(Editor's note: The following is a guest column by Cleveland Clinic's Dr. Daniel

Dr. Daniel Neides, Medical Director and Chief Operating Officer at Cleveland Clinic Wellness Institute.

Neides.)

LYNDHURST, Ohio – I was eating lunch when my colleague, Dr. Mladen Golbic, section head of Cleveland Clinic's Center for Lifestyle Medicine, came to my office and handed me a bowl of fermented beets. "This is for your microbiome. You need to feed the good bacteria so they can take better care of you," he explained. "Are you sure they don't like peanut M&M's or Mike and Ike's?" I replied. He just shook his head and reminded me that caring for my microbiome was as important as taking my blood pressure medicine – or perhaps more important!

The average human has 100 trillion microbes in the gut, which is 10 times more than the cells in the human body. This collection of bacteria and fungi that inhabit our bodies (weighing in at about three total pounds!) vastly outnumber our own human cells. Although it has been largely thought that these organisms simply co-exist on our skin and in our gastrointestinal tract, it has become evident that our microbiome is critical to our overall health and survival.

What actually is the microbiome? It is a community of microorganisms that share our body's space. Over tens of thousands of years, the human microbiome has evolved right along with human evolution. The diversity of our own microbiome will differ among people because of hygiene practices, social behaviors, and geneticsx5Flint, H.J. The impact of nutrition on the human microbiome.

Diet will also play a major role in defining the composition of the microbiome. In addition, we must think about metabolites (by-products of the microbiome) produced by gut bacteria that can potentially enter the bloodstream. These metabolites may have a positive effect on the human host, including anti-inflammatory and antioxidant properties. Some metabolites, however, can be damaging to the host. In a recently published study by researchers at Cleveland Clinic, gut bacteria exposed to L-carnitine in red meat led to the release of metabolites that caused atherosclerosis (disease of the blood vessels – think heart disease and stroke). How we treat our own microbiome will determine if we have a healthy and high quality of life.

Dr. Martin Blaser is the director of the Human Microbiome Program and former chair of medicine at New York University. Dr. Blaser is the author of "Missing Microbes: How the Overuse of Antibiotics is Fueling Our Modern Plagues". He points to the overuse of antibiotics and increasing rate of Caesarian section as major disrupters to the human microbiome. This has become a major contributor to the chronic disease epidemic in the United States. Since the 1940's, we have seen an exponential increase in chronic diseases like, asthma, allergies (seasonal and food), diabetes, obesity, and heart disease.

In one of his research studies, Dr. Blaser put mice on a high-fat diet. As expected, the mice gained weight and developed fat around the belly. He took a second group of mice and put them on antibiotics early in life and found that they also gained excess weight and developed fat around the belly. When a third group was given antibiotics and a high fat diet together, the mice became morbidly obese. It became clear that the effects of the antibiotics potentiate the effects of the high-fat diet. So how does this impact humans and what is the impact on those who consume the standard American (high fat) diet?

Let's go back in time and look at farming practices with livestock. Farmers have been feeding antibiotics to their farm animals for almost 70 years. Is it to keep the animals healthy and minimize disease among the livestock? The short answer is "yes", they can limit the spread of disease. However, farmers also recognized that the use of antibiotics also promoted the animal's growth. The livestock can quickly grow much bigger as they use their antibiotic enhanced food to convert calories into body mass. When antibiotics are given to animals, they are often given in sub-therapeutic levels – in other words, the dosing is not high enough to actually cure disease. Instead, these lower levels of antibiotics are really being used to efficiently increase the growth of the animal, which leads to more weight and ultimately more money to the farmer.

The damaging effects of antibiotics on the microbiome start early in life. The average American child is given nearly three courses of antibiotics in the first two years of life, and eight more during the next eight years. When we take antibiotics, they not only eliminate the bad bacteria but also also destroy the good bacteria in our microbiome. Dr. Blaser believes that the overuse of antibiotics in children is directly related to the surge in chronic diseases such as celiac disease, type I diabetes, asthma, and obesity.

In 2010, according to the CDC, there were 258 million courses of antibiotics prescribed in the United States. That is about 1 course of antibiotics for every citizen. Many of these infections are caused by viruses. Thus, the antibiotics will have no impact other than destroying the important bacteria in our microbiome and increasing the rate of antibiotic resistance. More research is needed to truly understand the magnitude of antibiotic use and our chronic disease epidemic. It seems to be in our best interest to avoid antibiotics unless absolutely necessary.

I also mentioned the rise in Caesarian section as a possible contributor to the chronic disease epidemic. During pregnancy, the developing baby is in a safe, sterile environment. Prior to a vaginal delivery, the membranes protecting the uterus will rupture. The once sterile environment is disrupted and the baby has its first exposure to a world full of microrganisms. As the infant passes through the birth canal, she is exposed to her mother's vaginal bacteria. She will swallow the bacteria and her skin will bathe in it. This is the first exposure to her new microbiome. But what about babies who don't pass through the birth canal and are delivered via caesarian section – are there potential health consequences? It looks like the answer to that is YES. First, the use of antibiotics often accompany a Caesarian section as standard practice, so the early exposure to antibiotics can impact the baby's microbiome right from the start. Second, because the baby is not introduced to bacteria in the birth canal, the microbiome in these infants will look vastly different. A review of 15 studies involving 164,000 births found that, compared with babies delivered vaginally, those born by cesarean section were 26 percent more likely to be overweight and 22 percent more likely to be obese as adults.

How can we positively impact our microbiome in order to improve our overall health and reduce the risk of chronic diseases? These several steps will help you enhance the good bacteria in your body and your immune system as well.

Don't murder your good bacteria – keep your microbiome vital by avoiding unnecessary antibiotics. Ask your doctor if you really need that antibiotic. And don't run to the doctor when you have a cold – it's viral!

Enrich your microbiome with probiotics – we can replenish the microbiome when we take good quality probiotics. These capsules, available over the counter, often contain billions of microrganisms. Look for ones that have lactobacillus and bifidobacterium, both critical for immune function.

Eat foods that are plant-based – greens and other vegetables are what your microrganisms feed on. Fermented foods like sauerkraut and pickled vegetables along with artichokes, garlic, beans, oats, onions and asparagus will help your good bacteria grow and flourish. When your microbiome is strong, so is your immune system. This will help to reduce inflammation in our bodies and reduce our risk of developing chronic diseases.

Avoid junk food – processed foods can be toxic to the microbiome. Sugar can promote an overgrowth of bad fungi. Think high fiber diet, with lots of fruits and vegetables to enrich your good bacteria

Get your hands dirty – working in the garden or digging around in the soil exposes you to trillions of good bacteria that can enhance your immune system Enough with the hand sanitizer already – with overuse, we limit our exposure to the very microrganisms that are here to protect us.

Early exposure to good bacteria and enriching their development will prove to be critical in our quest to reduce the chronic disease epidemic. If you were born via Caesarian section, don't panic. Simply follow the 6 steps and pay particular attention to the second recommendation. By treating our microbiome with the respect it deserves, we can live a high quality, healthy life. OK, so I plugged my nose and swallowed the fermented beets. I am sure my microbiome thanked me for the nutritious lunch!

Until next time, be well.