We are not alone

Science News Magazine has been published since 1922, over ninety years. The news arm of the non-profit Society for Science and the Public educates and informs the public about current happenings in science and technology. It has covered such seminal events as the first man-made nuclear reaction, the first electronic computers, man’s first walk on the Moon, and the first jet aircraft. For some time, the editors have selected the top science story of each year.

For 2013, there were plenty of candidates. The amazing rise of miniature unmanned aerial vehicles (drones). Gene therapy advances in managing blood cancers. The ability to grow replacement organs from scratch. The Nobel prize in physics for the discovery of the Higgs boson.

But what was the top science story of 2013? Bugs.

Or more precisely, bacteria and other organisms which make up the microbiota living on and within the human body.

In a steady stream of studies and reports throughout the year, we learned more and more about our remarkable little cousins. For instance, the fact that only 10 percent of your cells are human; the other 90 percent are a mixture of bacteria, fungi, and viruses. (That microbes are so tiny and human cells relatively huge accounts for the fact that, by mass, our microbiota only amounts to a few pounds).

Scientists are even beginning to argue that we should view the human body as a superorganism defined by this mixture of human and microorganism DNA (microbiome). The advantage in doing so is that it might help us better understand the effects of diet, chemical exposure, and other factors on our health.

It is important to note that our community of microorganisms is for the most part beneficial. They help us digest food and convert it more efficiently to energy. They influence the immune system, training it to identify and fight true pathogens. They produce hormones instructing our body to store fats, and create necessary vitamins. To understand the workings of the human body without considering our microbiome is, we are finding, impossible.

Michael Pollan, in an in-depth New York Times Magazine article (“Some of My Best Friends are Germs”, May 15, 2013), details his research into this new frontier. Starting with a submission of swabs to the BioFrontiers Institute at the University of Colorado, he received a detailed report of his personal microbiome. Pollan interviews the scientists involved in the project and describes how our microbiome, unique as a fingerprint, is developed. Soon after birth, a community of microbes takes hold in the infant gut. Its composition from there is influenced by environment and, mostly, diet. In fact, the BioFrontiers scientists can identify from a person’s swab samples both where they live in the world and what is the makeup of their diet.

Researchers have observed that obesity may be encouraged by a certain mix of gut flora. And that mix of flora is a result of diet. Meat eaters have a distinct pattern of gut flora from vegetarians. Diets high in sugars and fats are quickly absorbed, denying nutrition to our little minions. They prefer diets high in fiber and complex carbohydrates; these take much longer to digest. What a surprise, then, to see that independent research into low glycemic index (GI) diets have concluded that diets high in fiber and complex carbohydrates are highly preferable for health. The microbes are the key, and they live or die by our dietary choices.

So what might this flood of human microbiome research mean? Perhaps we’ll find that our war on bacteria, with a plethora of antibiotic soaps and cleaning products, might be taking a toll on our little helpers. Certainly we need to be concerned with pathogens, but perhaps we are overdoing it.

We might find that diet books of the future will focus on cooking for our whole selves. Lightly cooked vegetables, whole grains, al dente pasta, for instance, all take longer to digest and provide the fiber that our gut bacteria thrive on. Feed them well and they will serve us well. It would be a complete change in perspective and provide a grand new toolset for managing obesity and optimizing health.

There is much research yet to do and understanding to be gained. But it is exciting that we are beginning to comprehend the owner’s guide to the whole human being.

Socialization and social comity

President William Howard Taft

The CDC has spoken and we are fat. The worst state, Mississippi, has an obesity rate of 35%. Massachusetts, the third best, has nothing to brag about with nearly one out of four citizens tipping the scales at “unhealthy.” This 2011 study was based on self-reporting and people tend to gild the lily. Another more rigorous report which involved weighing participants estimates that 36% of all Americans are overweight.  We are in the midst of a true epidemic.

Obesity is serious because it increases the incidence of diabetes, heart disease, cancer, and stroke among other ailments. Quality of life is worsened and mortality rate increased. Obesity results in significantly elevated health care costs.  And while it is easy to make rationalizations, obesity is a choice. What and how much we put in our mouths, whether and how frequently we exercise; these are personal choices.

We hear the term “socialization” tossed about frequently. By this, we don’t mean the process of making your puppy play well with others, but rather, the spreading of risks and costs across a large group of people.

It is a familiar concept.  One common example of socializing risk is automobile insurance.  Every driver (at least in Massachusetts) is required to carry automobile insurance.  In a given period, not everyone will have an accident, but everyone pays premiums.  The unlucky few who actually suffer a loss are compensated from the pool.

But this is not, in itself, socialization of risk.  If a 19-year-old from Roxbury paid a premium based on his actual risk of loss, it might be $10,000 per year.  Meanwhile, a 50-year-old woman in rural western Massachusetts might pay only $400.  But that’s not how we do it.  The state, in its wisdom, has deemed that we should all pay more so that the young scofflaw in Roxbury pays less.  This is true socialization of risk, the salient point being that it is actuarially unfair. (Unfair in that the woman from western Mass, along with most of us, pay more than we should while the young man pays far less than he should). This leveling of risk premium removes from the young man in Roxbury the incentive to drive exceedingly carefully.

In other words, socialization of risk distorts our decision making process and leads to more risky behavior (because risk, and hence cost to the individual, is subsidized).  It is always true that to get less of something, tax it; to get more, subsidize it. Subsidizing risky behavior is a sure fire way to get more.

Any form of national health care is another variety of risk socialization. Our increasingly socialized health care system does not charge premiums based on risk factors.  For instance, an inveterate rock climber does not pay higher health insurance premiums than you do, but she takes much greater risks.  Likewise, a motorcycle racer, skier, pilot, scuba diver, or lumberjack do not pay higher premiums than you do.  Health risks are subsidized.

It was different in an earlier era.

William Howard Taft, our 27th president, served from 1909-1913.  He was morbidly obese, suffered from high blood pressure, severe sleep apnea, and died of a heart attack. But at that time, each was responsible for his own behaviors and the resultant consequences. Taft ate richly and drank to excess, did not exercise, packed on the pounds, and suffered poor health as a result. But no one had to pay Taft’s physician except Taft.

In this day of increasingly socialized medicine, where poor personal choices engender no individual costs but burden the public fisc, it is difficult to observe such profligacy without comment, or at least smoldering resentment.  Socialization is making us downright rude.

But government, which is adept in creating such a mess, can further intervene. A recent article in The Telegraph (London) offered such a solution:

“Ridiculing someone as 'fat' or 'obese' could become a hate crime under an idea being floated by a group of MPs and a leading charity.”

This is a solution of sorts.