Listening to My Gut
Using the Viome Microbiome Testing Service
Only half of the cells in our bodies are of human origin. The other half is made up of the cells of bacteria.
Along with single-celled organisms, fungi, viruses and other microbes living in our gut with bacteria, this makes up what is collectively known as our microbiome.
What's inside our stomach has an impact on our health and overall wellbeing. An increasing amount of scientific studies are looking into the microbiome and how this co-dependent relationship links to a plethora of diseases and conditions, from diabetes to autism and anxiety to obesity.
It's even been suggested that it's linked with how well we sleep, and improving sleep is an ongoing project of mine.
"We depend on a vast army of microbes to stay alive: a microbiome that protects us against germs, breaks down food to release energy, and produces vitamins."
The best way to improve our microbiome is by what we eat. Enter personalized nutrition service and microbiome testing company Viome. Here’s what I’ve learned using the Viome service . . .
Personalized Nutrition
Back in 2015, I did a first look at my microbiome using a service from Ubiome, one of the pioneers of this space.
While it did give me a look at my microbiome, it didn't give me very good actionable advice. It felt more like a citizen science project at the time, ultimately going bankrupt at the end of 2019.
Inside Tracker Report
I also have tried Inside Tracker, which “analyzes your blood, DNA, and lifestyle habits, and guides you to your goals with actionable recommendations.” I've tested with Inside Tracker three times since 2015 and found it informative, having impacted my supplement use and how often I eat fish.
But blood and DNA testing is different than microbiome testing since the latter is looking at the organisms inside you.
Microbiome testing had been improving since my uBiome experience 5 years ago, and Viome had emerged as a reputable service. So I wanted to give a microbiome test another try.
I believe nutrition is a personalized program. General advice is not good enough; we are all too unique. What we eat is a N of 1 experiment where you are the scientist and the subject of what works for your individual needs.
“Food is really to a large extent the personalized drug we take every day. Every food you take changes what is being expressed in your gut,” Viome founder and CEO Naveen Jain said.
And Jain is not the only entrepreneur realizing this potential to help people improve their performance and wellbeing as the personalized nutrition market is set to reach $11.35 billion by 2026, up from $5.59 billion in 2018.
Variability in the gut microbiome helps to explain why people respond differently to the same foods. “Whether tomatoes are good or bad for you, whether rice is good for you or worse for you than ice cream and so on is explained by your microbiome,” Rob Knight professor at the University of California San Diego and human microbiome expert told The Guardian.
Viome says they "offer comprehensive health insights about your internal ecosystem that empower you to make the best lifestyle and nutrition choices for you."
My Experience with Viome
I sent off for a microbiome testing kit, aka a poop test kit, which cost $119 for a single kit during a holiday sale.
I actually ordered two kits, one for my partner as well, a very glamorous holiday gift. The reality of changing nutritional behavior in a household is exponentially more likely when everyone bringing food into the home is working on the same goals.
Next I downloaded the Viome app, which turned out to be a little clunky and slow. That was surprising considering the sharp marketing experience and team behind the company. In contrast, the desktop experience was much smoother.
While I awaited for the kit to arrive, I answered the Viome Questionnaire so it could "tailer your results to your gut microbiome." The questionnaire takes some time to complete, over 30 min for me spread over a few sessions. The questions cover basic personal information, overall wellness, how food affects you, your physical and mental wellbeing, and daily lifestyle choices.
The kits arrived a week later in sleek packaging, a glamor lift to the task ahead.
The process was straight forward and ultimately pretty easy. The kit includes a paper cover for your toilet to collect a stool sample, a scoop, for what turns out to be a very tiny sample amount, and a vial to insert the sample. Close the vial and shake it up for a few minutes, then drop it into the included padded envelope. Insert into the prepaid mailer and the final step was to drop it into a US Postal Service mailbox.
Then wait.
And wait.
Six weeks total.
Viome indicated this was longer than "normal" when I noted in the app the day I sent it in. Maybe it's an indication of the growing popularity of the service and interest in the microbiome for personalized nutrition? Either way it was a long wait at a point when I was motivated to improve my gut health.
Finally in early January, the results were ready.
My Results & Recommendations
Categorized by foods to Avoid, foods to Minimize, foods to Enjoy, and Superfoods, the results were very informative and actionable -- lightyears better than the citizen science project of Ubiome five years ago.
Where Inside Tracker gave me information on what types of foods and supplements I needed more of to get into an optimal zone, what I found immediately drawn to with the Viome results was what foods to avoid or minimize, and why.
For example, tomato is Avoid for my microbiome. Viome results said: "Your microbiome contains tomato mosaic virus, which is known to infect tomatoes. Since plant viruses in the microbiome have been associated with an inflammatory response, it is recommended for you to avoid tomatoes."
This was a tough result to comprehend. Back in 2010, I began eating tomatoes more intentionally after attending the TED Active Conference and hearing William Li present his talk on "a new way to think about treating cancer and other diseases: anti-angiogenesis, preventing the growth of blood vessels that feed a tumor. The crucial first (and best) step: Eating cancer-fighting foods that cut off the supply lines and beat cancer at its own game."
Tomatoes were at the top of the list. At the time, I didn't care too much for eating raw tomatoes and made an intentional effort to change my eating behavior, even growing to crave heirloom tomatoes over time.
Viome also scores your results and breaks them into three categories:
Scores Within Range
Scores That Are Good
Scores to Focus On (which is where I started)
One of the areas on my "Focus On" list was Oxalate Metabolism Pathways. No idea what that is exactly, but the description connected with the recommendation to avoid tomatoes and reduce inflammation:
"This score measures all the activities of your microbes that can contribute to or reflect inflammation in your gut environment. Inflammation in your gut can be caused by harmful things your microbes produce when you are either inefficiently digesting your proteins, have excessive microbial gas production, or simply have a gut environment that your microbes perceive as threatening."
But uncontrolled inflammation plays a role in almost every major disease, including cancer, heart disease, diabetes, Alzheimer's disease and even depression. This was looking more and more like an early warning indicator I should address.
What Now? What Next?
To address the inflammation early warning indicator, it seems I'd need to address those tomatoes and a host of other foods on my avoid list including favorites like: bell peppers, spinach, and yogurt.
What most of these personal nutrition services lack is a solid behavior change program. It's one thing to show the data and give recommendations, and it's another to build new nutritional habits into your life.
Of course, that's not easy and why we have an $400+ billion diet and nutrition industry.
Based upon my years working with organizations and individuals to change their habits, I've approached building new nutritional habits utilizing the latest science in behavior change.
Make it Small
First, looking at the avoid list from Viome, I'm only going to start with one suggestion. Are you familiar with the question, How do you eat an elephant?
One bite at a time. Not that you'd want to eat an elephant, and the point is you take something large and bring it down to something you can handle and build lasting change from there.
Make it Enjoyable
Second make it something I want to do. Don't pick the hardest item on the list. Tomatoes may be a bigger hill to climb for the first change. I'm going to pick bell peppers. While I like to eat them, I could more easily remove them from my diet than tomatoes.
Is there a Substitution?
I usually eat bell peppers in my salads and on my tacos I make at home. Is there something I could use to replace them. In this case, I looked toward the Superfood suggestion list from Viome. I've already been eating more avocado, but haven’t been buying them consistently.
With bell peppers out, my salads and tacos would now always include avocado.
The behavior change.
Changing your behavior is about managing the intersection of your motivation and ability.
Basically, I need to make it harder for me to use bell peppers when I'm motivated to do so. This mostly comes down to grocery store shopping and not purchasing bell peppers. This is when it's important to have members of your household on the same page. If that's not possible, then make the bell pepper harder to access, decreasing the ability to use them when you're motivated to do so.
Finally, I've been successful with adding in fish to my diet, particularly salmon, which is on my Viome Superfood list as well as a consistent recommendation from Inside Tracker.
I use the Tiny Habits® behavior change method from Stanford's Dr. BJ Fogg. Match and a new behavior with an existing behavior. For example, when I sit down at a restaurant and open the menu (the prompt of the existing behavior), I look to see if they have a salmon dish and order that (new behavior). Then quietly celebrate to myself to help build the neural pathway of the new habit. Since I don't make salmon as home very often, the restaurant habit was a solution to add the fish into my diet.
The reality of microbiome science
One last word on the science of using the microbiome to guide your personal nutrition decisions.
"It is worth being cautious: many studies show associations rather than cause and effect, and some are based only on studies in germ-free mice and have not been explored in humans," according to The Guardian.
“I think everyone is right to be skeptical, and a lot of the links may just be that [microbes] are not necessarily the cause of [a disease], but they might be a secondary effect of it,” said Tim Spector, professor of genetic epidemiology at King’s College London and author of The Diet Myth.
But it's not surprising that our microbiome seems linked to our health.
“All of human development and all the systems in the body have all evolved, or co-evolved, with our microbes,” said Prof John Cryan, a neuropharmacologist and microbiome expert from University College Cork. “As humans we are very much human-focused and we feel that human cells and genes have primacy, but the microbes were there first.”
Viome points out once you get your test results that it takes 90 days for changes in your diet to affect you microbiome, which is when they recommend you get tested again.
In reality, for these services it's important to remember that behavior change takes time, and I would argue that nutritional change takes even longer than most new habits, especially when more than a few changes are needed.
My recommended strategy is to start small, build one or two changes into your life at a time and in a six months to a year, check in to see how your lifestyle changes have affected your insides.
Acknowledgments:
--I was not paid or have any financial involvement with the services in this post.
--I referenced the Biohackers Handbook for some of the information here on gut health.