"Our Grandchildren Will Not Live as Long as We Do"

Question: What are the biggest health risks facing America?

Francis Collins: If you look at health in the United States, you could point to some really significant achievements and you could also point to the role that NIH has played in making those things happen; cardiovascular disease has dropped by more than 60% in mortality over the course of the last 30 to 40 years, much of it from insights derived from groups like the Framingham Study which pointed out what the risk factors were and what we could do about them.  Cancer is dropping in its frequency, finally, after many years of going up.  

But there are clouds on the horizon of public heath, obesity and it’s related disease, diabetes, probably is the one that causes the greatest concern when you see the way in which our population is growing more overweight almost year by year with no sign that we’ve managed to turn this around.  And that could, if not somehow addressed, result in an outcome where our grandchildren will not live as long as we do and we would therefore turn down what has been upward curve in longevity over many decades.  A critical need there through research, research that involves nutrition, research that involves understanding exercise, then understand the built environment and how to motivate health behaviors to try to turn around this obesity epidemic.  

Certainly other areas of concern... Alzheimer’s Disease comes to mind as a condition which as our population is aging and as the Boomers are coming into this phase of potentially higher risk of Alzheimer’s, that we are gong to see very large numbers of people affected by this heartbreaking disease with terrible consequences for themselves and their families and for our medical economics because of the cost of caring for them.  So this has to be a very high priority for our high intensity efforts to come up with new solutions about prevention and treatment.

Question:
How much of research should be focused on prevention, as opposed to treatments and cures?


Francis Collins: NIH is intensely interested in prevention.  I think everybody would agree that we haven’t paid enough attention to this approach to maintaining health, that we’ve not had a health care system in terms of medical care—we’ve had a "sick care" system where if you get sick there might be some help for you, but there’s been relatively little invested in terms of helping people stay well.  And maybe as a part of that we’ve had modest efforts, really, to try to invest in research on prevention.  That’s all changing.  Some of that’s coming about because of a better understanding of the environment and things that people should be careful about as far as bad influences on their future health, whether it’s smoking or diet or exercise.  We’re learning a lot about that.  

And some of it is the ability through personalized medicine to begin to identify individual risks for a future illness to get us beyond the one-size fits all approach to prevention, which has been not that effective.  People haven’t necessarily warmed to these recommendations about what you should do about diet, exercise, colonoscopies, mammograms and so on because it all sounds very much generic.  

But if you could provide people with information about their personal risks and allow them therefore to come up with a personalized plan for maintaining health that seems to inspire a lot more interest.  Genomics is moving us in the direction of being able to do that and I think that’s one of the more exciting developments in the prevention arena even though it’s early days yet, to see how that’s going to play out.

Recorded September 13, 2010
Interviewed by David Hirschman

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An organism found in dirt may lead to an anxiety vaccine, say scientists

Can dirt help us fight off stress? Groundbreaking new research shows how.

University of Colorado Boulder
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  • New research identifies a bacterium that helps block anxiety.
  • Scientists say this can lead to drugs for first responders and soldiers, preventing PTSD and other mental issues.
  • The finding builds on the hygiene hypothesis, first proposed in 1989.

Are modern societies trying too hard to be clean, at the detriment to public health? Scientists discovered that a microorganism living in dirt can actually be good for us, potentially helping the body to fight off stress. Harnessing its powers can lead to a "stress vaccine".

Researchers at the University of Colorado Boulder found that the fatty 10(Z)-hexadecenoic acid from the soil-residing bacterium Mycobacterium vaccae aids immune cells in blocking pathways that increase inflammation and the ability to combat stress.

The study's senior author and Integrative Physiology Professor Christopher Lowry described this fat as "one of the main ingredients" in the "special sauce" that causes the beneficial effects of the bacterium.

The finding goes hand in hand with the "hygiene hypothesis," initially proposed in 1989 by the British scientist David Strachan. He maintained that our generally sterile modern world prevents children from being exposed to certain microorganisms, resulting in compromised immune systems and greater incidences of asthma and allergies.

Contemporary research fine-tuned the hypothesis, finding that not interacting with so-called "old friends" or helpful microbes in the soil and the environment, rather than the ones that cause illnesses, is what's detrimental. In particular, our mental health could be at stake.

"The idea is that as humans have moved away from farms and an agricultural or hunter-gatherer existence into cities, we have lost contact with organisms that served to regulate our immune system and suppress inappropriate inflammation," explained Lowry. "That has put us at higher risk for inflammatory disease and stress-related psychiatric disorders."

University of Colorado Boulder

Christopher Lowry

This is not the first study on the subject from Lowry, who published previous work showing the connection between being exposed to healthy bacteria and mental health. He found that being raised with animals and dust in a rural environment helps children develop more stress-proof immune systems. Such kids were also likely to be less at risk for mental illnesses than people living in the city without pets.

Lowry's other work also pointed out that the soil-based bacterium Mycobacterium vaccae acts like an antidepressant when injected into rodents. It alters their behavior and has lasting anti-inflammatory effects on the brain, according to the press release from the University of Colorado Boulder. Prolonged inflammation can lead to such stress-related disorders as PTSD.

The new study from Lowry and his team identified why that worked by pinpointing the specific fatty acid responsible. They showed that when the 10(Z)-hexadecenoic acid gets into cells, it works like a lock, attaching itself to the peroxisome proliferator-activated receptor (PPAR). This allows it to block a number of key pathways responsible for inflammation. Pre-treating the cells with the acid (or lipid) made them withstand inflammation better.

Lowry thinks this understanding can lead to creating a "stress vaccine" that can be given to people in high-stress jobs, like first responders or soldiers. The vaccine can prevent the psychological effects of stress.

What's more, this friendly bacterium is not the only potentially helpful organism we can find in soil.

"This is just one strain of one species of one type of bacterium that is found in the soil but there are millions of other strains in soils," said Lowry. "We are just beginning to see the tip of the iceberg in terms of identifying the mechanisms through which they have evolved to keep us healthy. It should inspire awe in all of us."

Check out the study published in the journal Psychopharmacology.