One Stool Sample Away from a Personalized Diet

Evidence supports the idea that a robust and diverse microbiome is what constitutes a healthy microbiome and it is influenced by our genetics, environment, and lifestyle choices (Rothschild et al. 2018; Sidhu & Poorten, 2017; Suez et al., 2018). Any disturbance in the composition of the human gut microbiome, or dysbiosis, can be correlated with a variety of diseases (Tsai, et al., 2019).

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

Aging reversal: Closer than we thought?

Aging reversal: Closer than we thought?

A Newsweek article this month discussed a recent clinical trial which concluded that we might be moving closer toward reversing the aging process (Lemon, 2019).  The aim of this relatively small trial, titled “Reversal of epigenetic aging and immunosenescent trends in humans” published in Aging Cell, was to determine whether or not using growth hormone was a safe and effective way to restore tissue in the thymus (Fahy et al., 2019).  The thymus gland, located behind the top of the breast bone, plays an important role in immune function (our protective shield against harmful pathogens). 

The clinical trial consisted of 10 healthy men between the ages of 51 to 65 and whose participation was voluntary. However, one participant was removed from the study due to bradycardia which started about 1 month after enrollment.  Patients were injected with a cocktail mix consisting of recombinant growth hormone (rhGH) and two diabetes medications (metformin and dehydroepiandrosterone (DHEA)).  Growth hormone was chosen because it had been previous shown to directly effect that thymus as well as have qualities of restoring the immune system (Fahy et al., 2019). 

Results demonstrated about a 1.5-year decrease of the epigenetic age when compared to patients who did not undergo treatment. Specifically, the rate of patient epigenetic (estimated biological age determined by DNA methylation (measure by how cells are expressed)) age when compared to their chronological age (actual age) rose from -1.6 years (from the initial 0-9 months) to -6.5 years (from 9-12 months with treatment).  In other words, it was estimated that age regression dramatically quickened with respect to the length of time they received treatment (Fahy et al., 2019). 

Although there are no other known studies to corroborated or substantiate these results (Horvath, 2013), the researchers are optimistic that this data may be of future significance because the study demonstrated significant results for thymic regeneration and a significant correlation between thymic fat-free factor (TFFF) (a factor associated with the accumulation of fat tissue around the thymus) and favorable changes in white blood cells of interest (monocytes and leukocytes which protect against infection and disease) (Fahy et al., 2019). In other words, this study implies an ability of the thymus to regenerate and improvement in disease risk factors (Fahy et al., 2019).

This clinical trial appears to be a good step forward in understanding the aging process, however, it does lack diversity through gender, age, and ethnicity. It would be interesting to see if there is any statistical or clinical significance if the population increase to 30+ participants and the gender is expended to include women as well as persons of different cultural ethnic background. 

References:

Fahy GM, Brooke RT, Watson JP, Good Z, Vasanawala SS, Maecker H, ... & Horvath S. (2019). Reversal of epigenetic aging and immunosenescent trends in humans. Aging Cell, e13028.

Horvath S. (2013). DNA methylation age of human tissues and cell types. Genome Biol, 14(10): 3156.

Lemon, J. (2019, September 8). Drug trial reverses patients' biological age by an average of more than two years. Retrieved from https://www.newsweek.com/drug-trial-reverses-biological-age-average-more-two-years-1458204