Mix of Bacteria in Gut May Depend More on Diet Than Genes
ucsf.edu
ucsf.edu
A NY Times article earlier this year gives a background on how the rise of antibiotics has been accompanied by a rise in weight among animals and humans alike:
http://www.nytimes.com/2014/03/09/opinion/sunday/the-fat-dru...
Kids in particular seem to be at risk. A recent study of 64,000 kids has associated repeated antibiotic exposure before age 2 with early childhood obesity:
http://archpedi.jamanetwork.com/article.aspx?articleid=19098...
It's good we're investigating diet-based therapy, so patients can someday hear their doctors say "after finishing this broad-spectrum antibiotic prescription, you [or your child] should eat like this for this amount of time to restore digestive health."
Also, they also found a connection between obesity and "Steroid use, male sex, urban practice, public insurance, Hispanic ethnicity, and diagnosed asthma or wheezing were also predictors of obesity; common infectious diagnoses and antireflux medications were not."
Six doctor visits, stool and blood tests later, the doctors found what moved in. New antibiotics and replenishment medicines, diet with lots of probiotics, and within a few months I was back to mostly normal.
My story is simple, if you end up on harsh antibiotics it can change your life. Plan for it.
Something other than C. Diff? Would you mind sharing what it was?
(http://www.nature.com/news/gut-brain-link-grabs-neuroscienti...)
Edit: It is ok to downvote if you disagree. But think what it says about you if you are downvoting facts.
edit: btw the way, I've been here for like 5 years now and I still don't know what flavor of Markdown is used here.
btw, I don't see how could you explain the second part of the experiment where were no fake patients at all as "gaming". If a mere expectation of a fake patient screws the results so much; your methods are garbage. This and other counter-arguments are mentioned on the wiki-page.
You posted something from 40 years ago.
The link mentions related experiments with similar results as recent as 2008.
Anyway, judging by "The Diagnostic and Statistical Manual of Mental Disorders", Fifth Edition (DSM-5) (2013) there has been no paradigm shift in the last 40 years.
It seems DSM-5 is bad even by psychiatry's own standards. People use phrases like "false 'epidemics'" https://en.wikipedia.org/wiki/DSM-5#Criticism
New DSM-5 Ignores Biology of Mental Illness http://www.scientificamerican.com/article/new-dsm5-ignores-b...
Yes. Big institutions have closed. Smaller hospitals replaced them and most people get treated in the community.
For example: my county has a population of about 600,000 people. About 4,500 people are on the books of the local MH trust at any time. There are only about 150 inpatient beds at any time.
People only go into hospital if they are a danger to themselves or others - hearing a voice that says "empty" or "hollow" or "thud" is not something anyone would be hospitalised for.
To get a diagnosis of schizophrenia you have to match the symptoms over a six month period and be assessed by the same doctor during that time. one of the benefits of the DSM / ICD is that doctors now use a set of standards when diagnosing mental illness.
The paper suggests that this is only a problem with psychiatry. This is something you hear from lot of people. "No test exists to diagnose a psychiatric illness, thus psychiatry is a sham. Look, I can get diagnosed if I lie to doctors!" This ignores the fact that there are a bunch of physical-health diseases you can get diagnosed with if you lie to doctors, but we don't call those a sham. Your link even talks about that:
> Many defended psychiatry, arguing that as psychiatric diagnosis relies largely on the patient's report of their experiences, faking their presence no more demonstrates problems with psychiatric diagnosis than lying about other medical symptoms. In this vein, psychiatrist Robert Spitzer quoted Kety in a 1975 criticism of Rosenhan's study :[5]
>If I were to drink a quart of blood and, concealing what I had done, come to the emergency room of any hospital vomiting blood, the behavior of the staff would be quite predictable. If they labeled and treated me as having a bleeding peptic ulcer, I doubt that I could argue convincingly that medical science does not know how to diagnose that condition.
Your link mentions RD Laing in the lead. RD Laing is now thoroughly discredited. (Although he did have some interesting ideas). You should read some of his books.
> Many defended psychiatry, arguing that as psychiatric diagnosis relies largely on the patient's report of their experiences, faking their presence no more demonstrates problems with psychiatric diagnosis than lying about other medical symptoms. In this vein, psychiatrist Robert Spitzer quoted Kety in a 1975 criticism of Rosenhan's study :[5] If I were to drink a quart of blood and, concealing what I had done, come to the emergency room of any hospital vomiting blood, the behavior of the staff would be quite predictable. If they labeled and treated me as having a bleeding peptic ulcer, I doubt that I could argue convincingly that medical science does not know how to diagnose that condition.
> The link mentions related experiments with similar results as recent as 2008
No it does not.
There's a probable hoax from someone who can't provide any evidence, from 2004; and a totally different "experiment" (tv show) from 2008 where doctors were not allowed to interact with patients. You'd get similar results if the patients had physical health ailments.
The misunderstanding is probably my fault -- the message was too short. Let's establish the basics: There can't be any science if you can't measure. Reproducibility (replication): theory and experiment (prediction <-> measurement spiral) are corner stones that support each other and build on the language of math.
"the results" -- as the very first message I've posted on the topic says -- are about the reliability of psychiatric diagnoses. If we can't have that (an ability to measure) there is nothing to discuss.
On "150 inpatient beds" -- how many people are in jail instead? And again, how does it relate to scientific foundations of psychiatry?
Both "lye to the doctor" excuse and "bleeding peptic ulcer" are addressed on the very same wiki-page where the quotes come from.
"Your link mentions RD Laing in the lead. RD Laing is now thoroughly discredited." Here's the only occurrence of the name in the article:
"while listening to one of R. D. Laing's lectures that Rosenhan wondered if there was a way in which the reliability of psychiatric diagnoses could be tested experimentally."
Does "the lead" mean "an inspiration"? In what way precisely anything about RD Laing changes the results of Rosenhan experiment?
I can go on pointing out imprecise statements but it don't see the point. What would be nice to see is even a single reference to an experiment that shows that yes we can reliably diagnose psychiatric illnesses and here's what changed in out assumptions -- where is the paradigm shift?
On 2008 experiment: the result: "The experts correctly diagnosed two of the ten patients, misdiagnosed one patient, and incorrectly identified two healthy patients as having mental health problems. If you think that the result:
psychiatric diagnoses are unreliable
is invalid due to the way the experiment was conducted (some
methodological issues) then do point them out.> doctors were not allowed to interact with patients.
Diagnosing a mental illness is a serious business with long term consequences. Have any of the "experts" refused to diagnose on the account of insufficient information? -- I don't know.
I'd like to be proven wrong and see psychiatry in the hard science camp.
Have I mentioned that psychiatric diagnoses are unreliable ;)
1. The speed at which the microbiome can change (<3 days)
2. The permanence of such changes (some of them are more permanent than others)
There are a couple mouse papers out that don't directly address the issue in 2, but that permanence (or lack thereof) played prominent roles in their findings.
What I'm really interested in is which types of bacteria create a feedback loop by releasing chemicals/hormones to increase hunger or cravings for specific foods. Definitely not an easy thing to determine given all the variables, but it seems very likely based on the other studies showing bacteria can promote fat or thin mice: http://www.scientificamerican.com/article/how-gut-bacteria-h...
Tradition? Capsicums are a new world crop. They didn't make much of a dent in cuisines outside of the Americas until the 18th century.
Spicing food has a preservative effect, which is probably a more important factor in the spread of the practice than masking food that has already gone off.
http://blogs.discovermagazine.com/notrocketscience/2012/05/0...
http://www.wired.com/2014/04/hadza-hunter-gatherer-gut-micro...
The second link is particularly interesting, as the Hadza hunter-gatherers have a lot of gut bacteria that cause disease in the west. So it seems that gut bacteria aren't the whole story. Something to complicate the story for people who want to cure mental illness or create skinny people via manipulating gut bacteria.
1) You might not get them all, and the ones that survive might transfer the traits of antibiotic survival and pathogenic-ability (if present) to the new population.
2) You would need to ensure that your hyper-specific diet contains the right mixture of microbes, say, you would need to avoid irradiated food, and a bunch of other things. "Bad microbes" coming into an empty gut seems to me like a bad thing.
We don't really enough enough about what should be the optimal mix of bacteria to make someone healthy.
They do "fecal" transplants to help people get back bacteria that are missing.
There was a graduate student talk (an hour) about some of this stuff last spring. slide decked linked to the right.
http://sitn.hms.harvard.edu/seminars/2014/in-the-loop-with-p...
repoopulate - http://www.microbiomejournal.com/content/1/1/3
equilibrium - http://www.generalbiotics.com
Both of them are designed thinking of ecosystems more than individual strains (repoopulate has 33 strains, equilibrium has 115). Of course, these aren’t an alternative to FMT if you’re treating a disease… but for general health/wellness I think they’re both quite good.
disclosure: I worked on equilibrium
In it, the author tells a story of someone in a village in a less developed country who cannot afford pesticides. So he starts a war between two ant colonies in order to drive out the ants that are destroying a beloved fruit tree.
You can do the same thing for gut flora. You don't have to wipe things out first. Trying to wipe the gut clean is extremely hard on the body. It's much easier on the body to just feed the good flora and give them support so they start crowding out things you don't want. It's a gentler path. It just takes persistence.
It's easy to find diets for losing weight in general, but I'm curious if we know enough to create a diet to make a microflora composition that can help the weight loss process along. I keep seeing mentions of the microflora factor influencing weight gain, so I'm assuming there's a way to cultivate it to help with loss as well.
The answer in humans does not quite match the answer in mice so far. Possible reasons to explain this discrepancy : might be the lack of a large enough group to study, or a local variation in the groups that does not generalize to mice.
It will be fascinating to see how our understanding of nutrition and diet changes as science finally catches up. Studies like this are just the beginning.
The problem with this is that they are frequently wrong. Many people respond poorly to these type of probiotic diets, and holistic medicine has observed outcomes in a small portion of the population and thus encouraged us to generalize them. All we really know about the gut is that it is extremely complicated and that in terms of gut conditions' ("IBS") relationship with gut microbiota they run the gamut. Many of them are either not directly affected by microbiota population (ie: nerve damage, circadian rhythm ), or gut microbiota are part of a multi-causal problem.
We need more science like this, that reaffirms what we "know," not more holistic bullshit.
Source: IBS sufferer who has spent years talking to GI specialists and reading research papers about this stuff. It's hard, and as soon as you think you have it figured out it smacks you in the face with another factor you haven't considered.
"Turnbaugh’s team found that switching mice to a high-sugar, high-fat diet reshaped the abundance of the community of microbes in the gut to a new, stable makeup within three days, in a reproducible manner that was largely independent of genetic differences among individual mice."
When babies are born, their gut is sterile before it gets colonized from outside. The diet definitely can affect which strain will outgrow others, but all gut bacteria is exogenous.
[0] http://www.whitemountainfoods.com/YogurtProductPage.html
For that case, you could find your favourite local milk and make yogurt who's ingredients you are certain of, because you put them in.
[0] http://www.lifeway.net/Products/OrganicKefir/WholeMilkKefir/...