[HN Gopher] Popular gut probiotic craps out in randomized contro...
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       Popular gut probiotic craps out in randomized controlled trial
        
       Author : zdw
       Score  : 104 points
       Date   : 2024-10-05 13:23 UTC (9 hours ago)
        
 (HTM) web link (arstechnica.com)
 (TXT) w3m dump (arstechnica.com)
        
       | zdw wrote:
       | The headline is some of the best output I've recently seen.
        
         | itronitron wrote:
         | It's a solid and well-formed contribution.
        
           | hanniabu wrote:
           | Both of you sound like bots
        
             | projektfu wrote:
             | That was the wrong criticism and your model will need to be
             | retrained. The correct response is "this isn't Reddit".
        
               | exe34 wrote:
               | good bot
        
             | zdw wrote:
             | Ah, I'm not definitely not todsacerdoti , who automated
             | reposting all of lobste.rs to HN.
             | 
             | My pithy comment was actually inspired by Sir Patrick
             | Stewart's interview about his role in the Emoji movie:
             | https://youtu.be/CgAIqP6hNlQ?t=215
        
             | Ekaros wrote:
             | I prefer these bots to those that prose profusely
             | generating larger than human piles of crap...
        
           | hedora wrote:
           | Yeah, but the register is more regular. This one's been
           | ripening for a decade and is as fresh as the day it was
           | produced:
           | 
           | https://www.theregister.com/2014/01/20/haribo_gummy_bears_im.
           | ..
        
         | morkalork wrote:
         | Beth Mole is as consistent as ever
        
         | ramesh31 wrote:
         | Every so often you get the chance to make something perfect.
         | Must have been a good day.
        
       | the_sleaze_ wrote:
       | Best gut related health I ever had was living in France and
       | eating stinky raw cheeses and different fermented foods. Like
       | clockwork.
        
         | m3kw9 wrote:
         | Gotta hit up the cheese fests now
        
         | darth_avocado wrote:
         | There's two different effects hidden in that statement
         | 
         | > living in France
         | 
         | I have had similar experience where my gut health was
         | immediately, noticeably better in Europe. I was eating the same
         | foods and somehow it was better.
         | 
         | > Eating stinky raw cheeses and different fermented foods
         | 
         | Raw and fermented foods in cultures across the world are linked
         | to better gut health. However, industrial fermentation and
         | packaging won't help you as much because the diversity of
         | microbes drops and packaging often kills most of them. We need
         | to bring back the culture of home fermentation.
        
           | waihtis wrote:
           | > my gut health was immediately, noticeably better in Europe
           | 
           | Its because a lot of the weird artificial junk that are
           | allowed to be put into your food is illegal in Europe. Even
           | things like popular sweeteners have been shown to have a
           | negative effect on your gut health.
        
             | hedora wrote:
             | Most sweeteners also have been shown to cause more weight
             | gain than sugar (they screw up your metabolism). Unless
             | you're diabetic, there's literally no reason to consume
             | them.
        
               | cenamus wrote:
               | I'd like to see a source on that, because (excessive)
               | sugar literally causes diabetes.
               | 
               | And of course high sweetener consumption is must be
               | strongly linked with in general high calorie input and
               | overweight people trying to reduce calorie consumption.
        
               | Spivak wrote:
               | Your first point probably isn't actually true. The
               | research that first connected the two showed that across
               | a population sugar consumption up -> diabetes rates up.
               | But it turns out that when you control for weight the
               | effect of sugar specifically is much much smaller. To the
               | point where if you're a healthy weight your sweet tooth
               | isn't moving the needle.
        
               | Spivak wrote:
               | Oh that's not true at all. First I think they taste
               | better, they're sweet without being syrup-y. Second it
               | allows me to drink a lot of soda, 5+ cans a day adds up
               | when it has calories. I have no expectation that it helps
               | me lose weight, it's just tastier water.
               | 
               | It's funny that folks will look down on diet soda but
               | then be fine with tea and coffee and sports drinks like
               | the bubbles make it meaningfully different.
        
               | riffraff wrote:
               | 5+ cans of soda a day seems unhealthy even if it's not
               | caloric, the gas and acid will mess up your stomach.
               | 
               | It is not just tastier water.
        
               | Spivak wrote:
               | Given that in France "water" means carbonated water and
               | you have to specifically ask for "still water" I can't
               | imagine the gas being that bad for you.
               | 
               | Acid I can get behind but soda is by far the least acidic
               | thing I consume on the daily.
        
               | Spooky23 wrote:
               | The carbonation creates carbonic acid in your teeth. It's
               | a huge driver of calories.
               | 
               | Of the of the issues with diet soda in particular is your
               | tastes favor sweets. I used to drink 4-8 cans of Diet Dr
               | Pepper daily. When I stopped, after a couple of weeks I
               | found my taste preferences to be very different. I'd
               | favor savory more attractive and sweet stuff would seem
               | too sweet.
        
               | loeg wrote:
               | No, they have not. The evidence points the opposite way
               | (people lose more weight on non-nutritive sweeteners than
               | sugar).
        
             | SoftTalker wrote:
             | Also non-flouridated, non-chlorinated water.
        
               | manoweb wrote:
               | I lived most of my life in an alpine European village;
               | water was chlorinated and flourinated, more than in my
               | current US location. There was a huge difference in
               | mineral content, US water being almost distilled (1 to 3
               | French degrees hardness) VS something like 15-20 in
               | Europe
        
               | azinman2 wrote:
               | Water hardness varies by location worldwide, including
               | the US.
        
               | pfdietz wrote:
               | Non-flouridated is gluten-free, right?
        
               | verisimi wrote:
               | Artisanal
        
             | sroussey wrote:
             | The preservatives in flour / bread / etc are illegal in
             | Europe. My sister is allergic and can't have any bread in
             | the USA. But can in France and Italy.
        
               | waihtis wrote:
               | Yeah, things like titanium dioxide are considered a
               | carcinogen by the International Agency for Research on
               | Cancer (IARC) yet FDA says its safe for use in food. But
               | i guess trust the science and authorities
        
               | raydev wrote:
               | Please share the names of these preservatives.
        
               | 10xalphadev wrote:
               | Durex and Trustex.
        
             | azinman2 wrote:
             | Europe puts plenty of E numbers in their food (the US just
             | spells it out versus hiding it under a number). There are
             | things illegal in the US that are used in food in Europe. A
             | lot of the time, at least for things like pesticides, the
             | different is country of origin of manufacturer.
        
               | jenny91 wrote:
               | E numbers have very little to do with this. They are just
               | a way to categorize food additives.
        
               | azinman2 wrote:
               | What else would you characterize " weird artificial junk"
               | as?
        
               | mikrl wrote:
               | Growing up in the EU in the 00s there was always the
               | public health concerns of E numbers causing this or that.
               | 
               | Ironic in a way, because E numbers mean that the specific
               | chemical has been cleared as a foodstuff in the EU, IIRC.
               | 
               | Though I suppose it's more concerning if an approved
               | substance has some unforeseen effect versus an unapproved
               | one and you'd want to investigate further.
               | 
               | I guess it shows how government regulation of naturally
               | occurring substances (though perhaps synthesized, or
               | refined) carries with it a new set of incentives, and
               | reasons to be political. Not that I'm against regulation,
               | but it's hard if not impossible to have a truly
               | politically neutral approach.
        
             | raydev wrote:
             | > a lot of the weird artificial junk that are allowed to be
             | put into your food is illegal in Europe
             | 
             | What are some examples? A list would be helpful.
        
               | Spooky23 wrote:
               | I don't follow this too closely, but having been in
               | Europe for a few weeks, the food tastes noticeably better
               | and is often cheaper than the US.
               | 
               | One of the things you notice is shorter ingredient lists
               | on prepared food. The ingredients in Italy for McDonald's
               | French fries are: potato, salt, oil. In the US there's
               | 7-8 including hydrogenated soybean oil and flavor/color
               | agents. Oreos were similarly different, and arguably
               | better tasting.
               | 
               | I believe they regulate flavors and coloring additives
               | differently, and many people feel both of these type of
               | items can be problematic.
        
           | Brian_K_White wrote:
           | But of course can never happen because it only takes a
           | minority to cry about a few factual bad stories and present
           | the fallacious "is it worth it" argument. "Is your epicurian
           | enjoyment worth even one dead baby?" And a majority who have
           | no reason to think much about it go along with it because no
           | one will say "yes it's worth it" and few are able to
           | articulate how the question was invalid in the first place.
           | 
           | The opposite minority argument, that variety, depth,
           | richness, are important, not luxuries, don't have their own
           | dead babies to present. They do exist, but they aren't
           | visible except in aggregate. You can measure a change in
           | average health over the course of entire generations, and
           | from that you can extrapolate the change in number or
           | frequency of deaths, and then you could compare numbers of
           | dead babies. But you can't obviously show any particular
           | cause & effect because there are so many other variables, and
           | even if you could, it took entire generations whole lives
           | lived and died before they could benefit anyway.
        
             | tyre wrote:
             | okay wow deep breath, you can just ferment things at home,
             | it's fine, I did it twice last week
        
               | Brian_K_White wrote:
               | That doesn't actually solve anything.
        
               | daneel_w wrote:
               | How do you know until you've fermented something at home
               | and risked life, limb, dead babies etc. by consuming it?
               | I think more people die from food poisoning in
               | restaurants each year than people do from doing something
               | stupid while making sourdough bread, natto, tempeh,
               | kombucha, beer, wine etc. at home.
        
               | elcritch wrote:
               | Also, it's usually pretty obvious when fermenting goes
               | bad. My take is fermentation takes a while which really
               | allows the biological process to become really positive
               | or really rancid.
        
               | Brian_K_White wrote:
               | It doesn't solve anything because it's an individual
               | action to a societal problem.
        
             | gamblor956 wrote:
             | _But of course can never happen_
             | 
             | Home fermentation of foodstuffs is allowed, and always has
             | been.
             | 
             | Lots of people do it. Kits are available on Amazon, and
             | many grocery stores will even sell them in-store. As other
             | people on this thread of have pointed out, they ferment a
             | lot of their own foods and drinks.
             | 
             | What isn't allowed is _selling_ home-fermented stuff to
             | others. When someone goes commercial, rules kick in to
             | protect their customers
        
               | Brian_K_White wrote:
               | What can never happen is the majority agreeing that it's
               | good, and actually doing it, and having this become so
               | accepted that it is no longer disallowed for selling.
               | Without selling, most people will not get it.
               | 
               | It's possible. A wave could go through where it becomes
               | popular and the majority adopt some new attitude on that
               | topic. But it "can never" because of the dynamic I
               | expressed. That works against it. The new thought is not
               | developing in a vacuum.
        
               | gamblor956 wrote:
               | _having this become so accepted that it is no longer
               | disallowed for selling._
               | 
               | This is a nonsensical train of thought that conflates
               | multiple distinct issues.
               | 
               | Fermented products are already widely sold in stores and
               | restaurants. And homemade foodstuffs _can already be
               | sold_ but are subject to the same rules and regulations
               | that govern foods made in commercial facility. These
               | rules generally preclude the sale of homemade fermented
               | foodstuffs, because the risk of contamination if the
               | foods are improperly fermented is extremely high and most
               | home kitchens lack the necessary equipment or facilities
               | needed because this is all very expensive compared to
               | consumer equipment. This is why there are so few
               | fermented foodstuffs available at farmer 's markets in
               | the U.S.; the initial capital outlay puts it out of
               | reach.
        
           | jonnycomputer wrote:
           | I agree about diversity. We use a very limited range of
           | cultures in mass manufactured foods.
        
           | murukesh_s wrote:
           | >I have had similar experience where my gut health was
           | immediately, noticeably better in Europe. I was eating the
           | same foods and somehow it was better.
           | 
           | Could be due to you being in a better mental state. Gut-brain
           | axis is very evident for me personally. If I am tense gut is
           | the first to get affected.
        
             | 4gotunameagain wrote:
             | The refusal to over-industrialise food in Europe (compare
             | to the US) leads to higher quality, more "natural" food.
        
           | FredPret wrote:
           | Another possibility: dishwashers are more rare in Europe -
           | the soap residue some of them leaves on irritates some
           | stomachs.
        
             | looperhacks wrote:
             | That sounds counter-intuitive? I doubt most people take the
             | time to rinse everything off with clear water. Dishwashers
             | on the other hand always have a rinsing step
        
               | pfdietz wrote:
               | Maybe the problem is rinse aids in dishwashers? These
               | prevent spotting on glass by adding detergent.
               | 
               | I just put water in the rinse aid dispenser of my
               | dishwasher.
        
               | bluGill wrote:
               | redacted, see correct info in replies
        
               | pfdietz wrote:
               | I don't believe that's true. To quote wikipedia: "Rinse
               | aid (sometimes called rinse agent) contains surfactants
               | and uses Marangoni stress to prevent droplet formation,
               | so that water drains from the surfaces in thin sheets,
               | rather than forming droplets."
               | 
               | Looking at the back of a bottle of Finish Jet Dry (which
               | I have refilled with water), the original stuff's first
               | ingredient (after water) is "C 12-15 Alcohols Ethoxylated
               | Propoxylated". These are nonionic surfactants, and are
               | not what one normally means by "alcohol" (ethanol).
               | 
               | I can understand where the idea came from. Drinks like
               | wine will exhibit sheeting on the sides of glasses too.
               | The concentration of alcohol needed for that to happen is
               | probably too high in a dishwasher, I'd imagine.
        
               | pxndxx wrote:
               | Yeah but dishwasher soap is a different kind of soap,
               | it's way stronger. Plus dishwashers also use rinse aid
               | which has its own set of problems.
        
               | AyyEye wrote:
               | There is enough residue left over that even diluted 1:10
               | its still cytotoxic. [1]
               | 
               | I seem to recall a post here a while ago showing that
               | dishwasher residue was genotoxic as well but can't find
               | it atm.
               | 
               | [1] https://www.sciencedirect.com/science/article/pii/S00
               | 9167492...
        
               | selimthegrim wrote:
               | It was about the rinse aids in commercial dishwashers at
               | commercial dose levels. Residential levels were not shown
               | to be harmful.
        
             | homarp wrote:
             | https://www.statista.com/forecasts/1174175/dishwasher-
             | owners...
        
               | FredPret wrote:
               | I'd love to see this stat but I don't have access - mind
               | posting the gist of it?
        
         | jajko wrote:
         | My wife recently got Kombucha mushroom from a friend, and got
         | into fermenting it herself. Its trivial to do, you need to
         | really screw up something for it to go wrong, tons of good
         | bacteria inside. She takes some basic precautions like avoiding
         | metal parts (since the drink becomes acidic), otherwise its on
         | autopilot, good bacteria outcompete everything else for
         | resources.
         | 
         | She mixes it with some cut fruits to get some sugars for
         | fermentation, the result is very mild alcohol content (maybe
         | 0.5%) and it tastes like cider. I mix it maybe 1:3 with water
         | and its semi-eternal homemade drink. Can't really complain.
         | 
         | That and of course french cheese, we live maybe 5km from French
         | border and for cheese its much better place than even
         | Switzerland (sorry guys gruyere is great but french variety is
         | huuuuge in comparison and they even usually have specialties
         | like old dutch gouda which is taste heaven for me and various
         | truffle-infused ones).
        
           | Y_Y wrote:
           | Fyi kombucha isn't made from a "mushroom". It's a combination
           | of bacteria and yeast and can be found in the liquid itself
           | or the pellicle (blob of organic tissue) that forms during
           | fermentation.
           | 
           | https://en.m.wikipedia.org/wiki/SCOBY
        
             | murkt wrote:
             | Wow, hearing about "tea mushroom" (that's how it's called
             | in Ukraine) for my whole life, and it's not a mushroom!
             | 
             | Fascinating.
        
               | zdragnar wrote:
               | Well, it is a partly a yeast, which is a fungus, as are
               | mushrooms. The main thing is that it is a symbiotic
               | combination of particular yeast and bacteria strains,
               | unlike what is used for brewing alcoholic drinks (just
               | yeast) or fermenting dairy into yogurt (just bacteria).
               | 
               | Kefir is another combination of yeast and bacteria,
               | though different strains.
        
           | bloaf wrote:
           | There are some choices you can make that seem innocuous but
           | dramatically increase the chances of lethal outcomes, like
           | using corn or coconut.
           | 
           | https://www.youtube.com/watch?v=yXnSYfv6bCA
           | https://en.wikipedia.org/wiki/Bongkrek_acid
        
             | jajko wrote:
             | Thank you, I would never thought about using corn for such
             | stuff, but that coconut surprised me
        
         | maxerickson wrote:
         | Are you lactose intolerant?
         | 
         | A small amount of lactose can have a sort of laxative effect
         | without causing discomfort.
        
       | trilbyglens wrote:
       | Should be noted that constipation relief is far from the only
       | benefit that probiotics provide to your gut biome. Healthy gut
       | biome has been linked to lower levels of depression and lots of
       | other things seemingly unrelated.
        
         | raincole wrote:
         | > Should be noted that constipation relief is far from the only
         | benefit that probiotics provide to your gut biome.
         | 
         | You mean _claimed to_ provide.
        
           | hanniabu wrote:
           | Anecdotal but I'm on a very strict diet, to the point where I
           | have the same thing every meal, every day. There's certain
           | probiotics I take that help bowel movements and some that
           | slow things down. It's very repeatable and given I eat the
           | same thing every meal every day and I'm on a regular eating
           | and activity schedule that leaves very little other
           | variables.
           | 
           | My guess is that for regular people the benefit is
           | insignificant but it's greater for people with issues
           | (dysbiosis).
           | 
           | And the type of dysbiosis you have will determine the effect
           | of the probiotics. For some it can slow motility or cause
           | constipation and others increase motility or cause diarrhea.
           | 
           | There's so many internal variables with your gut microbiome
           | and there's a general lack of reliable methods to test your
           | microbiome. This makes tests like these really difficult and
           | also makes it difficult to treat digestion issues. Because of
           | this, all gastro doctors can really do is slap on IBS/IBS
           | label but not really have a course of action with any decent
           | success rate.
        
         | homebrewer wrote:
         | Read the article, placebo was just as effective as these
         | "probiotics".
        
           | ecef9-8c0f-4374 wrote:
           | Wasn't this only about supplementation?
        
       | spants wrote:
       | If you want to improve your gut health, stop eating meat and go
       | vegan. But most of you would rather take meds instead.
        
         | hanniabu wrote:
         | Some people have dysbiosis which makes it impossible to have
         | most vegetables
        
           | shermantanktop wrote:
           | People who have things which are exotic, rare, or complicated
           | don't present some kind of existence proof against advice
           | directed at a general population which doesn't have those
           | conditions.
        
         | bryant wrote:
         | If the concern is just meat, why not go vegetarian instead?
        
           | CapitalistCartr wrote:
           | Wearing this leather belt is what's causing my constipation.
        
             | hinkley wrote:
             | Get a bigger belt, friend.
        
           | SoftTalker wrote:
           | What kind of vegetarian? Some allow eating eggs and dairy.
           | Some allow fish or even birds.
        
           | 2OEH8eoCRo0 wrote:
           | Because it's more about being an absolutist snob than
           | anything. Vegans don't eat honey. If I have a pet hen I can't
           | eat the eggs? Ridiculous.
        
         | wusher wrote:
         | I had the exact opposite experience. when I stopped eating meat
         | I got worse. When I stopped eating vegetables I got better. I'm
         | not saying you shouldn't eat vegetables, I'm saying your claim
         | isn't as strong as you think it is and peoples gut issues are
         | different.
        
           | dpassens wrote:
           | Am I misunderstanding or do you really not eat any vegetables
           | at all, not even in a dish with meat?
        
             | BenjiWiebe wrote:
             | Some friends of mine tried the carnivore diet for a while.
             | From what I understood they did not eat meat dishes that
             | included vegetables.
        
           | lepus wrote:
           | A lot of people go all in on increasing dietary fiber and
           | then experience gut issues and think it must be the plants
           | when they didn't work into it slowly enough. It's like going
           | to the gym and and feeling sore all over all the time or even
           | getting injured and then concluding that going to the gym is
           | bad when no one told you that you should start easy. In my
           | opinion there's harm in how people fail to communicate how to
           | get started on plant based diets when they miss important
           | issues like this that can permanently put people off from it.
        
         | loeg wrote:
         | There's absolutely no evidence that a vegan diet provides a
         | benefit for gut health relative to a diet including meat.
        
         | homebrewer wrote:
         | Just wondering, have you ever managed to convert or convince a
         | single person by acting like a stereotypical vegan?
        
           | kstenerud wrote:
           | If you're not going to judge people, then why bother at all?
        
             | hinkley wrote:
             | How do you know if someone is a vegan?
        
               | cwbriscoe wrote:
               | Don't worry, they will tell you.
        
         | BenjiWiebe wrote:
         | Some friends of mine tried the carnivore diet. One thing they
         | noticed was improved gut health.
        
       | njtransit wrote:
       | It's interesting that both groups had their number of bowel
       | movements double or more. Perhaps a lot of constipation is
       | actually dehydration.
        
         | mirekrusin wrote:
         | Like this magic pill to loose weight that you need to take
         | before every meal with large glass of water, where pill is
         | optional.
        
           | tyre wrote:
           | or Emegen-C or hangover cures
        
             | jeltz wrote:
             | If they contain some salt they are better than just water.
        
         | Nifty3929 wrote:
         | If you take one of these little pills with a large glass of
         | water for every alcoholic beverage you drink, then it will
         | prevent hangovers.
        
         | datavirtue wrote:
         | Bingo. These finding probably aren't much of a surprise to
         | many. Hydration is huge, as is having a well functioning and
         | diverse biome that you feed regularly with raw fruits and
         | vegetables. I have had my biome die back to the point of
         | medical emergency and had to restore it. Keifer, various Greek
         | yogurts, etc did nothing to help. I took half a bottle of a few
         | pills that were loaded with different strains. Not only did it
         | restore bowel function to its former glory, it improved my
         | health overall and I feel like a teenager again (46). I was
         | deficient and suffering for decades and just thought it was
         | normal. It dawned on me that most people are likely suffering.
         | 
         | I'm far too overweight for my liking but now I don't feel fat.
         | Restoring the biome made me stronger and more resilient (my
         | muscles stay stronger between workouts). I just feel good all
         | the time now. Before this I had psychologically written myself
         | off as dying and was ready to accept my fate.
        
           | lukevp wrote:
           | This sounds super interesting. The pills you are talking
           | about are probiotics? Have some links to which ones you took
           | and maybe some research you did about this?
        
             | datavirtue wrote:
             | Check my other replies for the brands. I don't think it
             | matters as long as the quality is assured. I had known
             | about probiotics for decades but never realized how
             | fundamental they were to overall health. When I was going
             | through this I just thought about my symptoms and took a
             | hail Mary with this treatment. Bowel movements were
             | extremely stressful at that stage. I was depriving myself
             | of anything solid to alleviate the issues but overall I was
             | not getting better. Previous to that I was doing fine, or
             | so I thought. I never ate out, rarely ate meat or anything
             | processed.
             | 
             | You will know when it's restored, you can even eat garbage
             | (meat, processed foods) and your gut will process it and
             | move on. You should be able to notice the subtle changes
             | when you eat something that does not digest readily. It's
             | not the acid and body mechanics, it's mostly the bacteria
             | giving you life by breaking down nutrients and solids. Feed
             | it what it needs and it will sustain itself. Raw and
             | fermented vegetables.
        
               | maxerickson wrote:
               | Meat is nutritious and very satisfying per calorie, it is
               | not "garbage". To think it is garbage is to have a very
               | confused view of nutrition.
        
           | calf wrote:
           | Wait what. I am 99% convinced my gas and bowel problem, an
           | impairment at this point, is IBS or SIBO that started 12
           | years ago. I never thought a about just taking a half bottle
           | of pills to see what would happen, I am going to have to look
           | into this.
        
             | olyjohn wrote:
             | What the hell? Half bottle of what pills? Are you and the
             | parent a bot?
        
               | magicalhippo wrote:
               | Probiotic pills presumably.
        
               | datavirtue wrote:
               | Half a bottle over two weeks. Geesh.
        
             | elcritch wrote:
             | I'm assuming the parent meant pills with few different
             | strains. Seems like a massive dose of a few different
             | strains would approach that of a fecal transplant.
        
             | datavirtue wrote:
             | You can't just slam pills. The pills contain the bacterium.
             | You have to send it raw vegetables to feed it so it
             | multiplies and sustains itself.
        
           | dylan604 wrote:
           | > These finding probably aren't much of a surprise to many.
           | 
           | Conversely, you might be surprised at how many this is new
           | information. Just because you learned something does not mean
           | everyone hearing the information at the same time. Some
           | people require hearing/reading something new only one time,
           | others takes many attempts. I think the number of people that
           | walk around with a suboptimal fluid intake is much higher
           | than we might hope, especially in the USA
        
           | kbmr wrote:
           | Which pills specifically did you take?
        
           | captain_coffee wrote:
           | what did you take - specifically?
        
           | hn_version_0023 wrote:
           | You should return and tell us with some specificity what you
           | took.
        
             | datavirtue wrote:
             | I'm hesitant to mention brands. Any independently tested
             | product with a wide variety of strains should be good. I
             | started on Physicians Choice from Amazon and followed up
             | with Garden of Life (not sure who sells it). During repair
             | phase I would only eat salads made of hand shredded green
             | and purple cabbage and kale. Equal amounts cabbage kale
             | mixture and shredded ice berg lettuce. I used ranch
             | dressing and added other vegetables and crushed corn chips.
             | To each his own.
             | 
             | These were huge salads. I couldn't even think of eating
             | anything else after I finished them.
        
         | gus_massa wrote:
         | I agree, and that's why they used a " _randomized triple-blind
         | placebo-controlled clinical trial_ ".
        
         | MostlyStable wrote:
         | That's plausible, but also, could be the frequent things just
         | getting better on their own over time.
        
       | XorNot wrote:
       | This is about Bifidobacterium animalis subsp. lactis.
       | 
       | Personally I take L. Reuteri supplements, which for me have made
       | an unbelievable difference in suffering from IBS symptoms (and
       | have some clinical evidence to support having an effect). This
       | was a result a recommendation somewhere else on HN about 2 years
       | ago now, so I'll pass it forward whenever the topic comes up.
       | 
       | In my experience it took about 3 months to see effects (during
       | which time I did feel somewhat worse), and currently if something
       | happens - i.e. I get sick - then there's a bit of reversion
       | towards feeling bad. But: I was also able to stop taking them for
       | about 6-9 months before it seemed like the effect was
       | diminishing.
        
         | graeme wrote:
         | Which version of L. Reuteri did you take?
        
         | bloopernova wrote:
         | This has helped some folks' IBS symptoms: https://www.vsl3.com/
         | 
         | Contains:                 Streptococcus thermophilus
         | Bifidobacterium breve        Bifidobacterium lactis (previously
         | classified as B. longum)       Bifidobacterium lactis
         | (previously classified as B. infantis)       Lactobacillus
         | acidophilus       Lactobacillus plantarum       Lactobacillus
         | paracasei       Lactobacillus helveticus (previously classified
         | as L. delbrueckii subsp. bulgaricus)
         | 
         | I'll have to research L Reuteri, thank you for mentioning it.
        
           | eth0up wrote:
           | Might include b. subtilis on your list.
        
       | jonnycomputer wrote:
       | For what it's worth, I always thought that yogurts, etc. are
       | better at slowing down digestion/dealing with diarrhea than
       | constipation.
        
         | guilhas wrote:
         | That is my experience too. Although *google says this probiotic
         | is associated with both diarrhea and constipation, by improving
         | gastrointestinal health
         | 
         | And would probably depend on what caused their constipation
        
       | AlbertCory wrote:
       | Whenever some theme gets broad advertising, I get suspicious.
       | "Helps boost the immune system!" -- WTF does that mean?
       | 
       | "Probiotics for gut health!" -- yeah, right. Get back to me in 10
       | years when you have some actual evidence.
        
       | mg wrote:
       | There is a lot of confusion on how to interpret studies.
       | 
       | The reasoning of this article seems to be "The study did not
       | produce a significant result, therefore the treatment is
       | ineffective".
       | 
       | But that is not how to think about significance.
       | 
       | Otherwise, you could show for any treatment that it is
       | ineffective. By simply doing a study small enough to produce an
       | insignificant result.
        
         | loeg wrote:
         | True, but in this case the study sponsor is financially
         | motivated to find a non-null result, not a null result.
        
         | jessriedel wrote:
         | This mistake is so unbelievably frequent. Need a concise quip
         | like "correlation isn't causation".
        
       | samuraijack wrote:
       | Why is it interesting to just test one brand of probiotic with a
       | single strain of bacteria?
       | 
       | Surprised to see it on arstechnica and HN.
        
         | loeg wrote:
         | The companies selling products containing that bacteria would
         | like to sell more units. Agree that the null result is not
         | super interesting.
        
         | SammyStacks wrote:
         | Yeah, both the title and content of the arstechnica are
         | spreading misinformation. The mainstream media has always been
         | terrible at accurately representing the findings of a given
         | academic study, but this is disappointing.
         | 
         | The study was conducted with people who had chronic
         | constipation as measured by complete spontaneous bowel
         | movements (CSBMs). A bowel movement qualifies as a CSBM if the
         | individual had not used a laxative within the last 24 hours.
         | Prior to intervention, participants had a mean of 0.77
         | CSBMs/week with an SD of 1.0. That is quite extreme so the
         | results of the study cannot be generalized to the general
         | public.
         | 
         | Additionally, both the probiotic group and control group
         | experienced positive effects, even if the probiotic group
         | didn't outperform the control group. That's extremely
         | meaningful and requires further investigation. Perhaps the
         | belief of taking a digestive supplement caused individuals
         | lower stress and/or motivated other healthy lifestyle changes?
         | Science shouldn't be viewing the placebo effect as evidence
         | that something else is BS; we need to view the placebo effect
         | as a psychological tool to effect positive change.
         | 
         | Finally, the study tested only one bacteria strain. I have not
         | seen any recommended probiotic supplement that includes only
         | one strain of bacteria.
         | 
         | More research is needed; the title is clickbait and the article
         | doesn't sufficiently emphasize the major limitations of the
         | study. Really a shame to see that type of reporting.
        
       | gojomo wrote:
       | I'd never heard a single strain could affect constipation, so
       | these results unsurprising.
       | 
       | Where attention to the gut biome has really saved lives is when a
       | person has massive Clostridium difficile overgrowth - which is
       | more associated with uncontrollable diarrhea than constipation.
       | This state of extreme illness is typically only possible because
       | prior antibiotic use cleared out the natural variety of commensal
       | bacteria that normally keeps this particular strain at bay (or
       | totally absent).
       | 
       | In such cases, people near death can bounce back after a full-
       | spectrum "fecal microbiome transplant" (FMT) where all of the
       | hundreds-or-more of distinct bacterial species are transferred
       | from a healthy donor to the patient.
       | 
       | It's quite hard to package all those sensitive, beneficial,
       | adapted-just-to-the-human-gut strains for reproducible evaluation
       | & administration - so FMT is hard to fit into standard medical
       | studies & FDA approval processes.
       | 
       | But sometimes a mere dot's worth of a healthy person's feces can
       | be a miracle cure for someone else! So, a company has driven an
       | approval of _their_ particular $10k-per-treatment shit-pill
       | through FDA processes, and partially as a consequence, the FDA
       | has been cracking down on people arranging FMTs in less-formal  &
       | far-cheaper ways - despite a great record of safety and
       | effectiveness.
       | 
       | A well-informed & highly-opinionated rant on this topic: "A
       | Monopoly on Poop"
       | https://stephenskolnick.substack.com/p/a-monopoly-on-poop
        
       | rbattula wrote:
       | im over ars
        
         | ptsneves wrote:
         | It also became a site I rarely visit compared to some years
         | back when I did several times a day and even subscribed. They
         | have some good writers in house but otherwise it has descended
         | into politics and pop culture movies and gadgets, with the odd
         | ode to violence like monkey torture stories or Viking
         | eviscerations. The space news are maybe the best online.
        
       | frereubu wrote:
       | After getting really annoyed with the pseudoscientific naming
       | around this I built a whole site about it a couple of decades ago
       | to get to the top of search results and got threatened with a
       | lawsuit by Danone...
       | 
       | https://whatisbifidusregularis.org/
        
       | nikolay wrote:
       | Don't buy probiotics - eat quality grass-fed organic yogurt (such
       | as Trimona [0]) and home-made sauerkraut - these have centuries
       | of evidence. As a Bulgaria, we traditional make sauerkraut every
       | year. It's pretty easy to have it, you just need a little more
       | attention to it in the first weeks. The juice is amazing, too.
       | You can buy it from Amazon [1].
       | 
       | [0]: https://trimonafoods.com/
       | 
       | [1]: https://amzn.to/3ZO0Sxl
        
         | permo-w wrote:
         | and by "evidence" you mean?
        
           | nikolay wrote:
           | Longevity in general (don't judge by today's fully Lidl-ized
           | & Kaufland-ized diet of modern Bulgarians). The research
           | dates back to the 19th century and Ilya Ilyich Mechnikov [0].
           | 
           | [0]: https://en.wikipedia.org/wiki/%C3%89lie_Metchnikoff
        
           | 2OEH8eoCRo0 wrote:
           | https://nutritionsource.hsph.harvard.edu/food-
           | features/yogur...
        
             | jessriedel wrote:
             | That article says
             | 
             | > Epidemiological research on specific health effects of
             | yogurt is still limited but a few studies suggest a
             | benefit.
             | 
             | It then describes three non-randomized observational
             | studies.
        
               | nikolay wrote:
               | That's the issue with nutrition - you can't really
               | randomize as every person is on a different diet that's
               | hard to control. Plus, how are you going to radomize when
               | people know what they're eating - you can't create non-
               | yogurt that's identical to yogurt for the controls!
        
       | guilhas wrote:
       | More specifically "probiotic X didn't work for Chinese people
       | with constipation"
       | 
       | But that's a typical arstechnica title
        
       | sgc wrote:
       | Apparently almost any strain of lactobacillus should be able to
       | make some type of yogurt (each one with a distinct flavor). I
       | have taken relatively expensive probiotic supplements sold in a
       | very famous supermarket in the US known for this type of thing
       | (yes, that one), which claim to have close to a dozen strains of
       | lactobacillus. It was utterly incapable of even beginning to make
       | yogurt. It was just plain milk at the end of the process, not
       | even a discernible yogurty taste to it. On the other hand, we had
       | great success using a cheap yogurt starter we found sitting
       | around that had expired 5 years ago. I would love to have a full
       | spectrum of probiotics, but can't spend the money to actually
       | find one that works, so I have to stick to homemade yogurt.
        
       | albertsw wrote:
       | Huberman [1] lists several studies emphasising mucrobiota
       | diversity and health as the major factor. These studies seen to
       | find that the way to get it is fermented foods, like sauerkraut,
       | kimchi, kefir etc. and that commercial probiotics don't seem to
       | do much.
       | 
       | [1] https://www.hubermanlab.com/newsletter/6-key-tools-to-
       | improv...
        
       | hnpolicestate wrote:
       | The thing that has treated acute IBS episodes for me is ib guard.
       | The green box. Though I'm pretty sure the primary ingredient is
       | just peppermint oil.
        
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