that being raised in a farm
[00:17:16.320]
is a protective factor.
[00:17:18.710]
This exposure to the microbes
[00:17:21.310]
that are common in a farm,
[00:17:23.503]
they are able to train the immune system
[00:17:26.950]
into this state that is not going to lead to asthma.
[00:17:31.300]
So it seems that it's early life when it matters the most.
[00:17:34.473]
[00:17:39.480]
- All right, let's dig into that a little.
[00:17:41.380]
Asthma is a chronic disease that already affects
[00:17:44.650]
about 1 in 12 North American children.
[00:17:47.230]
And it's on the rise.
[00:17:48.803]
[00:17:50.700]
Scientists who study the microbiome
[00:17:52.500]
focus so much of their attention on asthma
[00:17:54.680]
because it's often just the first
[00:17:56.350]
of many immune disorders that cause problems.
[00:17:59.063]
[00:18:00.500]
- It affects families like you wouldn't believe.
[00:18:03.103]
[00:18:04.070]
Parents miss work, children miss school.
[00:18:06.560]
I've had parents actually lose jobs
[00:18:08.620]
because they had to take off so much time.
[00:18:10.970]
So that affects all of society,
[00:18:12.820]
because then now the parent isn't able to go back to work
[00:18:15.670]
because the child has been sick so often
[00:18:17.850]
that the employer finally has to let them go.
[00:18:20.960]
So it has large, far-reaching repercussions.
[00:18:25.960]
[00:18:26.403]
[water bubbling]
[00:18:27.953]
[00:18:33.002]
- Do you see how much he's pouring?
[00:18:34.782]
Keep on going.
[00:18:36.420]
I began to see him labor with his breathing.
[00:18:40.640]
I could literally see in his throat,
[00:18:43.504]
[inhaling and exhaling slowly] I could see that.
[00:18:48.504]
[00:18:49.410]
Then I began to hear it.
[00:18:51.847]
[00:18:54.671]
He literally would not be able to breathe,
[00:18:56.588]
and it would just come out of nowhere.
[00:18:58.740]
- It's hard to breathe when I'm like that,
[00:19:01.230]
and then my stomach starts hurting and I feel sick.
[00:19:05.950]
- This is an illness that's chronic,
[00:19:08.590]
that could take my son's life.
[00:19:10.383]
[00:19:14.770]
- I hear children saying all the time, "I don't take gym.
[00:19:17.347]
"I know I'm overweight, but I can't take gym
[00:19:19.577]
"because I have asthma."
[00:19:21.037]
[00:19:22.780]
We want them to be physically active,
[00:19:24.700]
but they are afraid to be active
[00:19:26.110]
because they're afraid they're going to have
[00:19:27.460]
an asthma attack and die.
[00:19:28.713]
[00:19:30.016]
[tender piano music]
[00:19:32.516]
[00:19:33.980]
- We try to let him operate as a regular kid, you know.
[00:19:37.520]
But the reality is, is he's not.
[00:19:40.143]
[00:19:44.775]
- When the kids are playing I'll be like,
[00:19:47.072]
"Naw, I don't wanna go outside."
[00:19:49.922]
[00:19:51.514]
And I just stay inside.
[00:19:53.730]
[00:19:54.750]
- I can't control his breathing.
[00:19:56.940]
I can't control the medicine intake.
[00:19:59.630]
I can't control the doctor's prescription.
[00:20:02.530]
But what I can control is the love
[00:20:05.500]
and the commitment that we have for one another.
[00:20:08.343]
[00:20:12.510]
Ziair's big brother, Amir, takes really good care of him.
[00:20:16.593]
[00:20:17.590]
He is always around and, like, literally,
[00:20:20.780]
he wants to be around him.
[00:20:22.620]
He comes around when other big brothers
[00:20:25.230]
would rather have their little brother be somewhere else.
[00:20:28.690]
How you feel? - I feel good.
[00:20:30.976]
- You need your medicine? No? - I don't think so.
[00:20:34.678]
- [Audrey] Amir is often sad
[00:20:37.150]
because he's in the same position as me,
[00:20:39.740]
watching his baby brother struggle to gasp for air.
[00:20:44.740]
[00:20:48.060]
If I had a magic wand, my son would be able to breathe
[00:20:51.360]
so that he could live the best life that he can have.
[00:20:54.483]
[00:20:59.140]
- Asthma is the number one reason
[00:21:01.460]
for children going to hospital,
[00:21:03.430]
number one reason for children missing school.
[00:21:05.990]
Number one reason for billing
[00:21:07.750]
to the healthcare system, is asthma.
[00:21:09.673]
[00:21:10.980]
About 10 years ago a bunch of Canadians
[00:21:13.150]
got together and said, "We don't know what's causing asthma.
[00:21:15.697]
"There's a huge increase, we've gotta do something."
[00:21:18.297]
[00:21:21.120]
The Allergy, Genes and Environment Network
[00:21:23.370]
had already been looking into the causes
[00:21:25.250]
and treatments of asthma and allergies.
[00:21:27.290]
So AllerGen, along with a Canadian team of leaders
[00:21:30.490]
in clinical work and research, launched
[00:21:32.720]
the Canadian Healthy Infant Longitudinal Development Study.
[00:21:36.293]
[00:21:39.010]
- The CHILD Study was developed to explore
[00:21:41.530]
the early origins of allergy and asthma--
[00:21:44.550]
what happens during pregnancy
[00:21:46.270]
and the first few years of life.
[00:21:48.273]
[00:21:50.010]
- One of the things that was really brilliant
[00:21:51.720]
about the CHILD study was that we took the stool samples
[00:21:54.940]
from those kids when they were born,
[00:21:57.020]
when they were three months old,
[00:21:58.283]
when they were one year old, and we froze them down.
[00:22:01.432]
And then we were able to compare the bacterial composition
[00:22:04.462]
in kids who went on to have asthma versus those who didn't.
[00:22:08.170]
And we found that those kids who were at highest risk
[00:22:10.372]
of asthma seemed to be missing four bacteria,
[00:22:14.032]
and interestingly they were missing those bacteria
[00:22:16.357]
in the first 100 days of life.
[00:22:18.800]
- What are the bacteria? - So the bacteria
[00:22:21.030]
have complex Latin names--
[00:22:23.310]
Faecalibacterium, lachnospira, veillonella and rothia.
[00:22:27.790]
That's a bit of a mouthful, so we nicknamed them FLVR.
[00:22:31.760]
F-L-V-R.
[00:22:33.180]
- But how would the bacteria fight asthma?
[00:22:37.011]
- So asthma and allergy is really actually
[00:22:39.003]
an immune system problem.
[00:22:40.728]
And what we've learnt is that the gut bacteria,
[00:22:43.430]
we call that the microbiome,
[00:22:44.990]
is really important for training
[00:22:46.690]
and educating the immune system.
[00:22:48.700]
We don't know exactly what's going on yet.
[00:22:51.720]
We have evidence that those FLVR bacteria make chemicals--
[00:22:54.675]
we call them metabolites--
[00:22:56.333]
and that those metabolites train up the immune system.
[00:22:58.820]
We know that children who get more antibiotics,
[00:23:01.427]
they have higher risk of asthma.
[00:23:04.183]
Children born by ceasarean section
[00:23:06.424]
have higher risk of asthma.
[00:23:08.230]
Kids who live on farms have a lower risk of asthma.
[00:23:11.180]
[00:23:12.110]
So when you start putting all those elements together
[00:23:14.602]
one of the common themes there is actually
[00:23:16.540]
the bacteria that live inside us.
[00:23:18.503]
[00:23:21.050]
- If this were a crime show, I'd say
[00:23:23.358]
"Lifestyle changes. Guilty"
[00:23:25.616]
But lifestyle and environment aren't the only suspect,
[00:23:29.470]
and asthma is not the only crime.
[00:23:32.363]
[00:23:33.421]
[brooding instrumental music]
[00:23:36.088]
[00:23:38.440]
Every doctor and scientist I've talked to
[00:23:40.600]
says you can't start too early
[00:23:43.180]
developing a healthy microbiome.
[00:23:45.170]
Those first 100 days are crucial.
[00:23:48.000]
There is some indication of microbial transfer in utero,
[00:23:51.970]
but the biggest transfer happens at the moment of birth.
[00:23:55.463]
[00:23:59.250]
- Birth is a very messy process.
[00:24:00.660]
Ironically, this is important.
[00:24:02.010]
I jokingly say that the best birthday present
[00:24:04.720]
you ever give your kid is the very first one
[00:24:06.630]
and that's this-- this big dose
[00:24:08.400]
of vaginal and fecal microbes.
[00:24:10.380]
Boom, you're born with this.
[00:24:11.955]
Welcome to the world, kid.
[00:24:13.338]
- Happy Birthday! - Happy Birthday.
[00:24:14.670]
That's really important because it kicks up
[00:24:16.390]
the immune system and it gets the digestive tract going,
[00:24:19.140]
it gets the brain going, and if you have a C-section,
[00:24:22.010]
unfortunately you miss that.
[00:24:24.343]
[00:24:25.230]
- Between 2000 and 2015, the rate of C-section worldwide
[00:24:28.950]
has doubled, and children at the age of seven
[00:24:31.700]
had a 50% increased risk of obesity
[00:24:34.460]
if they were delivered by C-section
[00:24:36.470]
compared to their vaginally-delivered counterparts.
[00:24:39.323]
[00:24:41.870]
- We know that ceasarean sections
[00:24:44.055]
are often life-saving and medically necessary
[00:24:46.580]
for both moms and babies,
[00:24:48.500]
but babies born by C-section really don't get exposed
[00:24:51.530]
to mom's vaginal flora at all.
[00:24:53.500]
Their bacteria often resemble that in the
[00:24:55.690]
operating room, or of the mother's skin.
[00:24:58.850]
But babies born by ceasarean section
[00:25:00.960]
are at increased risk of different health problems
[00:25:03.550]
including obesity, allergies and asthma.
[00:25:06.653]
[00:25:08.930]
- My first children are one-year-old twins
[00:25:11.210]
and they were born via C-section.
[00:25:12.890]
And then I did get pregnant again [laughs],
[00:25:15.957]
and because it was so close together
[00:25:19.210]
it's really not recommended to have a vaginal birth
[00:25:22.150]
because there's a possibility of uterine rupture.
[00:25:25.033]
[00:25:27.630]
- I had a complete previa with her,
[00:25:30.260]
so they had to do a C-section for that one
[00:25:32.650]
and there were some complications.
[00:25:34.910]
So then the doctor recommended a C-section for Liv also.
[00:25:39.683]
[00:25:40.950]
- I've worked with kids that have had health issues,
[00:25:43.300]
and even the minor ones, it's alot for a child.
[00:25:45.820]
It's alot in school, it's alot for the parents.
[00:25:48.510]
It can be very difficult.
[00:25:49.950]
So if there was any way that I could decrease
[00:25:52.840]
those chances of them having health issues, I would do that.
[00:25:57.170]
I think any parent would do that.
[00:25:58.673]
[00:26:02.330]
- I hope that they're going to be safe,
[00:26:04.230]
[00:26:07.602]
and that they have a good childhood growing up
[00:26:10.470]
[00:26:13.140]
and that nothing ever happens to them.
[00:26:16.307]
[00:26:21.900]
- [Becky] Antibiotics are wonder drugs.
[00:26:24.340]
They've saved countless millions of lives.
[00:26:27.482]
But what we now realize is that antibiotics
[00:26:30.310]
don't just kill the bad germs that cause infection,
[00:26:33.660]
they can kill all microbes.
[00:26:35.673]
[00:26:36.800]
- The negative effects of damaging the microbiome
[00:26:39.270]
at an early age is that you are damaging
[00:26:41.972]
the way their immune system develops.
[00:26:44.453]
[00:26:45.910]
And because of that, they can get diseases
[00:26:48.232]
such as asthma, allergies, multiple sclerosis--
[00:26:51.468]
even autism, we're learning now--
[00:26:53.540]
and also metabolic diseases such as obesity and diabetes.
[00:26:57.043]
[00:26:59.910]
- Life expectancy today is 30 years longer
[00:27:02.670]
than it was just a century ago, largely due to antibiotics.
[00:27:07.303]
[00:27:08.810]
During the Civil War, more people died
[00:27:10.820]
of infectious diseases than from bullet wounds.
[00:27:14.463]
[00:27:15.550]
But with all the benefits of antibiotics,
[00:27:17.690]
have we traded one class of ailments for another?
[00:27:20.935]
[00:27:25.460]
Doniga Markegard raises grass-fed beef
[00:27:27.838]
just south of Half Moon Bay, California.
[00:27:30.660]
And her kids? - Oh, it pooped!
[00:27:32.600]
- Yeah, they're fairly free-range as well.
[00:27:34.913]
[00:27:38.760]
I love seeing your kids out here playing in the pond.
[00:27:42.090]
Do they swim in here in the summer?
[00:27:43.500]
- Oh gosh, yeah. [laughing]
[00:27:45.310]
Strip down naked, cover themselves with mud.
[00:27:48.383]
Yeah, they love it. - It's great.
[00:27:50.500]
- Yeah, all my kids were born right here on the ranch.
[00:27:53.620]
And I made it a point that they would go
[00:27:57.710]
right from breast milk to food that we either
[00:28:01.003]
grow or raise, or that we source from local organic farms.
[00:28:04.830]
And they don't suffer from any of the common things
[00:28:08.278]
that you see with kids, like allergies or asthma
[00:28:12.336]
or runny noses and things like that.
[00:28:15.470]
[00:28:17.760]
- [Becky] Of course, this is just one family
[00:28:20.330]
who might just be lucky.
[00:28:22.550]
But the real reason I've come here
[00:28:24.110]
is to talk about a simple fact.
[00:28:26.660]
- 80% of the antibiotic use in this country
[00:28:30.230]
is fed to livestock. - Wow.
[00:28:32.163]
[00:28:33.030]
- It's proven that antibiotics help growth promotion,
[00:28:36.573]
[00:28:37.810]
whereas our animals that are raised on a natural diet
[00:28:42.440]
take a couple years to finish.
[00:28:45.110]
In a feedlot, many of those animals might start on grass,
[00:28:48.446]
but then they'll go into a feedlot to finish.
[00:28:51.380]
And so with the feed rations and that antibiotic use,
[00:28:55.504]
they can get those animals to finish in 18 months.
[00:28:58.423]
[00:28:59.990]
It's a profitable way that farmers have found
[00:29:04.160]
that they can produce large amounts of meat
[00:29:06.840]
in a shorter amount of time.
[00:29:09.073]
[00:29:10.420]
- [Becky] So it seems like ranchers have known for decades
[00:29:13.530]
that antibiotics make livestock put on weight faster.
[00:29:17.530]
And experts confirm the same is true of humans.
[00:29:21.816]
- Babies exposed to antibiotics,
[00:29:23.770]
especially in the first six months, the first year,
[00:29:25.861]
are more likely to develop obesity later in childhood.
[00:29:29.273]
[00:29:31.370]
It's not that every child that receives antibiotics
[00:29:33.570]
is going to develop asthma or become obese.
[00:29:35.820]
But we do see a significant association.
[00:29:38.173]
[00:29:39.780]
Antibiotics sometimes are really important
[00:29:41.475]
and life-saving drugs,
[00:29:42.712]
but sometimes they're also used unnecessarily.
[00:29:44.903]
[00:29:46.570]
- In fact, even the CDC states that
[00:29:48.847]
"30% to 50% of antibiotics prescribed in hospitals
[00:29:52.237]
"are unnecessary or inappropriate."
[00:29:54.927]
[00:29:58.150]
So, antibiotics-- good, but not great.
[00:30:01.963]
[00:30:08.680]
Food allergies increased 50