Kollath on Diseases of Civilisation, Teeth and Gut Flora

Table of Contents

1. The Rise of the Diseases of Civilisation
2. From Partial-Value Food to Chronic Disease
3. The 1958 Book on Diseases and Causes of Death
4. Teeth as a Measure of Deficiency
5. Getreide und Mensch and the Causes of Dental Decay
6. Dysbacteria: The Diseased Intestinal Flora
7. The Word “Probiotic”
8. Cancer and the Natural Diet
9. Calcium, Phytin and Chewing
10. Later Research on Fibre, Gut Flora and Caries
11. Key Research Papers
12. Connections
13. Featured Videos

1. The Rise of the Diseases of Civilisation

The German word is Zivilisationskrankheiten — “diseases of civilisation,” the chronic illnesses that grow more common as a society industrialises its life and its food. Kollath made them the subject of a paper in the Münchener Medizinische Wochenschrift in November 1953, under the title Die Zunahme der Zivilisationskrankheiten und ihre Verhütung — “The increase of the diseases of civilization and their prevention.”

The title carries both halves of his position. The first is that these diseases were increasing. The second, and for a hygienist the more important, is that they could be prevented. The Rostock historian Gunther Viereck, in his 2012 essay on Kollath for the University of Rostock, sums up the approach of Kollath’s post-war hygiene textbook in the same terms:

• Prevention instead of cure. Starting from a holistic, long-term view, Kollath “demands Vorbeugen statt Heilen” — prevention instead of healing.
• Nutrition as the centre. He put the weight of prevention on a healthy diet.
• The working hypothesis. He started, Viereck writes, from the hypothesis “that many diseases are the results of a wrong diet.”

The rest of this page follows that hypothesis through the organs and the decades in which Kollath tested it.

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2. From Partial-Value Food to Chronic Disease

Kollath’s explanation of the diseases of civilisation was a chain of three links, each built on the vocabulary of his 1942 book Die Ordnung unserer Nahrung (“The Order of Our Food”):

1. Partial-value food. Heated, preserved and refined foods were, in his terms, teilwertig (“of partial value”): they still supplied calories and the nutrients known at the time, but had lost part of the Vollwert (“full value”) of the living food — its own enzymes, its aroma substances, and the growth substances he called Auxone (“auxones”). The grades are set out on Kollath’s Order of Our Food.
2. Mesotrophy. A diet built from partial-value food would, he held, produce not an acute deficiency disease but Mesotrophie — “mesotrophy,” or semi-nutrition, which Viereck, quoting the Watzl–Leitzmann commentary, describes as “a state of life on the border between health and disease.” In his 1957 title Kollath called it the “mesotrophic complex as unspecific chronic deficiency condition.” The theory and its experiments have their own page, Mesotrophy and Auxones.
3. Chronic disease. In his rat experiments, Viereck writes, the animals looked healthy from outside, but as time went on metabolic disturbances set in “which led to an increase of chronic diseases.”

The step from rats to people is stated plainly in Viereck’s essay. Kollath equated the rat diet and its effects with the usual, mostly industrially produced food of human beings, and with the diseases of civilisation obesity, diabetes and high blood pressure. His reason, Viereck explains, was the similarity he had noticed, as a trained physician, between the organ changes of chronically ill people and those of his animals.

He also had a cure in the same experiments. Viereck records that Kollath observed that eating fresh grain porridge led to a decline in, or the healing of, the chronic disorders the deficient base diet had caused — which is why cereals took a central place in his later research, and in his teaching on teeth (section 5).

Colleagues disputed the link from the start. German Wikipedia records that in the 1950s several specialists and the German Society for Physiological Chemistry argued that mesotrophy was not a specific disease picture and was no model for the diseases of civilisation; Kollath answered in a series of papers between 1955 and 1959, including one with the title “Was I mistaken?”

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3. The 1958 Book on Diseases and Causes of Death

Five years after the 1953 paper Kollath gave the subject a book of its own. The German National Library records it as:

Zivilisationsbedingte Krankheiten und Todesursachen. Ein medizinisches und politisches Problem — “Diseases and Causes of Death Brought About by Civilisation: A Medical and Political Problem.” Ulm/Donau: Haug, 1958. 321 pages.

The University of Rostock’s professor catalogue lists the same title, the 1962 second edition and the 1985 reprint in its selection of his works. Two features of the title matter for reading his position:

• “Brought about by civilisation.” The adjective zivilisationsbedingt means “conditioned by civilisation”: the title places the cause of these diseases and deaths in the way modern societies live and eat, not in fate or in ageing alone.
• “A medical and political problem.” For a hygienist, prevention was public policy as much as private advice. The subtitle says outright that he saw the diseases of civilisation as a matter for the state as well as for the doctor — consistent with his early post at the Social Hygiene Academy in Berlin-Charlottenburg (1922–1923) and his years as director of Mecklenburg’s state health office (1935–1946).

The text of the book itself was not available to the authors of this page, so its chapters are not summarised here.

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4. Teeth as a Measure of Deficiency

Kollath twice took his deficiency theory to the dentists, both times in the Deutsche Zahnärztliche Zeitschrift, the German dental journal:

• 1948. Die Bedeutung der Krankheiten der Zähne und des Zahnhalteapparates für die Systematisierung der Mangelkrankheiten — “The importance of diseases of the teeth and the teeth holding system for the systematization of deficiency diseases.” The Zahnhalteapparat, the “tooth-holding apparatus,” is what dentists now call the periodontium: the gums, the ligament and the bone that anchor the tooth. As the title states, his subject was where diseases of the teeth and gums belong in the classification of deficiency diseases.
• 1953. Ernährung und Zahnsystem; Übersichtsreferat mit besonderer Berücksichtigung der Vitamine — “Nutrition and the tooth system; general review with special reference to vitamins,” a long review in a supplement of the same journal.

Both papers placed the tooth system inside his scheme of deficiency disease rather than treating it as a local problem of the mouth.

The same idea had been argued in North America in the 1930s by the dentist Weston A. Price, who travelled to isolated communities to compare their teeth before and after the arrival of refined flour and sugar. His work is set out on Dr. Weston A. Price.

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5. Getreide und Mensch and the Causes of Dental Decay

Kollath’s fullest statement on teeth came in his book on grain. The German National Library records it under the full title:

Getreide und Mensch – eine Lebensgemeinschaft. Das Getreide als unentbehrliche Grundlage für eine vollwertige Ernährung. Mit einer Studie über die Ursachen des Gebissverfalls — “Grain and Man, a Living Community: Grain as the Indispensable Basis of a Full-Value Diet. With a Study of the Causes of the Decay of the Teeth.” Bad Homburg, 1964. 156 pages; 3rd edition 1980.

The title joins the two halves of his teaching in one volume:

• Grain as the foundation. He called grain “the indispensable basis” of a full-value diet. This follows from his rat experiments, in which fresh grain porridge reversed the chronic disorders of the deficient diet (section 2), and it is the reason his best-known practical legacy is a breakfast of freshly ground grain.
• “A living community.” The word Lebensgemeinschaft — a community of life, the word biologists use for organisms that live together — casts people and grain as partners that have shaped each other over the history of farming.
• The decay of the teeth. The attached study is on the Gebissverfall — literally the decay of the whole set of teeth, not just single cavities. By printing it inside a book on grain, he tied the state of the teeth to the state of the grain people eat, whole or refined.

The Kollath breakfast in the dental clinics

Two papers by dental researchers in the German Democratic Republic later tested the Kollath breakfast (Kollath-Frühstück), the fresh-grain porridge sold from 1951, against caries: Kariesprophylaxe durch Kollath-Frühstück (“Caries prevention with Kollath breakfast,” Künzel and Maiwald, 1966) and Klinische Untersuchungen zur kariesprophylaktischen Effektivität des Kollath-Frühstücks (“Clinical studies on the caries preventive effect of the Kollath breakfast,” Maiwald, Bronisch and Künzel, 1969). PubMed carries no abstract for either paper, so their results are not given here. The breakfast itself has its own page, The Kollath Breakfast (Frischkornbrei).

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6. Dysbacteria: The Diseased Intestinal Flora

As a bacteriologist Kollath had spent his early career on the growth conditions of bacteria — his 1926 habilitation studied vitamins through the growth of Pfeiffer’s influenza bacillus. After the war he turned the same eye on the bacteria of the human gut, and gave their disorder a name: Dysbakterie (“dysbacteria,” a disordered bacterial flora; the word in use today is “dysbiosis”). Three papers carry the idea:

Read together, the titles show how the idea fitted his larger theory:

• The internal environment. The 1949 paper set dysbacteria beside the innere Umwelt (“internal environment”) and vitamin research. The gut flora was, for Kollath, part of the inner environment of the body, and like it could be put in order or disorder by food — the same food whose vitamins and auxones he had studied in his rats.
• A disease of its own. By 1954 he treated a diseased flora as something to be diagnosed, writing a paper on how intestinal dysbacteria can be recognised, in the bacteriology journal in which he had published his habilitation.
• A link to tumours. In 1953 he set Tumorbildung (“tumour formation”) directly beside dysbacteria in a single title (section 8).

The modern science of the gut microbiome is followed on the site’s Your Microbiome page.

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7. The Word “Probiotic”

If a wrong diet could disorder the gut flora, the opposite question followed: what supports healthy life, in the gut and the body? Two sources credit Kollath with the word that is now used for the answer:

• Viereck (2012). In his University of Rostock essay Gunther Viereck writes that the term Probiotika (“probiotics”), which stands for health-promoting microorganisms, “goes back to Kollath, who coined it in 1953.”
• English Wikipedia. The English Wikipedia article on Kollath states that in 1953 he wrote about probiotics as the contrast to harmful antibiotics, and that he defined Probiotika as “active substances that are essential for a healthy development of life” — citing a 2009 handbook on bioactive components in milk and a short overview of probiotic definitions from a German institute for integrative biology.

Neither source names the 1953 publication in which the word appeared, and that text was not available to the authors of this page; the attribution is therefore given here as Viereck’s and Wikipedia’s. The pairing itself is plain in the words: anti-biotic, “against life,” and pro-biotic, “for life.”

Two points about the word’s later history:

• His meaning was broader. In the definition Wikipedia quotes, Kollath’s probiotics were active substances needed for healthy life, in keeping with his auxones, not specifically living bacteria. The modern meaning is narrower. The 2014 consensus statement of the International Scientific Association for Probiotics and Prebiotics reaffirmed the FAO/WHO definition of a probiotic as “live microorganisms which when administered in adequate amounts confer a health benefit on the host.”
• He made them as well. German Wikipedia, citing the Rostock professors’ lexicon of Buddrus and Fritzlar, records that on the basis of his nutrition research Kollath also had animal feed and probiotics produced and sold.

The site’s Probiotics page covers the modern use of the word, and Fermented Foods the traditional foods that carry live bacteria.

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8. Cancer and the Natural Diet

Cancer was the gravest of the diseases of civilisation, and Kollath wrote on it three times in the journal Hippokrates in the early 1950s:

• 1952: “Does a natural diet promote cancer?” The German title is a question, Wirkt naturgemässe Ernährung krebsfördernd? — “Does a diet in accordance with nature promote cancer?” (PubMed renders it loosely as “Carcinogenesis and the natural diet”). In it Kollath took up, in the form of a question, the relation between the natural diet of his teaching and the development of cancer. The paper drew a published reply in the same journal that summer from K. Przygodda, under the question “Answer to Kollath’s paper on carcinogenetic effects of natural nutrition?” — a sign that it was read and debated by physicians at the time.
• 1953: Tumorbildung und Dysbakterie (“Tumour formation and dysbacteria”; PubMed: “Tumor formation and diseased intestinal flora”). Here he joined two lines of his work, linking the formation of tumours with the dysbacteria of section 6.
• 1955: Krankenernährung, insbesondere bei Krebskranken (“Nutrition of sick persons, with special reference to cancer patients”). The step from prevention to the sickbed: what the sick, and cancer patients in particular, should eat.

In these titles Kollath placed cancer inside the same chain as the other diseases of civilisation — food, then the inner environment and the gut flora, then disease — and gave diet a role both before and after a diagnosis. The texts of the three papers were not available to the authors of this page, so their arguments beyond their titles are not reported.

Kollath was one of several German-speaking physicians of his time who wrote on diet and cancer; the best known is Max Gerson, whose dietary therapy is set out on Dr. Max Gerson and the Gerson Therapy.

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9. Calcium, Phytin and Chewing

Does grain rob the body of calcium? (1960)

A grain-centred diet faced an obvious objection. Whole grains are rich in Phytin (phytin, the calcium-magnesium salt of phytic acid), which binds calcium and other minerals in the gut. If whole grain was the foundation of a full-value diet — and if teeth were a measure of good nutrition — did the bran itself rob the bones and teeth of calcium?

Kollath took up the question directly in a short paper in Hippokrates in 1960, which PubMed lists as “Doses corn cause calcium depletion because of its phytin content”; the title means “Does grain cause calcium depletion because of its phytin content?” That he wrote it shows he treated the objection as one his teaching had to answer. Traditional ways of reducing phytate — soaking, sprouting, sourdough fermentation — are described on Soaking, Sprouting and Fermenting.

The phases of nutrition and the work of chewing (1967)

His last paper in the PubMed record, in the International Journal for Vitamin Research in 1967, returned to the mouth: Die Phasen des Ernährungsvorganges: Von der Bedeutung des Kauens — “The phases of the nutritional process; on the significance of mastication.” As the title states, he treated nutrition as a process with phases, beginning with chewing. The theme connects the end of his career with its central ideas:

• Food that must be chewed. Whole grain, raw vegetables and fresh-grain porridge — the foods of his grades 1 to 3 — need chewing; refined and heated foods largely do not.
• Teeth in use. Teeth and the tooth-holding system, whose diseases he had placed among the deficiency diseases in 1948, are the organ of that first phase.
• The aroma substances. In Die Ordnung unserer Nahrung he had counted the natural aromas of fresh food, with their “immediate effects during the taking of food,” as part of its value — effects that begin in the mouth.

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10. Later Research on Fibre, Gut Flora and Caries

Kollath’s terms — mesotrophy, auxones, dysbacteria — are not used in modern research. But each of the subjects he wrote about has since become a large field of its own, and later work on them is summarised here neutrally, as research on the same subjects rather than as tests of his theory.

Fibre and the “Western” diseases

• Burkitt, Walker and Painter (1972). Two decades after Kollath’s 1953 paper, the British surgeon Denis Burkitt and colleagues published in the Lancet on the effect of dietary fibre on stools and transit times, “and its role in the causation of disease” — the paper that made the fibre hypothesis of the Western diseases widely known.
• Whole grain and mortality (2016). A meta-analysis by Dagfinn Aune and colleagues of 45 prospective studies found that each 90 g a day more of whole grain (about three servings) was associated with a 19% lower risk of coronary heart disease, 22% lower cardiovascular disease, 15% lower cancer mortality and 17% lower all-cause mortality, with little evidence of an association for refined grains or white rice.
• Carbohydrate quality (2019). A Lancet series of reviews by Andrew Reynolds and colleagues found 15–30% lower all-cause and cardiovascular mortality, and lower rates of heart disease, stroke, type 2 diabetes and colorectal cancer, among the highest fibre consumers, with similar findings for whole grain.

Diet and the gut flora

• Diet-induced extinctions (2016). Erica Sonnenburg and colleagues at Stanford noted the reduced diversity of the gut microbiota in Western populations compared with traditional ones. In mice carrying a human microbiota, a diet low in the fibre carbohydrates that gut microbes can use caused changes that were reversible within one generation, but over several generations led to a progressive loss of diversity that was not recovered when fibre was restored.
• Fibre and the microbiota (2018). A review by Makki, Bäckhed and colleagues describes how the type, quality and origin of food shape the gut microbes, and how dietary fibres are turned by them into metabolites such as short-chain fatty acids that affect the host’s physiology and health.

Sugar and dental caries

• For the WHO (2014). A systematic review by Moynihan and Kelly, written to inform World Health Organization guidelines, found 55 eligible studies; 42 of 50 in children and 5 of 5 in adults reported at least one positive association between sugars and caries, with evidence of moderate quality that caries is lower when free sugars are under 10% of energy.
• Sugar as the cause (2015). Aubrey Sheiham and Philip James argued that dietary sugars are the essential cause of caries, providing the substrate on which acid-producing oral bacteria flourish, with a log-linear dose-response relationship between sugar intake and lifelong caries; they found processed starches cariogenic when they accompany sucrose.

The site follows these subjects further on Dietary Fiber, Tooth Decay (Dental Caries), The Oral Microbiome and Whole Grain vs Refined Wheat.

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Key Research Papers

1. Kollath W. [The importance of diseases of the teeth and the teeth holding system for the systematization of deficiency diseases]. Dtsch Zahnarztl Z. 1948;3(9-12):373-81. — PubMed PMID: 18884452
2. Kollath W. [Internal environment, vitamin research and dysbacteria]. Schweiz Med Wochenschr. 1949;79(41):973-7. — PubMed PMID: 18143768
3. Kollath W. [Carcinogenesis and the natural diet]. Hippokrates. 1952;23(1):9-12. — PubMed PMID: 14906918
4. Przygodda K. [Answer to Kollath’s paper on carcinogenetic effects of natural nutrition?]. Hippokrates. 1952;23(15):420-2. — PubMed PMID: 12989870
5. Kollath W. [Tumor formation and diseased intestinal flora]. Hippokrates. 1953;24(8):233-7. — PubMed PMID: 13068871
6. Kollath W. [Nutrition and the tooth system; general review with special reference to vitamins]. Dtsch Zahnarztl Z. 1953;8(11):Suppl 7-16. — PubMed PMID: 13068115
7. Kollath W. [The increase of the diseases of civilization and their prevention]. Munch Med Wochenschr. 1953;95(47):1260-2. — PubMed PMID: 13132859
8. Kollath W. [Diagnosis of intestinal dysbacteria]. Zentralbl Bakteriol Orig. 1954;161(7-8):501-3. — PubMed PMID: 14360530
9. Kollath W. [Nutrition of sick persons, with special reference to cancer patients]. Hippokrates. 1955;26(12):368-74. — PubMed PMID: 13242016
10. Kollath W. [Mesotrophic complex as unspecific chronic deficiency condition]. Hippokrates. 1957;28(9):267-71. — PubMed PMID: 13438447
11. Kollath W. [Doses corn cause calcium depletion because of its phytin content]. Hippokrates. 1960;31:155-6. — PubMed PMID: 14410720
12. Künzel W, Maiwald HJ. [Caries prevention with Kollath breakfast]. DDZ. 1966;20(13):409-12. — PubMed PMID: 5220841
13. Kollath W. [The phases of the nutritional process; on the significance of mastication]. Int Z Vitaminforsch. 1967;37(2):212-25. — PubMed PMID: 5595593
14. Maiwald HJ, Bronisch D, Künzel W. [Clinical studies on the caries preventive effect of the Kollath breakfast]. Dtsch Stomatol. 1969;19(1):52-6. — PubMed PMID: 5253901
15. Burkitt DP, Walker AR, Painter NS. Effect of dietary fibre on stools and the transit-times, and its role in the causation of disease. Lancet. 1972;2(7792):1408-12. — PubMed PMID: 4118696
16. Moynihan PJ, Kelly SA. Effect on caries of restricting sugars intake: systematic review to inform WHO guidelines. J Dent Res. 2014;93(1):8-18. — PubMed PMID: 24323509
17. Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, Morelli L, et al. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014;11(8):506-14. — PubMed PMID: 24912386
18. Sheiham A, James WP. Diet and dental caries: the pivotal role of free sugars reemphasized. J Dent Res. 2015;94(10):1341-7. — PubMed PMID: 26261186
19. Sonnenburg ED, Smits SA, Tikhonov M, Higginbottom SK, Wingreen NS, Sonnenburg JL. Diet-induced extinctions in the gut microbiota compound over generations. Nature. 2016;529(7585):212-5. — PubMed PMID: 26762459
20. Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, Tonstad S, et al. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ. 2016;353:i2716. — PubMed PMID: 27301975
21. Makki K, Deehan EC, Walter J, Bäckhed F. The impact of dietary fiber on gut microbiota in host health and disease. Cell Host Microbe. 2018;23(6):705-715. — PubMed PMID: 29902436
22. Reynolds A, Mann J, Cummings J, Winter N, Mete E, Te Morenga L. Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. Lancet. 2019;393(10170):434-445. — PubMed PMID: 30638909

PubMed Topic Searches

1. https://pubmed.ncbi.nlm.nih.gov/?term=Kollath+W%5Bau%5D
2. https://pubmed.ncbi.nlm.nih.gov/?term=Kollath+breakfast
3. https://pubmed.ncbi.nlm.nih.gov/?term=dietary+fiber+gut+microbiota+diversity
4. https://pubmed.ncbi.nlm.nih.gov/?term=free+sugars+dental+caries
5. https://pubmed.ncbi.nlm.nih.gov/?term=whole+grain+chronic+disease+meta-analysis

Further Reading

• Kollath W. Zivilisationsbedingte Krankheiten und Todesursachen. Ein medizinisches und politisches Problem. Ulm/Donau: Haug; 1958. 2nd ed. 1962; reprint Heidelberg: Haug; 1985. Deutsche Nationalbibliothek catalogue records
• Kollath W. Getreide und Mensch – eine Lebensgemeinschaft. Das Getreide als unentbehrliche Grundlage für eine vollwertige Ernährung. Mit einer Studie über die Ursachen des Gebissverfalls. Bad Homburg: Schwabe; 1964. 3rd ed. 1980. Deutsche Nationalbibliothek catalogue records
• Catalogus Professorum Rostochiensium. “Kollath, Werner.” University of Rostock. purl.uni-rostock.de/cpr/00001815
• Viereck G. „Laßt das Natürliche so natürlich wie möglich“ – Der Hygieniker und Ernährungswissenschaftler Werner Kollath (1892–1970). In: Boeck G, Lammel HU (eds.). Die Universität Rostock in den Jahren 1933–1945. Rostocker Studien zur Universitätsgeschichte 21. Rostock; 2012. pp. 107–113. rosdok.uni-rostock.de (PDF)
• “Werner Kollath.” English Wikipedia (source of the 1953 “probiotic” definition quoted in section 7). en.wikipedia.org
• “Werner Kollath.” German Wikipedia, citing Melzer 2003 and Buddrus and Fritzlar 2007. de.wikipedia.org

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Connections

• Prof. Werner Kollath and Whole-Food Nutrition
• Werner Kollath: Life and Career
• Die Ordnung unserer Nahrung: Kollath’s Order of Our Food
• Mesotrophy and Auxones
• The Kollath Breakfast (Frischkornbrei)
• Werner Kollath’s Whole-Food Legacy
• Dr. Weston A. Price
• Dr. Max Bircher-Benner and the Raw Food Cure
• Dr. Max Gerson and the Gerson Therapy
• Tooth Decay (Dental Caries)
• Dentistry & Oral Health
• Your Microbiome
• Dietary Fiber
• Probiotics
• Ultra-Processed Foods
• Nutrition and Orthomolecular Pioneers

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