I Contain Multitudes: The Microbes Within Us and a Grander View of Life

I contain multitude by Ed Yong is a mind-blowing book. - Every single animal on the planet except for a few genetically engineered animals that are kept gem free. has a whole feast and array of trillion of microbes on its skin but mainly in its gut and throughout its body. This book explores what that means. These microbes live with us, and they help us eat food, digest it and keep our health and well-being good. Yet microbes are so small that ‘a million could dance on the head of a pin’. - Our planet is full of the range of diverse sort of ecosystems and like Earth’s coral reefs, dry arid plains to rainforest and the same can be said of the Microbiome that live on us and within us and every animal on the planet. - The earth is 4.54 billion years old and for most of the time on this planet, the only life form (formed around 3.6 billion years ago) found on earth was microbes. Then, for roughly the first 2.5 billion years of life on Earth, bacteria and archaea followed largely separate evolutionary courses until, on one fateful occasion, a bacterium somehow merged with an archaeon and complex life emerged, and the bacteria become mitochondria (the energy source within all living cells). They became eukaryotes (complex cells with a nucleus). - We are awash with horror stories about how bacteria is everywhere and around us there's only 100 odd pathogens (micro bacteria that causes harm) and most bacteria is beneficial to us. They do a wide range of things through the diversity in our gut. Fermentation helps us to make beer, cheese, kimchee and sauerkraut. We need bacteria and most of it is beneficial rather than causing harm. - There are around 26,000 genes in the DNA that help make us who we are. But in the microbiome, there are hundreds of thousands more genetic makers that makes up the DNA within the microbiome. - BENEFITS: The Microbiome benefits us by “helping us to digest our food, releasing otherwise inaccessible nutrients. They produce vitamins and minerals missing from our diet. They breakdown toxins and hazardous chemicals. They protect us from disease by crowding out more dangerous microbes or killing them directly with microbial chemicals. They produce substances that affect the way we smell. They are such an inevitable presence that we have outsourced surprising aspects of our life to them. They guide the construction of our bodies, releasing molecules and signals at steer the growth of our organs. The educate our immune system, teaching it to tell friend from foe. That that that development of the nervous system and perhaps even influence our behaviour. They contribute to our lives in profound and wide-ranging ways; No corner of our biology is untouched. If we ignore them, we are looking at our lives through a keyhole.” - There are many conditions such as an obesity and autism that we know have a change in the Microbiome, but the question might be what if these are the cause of some of these health conditions and if this is the case what can we do to help support our Microbiome. - HISTORY: If you combine the whole of human planet into a year, the things that make up the Microbiome will have been around and from March to November, they were the only source of life on the planet. Human beings have only been around for 30 seconds – but they continue to exist and live in a symbiotic relationship with us and all living creatures. - OTHER ANIMALS RELATIONSHIPS: Grazing animals like cows and sheep are dependent on their gut microbes to breakdown the tough fibres in the plants that they eat. Great herds of Africa’s grasslands would vanish., and other sap-sucking bugs would perish without their microbiome to supplement the nutrients they're missing from their diets. In oceans, many worms, shellfish and other animals require bacteria for all their energy. Studies in mice that are germ-free show that they live shorter lives and are more susceptible to disease and their anatomy doesn’t develop as it should. - Robert Van Hooke when inventing the first microscope was the first to see these first living creatures naked to human eye in water and his own body but then these bacteria and viruses got linked to disease and germ theory. - The view today of microbes is very different, we think of them as agents of disease and dirt. This is due to many of the most infamous plagues of humanity caused by bacteria or infectious germs. This includes tuberculosis, plague, cholera, leprosy, gonorrhoea and syphilis. All these terrible diseases were the work of microbes and became linked only with things that killed or destroyed us. Yet this reputation is deeply unfair as only a small minority of microbes are responsible for diseases, maybe around 200. The vast majority are benign or beneficial to us and they are in fact the Lords of the planet, they run the show, and humans are just a footnote in their world. They’ve been here for the longest time. If we consider the length of a desk or arms outstretched, that covers as a visual representation of the entire history of life on earth, Earth began 4.6billion years ago, life originated less than a billion years later. For over 2 billion years they ruled the planet until multi-cellular life forms emerged. Dinosaurs emerged in December and humans in the last few seconds. These little organisms that share our bodies are not just stowaways, they are in fact important parts of our lives and in many species, they bestow their hosts with incredible superpowers. - BREASTFEEDING: Breast feeding is a way for a mother to nourish a baby, but about ten percent of breast milk contains sugars called human milk oligosaccharides or HMOs; complex sugars that the babies are incapable of digesting. These sugars are there to nourish the baby's first microbes and particularly some strains of bacteria known as bifidobacterium longum infatis (B infantes for short) that have evolved to specifically digest those sugars with incredible efficiency. They also nourish the baby's gut cells they seal up the lining of the infant’s gut, and they quench inflammation, so a breastfeeding mother isn't just nourishing a baby, she's building an entire ecosystem in her infant’s gut. She is shaping a world and that world in turn shapes us. Bottle feeding might exasperate problems. Breast milk engineers the baby’s ecosystem and it provides more microbe colonists for a baby's gut. Certain countries in Africa (e.g. Ugandans) rarely suffer from diabetes, heart disease, colon cancer and other diseases more common in the developed world due to the high amount of fibre that they eat in their diet. Milk is a super food and every single mammal dissolve parts of its body to create milk to feed babies and this has evolved over millions of years. After lactose and fats, HMO’s are the third biggest part of human milk – even if babies can’t digest them. - BABIES IMMUNE SYSTEM: “To allow our first microbes to colonise newborn babies, a special class of immune cells suppresses the rest of the body's defensive assembly, which is why babies are vulnerable to infections for the first six months of life, not because their immune system is immature as is commonly believed: it's because it's deliberately stifled to give microbes a free for all window during which they can establish themselves…. Mother's milk is full of antibodies which control the microbial population of adults and babies take up these antibodies during breastfeeding.” - BOWEL CANCER: James Kinross, a GI surgeon, states that 90% of all cases of bowel cancer are entirely preventable. People born in 1950 have a much lower incident risk of bowel cancer than millennials, we also know that if you live in London you have a much higher risk of bowel cancer than in Sahara in Africa where there are tribes that have no reported cases of bowel cancer, and it probably due to the high levels of fibre that they eat as well as the environment with clean air they live in. You're 4 times more likely to get bowel cancer if you're a millennial or young person then if you were born in the 1950s or 60s. It can't be due to our genes, it's not genetic. Change doesn’t mutate and change that quickly. It must be an environmental driver. Our microbes appear to be a very important determinant. Therefore, what you eat, what you drink and how you live your life, the lifestyle choices you make are incredibly important determinant of that risk. If you live in London your risk is high but if you're a sub–Saharan African and you live in a rural environment, have buckets of fibre, you don't get bowel cancer. We don't know why this is happening, but many experts believe that the microbiome is having a role in all of this. - ANTIBIOTICS: We know antibiotics are a lifesaver and absolutely essential part of medicines, but they have been abused and they destroy your microbiome. It's not just doctors giving them out inappropriately but also in the farming community, where we know that if we give a chicken antibiotics, they will become much fatter and larger more quickly, but this is having a detrimental effect on our well-being and health. We have an internal climate change crisis going on within us. 80% of all the antibiotics used in the world are used in farming and not in medicines. This is particularly in developing countries such as India. Penicillin was first discovered by Alexander Fleming in 1928 and by 1945 everybody had access to antibiotics or penicillin. The first woman given it, literally was given half a spoonful and recovered from a disease which she would've certainly died from, and it was miraculous, but at the time that she was given it, she literally was given half the world supply. The problem with penicillin is that although it's a significant lifesaver, it's a bit like nuclear war or Armageddon, like wiping out a whole city just to kill a rat. There are many consequences of the antibiotics that we now use that are damaging our Microbiome. just as climate change and heating the atmosphere with carbon molecules is destroying our planet. The problem isn't their use, it’s their overuse of antibiotics prescribed for so many conditions that they do not need, but people are now burning up antibacterial resistance and that's a very dangerous place to be in. - 80% of the world's antibiotics are used in food production. Used in the healthcare industry. Antibiotics have been manufactured at a massive scale, and we consume huge amounts of them. We now consume about 38 billion daily doses of antibiotics globally. Many of them to given to feed those in India and China, being consumed by young people and children. Their also in the soil and water and you can't really escape them. - If you give a child lots of antibiotics early in life, their risk of obesity, risk of diabetes and their risk of asthma goes up. We know that the risk of bowel cancer and other cancers go up. But we just keep giving antibiotics. There are many different types of antibiotics and the frequency that you're prescribing can impact in different ways on our gut. Penicillin will give a temporary change in the microbiome and the mechanisms in the microbiome will bounce back, but in six weeks it will bounce back. However, if you give a broad-spectrum antibiotic, an antibiotic designed to kill more different types of bacteria, you'll see much more profound change. Sometimes the microbiome will never come back. - EMBRYOS: Every animal begins life from a single fertilized egg into a fully adult body, composed of trillions of cells. The pathway of development doesn't unfold under our own steam or under the instructions encoded within our own genome, it also occurs in partnership with our microbiome. It happens to fire conversations between us and the multitudes that we carry, so some animals don't even make that complete journey if they don't contain the right bacteria in their environment. Mice for example rely on microbial signals throughout their entire lives to shape the development of their organs which doesn’t occur in germ free mice raised in sterile conditions. The immune system sculpts our bodies they help to influence the development of our organs and that includes the immune system. the thing that's meant to keep us healthy. - ALLEGIES: They can overreact to harmless threats like dust, pollen and other allergens in the world around us, and it is thanks to microbes that we can calibrate our response that those kinds of responses striking a balance between reacting but not overreacting. In return the immune system selects for the microbes that live with us rather than indiscriminately killing them. A useful metaphor would suggest it gets to decide which species get to live with us and where they get to live. Think of the immune system more as a team of Rangers in a national park, they care for the species of the park, they decide who gets to live there, what their population sizes should be, and remove invaders. - BEHAVIOUR: Microbes influence our behaviour. There have been many studies using mice and rats. including germ-free ones. The microbes in our guts can influence the way we behave, think and everything from our resilience to stress to our susceptibility to anxiety. Aspects of personality and mood have this microbial influence though how it influences human behaviour is still unclear, but it’s entirely plausible that the microbiome shapes the way we think. There are many connections between the gut and the brain, including a so-called gut brain axis, a two-way line of communication where there are nerves that run from the gut to the brain. The immune system can send signals between the two and bacteria in our gut produced chemicals such as dopamine and serotonin, chemicals that we normally think of as responsible for signalling in the brain. - FIBRE: lack of fibre also reshaped their gut microbiome. Fibre is so complex that it creates openings for a wide range of microbes with the right digestive enzymes. The recommended amount of fibre to have each day is around 30 grammes and yet most of us are having nowhere near this amount. - AUTISM: in 2001, neuroscientist Paul Patterson injected pregnant mice with a substance that mimics a viral infection and triggers an immune response. The mice gave birth to healthy pups but as the babies grew into adults, Patterson started noticing interesting quirks in their behaviour. Mice became naturally reluctant to enter open spaces, became startled by loud noises, groom themselves over and over or repeatedly tried to bury a marble. They were less communicative than their peers and they shied away from social contact. Anxiety, repetitive movements, social problems were noted in these mice. There were similarities to the two human conditions of autism and schizophrenia. He wondered if a mother's immune response might somehow affect the development of her baby's brain. in twins, where one has autism and the other doesn't, if their microbiome is passed on to germ free mice, the one that is given the microbiome from someone with autism will often begin to show similar features as mentioned above. However, if they are then given the microbiome from a twin child that doesn't have autism, these symptoms can disappear but only up to the point where the mice are weaned. We have to be careful with these results but it does show that the microbes are at least partially responsible for these behaviours. - DATING AND RELATIONSHIPS: If you change fly’s diet, you change their sex life. In one experiment, over 25 generations of flies where one group were given starch foods to eat and the other one sweet food and within 25 generations the flies that had only eaten starch-based diet only mated with other flies of starch or those who ate sugar-based foods would only mate with the sugar flies. This experiment shows how genes and the diet can influence who we attract to even at such a profound level. Quite a lot of our sexual behaviours are also very heavily influenced by the microbiome. Rats will avoid mating with animals if they contain parasites because they can smell some of the molecules in the rat’s urine. - SANITATION: Another important point is sanitation which again has saved many lives but nowadays we have over sanitised the world that we live in so that children do not have the potential to develop a healthier microbiome, over sanitisation is harming all the good bacteria in the same way that we are doing when we over-prescribe medication. - The average human consumes and swallows something like million microbes with every with every 30g that it eats, and you share 80 million bacteria to another person when we kiss. Many animals can detect through smell if another animal is carrying pathogens and may even play a role in dating. - FAECES, FAECAL TRANSPANTS AND C-DIFF: Many animals get their microbes by eating faeces from other animals. These include cows, elephants, pandas, gorillas, rats, rabbits, dogs, iguanas, burying beetle’s, cockroaches and flies regularly each eat each other’s faces. Faecal transplants are currently being looked at and we know they can treat clostridium difficile (known as C-diff) when all other treatments have been tried. People have gone from death door to walking out of hospital cured. It’s caused by overuse of antibiotics. However, treatments in other conditions, the jury is still out but they are cheap, don’t require surgery and clinical trials, are looking into these as a form of treatment in other conditions. However, it's important that faecal transplants are monitored and it's important that we don't pass on infections although many people are doing these at home in such treatments as autism. There are 400 randomised controlled trials happening across the world trying to understand the mechanism. Giving people FT is also quite safe once people get over the yuck factor. In C-diff infections 90% of patients get completely better the compared to those taking more antibiotics. - PROBIOTICS: The book looks at probiotics and in many cases they do not have appear to have much in the way of benefits and these claims are now removed from claiming they are like a medicine, which would go through extreme trials and when they have been asked to do research into their effectiveness, the results have not been strong, although there are a few conditions such as NEC which they can be a benefit. - MICROBES ARE GOOD: We need to stop criticising and waging war against germs on microbes and realise that they are our friend, just as a gardener might plant and feed a garden. We need to make sure its nourished, fed, watered, good soil – put the same seeds in a neglected garden and they don’t bloom in the same way (or not at all). Our world is built on microbes they support us more than harm us.

The subject matter of this book is fascinating and the effects of our internal and external microbes can be great. There is a great deal of information in this book and much food for thought. Ed Yong has done a fair job of explaining the unseen world of microbes. However, although he has written in a very straightforward style, this book did not demand my attention and I had to force myself to settle down and read it. I think, possibly, that Mr Yong gives so many examples that I felt overwhelmed and this kept breaking my concentration on the main theme. All the footnotes and references were gathered together in a separate chapter (30 out of 302 pages) but some information here would have been better being included in the book as it is relevant but referring to the notes increased the feeling of distraction. There's also a large bibliography of a further 40 pages. All this begs the question of who is the target readership for this book? It's written as popular science but there is so much reference material that it seems more like a text book but it's far too verbose for a text book. I will probably re-read this book in one or two year's time and may possibly change my opinion but at least it has given me a glimpse into the complex and convoluted world of the microbes surrounding us all.

This book is well-researched and contains a wealth of facts presented in an easily readable style. Our guts are obviously so much more 'just' than a digestive system, they are a complete ecosystem, and we all can benefit by reading this book! Recommended.

This is a very readable and fascinating story about the unseen creatures that not only live in our world but also live in us and all animals: some good and some dangerous in the wrong company. The scientists who study these microbes are changing the world as we know it and, hopefully, many diseases will be eliminated in the process. This is a book full of delight and wonder and full of hope for the future of the planet and its inhabitants. I would recommend it to anyone who has an interest in what makes us tick.

I like popular science books (so long as they are well-written) but I usually stick to physics and computing. However a "look inside" the Kindle version was enough to tempt me into the world of microbes. I'd heard of gut bacteria and extremophile organisms before, but this in no way prepared me for the deluge of astonishing new (to me) information right from the start. Yong is passionate about his subject and his writing style is so enjoyable it makes it a treat to learn about the subject. Best read I've had in a long time.

This is a scarey read despite it being very factual. It really puts humans into their place in this world and changes your opinion of yourself and others. A lot of scientific names used but not essential to the readers understanding of the overall content, even if you could pronounce them. I had no idea of the high level of research into these millions. In the context of this book one wonders what will happen when we first land on another planet! I would give this read 5 stars but some microbe forced to to give iit only 4. Don't blame me I do what the microbes tell me what to do.

This is a fascinating book. Accepting the current knowledge about how our microbes influence and indeed manipulate not only our health but our mood and our neural development is a bit like reading Brian Cox and accepting the infinite universe and the possibility of multiverse. It is mind blowing. I have read this, and my husband, and have now passed it on to my son, so we have got or money's worth. Basically; Look after your microbes and they will look after you. Symbiosis is amazing.

This is a book that, at times, absolutely sparkles. Ed Yong is a good writer but also an intelligent researcher, able to delve a lot deeper into subjects a lot more than most journalist could. The detail and information goes well beyond the simplicity found in most healthcare articles, particularly around the gut bacteria. The complexities of the performance of drugs and illnesses relating to the bacteria present in the gut are fascinating. Wolbachia features in the book prominently. In parts the book really gripped me. Yet, as a whole the book didn’t really grasp my attention, primarily as I found there to be little holding the chapters together despite the common theme. The book seems to be a bit of a brain dump of all the things Ed Yong has covered in the past. While there are many interesting snippets, most are lost and are sure to be forgotten. It seems like the chapters are almost seperate articles in themselves at times. The book is informative and intelligent but the lack of connectivity and a sense of a story made it a bit of a drag.