[SCMP Column] Health Matters

January 02, 2017

By today, thousands in Hong Kong and millions around the world will more-or-less seriously have made New Year Resolutions. Most will not be kept, but so what. I’m sure we are healthier, happier and generally nicer people for making them. For 2017, my own resolution is simple: I am going to take better care of my microbiome.

This time a year ago I don’t think I had ever heard of the word microbiome. But then two marvelous books filled the void. They are not for the squeamish. Did you know that we humans on average boast about 10 trillion cells – and 100 trillion tinier microbial cells – yeasty volatile stuff that digests our food, gobbles up nasty bacteria, and generally wages war inside our immune system? Most of these good bacteria live in our gut, but they also keep busy in our mouth, our armpits and all the other smelly and better-not-talked-about parts of our body. In all, they weigh around 3lb – about the same as our brain.

The two books – The Diet Myth by Prof Tim Spector at Kings College London who heads the British Gut Project, and Follow Your Gut  co-authored by Prof Robert Knight, head of the American Gut Project, with journalist Brendan Buhler – made two things shockingly clear: first, that the state of our health depends more heavily on the balance and vigour of the bacteria populating our microbiome than we had ever realized; and second, that modern diet and lifestyle are putting healthy microbiomes under unprecedented stress.

Apparently, many of our modern-day ailments, ranging from obesity, heart conditions and diabetes to eczema, asthma, and even depression, are the result of bacterial imbalances in our gut and elsewhere. Studies comparing Americans and Europeans with tribespeople living in Papua New Guinea and the Amazon rainforest show that we in the industrialized world have lost a huge variety of beneficial bacteria that have for millions of years evolved together with us and protected us from bad bacteria and an often-hostile external environment.

Things have gone wrong because of processed food diets, a surge in sugar consumption, hyper-hygienic lifestyles and steady attrition from antibiotics. Apparently, the average American child takes 17 courses of antibiotics before he or she reaches adulthood. These purge us of bad bacteria that may be making us sick, but they at the same time purge us of the good bacteria, and compromise our immune systems against future attacks on our health.

Some of the most vivid evidence comes from babies delivered by Caesarian section operations, and babies that are not breastfed. Apparently the bacteria smeared on a baby during its transit through the vagina endow it with immunity that C-section babies never get – which means C-section babies suffer much more extremely from asthma, eczema and other auto-immune sicknesses. Given the proportion of babies in Hong Kong that are delivered by C-section, and are not breast fed, this ought to be a matter of keen concern to us here in Hong Kong.

The fact that I was delivered naturally, was breast fed – and was lucky enough to roll around in lots of countryside mud as a child – perhaps explains why I have never suffered such autoimmune ailments. But after a long period of antibiotic treatment 18 months ago, I have felt my digestive system go haywire. Time for action, I think.

So my New Year Resolution is nothing so commonplace as giving up coffee or wine for a month or two. It involves two specific plans – one simple, and the other a bit more exotic. First, focus on dental care. This may seem trite, but there is a direct link between bacteria active in the mouth and bacteria in the gut. Evidence of imbalances in the mouth can provide important signals to overall health.

Meticulous dental care ought to make sense anyway, given that dental ill-health is the most widespread source of ill-health on the planet, and that one third of the people my age around the world no longer have their own teeth. Untreated tooth decay affects one third of the world’s population – 2.4bn people, with a further 740m suffering severe periodontal disease. According to the World Health Organisation and other expert bodies, the worldwide cost of dental disease is around US$300 a year, and costs over 160 million work hours due to absenteeism in the US alone.

Apparently, the medical profession is waking up to the reality that good oral health translates directly into a healthy microbiome and overall better health. Many are raising questions about why the medical and dental professions are not working closer together to ensure patient health.

For example, in the US, 20m people go to a dentist every year who never see a doctor. Simple swab tests for bacteria in the mouth during a dental examination would give early warning of literally dozens of ailments at early stages of development. And they say people with poor oral health are twice as likely to suffer heart attacks than people with healthy teeth. For Hong Kong, better links between dentists and doctors would seem sensible, and easy to facilitate.

My second resolution is a bit more drastic. After my usual full body check at the Bumrungrad Hospital in Thailand in February, I plan to retreat for a week of starvation and colonic irrigation. I have done this twice before and am quite a fan, despite the discomfort involved. The aim is to rid myself of my currently-impaired microbiome and replenish. As side benefits, I should eliminate the future threat of any colon cancer, have a thoroughly restful week, and – most important – lose five to ten pounds. With a slimline body and a reinvigorated microbiome, I am confident that 2017 is set to be a happier year – whatever the stresses Donald Trump and other political mischief-makers may generate.
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