Gut Health Testing Kits – Expert Opinion

Gut health is an exciting area, and there’s tons of emerging research. You might be wondering how we can best manage our relationship with food, whilst juggling the improving gut health?

Why do we care about gut health?

Our guts do a whole lot of important work. Our small intestines play a role in up-taking nutrients from the food we eat and then shuttling those nutrients around for use in the rest of the body. The large intestine is important to maintaining fluid and electrolyte metabolism (like salt, potassium, and magnesium) while also digesting the more fibrous foods we like to eat. Both the small and large intestine are home to bacteria that help maintain our internal ecosystem. These bacteria are thought to play a role in: The digestion of nutrients, our ability to fight infections (most of our immune system is located in the gut!), and are thought to play a role in our mental health as well.

Principle no.10 of Intuitive Eating (IE) is “honour your health with gentle nutrition”. There’s a reason that this principle is last. So if you’re still working through your relationship with food, keep working through the principles! “Healthy eating” really needs to be put on the back-burner for a short while – I know this might sound a little odd coming from a Dietitian.

In light of ‘honouring health’, Atlas Biomed asked me to try out their microbiome testing kit. They’re on a mission to drive the movement towards preventive healthcare with technology that helps people understand their gut. They’re the only company in the UK to have MHRA approval to sell gut tests directly to consumers – this means they are regulated for safety, quality, and effectiveness and are supported by Gov.uk.

After receiving my home test kit, I posted a very small sample of my poop off to the lab in a pre-paid box. My results came back in 5 weeks. I was fascinated to see that my microbiome diversity level was just above average, that I’m a “veggie muncher”, and that my risk of certain disease is “average” to “low”. It was also interesting to see the long lists of the bacteria in my gut!

So what’s the low down? Are these tests worth your money? I will let you decide.

Pros:

• It’s fascinating to get a glimpse into the diversity of bugs in my gut.
• It could be interesting to compare test results month on month.

Cons:

• No standards of ‘normal and healthy’ exist for the gut microbiota.
• When assessing risk of disease based on gut microbiome, there’s a huge chicken-and-egg question involved.
• There is little understanding for what healthcare professionals can recommend off the back of these results that would be different to current dietary recommendations for health individuals which are to increase our variety of fibre containing foods.
• The recommendation and insight could be triggering for someone with disordered eating/eating disorders.

What will change for me off the back of this? Not much! As per the current recommendations to improve gut bacteria in a healthy individual, I will continue to be a “veggie muncher”, finding tasty and exciting ways to add different fruits, veggies and fibrous foods to my diet amongst munching on other tasty fun foods too!

So now you may be wondering, what can you do specifically to support your gut health outside of taking a test?

Here are 4 dietary strategies to support your gut

1. Enjoy those fruits and veggies! Fruits and vegetables are high in vitamins, minerals, and fiber that not only support our gut health but support our whole body. Incorporating a few fruit and vegetable sources throughout the day has been shown to promote the health of your gut. Consuming increased amounts of these foods have been shown to be associated with lower risks of colon cancer too!

2. In addition to increasing dietary fiber through fruits and vegetables, you can increase dietary fibre through the consumption of whole grains! Oats, whole grain breads, brown rice, and quinoa are all examples of whole grains you could give a try.

3. Probiotics are another means of improving gut health. When you think probiotics, think fermentation! These foods include yogurt, kimchi, kefir, miso, and sauerkraut. These are microorganisms that support gut health. Some health-food stores may sell probiotics in a pill form, but they are rather expensive. We also don’t know what combination of these microorganisms and at what dose are necessary to promote health and what microorganisms don’t really help. Therefore, for healthy individuals, it is recommended to take a food-first approach and include probiotics from food sources rather than a pill.

4. We have discussed probiotics and how having those in your diet are good for your gut health, but what supports probiotics? Prebiotics are microorganisms that support the health of the probiotics, which ultimately support us. Not all fiber sources are prebiotics but most prebiotics are a source of fibre.* Sources of prebiotics include many different fruits and vegetables, like; apricots, dates, dried figs and mango, watermelon, asparagus, beetroot, leeks, okra, onions, almonds, pistachios, rye, spelt, cashews, chamomile tea, silken tofu, fennel tea, and legumes.

One thing that is unique about the Atlas Biomed microbiome test is that they remove some of the guess work for you. They were able to provide me with some more insight into my own personal microbiome diversity and made recommendations on which foods I could opt to include in my diet to increase the diversity of my microbiome. It looks like meals with marrow, pumpkin, garlic, and walnut are on the cards for me!

If you want to know more ways to support not only your gut health, but your overall health through gentle nutrition, seek out the help of your local registered dietitian. Because this article cannot replace individualised recommendations. We would love to help!

*Hannah D. Holscher (2017) Dietary fiber and prebiotics and the gastrointestinal microbiota, Gut Microbes, 8:2, 172-184, DOI: 10.1080/19490976.2017.1290756

Note: This article was written as a paid partnership with Atlas Biomed. 

Is the Game Changers credible?

Let’s discuss some of the claims, faults, and truths of the Game Changers Movie.

Are eating plants good for us?

Will transitioning to a plant-based diet give you more athletic endurance?

Plant-based sources of protein like beans, pulses and other starches do not contain all the essential amino acids that our bodies need. To achieve a balanced diet, a variety of plant-based protein sources are required. These plant-based protein sources, tend to naturally contain more carbohydrates. So eating a low-carbohydrate vegan diet would be next to impossible.

What about the doctors featured in Game Changers who swear by vegan diets?

Does eating meat hurt how blood flows throughout the body?

Does eating plants help endothelial function?

Can I get enough protein on a vegan or vegetarian diet?

Is a plant-based diet vegan?

Take home message from the Game Changers:

• Veganism and vegetarianism are acceptable ways to eat.
• Veganism and vegetarianism are not for everyone.
• Eating more of the plants we like to eat, regardless of whether we eat meat, is good for our health.
• Documentaries like The Game Changers or What the Health are often sensationalised and use language that can be fear-mongering.
• While studies have found there to be a reduced risk of certain health conditions when following a vegetarian or vegan diet, this is observational data. This means that large groups of people are followed/observed over time and associations are made. This sort of data cannot speculate that the vegan diet caused the person to be more healthy or have reduced risk of certain health conditions. We can only make associations. We also know from population data that those who follow vegan-based diets,  then to be more “health-conscious” in general. So is it all about the diet? Or is it that they engage in other health-promoting behaviours? For example not smoking, moving more, using strategies to reduce stress etc.

It feels like everyone and their brother has been at this place: They’ve gone on a diet, lost some weight, and despite their best efforts, the weight and more may have come back on. With this, family or their doctor may have said, “Well, they probably just got tired of the diet” or say something silly about willpower. But is the answer really that simple? Why is it that most people can’t keep it off?

There is an idea called set-point theory and it theorises that every unique individual has a weight range their body likes to be at. Some people’s bodies may stay at the lower end of the spectrum while other bodies may stick to a higher size.

This idea is a bold statement.

How could potentially a body be meant to be large?

A multibillion-dollar diet industry has even been built upon this idea that large is unhealthy and we must become smaller for the sake of health.

But if set point theory is true, wouldn’t that mean some people are just high weight and that is that?

Let’s see what the science says…

The Science of our body weight

Scientists have noticed for some time that our weight loss methods aren’t effective in the long term. In a study published twenty-five years ago, scientists who recognised the futility of dieting decided to see what happened when they made subjects in two groups either lose 10% of their body weight or gain 10%.* After measuring how much energy the participants used (like how many calories they needed in a day) they divided the groups and measured how their energy needs changed after weight loss or gain.

The results?

In the first group, after gaining 10% of their body weight, something happened. Their bodies adjusted how much energy they were using. The weight gain was correlated with their bodies using up more energy than they were previously. The participants fell back down to their usual weight. Those who lost 10% of their body weight saw the opposite effect. Their bodies started using less energy. The participants in the weight loss group once again went back to their usual weight.

In summary: The energy usage of the study participants bodies changed to either be more or less efficient so the participants would bounce back to their usual size. 

This study was back in 1995. That could mean one of two things:

1. It is now outdated
2. It was an early indication that body size management was much more complex than diet and exercise.

In more recent years, scientific studies have not only found similar results to the 1995 study but have gone a little further.

More Science – The Biggest Loser Show

There is a famous study that looked at the metabolism changes of participants who were on the television show, The Biggest Loser. For those of you who are unfamiliar with the show, it is a weight loss competition. In this study, we saw further indication for set-point theory, but also realised that set point, rather than being a single number, is on a sliding scale and may change with years of dieting.

The participants in the study had all, but one person, regain a significant amount of weight back by the time of the 6-year follow-up.**

The one participant who hadn’t regained a significant amount of weight had a medical procedure called a gastric bypass or weight loss surgery. There is some scientific thought that for an unknown reason, a gastric bypass impacts the body’s ability to use energy differently than from standard dieting. They were more likely to keep the weight off (you can read additional information on bariatric surgery at the bottom of this article).

Regardless, the important findings of this study showed that the participants who hadn’t received gastric bypass surgery had changes to their metabolism that seemed bent on having them not keep the weight off. Those who had the most, “success” over time at maintaining their weight-loss, had proportionally greater slowing of their metabolism. In other words, they needed consume fewer and fewer calories as time went on in order to keep it off.

In summary: Their bodies were bent on altering their metabolisms to stop them maintaining the lower size. Keeping off the weight loss therefore required an extreme amount of attentiveness. We see that the longer the weight loss is maintained, the greater the human body will try and counteract that loss through the slowing of the metabolism.

Other factors involved in maintaining body size include shifts in hormones such as ghrelin, a hormone related to hunger. Ghrelin increases during weight loss causing increased hunger, designed to make us eat more and store more body fat. These are survival mechanisms when it comes down to it. Your body doesn’t know the difference between a long-term famine or a short-term diet.

What about genetics?

One way for scientists to control for genetic influences in their work is to study twins. One example of this is a scientific research article entitled, “Does dieting make you fat? A twin study”.*** The twins that partook in intentional weight loss pursuits gained more weight over time than their twin. In females, this result was even steeper. With every attempt of intentional weight loss, the researchers saw proportionally greater weight gain. These results didn’t change after the researchers controlled for factors like BMI, social class, and smoking.

In summary: The study concluded that more dieting resulted in more weight regain. These findings provided further indication that dieting had the opposite result of its intent.

What about NEEDING weight loss for Type 2 Diabetes management?

This is interesting in the context of conditions like type 2 diabetes where intentional weight loss is a normal recommendation for treatment. An intensive lifestyle study aimed at weight loss in the scenario of type 2 diabetes was actually discontinued. Why you ask? The efforts were labeled as “futile” by the researchers after the intervention had not impacted rates of heart disease related outcomes.****

In fact, we know that since there isn’t a method of sustainably maintaining a lower size, regain after dieting will likely occur. According to Lauren Newman, RD.

“Weight cycling (yo-yoing) increases insulin resistance and I never see that acknowledged in the diabetes world.”

Weight cycling occurs with repeated weight gain and loss over time. If there isn’t a scientifically proven weight loss diet to work, we are essentially sending these patients down a path of yo-yo dieting without considering the consequences yo-yoing holds to insulin resistance.

Overall, due to our body’s complicated mechanisms of maintaining our present body size, there seems to be minimal chance of keeping the weight off. Efforts should be put into behaviours that can be controlled, such as dietary changes, participating in joyful movement, stopping smoking, and reducing alcohol intakes. Body size is not a behaviour.

In summary

Difficulty in keeping the weight off can be due to a multitude of factors: from the discontinuation of the diet due to unsustainability, genetic conditions, to of course set-point theory.

In the consideration of the achievability of keeping the weight off, the set-point theory cannot be overlooked. We know our body changes in response to restriction and excess, that dieting is associated with greater weight gain over time, and that in the long-term diets fail 95-97% of the time.

All of this information should come together to indicate that our bodies will fall where they want to fall in the context of food freedom. Unrestricted eating in the intuitive eating framework is an opportunity for folks to land on their body’s current set point in way that protects mental and physical well-being. Our bodies are meant to change and adapt over time. Set-points are not a notion of one stable number, but rather the acknowledgement that at different points of your life, after facing varying and unique exposures, your body will make adaptations to achieve the size it is comfortable being.

References

*Rudolph L, Rosenbaum M, Hirsch J. Changes in Energy Expenditure Resulting from Altered Body Weight. New England Journal of Medicine. 1995;333(6):399-399. doi:10.1056/nejm199508103330628.

**Fothergill E, Guo J, Howard L, et al. Persistent metabolic adaptation 6 years after “The Biggest Loser” competition. Obesity. 2016;24(8):1612-1619. doi:10.1002/oby.21538.

***Pietiläinen KH, Saarni SE, Kaprio J, Rissanen A. Does dieting make you fat? A twin study. International Journal of Obesity. 2011;36(3):456-464. doi:10.1038/ijo.2011.160.

****Cardiovascular Effects of Intensive Lifestyle Intervention in Type 2 Diabetes. New England Journal of Medicine. 2014;370(19):1866-1866. doi:10.1056/nejmx140022.