A team of researchers from the Weizmann Institute of Science in Israel decided to focus specifically on the human gut microbiome and blood glucose levels due to its implications in diabetes, metabolic syndrome, and obesity (Zeevi, D., et al., 2015). What they found was that the glycemic response is highly individualized. Individuals who ate the same meal would show drastic differences in the amount of blood glucose after eating (Zeevi, D., et al., 2015). This led to the idea of a personal approach to eating recommendations based on biometric and microbiome data (Zeevi, D., et al., 2015).
DayTwo is the evidence-based eating program the researchers developed based on their 5 year-long study. To get started, the patient will send in a stool sample, blood test results, and answer a questionnaire. Then, DayTwo will sequence their microbiome DNA and provide them with their results and food recommendations based on a scoring system. Finally, the patient is able to build a balanced diet based on the "food scores" they receive and essentially increase their glycemic control.
While this program could benefit individuals struggling with diabetes or pre-diabetes, DayTwo also takes precautions to limit potential harm to patients. They suggest that you take the results from the microbiome sequencing to a registered dietician or a physician before undergoing a drastic diet change. Additionally, while personalized diets and health therapies seem ideal, they are typically not cheap. The kit for DayTwo costs around $500, making it inaccessible to individuals without the financial means to pay for it.
Official Website:
https://www.daytwo.com/
References:
Rothschild, D., Weissbrod, O., Barkan, E., Kurilshikov, A., Korem, T., Zeevi, D., Costea, P., Godneva, A., Kalka, I., Bar, N., Shilo, S., Lador, D., Vich Vila, A., Zmora, N., Pevsner-Fischer, M., Israeli, D., Kosower, N., Malka, G., Wolf, B. C., Avnit-Sagi, T., Lotan-Pompan, M., Weinberger, A., Halpern, Z., Carmi, S., Fu, J., Wijmenga, C., Zhernakova, A., Elinav, E.& Segal. E. (2018). Environment dominates over host genetics in shaping human gut microbiota. Nature, 555, 210-215. doi:10.1038/nature25973
Sidhu, M., & van der Poorten, D. (2017). The gut microbiome. Australian Family Physician, 46(4), 206-211. Retrieved from https://www.racgp.org.au/afp/2017/april/the-gut-microbiome/
Suez, J., Zmora, N., Zimberman-Schapira, G., Mor, U., Dori-bachash, M., Bashiardes, S., Zur, M., Regev-Lehavi, D., Brick, R., Federici, S., Horn, M., Cohen, Y., Moor, A., Zeevi, D., Korem, T., Kotler, E., Harmelin, A., Itkovitz, S., Maharshak, N., Shibolet, O., Pevsner-Fischer, M., Shapiro, H., Sharon, I., Halpern, Z., Segal, E., Elinav, E. (2018). Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT. Cell, 174(6), 1406-1423. https://doi.org/10.1016/j.cell.2018.08.047
Tsai, Y., Lin, T., Chang, C., Wu, T., Lai, W., Lu, C., & Lai, H. (2019). Probiotics, prebiotics, and amelioration of diseases. Journal of Biomedical Science, 26(3). https://doi.org/10.1186/s12929-018-0493-6
Zeevi, D., Korem, T., Zmora, N., ..., Halpern, Z., Elinav, E., Segal, E. (2015). Personalized Nutrition by Prediction of Glycemic Response. Cell, 163 1079-1094. .
http://dx.doi.org/10.1016/j.cell.2015.11.001
The findings of the Weizmann Institute study for the glycemic index to be individualized is interesting in relation to the role the microbiome has on metabolic disorders. I wonder how different bacteria affect our gene expression? What particular metabolic and biochemical pathways are affected fro metallic disorders? Is this why it is so personalized, or is there a greater environmental (or prior diet) factor that influenced the presence of the particular bacteria making the microbiome? I found an article discussing microbiota and insulin resistance. From what I gathered certain types of bacteria initiate a cascade response that starts out with an increased permeability and absorption of LPS. This initiates a series of inflammatory pathways that lead to a disruption in insulin signaling an ultimately a resistance. They also talked about environmental factors of insulin resistance. Here is the link of this study. Enjoy! https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705322/
ReplyDeleteAlso, I wonder what a "balanced" diet is for this study because nutrition seems to be a very opinionated topic. I wonder where they get their research in regards to nutrition in this context...
One last note, this program seems to be quite expensive which would leave a lot of people out, which is unfortunate but not surprising. Since it is a program, I wonder if they teach the patients how to live healthier lives rather than just telling them how to follow a protocol. Would there be an end point to the program or is this something that a patient would have to invest in for a while?
Thanks for the read!
I found this information very interesting, especially since we have discussed it so much in class. I looked into DayTwo to learn more about what they do. It looks like their main focus is on the treatment of diabetes and as you said differences in glucose metabolism and distribution by person. However, I looked into the some of the articles that they listed as their scientific support for their company. Their main article, Microbiome-wide association studies link dynamic microbial consortia (Gilbert, Quinn, Debelius, Xu, Morton, Garg, Jansson, Dorrestein, & Knight, 2016) had some great information regarding Diabetes and the microbiome, but it also mentions a large amount of other diseases, such as rheumatoid arthritis, Parkinson's disease, & ASD. After some research of my own, both diabetes and rheumatoid arthritis have been linked with decreases in gut bacteria diversity (Singh, Chang, Yan, Lee, Ucmak, Wong, Abrouk, Farahnik, Nakamura, Zhu, Bhuatni, & Liao, 2017). The decreased diversity in microbiota have prevented biosynthesis of vitamins, essential amino acids, short chain fatty acids (butyrate, proionate, and acetate are all examples) in both diseases. So my question is, if DayTwo is conducting studies with promising results for people with diabetes, would it be unethical to also do studies on how their potential diet switch would also cure other diseases with similar disease processes? If DayTwo is determining the ideal diet for people with diabetes, would they also be able to alleviate symptoms for other diseases? I realize that DayTwo is an expensive treatment option, which limits those who have access to it, directly contradicting the bioethical theory of justice. However, if studies were able to prove without a doubt that diets can assist in treatment of certain diseases, would that be enough to convince insurance companies that this a worthwhile option? This might be something worth looking into, in the scientific community. I am all for treatment options that are long-term and minimally invasive, and diet changes are both of those things.
ReplyDeleteReferences:
Gilbert, Jack A., Quinn, Robert A., Debelius, Justine., Xu, Zhenjiang Z., Morton, James., Garg, Neha., Jansson, Janet K., Dorrestein, Pieter C., & Knight, Rob. (2016) Microbiome-wide association studies link dynamic microbial consortia to disease. Nature. 535, 94-103.https://www.nature.com/articles/nature18850
Singh, Rasnik K., Chang, Hsin-Wen., Yan, Di., Lee, Kristina M., Ucmak, Derya., Wong, Kirsten., Abrouk, Michael., Farahnik, Benjamin., Nakamura, Mio., Zhu, Tian Hao., Bhutani, Tina., Liao, Wilson. (2017) Influence of diet on the gut microbiome and implications for human health. Journal of Translational Medicine. 15(73). doi:10.1186/s12967-017-1175-y.