19 million people in SA are either obese or overweight, mainly due to a sedentary lifestyle and over eating. Globally, there are about 150 million people with diabetes, with Africa experiencing the largest increase in prevalence in diabetes across the globe. This presentation provides information on the human microbiome, particularly the gut microbiome and its importance in health and disease. Prof Dave, speaking at the Physician's Update Conference in Cape Town during February 2018, reports that, from a human genome perspective, 99% of genes are the same in every person and that it could be the gut microbiome which provides the genetic diversity. Microbiota have shown to play a significant role in multiple diseases including diabetes and obesity, therefore altering the microbiome is a future treatment option for many diseases Professor Dave provides information on the microbiome in early life and implications for health. He states that there are multiple inputs from conception until about 3 years of age, including type of delivery; state of health of mother; breastfeeding; age at introduction of solids; age of introduction of antibiotics, and many other factors which determine the health of the gut microbiome. Dave also discusses how gut dysbiosis can be caused by many factors and that a changing gut microbiome could cause disease. He provides details of those factors which are the culprits and those which enhance health. Professor Dave discusses a number of studies related to the gut microbiome. One of which shows the importance of diet in maintenance of harmonious gut microbiota. Another of which shows the role of microbiome in the weight of a subject, and another which looked at microbiome in patients with type 2 diabetes vs those without.