A particularly timely commentary was published last week in the Nutrients Journal. It was published “open access” under a Creative Commons license, so feel free to read, share, and quote appropriately.
Dr. Moul Dey, professor at South Dakota State University has been studying resistant starch and human health. She’s noticed variations between people when they supplement with different types of RS, just as we have. Dr. Dey’s commentary gives some very poignant insight to the inter-personal variations and the ramifications of individuality in treating diseases of the gut.
Please read the entire commentary, it’s not too long. I had thought about copying and pasting it here, since it would be legal under the license, but instead I decided to just pull my favorite lines.
Mapping microbiome diversity has unlocked many mysteries—but also triggered new questions. The answers to many such questions still elude us, including a very basic but pressing question, “what diet is ideal for a healthy gut microbiome?” It remains unknown if there is an ideal gut microbiome that can be considered “healthy”, nor do we know of one ideal diet that can positively manipulate the microbiome of people of all ages across the globe. Furthermore, a plethora of contradictory research findings on what dietary component may or may not be healthy frequently confuse the public.
Scientists prioritize collective outcomes with high statistical significance. While these benchmarks are a sign of a successful clinical trial, individual responses to the dietary treatment are often ignored.
[M]icrobiome-based biomarkers for personalized prognostic, diagnostic, and treatment may vary by geographic locations, lifestyle, and many other factors. Therefore, while personalized microbiome profiling may be useful for predicting and mitigating disease, it will take a huge scientific undertaking before it is ready for the clinical setting.
Decades of generalized nutritional recommendations do not seem to be mitigating the metabolic health crisis, although at present there is no alternate to an overall healthy diet and regular physical activity recommendation for long-term health maintenance.
Even taking into account the huge undertaking discussed above, current knowledge about the microbiome suggests that integrating microbiome profiling into patient care will likely allow for a faster, more accurate, and less invasive clinical decision-making processes. In this context, prebiotics will be critical components of personally tailored dietary interventions aimed at altering the microbiome to a more beneficial configuration for disease prevention.
While the benefits of dietary fibers, many of which have prebiotic properties, are well-known, their mechanisms of action mostly remain a mystery.
Looking to the future, it will be critical to consider the collective effects that are statistically significant, as well as individual response variations, for harnessing the many potential health benefits of prebiotics. Encouraging the scientific community to report variations observed in clinical trials, even if such observations may not meaningfully contribute to the main conclusions of the current study, will be important.
I sense Dr. Dey’s frustration as I read her commentary. She’s been studying the microbiome and noticing small differences that are neither exciting nor statistically significant. In her attempts to understand why these differences occur, she finds nothing in the journals. No one is interested in writing about slight differences, or outcomes that do not support a theory. Probably lots of interesting studies are stopped early or not written up because the researchers found conflicting results or variations that did not fit their conclusions.
I think that these inter-individual differences are most interesting. Why does one person respond well to a spoonful of Bob’s Red Mill potato starch while another sees nothing, or feels bad? Why can one man lose 20 pounds in a couple weeks doing the Potato Hack, while his wife loses nothing and feels terrible?
Beware the Snake Oil
This week, two of my good email buddies shared some information with me. One shared a link to Dave Asprey’s Bulletproof podcast with Naveen Jain. It’s a great interview, have a listen, they discuss how processed foods destroy our gut flora and the dangers of over sanitization. But then I heard “They are gearing up to launch an amazing service to test not just gut but also blood microbiome and then recommend how to balance the issues…”
I’d like to share my response with you all:
The science behind just gut bacteria is so new and so difficult, no one is even close to cracking the code. To add “blood bacteria” into the mix is just a way to sell a service and products…no way these guys are competent enough to make health claims based on gut/blood bacteria reports. So, be very, very skeptical of all this! Right now the prebiotic and gut testing world is like the Wild West. No real oversight, and lots of trickery, false assumptions, and expensive products.
For gut health, the best anyone can do is just tweak the diet and include lots of fiber that they tolerate. Potato starch, green banana/plantain flour, Hi-Maize, and inulin/FOS are the four to beat in terms of proven gut benefits. As everyone has a different starting point, it pays to experiment with these and see which helps the most. If they leave you gassy and bloated after a week, move on to something else, but also take the time to start slowly and work up the dose to a couple spoonfuls a day.
I’d love to be proven wrong, but I find it highly unlikely that anyone has cracked the bacterial identification code on a level that they can not only correct your gut, but also your blood. My good friend and collaborator Barney should be able to confirm the difficulties of testing bacteria as we’ve spent years studying the methods and information systems involved. Which brings me to the second email I got this week:
Not IMO or Nemo. Cost prohibitive, but ever heard of it?
ISOThrive is gastroenterologist-recommended microFood for the good bacteria in your gut. It is a lightly sweet nectar of prebiotic soluble fiber called MIMO(TM) (maltosyl-iso-malto-oligosaccharides).
What are the ingredients in ISOThrive?
Each sachet of ISOThrive Prebiotic Nectar contains 1g of maltosyl-iso-malto-oligosaccharides (MIMO). These are just zero calorie complex carbohydrates. It’s like calling Vitamin C … Ascorbic Acid. The scientific name sounds weird and scary but it’s not actually weird and scary. ISOThrive is the same ingredient found in naturally fermented foods like kimchi and sauerkraut as well as traditionally fermented sourdough bread.
After several emails discussing and looking for any scientific support, we found this product is used as a sweetener in industrial food processes like many prebiotics (FOS, inulin, etc.). The manufacturers even wrote a paper extolling MIMO’s virtues.
For $59.99 you get a 30-day supply of MIMO sold as IsoThrive. The recommended dose of MIMO is 1 gram per day. The 30-day supply is less than 3TBS! We’re talking $20 a spoonful. We are to believe that this company has found an artificial sweetener that can shape your gut flora with just 1/3 of a teaspoon a day. Again, I’d love to be proven wrong…but this does not pass my sniff test.
When shaping gut bacteria, it’s a “numbers game.” Realistic doses of prebiotic fibers are more like what Gut Garden’s Resistant Starch blend recommends, a “serving” is about 2TBS (17.96g) or “1 scoop.” Gut Garden recommends starting slow, 1/4 a scoop, and working up to 3 scoops, or as tolerated.
I think as more resistant starch and other prebiotics hit the store shelves, unscrupulous sellers will promise the moon, but recommend doses so low that the fiber will not work as promised. But people will buy these products because of slick marketing.
From Dr. Dey’s commentary, one line stands out:
…at present there is no alternate to an overall healthy diet and regular physical activity recommendation for long-term health maintenance.
Take Home Message
Won’t it be great when science catches up to what we’ve been observing? I’m thankful that there are professional researchers like Dr. Moul Dey who are not afraid to tell it like it is, acknowledging the shortfalls in the promising field of microbiome modulation. Until it’s settled, eat right, stay fit, and supplement wisely. No amount of supplements will correct a bad diet and a stressful, sedentary lifestyle. Experiment and listen to your gut–it knows what it needs. Watch this space.