'Gut Health' Has a Fatal Flaw: The obsession with digestion has gone too far(theatlantic.com)
theatlantic.com
'Gut Health' Has a Fatal Flaw: The obsession with digestion has gone too far
https://www.theatlantic.com/health/archive/2024/02/gut-health-digestion-obsession/677510/
25 comments
The problem is not obsession with the gut, but that the entire notion of gut microbiota is being misappropriated by snake oil salesmen and "alternative medicine" crazies while healthcare professionals continue to have zero incentive to keep up with new science or go above the usual "eh idk your basic bloodwork is fine, must be in your head", and people are clever enough to home in on there being something wrong, but not to be rational about it.
As far as the science goes, probiotics have modest ability to improve gut biota and may sometimes worsen it, while the effects of diet are nearly strictly temporary despite rapid changes. The only thing that's been shown to reliably effect big, durable changes is Fecal Microbiota Transplantation - and even then, the response rate for most disorders is limited due to how entrenched the existing microbiome is and difficulty of transferring sensitive strains, especially for conditions like IBS that appear to often entail antibiotic-resistant biofilms. For a healthy microbiome, even sugar has minor effects unless consumed all day every day.
Past that, there's science linking elevated gut bacteria toxins levels and antibodies with depression, fatigue, neurodegenerative disease, or demonstrating large influences of certain microbes or their metabolites on conditions like diabetes, ADHD, autism, hypertension, PCOS. Some conditions seem to be caused by other infections, like endometriosis(endometrial bacterial infiltration), UTIs in elderly, especially women, oral gingivitis bacteria contributing to Alzheimer's Disease and cardiovascular disease, or herpesviral (re)activation and AD and ME/CFS, though I suspect that may be secondary to other immune system activation.
Also: Almost all diarrhea is caused either by C. Difficile or by deficiency of SCFA-producing microbes. The only way to get bloating is by bacterial fermentation of stuff that shouldn't be being fermented. And sure, changes in gut motility and physiological function affect that, but the microbiome has been demonstrated to be a significant predictor of all of it.
Animal models replicate anorexia in mice using stool transplants from ill humans(Parkinson's, schizophrenia's neurological changes, too), gut dysbiosis predicts colorectal cancer, butyrate production predicts energy levels in healthy volunteers and disease severity in ME/CFS patients... and the list goes on and on and on.
It's not the ONLY thing wrong with people, so many of us have undiagnosed breathing-related sleeping disorders - apnea is often scored using antiquated, insufficiently sensitive criteria, and many young people, especially women, wake up so fast and often that apneas/hypopneas barely happen, termed Upper Airway Resistance Syndrome. Urogenital dysfunction seems typically related to pelvic floor function and posture&breathing. ME/CFS often persists after a single viral trigger, and Long COVID can be just as bad.
But overall? Yeah, almost everything links back to inflammation, and usually the gut, to a point that makes treating everything as a mental disorder and psychiatry look as barbaric as their origins in mental asylums and lobotomies.
As far as the science goes, probiotics have modest ability to improve gut biota and may sometimes worsen it, while the effects of diet are nearly strictly temporary despite rapid changes. The only thing that's been shown to reliably effect big, durable changes is Fecal Microbiota Transplantation - and even then, the response rate for most disorders is limited due to how entrenched the existing microbiome is and difficulty of transferring sensitive strains, especially for conditions like IBS that appear to often entail antibiotic-resistant biofilms. For a healthy microbiome, even sugar has minor effects unless consumed all day every day.
Past that, there's science linking elevated gut bacteria toxins levels and antibodies with depression, fatigue, neurodegenerative disease, or demonstrating large influences of certain microbes or their metabolites on conditions like diabetes, ADHD, autism, hypertension, PCOS. Some conditions seem to be caused by other infections, like endometriosis(endometrial bacterial infiltration), UTIs in elderly, especially women, oral gingivitis bacteria contributing to Alzheimer's Disease and cardiovascular disease, or herpesviral (re)activation and AD and ME/CFS, though I suspect that may be secondary to other immune system activation.
Also: Almost all diarrhea is caused either by C. Difficile or by deficiency of SCFA-producing microbes. The only way to get bloating is by bacterial fermentation of stuff that shouldn't be being fermented. And sure, changes in gut motility and physiological function affect that, but the microbiome has been demonstrated to be a significant predictor of all of it.
Animal models replicate anorexia in mice using stool transplants from ill humans(Parkinson's, schizophrenia's neurological changes, too), gut dysbiosis predicts colorectal cancer, butyrate production predicts energy levels in healthy volunteers and disease severity in ME/CFS patients... and the list goes on and on and on.
It's not the ONLY thing wrong with people, so many of us have undiagnosed breathing-related sleeping disorders - apnea is often scored using antiquated, insufficiently sensitive criteria, and many young people, especially women, wake up so fast and often that apneas/hypopneas barely happen, termed Upper Airway Resistance Syndrome. Urogenital dysfunction seems typically related to pelvic floor function and posture&breathing. ME/CFS often persists after a single viral trigger, and Long COVID can be just as bad.
But overall? Yeah, almost everything links back to inflammation, and usually the gut, to a point that makes treating everything as a mental disorder and psychiatry look as barbaric as their origins in mental asylums and lobotomies.
Awesome comment. I'd love to hear your take on:
1. Best place to learn more about Fecal Microbiota Transplantation
2. How do you increase SCFA-producing microbes?
3. Your take on the "everyone has SIBO and should eat hyper-fermented yogurt" https://drdavisinfinitehealth.com/2019/07/how-to-make-l-reut.... This feels like mostly snakeoil sales, but the idea that probiotics are basically useless because the CFU is too low does makes sense and it seems like there is research around L. reuteri improving many IBS/SIBO symptoms.
Feel free to DM me as well—very curious about this.
1. Best place to learn more about Fecal Microbiota Transplantation
2. How do you increase SCFA-producing microbes?
3. Your take on the "everyone has SIBO and should eat hyper-fermented yogurt" https://drdavisinfinitehealth.com/2019/07/how-to-make-l-reut.... This feels like mostly snakeoil sales, but the idea that probiotics are basically useless because the CFU is too low does makes sense and it seems like there is research around L. reuteri improving many IBS/SIBO symptoms.
Feel free to DM me as well—very curious about this.
1. I only read scientific publications. No way to find anything but SEO spam on Google nowadays.
2. Some probiotics might help, not sure which or how much. FMT should help. Healthy diets should shift bacterial composition favourably, though this won't be permanent changes.
3. I don't think there's any food out there that can permanently change the microbiome composition enough to make a big difference. I doubt much if any of the L. Reuteri survived the gastric acid, and if it did, it's just one species among hundreds.
2. Some probiotics might help, not sure which or how much. FMT should help. Healthy diets should shift bacterial composition favourably, though this won't be permanent changes.
3. I don't think there's any food out there that can permanently change the microbiome composition enough to make a big difference. I doubt much if any of the L. Reuteri survived the gastric acid, and if it did, it's just one species among hundreds.
>the effects of diet are nearly strictly temporary despite rapid changes.
Is the claim here that transient dietary changes don’t have a lasting effect or that long term dietary modifications will lead to a temporary change in the microbiome, with an eventual return to baseline, despite said dietary changes being permanent?
I am not deep into the research but I have a hard time believing that long term dietary patterns don’t have a lasting causal relationship here.
Is the claim here that transient dietary changes don’t have a lasting effect or that long term dietary modifications will lead to a temporary change in the microbiome, with an eventual return to baseline, despite said dietary changes being permanent?
I am not deep into the research but I have a hard time believing that long term dietary patterns don’t have a lasting causal relationship here.
For the most part, as an adult, your microviome has a fixed composition - what you eat will rapidly alter the relative proportions of your gut microbes, but even drastic dietary shifts are unlikely to either kill strains off, or introduce new ones, so any diet will only have so much of an effect, and it'll bounce right back if you go back to your old diet.
The key component being going back to your old diet though.
So dietary changes do have a direct impact. It’s just dependent on whether the dietary pattern is consistent long term.
So dietary changes do have a direct impact. It’s just dependent on whether the dietary pattern is consistent long term.
My goodness, i am glad i have made it that far. At least up to now. Deterioration is coming.
Waiting for the Tricorder, that helps me maintain the equilibrium, if there is any.
Waiting for the Tricorder, that helps me maintain the equilibrium, if there is any.
> durable changes is Fecal Microbiota Transplantation
And even that is a bit random. You're getting everything, good and bad - someone else's solutions and problems. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438885/
So it has to be really worth it to try...
And even that is a bit random. You're getting everything, good and bad - someone else's solutions and problems. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438885/
So it has to be really worth it to try...
That case report demonstrates why careful donor selection is critical. You want someone who maintained healthy weight their entire life, never had any chronic or mental illness, no GI symptoms, limited antibiotic use, no ADHD, autism, no family history of schizophrenia, Parkinson's, etc.
When in doubt, assume there's at least a chance of getting their health issues.
When in doubt, assume there's at least a chance of getting their health issues.
Great comment.
> at the exact same time every day, to promote regularity and thus overall health
I don't believe that regularity promotes health.
There are thousand ways you can hurt yourself doing the same thing over and over long enough. Even very mild things repeated can lead to repetitive strain injury.
The chance that you have found a perfect cycle that does no harm to you as you repeat it are very slim.
Instead you should listen to your body and eliminate stuff that is in any way suspicious and carefully introduce new stuff for variety.
I don't believe that regularity promotes health.
There are thousand ways you can hurt yourself doing the same thing over and over long enough. Even very mild things repeated can lead to repetitive strain injury.
The chance that you have found a perfect cycle that does no harm to you as you repeat it are very slim.
Instead you should listen to your body and eliminate stuff that is in any way suspicious and carefully introduce new stuff for variety.
The most palpable change for me was drinking at least 2 liters of water per day. Not sure how it works but bacteria needs moist?
I fill a bottle at the start of the day just to make sure it is really 2 liters of water. If I fill my cup from the filter (slow debit) I drink 3 to 5 times less because I don't have the patience to fill it.
I fill a bottle at the start of the day just to make sure it is really 2 liters of water. If I fill my cup from the filter (slow debit) I drink 3 to 5 times less because I don't have the patience to fill it.
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Didn’t read because paywall, but just eat like a successful hunter gatherer from the region of your primary genetic origin, and you’ll probably be fine. Easier said than done.
It really isn't that simple. Diet has a huge influence on which of your gut microbes flourish and even their gene expression, but as an adult, its effect on its overall composition are absolutely minimal - it can't kill any species off, and introducing new ones is likewise unlikely. Even probiotics have been shown to have limited effect.
Your advice would be sound if we didn't already have an epidemic of gut microbiomes compromised by antibiotics and poor diets over several generations.
Your advice would be sound if we didn't already have an epidemic of gut microbiomes compromised by antibiotics and poor diets over several generations.
And where can we find this table of the various diets of the successful hunter gatherers from each region so we can correlate it with our genetic ancestry?
Also looking for this answer. I think my blood hails from Northern Germany. Wild boar? I don’t know.
>but just eat like a successful hunter gatherer
Does this including eating parasites as well?
Does this including eating parasites as well?
The funny thing is... maybe?
There's some evidence that the absence of parasites might be a contributing factor to autoimmune diseases, asthma and inflammatory disorders. See: https://www.verywellhealth.com/helminth-therapy-5225248 for an example.
There's some evidence that the absence of parasites might be a contributing factor to autoimmune diseases, asthma and inflammatory disorders. See: https://www.verywellhealth.com/helminth-therapy-5225248 for an example.
Unironically, it might. Many people suffering from IBD have found relief by ingesting certain parasites (helminth is one I’m aware of). To add anecdotal evidence to the parent, I’ve found relief with my IBD by eating “simpler” foods - on top of overall health benefits.
Chesterton’s fence is not a well respected concept in the modern world (understandably so).
Chesterton’s fence is not a well respected concept in the modern world (understandably so).
How else are ya gonna lose weight, fatty? That tapeworm can't feed itself.
Instead, shouldn't we research & experiment? Especially since solving cronic health issues is not straightforward (too many variables, requires lots of experimentation since we do not fully understand the underlying system we are operating in).
Am I no doctor, but my anecdotal evidence (most friends have some sort of weird gastro issues), market changes (tons of gluten-free & dairy-free foods compared to even 5 years ago), combined with research seems to indicate that there is a big problem and we should be thinking about this.
- https://drdavisinfinitehealth.com/2022/05/the-sibo-epidemic/
- https://www.cedars-sinai.org/newsroom/study-prevalence-of-ib...