Episode Transcript
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Welcome to Nutrition For Mortals, the podcast that says life is too damn short to spend your time and attention worrying about your food choices.
So let's take a deep breath and then join us two registered dietitians and friends as we explore the world of nutrition with a special focus on cultivating a healthy and peaceful relationship with food.
My name is Matt Priven, and I am joined as always by my co-host and the best dietitian on planet Earth, Jen Baum.
Hey, Jen.
Hey, Matt.
And just a couple of quick reminders if you are enjoying the show.
We do have a Patreon where we do an extra bonus episode every month.
A portion of our Patreon does go to support The Hunger Project, which is a fabulous organization.
And we are also real live dietitians in private practice.
And so if you or anyone you know has ever thought about working with a dietitian, you can always reach out to us at oceansidenutrition.com.
Absolutely.
And so let's jump in.
We've got a lot of ground to cover.
Yeah, so Matt, what are we talking about today?
Okay, so today we're talking about personalized nutrition.
This sounds pretty vague, but it's actually something really specific.
It's sometimes called precision nutrition.
And this area of personalized nutrition is really often cited as the future of our field, the future of nutrition, much the way personalized medicine is assumed to be the future of medicine.
The same is true in nutrition.
So I think it's really important that today and in a couple subsequent episodes, we actually dive deep into personalized nutrition.
What are the offerings out there?
What are companies trying to sell you?
What does the science say?
What's going on online?
How are people reacting to this?
So we'll play clips along the way.
And I wanna do a really honest deep dive into personalized nutrition so we all can get our heads around it.
And this is a huge topic that requires an understanding of many different areas of science.
And frankly, we need some help here on the show.
So today we are joined by Dr. Lara Hyde, who is a nutritional biochemist with a PhD in biochemical and molecular nutrition. She's an adjunct instructor at the Tufts Friedman School of Nutrition Science and Policy and creator of the wonderful YouTube channel Nourishable where she gets super nerdy about the exact kind of topics that we'll need her help with today on the show.
So welcome Lara.
Thank you.
I'm so excited to be here today.
Yeah, we are so excited that you are here.
When Matt and I were talking about wanting to do an episode or even a series of episodes on personalized nutrition, we realized that we really wanted to bring in an expert.
So I just, I'm so grateful that you're joining us in this conversation today.
And I'm so thrilled to be here.
There are so many different areas to dive in, both from the science side, as well as from the application side.
What does this look like with you where to actually try and apply it in your life?
And is the evidence base there yet?
Yeah, this is an area where there's a lot of companies investing a lot of money, a lot of money floating around because people are betting that these personalized nutrition programs are the future of our field.
So like you said in our chat, I want to take a look at some of these offerings, see if there's value to be had.
But I want to be really clear about the state of the science and potential pitfalls.
But before we can do any of that, we need to bring everyone up to speed.
So Lara, I'd love to ask, just what is personalized nutrition exactly?
Certainly, great question.
Important place to start.
So I think before diving into personalized nutrition, we can look at what it's often compared to, which is more population-based dietary guidance.
And so this would be things like the dietary guidelines for Americans, where there are food-based recommendations based on your sex and your life stage that look like, for example, aim to consume two and a half cups of, cup equivalents of vegetables per day.
So these are gonna be more population-based guidance that should be beneficial for everybody in supporting their health and wellness and reducing risk of disease.
Now, if we switch gears to look at more personalized nutrition recommendations, that is when unique characteristics of an individual are being considered when tailoring nutrition recommendations to a person.
And so what are some of those unique characteristics?
It could be your genetics, which may impact how you metabolize and process nutrients.
It could be your microbiome.
It could be your metabolism.
Those are a lot of the areas right now that are being explored in personalized nutrition.
But I think some other considerations too that may be especially relevant for the two of you working within the field of dietetics is it could also be things like your lifestyle or your preferences.
These are all different ways of taking what are population-based guidance and personalizing them to an individual who you are working with.
So I think we know that there are a few different types of personalized nutrition offerings on the market.
I'm guessing that people are pretty familiar with seeing things like microbiome testing or continuous glucose monitoring or genetic testing.
And I think it's gonna be really important that we do justice to each one of these categories.
And so today, maybe we can focus just on the microbiome and then make this a series where episode two, we talk about genetic testing and then we can kind of wrap it up by talking about metabolic response testing and continuous glucose monitoring.
Let's do it.
That sounds good.
Awesome.
So why don't we jump in with the gut microbiome?
And so when we think about personalized nutrition based on your individual gut microbiome, what are we talking about exactly?
So an important place to start here is first by defining what is the microbiome.
The microbiome is the population of microbes that live on and inside your body.
We often talk about the population of microbes living on your skin or in your mouth or all throughout your gastrointestinal tract.
Historically, there had been some estimates that we have 10 times more microbes than human cells.
And whereas more recent estimates are estimating it's about one microbe per human cell, but when we consider how many genes all of those microbes bring along with them, there's about 10 times more microbial genes than human genes.
And the reason that is relevant is because all of those genes are impacting how we are metabolizing and breaking down foods and in turn interacting with the microbes in our body.
Now, if we're to talk about how you're looking at the relationship between the microbiome and diet, that is a place where it's pretty well established that what you eat can change the composition of your microbiome.
One really seminal study that looked at this, I think it was published back in 2014, and it was a study where the researchers took a group of people and they put them on a exclusively plant-based diet for five days, and then switched them to an exclusively animal-based diet for five days.
And what they found was that there were really drastic changes in the microbiomes of the participants when they were on the plant-based diet versus the animal-based diet.
And much of this was due to particular microbes that were present in the plant-based diets are ones that are really good at digesting fiber, whereas they found the microbes that were abundant during the animal-based diet were really good at digesting protein and were also really tolerant to living in an intestinal tract that had lots of bile in it.
So that was one of the early studies that was showing that you can actually change the microbiome community through diet.
Yeah, it sounds like there's a lot of promise in getting a really great understanding of this whole world of microorganisms inside of us.
And if we look at a study like the one you mentioned in 2014, the animal versus plant-based eating style, I mean, it's kind of intuitive, right?
It's like if you think of a forest with different species in them and you provide a food source to half of them and restrict the food source to the other half, you're gonna see a proliferation of certain species, right?
And so it does make sense that the way we eat influences the organisms that thrive within us.
But when we start to look at some of the current offerings from companies who are selling things like microbiome nutrition-based testing, where you test a stool sample, for example, and then they return a flashy app that tells you every food you should eat and every food you shouldn't eat, I start to cock an eyebrow and go, what's going on here exactly?
It seems like we took a big leap in the logic.
And I hope in our chat today, we can really dig into how consumers should be feeling, especially when they stumble across a social media post or an ad that's encouraging them to do one of these personalized nutrition tests.
And so I know that you've spent a lot of time doing some assessment of the market and seeing what offerings there are out there.
So I'd love to ask you, can you give us a glimpse into the current offerings from companies in this specific space we're talking about now, which is nutrition-based programs through microbiome testing?
Absolutely.
This is definitely an area where I've been kind of using myself as a guinea pig to see what is out there that is in the direct-to-consumer space.
And so I have tried multiple of these direct-to-consumer microbiome tests and in fact did an experiment where I used one same poop sample and sent it off to four different companies to see how they rated me and what kinds of nutrition recommendations they gave me.
So before I jump into some of those comparisons there, I do want to dig a little bit into what is the data that is behind some of these recommendations that are made.
Typically, these companies will each give you some kind of score for the healthfulness of your microbiome.
However, the way that these scores are calculated isn't really clinically validated yet.
And amongst the field of microbiome researchers, there isn't a consensus on what is considered a healthy microbiome.
So that I think is the first place where perhaps you could have a bit of skepticism when looking at these direct-to-consumer products is that they are often comparing your microbiome to what they call a healthy microbiome, but there's really no consensus on what a healthy microbiome is.
Yeah.
Yeah, I'm gonna hold you there.
How do they, what is their idea?
What are they basing it off of?
What is their attempt, even though it's not validated, which is important to say, what do they think they're doing when they're assessing the healthfulness of a microbiome?
That's a really good question.
It somewhat varies by company.
Often it seems to be that they will take an average of their customer base, who they call a healthy customer base.
So that's one approach for doing it.
Now, the scientist in me says, well, I think there's some problems with that.
Are all of these customers really considered optimally healthy?
And are we missing out on some of the, perhaps, diversity of what a healthy microbiome could look like when we only consider customers who are able to pay, say, $200 for a gut health test kit?
And some other companies will do something like take the average microbiome from a large citizen science project called the American Gut Project.
And so this was a pretty cool project, if you ask a science nerd like me, where researchers, I believe they were at UC San Diego, are based there, they asked volunteers from all over the country to send in a poop sample.
And they were just really curious about what does the microbiome of Americans look like?
So that's another, that has also been used as the basis for like what can be considered a healthy microbiome.
If you talk to microbiome researchers though, the one thing that they tend to agree on is that a healthy microbiome is a more diverse microbiome, meaning that it contains more different kinds of microbes.
And just so I'm clear, we're talking about many different species of microorganisms here, both bacterial and fungal.
We're still discovering new ones all the time, correct?
Absolutely, bacterial, fungal, viruses.
There's so many different kinds and there have been a lot of advances in the technology that allow us to sequence them.
So we're learning about more all the time.
And this is kind of an advancement from the past where we used to have to try and culture microbes on a little Petri dish.
And the reality was we just didn't really know how to culture all of them.
So I think the developments in sequencing technology is something that has really allowed this field of research to expand and exist.
Yeah, that's super helpful to understand.
So now let's turn our attention to some of the companies that are really trying to market products, right?
So like you're saying, there's a lot we're still trying to understand about this space, but it doesn't stop companies from aggressively marketing products and making some big promises to consumers.
So what are the big names in the market right now in this space?
So Viome is certainly one of the really prolific players in the direct-to-consumer microbiome space.
So that is one that I have tested out.
Another company is called Biome with a B.
So we have Viome, we have Biome.
There's another company called Ombre that I have tested out, as well as another company called Flore.
So those are four of the big companies that I've had personal experience testing out and can comment a bit on the similarities and differences between them as far as how they give you scores, how they test, and some of the claims and science behind them.
Yeah, so what are the differences in what they're promising with their products?
Is it all pretty universal, or do they promise different things based on the sort of branding of the company?
So there seem to be a lot of promises about bloating, fatigue.
Some will go, we'll talk a bit about mental health.
There's a lot of talk about leaky gut, inflammation.
I guess I haven't personally dug in specifically to how those claims are different between the different companies, but those are definitely some of the buzzwords that seem to pop out.
Yeah, I wanna dig into the science quite a bit more, but I wanna hang on Viome for a sec, because it does seem like it's the big name in the space.
That's the big one?
It is definitely a big one, and it's one that I have dug into my results quite deeply, so I'm happy to talk about that.
Nice, okay, awesome.
So I did look them up, and I know that their gut intelligence test is $260, and then they're aggressively upselling their precision probiotics plus prebiotics for a mere $80 a month as a subscription.
So it costs a lot of money to engage with Viome.
And I want to talk just for a sec about their social media marketing, because I must have accidentally lingered on a post too long by Viome, and then I got 500 ads from Viome over the next couple of weeks.
And so I want to call out that this company is clearly paying a lot of influencer ambassadors to make a ton of content.
And if anybody listening has seen these Viome ads, they'll recognize some themes.
So like you mentioned, some of the promises these companies make are about bloating and inflammation.
You see a lot of ads where women are marveling about how flat their stomach is after finally quote unquote beating the bloat.
But there are just a lot of before and after videos with women like literally just pushing out their belly in the first clip and then sucking it in in the second clip.
And you see a lot of praise for Viome from people who are saying like, it helped me heal my body from inflammation, again, with a lot of before and after photos.
And to what I'm seeing, the weight loss dog whistling is like overwhelming.
It's mostly directed at women, but it is also directed at men.
And is that a fair assessment from what you've seen like a lot of these companies, especially Viome are really trying to use the idea of weight loss with sort of a wellness pastiche over it to market these tests?
I would agree, yes, with that assessment of it.
The algorithms have also been presenting me with a lot of Viome influencer ads, and there's claims in there that I question, as well as I see promotion of perhaps some disordered eating patterns that are also raise some red flags for me.
Yeah, I actually have a couple clips we could listen to quickly.
These are ads from Viome where they're using content created by what I'm assuming are sort of paid ambassadors.
So let's listen to one first that's directed towards men.
I'm sure someone out there can relate to this.
I was hitting the gym five days a week, but somehow felt like I wasn't getting the results I wanted.
“No matter how much I worked out, I felt like my bloating was covering up the ads I was working so hard for.
Then, a buddy spilled the beans about these test kits from Viome.
They ship a test kit right to your door, and all you've got to do is provide a sample.
Fast forward a couple weeks, and bam, you get a full report on your gut health, complete with a list of foods that you should and shouldn't be eating to beat the bloat.
If you're ready to discover what's holding you back from the physique that you've always wanted, you've got to give Viome a shot.”
Oh my, that ad had not been presented to me before, but yes, there's a few things that jump out as red flags to me on that.
Yeah, it sounds like they're very specifically talking about getting the physique of your dreams through a stool sample test, right?
Correct, yes.
As well as a lot of categorizing foods as good or bad, which is also something I typically don't agree with from a healthy relationship with food perspective.
And to that point, let's listen to one more.
So I just checked my gut health report that I got back from Viome.
Basically, it told me all the foods I've been eating for the past year are foods I should be avoiding.
And all the foods that I've worked so hard to cut out are actually the ones I'm supposed to be eating.
I eat bananas every morning.
And I guess that's supposed to be one of the things I'm not supposed to be eating.
I'm so overwhelmed right now, but obviously I'm super grateful that I know the truth.
Starting over in the new year and finally knowing what I really need to be eating.
I'll keep you guys updated with how it goes.
But in the meantime, this is where you can find the test that I took.
Yes, I have also seen that one.
And I'm curious about your perspectives on that as well.
Well, I, you know, what jumped out to me from that second clip is the fact that it sounds like, and I did engage with Viome's website a little bit and I kind of dug around some, but it seems like they are making some pretty restrictive food recommendations based on the testing that they're doing.
And my question to you, Lara, is now that we kind of know that, you know, diversity of the gut is good, how much do we know about altering our intake significantly in response to one of these tests, like a Viome test, for example?
We don't know much, that is quite clear.
So when I did my Viome test, one of the way that they present your nutrition recommendations to you is they categorize food into one of four categories, your super foods, your enjoy foods, your minimize foods and your avoid foods.
And so being the nerdy scientist that I am, I like to go through my lists and then follow the references that they provide to indicate why is this particular food an avoid food for me.
So I'll give you an example.
Bell peppers were on my avoid list.
Now I was very upset about this because I really love bell peppers.
I think they're delicious.
They're something that both my partner and I really enjoy.
So they're a frequent player in our dietary patterns.
So I was like, oh my goodness, what is the evidence to support that bell peppers are not healthy for my microbiome?
And it was indicated that my microbiome contained a pepper model virus, which is a virus that can be in bell peppers.
And then I followed the references to indicate that we're meant to be supporting the claim that pepper model virus is inflammatory.
But then when I followed the references, they were both these very general review articles indicating that there's a lot we don't know about the viral contents of our microbiome.
And maybe there's some inflammation, but we don't really know when all of this is hypothetical.
So I go back and I think, well, is there really a reason I need to restrict bell peppers from my diet?
I'm not convinced based on that evidence.
So for me, I continue to eat bell peppers and enjoy them very much, but I recognize that digging into the evidence at that level isn't necessarily going to be accessible to most consumers who are going to take these categories at face value and can lead them perhaps down some really problematic, restrictive paths.
Yeah, exactly.
I always think about, Matt and I did an episode on food sensitivity tests, and we did a bunch of debunking there, and we talked in that episode just about how challenging it would be for many people to get this type of information.
And they, in good faith, think that they are getting very evidence-based recommendations.
And it sounds like what you're telling us is that even when you follow the evidence that the company itself is citing, the evidence just doesn't really stand up to support the elimination of many of these foods.
Absolutely.
I have also done some experimenting with those food sensitivity tests.
And I think a similarity between those food sensitivity tests that are looking at a particular type of antibody, as well as this example with the pepper model virus, is that they're more an indication of exposure to that food in your diet, but not at all an indicator that it's bad for you or should be eliminated.
Oh, that's interesting.
And so am I right in saying that maybe potentially because you're somebody that enjoys bell peppers and you eat them a lot, that it makes sense that this was kind of flagged in your results?
It makes sense to me that I would have components that are often found in bell peppers in my microbiome.
That would not be very surprising to me at all.
And so far, I haven't uncovered any data suggesting that those pepper model viruses are detrimental to me.
Interesting, interesting.
Well, and can we, because since we're digging, really kind of digging into the science, I mean, I guess what I think is important is to understand what the scientific literature says about the efficacy of these microbiome-based nutrition plans and interventions.
Like, do we have any data to support that the supplements recommended by these companies or the, you know, diet plans that are being offered by these companies are grounded in any good science?
So the answer is no, there haven't been any really well-designed studies that are showing that following these very specific nutrition recommendations and supplement recommendations lead to an improvement in the microbiome and even further out, an improvement in any health outcomes.
So I did manage to track down a study that was really highlighted on the Viome website that they were using to indicate that their Viome program, so following their nutrition recommendations and supplements can improve depression and improve IBS symptoms as well as lower risk of type two diabetes.
Those are pretty big claims.
It was a study of Viome customers who filled out baseline surveys that scored them based on their depression symptoms, their anxiety symptoms, IBS symptoms.
All these customers then apparently followed their recommendations and supplements for five weeks, and then they filled out the surveys again five weeks later.
Now, the problem here is that there's no placebo group.
There's no control group.
So you could imagine that if you are someone who has invested money into testing your microbiome and paying for the personalized supplements, that you could have an attitude of like, yes, I'm really hoping that this improves my symptoms and that can really impact how you respond on something like a survey.
Whereas they didn't have a control group who were given either fake recommendations or just no recommendations at all.
So we don't have anybody to compare them to.
I interpret that and say, well, I don't think I can really make any conclusions about the impact on depression symptoms, IBS symptoms from that type of study design.
Yeah, that's so important to call out.
And I think another thing we should think about here is, where did the study come from?
Who made the study?
Who funded this specific study on Viome's product?
Very important question.
This was a study that was funded by Viome and the study authors were Viome employees.
And the test period was five weeks without a control group in a very specific population of people who have enough money and also the interest to engage in a gut microbiome test and follow the recommendations.
Yes, so a pretty selective group.
We can't really make very many conclusions from this particular type of study design.
Many limitations.
Well, thank you for sharing all this information.
I think this really helps even me go, okay, so these products have a long way before we can put any faith in them.
And you were talking about your example with how they translate these results from your stool sample into a nutrition recommendation and how like with bell peppers for you, you don't really put a lot of faith in their evidence, but there's a lot of different factors that go into these nutrition recommendations.
And one thing I've realized from looking into Viome is they're using artificial intelligence to generate your nutrition recommendations.
Is that correct?
That is correct.
Now it tends to be kind of a hand wavy artificial intelligence.
So from the best that I can assess based on how it's described, for example, in that pilot study I was just describing, it sounds like it is artificial intelligence based on studies that have been done in the literature that are all kind of compiled together to predict how certain microbes would respond to particular nutrient compounds in foods.
Now, what kind of studies are included?
Are they animal studies?
Are they big?
Are they small?
How much diversity of populations are in them?
We don't really know.
To me, I have a red flag about just blindly trusting and artificial intelligence to make recommendations like this.
Yeah, and you were lucky to actually access what their idea was about bell peppers.
A lot of times when we hear the term AI, it's just we've created a black box nobody can look into any longer.
We don't know what studies they're referencing.
And so I guess that's a huge risk for the future of this space too is the more we embrace artificial intelligence, the less understanding we have about the sort of like digital meta analysis that these AIs are doing.
And with the scientific method, we do not want to give up control over what studies are being included and excluded, right?
Right, absolutely.
I think though, on the other hand, there could be a great potential for AI.
I just think we have to be really clear and transparent about what goes in to create these AI models.
Tell me more.
Well, for example, if the types of analyses that companies like Viome do, these are also types of analyses that researchers will do as well, studying what genes are being turned on in response to particular dietary influences.
So there's just too much data for you to be an individual person running one statistical test individually across each of the permutations.
It's just kind of impossible.
So I can see there being a benefit of using AI to take these large amounts of data and compile them together.
But I think we need to be careful about what gets included in the model in the first place.
That makes a lot of sense.
And when it comes to the point of translation to human interventions, we need a human involved in that process.
Absolutely.
And we probably need quite a lot of humans involved in that process.
There's one other thing I would love to just comment on about these testing kits.
And it's, so I have mentioned that many of these direct to consumer testing kits encourage you to retest after four to six months after you have been following the recommendations.
What can happen then is you can, six months later, get a whole new list of different food recommendations that are on your superfood and avoid list.
And I think one of the concerns I have about this is that to me, it almost feels like it's removing your agency in choosing how to eat.
I feel like I could see some red flags or slippery slopes of feeling like you have to eat perfectly according to these lists, which aren't necessarily evidence-based as we have talked, but also just this feeling that it's constantly changing and it's out of your control and that you are not allowed to make your own decisions.
And I feel like that could really distort a relationship with food.
That's a really important point.
I'm so glad you mentioned, and why do you think these companies encourage repeat testing at the end of the day?
What's their motive for repeat testing?
Well, I think this is one of the places where there's a nugget of scientific truth that then gets over-extrapolated.
So there is good evidence that changing your diet can change the microbiome.
So it makes sense that it's a dynamic thing that you may want to see how it changes over time.
But from the business perspective, it's a really great way to have repeat long-term customers.
And so I think that that is certainly a motive incorporated into many, many of these companies.
Yeah, I think you said that well.
And I think that a lot of these companies are walking this line.
They're like, there is a nugget of truth and sort of like real science to what we're doing, but they're taking every opportunity to capitalize and get a lot of money out of individuals.
And so since this is the last time we might have a chance to talk about Viome, I do want to squeeze in here.
The owner of Viome, a man named Naveen Jain, I did a little digging into his background and he was the co-founder of a company called Intelius, whose whole business was selling private data on individuals.
And now he's gathering a lot of private data on individuals.
And he also co-founded a company called Moon Express, which you literally can't make this stuff up, was founded to mine the moon for precious materials, like gold, platinum and sources of nuclear fuel.
So anyone trying to mine the moon and gather personal data for reselling is absolutely on my super villain list.
So I have no trust in the business model of Viome.
I'm assuming everything they do is predatory at this point.
I had no idea about this, about some of that background.
Yeah, so I know you're a woman of science and I have now scared you with gossip about Mr.
Jane here, but I do wanna squeeze that in for our listeners to understand that these companies that they're seeing that are making these big promises about your health, it's another very rich man trying to create a new product on the market.
And so important to keep in mind.
Sorry, Matt, I'm just laughing about mine the moon.
I don't know why that's like so funny.
He literally is trying to mine the moon.
Don't mind, leave the moon alone.
Could you leave the moon alone, maybe?
Like, I love how outraged you are about like mining the moon.
Mining the moon.
Like what is more sacred than the moon?
Like, should we mess with the, like what could go wrong if we mine the moon?
It's not like it has any relevance to our world here.
All right, I do want to move on to talking about the specific tests that you did, Lara, because I think that's a great place to really bring it back to the individual experience.
And you have this really rare situation where you've done a variety of these microbiome tests and nutrition programs.
And so I'd love to hear from you, what really stood out in your results?
Because did they all look uniform?
Did you have the same profile in each program?
Really great question.
The short answer is no, I did not.
So again, what I did is from the same sample of poop, I sent a sample off to Viome, to Biome with a B, to Flore and to Ombre.
Now, some of the big takeaways I had when comparing my results from all four of these companies was that they all gave me some kind of score for the quote unquote healthfulness of my microbiome.
Each one had a bit of a different name, but on one test, I was like very low score, two out of 10, terrible, failing when it comes to microbiome health.
I believe that was from Biome, they scored me very low.
Whereas Flore gave me a 10 out of 10 overachiever microbiome.
And then I was kind of in the middle for two of the others.
So this goes back to that whole really important underlying question of what is a healthy microbiome.
Microbiome researchers haven't really established that.
And the way that it seems to be established by all of these companies is very different.
And so when we recognize that comparisons between yourself and this made up healthy microbiome are the basis for all these nutrition recommendations and personalized supplements, it can really make you question whether we're using the right comparison, whether any of these recommendations actually matter at all.
And I realized this is probably a unique thing.
I would imagine most consumers aren't going to do tests from multiple companies, nevermind from the same sample.
So I thought this was kind of a unique experiment to do.
Wow, yeah, that is very fascinating and very surprising that the same sample led to such variability across these different companies.
So now if we get into the nutrition recommendations that were given by these four different companies, this was also a place where there was a lot of variability.
So some companies gave very specific recommendations, whereas others gave more general recommendations.
For example, Flora gave me two overarching recommendations.
Aim to consume less saturated fat and increase the amount of fiber in your diet.
And those are both nutrition recommendations that I can get behind pretty similar to a lot of population-based guidelines.
So perhaps I didn't need to send my poop in the mail to find that out.
But then some other companies, both Viome and Ombre, gave me very specific lists of foods that I should aim to eat a lot and really try and restrict from my diet.
And so I nerded out here and I compared the lists.
And what I thought was really interesting was how sometimes a food that was recommended by Ombre was meant to be restricted by Viome.
So for example, cabbage was a food that my Ombre test said, oh, you should, it's recommended that you eat cabbage.
Whereas Viome recommended that I restrict cabbage from my diet.
So that was kind of fascinating to me.
And so there were several examples of these places where I got pretty contradictory nutrition recommendations between these different companies.
Do you think there's also just a big difference in how these companies are analyzing and interpreting the data that they're getting from people as well?
Yes, that's a really, really good point, Jen.
I haven't dug into this too much yet, but the way that they're actually doing the testing is variable between these different companies.
So several of the companies will test by DNA sequencing of the microbes.
Some companies will also test the fungal communities.
So you might get different recommendations due to that.
Other companies will ask the question more, what are the microbes doing?
And so instead of testing DNA, they're actually testing the RNA, which is determining which genes are these microbes turning on so we can get an insight into what their activities are.
So on one hand, the scientist in me says, okay, we're testing in different ways.
Perhaps that is why I might get different recommendations.
But ultimately, I really feel like it goes back to, we just don't have a strong evidence base yet for making these recommendations.
So many times on the show, we've talked about how difficult nutrition research is.
Even in these big population-based nutrition recommendations, we're still arguing about saturated fat, right?
But then to get to the granular level of cabbage, yes or no, we have no idea.
And so to then assume that these companies have programmed the right answer into your results is a ridiculous leap of faith.
It really is.
And I really like cabbage.
So no matter what these companies say, I'm gonna continue to eat cabbage.
Well, and that's the other thing, right?
Is that there's also, I mean, that second clip that we played where there was that young woman talking about, oh, all these foods that I like, and I enjoyed eating, or I thought I should be eating, now I have to cut out.
I mean, I think the fact that they're making very restrictive recommendations on foods to eliminate without having a lot of strong evidence behind it really could lead to people not enjoying food as much, because now they're cutting out things like cabbage, like bell pepper that they really like and enjoy, because they're trying to be, you know, concerned with their health, or they're trying to follow some of these recommendations.
Yeah, I think that that's a really major red flag that jumped out to me, is that I could see how it could be a very slippery slope to feeling like you're only allowed to eat based on what are in these lists.
That sounds really sciency when they're presented to you.
Yeah, it's so similar to our food sensitivity discussion.
I mean, it's gonna, I would guess, have a disproportionate amount of people who are hyper fixated and hyper anxious about their eating show up to these products.
And so you're gonna have a population of people who are already really concerned.
And so this is gonna fan the flames of disordered eating and eating disorders without a question.
And so when we hear the clip of this woman saying, gosh, I've been eating bananas every morning and I've been harming myself by eating bananas, that's gonna add so much stress.
And these different interventions, whether it's a personalized nutrition program or someone did Whole30 or whatever it was, right?
You keep cutting things off your list.
And a lot of people, even though they ostensibly have moved on from their previous diet program, they still have this feeling that there's a lot of foods that are a problem for them and the list grows and grows.
And then when we give people an app that says, like 50% of your favorite foods are avoid foods, that list gets so small so quickly.
And I hope our conversation today is really highlighting that nobody needs to be interpreting the nutrition programs from these companies in a black and white way where they absolutely need to avoid these foods.
And I wonder for you, Lara, would you recommend these products to any types of people?
Who would be somebody who you think would benefit from these programs like Viome or Biome or these other companies we've been discussing?
I would say I have a lot of pause in recommending the companies that give such specific nutrition recommendations.
To me, the potential harm of stimulating some unhealthy relationships with food is too great, in my opinion.
I do think, though, that perhaps some of the companies that are a bit more exploratory can have benefits.
I think that there can be benefits in individuals being curious about their health and being curious about their microbiome.
And so from my experience from the four that I tested, I felt like Flore was one where it gave you a lot of tools in trying to explore what microbes are there and how can we categorize the microbes that are present in different ways.
And so I kind of appreciate that opportunity to explore a little bit more, but I almost would recommend avoiding the nutrition and supplement recommendations that they give you and more use them perhaps as a way to explore the composition of your microbiome out of curiosity.
Yeah, yeah.
And so maybe we can just wrap up today, Lara, by having you, you know, if you were to really sum up in a few sentences what you would want the average person knowing about the microbiome and nutrition, what would you want people's big takeaways to be?
So to me, the big takeaways go back to the one thing that microbiome researchers can agree on, which is a more diverse microbiome is healthiest.
And how do we feed a more diverse microbiome?
With really diverse forms of fiber and plant foods.
So I think to me that is a tangible takeaway that will likely be beneficial for everybody, and everyone can have their own ways of incorporating that into their dietary pattern.
So one way I love to do that is I love going to the grocery store, the farmers market and picking out a new fruit or vegetable that I've never tried before, or trying to incorporate a new whole grain into my dietary pattern.
And so I think those are some really fun ways where you can have fun and experiment and find what suits your preferences and your lifestyle in ways that also support a healthy, diverse microbiome to the best of our knowledge right now.
And you know where else I like to have diversity?
The minerals in the moon.
Can we keep our gold and platinum in the moon, please?
Maybe we can do that.
I cannot let it go.
So big takeaways today, eating lots of plants is cool.
You don't need to do a Viome test, and let's please not mind the moon.
I think we can all agree on that.
Yes.
Consensus.
Well, Dr.
Lara Hyde, thank you so much for this conversation.
I know it ended up being longer than anticipated, but we cannot wait to see you in the next episode where we talk about genetic testing and nutrition.
Thank you so much for having me today.
I am so excited to come back and chat with the two of you some more.
There's just so many exciting rabbit holes to dig into and important considerations in how we actually apply it to our life.
All right, amazing.
We will see you in the next one.
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