WEBVTT 00:00:01.500 --> 00:00:03.934 Now, I know it might be easy to think 00:00:03.958 --> 00:00:05.851 that microbes are bad, 00:00:05.875 --> 00:00:08.268 especially for infants, 00:00:08.292 --> 00:00:11.125 but research has in fact proven the opposite. 00:00:12.375 --> 00:00:15.393 And the truth might be a little bit more complex, 00:00:15.417 --> 00:00:18.542 but it's actually way more interesting. 00:00:19.500 --> 00:00:21.851 It seems that we need microbes 00:00:21.875 --> 00:00:24.000 to be programmed for good health, 00:00:25.083 --> 00:00:26.809 but not just any microbes, 00:00:26.833 --> 00:00:29.226 we need the right combination. 00:00:29.250 --> 00:00:31.934 We succeed best with the little microbial bodies 00:00:31.958 --> 00:00:35.708 we have adapted to coexist with during evolution. 00:00:36.875 --> 00:00:38.518 And I guess it won't surprise you 00:00:38.542 --> 00:00:43.226 to learn that we start acquiring that right combination right at birth. 00:00:43.250 --> 00:00:45.458 Well, at least, some of us do. 00:00:46.667 --> 00:00:49.684 Babies born by C-section and babies born vaginally 00:00:49.708 --> 00:00:50.976 aren't the same 00:00:51.000 --> 00:00:54.143 when it comes to microbial start to life, 00:00:54.167 --> 00:00:58.559 and after birth there are countless different early life events 00:00:58.583 --> 00:00:59.893 and circumstances 00:00:59.917 --> 00:01:04.059 that further modulate the way the gut microbiota is developing, 00:01:04.083 --> 00:01:09.184 such as the medications that might be prescribed for the infant or the mother, 00:01:09.208 --> 00:01:12.351 number of pets and siblings in the family, 00:01:12.375 --> 00:01:14.184 as well as level of hygiene at home, 00:01:14.208 --> 00:01:16.184 and, in this case, it's actually better 00:01:16.208 --> 00:01:19.083 if it's not that perfectly clean all the time. 00:01:20.542 --> 00:01:23.809 And also nutrition, both mothers and infants. 00:01:23.833 --> 00:01:28.768 All of these events and circumstances play a huge role 00:01:28.792 --> 00:01:31.268 in the gut microbial development 00:01:31.292 --> 00:01:35.833 and that has a huge impact on the lifelong health of that baby. 00:01:37.167 --> 00:01:40.684 And I'm not talking about small health implications here. 00:01:40.708 --> 00:01:43.143 I'm talking about the big stuff. 00:01:43.167 --> 00:01:46.226 Microbes we acquire or do not acquire 00:01:46.250 --> 00:01:51.268 affect our likelihood of developing diseases like obesity, diabetes, 00:01:51.292 --> 00:01:52.833 and even some cancers. 00:01:54.000 --> 00:01:57.101 Since many of these early life events I just listed 00:01:57.125 --> 00:01:59.476 are such that we cannot affect them, 00:01:59.500 --> 00:02:00.934 they are inevitable, 00:02:00.958 --> 00:02:04.268 for example C-sections have been invented to save lives, 00:02:04.292 --> 00:02:06.351 and they do that daily, 00:02:06.375 --> 00:02:10.143 and most medications are prescribed for a valid reason, 00:02:10.167 --> 00:02:13.018 especially for infants, and so on. 00:02:13.042 --> 00:02:16.143 That is why we have to learn 00:02:16.167 --> 00:02:18.684 how to protect the health of these babies 00:02:18.708 --> 00:02:22.143 after the occurrence of such early life events 00:02:22.167 --> 00:02:25.042 that might disrupt their gut microbiota development. 00:02:26.542 --> 00:02:27.893 I work as a researcher 00:02:27.917 --> 00:02:31.268 and as a technical lead of an infant health platform, 00:02:31.292 --> 00:02:35.518 and the question I'm trying to find a solution to every day at work, 00:02:35.542 --> 00:02:39.309 and the same question I'm aiming to answer in this talk, 00:02:39.333 --> 00:02:41.809 is how can we make sure 00:02:41.833 --> 00:02:45.101 that all babies get the same shot at lifelong health, 00:02:45.125 --> 00:02:50.208 no matter how they're born or what early life events they encounter. 00:02:51.375 --> 00:02:53.333 Seems like a noble cause, right? 00:02:54.125 --> 00:02:55.393 Great. 00:02:55.417 --> 00:02:57.101 So let's figure this out. 00:02:57.125 --> 00:03:02.500 To begin, remember how I said that we need the right combination of microbes? 00:03:04.333 --> 00:03:06.434 Well, to get that combination right, 00:03:06.458 --> 00:03:09.934 we need to receive those microbes that inhabit our bodies 00:03:09.958 --> 00:03:11.583 in a certain order. 00:03:12.875 --> 00:03:16.351 You can think of it like a colonization march. 00:03:16.375 --> 00:03:21.101 The very early microbes that inhabit our bodies first 00:03:21.125 --> 00:03:24.684 change the environment in the infant's gut 00:03:24.708 --> 00:03:28.768 so that the next microbes are able to move in, 00:03:28.792 --> 00:03:30.684 kind of like the first invaders 00:03:30.708 --> 00:03:33.059 come in first and set up the infrastructure 00:03:33.083 --> 00:03:35.208 for the other settlers to build upon. 00:03:36.292 --> 00:03:39.059 Now, if babies are born via C-section, 00:03:39.083 --> 00:03:43.101 that early phase of colonization is greatly altered, 00:03:43.125 --> 00:03:47.851 because instead of vaginal, fecal, and skin bacteria of the mother, 00:03:47.875 --> 00:03:51.809 mainly only skin bacteria enter the infant gut. 00:03:51.833 --> 00:03:56.726 And that sets that colonization march to a totally different tone, 00:03:56.750 --> 00:04:02.601 and simply because that's different to what we've adapted to during evolution, 00:04:02.625 --> 00:04:08.226 that might cause some health disadvantages for C-section-born babies later on. 00:04:08.250 --> 00:04:11.184 We can take weight development as an example here. 00:04:11.208 --> 00:04:14.143 It has been already shown in several studies 00:04:14.167 --> 00:04:16.309 that gut microbiota composition 00:04:16.333 --> 00:04:18.184 is associated to weight 00:04:18.208 --> 00:04:20.518 as well as the likelihood of developing diseases 00:04:20.542 --> 00:04:24.226 like diabetes or cardiovascular diseases. 00:04:24.250 --> 00:04:26.684 But now there are some indications 00:04:26.708 --> 00:04:29.226 that you could already at infancy 00:04:29.250 --> 00:04:31.726 see from a fecal sample of a baby 00:04:31.750 --> 00:04:34.768 some microbes missing from those individuals 00:04:34.792 --> 00:04:38.250 who will later on develop to be obese or overweight. 00:04:39.125 --> 00:04:43.101 It has also been shown that those same microbes 00:04:43.125 --> 00:04:46.351 might be missing from babies who are born by C-section 00:04:46.375 --> 00:04:50.768 or who are predisposed to heavy loads of antibiotics in early life. 00:04:50.792 --> 00:04:52.434 And to kind of close this loop, 00:04:52.458 --> 00:04:54.809 it has also been shown in some research 00:04:54.833 --> 00:04:56.934 that babies born by C-section 00:04:56.958 --> 00:05:01.018 or are prescribed with many, many antibiotics early in life 00:05:01.042 --> 00:05:05.143 are more likely to be obese or overweight, even by 50 percent, 00:05:05.167 --> 00:05:06.417 which is a lot. 00:05:07.500 --> 00:05:09.768 Now, I know you might be thinking at this point 00:05:09.792 --> 00:05:14.268 that, oh no, I just had a C-section or I was born via C-section 00:05:14.292 --> 00:05:16.792 or my child had the antibiotics. 00:05:17.917 --> 00:05:20.851 But I want you to not worry. 00:05:20.875 --> 00:05:23.809 If these microbes are missing 00:05:23.833 --> 00:05:26.143 or are lost for any reason, 00:05:26.167 --> 00:05:29.309 they can be acquired later, 00:05:29.333 --> 00:05:31.792 but the baby just needs a little help with that. 00:05:32.708 --> 00:05:37.500 One thing that has already for some time been known to help is breastfeeding. 00:05:38.417 --> 00:05:40.476 Breast milk is kind of miraculous: 00:05:40.500 --> 00:05:43.601 in addition to containing nutrients for the baby, 00:05:43.625 --> 00:05:48.417 it seems to contain food for the good microbes as well. 00:05:49.792 --> 00:05:52.643 That's great for a breastfed baby, 00:05:52.667 --> 00:05:56.684 but we all know that all babies are not breastfed. 00:05:56.708 --> 00:06:01.934 So what could we do to ensure that also those babies who are not breastfed 00:06:01.958 --> 00:06:04.393 could restore their microbiota development 00:06:04.417 --> 00:06:08.143 after encountering those disruptive early life events 00:06:08.167 --> 00:06:11.893 that might disrupt their gut microbiota development. 00:06:11.917 --> 00:06:16.667 And now we get to the actual solution part of this talk. 00:06:17.375 --> 00:06:21.601 The research in this field has been taking giant steps lately. 00:06:21.625 --> 00:06:25.684 First, it was understood that if there are some microbes missing, 00:06:25.708 --> 00:06:27.976 they can be ingested. 00:06:28.000 --> 00:06:32.059 We call the good microbes, when they are ingested, probiotics, 00:06:32.083 --> 00:06:33.643 and probiotics have been tested 00:06:33.667 --> 00:06:36.434 in several clinical trials during the years 00:06:36.458 --> 00:06:38.726 also in infants with great effects 00:06:38.750 --> 00:06:41.875 such as reducing their risk of eczema later in life. 00:06:43.458 --> 00:06:45.976 Now, a second revolution was realized 00:06:46.000 --> 00:06:49.101 when the eyes of researchers were turned to breast milk. 00:06:49.125 --> 00:06:51.434 That was logical, as, like I mentioned, 00:06:51.458 --> 00:06:56.309 it was already known that breastfeeding is able to support the healthy development 00:06:56.333 --> 00:06:58.000 of gut microbiota. 00:06:59.750 --> 00:07:03.476 There were these particles in breast milk 00:07:03.500 --> 00:07:07.059 that were found already in the 1930s 00:07:07.083 --> 00:07:09.601 called human milk oligosaccharides, 00:07:09.625 --> 00:07:12.559 but their function remained a mystery 00:07:12.583 --> 00:07:17.000 for decades and decades after their initial discovery. 00:07:17.833 --> 00:07:20.476 They were really puzzling for researchers, 00:07:20.500 --> 00:07:24.226 as they are really abundant in human milk. 00:07:24.250 --> 00:07:27.851 They are actually the third-largest group of solids, 00:07:27.875 --> 00:07:31.643 but they are not digestible by humans, not even infants. 00:07:31.667 --> 00:07:35.351 So why would mothers synthesize something to breast milk, 00:07:35.375 --> 00:07:38.143 use their resources to put something there 00:07:38.167 --> 00:07:41.184 that is not utilizable by the infant? 00:07:41.208 --> 00:07:43.643 Usually nature does not work that way. 00:07:43.667 --> 00:07:44.934 Right? 00:07:44.958 --> 00:07:48.726 So it was quite a revelation when it was finally understood 00:07:48.750 --> 00:07:50.934 what's the role of these particles, 00:07:50.958 --> 00:07:56.351 and that it is to selectively feed the microbes that are best for infants, 00:07:56.375 --> 00:07:59.768 and that way to affect the infant health. 00:07:59.792 --> 00:08:03.893 There are over a hundred of different HMO structures, 00:08:03.917 --> 00:08:08.708 and nowadays we are able to synthesize some of them also in the lab, 00:08:10.000 --> 00:08:12.393 and that enables us to package them up 00:08:12.417 --> 00:08:15.643 with probiotics for children and infants 00:08:15.667 --> 00:08:18.393 who are not able to receive them from breast milk 00:08:18.417 --> 00:08:20.559 to restore their microbiota 00:08:20.583 --> 00:08:24.375 after encountering disruptive early life events. 00:08:25.417 --> 00:08:27.684 And that is the solution. 00:08:27.708 --> 00:08:30.893 As a researcher, I must say at this point 00:08:30.917 --> 00:08:33.851 that research in this field is still ongoing 00:08:33.875 --> 00:08:36.809 and a lot of work remains to be done. 00:08:36.833 --> 00:08:40.226 That's a favorite sentence of us scientists. 00:08:40.250 --> 00:08:45.268 But we are taking steps towards understanding better and better 00:08:45.292 --> 00:08:49.018 which are the key missing microbes in various situations 00:08:49.042 --> 00:08:53.601 and what HMOs we should package with which probiotics 00:08:53.625 --> 00:08:59.583 to help restore the microbiota of that particular baby in that particular case. 00:09:01.458 --> 00:09:04.059 What I wish you to remember from this talk 00:09:04.083 --> 00:09:08.809 is that, yes, vaginally born breastfed baby has the microbiota 00:09:08.833 --> 00:09:10.809 we have evolved to adapt to, 00:09:10.833 --> 00:09:14.268 but in cases where that is not possible, 00:09:14.292 --> 00:09:18.625 there are means to reduce the negative health consequences. 00:09:21.083 --> 00:09:25.893 Lastly, I wish you to imagine a world for a while, 00:09:25.917 --> 00:09:28.684 a world where there would be such a health care system 00:09:28.708 --> 00:09:31.476 that when you take your baby to a health care check, 00:09:31.500 --> 00:09:35.809 they would routinely monitor the gut microbiota development of that baby, 00:09:35.833 --> 00:09:38.476 and if any disruptions would be noted, 00:09:38.500 --> 00:09:42.184 a tailor-made product to restore the microbiota 00:09:42.208 --> 00:09:43.500 would be prescribed. 00:09:44.583 --> 00:09:47.518 I mean, how wonderful would that be, 00:09:47.542 --> 00:09:52.101 if the onset of any chronic diseases would be extremely rare 00:09:52.125 --> 00:09:55.042 because of this preemptive health care system? 00:09:56.458 --> 00:09:58.167 Can you imagine such a world? 00:09:59.458 --> 00:10:03.000 Do you believe that that kind of future would be possible? 00:10:05.583 --> 00:10:07.059 I do. 00:10:07.083 --> 00:10:09.809 I believe in that future and I want to contribute 00:10:09.833 --> 00:10:11.750 in the unfolding of that future, 00:10:13.250 --> 00:10:18.101 a future in which each baby has an equal starting point for life 00:10:18.125 --> 00:10:20.250 to be programmed for lifelong health. 00:10:21.208 --> 00:10:22.476 Thank you. 00:10:22.500 --> 00:10:25.125 (Applause)