WEBVTT 00:00:00.991 --> 00:00:04.132 Now, I know it might be easy to think 00:00:04.132 --> 00:00:06.413 that microbes are bad, 00:00:06.413 --> 00:00:08.373 especially for infants, 00:00:08.373 --> 00:00:11.488 but research has in fact proven the opposite. 00:00:12.323 --> 00:00:15.649 And the truth might be a little bit more complex, 00:00:15.649 --> 00:00:18.595 but it's actually way more interesting. 00:00:19.770 --> 00:00:22.011 It seems that we need microbes 00:00:22.011 --> 00:00:25.025 to be programmed for good health, 00:00:25.025 --> 00:00:27.066 but not just any microbes, 00:00:27.066 --> 00:00:29.410 we need the right combination. 00:00:29.410 --> 00:00:32.158 With succeed best with the little microbial bodies 00:00:32.158 --> 00:00:35.973 we have adapted to coexist with during evolution. 00:00:37.043 --> 00:00:39.239 And I guess it won't surprise you 00:00:39.239 --> 00:00:43.507 to learn that we start acquiring that right combination right at birth. NOTE Paragraph 00:00:43.507 --> 00:00:46.178 Well, at least, some of us do. 00:00:46.178 --> 00:00:49.773 Babies born by C-section and babies born vaginally 00:00:49.773 --> 00:00:51.016 aren't the same 00:00:51.016 --> 00:00:54.271 when it comes to microbial start to life, 00:00:54.444 --> 00:00:57.665 and after birth there are countless 00:00:57.665 --> 00:01:00.610 different early life events and circumstances 00:01:00.610 --> 00:01:04.477 that further modulate the way the gut microbiota is developing, 00:01:04.477 --> 00:01:08.602 such as the medications that might be prescribed for the infant or the mother, 00:01:08.602 --> 00:01:12.992 number of pets and siblings in the family, 00:01:12.992 --> 00:01:15.043 as well as level of hygiene at home, 00:01:15.043 --> 00:01:20.015 and, in this case, it's actually better if it's not that perfectly clean 00:01:20.208 --> 00:01:21.075 all the time. 00:01:21.075 --> 00:01:24.311 And also nutrition, both mothers and infants. 00:01:24.311 --> 00:01:29.192 All of these events and circumstances play a huge role 00:01:29.192 --> 00:01:33.861 in the gut microbial development and that has a huge impact 00:01:33.861 --> 00:01:37.492 on the lifelong health of that baby. 00:01:37.492 --> 00:01:41.988 And I'm not talking about small health implications here. 00:01:41.988 --> 00:01:44.040 I'm talking about the big stuff. 00:01:44.040 --> 00:01:46.626 Microbes we acquire or do not acquire 00:01:46.626 --> 00:01:51.357 affect our livelihood of developing diseases like obesity, diabetes, 00:01:51.357 --> 00:01:54.640 and even some cancers. 00:01:54.640 --> 00:01:57.121 Since many of these early life events I just listed 00:01:57.121 --> 00:01:59.676 are such that we cannot affect them, 00:01:59.676 --> 00:02:02.044 they are inevitable, 00:02:02.044 --> 00:02:04.770 for example C-sections have been invented to save lives, 00:02:04.770 --> 00:02:06.586 and they do that daily, 00:02:06.586 --> 00:02:10.520 and most medications are prescribed for a valid reason, 00:02:10.520 --> 00:02:13.165 especially for infants, and so on. 00:02:13.165 --> 00:02:16.138 That is why we have to learn 00:02:16.138 --> 00:02:19.798 how to protect the health of these babies 00:02:19.798 --> 00:02:23.012 after the occurrence of such early life events 00:02:23.012 --> 00:02:26.079 that might disrupt their gut microbial development. NOTE Paragraph 00:02:26.730 --> 00:02:31.596 I work as a researcher 00:02:31.596 --> 00:02:31.846 and as a technical lead of an infant health platform, 00:02:31.846 --> 00:02:35.748 and the question I'm trying to find a solution every day at work, 00:02:35.748 --> 00:02:39.512 and the same question I'm aiming to answer in this talk, 00:02:39.512 --> 00:02:42.028 is how can we make sure 00:02:42.028 --> 00:02:45.749 that all babies get the same shot at lifelong health, 00:02:45.749 --> 00:02:47.988 no matter how they're born 00:02:47.988 --> 00:02:51.373 or what early life events they encounter. 00:02:51.600 --> 00:02:54.125 Seems like a noble cause, right? 00:02:54.125 --> 00:02:57.023 Great. 00:02:57.213 --> 00:02:57.889 So let's figure this out. NOTE Paragraph 00:02:57.889 --> 00:03:03.173 To begin, remember how I said that we need the right combination of microbes. 00:03:03.173 --> 00:03:07.236 Well, to get that combination right, 00:03:07.236 --> 00:03:10.216 we need to receive those microbes that inhabit our bodies 00:03:10.216 --> 00:03:13.186 in a certain order. 00:03:13.186 --> 00:03:16.585 You can think of it like a colonization march. 00:03:16.585 --> 00:03:20.439 The very early microbes that inhabit our bodies first 00:03:20.439 --> 00:03:23.343 change the environment 00:03:23.343 --> 00:03:24.943 in the infant's gut 00:03:24.943 --> 00:03:26.708 so that the next microbes 00:03:26.708 --> 00:03:29.288 are able to move in, 00:03:29.288 --> 00:03:31.993 kind of like the first invaders 00:03:31.993 --> 00:03:35.379 come in first and set up the infrastructure 00:03:35.379 --> 00:03:37.209 for the other settlers to build upon. 00:03:37.209 --> 00:03:39.342 Now, if babies are born via C-section, 00:03:39.342 --> 00:03:43.621 that early phase of colonization is greatly altered, 00:03:43.621 --> 00:03:47.973 because instead of vaginal, fecal, and skin bacteria of the mother, 00:03:47.973 --> 00:03:52.015 mainly only skin bacteria enter the infant gut. 00:03:52.176 --> 00:03:57.025 And that sets that colonization march to a totally different tone, 00:03:57.025 --> 00:04:02.653 and simply because that's different to what we've adapted to during evolution, 00:04:02.653 --> 00:04:08.417 that might cause some health disadvantages for C-section born babies later on. 00:04:08.417 --> 00:04:11.452 We can take weight development as an example, here. 00:04:11.452 --> 00:04:15.014 It has been already shown in several studies 00:04:15.014 --> 00:04:17.238 that gut microbial composition 00:04:17.238 --> 00:04:18.628 is associated to weight 00:04:18.628 --> 00:04:21.863 as well as the likelihood of developing diseases 00:04:21.863 --> 00:04:24.509 like diabetes or cardiovascular diseases. 00:04:24.509 --> 00:04:27.497 But now there are some indications 00:04:27.497 --> 00:04:31.908 that you could already at infancy 00:04:31.908 --> 00:04:34.871 see from the fecal sample of a baby 00:04:34.871 --> 00:04:36.290 some microbes missing from those individuals 00:04:36.290 --> 00:04:39.235 who will later on develop to be obese or overweight. 00:04:39.235 --> 00:04:43.204 It has also been shown that those same microbes 00:04:43.204 --> 00:04:46.886 might be missing from babies who are born by C-section 00:04:46.886 --> 00:04:49.719 or who are predisposed to heavy loads of antibiotics in early life. 00:04:49.719 --> 00:04:52.631 And to kind of close this loop, 00:04:52.631 --> 00:04:55.777 it has also been shown in some research 00:04:55.777 --> 00:04:57.329 that babies born by C-section 00:04:57.329 --> 00:05:01.485 or are prescribed with many, many antibiotics early in life 00:05:01.485 --> 00:05:05.477 are more likely to be obese or overweight, even by 50 percent, 00:05:05.477 --> 00:05:07.657 which is a lot. 00:05:07.657 --> 00:05:11.193 Now, I know you might be thinking at this point 00:05:11.193 --> 00:05:15.208 that, oh no, I just had a C-section or I was born via C-section 00:05:15.208 --> 00:05:17.231 or my child had the antibiotics. 00:05:17.231 --> 00:05:21.077 But I want you to not worry. 00:05:21.077 --> 00:05:24.033 If these microbes are missing 00:05:24.033 --> 00:05:26.521 or are lost for any reason, 00:05:26.521 --> 00:05:29.272 they can be acquired later, 00:05:29.272 --> 00:05:32.538 but the baby just needs a little help with that. NOTE Paragraph 00:05:32.538 --> 00:05:37.607 One thing that has already for some time been known to help is breastfeeding. 00:05:38.026 --> 00:05:41.608 Breast milk is kind of miraculous: 00:05:41.608 --> 00:05:43.719 in addition to containing nutrients for the baby, 00:05:43.719 --> 00:05:48.818 it seems to contain food for the good microbes as well. 00:05:49.116 --> 00:05:52.369 That's great for a breastfed baby, 00:05:52.369 --> 00:05:57.152 but we all know that all babies are not breastfed. 00:05:57.152 --> 00:05:59.740 So what could we do to ensure that also those babies who are not breastfed 00:05:59.740 --> 00:06:04.678 could restore their microbial development 00:06:04.678 --> 00:06:08.858 after encountering those disruptive early life events that might disrupt 00:06:08.858 --> 00:06:11.910 their gut microbial development. NOTE Paragraph 00:06:12.265 --> 00:06:17.074 And now we get to the actual solution part of this talk. 00:06:17.074 --> 00:06:22.054 The research in this field has been taking giant steps lately. 00:06:22.054 --> 00:06:23.979 First, it was understood that if there are some microbes missing, 00:06:23.979 --> 00:06:28.156 they can be ingested. 00:06:28.156 --> 00:06:32.381 We call the good microbes, when they are ingested, probiotics, 00:06:32.381 --> 00:06:36.579 and probiotics have been tested in several clinical trials 00:06:36.579 --> 00:06:39.079 during the years also in infants with great effects 00:06:39.079 --> 00:06:43.298 such as reducing their risk of ?? later in life. NOTE Paragraph 00:06:43.662 --> 00:06:48.398 Now, a second revolution was realized 00:06:48.398 --> 00:06:49.756 when the eyes of researchers were turned to breast milk. 00:06:49.756 --> 00:06:51.653 That was logical, as, like I mentioned, 00:06:51.653 --> 00:06:57.031 it was already known that breastfeeding is able to support the healthy development 00:06:57.031 --> 00:06:59.231 of gut microbiota. 00:06:59.231 --> 00:07:03.701 There were these particles in breast milk 00:07:03.701 --> 00:07:07.400 that were found already in the 1930s 00:07:07.400 --> 00:07:09.827 called human milk oligosaccharides, 00:07:09.827 --> 00:07:12.811 but their function remained a mystery 00:07:12.811 --> 00:07:18.288 for decades and decades after their initial discovery. 00:07:18.288 --> 00:07:20.895 They were really puzzling for researchers, 00:07:20.895 --> 00:07:24.578 as they are really abundant in human milk. 00:07:24.578 --> 00:07:28.287 They are actually the third-largest group of solids, 00:07:28.287 --> 00:07:30.529 but they are not digestible by humans, not even infants. 00:07:30.529 --> 00:07:32.043 So why would mothers synthesize something to breast milk, 00:07:32.043 --> 00:07:34.491 use their resources to put something there 00:07:34.491 --> 00:07:41.775 that is not utilizable by the infant? 00:07:42.029 --> 00:07:45.041 Usually nature does not work that way. 00:07:45.041 --> 00:07:46.109 Right? 00:07:46.109 --> 00:07:47.626 So it was quite a revelation 00:07:47.626 --> 00:07:49.343 when it was finally understood 00:07:49.343 --> 00:07:51.292 what's the role of these particles, 00:07:51.292 --> 00:07:55.209 and that it is to selectively feed the microbes that are best for infants, 00:07:55.209 --> 00:08:00.088 and that way to affect the infant health. 00:08:00.088 --> 00:08:04.276 There are over a hundred of different HMO structures, 00:08:04.276 --> 00:08:10.425 and nowadays we are able to synthesize some of them also in the lab, 00:08:10.425 --> 00:08:12.853 and that enables us to package them up 00:08:12.853 --> 00:08:16.075 with probiotics for children and infants 00:08:16.075 --> 00:08:18.746 who are not able to receive them from breast milk 00:08:18.746 --> 00:08:20.883 to restore their microbiota 00:08:20.883 --> 00:08:24.719 after encountering disruptive early life events. 00:08:25.617 --> 00:08:27.937 And that is the solution. NOTE Paragraph 00:08:27.937 --> 00:08:30.520 As a researcher, I must say at this point 00:08:30.520 --> 00:08:33.546 that research in this field is still ongoing 00:08:33.546 --> 00:08:37.392 and a lot of work remains to be done. 00:08:37.392 --> 00:08:40.584 That's a favorite sentence of us scientists. 00:08:40.584 --> 00:08:45.508 But we are taking steps towards understanding better and better 00:08:45.508 --> 00:08:49.304 which are the key missing microbes in various situations 00:08:49.304 --> 00:08:55.402 and what HMOs we should package with which probiotics to help restore 00:08:55.402 --> 00:09:00.111 the microbiota of that particular baby in that particular case. NOTE Paragraph 00:09:01.669 --> 00:09:05.023 What I wish you to remember from this talk 00:09:05.023 --> 00:09:09.882 is that, yes, vaginally born breastfed baby has the microbiota 00:09:09.882 --> 00:09:11.474 we have evolved to adapt to, 00:09:11.474 --> 00:09:14.434 but in cases where that is not possible, 00:09:14.434 --> 00:09:19.156 there are means to reduce the negative health consequences. NOTE Paragraph 00:09:19.156 --> 00:09:26.078 Lastly, I wish you to imagine a world for a while, 00:09:26.078 --> 00:09:29.091 a world where there would be such a health care system 00:09:29.091 --> 00:09:31.610 that when you take your baby to a health care check, 00:09:31.610 --> 00:09:36.474 they would routinely monitor the gut microbiota development of that baby, 00:09:36.474 --> 00:09:38.806 and if any disruptions would be noted, 00:09:38.806 --> 00:09:42.664 a tailor-made product to restore the microbiota 00:09:42.664 --> 00:09:44.080 would be prescribed. 00:09:44.080 --> 00:09:47.195 I mean, how wonderful would that be, 00:09:47.195 --> 00:09:50.812 if the onset of any chronic diseases would be extremely rare 00:09:50.812 --> 00:09:56.519 because of this preemptive health care system? 00:09:56.519 --> 00:09:59.746 Can you imagine such a world? 00:09:59.746 --> 00:10:04.518 Do you believe that that kind of future would be possible? NOTE Paragraph 00:10:05.291 --> 00:10:07.127 I do. 00:10:07.127 --> 00:10:10.021 I believe in that future and I want to contribute 00:10:10.021 --> 00:10:12.440 in the unfolding of that future, 00:10:12.440 --> 00:10:18.748 a future in which each baby has an equal starting point for life 00:10:18.748 --> 00:10:20.929 to be programmed for lifelong health. NOTE Paragraph 00:10:20.929 --> 00:10:24.826 Thank you. NOTE Paragraph 00:10:24.826 --> 00:10:26.690 (Applause)