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Relationships, Health, and Sustainability

Interview with Maya Cosentino, M.D.

Maya Cosentino,M.D., is a physician and fellow Think Tank 30 member who researches on connections between relationships (to self, others & the environment), health & sustainability. In the following interview we explore the power of social relationships and microorganisms on our personal health and well-being as well as their effects on our environment.


Do relationships influence our health?

There are many fields of research that illuminate how relationships to ourselves, others and the environment influence health. Examples that I have explored over the last years are related to the effects of social and microbial environments on health.

In cultures that promote principles of individualism and stringent body hygiene, the idea that socially isolated people have shorter life expectancies, and that our health depends on bacteria in our gut might come as a surprise. But, research actually indicates that insufficient social relationships present a mortality risk similar to tobacco and alcohol use, and greater than physical inactivity and obesity.

Bacteria and other microorganisms in the gut significantly influence interrelated physiological processes including the development and regulation of the immune system, gene expression, and brain function. A large number of predominantly animal studies also suggest that the gut flora affects mood and social behaviors via neural, endocrine, and immune pathways.


Do you think that relationships are relevant to socio-ecological processes?

If we recognise human health and behavior as inextricably linked to our relationship to self, others and the environment, our experience of the world is influenced by that recognition. Awareness of our relational interdependence, enables us to view and understand the world through a more systems-oriented lens.

When people connect less directly with each other via social media and less directly to the earth with microwave-ready frozen meals, their understanding and experience of relationships change.

Research suggests, for example, that social media cannot substitute the real-world interactions and relationships we need to lead healthy lives. Real-world social relationships are positively linked to well-being and have been found to affect the activity of the immune system as well as disease progression. Active Facebook use, on the other hand, is associated with diminished well-being over time. More specifically, status updates are associated with mental health deterioration, while reacting to others’ posts and clicking links are linked to a decline in self-reported health (physical and psychological) and life satisfaction.

So, while direct, intimate contact with the life that nourishes and sustains us might feel less and less essential, it seems to be fundamental to our health.


What do you mean when you say systems-oriented?

Systems thinking acknowledges that the world is made up of interrelated and interdependent systems and recognizes that changing one part of a system usually affects the system as a whole. Microbial environments, for example, can be viewed as integral systems within the earth’s ecosystems, vital to the health of diverse environments including the soil that provides us with the food we eat.


What role does diet play in maintaining our health and the health of our environment?

The EAT-Lancet Commission (a nutrition initiative led by The Lancet, one of the world’s most prestigious medical journals) recognises diet as a major non-communicable disease and moratlity communicator. Worldwide, it is estimated that 2 billion adults are overweight or obese, 0.8 billion people are starving, and 2 billion people are micronutrient deficient.

The Food and Agriculture Organisation of the U.N. estimates that food production will need to increase by about 50 percent by 2050 in order to feed the anticipated world population of close to 10 billion. Given the current food system, especially livestock production, is indirectly responsible for about 30 percent of green house gas emissions worldwide, intensifying agricultural practices to increase crop production will present major challenges connected to maintaining biological and physical soil quality, and preventing food scarcity.

Like agricultural practices influence the microorganisms and health of soil and plant life, diet influences the microorganisms and health of humans and animals. High intake of the ingredients found in many processed foods including refined grains, sugars, artificial sweeteners and fat is linked to negative changes of the gut flora and a wide range of adverse health consequences. The consumption of artificial sweeteners, for example, has been connected to alterations in the gut flora associated with type two diabetes as well as the development of glucose intolerance.

Simply said: what we eat does and will continue to significantly affect global and personal health as well as the environmental challenges we face ahead.


I am fascinated by the role of bacteria in our bodies and the environment. Could you tell me more about bacteria and how they influence our well-being?

Microorganisms colonize and influence the physiology of humans, animals, and plants. Microbe biodiversity is associated with health. Humans are in unconscious but intimate contact with microbes, most of which are bacteria located in our gut. Dietary and environmental exposure to bacteria and other microorganisms significantly influence the gut flora, which is made up of trillions of microorganisms — about as many organisms as the number of cells in the human body. These microbes are like an intermediary link or bridge between the body and the environment. They protect us against harmful, illness causing microorganisms and also aid food digestion and absorption.

The gut flora influences physiological processes like the development and regulation of the immune system, gene expression, and brain function. Alterations to the gut microbiome (e.g. through treatment with antibiotics) are connected to the development of various, common physical and psychological illnesses and infections. Children who are exposed to more and a diverse variety of bacteria during childhood — e.g. via birth canal flora exposure, contact with older siblings, living on a farm — are less likely to develop atopic diseases like eczema, hay fever, and allergic asthma.


Can one also argue that these tiny organisms influence the status quo of our world and climate change?

Yes. Humans, animals and plants rely on microbe biodiversity for health, and microbes in the environment influence the constellation of microbes in and on organisms.

Healthy soil, for example, is full of different microorganisms (mostly bacteria) that regulate the cycling of nutrients vital for plant growth. The so called soil microbiome shields plants from harmful, environmental stressors, enabling their growth and of course the production of the food we eat. Soil microbes also significantly affect the gut microbiome, as demonstrated in a study showing that the gut flora of baboons is influenced by soil microbes 15 times more than by genetics.

Given our physiological and nutritional dependence on diverse, microbial soil-ecosystems, I think it is important to understand that many of our agricultural and industrial activities are changing and straining their equilibrium. Understanding the effects of the warming climate on soil microbiomes will be crucial to understanding and predicting future ecosystem functioning.


Do you think there are aspects that are often left out of discussions about sustainability?

When thinking about sustainability and sustainable activism, I think it is important to consider the influence of mindsets and cultures. Both our mindsets and cultures shape how we perceive and behave in the world.

The results of isolated, academic research generally don’t influence behavior or promote interdisciplinary, systems thinking. When different areas of study are examined together, however, we can develop a picture of ourselves and the natural world in the context of a complex network of interdependent relationships. This picture of interconnection has the potential to diminish destructive (dis)connection by promoting sustainable thought and cultural transformation. I believe, how we perceive the world is essential to the development of sustainable mindsets and cultures.

The Lancet One Health Commission recognizes “the interaction between humans, animals and the environment as a prerequisite for understanding and managing global health threats”. Growing interdisciplinary initiatives like One Health and Planetary Health illuminate the inextricable linkages and relationships between eco-systems and living things. These initiatives offer a lens through which we can recognize the significance and complexity of our relationships in and to the world.


This interview is published in German at Finding Sustainia — Think & Action Lab.