Gut Feelings On Obesity And A Long Healthy Life

Presenter: Katherine
Guest: Dr. Mark Donohoe
Guest Bio: He is one of Australia’s most experienced and best-known medical practitioners in the fields of nutritional and environmental medicine, as well as the emerging field of integrated medicine.


Health Professional Radio

Katherine: Thanks for listening to Health Professional Radio. My name is Katherine, and today I am joined by Dr. Mark Donohoe. He is one of Australia’s most experienced and best-known medical practitioners in the fields of nutritional and environmental medicine, as well as the emerging field of integrated medicine. He will also be a speaker at this year’s AustralAsian Academy of Anti-Ageing Medicine Conference. Welcome to our show.

Dr. Mark Donohoe: Nice to be here, Katherine.

Katherine: Now, today we’re talking about “Who’s the Boss of Number Two – Gut Feelings On Obesity and A Long and Healthy Life”.  Can you tell us about number two?

Dr. Donohoe: Yeah.  We’ve moved in medicine from regarding the number two, the poo, as just what’s left in the bowel, and we haven’t paid much attention to health and, if you like, cultivating or gardening our bowel successfully.  A lot of research, just in the last decade, has emerged to say if we keep the creatures in our bowels healthy, if we, in other words, cultivate them at birth … natural birth seems to inoculate the baby’s bowel, breastfeeding helps it, a variety of foods in season seems to help it.  If we cultivate those bugs in our bowel, there’s an enormous variety, and they look after our health.

And so, rather than them just being the waster removers, they in fact do an enormous amount regarding human health.  What we regard as illness and disease is often our failure to look after them, the antibiotics, the Caesareans, the problems that we end up creating for what we call the “invironment” as opposed to the environment.  A lot of the problems that we cause, we cause ourselves just by our terrible diets, by interventions and by not thinking about keeping the inner world healthy.

Katherine: You just mentioned this before, that there is a link with childbirth and Caesareans and things like that.  Can you elaborate on that a little bit?

Dr. Donohoe: Yeah.  I mean we’ve always … in medicine, as doctors, we always regard aseptic techniques, minimizing germs as the goal of medicine – and it’s a really important principle when you are cutting people open.  We regard things that happen in nature as somewhat messy and risky to life.  But it turns out childbirth, where we thought it would be better for the baby if they didn’t have to have their heads squeezed to go through the vagina and get their mouths full of muck, it’d be a lot cleaner and better.  It turns out that that muck and going through the birth canal is essential to the first six to eight weeks of normal flora development and that’s fed by breastfeeding immediately afterwards.

And so now in this last year, we have three big studies, each of them showing that Caesareans result in a very stunted growth of that population, and it’s still stunted two to six years out from the birth.  So it shows you that the importance of a good start, which we thought we were doing something to help – you know, a better start will be if you were a bit cleaner and you didn’t have all that risk of infection.  But that messy start is in fact what a baby thrives on.

Katherine: Yeah, I see.  In some cases, emergency Caesarean is vital for whatever complication.  But for those do not have the vaginal birth and all, can we cultivate these microbes if they’ve missed out on … give it through breastfeeding.  Can you … other ways?

Dr. Donohoe: It’s a very good question.  As you probably know, medicine progresses through first identifying the problem.  When I said these studies have appeared in this last year, we can now be very confident that Caesareans result in an impairment of that first microbiome creation, that first start in life.  As you said, essential Caesareans, there is no question that you have to have the Caesareans when the baby’s health and the mother’s health is at risk – so I’m not arguing about that.

The question becomes, do we now favour elective Caesareans, where simply it’s a choice of mum to say “I’d prefer a Caesarean,” should we as doctors be saying, “Look, there are risks associated with this that may cause your child to be obese, that may cause your child to develop infections and illnesses, get gastroenteritis at a higher rate.”  My feeling is that we should be saying that to mums until we know what to do to cover those microbes on the other side of the Caesarean.

Katherine: Yes, right.  As you mentioned before, there’s these studies that have come out in the last year, and one of the things I wanted to talk to you about was that the gut microbiome is directly linked to obesity?

Dr. Donohoe: Yeah.  This is the work of … I have to give attribution to a well-known guy who’s also talking at the A5M Conference, named Gary Egger.  But we are starting to understand obesity more.  In the past 100 years, we’ve said this is calories in versus calories out, or kilojoules in versus kilojoules out.  And it’s just, you know, you balance one and someone who eats too much and another one too little, and that’s all it is.  Yet we all know people who can eat like a ravenous tiger and put on no weight and others who, no matter how meticulous in their diet, never lose a kilo.  It’s been a mystery because you think it goes in the mouth.  What happens?

It turns out microbes in the gut gets a say on many of these things and they get to see the food first and there are energy-harvesting bacteria and there are energy-wasting bacteria.  Depending upon the [inaudible 0:05:54] that you get, this group of microbes called Firmicutes seem to be the ones that harvest it and hold it, and they actually build weight in the host.  So they manipulate the owner to produce more fat, to provide for them and to also minimize the effects of inflammation.

So it’s a very fascinating kind of symbiotic relationship that we have, that if you start off with the wrong microbes – the babies that we were talking about with the Caesarean – they end up with the microbes that put on the weight.  Now we’d always thought, 30 years back, that’s a healthy-looking baby.  They’re chubby and they’re round and it looked good, but now we have an obesity epidemic.  We’re looking back on that with jaundiced eyes, shall I say.  We’re saying maybe it’s not such a brilliant idea to have what we call obesogenic bacteria or the bacteria that cause the host to put on weight and hold that weight and prepare for the famine that they believe may be ahead.  Maybe they’re not the right bugs to have.

We’ve got some rat studies which show that if you take lean rats and fat rats and you take the bowel flora from the fat rats and put them in the lean ones, they become fat.  It’s that simple.  You can transfer the fatness not by moral turpitude or anything like that.  All you’ve got to do is take the bugs from the fats ones, put them in the lean ones, and the lean ones become fat.  Now the suspicion is that unless we pay attention to the microbiome in ourselves, then we’re missing a whole big area of obesity, and this kind of blooming diabetic problem that we’re coming up to.

Katherine: Exactly.  Can you give us some advice on providing the ideal environment for these microbes?

Dr. Donohoe: Sure.  The ideal environment, this comes back to something that we all do know about, called evolutionary biology.  What did nature start us off with?  Because in general, we do better with the kind of environment and food that we are born into.  All the babies that could have been otherwise are no longer with us.  So you can say that if we focus on natural childbirth, where it’s all possible, breastfeeding, terribly important for those first … maybe up to 12 or even 18 months of life, and then a variety of foods in season, obviously for babies and the like mashed up.  But changing our diet around so that we are not focusing on carbohydrates coming from a supermarket with exactly the same food every single day of our lives, going for a variety of fresh foods in season.

There’s also an argument that we should be looking at organic foods because the pesticides, although they don’t affect humans much, are also another factor in changing that internal environment.  So there is some rationale now for people who have focused on organic foods, that organics foods don’t contain the pesticides and that’s exactly how nature provided those foods when we were hunter-gatherers.

So it’s not rocket science.  It is also though avoidance of unnecessary medical intervention.  As a doctor, I know the value of antibiotics and the value of Caesareans and the value of certain medical interventions like the acid suppressants, but I also know that they have their downside.  Now the focus is on the gut, to say this is where the downside occurs and unhappy bacteria inside your bowel can manipulate you to do things you would otherwise not want to do; catch infections, get fat, feel weak and fatigued.  They do a lot to manipulate even things like sleep.

So we’ve got to look after the bowel, look after the flora there, and relearn just normal, everyday techniques of maintaining that biodiversity on the “invironment”.

Katherine: Yeah.  Thank you so much for that advice.  As I mentioned, Dr. Donohoe is speaking at the conference, and for those of you that would like to know more, you can go to  Thank you for your time today, doctor.

Dr. Donohoe: It’s been a pleasure.  Thanks.

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