
If being too clean makes us sick, why isn’t getting dirty the solution? - neverminder
https://theconversation.com/if-being-too-clean-makes-us-sick-why-isnt-getting-dirty-the-solution-50572?utm_medium=email&utm_campaign=Newsletter%20for%20Sunday%20January%2017%202016&utm_content=Newsletter%20for%20Sunday%20January%2017%202016+CID_458a2368e784f399b1f1105283ab13b1&utm_source=campaign_monitor_us&utm_term=If%20being%20too%20clean%20makes%20us%20sick%20why%20isnt%20getting%20dirty%20the%20solution
======
jerf
Thinking in English words makes "clean" and "dirty" sound like single-
dimensional vectors that directly oppose each other. But that's not true. What
is actually true is an n-dimensional vector, with an enormous variety of
"cleans" and "dirties", and even more complicated when you start combining the
vectors. Plus you don't get to custom-design them; you have to take what
exists in the world. So when you "clean" yourself with a certain soap of the
"dirtiness" you currently have, you don't get to custom design a cleaning
agent that precisely knocks out only the portions of the "dirty" vector you
have, you can only use things that exist, with all their side effects.

A lot of things in the real world work like that, but the medical world, since
it involves biological bodies, the most complicated things in the known
universe, seem particularly prone to this problem. Similarly, if you have a
genetic disease where X is overexpressed, but its action is opposed by Y, it
isn't necessarily a solution to just increase the expression of Y, because
where English makes "oppose" sound nice and clean, in reality that's a
summation of two complicated vectors. For all you know, X and Y also have a
way in which they work in the same way, and having a system that overexpresses
both will suddenly expose a pathology where the combination of both becomes
fatal even so. Biology's a nasty place. The engineering is profoundly non-
human.

------
adrianN
I think "inflammation" is the modern day's "bad humors". We don't really
understand the relationship between inflammation and illness and yet
inflammation get's sold to the public as an important cause. Unfortunately,
anti-inflammatory drugs don't improve outcomes for heart disease or
Alzheimer's, even though inflammation is somehow implicated.

So mucking about with worms or other parasites to give the immune system
something to do is most likely not a good idea until we better understand the
underlying mechanisms.

~~~
brianwawok
Sports medicine has always been a bit more pragmatic than other branches of
medicine. "We have no idea how this works, but it makes people run/swim
faster, so let's do it!"

I think a lot of work 10 or 20 years ago went into reducing inflammation. Less
inflammation = could train again the next day! Pound down that Advil at the
end of your workout so you are ready to go!

Over the last few years, it seems more and more people are saying "The
inflammation process is what makes your body stronger - you can't stop it
without losing the benefits!"

On the other hand, I do still see inflammation stopping treatments around.
i.e. football players after a game getting into basically a freezer for 15
seconds to reduce muscle inflammation. Possibly the logic there is that they
are already trained and not looking to get "stronger", just recover from the
days damage as fast as possible to get ready for the next game.

~~~
marincounty
Sports medicine seems to forget about the placebo effect.

I've seen players, weekend warriors, even former amateur athletes trying to
improve injury recovery times/performance with procedures, folklore, gadgets,
or just "This is what my coach said".

I believe we need to get the strong science into sports medicine. And when
pointed to studies, they are like studies done in too many psychology
studies--"The study compared twenty athletes to blah, and no follow up with
larger objective studies.

The athlete is the perfect candidate for placebo cures, in so many cases.

Sports medicine seems to hurt a lot of athletes with the whole, "Hay--it
works!". Yea, and it kills, and shortens life spans in athletes(professional)
too?"

I don't want to argue, but I believe Lance Armstrong won most of those wins
with the placebo effect.

Yea--scream all you want. Lance didn't come across as that knowledgable. He
belived everything those doctors were telling him.

I'll never forget something his Italian doctor said when he was being roasted
over all the drugs. I won't get the quote right, but it was after all the
villagers/authorities busted the two of them. Lance one one race without
anything in his system. He might have had blood transfusions? It doesn't
matter, his doctor said, "Lance won on the placebo effect! Probally all
along?"

Not one reporter asked what the placebo effect was. I have a weird feeling
most of those drugs were hampering his performance. But the super powers of
that placebo effect were magic?

~~~
crpatino
> I believe we need to get the strong science into sports medicine.

Professional sports already bring on board the best (applied) science that
money can buy. The approach is practical because there are billions of dollars
on the line. If that is not good enough for you uppity sense of scientific
purity, too bad. When you own a team, you'll be free to do as you please with
your own money (just don't complain if your team is beaten by all the others
that do not share your scientific sensitivities).

Professional athletes and their coaches will not stop doing what is well known
to work just because a bunch of nerds have a quasi-religious taboo against the
"placebo effect".

------
kaitai
Practically, one could:

* wash hands, and frequently (but you don't need an antibacterial soap -- they're bad for fish)

* use your well-seasoned wok/cast-iron skillet and not wash it with soap

* eat your fermented foods (from funky cheese to kimchi)

* eat things straight out of the garden without washing as long as there is no visible raccoon poop

etc. It is also possible to use different gradations of cleaning power for
your body and house: bleach kills everything while vinegar and baking soda
clean most things just fine; some soaps are less harsh than others. Showering
regularly is a blessing in high population-density areas, but you don't need
to sanitize every part of yourself every day.

The only area in my life where I'm fanatical about sanitization, in fact, is
brewing beer. There a certain outcome is desired and my usually carefully
cultivated lackadaisical attitude is not appropriate.

------
refurb
The problem with the hygiene hypothesis is that clinical trials to test it
haven't really shown any results so far. Coronado Biosciences tried using pig
whipworm eggs to treat Crohn's disease and other inflammatory conditions and
the result was it showed no impact whatsoever.

Now that's not to say the theory is completely debunked, but so for our theory
hasn't really held up with testing.

It kind of reminds me of antioxidants as well. Yes, there is a lot of evidence
that oxidative stress plays a role in disease, but attempts at levering
antioxidants hasn't shown any impact.

~~~
dorfsmay
But, if the problem I'd that the immune system learned the wrong thing, then
you can't fix it with whipworw, it's too late. Kinda like somebody learning a
second language late in life.

The only to test a theory would be to use infants twin, raise half of them in
clean conditions and expose the other half to all kind of bacteria, etc...

------
verbify
I can't be bothered to write a complete takedown, but two things come to mind:

1) The author falls prey to the naturalistic fallacy:

> We can actually achieve a good mixture of gut bacteria very similar to that
> of our hunter-gatherer ancestors by adopting a good diet high in fiber and
> low in processed foods.

2) I've read studies to the effect that some infectious diseases can affect
intelligence. Particularly when children are young - apparently there is a
mechanism to either further develop the immune system or the brain depending
on the environment (this might partially explain the Flynn Effect). I can't
find the exact study (this used to be in this section -
[https://en.wikipedia.org/wiki/Impact_of_health_on_intelligen...](https://en.wikipedia.org/wiki/Impact_of_health_on_intelligence#Infectious_diseases)
\- but I think it was edited out at some point).

~~~
chillwaves
Your point one sounds like a fallacy fallacy, i.e., just because some
conditions of a fallacy are present, does not mean it applies.

The article does not state that every aspect of the hunter gather microbiome
is superior to the modern day ancestor, rather just acknowledges the complex
and long process of evolving mutually beneficial microbiota which is being
disrupted by modern technology. That statement is not as controversial as you
imply.

Perhaps when you aren't so busy reading Hacker News, you might be "bothered"
to give a more complete reposte.

~~~
meowface
Ironically, I think you may have fallen victim to a kind of fallacy fallacy
fallacy, because the fallacy fallacy concerns the interpretation of an
argument assuming a valid fallacy in it does exist. At least according to
Wikipedia's definition of fallacy fallacy.

Rather, in this case the parent post merely misidentified a fallacy.

------
anupshinde
I think the habit of getting in touch with nature begins as kids - playing
with mud, getting enough sun, swimming/playing in ponds/lakes/rivers. That
improves our immunity to a good extent. However these are good only in natural
settings and not so good in the nature-pockets in urban areas.

------
tcsnell
It seems like a focus on the internal human biome could be a Kuhnian paradigm
shift -- but like everything else about health, it also presents ripe
opportunities for quackery. Let's see some more real research on this before
anyone starts trying to self-infect.

~~~
norea-armozel
I believe there was an article about how one research study was wrong about
the percentage of human mass being bacteria (I think the claim was 50% of our
mass is bacteria). So, I expect Mercola and company to latch onto this craze
soon enough if they haven't already.

~~~
maxerickson
I've never heard it stated in terms of mass, I've always heard it in terms of
a human body having many more bacterial than human cells. But that is being
revisited (probably the research you mention):

[http://www.nature.com/news/scientists-bust-myth-that-our-
bod...](http://www.nature.com/news/scientists-bust-myth-that-our-bodies-have-
more-bacteria-than-human-cells-1.19136)

Turns out it is probably ~1:1.

~~~
grhino
And prokaryotic cells are much, much smaller than eurkaryotic cells. I think
the mass of a eukaryotic cell is over 1000x the mass of a prokaryotic cell.

------
nathanvanfleet
I think in our lifetimes we went from "antibacterial in everything" to "wait
there is something about these bacteria that we want." Science is catching up
to the idea because of the mistakes we've been making over the past decades.
Hopefully they can figure it out in our lifetime.

------
SuddsMcDuff
Some people go to extreme lengths to implant beneficial flora into their
gut... with, I kid you not, POO TRANSPLANTS
([https://en.wikipedia.org/wiki/Fecal_bacteriotherapy](https://en.wikipedia.org/wiki/Fecal_bacteriotherapy)).

Seems like it's mostly done for medical reasons at the moment, but I could
easily see this becoming a fad craze.

You can actually buy poo tablets, and become a poo donor.
[http://www.openbiome.org/](http://www.openbiome.org/)

~~~
geomark
Those poo transplants have saved a lot of people suffering from Clostridium
difficile colitis, a very serious and potentially fatal condition.

~~~
sridca
Also there are a bunch of clinical trials to see to what extent FMT helps with
other diseases (inasmuch as those diseases stem from dysbiosis).

[https://clinicaltrials.gov/ct2/results?term=fMT&Search=Searc...](https://clinicaltrials.gov/ct2/results?term=fMT&Search=Search)

~~~
geomark
Is dysbiosis being considered as a possible contributor to colorectal cancer?
It's a big killer in the US. Lists of risk factors only include eating
processed meats, type 2 diabetes, alcohol consumption and being overweight.

~~~
tstactplsignore
Well, there are changes in the intestinal / colonic microbiota changes
associated with CRC, and some putatove mechanisms of causation. See:

[http://www.sciencedirect.com/science/article/pii/S1931312813...](http://www.sciencedirect.com/science/article/pii/S1931312813002552)

------
jhallenworld
The post-cleanliness society is one of Samuel R. Delany's visions:

[http://www.lesleyahall.net/clean.htm](http://www.lesleyahall.net/clean.htm)

~~~
cgh
I remember reading Nova as a teenager and being simultaneously fascinated and
revolted by how filthy everyone was.

------
Diederich
About a year ago, after reading some material (I think posted on HN) I decided
to stop using soap on my body, for the most part.

I have long hair, and I've struggled with dandruff in the past, so washing it
with shampoo and conditioner seemed to be the only way for a long time.

But for the last year, I get up and do a relatively quick, hot shower. I use a
tiny bit of soap between my legs. For the rest of my body, and especially my
scalp, I vigorously scrub with my hands and fingernails.

My hair, scalp and skin have never been more healthy. I produce notably less
body odor now.

So...I have been and remain a clean person. But now I'm not using substances
that'll kill most everything on the surface of my body. And this has been a
very good thing.

~~~
Frondo
In my experience with a pair of friends who have gone the "no more soap" road,
it isn't that they produce less odor (quite the contrary, and to the detriment
of their careers, I'm really a bit sad to say), it's that they get accustomed
to their odor.

------
stinos
Uhm, that's all possible but 'sick' is rather general. IIRC there was an
article here recently where children growing up on farms were compared to
children growing up in cities and the consensus was that because the farmers
were more exposed to typical 'farm dust' (think pollen, animal excrement, ...)
they were less likely to develop all kinds of allergies (indeed: pollen,
animal excrement, ...) than those from the city, and less allergies in turn
means less prone to asthma and other respiratory problems etc. In other words,
that article is like exactly the opposite of this title, in a way.

------
spydum
So... Implanting symbiotic worms in our bodies for improved immunoresponse?
Someone has been watching Stargate SG-1.

~~~
geomark
The story of Jasper Lawrence is pretty interesting. He suffered from severe
allergies that incapacitated him much of the time. He got so deperate that he
went to Cameroon and walked around in poop in open latrines to infect himself
with hookworms. Couple of months later his allergy symptoms were gone.

~~~
rsync
An interesting bit of Internet-culture history is that the original "guide"
was a long post to kuro5hin:

[http://www.kuro5hin.org/story/2006/4/30/91945/8971](http://www.kuro5hin.org/story/2006/4/30/91945/8971)

------
threesixandnine
As everything in life. The secret is in the balance.

~~~
chillwaves
That is a platitude to me when you have no idea what the range values are. We
may be in an extreme end but if the dimensions are not defined in a meaningful
way, where is the wisdom in this statement?

You might as well say the secret to winning a football game is to score more
points than the opposing team.

~~~
threesixandnine
To tell you the truth I don't really know (and understand) what you are
talking about. Myself, I understand balance as not to be phlegmatic and not to
exaggerate towards things, life. Hopefully you can understand what I wrote and
tried to say (English is my 4th language) better now? Let's take washing hands
as an example. Don't wash your hands every 15 minutes just because you touched
door handle or shook hand with someone but be sure to wash it when you finish
your toilette business...

Your football game example reminds me of :

"If you want to win you must not lose" – Number One (Alan Ford)

------
somberi
A good read :

Riddled with Life: Friendly Worms, Ladybug Sex, and the Parasites That Make Us
Who We Are by Marlene Zuk

[http://www.goodreads.com/book/show/832783.Riddled_with_Life](http://www.goodreads.com/book/show/832783.Riddled_with_Life)

------
lmilcin
I guess for the same reason that starving to death isn't the solution to
overeating.

------
miseg
If vegetables are part of the answer, I wonder if vegetarians show less immune
diseases.

~~~
jhartmann
I have an autoimmune disease (Ankylosing Spondylitis) and I've been
pescatarian for a little more than a year. I'm not on any biologics, my sed
rate is pretty normal and I feel SO much better. Part of my diet change is
that I eat a large amount of fiber (40+ grams a day generally), which is very
prebiotic. I would say it really has helped me, its probably worth trying a
diet change if you have an autoimmune condition.

------
baldfat
My doctor: "Let the kids play in dirt. It actually will help them become
healthy."

Good advice. I live int he city so the kids get to play in the garden. :)

~~~
tootie
There's really no evidence to support it. It sounds nice and may turn out to
be true, but we can't say for sure. Riding the subway probably does more for
immune development than playing in the dirt.

~~~
baldfat
John Hopkin's might disagree:

[http://www.hopkinsmedicine.org/news/media/releases/newborns_...](http://www.hopkinsmedicine.org/news/media/releases/newborns_exposed_to_dirt_dander_and_germs_may_have_lower_allergy_and_asthma_risk)

~~~
mhandley
The interesting thing about that study is that the protective effects only
work if you're exposed before you're one year old. This makes it a bit late
for most of us on HN.

~~~
baldfat
No I think ti says the benefits only last till one years of age.

------
flormmm
Is too clean really making us sick? Seems like it encourages allergies and
such

------
headShrinker
To me it's obvious. Till now no one questioned pharmaceutical and body care
products. We've been led astray. We used soap/shampoo when we wake up,
antibacterial soap morning noon and night, lysol disinfectant spray on all
surfaces, a pill for ADD before bed. So for 40 years we have been doing
exactly the wrong things.

You can't unscrew this by throwing dirt on it. Dirt isn't the right bacteria
either. Even bacteria has an order to it. There are a common set of bacteria
on us and things and they needs to be there. We've been convinced by
corporations selling a products, that bacteria is bad.

~~~
bryanlarsen
Blaming the allergy and inflammation epidemic on anti-bacterial soap and other
similar products is a common hypothesis, which is probably why this article
was written to argue against the hypothesis.

The article's hypothesis is that the cause is indoor living and processed
foods.

~~~
chillwaves
Your statement does not agree with the article. Encapsulated in the sentence
"cause is indoor living" implicates products such as antibacterial drugs used
in soap, toothpaste, everywhere etc.

~~~
bryanlarsen
The article includes lines like "giving up soap won't help your biome".

