 Come back to Think Tech here, research in Minoa, our flagship science show every Monday at one o'clock, one o'clock rock, so to speak. And today we have a very, very special guest who has flown in to give a talk at the university, the university at Minoa tomorrow, and his name is Brett Finley, and he is professor of microbiology at the University of British Columbia where he is the Peter Wall Distinguished Professor. He is a world leader in how bacterial infections work, and he's been studying microbes for over 30 years and has published over 450 articles. He's also a founder of the biotech companies NMX, Vendanta and Microbiome Insights. He's an officer of the Order of Canada, which is the highest Canadian civilian recognition you can get. He lives in Vancouver with his wife, and this is a salient point. She is a pediatrician. That's important. Welcome to the show, Brett. Yes, Jay. Yeah, thanks. Great to have you here. And a pleasure. Well, let's talk about your book, which is a scientific bestseller and readable. It's called Let Them Eat Dirt with Brett Finley, and as they say, it's an earthy book. Yeah. Well, I said I always once read a dirty book, so there we go. Dirty book? Okay. I guess the title's a bit misleading. It should be Let Them Eat the Microbes That You Find in Dirt, but really the idea of the book is to write a layperson book, so the science is there, but it's not up front and center. We don't have references so much in it, and it's to basically educate parents, anyone of interest, really the effect that these microbes are having on kids early in life, and knowing that, how can you do better things for your child to help them raise them with your microbes instead of without them, which is what we're trying to do now. So what do microbes do for me? I know that microbes are part of the deal, and if I had no microbes, I could not live. Yeah. But what do they do for me? I do a lot of things. So they live all over us. The numbers are astounding. There's at least as many microbes in and on you as there are human cells. There's 15 times more genes and genetic material, so I love to tell my students they're more microbial than human, which they always get upset at. And they live, like I said, on the skin, scalp, armpits, wherever it's moist, urinary tract. Most of them live in the intestine, especially way down low in the intestine. And I jokely say diarrhea is my bread and butter, because that's where we're gone, so we're going to restrict this for fecal content, but to put it in perspective, if you had one gram of feces, which is basically the tip of your finger, there's more microbes in that in your intestine than all the people in the world. So it's just there's 100 trillion microbes in and on us. What kind of microbes are they? All sorts. Most of them, especially in the gut where there is no air, they live, they're called anerobes. There's no air, so they metabolize differently. But they're very different, and the microbes on your scalp are very different than your armpit than in your intestine, because these are different environments. And what's interesting is everyone's different. There is no conserved human. There's no one species that's found in all people. So they're very different. So even though you and I are 99.9 percent genetically identical, our microbes are at past 50 percent. So I argue that's what makes us individuals. That's what makes us different. It sounds like a great way to do a CIS, that you could make an identification of somebody that would be unique in the world by taking a profile of its microbes. They're already doing that, and they're actually doing pretty good at digging up dead pigs and checking out their microbes change and can we identify which one it was. The other things they do is they help break down our food. So they do most of your digestion, especially, you know, plants and fibers and nuts and legumes and all the things your mom told you you should eat. You never wanted to. They don't do much with white sugar and white flour, because that's already broken down, which is actually bad diet wise. They help us develop our immune system, and that's why they can push you towards allergies and asthma or other ways. And probably the most fascinating area I'm finding these days, the effect of the brain and the effect of how the brain develops. And there's animals that don't have any microbes in them. We call them germ-free animals. Their brains are screwed. They actually do not develop normally. So they're part of our normal development. So and then all the brain diseases such as ADHD and autism and stress and anxiety and depression, these things now all seem to have microbial lengths too. So we knew they were there ever since anti-van leave and hook made the first microscope 330 years ago, but we didn't know what they did. And the last five years as sequencing came online, so you don't have to grow them, we now realize they're there. And that's where this world is just exploding. Yeah, wow, really interesting. So how do I get my microbes? You know, I mean, am I born with them? Yes. So generally thought, it's thought the fetus is sterile, but there's some argument not they can find. So basically, your mother's very first birthday present for you is, it's gross, is basically a big gulp of vaginal and fecal microbes. Sounds terrible, but that actually is really important for setting up life. And if you're born by a caesarean section, your microbes will be more like the mother's skin than the vagina. And the reason that's important is vaginal microbes and fecal microbes are the one that break down breast milk and do this. And so if you're born by a caesarean section, you don't have these. And also the simple fact of born by a caesarean section puts you at much more risk for getting asthma and obesity later in life. So it's as soon as you're born, you bam, you come into this microbial world and you get it from everything you put in your mouth and just everything you contact and watch a little kid, what do they do? They do this the whole time, right? Why are they doing that? You know, they're sampling the microbes. So it starts at birth, it bounces around. If I had a choice, I'd rather not do caesarean then. Yes, but 10% of women have to have caesarean medically. So then the question comes, so there's work going on when the company's involved in is recolonization of vaginal microbes following caesarean section. So even some naturopaths are swabbing out the vagina and then colonizing the kid's mouth and things. So can you replant these microbes that they've missed out on because of medical reasons? Well, the data is still out. We know that you can do that, but whether or not you have to wait three years to see if that affects asthma and obesity. So that experiment is ongoing and I'll call you three years. So there's a lot of look at that. And then as you grow, basically in your childhood, micro, and then you go through adolescence and then you get your adult microbes. And you're collecting them. You're collecting them all the time. But if you live your normal life, your whole adult life is pretty constant unless you do something drastic like move to India, become a vegetarian. If you change your environment, then it changes. But generally speaking, it's pretty constant. And then as you turn 65 or older, your microbes then change again. So they're your friends for life, they're there. If I moved to India, would I do better? If I have a diverse collection of a microbiome, would I be better off? Well, you're going to suffer for several months a severe diarrhea, but once you get past that. So yes, you're right. In a place like India, they have much more diverse microbes, but they also have a lot of infections. And so it's this kind of balance between hygiene, avoiding these infections, and then acquiring your normal microbes. So theoretically, you could establish the perfect, I know I'm wrong about this, but you could establish the perfect biome. I give you an infusion, if you will, of the perfect biome and you're good to go. Yeah, the problem is we don't know what the perfect biome is yet. So we have some clues. And some of the early work we did on asthma, we can take a three-month-old baby, look in their feces, and say, do you have these four microbes or not? If you have these four microbes, you're not going to get asthma. If you don't have those four microbes, you're at high risk for asthma. So then in a mouse, we then showed we could add those four microbes back to human feces, put it in a mouse, we could actually prevent asthma. So where we're heading with this is your child is three months old, you screen the microbes, say you're lacking these, you need to take this probiotic kind of mix of these four microbes. Or if you have to have antibiotics at three months of age, we can replenish this. And by one year of age, it's too late. So yeah, in theory, we can do the recallization, but we just don't know what the good ones are yet. We're still too stupid in that sense. Well, extending the same notion, I mean, if I catch it at the right time in development, say before one year or whatever, whatever that is, I can prevent things other than asthma too, right? Yes, you would prevent allergies, obesity, diabetes, autism, ADHD. There's significant indications there. Really, when you look at the diseases of what we call the Western world or developed world diseases, those are the ones I'm listing, inflammatory bowel disease, et cetera, those all have microbial lengths. And many of those links are set up very early in life. Even before you're born, you're a thin mother, third trimester, and you say, OK, I'm pregnant. I can eat anything I want for once. I don't have to diet. I'm going to gain 100 pounds more than I should. It turns out that when that happens, the mother's microbes go to the obese microbes. When that child is born to a thin mother that over age, they have a much higher chance of being obese, because they inherit the mother's, quote, obese microbes, even though she was thin before that. So even early when the mother's pregnant, you've got to think about what's happening here. Fascinating. So the whole idea, the title of the book, is it's OK to allow your child to have contact with microbes, dirt, whatever it might be. It's OK that he touches his mouth. Is there more specific advice that you would give about that? I mean, where's the limit on it? Yeah, so I mean, the book is full of helpful do's and don'ts. Like, what can a parent do in this sense? And for example, let the kid lick the Florida house. That's probably fine. But the floor of the subway station is probably not such a good idea. Let them play in the sandbox unless there's cat feces in there. They probably shouldn't be chewing on cat feces because it's got parasites in it, for example. So it's this whole balance between hygiene, avoiding infections, but also microbial exposure. So some simple things, such as getting a dog. Having a dog in your house will decrease asthma by 20% because what does a dog do? It goes rules in the yard and everything, furbling feces, and it comes and smothers the kid and licks it, right? And for the cat lovers in the audience, there's no daddy either way, I think, because cats sort of sit in the corner and kind of go like, they don't interface with the kid as much. So it's not good or bad. So yeah, that's in the book we've tried to allow parents to say, based on this, like if a kid spits a soother on the ground, you can go and wash it off, or binky way we call it here, you go and wash it off, or you can put in your own mouth for that kid. If you put it in your own mouth, back in the kid's mouth, that kid will have less chance of getting asthma and obesity, whereas the one that ran to the washroom and washed it off, they have much higher rates, just by the simple fact of a nicotine, the parent's microbes into the kid. You can do that. I mean, that's not hard to do as a parent. And so, I mean, the biggest issue, the worries I have is the parents that are real germaphobes, they bubble wrap their kid that they use hand sanitizer on their kid 100 times a day and they don't let the kid get a tall dirty. And I understand where they're coming from because if clean is good, and we've shown them last 125 years, hygiene works, we've gotten rid of infections, then cleaner must be better. So let's just clean them up. Let's never let them near a microbial. Let's keep them in the condominium and never let them go outside. And they're gonna be perfect. All the studies show that's wrong. Those kids are much more risk for all the disease that we're talking about. And so, it's very hard to convince a germaphobes off, let them get a little dirty, let them chew in that stick for a while, or crawl around a lick the floor. But it makes sense, because what do kids do? This is what a kid does, right? They shovel everything in their mode. And if that was so bad for us evolutionary, I'm convinced we wouldn't do that. So I'd convince the kids are trying to figure out what's in my world. Let's put it all in my mouth and check it out. So when they turn 20, they've already seen it. It's no big deal. Instead of reacting to it and having all these Western people do it. Maybe it's a good behavior. Maybe that came down the generations. I mean, biology doesn't do many things by accident. I mean, it probably is. And if you think the way that our ancestors lives a thousand, 10,000 years ago, they don't have anything like we do now, right? They were out there, and the kids were rolling around all the time. They were strapped in the mother's breast and they were on the back. And they just chucked them in a dirt ball. And they got to do something. Earthy, exactly. So yeah, I mean, I guess the point I want to make is that we are taking something out of our evolution that we have always evolved. We have taken the microbes that we have always evolved out of it. And we now realize that's a mistake. These things are doing stuff for us. And there's a reason, because we know they'll be there. We've evolved to do that. And so that's my big concern. We have to be somewhat careful about it because we have to take a page out of modern science and make sure we're not doing damage in the process. And when we come back from this break, Brett, I want to talk about how you bring it all together, how you harmonize both the earthiness and the science so that you get the best possible reason. That's Brett Finley. He's a scientist in microbiology from the University of British Columbia. We'll be right back. Aloha and happy new year. It's 2017. Please keep up with me on Power Up Hawaii, where Hawaii comes together to talk about a clean and just energy future. Please join me on Tuesdays at one o'clock. Mahalo. My name is Richard Emory, host of Kondo Insider. More than a third of Hawaii's population live in some form of association. And our show is all about educating board members and owners about their responsibilities and obligations and providing solutions for a great association. You can watch me live on Thursdays, 3 p.m. to 4 p.m. each week. Aloha. You're watching Think Tech Hawaii, meeting people we may not have otherwise met and helping us understand and appreciate the good things about Hawaii. Great content for Hawaii from Think Tech. We're alive and well learning. We're doing lifelong learning with Brett Finley, who's a professor of microbiology at the University of British Columbia, and he's visiting Hawaii to give a public talk tomorrow. I was so excited to have him here today. So, we gotta sort of bring everything into harmony between being really super clean and also dealing with antibiotics and vaccinations and the like. Can you talk about that? Yeah, let's talk about antibiotics because I think that's something that we really need to chat about. So antibiotics, they were the wonder drug in the last century. They saved so many people from dying of bacterial infections. And go talk to someone who lived in the pre-antibiotic era about the fear if you had a fever, you could die and they work. And they work. But what we didn't think about with antibiotics is they carpetbought microbes. They don't care if you're a germ, a bad one or a good one. They just kill everything. And they industrially wipe it all out. And we now realize that they take out the good with the bad. And every time you take antibiotics, your microbes get pushed further and further away from where they were towards the unhealthy end of things. And so I really think we need to rethink in antibiotics. We know overuse causes of resistance. Everyone knows that. What people I don't think realize is they're not perfectly harmless. Yes, if you have a serious bacterial infection, take antibiotics. You need that. But if it's a viral ear infection, then antibiotics aren't going to work against the medical community. You see Iowa just take it, can't hurt, right? We now realize that yes, indeed these, especially in life, can have a big effect. So we have to use these things much more wisely. Another thing about antibiotics is that we use them in agriculture. About 80% of the antibiotics we use in the US are in agriculture because they cause a 15% increase in weight. In pig, sheep, fish, any animal you choose. Well, humans are animals, right? So the average American kid gets up to 10 courses of antibiotics before they go to school. In voluntarily, yes. So, and if they cause weight gain in every single animal, we're just animals. So there's a lot of thought that maybe this is actually contributing to childhood obesity. We're just seeing so much now is these antibiotics. So yes, they're wonder drugs, but they do have some side effects that I think we didn't appreciate before. So use them carefully. Yeah, yeah. So you talk about resistance, the resistance of the bacteria to antibiotics. I mean, is there a lesson here that we need to know about between the earthiness and do we need to change our thinking about designing antibiotics? Yeah, so yes, I think that, well, I think we've exhausted most of the obvious antibiotics and we went through a wonderful, heyday of antibiotic discovery. And we really haven't made many new antibiotics lately. I think we've sort of exhausted it. So I think we're gonna see new kinds of antimicrobial agents that, like for example, could exist of a very sophisticated probiotic that actually goes in and kicks the pathogen out and it's not really an antibiotic. I think we do have to really think about our usage of antibiotics and use them wisely. These are, we have to treasure these gifts there. Just don't use them willy-nilly just because you can. If you really need to use them, use it spiraling because from microbial point of view, resistance is futile. They will overcome these things and become resistant. So just use them wisely. And the best antibiotic is when it doesn't, you know, destroy or damage your regular microbial. Yeah, but all antibiotics are not specific. There is no antibody you can take that will target a particular bacterium. There's some that will target sort of a smaller subgroup but these things have drastic effects on the microbial population in you. I mean, ask any woman who's taken an antibiotic for an ear infection is she gets a urinary tract infection. That's because it's affect the microbes in the urinary tract and then these pathogens crawl in and they get yeast infections, bacterial infections. So yeah, they're tough. Action, reaction. What about vaccines now? That's an even more interesting topic. Yeah, so I dedicated a chapter to the vaccines and that's the one chapter I must admit. I come out very strongly saying, get your vaccines. My wife is a pediatrician. She spends her many much of her time trying to convince someone that says, I'm not going to get vaccinated. She has yet to have someone that by the time she's done with them doesn't vaccinate their kids. She knows every trick of the book for convincing these people. And you know, there's a lot of fraudulent science about vaccines and I mean, the data says they work and they work beautifully. I think what people need to remember is they're living in a wonderfully safe from an infectious point of view time in the world and they don't remember what, you know, someone that gets paralyzed with polio and ends up in an iron lung the rest of their life. Ask anyone who's been around a while. They know what this disease is. It's terrible. And all these kids used to die of all these things but because the vaccines work. So vaccines work. I mean, you know, we jokingly, we have, you know, every flu season, my wife brings home the flu vaccines and we have a shot party. So you get your flu vaccine and you have the tequila shot and then we invite the neighbors and it's a wonderful time. So yeah, no, every parent really should get their kids vaccinated. Now when we spoke earlier, you mentioned that your biome has something to do with how successful the vaccine is because your biome deals with immunity. Can you talk about that? Yeah, so what we know is these microbes really do influence how our immune system develops. They're really important. That's why you can be pushed towards asthma or allergies if your microbiome is upset by antibiotics or C-section. And so yeah, there's, we and others are doing some really neat research on even improving vaccines further, making them work better by basically tweaking the microbes. So when you get vaccinated, your immune system is even better for this. It's early days, it's not commercial yet, but I mean, we're all thinking that direction. So, you know, you talk in the book, I suppose, in large part about kids. You mentioned here that you have to do some, you should do some things before the child is like one year old. And after that, the child's development involves, you know, new relationships with new bacteria. Yeah. But what about adults? What about me? What about you? What does this mean for us? It means a lot. So, I mean, okay, you know, we can't fix when we were one, but we can sure fix, you know, whether what's the expression wins the best time to plant an oak tree 20 years ago, wins the next pack's time now, right? And we're realizing that at all stages of life, these microbes play a big role. You know, exercise affects microbes and we know, you know, weight issues and everything. Is there all microbial, microbial? And I think, you know, depression and anxiety, these types of mental illness associated with it, microbes play a role in that. And I was telling you, we, I wrote a list of the top 10 reasons why Americans die. Only one is obviously microbial and that's some influenza and lung diseases. But actually, when you look closely, nine out of those 10 have microbial links now. In five years, we didn't know this. The only one that doesn't have effect is accidents. So you can't say the microbes made me do it, at least not yet. But all these others, things like astral sclerosis, now there's links to cancer and cancer chemotherapy. There's microbes, links to it. And to mention Alzheimer's, there's microbes, links to it. So it's a whole new world in realizing healthy aging and the microbes are involved in it. So yeah, I think as an adult, just like kids, you need to think about you and your microbes and what you eat. Not only, you know, people say, I am what I eat. I disagree. Your microbes are really what you eat. And if you eat lots of white sugar and white flour, that doesn't even get down to the microbes in the guidance of the microbes. And you got to actually starving, even though you're eating, quote, food. And this is one of the big reasons you'll eat to obesity. So there's some fascinating things coming on the horizon. There's these personalized diets where you can say, okay, you have these microbes based on this, you should eat that. You have those microbes based on this, you should eat that. And this is showing real promise in weight issues, mental issues, these are doing it. So yeah, I think we're gonna see just a whole new renaissance in microbiology. Fecal transfusions, what about that? Should I have one tomorrow? Well, first of all, let me say about fecal transplants. This is not DIY. There's YouTube videos and they say, all it takes is a blender. If you perforate your gut, you will die. So first of all, remember that. Okay, thank you. But that being said, fecal transwers have worked wonderfully for a disease called clostridium edificio. This is if you have to have a hip transplant, the surgeons will fill you with antibiotics, wipe all your microbes so you don't get infection. That's a friendly bacteria. No, it's a terrible bacteria. They kill off the bad ones, the good ones and then this bad one clostridium edificio comes in and this can kill you. And because antibiotics caused it, they try to treat with antibiotics, so they have 20% cure rate. But again, a fecal transfer from a healthy person causes a 95% cure rate. And so now these fecal transfers have been tried in things like inflammatory bowel disease and in autism and many other diseases. And what we're finding is that they work, sometimes don't work others. And the reason I think that is it depends on the donor. And so we're still trying to figure out, you're a good donor and you aren't. You read papers where this donor worked beautifully, this one it didn't. And so, and then another interesting tidbit is the only adverse event associated with fecal transfer so far is when they did it from an obese person who was healthy into a thin person who had IBD. They cured the IBD, but that person also became obese. So that makes sense with all we talked about weight and things. So I think in the future, I call it repopulate and this is to use microbes you grow in the lab, here's 20 good ones you take these because it's way better than the idea of putting a tube down your throat and getting all those feces or anemone type thing. So there'll be a defined population that you will take to fix something. And that's where we're heading, we're not there yet. Because a fecal transfer is a body fluid transfer and we learn from hepatitis and HIV that this can have problems. And so I think the future will be defined microbes for a particular problem and it'll get way less gross. It'll take the gross factor out of it. It's medicine. It will be medicine. Designer biome with a focus on this side of the other thing. Exactly, exactly. How far along are we on the path to that? I mean, you've been working on this for decades, many decades already, sorry to say. But how is the trajectory going here? The trajectory is fast. It's really easy to change someone's microbes diet or antibiotics or prebiotics or probiotics. We know that now. So you can change someone's microbes really quick. So it's way quicker than we still can't go in and fix a gene in you or I. So it's happening fast. The FDA is actually struggling to keep up. How do we license these things? Are they drug? It's a live microbe. These are probiotic. Are they regulated? What's the rule right now? Well, it's chaos right now to be blunt. They're still trying to figure out how do we regulate these things? How do you regulate a fecal transfer? They just don't know yet. But it's happening fast. And in the end of my book, I sort of give some future predictions of what microbes might actually, how they might actually be used therapeutically. But I think within three to five years, we're already going to start to see some of this in the clinic and see it happening. Fabulous. What interesting research. Can you read us a paragraph and give us the flavor of your book, so to speak? Sure. Let them eat dirt. This is the flavor of let them eat dirt. Well, there's just a little blur by what we're talking about the future. So here's a doctor talking to a new mother. Congratulations. You're now pregnant. Your fecal microbiome tests. They all suggest there are made ways to improve the development of your baby during pregnancy. Our nutritionals suggest a modified diet that will alter your intestinal microbiota and enhance the health of your baby. OK, then a little another visit. Congratulations. It's going to be a girl. Everyone looks great. On the ultrasound, your baby is still in breech position. We might have to do a C-section. One thing we might consider for this is take a vaginal swab before the delivery and wipe your baby's mouth with it in order to colonize your baby with the microbes that you would have given her if she'd born vaginally. This will make her healthier in the long run. And you know, OK, so doctor says congratulations. Your baby turned around just in time. Your vaginal delivery was great. As you know, you've even antibiotics for group B strep has prevented a measure which may have altered the newborn's microbiota. It actually does. Since you're breastfeeding, we'd like you to put these few drops of the solution on your breast just prior to feeding. It contains a few probiotics where you replenish your baby's microbiota with microbes that are beneficial to the stage for your baby's early mental and in development. And so, you know, doctor, don't worry. Urinary tractions, infections like the one your daughter had are fairly common at six months of age. The antibiotic treatment worked nicely, and the infection is now clear. However, we notice that because the antibiotic we gave her, your child's gut is now missing some good microbes, putting her at risk for getting allergies and asthma. Here's a solution of four microbes you can just squirt into their mouth or replenish these organisms. Fabulous. A new science, a whole new world. Everyone should know about this. And you know what? After this show, I'm going to go out and have lunch. And while I have lunch, I'm going to be thinking about my microbiome. Excellent. Thank you, Brett. Brett Finley, thank you so much. Good luck on this.