[HN Gopher] Gut microbe linked to depression in large health study
       ___________________________________________________________________
        
       Gut microbe linked to depression in large health study
        
       Author : pella
       Score  : 257 points
       Date   : 2022-02-06 18:29 UTC (4 hours ago)
        
 (HTM) web link (www.science.org)
 (TXT) w3m dump (www.science.org)
        
       | wdwvt1 wrote:
       | Gut microbiome researcher here - not involved in this study but
       | happy to answer questions or dig in with anyone interested!
        
         | [deleted]
        
         | goodpoint wrote:
         | People are sharing anecdata around improving their biome by
         | eating sauerkrauts and nobody asked you any question yet...
         | this is sad.
        
         | antiterra wrote:
         | Is there evidence of gut biome activity directly interacting
         | with the mesh of nerves in our digestive tract?
        
           | wdwvt1 wrote:
           | Absolutely - the chemicals that microbes make in the gut pass
           | into your blood stream and from there access the entire body.
           | There are mechanisms the body uses to ensure these chemicals
           | are detoxified (phase I and phase II metabolism in the liver)
           | and that they are excreted if they reach too high a
           | concentration.
           | 
           | More locally, the enteroendocrine cells
           | (https://en.wikipedia.org/wiki/Enteroendocrine_cell) that
           | line the gut translate much of the internal nutrient state of
           | the gut up to the brain to tell you things about if you
           | should eat, etc.
           | 
           | There is a lot of research on how we could alter satiety by
           | finding the right language that these cells use. There are
           | approved drugs on the market that mimic the activity of these
           | cells (incretin mimetics) to reduce appetite/weight control.
        
         | ninesnines wrote:
         | Hi!
         | 
         | Thanks a ton - super curious research. What determines if
         | individuals get Morganella and Kiebdiella bacteria? Is it
         | genetic or can it be impacted by the food we eat?
         | 
         | What is the mechanism of how these bacterias interact with the
         | brain through the enteric system?
         | 
         | Thank you!
        
           | wdwvt1 wrote:
           | Fascinating question - also not totally known.
           | 
           | We know that microbes colonize the gut in a somewhat
           | predictable way as a function of age. As a newborn your gut
           | is largely dominated by Bifidobacteria, and this slowly
           | transitions to a more complex community over the next several
           | years of life. Events like early childhood antibiotics,
           | malnutrition, other disease, etc. can alter this trajectory.
           | Interestingly this kind of ecological succession seems to be
           | driven by an interplay of both immune maturation (as your
           | immune system matures it starts being more selective about
           | who it tries to let in) and by chemical processes. The gut
           | becomes more anaerobic as the number of bacteria increase
           | (and transition away from the Bifido dominated state) and
           | that has a strong selective effect on the microbes that will
           | grow well.
           | 
           | For specific commensal bacteria we know some of the
           | mechanisms of colonization - there are particular genetic
           | programs that bacteria turn on when they sense they are in
           | the gut to enhance their ability to be retained and not
           | washed out. These programs include physical attachment,
           | motility, and chemical signalling to try to dampen the local
           | immune response.
           | 
           | Pathogens are extremely good at getting in to the gut despite
           | our best attempts at keeping them out. Salmonella typhimurium
           | is notoriously adept at colonizing the host - the infectious
           | dose you need is maybe 10 microbes taken orally in a
           | susceptible host (compare that to 10 billion microbes/capsule
           | in a probiotic).
           | 
           | For these specific bugs I don't know that much. I am excited
           | to read more.
        
         | happylion0801 wrote:
         | At the current pace of research and studies, when do you think
         | we could expect to see something come to 'market' that could be
         | used - first as a diagnosis and then as a
         | treatment/medication/technique.
         | 
         | As someone with IBS - right now I feel like there is no clear
         | 'problem' defined for it. You are just categorized by the
         | doctor (Rome 3 or whatever) and people go through various
         | tests, medications, non-fda approved stuff to see what works.
         | 
         | I am eagerly looking forward to some progress in this area to
         | hopefully fully understand whats going on and get a proper
         | diagnosis
        
           | wdwvt1 wrote:
           | There are a variety of strategies being pursued to make
           | pharmaceutical products out of microbiome research. Broadly
           | those are: 1: "bugs as drugs" - genetically engineered
           | microbes that perform some function. The idea here is that
           | having the microbe in situ performing some function will be a
           | much better way to administer a particular compound (or set
           | of compounds), or remove a compound, than a traditional
           | pharmaceutical. Large pharma companies have studied
           | phenylketonuria as a metabolic disease for which the bugs as
           | drugs approach would be great. Find a microbe that consumes
           | phenlyalanine at a high rate and administer it at high levels
           | (or get it to stably engraft in the host) and you have a
           | treatment that would be vastly better than current dietary
           | regimes. 2: "community engineering" - this takes many forms
           | from fecal transplant, to trying to engraft a certain small
           | cocktail of strains, to altering what the in situ community
           | is doing by feeding a probiotic. The idea here is that there
           | are tens of thousands of metabolites that microbes are
           | producing in the gut, and by balancing or tailoring the set
           | of metabolites that are made, you can improve health. Fecal
           | transplants have good data for clearing recurrent C. diff in
           | phase III clinical trials - this is the best developed of the
           | microbial therapeutic strategies currently. Everything else
           | is phase I or before. 3: "microbial natural products" - this
           | is the world I work in (shameless self-promotion - if you
           | want to come work at a very early stage microbiome startup
           | email me at will@interface.bio). The idea here is to find the
           | particular chemicals/metabolites that microbes make that have
           | positive influences on our physiology. Most research here is
           | focused on immune conditions, metabolic syndrome/dietary
           | stuff, though there is increasing interest in depression and
           | other conditions.
           | 
           | At a broad scale, I would say it will be 1-2 years before
           | fecal transplants receive approval as a therapy for recurrent
           | C. diff infection, at least 5 years before a bug-as-drug will
           | be available, and at least 7 years before a microbe-derived
           | natural product is on the market as a pharmaceutical. It
           | takes an incredible amount of work to get from these
           | associational studies to a pharma-grade product.
           | 
           | In the interim, I think there will continue to be a bunch of
           | diagnostics and probiotics companies that (IMO) are bordering
           | on absolute nonsense. There is very little predictive value
           | to the tests supplied by most of these companies, and the
           | data on probiotic efficacy is bad in humans. There is good
           | evidence of probiotic and prebiotic effectiveness in animal
           | husbandry (e.g. fish and livestock) but the data just aren't
           | there in humans.
        
             | happylion0801 wrote:
             | Thank you, appreciate the breakdown. With so much focus on
             | the gut research recently I feel like we are on the cusp of
             | bringing together lots of things and new understandings and
             | that hopefully happens soon
        
           | james-skemp wrote:
           | Also have an IBS diagnosis.
           | 
           | Had a great doctor that helped me get started, after many
           | that did a shoddy job, and this has been my experience as
           | well.
           | 
           | Very much a 'seems like IBS, try low FODMAP, see what works
           | and doesn't via experience,' which was pretty
           | amazing/alarming how little is understood about our guts.
           | 
           | I'd love to know when the science is going to start catching
           | up. Especially since I think it'll be interesting to find out
           | if something has been added to our diets that's causing an
           | increase in intolerance over the last decade+.
        
             | happylion0801 wrote:
             | > Very much a 'seems like IBS, try low FODMAP, see what
             | works and doesn't via experience,' which was pretty
             | amazing/alarming how little is understood about our guts.
             | 
             | Yes exactly this.
             | 
             | > Especially since I think it'll be interesting to find out
             | if something has been added to our diets that's causing an
             | increase in intolerance over the last decade+.
             | 
             | One thing I read is that western diets severely lack in
             | fiber which usually leads to loss of microbiome diversity
             | [1]. But studies like this are still early stages, we need
             | targeted results based on all this to really have any
             | effect.
             | 
             | [1] https://nautil.us/how-the-western-diet-has-derailed-
             | our-evol...
        
             | fodmap wrote:
             | I'm in the same boat as you. After some clueless doctors,
             | I'm in the 'try low FODMAP' phase currently, and for the
             | first time I'm improving.
             | 
             | I mean, we know there isn't a cure for now but it's good to
             | have something similar to a 'normal life' again.
             | 
             | I also have my fingers crossed waiting for science to do
             | its job.
             | 
             | I share your suspicion about current Western diets.
        
         | steelstraw wrote:
         | Is there a good way to test one's own gut microbiome? To
         | determine how healthy it is or isn't, and to track how it
         | changes over time. Basically I want to be able to tell how my
         | diet and things like antibiotics affect it.
        
           | wdwvt1 wrote:
           | I think it's really hard - we don't know what a healthy state
           | of the microbiome is. There is likely a lot of individuality,
           | what is healthy for me is maybe not healthy for you. This
           | probably has to do with early life immune system development
           | and what we were exposed to as kids.
           | 
           | At a high level we know that diversity of microbial species
           | in the gut (but for instance, not in the vagina) is linked to
           | better overall health state. Is this because of the microbes?
           | Probably not, it's probably that the microbes are a
           | sensor/responding to an overall healthy diet/ecosystem.
           | 
           | In general, there are commercial services to track your
           | microbiome and they are interesting from a data perspective,
           | but I am not sure you will get much health information out of
           | them.
           | 
           | We know the answer to a healthy diet - there are no microbial
           | talismans - but it's just not sexy. Eat lots of plants, less
           | sugar, and exercise. I wish it was as easy to follow this
           | advice as it is to write haha.
        
             | Jare wrote:
             | Wonder what evolutionary mechanisms made us (in general)
             | enjoy food that's bad for us a lot more than the one that's
             | good.
        
         | sprkwd wrote:
         | What are your thoughts on Biomel, Symprove, etc in helping the
         | gut biome?
        
         | EL_Loco wrote:
         | Regarding your advice on eating plants, do you know if it
         | matters wheter they are cooked or eaten raw? I mean, is one
         | preferable over the other, from a gut biome perspective. By the
         | way, thanks a lot for your answers!
        
         | sddat wrote:
         | What supplements do you take based on your scientific
         | background?
        
         | abootstrapper wrote:
         | What is the "gut?" Colon, small intestines, stomach, all of the
         | above? If gut microbiome affects mood, what happens if someone
         | has a total colectomy?
        
         | pknight wrote:
         | Weird question perhaps, some research suggests that bacteria
         | source nutrients from the cell lining in the gut if there is an
         | absence of sufficient nutrients from the food coming into the
         | digestive system. (example:
         | https://www.cell.com/cell/fulltext/S0092-8674(16)31464-7)
         | 
         | That made me wonder what the triggers might be, since the
         | studies see the corroding effect appear in diets deficient in
         | polyphenols/insoluble fibres. At what interval do microbes need
         | nutrients and is simply eating a highly-processed snack that
         | has nothing much to offer bacteria in the gut a possible
         | trigger in itself?
        
           | wdwvt1 wrote:
           | Fascinating question - and not one whose answer is known.
           | 
           | Fiber is good for microbes merely by the virtue that humans
           | lack the glycan-degrading enzymes that are necessary to break
           | it down, so it reaches the colon intact where the microbes
           | can eat it. Humans can digest starch (though it can be
           | physically and chemically modified to be harder to digest)
           | but not the hundreds of other types of fibers that are found
           | in a traditional diet.
           | 
           | I think there is good research that shows that higher fiber
           | diets are associated with lower risk of developing a range of
           | metabolic and immune pathologies, but the particular
           | mechanistic linkages are so subtle that it will require
           | absolutely massive studies to identify them. In general, we
           | know that humans used to eat a much higher fiber diet (e.g.
           | the Hadza people eat 70-150 grams of fiber a day), and we
           | believe that produces a much healthier microbial composition.
           | 
           | The paper you cited is really interesting! I haven't read it
           | - but the overall idea that the mucus lining of the gut can
           | be degraded by microbes who are sourcing carbon, energy, and
           | nitrogen from it is well established.
           | 
           | I think there is consensus that some amount of gut barrier
           | integrity is due to microbial signals. This occurs in two
           | ways - 1) our epithelial cells sense microbial products
           | (proteins, carbohydrates, etc.) and respond by tightening the
           | junctions between them. The overall idea being that you want
           | to keep the bacteria in the colon, but you must balance some
           | level of nutrient flow. 2) The goblet cells which produce
           | mucus in the gut, respond to microbial signals to increase or
           | decrease their mucus production.
           | 
           | There is a lot of research going on trying to understand how
           | certain diets cause defective mucus production and in turn
           | how that can allow microbes to get to close to the epithelial
           | lining (usually the mucus is ~100 microns thick) which
           | results in inflammation.
           | 
           | Recent evidence of another function of microbial activity in
           | the gut of hibernating animals. In short, it appears that
           | they help the host supply enough nitrogen for maintaining
           | muscle mass during hibernation:
           | https://www.science.org/doi/10.1126/science.abh2950
        
             | pknight wrote:
             | Very interesting, thank you for answering!
        
         | Herodotus38 wrote:
         | In your opinion, what is the best study that shows direct
         | evidence that changes in gut flora can change health outcomes
         | (preferably something that is a randomized control study). The
         | only area I feel comfortable that good data exists is in the
         | setting of fecal transplants for refractory clostridioides
         | difficile infection. Thanks.
        
           | wdwvt1 wrote:
           | I think you hit it on the head - the C. diff stuff is good
           | and will meet FDA criteria soon (the phase III data from
           | ECOSPOR was good:
           | https://www.clinicaltrials.gov/ct2/show/NCT03183128).
           | 
           | In general we only have mouse or other animal data for other
           | indications.
           | 
           | There are retrospective analyses of patient cohorts receiving
           | anti-PD1 or anti-CTLA4 therapies which have identified
           | certain microbiome states as supportive of those therapies. I
           | believe that these are probably real effects, though I don't
           | think the particular microbes matter - instead I think it's
           | the metabolites they produce and how those influence resting
           | immune state
           | (https://www.science.org/doi/10.1126/science.abf3363 - but
           | you can find many more).
           | 
           | A paper I really like shows that a specific protein from a
           | common gut microbe (Akkermansia muciniphila) confers
           | resistance to diet induced weight gain, insulin
           | insensitivity, etc.
           | (https://www.nature.com/articles/nm.4236).
           | 
           | In general, I think the majority of microbiome work has been
           | associational and demonstrative of the kind of hypothesis-
           | free science that is prone to all sorts of statistical
           | artifacts and misaligend incentives between truth-finding and
           | paper publishing (garden of forking paths, file-drawer
           | effect, etc. etc.)
        
       | antiterra wrote:
       | If you're like me and somehow missed out that there's an
       | significant mesh of neurons in your guts that's capable of
       | independent neurotransmitter release, you should look up the
       | enteric nervous system.
       | 
       | Intuitively, at least, it seems to make sense of all the 'gut'
       | connections to mood.
        
         | musingsole wrote:
         | It's been described as a "cat's brain" equivalent of neurons.
         | Largely seems attached to regulating various rhythms of the
         | gut, but who knows what computations it could be influencing.
        
           | stjohnswarts wrote:
           | Considering how often my cat manages to outsmart me I'd say
           | that is a significant amount of neurons.
        
       | vletal wrote:
       | Is this really the causality. Could it be the other way around?
       | Depressed people might in time develop bowl disorders?
        
       | hirako2000 wrote:
       | or depression causes this bacteria to proliferate more easily? I
       | see nothing in that research showing causation. It doesn't
       | invalidate their correlation though.
        
         | msrenee wrote:
         | Do they claim causation anywhere? All I see is them saying
         | there appears to be a link.
        
         | charisma123 wrote:
         | "One of them, Morganella, was significantly increased in a
         | microbial survey of the 181 people in the study who _later_
         | developed depression."
         | 
         | they would have been diagnosed with depression first leading to
         | increase in morganella, if it was the other way around? agree
         | this could be correlation, but I guess thats why they say that
         | the field is still in its infancy.
        
         | mateo1 wrote:
         | That's my thinking as well. Depression leads to lifestyle
         | changes which includes dietary changes which can cause certain
         | bacteria to grow faster, as your gut bacterial makeup changes
         | constantly based on what kind of food you consume and which
         | microorganisms are specialized for it.
         | 
         | I think there will be some breakthroughs by studying the human
         | microbiome, for example there could be reasons that a
         | moderately harmful microorganism or strain becomes dominant in
         | your gut for whatever reason and causes problems, but from my
         | personal anecdotal experience with gut health and diet, I
         | believe most issues will still be solved with dietary changes
         | and perhaps some targeted antibiotics or antimicrobial
         | treatments in general.
         | 
         | I'm also willing to bet we'll discover a lot of immune
         | involvement in the regulation of various bacterial population
         | in the gut. There must be an adaptive system that minimizes or
         | eliminates most harmful organisms in the gut, otherwise we'd
         | all be dead.
        
       | fnord77 wrote:
       | as the article states, this was suspected or known for at least
       | 15 years.
       | 
       | Has anything actionable (treatment-wise) come of it?
        
       | testemailfordg2 wrote:
       | Strange coincidence, just last night drank milk kefir and woke up
       | feeling much more lighter in my head...Guess I know the reason
       | now...
        
         | grp000 wrote:
         | I've found kefir to be useful myself, but only after a few
         | weeks of daily consumption.
        
       | exdsq wrote:
       | I assume Tom Brady retired to make an income from the spice
       | malange on the back of this news
        
       | animal_spirits wrote:
       | Since diet can affect the microbiome of the gut and I can't
       | imagine how gut bacteria affect moods (although I'm open to the
       | idea I suppose) I'd wager it is actually diet and nutritional
       | input that affects mood as well as the gut bacteria. Makes more
       | sense to me that your mood can be affected by your diet, and what
       | we are measuring is the altered microbiome of the gut because of
       | the diet.
        
         | eightysixfour wrote:
         | As mentioned in the article, there is already a causal
         | hypotheses for why the biome itself is the cause, certain
         | people have strong immune responses to the products of these
         | bacteria which causes a chronic inflammatory response.
        
         | tejtm wrote:
         | ..." I can't imagine how gut bacteria affect moods"...
         | 
         | But you can imagine looking at a picture and feeling hungry.
         | 
         | In addition to our fast new electrical nervous system for rapid
         | response there is the older slower endocrine system from when
         | we were just bags of chemicals coordinating with concentration
         | gradients (still are, but were).
         | 
         | visual -> brain -> signals gut -> gut makes molecules to get
         | ready -> molecules detected report to brain -> you drool
         | 
         | Moods depend on the chemical balance of small molecules
         | bacteria eat sleep and poop small small molecules.
         | 
         | To consider that after billions of years of coexisting we, both
         | multi cell & single cell, have not adapted to responding each
         | others's small molecules is unthinkable
        
         | roywiggins wrote:
         | You wouldn't expect a fecal transplant to help if the bacteria
         | were entirely incidental though.
        
           | PragmaticPulp wrote:
           | Two patients and no control group is virtually useless for
           | drawing any conclusions:
           | 
           | > Indeed, researchers recently reported in Frontiers in
           | Psychiatry that fecal transplants improved symptoms in two
           | depressed patients.
           | 
           | Depression research is challenging because even placebo
           | groups tend to have dramatic improvements.
        
             | robocat wrote:
             | > Two patients and no control group is virtually useless
             | for drawing any conclusions
             | 
             | That is a frequentist argument.
             | 
             | If the response to treatment is significant enough, then
             | that is a worthwhile signal (cliche: parachutes save lives
             | without a control group).
             | 
             | Placebo is an obvious contender. However presuming the
             | patients had a chronic condition with plenty of previous
             | interventions, then the placebo effect has had plenty of
             | chances in the past. If it were due to placebo then there
             | would be something to learn about why the placebo effect
             | were so effective in that situation!
        
         | sushid wrote:
         | So... you can imagine how gut bacteria affect mood after all?
        
           | winrid wrote:
           | I wonder which gut bacteria make me crave cheap Mac and
           | Cheese...
        
             | galangalalgol wrote:
             | It seems like you are joking, but many of the fecal
             | transplant patients report their food preferences changing,
             | sometimes dramatically.
        
               | winrid wrote:
               | Half joking. I do wonder about how the bacteria
               | influences cravings, and if sometimes a craving means I'm
               | missing some kind of vitamin/mineral.
        
           | taeric wrote:
           | To be fair, I think the parent is that they expect that both
           | are affected in similar ways. That is, gut biome is an
           | effect, not an affect with regard to mood.
           | 
           | The sibling point that treatments targeting the biome would
           | be expected to fail, if that were the case, is complication.
        
         | manmal wrote:
         | If you believe that nutritional input has an effect on mood,
         | then, by proxy, you also believe that the microbiome has an
         | effect. We have outsourced a lot of food preprocessing to gut
         | microbes, and if they are wiped out, then you'll suffer from
         | malnutrition.
        
         | antiterra wrote:
         | There has been scientific recognition of the gut affecting
         | brain function for well over 100 years. This might help it make
         | more sense:
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772764/
        
       | mrfusion wrote:
       | But could the causation be in the opposite direction?
        
       | fulafel wrote:
       | This is a bacterium that is killed by antibiotics, right?
       | Interesting that the effect wasn't noticed before.
        
       | yoyar wrote:
       | I think the causal nature of this relationship is way
       | overestimated.
        
         | antiterra wrote:
         | I'm curious, why do you think that?
        
           | potatoman22 wrote:
           | Playing devil's advocate, do we have any reason to believe
           | that people who are genetically more succeptible to
           | depression aren't also more likely to have this sort of gut
           | via genetics? That would result in this correlation.
           | 
           | Perhaps improving your gut biome wouldn't actually help with
           | depression?
        
             | antiterra wrote:
             | If people with depression have this sort of gut, that still
             | doesn't establish directional cause or mechanism.
             | 
             | The semi-autonomous nervous system in our guts, the
             | microbes in our guts, and our central nervous system have
             | complex chemical signaling interactions. Neurotransmitters
             | linked to effects on mood are generated by the gut.
             | Therefore, the brain can signal to the gut that it should
             | release neurotransmitters, and the gut can release those
             | neurotransmitters itself.
             | 
             | Because of this interaction, it's possible the 'culprit'
             | for depression is behavior by the brain, microbes on the
             | gut, the gut itself, or the brain-gut interaction (Or any
             | combination of the four.)
             | 
             | A good summary of our understanding of these mechanisms is
             | at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772764/
        
             | yoyar wrote:
             | Agreed. No one knows.
        
       | EasyTiger_ wrote:
       | I thought this had been known for a while?
        
         | eightysixfour wrote:
         | From the article:
         | 
         | > Morganella has already been implicated in depression. As far
         | back as 2008, researchers investigating a possible link between
         | depression and inflammation found depressed people had stronger
         | immune responses to chemicals produced by Morganella and other
         | gram-negative bacteria in the gut. Thus, the newest study seems
         | to be "further proof" that inflammation caused by gut microbes
         | can influence mood, Gilbert says.
        
       | annoyingnoob wrote:
       | Then there is this: https://www.npr.org/sections/health-
       | shots/2022/02/06/1074719...
       | 
       | Zap your head or a fecal transplant? Choices, choices.
        
       | bell-cot wrote:
       | > ... When it came to depression, two bacteria [...],
       | _Morganella_ and _Kiebdiella_ , seemed to play a causal role,
       | [...] _Morganella_ has already been implicated in depression. As
       | far back as 2008 ...
       | 
       | This situation looks _relatively_ simple to me - start searching
       | for bactiophages which are specific to _Morganella_. Briefly test
       | those in animals, then try them on a few volunteers who both are
       | suffering from profound depression and seem to have very high
       | _Morganella_ levels in their guts. (While giving  'em fecal
       | transplants from depression-free relatives and monitoring them
       | intensively and such.)
       | 
       | If that shows promise, then you might really have something
       | (minus a _whole_ lot more testing  & refinement & such). If
       | not...maybe back to the drawing board.
        
       | phantom_oracle wrote:
       | Perhaps Westerners view all non-western science as pseudoscience
       | or made up, but it is a well-known fact in many Eastern cultures
       | (and their medicinal practices) that the stomach is a primary
       | source of disease (and not just depression, but all kinds) when
       | abused through bad eating habits.
       | 
       | Then the wheel is re-invented with intermittent fasting, a diet
       | with less processed foods, more veg/fruit, less meat, etc.
       | 
       | Whenever I see articles about health on HN, I no longer take them
       | too seriously because the reductionist approach to medicine is
       | why people get mistreated for symptoms instead of the disease.
       | 
       | Even the ancient Greeks (the so-called birthplace of "western
       | knowledge") took a more holistic approach than what the sketchy
       | for-profit medical/pharmaceutical cabal does.
       | 
       | But of course, we need to take it seriously because "the
       | scientists say so", even though their own research system is so
       | badly broken that a for-profit cabal runs the publishing arm of
       | research.
       | 
       | Strange times we live in.
        
         | CapitalistCartr wrote:
         | "Western Science"'s insistence on procedure, double-blind
         | studies with control groups, finding provable reasons why, etc.
         | have debunked most of pre-modern medicine. That some elements
         | have withstood the test of close examination is not a criticism
         | of our methods, more a validation. As are stunning improvements
         | in life.
        
       | belltaco wrote:
       | What if depression was causing the gut microbe changes? Like it
       | was recently found with autism and gut changes.
       | 
       | https://cosmosmagazine.com/health/body-and-mind/autism-gut-m...
        
         | thih9 wrote:
         | Note that the original article mentions:
         | 
         | > "researchers recently reported in Frontiers in Psychiatry
         | that fecal transplants improved symptoms in two depressed
         | patients"
        
           | smt88 wrote:
           | That doesn't disprove that depression caused the microbial
           | imbalance in the first place.
           | 
           | It's very reasonable to think that a lot of these systems are
           | bidirectional, and for any individual, you may not know which
           | part of the body was dysfunctional first.
        
         | kibwen wrote:
         | From the beginning of the article:
         | 
         |  _" Whether those microbial deficits actually help cause the
         | disorders is unclear, [...]"_
         | 
         | For the time being it appears to be careful in only suggesting
         | correlation, not causation.
        
       | zabzonk wrote:
       | > Thus, the newest study seems to be "further proof" that
       | inflammation caused by gut microbes can influence mood
       | 
       | Of course it bloody can - if you have IBS or any number of other
       | gut-related problems, believe me you are very likely to be
       | depressed, because the symptoms of these are very nasty and
       | humiliating. This does not mean that the bacteria are directly
       | affecting the CNS.
       | 
       | Also:
       | 
       | > Kiebdiella
       | 
       | It's Klebsiella
        
         | wutbrodo wrote:
         | It seems pretty obvious from reading the article in its
         | entirety that the claim is that the inflammation is affecting
         | mood directly, not via nasty and humiliating gastro symptoms.
        
           | zabzonk wrote:
           | How would you differentate between the two?
        
         | asdfman123 wrote:
        
           | zabzonk wrote:
           | No. https://en.wikipedia.org/wiki/Klebsiella
        
       | zackmorris wrote:
       | Just another data point, but my journey through digestive issues
       | and recovery was kicked off by the worst depression and burnout I
       | ever experienced, which started in 2019 and lasted 3 years.
       | 
       | My best guess for what happened is that work stress, excessive
       | celebration and coping with the cognitive dissonance of the pre-
       | COVID era and subsequent pandemic, combined with overtraining and
       | the misuse of protein shakes in place of food, left me in a
       | chronically dehydrated state. The body tries to collect moisture
       | from the gut, which opens an opportunity for bacteria to get into
       | the body cavity and blood, which is colloquially called leaky
       | gut. This sets off food sensitivities and eventually an
       | autoimmune condition/response to lectins, gluten, etc, which have
       | proteins similar to linings in the body, joints and thyroid. Then
       | a cascade happens where everything goes out of whack quickly. In
       | my case, I went from being in the best shape of my life, the
       | strongest I had ever been in the gym, to barely able to get out
       | of bed in the morning. In other people, it might present as
       | chronic fatigue, arthritis, etc.
       | 
       | I didn't really believe any of this in 2018, and my meal plan
       | then consisted entirely of everything that I can't eat today. So
       | I consider what people say politely, but for the most part, they
       | have absolutely no idea what they're talking about. This
       | experience has made stuff like GMO foods sound absolutely insane
       | to me. Like, why would we ever taint our food supply to make food
       | 5 cents cheaper or "feed the world" when we've been operating
       | under artificial scarcity since the end of the second world war?
       | It's all a crock.
       | 
       | Every time you eat inflammatory food, the risk is similar to
       | smoking a cigarette. Probably nothing will happen, but if it sets
       | off your immune system, you may wake up one morning chronically
       | depressed and/or unable to eat something that you rely upon. It
       | got me after I turned 40, YMMV.
        
         | mahathu wrote:
         | Thanks for sharing, but can you (or anyone else) elaborate what
         | he means by "the cognitive dissonance of the pre-COVID era"?
        
         | Permit wrote:
         | > I didn't really believe any of this in 2018, and my meal plan
         | then consisted entirely of everything that I can't eat today.
         | 
         | I suspect you had the same degree of confidence in your
         | understanding of these issue then as you do now. It's
         | interesting that you can reflect on your overconfidence in the
         | past, but don't seem to express any skepticism regarding your
         | current beliefs surrounding nutrition.
         | 
         | By the way, I'm not saying that you're wrong! GMOs may be bad,
         | but I think you would do well to level some degree of
         | skepticism over your current understanding of nutrition as you
         | do toward your past understanding. Consider that perhaps you
         | will be here in 2026 telling us about how you got it wrong
         | today.
        
           | omreaderhn wrote:
           | There's an asymmetry in the risks associated with choosing
           | either a) to restrict or b) not to restrict the set of foods
           | you eat.
           | 
           | Overconfidence in (b) carries more risk than overconfidence
           | in (a). The set of chemicals that are toxic is much larger
           | (as in >>>) than the set of chemicals that are necessary for
           | sustaining life.
        
         | treeman79 wrote:
         | Autoimmune protocol diet exits for this.
         | 
         | Spent a month eating sweet potatoes. Best I ever felt.
        
         | baxtr wrote:
         | So, what are you actually eating now that has helped?
        
         | rkalla wrote:
         | This was a _fascinating_ read and I thank you for writing that
         | all up - I'm in your "3 year" dip and in the past made attempts
         | at tackling the gut biome issue with cycling probiotics, fresh
         | vegetable fibers, organic/local yogurts, staying away from fake
         | sugars and other dietary things that blow out the biome and
         | even after a few weeks of doing this I never felt any better -
         | would shrug my shoulders and go back to not really caring.
         | 
         | Was there 1 inflammatory food item that is like kryptonite to
         | you now? Fake sugars? Wheats?
        
         | technosamay20 wrote:
         | Insightful journey. Can you please share your discoveries and
         | what do you eat now!
        
         | jwuphysics wrote:
         | I'm sorry to hear about your experiences and it sounds like you
         | learned a lot from firsthand knowledge. But, respectfully
         | asking, what does inflammatory foods or poor eating habits have
         | to do with GMO foods?
        
           | sdze wrote:
           | Also why would GMO be bad? The criticism comes mostly from
           | people that also believe in osteopathic / homeopathic
           | medicine in my social circle.
           | 
           | I find it a terrific chance for humanity to engineer plants
           | in such a way that they are more robust against disease and
           | bad weather (with CRISPR/CAS and such methods).
        
             | Dma54rhs wrote:
             | Anti - GMO crowd is definetly very similar to anti vaxxers
             | and other science deniers spreading dangerous propaganda
             | while eating oranges and bananas.
        
               | hutzlibu wrote:
               | Are you implying oranges and bananas were made with
               | modern GMO methods?
               | 
               | I agree that the anti gmo/vaxx etc. crowd is quite
               | irrational in many regards, but I can see a difference
               | between traditional breeding plants - and directly
               | editing DNA.
        
               | sdze wrote:
               | Don't forget the 5G radiation...
        
             | rogers18445 wrote:
             | Currently there doesn't appear to be any evidence that GMO
             | is bad for your health and most GMO is just transplanting
             | genes from other edible organisms.
             | 
             | Hopefully regulators aren't going to allow insertion of
             | engineered genes producing novel molecules without going
             | through actual medical grade trials for those molecules. Or
             | it may torpedo the entire industry.
        
               | netizen-936824 wrote:
               | In every case of GMO food I have encountered, the
               | compounds are not novel. Rather, they're an adaptation or
               | resistance found in one species and transferred to
               | another.
        
             | rjsw wrote:
             | As someone else with immune system reactions to food, it
             | doesn't seem a great idea to modify food even more than we
             | have done already.
        
               | freshpots wrote:
               | That's not a good argument at all. What 'modification' do
               | you think is a risk and how would it cause the concerns
               | your worried about?
        
               | ipaddr wrote:
               | To put the question back what benefit does it provide
               | aside from cost?
        
               | csnover wrote:
               | As just one example, if you live in an area where it is
               | difficult to get dietary Vitamin A, you might enjoy the
               | benefits of not going blind due to Vitamin A deficiency
               | by eating Golden Rice[0].
               | 
               | Have you ever eaten a SweeTango apple? It is one of
               | dozens of varieties that have been created in the last
               | hundred years using genetic engineering via cross
               | breeding[1]. Do you know why commercial tomatoes are so
               | bland? Genetic engineering via selective breeding[2].
               | 
               | The fact of the matter is that all of the crops and
               | livestock that we cultivate today are genetically
               | engineered. The main distinction now is that we are
               | technologically advanced enough to introduce beneficial
               | modifications deliberately, rather than relying on random
               | mutations and gene recombinations that occur in nature at
               | random over hundreds or thousands of generations.
               | 
               | [0] https://en.wikipedia.org/wiki/Golden_rice
               | 
               | [1] https://mnhardy.umn.edu/varieties/fruit/apples/all-
               | apple-var...
               | 
               | [2] https://en.wikipedia.org/wiki/Tomato#Modern_commercia
               | l_varie...
        
             | ericbarrett wrote:
             | Here is my criticism of GMO foods; or at least, the reason
             | I'm wary of them. I don't believe in any "woo" at all.
             | 
             | Why would the massive corporations that have driven the
             | food in our supermarkets ever cheaper, ever thinner in
             | nutrients, ever higher in fat and sweeteners and fillers,
             | ever more laden with pesticides and antibiotics, ever more
             | processed--why would they use a technology like GMO crops
             | for good? Why wouldn't they just splice pesticide and sugar
             | genes into them directly and juice the yield even harder so
             | that the soil is stripped and ruined even faster? I think
             | they will be used to boost profits, not make our food more
             | nutritious, or even cheaper in any way except per calorie.
             | 
             | I understand there are potentially benefits, e.g. growing
             | crops resistant to pests so that spray pesticides can be
             | reduced. I just have no faith whatsoever that these kinds
             | of considered actions will be taken, based on the last 100
             | years of technology. It's just going to be wheat and corn,
             | wheat and corn, wheat and corn until caloric yields
             | approach insolation and the soil is as gray and lifeless as
             | the moon.
        
               | tomjakubowski wrote:
               | The risks from unknown unknowns are even worse with
               | genetic engineering in crops, due to the inevitability of
               | hypothetical "harmful to humans genes" propagating from
               | one population to others by pollination.
               | 
               |  _The Precautionary Principle (with Application to the
               | Genetic Modification of Organisms)_
               | https://www.fooledbyrandomness.com/pp2.pdf
        
             | jay_kyburz wrote:
             | I'm not into osteopathy or homeopathy but my concerned
             | about GMO are because I don't trust that the scientist
             | really know what they are doing, or can fully understand
             | the impact any changes they might make, not only on humans,
             | but on the environment at large. Nor do I trust our
             | government to be able to police and regulate the industry.
             | Nor do I trust big farma to put health before profits.
        
               | sdze wrote:
               | I think humans always genetically "engineered" plants by
               | selection process. Our current cultivated plants are the
               | result of thousands of years of breeding.
               | 
               | Who knows what accidental genetic damage from breeding
               | will cause problems in humans?
        
               | broptimist wrote:
               | Harmful crop breeds would have been selected against over
               | the course of many generations, right? Now we're doing it
               | on a larger scale, so the risks and rewards are greater.
               | What is our knowledge of the risks and rewards? Are the
               | rewards aligned with general human wellbeing, or just a
               | profit motive? I don't know.
        
           | manmal wrote:
           | Not OP. In many cases, the genetic modifications are either
           | performed to either let the plant produce (more) lectins that
           | kill insects, or make the plant immune to certain herbicides
           | like glyphosate. The human gut and microbiome might be able
           | to deal with lectins they have evolved to deal with, and in
           | "normal" quantities. But those additional GMO lectins are
           | suspected to be hard on the intestinal barrier. If that
           | barrier is compromised, autoimmunity might be the result, as
           | OP indicated.
        
           | zackmorris wrote:
           | Two main things:
           | 
           | 1. Genetically modified (GMO) foods can cause non-food
           | compounds to get synthesized in the food that our bodies have
           | never seen before, which can trigger autoimmune issues. I
           | consider this the lower risk.
           | 
           | 2. GMO foods are designed specifically to allow more use of
           | pesticides and herbicides. These get incorporated into the
           | food and can stay around after washing, especially in
           | processed food. Pesticides are low-level neurotoxin and
           | disrupt gut nerves, while herbicides disrupt gut flora.
           | Loosely, what happens is that the body is sensitive to most
           | plant husks, since they are designed to keep bugs out that
           | feed on them. GMO copies that defense mechanism, often
           | amplifying it hugely, resulting in amplified food
           | sensitivities. I consider this the higher risk, so high in
           | fact that the consequences of it can be life-altering.
           | 
           | Edit: These effects combined turn ordinary food into
           | inflammatory food
        
             | PeterisP wrote:
             | My impression is quite the opposite - GMO insect-resistant
             | plants enable using much _less_ pesticides (the savings
             | from reduced frequency and quantity of pesticides being the
             | economic reason for choosing such crops) than non-modified
             | equivalents.
        
               | wfme wrote:
               | This article [0] points towards the reality being
               | somewhere in the middle - more herbicides but less
               | insecticides.
               | 
               | > GMOs have been changing the way that pesticides are
               | used in agriculture. Herbicide-tolerant genetically
               | modified (GM) crops have led to an increase in herbicide
               | usage while insecticide-producing GM crops have led to a
               | decrease in insecticides.
               | 
               | [0] https://sitn.hms.harvard.edu/flash/2015/gmos-and-
               | pesticides/
        
               | more_corn wrote:
               | GMO roundup resistance allows us to use a bunch of
               | herbicide without killing the food crop. This seems to
               | indicate that we'd be using a lot more roundup on those
               | crops than otherwise.
        
         | avdlinde wrote:
         | Sorry if I didn't understand correctly, but how did you make
         | the alcohol (celebration), work stress, pandemic stress > GMO
         | link?
        
           | zackmorris wrote:
           | I only made it very recently. I had tried absolutely
           | everything and gotten almost nowhere. I finally stumbled onto
           | everlywell.com tests, took the comprehensive test of 200+
           | foods, and discovered almonds and dairy were the main
           | culprits. I would ave been very unlikely to eliminate almonds
           | as part of an elimination diet.
           | 
           | Anyway, once I was able to feel better again, even for a day
           | or two, I then was able to try other changes along the
           | decision tree in the problem space. It soon became obvious
           | what caused what. Everlywell says that 18 months of avoidance
           | can often allow us to eat foods we're sensitive to again.
           | I've blabbered about it at length in my previous comments,
           | probably too much haha.
        
       | Goety wrote:
       | an army runs on their stomach and not anything else
        
       | maybeOneDay wrote:
       | Tangential: Is there any evidence that pro biotic foods or
       | supplements can increase gut health? Given the evident importance
       | of gut health, I wonder whether it's worth using something like
       | this, to grab a random example:
       | https://www.amazon.co.uk/Restored-Bio-Cultures/dp/B082SZXBF2...
        
         | everybodyknows wrote:
         | Anecdata: Tried various probiotics, no help. _Pre-biotics_
         | however, have been huge. Search for  "resistant starch".
        
           | pknight wrote:
           | What was your diet like when you were taking them? It's been
           | observed in some studies that delivered mixed results that
           | responders had better diets (i.e. more bacteria friendly
           | components in the diet such as indigestible carbs from
           | vegetables/legumes/fruit etc) whereas non-responders had
           | weaker diets in terms of providing the gut microbes
           | nutrients.
        
           | asdfman123 wrote:
           | The best treatment for my own ADHD, depression and anxiety is
           | living a healthy lifestyle, across the board, full stop.
           | 
           | It means regular exercise, 6 hours of cardio a week, eating
           | healthy, meditating, spending time in the sun, etc. etc. (And
           | anti-depressants/therapy, which play an important role too.)
           | 
           | Of course, it's too much to tell someone struggling to do all
           | those things, but if you can work towards that, I strongly
           | recommend it. I've had to declare war on my depression and
           | ADHD because I can't afford to have it in my life anymore.
           | 
           | At some point perhaps the science will catch up and explain
           | precisely how these things help, but until then, I feel like
           | you have to take the ancient approach of observing people who
           | have things figured out and emulating them. (And I say this
           | as someone who is very much pro-science.)
        
         | happylion0801 wrote:
         | As a fellow comment says - its all over the place and kind of
         | hard to say, see [1] saying they are useless but lots of
         | studies saying they are useful .
         | 
         | Personally as someone with IBS, I have tried many probiotics
         | over the years and have mixed results - most of them were
         | useless but for some time I found one or 2 that worked but I
         | couldnt say for sure if they worked due to other factors (for
         | e.g generally healthier food, lifestyle, mindset etc). You
         | would have to try it out for weeks to see their effect
         | (according to studies that say it work).
         | 
         | The doctors I spoke to though gave me strong probiotics (>100
         | billion CFU, for e.g something like [2]). I found anything that
         | had 1 or 10 billion CFU to be pretty much useless.
         | 
         | I think you should work on your diet before taking probiotics.
         | I dont think I am lactose intolerant, milk gives me bad
         | bloating but yogurt doesnt. Yogurt worked for me over the
         | course of weeks, kefir and sauerkrat gave me mega-bloating.
         | 
         | [1] https://www.bbc.com/news/health-45434753 [2]
         | https://www.amazon.com/Visbiome-Potency-Probiotic-Shipped-Sh...
        
           | aussieguy1234 wrote:
           | Not sure if you have heard of the low FODMAP diet? Its now
           | the standard treatment for IBS. The theory is certain
           | bacteria ferment FODMAPS into gas and water which leads to
           | the symptoms. They don't know which bacteria yet but going
           | low fodmap is now a well researched and accepted treatment.
           | 
           | Everyone is different but personally, I'm able to tolerate
           | everything except Fructans (one of several types of FODMAPS).
           | So no garlic, onion or wheat for me.
           | 
           | https://www.monashfodmap.com/ibs-central/i-have-
           | ibs/starting...
        
             | dan353hehe wrote:
             | I was skeptical of this when I first heard of it several
             | years ago. It sounded just like every other popular diet
             | does: "Just (don't) eat this certain food, and you will
             | feel amazing!"
             | 
             | But I have several family members on it right now, and they
             | all report feeling WAY better. And this is after years of
             | dealing with IBS type problems too.
        
               | CodeGlitch wrote:
               | Another successful patient of the low FODMAP diet here.
               | As soon as I stray from the restrictions I will suffer
               | the next day. IBS can be crippling.
               | 
               | Honestly the scientist(s) who developed the low FODMAP
               | diet needs to be awarded a Nobel prize.
        
               | aussieguy1234 wrote:
               | It's the same for me. If I eat the wrong food, I'll feel
               | fine for the rest of that day.
               | 
               | Then the next day, almost always in the morning is when
               | the problems will start. Perhaps the bacteria had time to
               | ferment the food overnight.
               | 
               | So when I have symptoms, I always look at what I ate the
               | previous day.
        
               | Shank wrote:
               | Low FODMAP works, but it's precisely because it's unlike
               | all other "diets". It's a systematic removal of basically
               | all short-chain sugars. The problem with it, as someone
               | who was instructed to follow it, is that it's extremely
               | unintuitive to know what foods are low or high FODMAP
               | without the list. Because of this, it's really easy to
               | make mistakes unless you consult the list prior to
               | eating.
               | 
               | So it definitely gives positive results, but it's also
               | very difficult to follow.
        
               | aussieguy1234 wrote:
               | Yep, there are hundreds of foods out there that have
               | them.
               | 
               | Personally I use this app when eating anything I'm not
               | sure about, it has a database of foods and their fodmap
               | content: https://www.monashfodmap.com/ibs-central/i-have-
               | ibs/get-the-...
        
               | nvarsj wrote:
               | As someone on FODMAP, what works for me is to do
               | breakfast/lunch meal replacement with low FODMAP shakes
               | (like Huel), then get a few FODMAP cookbooks and make
               | dinners out of that. Works great and is fairly painless -
               | lots of delicious meals can be made that are low fodmap,
               | fortunately. It's really difficult to avoid FODMAPs when
               | eating out, western food loves onions and garlic for
               | instance - for these cases, I use alpha-glucosidase
               | enzyme tablets (I take 2x 350mg tablets with a meal).
        
             | happylion0801 wrote:
             | Yes of course. I did low-fodmap for many months few years
             | ago and continue to do it (when I go to an unknown place
             | for example or travel).
             | 
             | In studies Low-fodmap is typically only recommended for ~6
             | weeks. I now try to eat any kind food though, I eat
             | everything in smaller quantities and this also helps.
             | 
             | I personally found that a combination of diet, stress,
             | sleep control are the most effective for managing IBS
             | symptoms. Any one of those can flare up the symptoms at any
             | time and managing all of them is key
        
         | car wrote:
         | Rather than using these processed foods, one should provide the
         | gut microbiome with "food" in the form of fiber from whole
         | plant foods, i.e. not 'fiber' supplements like Metamucil.
         | 
         | Lots of accessible information can be found at
         | https://nutritionfacts.org.
        
         | tharkun__ wrote:
         | Another anecdata point:
         | 
         | I used be lethargic, couldn't get myself to do anything but be
         | on the sofa. I would get horrible migraine headaches if
         | drinking alcohol or even alcohol free beer or eat certain
         | foods. I self-diagnosed histamine intolerance through trial and
         | error.
         | 
         | I tried multiple pro-biotic combinations. An easy one I tried
         | in the beginning was simply some Danone Actimel the family had
         | in the fridge anyway. I can attest to the fact that it contains
         | live bacteria (a strain that makes lots of histamines) that do
         | make it to the gut because it gave me the horrible migraine
         | headache as would Sauerkraut actually. Researched what strains
         | don't create lots of histamine. I landed on Garden of Life -
         | Primal Defense Ultra. What I think made the difference is that
         | it contains Bacillus subtilis. I say that because I tried two
         | or three others that had largely the same makeup of strains but
         | none had that particular bacterium. It's a soil based bacterium
         | which you might get from eating your own cabbage you grew in
         | the garden as well. Almost everything else just has various
         | different strains of lactobacilli.
         | 
         | Taking 3 capsules a day I felt like crap for 2 weeks (no
         | headaches, just feeling sick, like a bad cold) and then things
         | got better. I am able to drink alcohol again (I'll get a
         | hangover headache like anyone would if I drink too much but
         | it's not longer a day long migraine from just sipping 10ml) and
         | eat anything I want to in any quantity. I still take one in the
         | morning and one in the evening and I put one into the
         | Sauerkraut I make.
         | 
         | YMMV as always, not a doctor, try at your own risk, not
         | affiliated etc :)
        
           | itronitron wrote:
           | Thanks for sharing this, most of your experience sounds
           | similar to those of a friend of mine (Yokult gives them
           | migraines) although they haven't yet tried Bacillus
           | subtillis.
        
           | manmal wrote:
           | Really interesting indeed! I just found this paper on B.
           | subtilis from November:
           | https://pubmed.ncbi.nlm.nih.gov/34630666/
           | 
           | Reducing intestinal permeability is a highly desirable
           | effect.
        
             | csdvrx wrote:
             | It's the same bacteria found in Natto
        
         | newsclues wrote:
         | https://pendulumlife.com/pages/science
         | 
         | From the maker but I heard about it on a podcast and was
         | convinced.
        
         | dade_ wrote:
         | Sauerkraut is simple to make and cabbage is cheap.
         | 
         | https://www.livestrong.com/article/413921-does-sauerkraut-ha...
        
           | MikeDelta wrote:
           | Or Kimchi if you're into Korean food.
        
             | umeshunni wrote:
             | Do you have an easy to make recipe?
        
               | OJFord wrote:
               | Not GP and don't have one to suggest, but as you're
               | asking for 'easy' (and at risk of stating the obvious,
               | but only once you know I suppose) - ignore anything that
               | says something like 'refigerate for 30mins and enjoy'.
               | 
               | Or don't, I'm not denying quick such er salads can taste
               | great, just that if what you want is a fermented or
               | pickled product, that takes time. (And much longer if at
               | all in the fridge - that's their purpose!)
               | 
               | A 'proper' recipe for sauerkraut for example will tell
               | you something on the order of weeks at minimum, and it's
               | done when you like the taste. Kimchi I think is typically
               | fermented for longer, more like months or over a year
               | (not including any transferred to the next batch).
        
               | scott_paul wrote:
               | I use a variant of Emmymade's variant of Maangchi's
               | recipe. It works really well.
               | 
               | Rinsed pickle jars work great, a head of Napa cabbage
               | usually fills about 2+1/2 ~ 3 jars. If you're not into
               | high spicy, dial back the red pepper by about half, for
               | your first try. If you don't like funky, skip the fish
               | sauce or any seafood component, I always do this so that
               | the flavor won't clash with some dishes, you can always
               | add fish sauce to a dish but you can't remove it.
               | 
               | I ferment it for about 3 days at about 65 ~ 68
               | degrees(f), then into the fridge. It keeps indefinitely
               | but is best within a few months.
               | 
               | Do not bring it into work, just as you would not
               | microwave fish at work. The aroma is very much not to
               | everyone's preference, even when made without seafood.
               | 
               | https://www.youtube.com/watch?v=vaoA7SKN0g0
               | https://www.maangchi.com/recipe/easy-kimchi
        
               | asiachick wrote:
               | it would never have occured to me not to bring kimchi to
               | work. Durian? Stinky Tofu? ok but Kimchee? I'll bet most
               | company cafeterias have blue cheese around
        
               | dekken_ wrote:
               | https://www.thekitchn.com/how-to-make-easy-kimchi-at-
               | home-18...
               | 
               | good base to build from, it didn't use to be so spammy
               | tho
        
               | arrosenberg wrote:
               | Most lactofermented foods are: Main ingredient, spices, a
               | few tbsp of salt. Add to sterile jar, fill with water
               | (add a glass weight to the top if needed to keep
               | everything submerged) and leave in a dark cabinet for a
               | few weeks. Trial and error to get the flavor the way you
               | want it, but that's basically it. If you see little air
               | bubbles forming near the bottom after 2-4 days, you have
               | a live culture.
        
           | ng12 wrote:
           | I brew my own kefir, sauerkraut, kimchi, and occasionally
           | kombucha. Of those kefir is the most demonstrably effective,
           | all of them are cheap.
           | 
           | The only effective probiotics I've found are very expensive,
           | costing around $120/mo.
        
             | ijidak wrote:
             | > The only effective probiotics I've found are very
             | expensive,
             | 
             | But how do you know if they're effective?
             | 
             | That's always been my question.
             | 
             | What is the effect one should notice?
        
               | ng12 wrote:
               | I have some odd GI issues so there's a clear impact
               | there. The alternative treatment is some very nasty
               | medication. Effective probiotics restore normality
               | without the side effects the medications have. I'll spare
               | you the details ;)
               | 
               | More anecdotally I do feel generally better even when my
               | GI symptoms aren't present: more energy, better mood,
               | more restful sleep.
        
           | happylion0801 wrote:
           | Personally kefir, sauerkraut, kimchi, kombucha - all give me
           | lots of bloating even after trying out for weeks. Maybe thats
           | just how its supposed to be? Not sure but I stopped after a
           | while after it affected my daily life
        
         | pknight wrote:
         | I've come across plenty of evidence in the literature but there
         | are lot of variables that can prevent any positive effects from
         | taking place. If you're taking probiotic supplements in
         | isolation and the rest of your diet is suboptimal in terms of
         | bacteria-friendly nutrients, it's unlikely that you'll get
         | results. It could be the case that many people are throwing
         | money away if they're taking probiotic supplements without
         | addressing their diet and lifestyle.
         | 
         | There's so much variety between people, one formulation for one
         | person might work well for one person but have negative effects
         | on another even if they have a supportive diet and lifestyle.
         | People might simply have to trial multiple formulas that have
         | the right mix of strains before they find one that works for
         | them.
         | 
         | Prebiotic foods seem to have more consistent results on gut
         | health, according to some studies.
         | 
         | (not medical/health advice disclaimer)
        
         | PragmaticPulp wrote:
         | Probiotic and gut biome research is all over the place.
         | 
         | It's possible to find some studies showing correlations, but
         | it's harder to find successful replications of those studies.
         | 
         | Some probiotics have been shown to temporarily alter gut flora,
         | but it usually reverts after the probiotic is stopped. Dietary
         | and activity changes are generally good at improving the biome.
         | 
         | It doesn't help that one of the commercial guy biome measuring
         | companies basically turned out to be fraudulent a few years
         | ago. Even some of the public efforts to measure correlations
         | are suspect or bunk because they relied on these services.
        
         | throw_me_up wrote:
         | Eat fiber. Meet the recommended amount and eat a diverse set of
         | fiber which will feed different microbes in the gut. It will
         | take some time for the gut to adjust to the new levels though.
         | Expect gas, cramping, etc for a few days.
        
           | EL_Loco wrote:
           | Do you advise just fiber from natural foods, or do you take a
           | fiber supplement (like those that come in powder form)? I
           | guess the supplement route won't give me the diverse fiber
           | types you mention, am I right?
        
         | CodeGlitch wrote:
         | I've always been prescribed them by doctors after taking
         | antibiotics... As you guessed it the guy microbes are killed
         | off by the medication.
         | 
         | Well that's the theory anyway...
        
         | kazishariar wrote:
         | It's better for you if you tried something more well-reviewed:
         | 
         | https://microbz.co.uk/product/bio-live-gold/
         | 
         | Thank me later- and you're welcome.
        
       | Gatsky wrote:
       | There was a lot of work on microbiome and cancer immunotherapy...
       | the latest study in the field published in the most prestigious
       | journal there is [1] seemed to show that fibre intake was more
       | important than any specific microbe. In fact they found that
       | eating more fibre and taking probiotics resulted in worse
       | outcomes than just eating more fibre alone. This was
       | recapitulated in a mouse model:
       | 
       | > Together, these data have important implications. We show that
       | dietary fiber and probiotic use, factors known to affect the gut
       | microbiome, are associated with differential outcomes to ICB.
       | Although causality cannot be addressed from the observational
       | human cohort, where unmeasured confounders may exist, our
       | preclinical models support the hypothesis that dietary fiber and
       | probiotics modulate the microbiome and that antitumor immunity is
       | impaired in mice receiving a low-fiber diet and in those
       | receiving probiotics--with suppression of intratumoral IFN-g T
       | cell responses in both cases.
       | 
       | It would be a bit disappointing if the final conclusion from all
       | this microbiome work was 'Eat more vegetables'...
       | 
       | [1] https://www.science.org/doi/10.1126/science.aaz7015
        
         | enchiridion wrote:
         | Interesting result about the fiber plus probiotic. To me that's
         | saying that's your body mostly knows how to maintain a micro
         | biome if given the right building blocks.
         | 
         | I wonder how the immune system comes into play to actively
         | shape the microbiome, vs our typical understanding of just
         | "fighting bad bacteria".
        
         | baxtr wrote:
         | Why only more vegetables? Isn't fiber also in some other food?
        
       | brainaxis wrote:
       | Great to see the gut brain axis becoming more well known in
       | medicine. Less than 10 years ago it was considered near
       | pseudoscience to consider that the gut could actually influence
       | the brain.
       | 
       | https://www.hopkinsmedicine.org/health/wellness-and-preventi...
       | 
       | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367209/#:~:tex....
       | 
       | https://en.wikipedia.org/wiki/Gut%E2%80%93brain_axis
        
         | The_rationalist wrote:
        
         | vmception wrote:
         | I went down that rabbit hole to have a more informed opinion
         | and I found that accepted science would converge on some of the
         | same goals naturopaths and other alternative medicine
         | practitioners eventually.
         | 
         | Basically, they both want personalized medicine. As in,
         | remedies that are custom tailored to the internal state of the
         | individual, instead of "personalized" by listening to an
         | individual describe a current ongoing affliction.
         | 
         | Alternative medicine lacks any method for peer review or
         | repeatability and practitioners themselves procedurally
         | generate the remedies, which makes it incapable of being
         | accepted science except by mere coincidence of some practices
         | eventually being peer reviewed if reviewable at all. This is by
         | a design that is comical to the scientific community, where
         | "everybody is different".
         | 
         | At the same time, the scientific method and peer review itself
         | is too rigid to evaluate all ailments, without associated
         | advances in technology. This is also by design as it was
         | necessary to distinguish the sciences from arbitrarily
         | religious or arbitrarily heretical practices at one point in
         | some areas.
         | 
         | Now we are on the cusp of convergence of the ideals, by being
         | able to analyze and sequence the symbiotic relationships within
         | our bodies. How little control we have in many cases, or at
         | least potentially redefining the sense of self.
        
       | taeric wrote:
       | For those curious, morganella is the main culprit listed here, it
       | seems. Wikipedia isn't clear to me on how one gets this in your
       | biome. Outside of other susp conditions. :(
        
         | cmckn wrote:
         | My personal, completely unsubstantiated take is: your diet
         | allows certain bacteria to thrive (or not). It's less about
         | trying to avoid the bad ones and more about trying to nurture
         | the good ones. One incredible thing you can do for your gut is
         | eat more fiber; which the vast majority of Americans don't. Try
         | psyllium husk powder (the stuff in Metamucil). Eat less refined
         | sugar and saturated fat; eat more raw and fermented vegetables.
         | Probiotics are kind of a scam, and are usually _really_
         | expensive. Like most things with health, you have to
         | consistently do the not-so-fun things to get good results, you
         | can't just take a pill and move on.
        
           | asdfman123 wrote:
           | The rule of thumb in nutrition is diet is way more effective
           | than supplements.
           | 
           | There's a place for supplements, some of them may be helpful
           | or not, but having a good diet that naturally includes those
           | things is always better.
        
           | taeric wrote:
           | That is as may be, however, this study shows that removing
           | that bacteria helps with mood disorder. And, there is no
           | evidence that diet gives you this bacteria. Nor that it can
           | help remove this one, either.
           | 
           | That is, discussion of diet is a bit of a non sequitur. Not
           | wrong, but also not necessarily relevant.
        
             | cmckn wrote:
             | The paper is titled " Combined effects of host genetics
             | *and diet* on human gut microbiota and incident disease..."
             | (emphasis mine). Dairy (and the way some people process it,
             | because of genetics) was shown to influence levels of
             | certain bacteria.
             | 
             | The study also does _not_ show that removing Morganella
             | resolved depression; the study did not attempt to remove
             | it, and a researcher is quoted as saying it's not clear how
             | one would do so (last line of the article):
             | 
             | > But it's less clear how Morganella could be eliminated
             | from the gut to relieve symptoms. "That's a bit more
             | challenging."
        
               | taeric wrote:
               | Ah, fair. I was going with what I saw as an implication
               | that removing it would help. My apologies.
               | 
               | Clearly, I had not made it through the article to the
               | underlying studies. My reading was that they were looking
               | for lactose related bacteria, but landed on this other
               | one. And that they did not find a way to control it's
               | presence.
        
       | bladegash wrote:
       | Will be interested to at some point see what kind of connection
       | gastrointestinal autoimmune (among others) diseases such as
       | Crohn's and Ulcerative Colitis have on not only the guy microbe
       | balance, but mental health as well. Many mental health disorders
       | have strong genetic ties, as well as autoimmune diseases. Wonder
       | if existence of one makes the likelihood of existence of the
       | other greater.
        
         | whatshisface wrote:
         | There's some progress now in tying specific mental disorders to
         | autoimmune problems in the brain. Wish I could tell you more
         | but all I know about this is that they test people's cerebral
         | spinal fluid for antibodies against specific neurotransmitter
         | receptors, and they've discovered several connections between
         | those and problems people have.
        
           | bladegash wrote:
           | Very interesting! I actually have both Crohn's and bipolar
           | disorder, and one anecdote that's interesting (to me) is that
           | the TNF inhibitor I'm on, which has put Crohn's in remission,
           | has simultaneously appeared to have a positive effect on the
           | mood disorder side of things as well.
           | 
           | Really cool to see the GI getting so much research!
           | 
           | Edit: Found an interesting study that addresses the
           | relationship between TNF and mood disorders - go figure!
           | 
           | https://pubmed.ncbi.nlm.nih.gov/19477018/
        
       | thenerdhead wrote:
       | I've seen these studies time and time again. I do wonder what are
       | the practical steps one takes to "repair" or "renew" their gut?
       | I'm not a fan of drugs being the cure. In fact, I don't think
       | they are the first solution people should hope for or supplement
       | with unless it's not practical to get them in a natural way.
       | 
       | I feel like we see more and more gut related issues due to
       | depression & depression's little cousin anxiety. IBS for example
       | manifests itself from anxiety and can also be a gut microbiome
       | imbalance.
       | 
       | If there are more and more studies around gut health being a
       | sort-of panacea of mental & physical health, why aren't we
       | focusing on making healthier decisions for our diet, exercise,
       | and mental well being?
       | 
       | It's no surprise that many people(myself included) in our always
       | connected world suffer with crippling anxiety from over
       | stimulation/shock & awe news/comparison to others/overwork/etc.
       | That anxiety manifests in your gut as digestive issues. Those
       | digestive issues make you less likely to exercise for long
       | periods of time or even at all.
       | 
       | In my opinion, it's four main things. Increase sleep,
       | improve/wide ranging diet, moderate exercise, and reduced stress.
       | There are definitely hacks like fiber, yogurt, sauerkraut, and
       | more that people swear by, but I am genuinely curious if a study
       | had tracked some of these variables to see if they improve gut
       | microbiomes.
        
         | cesnja wrote:
         | > what are the practical steps one takes to "repair" or "renew"
         | their gut?
         | 
         | Look up nutritionfacts.org and read/view it with a generous
         | pinch of salt. A few years ago it took me half a year to switch
         | to a mostly WFPB diet advertised there and I had no issues
         | whatsoever. My gut is now more resilient, I remember having
         | problems with bloating and/or diarrhea if I ate just a bit more
         | fiber some days.
         | 
         | > why aren't we focusing on making healthier decisions for our
         | diet, exercise, and mental well being?
         | 
         | The answers are there, but cognitive dissonance prevents us
         | from recognizing or accepting them.
        
           | thenerdhead wrote:
           | This dude sounds like Jeff Goldblum. Thanks for the
           | recommendation!
        
         | noneeeed wrote:
         | It seems to be a case of lots of variety in your diet, ideally
         | lots of different vegetables, nuts, pulses etc, and cutting
         | down/out highly processed foods. Variety seems to be the spice
         | of life, quite literally.
         | 
         | I've just finished reading Prof. Tim Spector's "The Diet Myth".
         | The book's title is a little hyperbolic, but it works through
         | all the major food groups and how we eat and talks about both
         | the historic research and diet fads of the past (like Ansel
         | Keys research that sparked the obsession with low fat foods)
         | and how all these different foodstuffs tie into our gut
         | bacteria, which in turn affects us.
         | 
         | Tim's "thing" is the human biome, but I didn't read it as him
         | touting it as a cureall, but as something that is more
         | important than almost all of us are aware, and which has been
         | seriously neglected to the point that it's having an impact on
         | many aspects of our health. He's also pretty open that a lot of
         | this is still very much up in the air at the moment, and lots
         | more study is needed to really understand many of the effects.
         | He also seems pretty sceptical of the medicallisation and the
         | obsession with isolating one factor and packaging it up as a
         | supplement or magic pill that will solve your health issues.
        
           | thenerdhead wrote:
           | I've read similar books. Will pick this one up though. Thanks
           | for the recommendation!
        
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