More than half a century later, the Dutch gastro- enterologist Josbert Keller and his team at the Amsterdam Medical Centre randomised patients with recurrent C diff into three groups. The first group received vancomycin, a wash-out of the colon using a strong laxative, and a faecal transplant. The second had vancomycin and the colonic wash-out, and the third just received vancomycin. The FMT group did so much better than the other two groups that the study had to be stopped early, as it was deemed unethical to continue. I've long been interested in the microbiome, and have been eagerly awaiting a book that might uncover some of its mysteries. This is that book Heston Blumenthal The “gut microbiome” is the name we have used to describe not only the wildly diverse collection of microbes that live there, but also what happens when they interact with each other and with our bodies. In other words, it’s an ecosystem made up of trillions of microbial life forms going about their business inside us, as we go about ours. Books» Non-Fiction» Medicine» Pre-clinical medicine: basic sciences» Physiology» Biomechanics, human kinetics

Spector hopes his tests – which don’t just test for microbes, but also assess blood fat and blood glucose responses to specific foods – will change this. “We’re just starting to get to the point where we can suggest individualised foods. This is not just isolated microbiome testing,” he says. “We have trials in place to quantify this, but the initial results are exciting, with nearly everyone reporting weight loss and improved energy levels without any calorie counting or traditional weight loss methods. Previous microbiome tests have been sub-optimal [but the] ZOE approach is completely different: using state of the art sequencing allows us to detect species and strains and find strong associations between these microbes and both foods and health.” If you're a young parent, this book is particularly crucial for you. The gut microbiome plays a significant role in the health of young children, and Kinross provides actionable insights on what can be done to ensure better health for our children in the future. But what if I told you that faeces was not toxic waste and that it contained the secret to human health? Would you eat it, if your life depended on it? What if it was rebranded as a faecal microbiota transplant (FMT) or, more accurately, a faecal milkshake given through a tube that passes through the nose into the stomach? You could even take it in the form of a capsule – or “crapsule” – if you wanted. Dr Ben Mullish, a clinical scientist at Imperial College London, was running a trial of FMT in patients with C diff infections. Ray was so unwell that Dr Mullish offered him the treatment. Heather understood that there are good and bad bugs and advised her husband to go ahead with it, but Ray was not having it. The idea of taking another human’s faeces was just too much for him, and he refused. Three days later, however, he had deteriorated so much that there was no other choice. Ray consented to the trial. The Microbiome is a definitive account of the re-discovery of human ecology. It begins at the birth of man and it explains how the gut microbiome has evolved with us, shaped our biology and defined the success of our species. It explains what we know and importantly, what we don't. Just as we have discovered this delicate and complex new organ within us it is being irrevocably destroyed through the globalisation of our diets, lifestyles and the destruction of our environment.Love the story about how animals, and humans can have a poo transplant, which in some cases can save your life. The human microbiome represents the most important new therapeutic target that we have for treating the greatest threats to human life in the 21st century and for preventing future pandemics of pathogens. This was not only important for Ray – it is critical for all of us: without a stable and diverse microbiome, we may well lose our minds. Behind all this is a simple message: microbes are not the enemy.

We are also running a long-term study to help us understand the evolution of the microbiome in very early life and its importance for influencing your risk of disease later in life. This involves following two cohorts of children from birth and studying how their gut microbiome evolves as they grow up in varying circumstances. What prompted you to write your book, Dark Matter?In summary, "Dark Matter: The New Science of the Microbiome" is an enlightening and invaluable resource that I would highly recommend. Whether you're a health professional, a young parent, or simply someone interested in the future of healthcare, this book is a must-read. And how the biome is affected by your social environment; the brain-gut axis looks to be key to our survival. A spellbinding explanation of microbiology that will help you get to the bottom of health and happiness -- John Vincent, Co-Founder of Leon

An Imperial surgeon specialising in the gut microbiome has published a new book to explain why it is important for our health. A fountain of knowledge and sense in an overwhelming world of science Rhiannon Lambert, Registered Nutritionist and Sunday Times Bestselling Author Yet it is only now, as we are beginning to discover the microbiome's enormous potential, that we are realising it is in grave danger, being irrevocably destroyed through the globalisation of our diets, the war on bugs and the industrialised world. I think Dr Kinross is spot on when it comes to the Microbiome being the next very important area for modern medicine to get to grips with. He gives some excellent examples, and some very in depth explanations.

NHS safety measures remain in place

We compared these diets to those in Sub-Saharan Africa where rural communities have very high-fibre, plant-based diets. They eat meat very rarely, and when they do, it is very lean. They exercise a lot and live in social communities, where they farm together, cook together and share plates of food. So, they exchange and share microbes through lots of different routes. As a result, they have a much more diverse and resilient population of gut micro-organisms than we do. Everything we’re doing now is scratching the surface,” says Spector. “We are maybe 10% of the way there, because every week, we’re discovering something new. Humans want an easy answer [to improve our gut health], but you shouldn’t take anyone seriously who doesn’t say it’s complicated,” he says. “There’s a massive industry that needs a simple message to sell its products. They want to say all you’ve got to do is eat this bar, this yoghurt or this protein drink.” Books» Non-Fiction» Medicine» Medicine: General Issues» Public health & preventive medicine» Personal & public health

The scale of the task is immense. The bacteria in the gut alone weigh close to 1.5 kg, they’re made up of about 100,000,000,000,000 bacterial cells (that’s 100 trillion) – equivalent in number to the total number of cells that make up the human body – and they speak millions of different molecular languages. Another major challenge in studying the microbiome is its physical distribution. The micro- biome is dispersed across our bodies in different niches, each with varying total abundances of microbes. Being clear about our anatomical definitions is important.I also exercise more and try to keep fit and mobile. Can you tell me about some of Imperial’s research on the gut microbiome? Ideally, we need to nurture our gut microbiome from birth. I think that this is so important, that it should be a given human right. One of the ways to do this is for women to breastfeed if they can and for children to have all their vaccinations – that way, they’re much less likely to need antibiotics. When used correctly, antibiotics save lives, but overuse causes more harm than good. We also need our children to play outside with other children and to have a diverse diet that is high in fibre and low in saturated fats. Have you made changes in your own life because of what you’ve learnt about our gut microbiome? Ray’s response to his FMT treatment was just like that in the reported literature. Within three days of receiving the microbiota transplant he was out of bed. Heather described it as a miracle. If I’ve spent longer than is entirely comfortable talking about faeces, that’s because FMT is a starting point for understanding the importance of the gut microbiome to human health. The extraordinary benefit of FMT in some patients has opened the clinical world to the idea that our microbes may have an important role in the causation and treatment of diseases where their involvement runs contrary to medical science. Kinross makes it clear that the composition of the microbiome has been implicated in many conditions, but the truth is that this is really nothing new. The great unknowns are the exact mechanisms by which the composition of the microbiome may (and I stress may) be a factor in these conditions, and the science is so young that there simply isn't the evidence to make any definitive claims; given the extreme number of confounders, it's very unlikely we ever will.