The idea that humans are separate from the natural world is a new one. Humans and nature evolved together, developing and perfecting symbiotic (mutually-beneficial) relationships over 6 million years. Has our recent separation led to an increase in health issues, particularly autoimmunity?
The environment around us affects the environment within us, including our microbiome (the little organisms- bacteria, viruses, and other microbes- that live in and on us). The microbial diversity in our gut can have a major effect on our overall health, especially immune health.
Densely populated areas tend to have more concrete and less plant life, more chemicals and less clean air or water, and provide little opportunity for communing with the natural environment we were meant to live in. In fact, as we get less natural light exposure, our gut microbiome becomes less healthy!
How does being away from nature increase our chances of developing autoimmunity?
The Gut Microbiome
Have you seen the hit Pixar movie “Finding Nemo”? I bring this up because it demonstrates a great example of a symbiotic (harmonious, or mutually-beneficial) relationship between different organisms. Clownfish secrete a substance onto the surface of their skin that protects them from the sting of the sea anemone. This allows them to live and hide among the sea anemone’s tentacles. In return, the clownfish attracts other fish for the sea anemone to eat.
Over the course of millions of years, clownfish developed this special protective mucus that makes this mutually beneficial relationship possible. This is an example of coevolution!
Similarly to the clownfish and sea anemone, humans and microbes have coevolved to help each other. Human bodies provide a perfect environment for many types of bacteria, viruses, and fungi, which in turn help us digest, make nutrients, and provide a backbone for our immune system.
Keeping the balance between microbes in our gut is very important for our overall health. These little life forms help to regulate infection, digest foods, and even make some vitamins. Dr. Yehuda Shoenfeld, the “father of autoimmunity”, has been quoted as saying infections and microbiome diversity may be the key player in preventing and supporting autoimmunity.
Playing in the dirt allows our bodies to meet more microbes and build a stronger immune system. The hygiene hypothesis is the theory that our society’s obsession with sterility and killing germs has kept our immune systems from learning diverse microbes and building a strong backbone. If our immune system is not well-educated, it can become confused and start to mistake our own cells for pathogens that need to be destroyed, setting the stage for autoimmunity.
Air Pollution
Rising pollution levels are not only directly affecting the quality of air we breathe, but they are contributing to climate change and the increase in wildfires (more smoke in the air = even more pollution).
9 out of 10 people in this world breathe highly polluted air, which contributes to 7 million deaths per year. Breathing in polluted air irritates the lungs and mucosal lining, increases permeability of the mucus membranes (which allows for more irritants to enter the bloodstream), and causes both acute and chronic diseases as a result. It can aggravate and increase the risk of developing chronic conditions like asthma and emphysema (a type of lung disease).
Children’s lungs are in a state of development, with more than 80% of their air sacs developing after birth, so they are among the most highly affected populations. Children who grow up breathing polluted air are at a much higher risk for developing asthma, bronchitis, or even pneumonia. When air quality improves, children’s lung function shows clinically and statistically significant positive change, according to this large California study.
Air pollution can trigger autoimmune disease in genetically susceptible individuals by increasing inflammation. For example, rheumatoid arthritis (RA) is strongly associated with air pollution as a risk factor. In a 5-year Polish study, the prevalence of type 1 diabetes (another autoimmune disease) increased by 1.5 times as the air quality depleted.
Can We Use the Environment to Heal?
The average American spends 93% of their time indoors. Besides teaching our bodies new microbes and giving our lungs a break, are there other health benefits to be gained from spending time outside?
The ancient Japanese practice of shinrin-yoku, or forest bathing, has been shown to reduce blood pressure, reduce stress levels, and increase immune system balancing. This practice just refers to walking among trees and focusing on your senses- what you see, hear, taste, smell, and feel. It can be done in an actual forest, or simply at a park.
Similarly to shinrin-yoku, a growing trend in earthing, or grounding, simply means having skin contact with the Earth and absorbing it’s abundance of electrons. Our cells operate using electrons, but the frequencies we are exposed to throughout every day can deplete them. The Earth consistently gives off a frequency of 7.83 hz (the same as our alpha brain waves), which we can actually tune into!
Here in Boulder, Colorado, we are lucky enough to live within minutes of lush pine forests and incredible peaks. Wherever you are, find a safe spot among trees where you can go periodically, especially when you feel stressed or overwhelmed, just to play in the dirt, walk barefoot, and breathe.
Routinely incorporating this practice is not the newest fad. We have evolved around nature and as we digress from it we increase dis-ease, and as we move towards it we plant the seeds of healing and optimal health!
Yours in health,
Ian Hollaman, DC, MSC, IFMCP
Masks have become so politicized that even physical altercations have broken out regarding their usage. While many see mask-wearing as a decision that affects other people and is therefore not entirely personal, others maintain that everyone should take their health into their own hands.
Most schools around America that have been operating physically have implemented some sort of mask requirement. Even though children represent the demographic that is of the lowest risk and lowest spreading rate, they’ve still been forced to participate in the mask-wearing that has been the theme of this past year. Given the known negative effects of wearing masks along with the knowledge that children are of the lowest risk of mortality or getting severely ill from a COVID-19 infection, why are they still being forced to wear them?
Concerns have been raised over a false sense of security that may come from wearing a mask. If an individual is under the impression that a mask will protect them and others, they may become lax with other strategies that are equally, if not more effective at limiting the virus’s spread. Another concern is masks that are not properly kept clean may become spreading agents themselves. When considering children, can we really expect them to keep their masks properly sanitized? Sure, parents are responsible for this, but this brings us to our next issue. Think for a moment about how many people reuse their (often homemade) cloth masks every day.
The type of mask definitively alters its effectiveness. In this Vietnamese study, there was a significant difference in viruses spread among cloth mask wearers versus medical mask wearers. Hospital workers wearing cloth masks were 13 times more likely to contract an influenza-like virus. According to the study, “Penetration of cloth masks by particles was almost 97% and medical masks 44%.” Even more shockingly, cloth mask wearers were 3 times MORE likely to contract a virus than those who didn’t wear any mask at all. This means that the cloth masks actually increased the risk. Now ask yourself, is this good science or virtue signaling?
The Norwegian Institute of Public Health (NIPH) recommended against mask wearing for individuals without respiratory symptoms, citing concerns over proper usage. The researchers maintained that in order for an official recommendation to be effective, customized mask training needed to be provided directly to communities. They also stated that there is no reliable evidence that non-medical masks provide any protective effect. Let’s take a second to reflect on what this means, taking into account the supplies shortage we’ve seen regarding proper masks for medical workers. If we can’t even supply our front-line workers with proper equipment, the majority of the public is not going to be able to find the proper equipment. We’ve already seen that this leads to an increase in homemade cloth masks.
Children’s immune systems are young and flexible, making it the perfect time to introduce them to potentially harmful pathogens in the world so that they can learn how to protect themselves. It also makes them extremely resilient and quick to launch an attack on the virus (and we don’t have time to discuss how amazing breast feeding works for a baby’s immune system). Researchers have discovered that the SARS-CoV-2 virus is not able to replicate rapidly in childrens’ bodies due to a combination of factors. For one, because children’s immune systems are young, they contain many naive T cells just waiting to be deployed. Naive T cells are immune cells that have not yet been assigned to a specific virus or other pathogen, so they are readily available to study and launch an attack against a new pathogen. As a person grows up and is exposed to new environments, their bodies make less naive T cells because they’ve already learned the majority of antigens they encounter regularly.
Further evidence of a rapid immune response amongst children is found in the types of antibodies present in children versus adults following a COVID infection. Adults developed both antibodies against the SARS-CoV-2 spike protein (which allows the virus to enter a cell), and against its nucleocapsid protein (which is essential for the virus to replicate). Children, on the other hand, did not develop antibodies against the nucleocapsid protein because this protein is typically only present once the virus is widespread in the body.
All of these factors help to explain why some children develop Covid symptoms but repeatedly test negative for the virus on a PCR test. The virus simply is not able to replicate enough to show up on the test before the child’s body squashes it.
Another interesting possible reason for the low risk amongst children revolves around a specific enzyme found inside the nose called angiotensin-converting enzyme 2 (ACE2). This enzyme binds to spike proteins on the surface of the SARS-CoV-2 virus and allows it to enter the human cells. This study found that the amount of ACE2 in the nose increased with age, starting a very low amount for the youngest age group.
Age has been determined to be a large risk factor regarding Covid-19. One reason for this is the increased instance of comorbidities (other life-threatening conditions) amongst older populations. For example, Covid-19 patients who also have heart conditions are more likely to pass away from the infection. However in this study, age was independently a significant risk factor even after adjusting for such comorbidities. It is undeniable that children are at much lower risk than older adults, and not just for their lack of other health issues.
A child’s immune system is malleable and needs to be regularly challenged and stimulated in order to continue growing and strengthening. This study demonstrated the connection between growing up in a sterile environment and having a suppressed immune system. This concept is known as the ‘hygiene hypothesis’, which claims that early exposure to pathogens (amongst other things such as dander, mold and allergens) is integral to immune system development. If the child’s naive T cells never have the chance to meet any pathogens, how can they protect the child from disease later in life?
In addition to learning about the external environment, the immune system must also learn to tell the difference between a real pathogen and a human cell look-alike. When foreign material resembles a bodily cell, such as gluten proteins with thyroid tissue, an inexperienced immune system may accidentally end up attacking the host’s own body. This is how autoimmunity begins. But, gluten is not enough! We must remember that the immune system is complex and it involves genetics, environment and triggers (all three are required for autoimmunity). Merely having a family member with a chronic illness does not warrant the need to isolate our children – in fact, it harms their ability to respond when we don’t give them the opportunity to be outside, live life and just be kids!
There are also other factors to consider when discussing mask-wearing for children, notably the psychological effects it may have on them. Social distancing and school closures pose a new kind of challenge to a child’s interpersonal development. Hearing-impaired children lose the important tool of lip-reading as well as the practice necessary to hone that skill. Similarly, children within the autism spectrum lose the opportunity to practice reading facial expressions, which is something that they are predisposed to struggling with.
The question of whether we should force children to wear masks is a question of risk-benefit analysis. Simply, do the possible benefits outweigh the possible harms? If this isn’t the case, we cannot in good conscience advocate for society-wide mask requirements.
Yours in health,
– Dr. Ian Hollaman DC, MSc, IFMCP
