How To Read a Microbiome Study Like a Scientist

bmahersciwriter (2955569) writes Scientific reports have increasingly linked the bacteria in your gut to health and maladies, often making wild-sounding claims. Did you hear about the mice who were given fecal transplants from skinny humans and totally got skinny! Well, some of the more gut-busting results might not be as solid as they seem. Epidemiologist Bill Hanage offers five critical questions to ask when confronted by the latest microbiome research.

Comments

? what's a

[oldmac31310]

microblome?

Re:? what's a

[i kan reed]

It's a specific environment that hosts multiple species that are evolved to niches exclusively dependent on that environment, but the locality of conditions is so small as to be considered a part of another "bigger" biome.

Human intestines, small tidal pools, fig trees are some common examples.

You spelled it microbLome, which I assume is a mistake on your part since the summary doesn't.

Re:? what's a

[oldmac31310]

on my screen it looks like blome. I was trying - unsuccessfully to be a smart ass. Well, blow me down...

Re:? what's a

[i kan reed]

Do you have some sort of weird font pack?

Odd linux distro, maybe?

Re:? what's a

[oldmac31310]

nope. OS X on a 26" iMac screen, Chrome. Just looks like that. The bold type in the teal bar is the culprit. In fact all instances of the letter i look like l.

Re:? what's a

[reboot246]

Aha! That's the problem. Buy something other than an Apple product. :)

Re:? what's a

[oldmac31310]

Ha, ha. I knew someone had to make an anti Apple comment, even if only in jest.

You mean that...

[gurps_npc]

I can't become skinny by eating a skinny person's fecal matter?

I am going to have to insist on a refund!

Stop laughing, I'm serious!

Re:You mean that...

[geekoid]

Sure you can. You'll get ill and then loose weight from the illness.

Re:You mean that...

[Anonymous Coward]

You might even be able to lose the weight transitively. Watch 2 girls 1 cup, which is simply a documentary on fecal transplant; then see if you lose weight from the resulting vomiting.

Not just microbiome studies

[jstave]

Those 5 questions should be asked of pretty much every scientific study done, no matter what the field

Re:Not just microbiome studies

[jfengel]

Yep, came here to say that. And since effectively every daily news story on any science subject fails to answer any of them, it would be a pretty good heuristic to simply ignore all of them.

Newspapers and TV news are designed to sell news today, and to sell you news again tomorrow. Science doesn't turn out news on a daily basis like that. Important results take a very long time from first inkling to confirmation. You won't be able to act on that news today at any rate. Wait until the news comes out in a source like Science News or Scientific American, when it's got at least a few days worth of evaluation and consideration under its belt. Everything that comes out more frequently than that is going to be just plain rubbish the overwhelming majority of the time. And you'll hear about the stuff that isn't rubbish plenty quickly enough.

Re:Not just microbiome studies

[0bject]

:s/scientific study done/religion/g

Re:Not just microbiome studies

[nbauman]

Those 5 questions should be asked of pretty much every scientific study done, no matter what the field

That's the way to write a good science story. Whatever the story is about, you explain the basic questions that the reader should ask.

I despair about ever having people know the difference between association and causation. Nevertheless, it's worth repeating.

Gary Schwitzer's web site http://www.healthnewsreview.or... has more detail http://www.healthnewsreview.or...

Re:Not just microbiome studies

[raymorris]

Pretty strong correlation:
http://gizmodo.com/5977989/int... :)

Home fecal transplant went wrong

[nbauman]

There was an article this week in the New England Journal of Medicine about a guy who tried a home fecal transplant, and wound up in the hospital. He gave himself cytomegalovirus, with very bad gastrointestinal symptoms.

He had a 7-year history of ulcerative colitis. The doctors made recommendations but he declined many of them. Instead, he gave himself a "home brew" fecal microbiota transplant. He used stool from his wife and 10-month-old child. Some people think that stool from children is more "pristine" than stool from adults, and doesn't need testing for infectious disease. Actually, children are a bad source of stool, because they get frequent viral infections, especially if they attend day care.

He finally started following doctors' recommendations and the ulcerative colitis and cytomegalovirus cleared up after a couple of weeks.

Fecal microbiota transplant actually works well for Clostridium difficile, with more than 90% effectiveness, which is great since C. difficile can be fatal and is often antibiotic-resistant. However, in the few studies with ulcerative colitis it didn't work too well and sometimes made it worse.

The article found two other cases of people who got infections from fecal transplant.

http://www.nejm.org/doi/full/1...

case records of the massachusetts general hospital
Case 25-2014 — A 37-Year-Old Man with Ulcerative Colitis and Bloody Diarrhea
Elizabeth L. Hohmann, M.D., Ashwin N. Ananthakrishnan, M.D., M.P.H., and Vikram Deshpande, M.D.
N Engl J Med 2014; 371:668-675
August 14, 2014DOI: 10.1056/NEJMcpc1400842

A 37-year-old man with ulcerative colitis was admitted to the hospital because of abdominal cramping, diarrhea, hematochezia, fever to a peak temperature of 38.8C, and drenching night sweats. Several weeks earlier, he had performed home fecal transplantation.

Re:Home fecal transplant went wrong

[DigiShaman]

Brings new meaning to the phrase "eat shit and die".

Re:Home fecal transplant went wrong

[Guppy]

While the clinical picture and timing suggests the possibility, it's far from certain that this was a primary infection stemming from his home fecal transplant. I would have liked to see an analysis of anti-CMV IgM titers, although in this case it's also possible that his case was recognized too long afterwards to determine whether or not it was an actual primary infection.

Depends

[theshowmecanuck]

Are they skinny because they have a tapeworm? If so, it really should work.

Re:Depends

[gurps_npc]

Most doctors do not believe that tapeworms cause you to lose weight - at least not until you surgically remove them.

Tapeworms eat your nutrients, but they don't make the matter vanish. The tapeworm grows by X ounces for every X ounce you 'lose'.

They do however, cause multiple health issues. (Unlike certain other parasites that some believe trigger helpful immune responses).

Re:Depends

[Thud457]

"fecal transplant" is a concept I could have quite happily gone to my grave without learning. Thank you Dr. Gregory House.

Wait ... What?

[Virtucon]

Dammit I've been taking rat poop ever since that study was released? Are you telling me now I did all that for nothing? I wish you'd make up your minds!

Re:Wait ... What?

[iggymanz]

eating poop can definitely make you lose weight.....by catching cholera or similar

Re:Wait ... What?

[Virtucon]

Too extreme then?

Ask about everything

[troll -1]

Those questions should be asked of asked of all health claims including the benefits of vitamin C, fish oil, anti oxidants, and crystal therapy. It's amazing the amount of crap people believe where the evidence is either insufficient or the research flawed.

Re:Ask about everything

[crmarvin42]

The really frustrating part is when people who will rant against drug companies and a supposed lack of testing (which could not be further from the truth) will in the same breath rave about the latest dietary supplement (for which no testing is actually required, and over which the FDA has little legal oversight).

The food supplements industry is largely unregulated in the US due to an impressive mis-information campaign back in the 1980's which resulted in a special section of the regulations for dietary supplements. Animal feed is more tightly regulated than feed supplements. Feed additives have to prove, to the satisfaction of the FDA, that they are effective for a specific purpose. No similar requirement exists for dietary supplements.

Re:Ask about everything

[jfengel]

The Faustian bargain there is that they're not supposed to be expressing any specific purposes. If you're categorizing your product as a "supplement" you have to avoid making specific health claims. It generally says so, right on the package, via the incantation "This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease".

Generally in very, very tiny print. In much larger print, they'll hint strongly that it's good for something (often, something fairly vacuous). It's on the FDA to judge when it crosses the line into a medical claim, and they don't have anywhere near the kind of manpower it takes to evaluate the multi-billion-dollar market. It took an outside organization to sue the makers of Airborne, via the FTC, for false advertising rather than a violation of the more specific FDA rules.

So yeah, there are rules about dietary supplements, but they're badly flouted. They walk right up to the line, or even cross right over it, and rely on people's gullibility to make the jump to believe that these worthless products do anything.

Re:Ask about everything

[HornWumpus]

Boner pills. The FDA kind, not the snake oil kind.

Re: Ask about everything

[crmarvin42]

FDA regulations are use based. If you are taking vitamin C as a way to meet your daily requirement for vitamin c, then there is no health claim and your purchasing experience wouldn't change. However, the vitamin c seller would need to convince the FDA as to their supplements efficacy of disease prevention, which is BS anyway. The FDA oversight wouldn't do much to vitamin availability (the strawman the afore mentioned misinformation campaign used to drum up support for thei dietary supplement exclusions), but it would keep the "Magic" (read bullshit) pills Dr Oz keeps pushing off of the market in the first place. It would also cause other known BS like herbal supplements that lack any of the advertised herb, or the homeopathic sugar pills to be pulled due to a demonstrable lack of efficacy.

Re:Ask about everything

[david_thornley]

A friend of mine, who worked for the FDA, insisted on taking any herbal stuff as teas. She said that was somewhat regulated, while a pill claiming to be a herbal dietary supplement could contain pretty much anything.

Re:Ask about everything

[crmarvin42]

Probably because herbal tea is food and therefore falls under the more comprehensive oversight and rules that cover all foods. She is correct that dietary supplements can contain pretty much anything.

Re: Ask about everything

[crmarvin42]

I don't care what you want to put in your body. I expect the same respect from you.

Wow, you have a very carrying soul [/sarcasm]

Unlike you, the FDA has a statutory obligation to make sure that foods and drugs sold in the US are safe for their intended use. The "intended use" part allows for a surprising amount of wiggle room. How is the FDA to know if you bought vitamins to treat some disease (a drug use) or to make sure you meet the normal RDA (not a drug use)? They can't and don't try. The intended use limit is not on the end user, but the seller. VitaminsRUs cannot advertise that their vitamin pills prevent cancer, but if you believe they will there is nothing the FDA can do to stop you, and they won't even try.

You do not have the moral authority to tell another person what they may or may not ingest.

The FDA is not a moral authority, but a scientific one. They are staffed with experts in various fields necessary to decide which products are safe and effective, and which are not. You appear to feel yourself up to the task of sorting the wheat from the chaff, but most Americans are not. I'm going to go out on a limb here and guess that you consider yourself to be of above average intelligence and education (ironically, the vast majority of people do as well). But think about most of the people you see in a day (neighbors, friends, family, strangers). How many of them would you suspect are similarly equipped to handle sophisticated marketing made to give the appearance of scientific validity despite a demonstrable lack there of? That is why the agency was created (see patent medicines, most of which were simply different forms of cocaine). To protect the largely ignorant populace from unsafe and unproven products.

As I stated before: regulation to ensure the product contains only the labeled, unadulterated ingredients is the limit. I can also conceptually support banning "false claims" but that is a very squishy concept in biomedical terms and is typically advocated as an subterfuge to ban things.

All such regulations require oversight. Verification that companies are obeying the laws that are supposed to govern their actions. The dietary supplement market is exempt from much of this oversight because they lied to the US population and convinced them that the FDA was out to take away their vitamins and make they by prescription only. That would never have happened. I know this because I do regulatory work with the division of the FDA involved in regulating the animal equivalent to dietary supplements, namely Feed Additives. No prescription is needed for an approved feed additive, no consultation with a veterinarian is required, but feed additive manufacturers are required to prove that a new additive is safe and effective. Once approved, anyone can sell that feed additive for the approved use without further involvement of the FDA. A feed additive petition takes about 2 years (on average, with a HUGE SD due to a non-normal distribution) from submission to approval, but once the approval is made no more work is required. In most other countries the requirements are similar, except that approvals are vendor specific (Company A and B both have to register their Vitamin C), and have to be renewed periodically (US system only requires approval once).

Re:It's funny how excited Republicans are by this!

[Bob the Super Hamste]

I didn't know you rectum and throat were the same thing?