Title: Gut Feelings
Author: Alessio Fasano M.D., Susie Flaherty
Genre: Health and Diet
Publisher: MIT Press (2021)
This is the second book I've read and reviewed by Dr Alessio Fasano, Chief of Pediatric Gastroenterology at Massachusetts General Hospital for Children and Director of the Center for Celiac Research and Treatment. He is also professor of pediatrics at Harvard Medical School and professor of nutrition at Harvard T.H. Chan School of Public Health.
After reading Dr. Fasano's other book Gluten Freedom, where he connects celiac disease to issues of the microbiome, I just had to get this one.
Gut Feelings is all about the microbiome, the colonies of microscopic bacteria that live in and on our bodies and help us to maintain health.
Unlike Gluten Freedom which is specifically about celiac disease, Gut Feelings thoroughly covers history and current state of our understanding of and research into the microbiome. In addition to celiac disease, Fasano explores other chronic diseases that are related to and maybe even caused by an "imbalance" of our microbiome. Conditions like: obesity, gut inflammation, other autoimmune disorders, neurological disorders and even cancer seem to be associated with the quantity and species of bacteria we host.
What really stands out in Gut Feelings is how early it is in our understanding of these little creatures. How little we know about what constitutes a "healthy" or "balanced" microbiome as opposed to what signals disease.
The most exciting news is what the future may hold. It seems clear that medicine will become much more personalized and preventative care much more central. Progress is already being made toward understanding how we might predict the onset of certain conditions before symptoms begin and, with the right diet and / or the right combination of probiotics, prebiotics and even "post-biotics" many life altering diseases may be prevented.
This book is very different from Dr. Fasano's other book, Gluten Freedom. This one is far more dense and technical. This makes it less accessible to the general public, in my opinion. Take this quote for example "Cancer development results from co-occurrence of the dysregulation of cell intrinsic pathways and escape from immunosurveillance"
This doesn't mean that Gut Feelings is not a good book or that I didn't learn a ton. It is and I did. It just means that it may not be for everyone. I found myself having to slow down in certain sections and skimming others.
I enjoyed the history of our discovery and understanding of microorganisms. I found it eye opening to learn about the diversity of species among individuals and populations. I'm excited at the possibilities to come but impatient to see progress. I'm disappointed to learn that the multi-billion dollar probiotics industry is based more on hope and guesswork than conclusive studies. Mostly I was happy to read that, at least for now, the best approach to a healthy microbiome is a diet of whole foods with lots of fiber and minimal processed starches and sugars. That supports what I'm reading from other experts like Dr. Robert Lustig in Metabolical and Julie Daniluk R.H.N. in Becoming Sugar Free.
I gave this book three stars, not because it's not a great book, but because it's not for everyone. If you are a doctor or researcher or you're really into the technical details of the background and structure of studies and you have no problem navigating six syllable words you'll love this. If you're looking for a relaxing read then maybe not.