Understanding Gut Microbiome Science with Jeffrey Gordon, MD

“​​We're talking about the intersection between food science, microbiome science, and medical nutritional sciences. Those are linked inexorably and deserve increasing attention, particularly as we go into this time of an almost existential crisis with climate change. What kind of food systems are we going to establish? What kind of food systems can we support? How are the food staples that are coming out of these food systems going to be processed? How does the transformation of those foods by our microbial community further define the nutritional value of foods or the potential nutritional value of foods? This is an important thing to consider. And one that can't be ignored.” — Jeffrey Gordon, MD

• Robert J. Glaser Distinguished University Professor
• Director of the Edison Family Center for Genome Sciences and System Biology at Washington University School of Medicine in St. Louis 

Gordon and his lab have changed our understanding of how human physiology is shaped by microbial communities, influencing nutrient absorption, immune function and overall health. The promise of microbiota-targeted therapies, discovered by Gordon and his team, is unparalleled when it comes to treating childhood malnutrition, the leading cause of death in children age five and under across the globe. 

• As a young person, Gordon was heavily influenced by the notion of journeying into outer space by a book he read called: The Microbe Hunter by Paul de Kruif and by a liberal arts education that taught him values inspired by social justice and the foundations of human flourishing. 
• In the early stages of microbiology, microbes were difficult to culture. It was the advent of molecular tools and DNA sequencing that allowed investigators to identify and classify these microbial communities 
• Entering the field as a developmental biologist, Gordon’s research shifted to microbiology after realizing cells in the gut were highly influenced by microbial communities.  
• Eventually, Gordon and his lab developed the first mouse model of human gut microbiota, where they later learned just how impactful microbiota are in nutrient absorption, immune function and overall health.  
• Challenging their predecessors' view that microbiota are primarily pathogenic, Gordon and his team began investigating the role of microbiota in treating childhood undernutrition.  
• Childhood malnutrition can lead to poor development of an immune system, poor responses to vaccination, impaired neurological development and metabolic derangements, among many other issues. While mortality rates have been curbed, long-term complications from the condition remain.  
• Gordon’s team ran clinical randomized controlled trials on moderately malnourished children in Bangladesh between 12-18 months of age, administering microbiota-directed therapeutic foods to test health impacts. The results yielded positive growth outcomes above previous treatments.  
• The next task for Gordon and his team is to determine how generalizable these interventions are across geographies, age ranges, cultural traditions and health statuses. As a result, The World Health Organization, The Gates Foundation, and UNICEF have teamed together to support clinical trials of therapeutic foods in six different countries.  
• Regarding the Nemmers Prize, Gordon attributes the award to the collective effort of his lab members and other collaborators and addresses how the award highlights how microbiome research — in the context of disparities of access and social justice — is a project of how basic science intersects with regulation, policy and education. 

Recorded on September 17, 2024. 

Additional Reading 

• Read a Nature paper by Gordon and colleagues.
• Learn more about his visit to campus and lecture in September. 
• Check out a recent Nature Microbiology paper.

Target Audience

Academic/Research, Multiple specialties

Learning Objectives

At the conclusion of this activity, participants will be able to:

1. Identify the research interests and initiatives of Feinberg faculty.
2. Discuss new updates in clinical and translational research.

Accreditation Statement

The Northwestern University Feinberg School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation Statement

The Northwestern University Feinberg School of Medicine designates this Enduring Material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Board of Surgery Continuous Certification Program

Successful completion of this CME activity enables the learner to earn credit toward the CME requirement(s) of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

All the relevant financial relationships for these individuals have been mitigated.

Disclosure Statement

Jeffrey Gordon, MD, has nothing to disclose. Course director, Robert Rosa, MD, has nothing to disclose. Planning committee member, Erin Spain, has nothing to disclose. FSM’s CME Leadership, Review Committee, and Staff have no relevant financial relationships with ineligible companies to disclose.

[00:00:00] Erin Spain, MS: This is Breakthroughs, a podcast from Northwestern University Feinberg School of Medicine. I'm Erin Spain, host of the show. Every other year, Northwestern University recognizes a physician scientist with the Mechthild Esser Nemmers Prize in Medical Science, a $350,000 prize, which is awarded to a biomedical researcher whose body of work exhibits outstanding achievement in medical science, as demonstrated by works of lasting significance. The 2024 recipient of this prize is Dr. Jeffrey Gordon, who is often referred to as the father of microbiome research. Dr. Gordon is the Robert J. Glaser Distinguished University Professor and Director of the Edison Family Center for Genome Sciences and System Biology at Washington University School of Medicine in St. Louis. We are thrilled to have Dr. Gordon on the show today to discuss his career and research, which has transformed the understanding of human health and how it's shaped by the gut microbiome and has also led to new approaches in treating malnutrition and childhood undernutrition with microbiota targeted therapies. Welcome to the show, Dr. Gordon. 

[00:01:27] Jeffrey Gordon, MD: Thank you for having me. It's a pleasure to be here. 

[00:01:30] Erin Spain, MS: Well, it's so nice to have you here. I'd like to start at the very beginning to help our listeners get to know you. So, if you don't mind telling me, what first drew you into science and medicine? 

[00:01:41] Jeffrey Gordon, MD: Well, I was in an environment as a kid where my father was a doctor. So there was a lot of discussion about health and disease. I liked science. The things that I was reading as a young child often have to do with science. Questions about the Earth. I was fascinated by the idea of traveling beyond the Earth to planets. When I was young, the first satellite was launched by the Russians, Sputnik 1. And we all looked to the sky in awe. The whole idea of something being able to orbit the Earth, to think about our Earth from a different perspective. Soon thereafter, there was a program conceived and articulated by John F. Kennedy, the President of the United States, to land a man on the moon. And that thought was absolutely mesmerizing. And to grow up at a time when man's desire to travel to new worlds, to see things that have never been seen before, that was captivating. And again, it was also about something beyond ourselves, that we would have to unite as groups of people to solve problems that were very complex.  At later stages of my life I had to not travel tens of millions of miles to see something together with others that hadn't been seen before. I had to travel a few meters inside of myself to look at the world inside of our gut, populated by tens of trillions of organisms whose identities and functions were largely unknown. I also read a book when I was young called The Microbe Hunters, and it was this glorious rendition of how heroic scientists would try to track down the causes of infectious diseases. But those are my early exposures. I went to college at a liberal arts institution, where I had a broad view about the human journey, for which I'm forever grateful. That was Oberlin College. And a lot of the discussions there had to do with what are the foundations of human flourishing? How do issues of social justice get resolved? How are inequities addressed at many different levels of society? And there was a fundamental theme of trying to use your voice to try to effect change. Not for recognition, but as a part of a purposeful life. Basically forged by a belief in the fact that people can and do make a difference. 

[00:04:09] Erin Spain, MS: I can definitely see through your life's work those threads of the things you learned in your liberal arts education and the book you read as a child. Wow, they really had an impact on you throughout your career. 

[00:04:21] Jeffrey Gordon, MD: The evolution of a career follows many surprising directions. I went to medical school at the University of Chicago, a place of very broad disciplinary breadth and depth, and also suffused with a lot of deep curiosity. People were very, very curious trying to understand in medical school the origins of human health and the mechanisms underlying disease, but I could see how many different disciplines were required to come together to answer those very complicated questions, and that had a big impact on me. There's an African proverb that I very much like in our lab. It's a proverb that's written on the walls of the Gates Foundation when you go into their headquarters. It's "If you want to travel fast, go alone. If you want to travel far, go together." And I think that that's a good lesson in life in general. And certainly a lesson in science. That combined with the gift of attention so that you could see the significance of what's in front of you and around you, to do so collectively gives you an opportunity to really have a joyful ride of discovery. 

[00:05:27] Erin Spain, MS: Well, and you had this incredible lens as you were investigating a field that there really wasn't a lot of information on when you first started. Now, you mentioned a book that you read as a child about the microbiome, but tell me about when you entered this field, what was known and how you were able to contribute starting early on as a young scientist? 

[00:05:47] Jeffrey Gordon, MD: First of all, although some of the tools in the area of microbiome research are new, the questions are as old as microbiology itself. So it's a very dawn of the field of microbiology. People were wondering what the functions of microbes on and in our body were, and for a long time the technology to recover these organisms improved. But a lot of these organisms were very difficult to culture. And it was really the advent of molecular tools so that you could identify the citizens in a microbial community. Who are the actors on the stage using DNA sequencing directed at sort of these barcodes of life, genes that would allow us to classify the type of organisms that were present. And from that, which is a technology that depended upon the evolution of DNA sequencing, but also the ability to classify the sequences into different categories of life, that began a rapid and very dynamic pursuit of what do these communities look like? What are their structures? It didn't answer the question necessarily of how they function, but that was an important inflection point in the journey to try to understand our microbial communities. And we came into this field not as microbiologists, but as developmental biologists. We were very interested, as a lab, in how the lining cells of the gut know where they are in space and time. So let me explain that a little bit more. Our intestines are lined with a layer of cells called an epithelium. There are many different cell types that comprise the epithelium, four principal ones, and these cells are constantly being renewed. Now, how can these cells know where they are along the length of the gut and what functions to express despite the continuous refreshment of the epithelium? That was our question as developmental biologists and we studied that question in mice that were genetically engineered in ways that allowed us to probe this at a molecular level. And over time, it became evident that a lot of the instructions about space and time weren't hardwired into these cells, but rather were responses to cues from the environment. We made a decision to look above the cells in the lumen of the intestine at the microbes that started colonizing the intestine beginning at birth. That was the origin of our journey. How are these cells instructed about where they are in space and time, what functions to express? Who are the actors in the microbial communities that are responsible for this essential communication. And how the heck do we figure this out? Because there's so many different types of microbes, the system is so dynamic, the number of potential interactions between different types of microbes is literally astronomical. So we felt that we're gonna have to try to simplify the system. We went up 180 miles north. When I say up, we're talking about St. Louis , to the laboratory of this magnificent microbiologist named Abigail Salyers, who is able to culture some of the microbes in the human gut, particularly microbes that love to digest complex carbohydrates called polysaccharides. We asked for a few of these citizens that lived in the human gut microbial community. Then we thought we'd have to stage a drama where there would only be one actor in the center of the stage, and the drama would be conducted in a gut without any other microbes. The gut of a mouse that had been raised under completely sterile condition, a so called germ free animal. There were not many of these germ free animal facilities in the world, and it turns out there was a Swedish postdoc in the lab who had trained at the Karolinska Institute. And there, a man known as Tore Midtvedt had overseen this gnotobiotic facility for many years. And we called Tore and asked, could we bring this organism from the human gut, install it into the intestines of these animals, and create a very simplified model of the human gut microbiota. And there began the application of these molecular tools. What genes in the gut were influenced by the presence of this organism, what do these genes do, what functions in the gut could be regulated by this organism? And also how about the genes in the organism itself? A number of very talented students in the lab were learning that this organism was able to affect lots of different functions in the gut, more so than we would anticipate a priori. In order to figure out which genes in the organisms were important, we wanted to sequence the genome of that organism. This was the late 90s and not many microbial genome sequencing projects were active. Most of the projects were focused on pathogens. Going back to that book I alluded to before, this fascination of the collision between pathogens and human hosts and how disease forms. Most of the genome sequencing centers at the time were also racing to get the first draft of the human genome. 

So we decided to roll up our sleeves and set up all the technology necessary for doing a genome sequence and sequence this organism's genome. It took us two years to do that. And all the computational methods needed to identify or predict the function of the genes in the genome of this organism. And that sets the stage, of course, the rest of our journey in many respects. And it turns out that when we looked inside this organism and saw its genome, we saw so many functions that were important for breaking down complex carbohydrates in our diet that were not represented in our own genome, and it gave us the idea that a lot of the foundations for this wonderful marriage between microbes and our gut were predicated on nutrient sharing and how microbes might contribute to the nutritional value of food. And also the idea we could build up with increasing complexity to find communities of microbes where we would have the genome sequence of these organisms. We can install them into these germ free animals and we can look at how they talk to one another. The microbes to themselves, the microbes to the host. At that time, we were thinking about human disease and how microbes might influence nutritional status. We were developmental biologists, so one idea that was very captivating was to look at childhood undernutrition. But we didn't have a school of public health, and we realized that any sort of study of childhood undernutrition would have to be conducted in a setting where there was profound community engagement between the health care providers and the population so we could explain our intention. We could get permission to do longitudinal studies so we could follow individuals over time. We could understand what might be normal, how to define deviations from normal when we looked at the microbial community, do tests to see whether those deviations from normal might be an effect or a cause of disease, identify therapeutic targets, and maybe therapeutic agents. So, to make a long story short, Tahmeed Ahmed, who is then Director of the Nutritional Division at the International Center for Diarrheal Disease Research in Bangladesh, and I found one another. It was like brothers finding one another that had been separated at birth. We began a project that looked at the role of the gut microbial community in children who had undernutrition. 

[00:13:14] Erin Spain, MS: And that really broke open a whole area of research. And I wanted you to give us a little context too about malnutrition. It represents the leading cause of death in children under the age of five worldwide. Can you talk about that a little bit and how compelling it is to study malnutrition, and possibly find some ways to help these children. 

[00:13:34] Jeffrey Gordon, MD: Well, it is a global health challenge. It's pressing, it's vexing, and it's tragic in many, many ways. A lot of epidemiological studies have been done to look at the origins of childhood undernutrition: wasting, stunting, all the sequelae that are associated with that. And by that I mean, the poor development of an immune system, poor responses to vaccination, impaired neurological development, metabolic derangements, failure of bone to develop properly with stunting, many, many different aspects of undernutrition. And these epidemiologic studies have revealed, continue to reveal, it's not food insecurity alone that's responsible, that there are other factors that operate within and across generations. And we also know that this problem is intergenerational in the sense that, if a mother is malnourished, the effects are going to be profound on the child, and the outcome in a child's life is going to be significant. Most of the treatments for undernutrition have fortunately reduced mortality or death, but they haven't overcome the long-term complications of undernutrition, stunting, immunological dysfunction, failed neurodevelopment, and we felt that we're missing something. What else might contribute? And also, we were missing a comprehensive definition of the biological state of undernutrition. So to make it as concise as possible, there is a World Health Organization reference collection cohort of children who are described as healthy. They represent several nations and the height and weight of these children at different stages of postnatal life are included in this database. And a child's growth is assessed based on the degree to which they approach the average of this cohort. And stunting or other manifestations of undernutrition are described as the extent of deviation from this normal. Now stunting is described as moderate or severe based on the number of deviations from the mean value or median value. Wasting, which is a failure to gain weight also that way. But who would ever describe cancer as moderate or severe? We need a much more comprehensive definition of the biological state or states of undernutrition. So that was one of our goals. And here was our hypothesis: that there was a definable normal program of assembly of this microbial community beginning at birth, and that this program that we had thought could be defined was perturbed in children with undernutrition. And that perturbation, that disruption of this microbial organ's development was not an effect, but rather a contributing cause of undernutrition. And the final point is that we really should think about our development, at least after birth, from the perspective of this. well-choreographed program of assembling microbial communities that provide functions that aren't in our own human genome and the development of our organ systems, so that we are really a splendid combination of microbial and human cells and parts. So that's our hypothesis, and we went through this multi-step journey of defining normal in an area where the burden of disease was great, trying to develop tools to quantify deviations from normal, which we did. And the program of assembly of this microbial community was determined by studying so called birth cohorts, children enrolled at the time they were born, and sampled monthly through the first two and then five years of life. These birth cohort studies in children who remain normal in terms of their gain of height and weight allowed us to define who is in this microbial community of theirs. We also saw how the process was disrupted in children with undernutrition, so their communities look younger than you would expect based on their chronological age. And then we returned to these germ free animals that I described earlier, and did a test of causality. What do I mean by that? We took microbial communities from children who were undernourished, and microbial communities from children, same chronological age, who are healthy in terms of their growth patterns, and transferred those communities to the mice, and fed the mice the same diets as the children, and found that we could transfer many of the features of undernutrition to the mice. That was an animal model. And then we could also use a variety of computational methods based on AI. We were able to look at all the communities from all the children that we tested and identify key organisms that were linked to growth, at least in these animal models, and they became our therapeutic targets. So the animal models were representative of the population that we ultimately wanted to treat, and that was very important. 

[00:18:18] Erin Spain, MS: Tell me, at the time, this was a major breakthrough. It was a major discovery. What was the reaction like from your peers in the community? 

[00:18:25] Jeffrey Gordon, MD: I think it gave them a sense that our gut microbial community operates in ways that extend well beyond the wall of the gut, and that these communities are able to do things that influence so many different aspects of our physiology. And it also evoked the thought that perhaps just adding calories or vitamins and minerals were not sufficient to restore the healthy growth of these children, that there has to be some attention paid to the types of metabolic activities that these microbes in our gut perform on the foods that we eat, so that the foods are transformed into products that not only benefit the microbes, but benefit us. Every single family in the world has to make a decision when their child stops exclusive milk feeding and begins to be weaned to a solid diet. Now, none of the policies related to this time of quote unquote complementary feeding are based on a consideration of the developmental biology of the microbiota. So could we envision ways in which certain foods would sponsor the development of a healthy microbiota and wouldn't that have a large impact on making sure that our stewardship of our children's precious microbial resources would be the best possible and that they would realize healthy growth. We are funded by the Bill and Melinda Gates Foundation. So imagine our publishing these papers and saying, okay, How can we repair these microbial communities? Well, if you're funded by the Bill and Melinda Gates Foundation, the first thing you think about are solutions that are culturally acceptable, affordable, effective, but also scalable. So. it's not feasible, at least at the time, to simply create a next generation probiotic cocktail composed of these organisms that were either inadequately represented or not performing properly and administer it to thousands and tens of thousands of children. There are technical problems, there are regulatory issues, etc. So we turned to food. We went back to our animal models and began to screen the different complementary foods to identify those foods that could affect, that could target, that could impact our growth promoting organisms that we had identified. And we found those foods. We formulated them in a combination that we called microbiota directed complementary foods. That's a big mouthful. And we did clinical trials of these complementary foods and had a pun intended bake off. So this is a randomized controlled clinical trial. And we took the standard therapy used for children who had moderate malnutrition. They were 12 to 18 months of age. They lived in an urban slum in the capital of Bangladesh. And we then looked at the effects of the standard foods versus our microbiota directed complementary foods. Now, interestingly enough, the amount of calories in the foods that we had developed for transforming or repairing the microbiota was less, fewer calories than the standard. And despite the fact that there was a difference in the amount of calories, the children who consumed the microbiota directed complementary foods gained weight much more rapidly. And when we looked, not only during the three months, period of treatment but beyond because we followed these children for two years after treatment. We found that although there was not a significant difference in height at the end of the three months during the follow up period after we stopped treatment there was superior gain of height in those who had received the MDCF. So the effects of this microbiota directed complementary food were longer lasting. When you repair a microbial community in this fashion, you have this wonderful opportunity to connect the dots. So as the microbial community is being repaired, what parts that are changing in the microbial community are parts that affect bone growth or musculoskeletal development or metabolism or Central Nervous System Development. And this is one of the key opportunities in this field. As we learn how to repair a microbial community, we can see how its parts function and what their effects are on our biology. 

[00:22:43] Erin Spain, MS: I want to hear more about the food specifically as well. If you don't mind sharing, what was the difference in the diets that you were able to provide? 

[00:22:52] Jeffrey Gordon, MD: We had soy flour, peanut flour, we had banana, we had chickpea flour. We also had a source of lipids, soybean oil, and we had vitamins and minerals. The other standard of care formulation had rice and lentil, milk powder, the same lipids and the same minerals and vitamins. But microbes don't see the word chickpea. They don't see soy. They don't see the word banana. What they see are the molecules in those foods. We're living in a remarkable time when we have to make very profound decisions about the food systems that we create, which cultivars we plant, which foods are more nutritious. And the microbes can help us do that, answer those types of questions. 

[00:23:37] Erin Spain, MS: I mean, I can't help but to think of the quote, let food be thy medicine and medicine be thy food. I mean, that really speaks to what you have done here. 

[00:23:46] Jeffrey Gordon, MD: When we saw this result our clinical outcome measure, we paused for a moment and smiled, but the real work was ahead of us, and that was to take a deeper dive into, which organisms in the microbial community were responding? How are they responding? And could the genes that they changed in terms of how they were expressed give us a clue about the active component of these different complementary foods? What were the actual molecules? And also how were those molecules acting on some, but not all members of the microbial community? Because we knew that the targets were the first responders, the second responders in the microbial community, we could get a better view about how well equipped a child would be to respond to this intervention. Let's fast forward: we identified the bioactive components of these foods and they were complex polysaccharides largely. And these carbohydrate structures, distributed in different complementary foods, were being seen by organisms who had the capacity to not only detect them, but import them and transform them and to produce products that would not only benefit themselves but also other members of the community and presumably the human host. If you know what the bioactive components are, we can think ahead, try to understand what other food types contain them? Or could we mine the by-product streams from food manufacturing? The rinds, the pulps, the seeds that are normally thrown out, and recover these active molecules at scale and think someday that perhaps we could have prebiotic cocktail, compounds that would be coveted by these organisms that could be given as sprinkles or some sort of addition to a normal diet so as to enhance the capacity of these microbial communities of children who are at risk for, already have manifest undernutrition, to have a healthy life. 

[00:25:40] Erin Spain, MS: I mean, this could have a huge impact on the future evolution of humanity, really, on a much larger scale of something like that. How far away do you think we are from having something like this become a reality? 

[00:25:52] Jeffrey Gordon, MD: The first task is to determine how generalizable these effects are. So, if we give this therapeutic food to children living in different countries, all in the same age range, what will the effects be? Will they be similar across different geographies, different cultural traditions? How about the age in which we first administer the therapeutic food? If a child manifests undernutrition early in life, will her or his developing microbial community respond in the same way to a child that manifests a disrupted program of community development later on. So when can we first detect the development of undernutrition? How can we detect the first failures of the community to develop? And one of the values of the investments of the Gates Foundation in these clinical trials is to spend the time and financial resources to understand mechanisms of disease. What are the biomolecules that are present in the active therapeutic food? But also, who are the organisms that are responding? Which suites of genes are present in their genomes? Could that be used diagnostically to stratify the population prior to treatment as to whether they are likely to respond or not? What types of changes in blood proteins occur, give us an idea of how to categorize different states of undernutrition? Disease responses? Can we predict disease response? Can we do adaptive trials? Right now, the World Health Organization, the Gates Foundation, and UNICEF have teamed together so that we can do clinical trials of our therapeutic foods in six different countries representing different geographies and cultural traditions to see about the generalizability of the effect. Also across different age ranges, from six to 24 months. That will be an important event for us to get a body of scientific data confirming the efficacy. There are also important regulatory issues. How will these foods be classified? How will they be used in different countries based on their policies? How cost effective will they be? They also raised the question of how to educate a population about the meaning of these foods. And that issue of education comes very early on in this multi-step journey to be of paramount importance. We have to explain at this time that we did the first birth cohort studies, why were we doing this? We have to explain to a population of women who are very committed to the wellbeing of their children, but whose scientific literacy was very low. What is a microbial community? What is a microbiota? Why are we trying to do something about it? Who owns their microbes? What can we ask for in terms of future use of biological samples that we collect not only during our observational studies, but also during our actual clinical trials. 

[00:28:46] Erin Spain, MS: So many ethical considerations with a vulnerable population to consider. 

[00:28:51] Jeffrey Gordon, MD: Absolutely. I think that there is a dimensionality to this global health challenge that is captivating, awe inspiring and humbling. But nonetheless, that multifaceted view is going to be critical if we are to have impact. The partnerships that have to be forged to be able to consider this in a mindful, thoughtful, effective way have to be durable partnerships involving people with expertise that span many different subject areas. That's so exhilarating, so growth promoting for ourselves, for the students, for everybody who's involved. It also has a huge impact on how we educate students. This is an inherently interdisciplinary area. So how do you bring students together in an environment where, although they have different expertise, there's a sense of humility, other directness, so people can open up and say, I don't understand. Can we educate one another? Can there be a sense of shared joy as we climb a very tall mountain and embark on tasks that are very challenging, that are uncertain? And can this spirit of collaboration, of cooperation, of operating in ways where we leverage our naivete collectively, to learn more, can that be one of the most enduring lessons of the students who were lucky enough to have enter our laboratory? And can their career be influenced by this sense of community? And also, we're living in a century that provides us with absolutely profound challenges that will require commitments of many, many people working together over the course of not only one lifetime, but multiple lifetimes to address and to solve. And I think that it gives me great hope that there are students who I've been fortunate enough personally to have knock on the door who have that sense of humility, of hopefulness, of a desire to commit their lives to make the world a better place, not from recognition, but just from the fact that that is a measure of how they value the merits of their life work and their lives themselves. 

[00:30:59] Erin Spain, MS: I mean, it sounds like you are building an incredible team that is going to take this work and continue pushing it into the future. And I know, again, congratulations on winning this Nemmers Prize. Can you talk to me about how you're going to be able to leverage this prize to continue this work? 

[00:31:15] Jeffrey Gordon, MD: First of all, we, not me, we are very, very grateful for this prize because it does reflect the collective work of so many talented people over time within the lab, our collaborators. But I think also the fact that this prize, which recognizes area of medicine, of medical research that are thought to have impact not only now, but also in the future, and to change the way that we view health and disease, and to transform also not only our view of health and disease, but our ways of treatment and prevention. If the microbiome is elevated to that level in this form, I think it provides an important substance, important motivation, important attention to the opportunities that we have in this area. As long as we are very thoughtful in describing what we know now that we avoid hyperbole that we have sobriety, and that we use rigorous, clinical trials, rigorously studied preclinical models, this translational pathway in this era of precision medicine that is really a virtuous circle to be able to really move forward and impact human health. But we're also talking about doing this in countries that are high income, as well as countries, in this particular case, that are largely low and middle income where there are disparities of access, issues of social justice, there are huge, huge problems. How we can afford this, how can we make it the most effective type of therapeutic and preventative measures and policies possible. That's one of the things that this award I think will naturally highlight because our discussion, like the discussion we're having right now, is not only about the basic science and the clinical science, but how that intersects with regulation, with policy, with education. 

[00:33:07] Erin Spain, MS: Your work is also transforming the way that we think about food and the ingredients in the food that we're feeding our children and ourselves and how important it is to human health. There's a lot of interest in this topic and mainstream media, more people know about the importance of gut health and the microbiome, but do you think more needs to be done and academic medical centers and research institutions and in medical education to bring nutrition to the forefront? 

[00:33:36] Jeffrey Gordon, MD: I think you raise an incredibly important point, which is that we're really talking about the intersection between food science, microbiome science, and  nutritional sciences. And you're absolutely right. Those are linked inexorably and deserve increasing attention. Particularly as we go into this time of an almost existential crisis with climate change, what kind of food systems are we going to establish? What kind of food systems can we support? How are the food staples that are coming out of these food systems going to be processed? What is the effect of processing on the nutritional value or content of the food? And how does the transformation of those foods by our microbial community further define the nutritional value of foods or the potential nutritional value of foods? So, this is an important thing to consider. And one that can't be ignored. 

[00:34:28] Erin Spain, MS: Well, you're on the cusp of many things here and it's very exciting and we can't wait to see what happens next with your research. So thank you so much for being a part of this podcast and sharing your research story. It's very inspiring and I hope that you've inspired people here with your story today. 

[00:34:46] Jeffrey Gordon, MD: Well, thank you so much for giving me this opportunity. 

[00:34:49] Erin Spain, MS: Thanks for listening, and be sure to subscribe to this show on Apple Podcasts or wherever you listen to podcasts. And rate and review us also for medical professionals. This episode of Breakthroughs is available for CME Credit. Go to our website, feinberg northwestern edu, and search CME.