Showing posts sorted by relevance for query overselling. Sort by date Show all posts

Thursday, May 01, 2014

Overselling the microbiome award: Time Magazine & Martin Blaser for "antibiotics are extinguishing our microbiome"

Well, alas, Time magazine turned what could have been a story about the spread of antibiotic resistance into what appears to be a promotion for Martin Blaser's new book: Antibiotic-Resistant Bacteria Are Now In Every Part of the World | TIME.com.

The article starts of OK - reporting on the new WHO report on antibiotic resistance. But then it gets into the microbiome and what antibiotics supposedly do to it. Some quotes:

"But even more concerning, say experts like Dr. Martin Blaser, director of the human microbiome program at the New York University Langone Medical Center and author of Missing Microbes, is how these antibiotics are affecting the makeup of both good and bad bacteria that live within us – our microbiome. The first big cost of antibiotics is resistance,” he says. “But the other side of the coin is [the fact that] antibiotics are extinguishing our microbiome and changing human development.”

Extinguishing our microbiome? Really? The evidence simply does not support such a claim. I personally think antibiotics may be contributing to messing up the microbiome in many people and that this in turn might be contributing to the increase in a variety of human ailments (e.g., I mentioned this issue in my TED talk and many many times here and elsewhere). But "extinguishing"? Not even close. In fact, many of the published sutdies done so far suggest that the human microbiome is pretty resilient in response to antibiotics. Really serious overselling of the impact of antiobitcs by Blaser.

And "changing human development?" Not sure what the evidence for that is either. Most likely this refers to the role the microbiome plays in immune system development but I am not aware of strong evidence that antibiotics lead to changes in human devleopment.

They then quote Blaser again:

If I prescribe a heart medicine for a patient, that heart medicine is going to affect that patient,” says Blaser. “But if I prescribe an antibiotic, that antibiotic will affect the entire community to some degree. And the effect is cumulative.

Yes antibiotics can affect more than one person because microbes (and resistance) can spread. But "the effect is cumulative"? I do not think that has been shown.

Finally, Time (well, Alice Park, the author) states (in relation to limiting overuse of antibiotics)

That may also help to protect our microbiomes, which in turn could slow the appearance of chronic diseases such as obesity, cancer and allergies.

What? Now antibiotics cause obesity? And allergies? And cancer? Sure - there is good reason to think that antibiotic usage plays a role in obesity and allergies. The evidence is not yet completely overwhelming but it is certainly a reasonable notion. But how did cancer get thrown in here?

Saturday, November 10, 2012

Overselling the microbiome award of the month: Integrative medical group of Irvine

Wow. Just discovered this site: Fecal Transplantation | Integrative Medical Group of Irvine. Not sure how long it has been out there. But this is one of the more aggressive and perhaps egregious overselling of the power of the human microbiome that I have seen. They are promoting fecal transplants at their clinic as a way to cure a diverse array of ailments from ulcerative colitis to obesity and imply they can be used for cardiovascular health, emotional status, bone health, and more. My "favorite" part:

As our understanding of the enormous importance of bowel micro-biota (bacteria) grows, the indications for fecal transplant will expand greatly and public acceptance will follow. But there is no reason for you to wait. Dr. Lee, our naturopathic doctor, is one of only a tiny handful of specialists certified in the use of fecal transplant. She can expertly manage your case.

Yes that is right. We (the royal We of course) are on the verge of showing that the microbiota does EVERYTHING and therefore, if anything ails you, just wash your troubles away with some shit from a relative. There is no reason to wait. Come in to our clinic now.

And for the misleading nature of this site, I am giving this Integrative Medical Group of Irvine my coveted "Overselling the microbiome award." Previous winners and discussions of this issue are listed below:

------
UPDATE September 2017

Was just looking back at this post. Alas the link to the Irvine web site was dead. But thankfully the Internet Archive indexed this page. See https://web.archive.org/web/20130405021335/http://integrativemgi.com/fecal-transplantation/. It is from 2013 but may be the same as what I was seeing.

I am copying the text below

Fecal Transplantation

The gastrointestinal (GI) system is largely responsible for the well-being of every other cell and system in the body. It absorbs the nutrients which all cells require, expels toxic wastes, nurtures the complex bacterial bio-matrix which produces essential enzymes and vitamins, protects the body from invading organisms, and participates in critical “cross-talk” with the brain and the immune system.

When the bacterial communities of the intestinal tract become altered or damaged, their essential processes malfunction and the health of the individual declines – sometimes slowly, but at other times with devastating speed. When this happens, we attempt to “heal the gut,” a process that involves elimination diets, healing supplementation and probiotics. This can take many weeks or longer.

Recently, however, a new treatment has been developed that is proving highly beneficial, amazing fast, and in many cases lifesaving. Though fecal transplantation sounds unappealing, this amazingly simple procedure rejuvenates the gastrointestinal (GI) system literally overnight by taking fecal material from a healthy donor (preferably a relative), carefully processing it, and then inserting it into the colon of the patient. This is a simple and safe procedure, and, of course, the donor is thoroughly screened for communicable diseases.

The most common application of fecal transplant is in patients suffering from a serious intestinal infection caused by Clostridium difficile bacteria. Usually infections with C. diff occur following oral administration of antibiotics, and with increasing frequency the resulting infection is resistant to all antibiotic therapies. Lives have been saved and transformed in a matter of days following a fecal transplant treatment.

Exciting novel applications are evolving for fecal transplant. One is for the treatment of ulcerative colitis (UC). Patients on the verge of having their colons removed or patients living in misery with UC have experienced dramatic remissions following fecal transplants.

Another novel application involves the use of fecal transplants in obese patients. It has been discovered that in these individuals, the GI bacteria differ from those found in thin, healthy people. These so-called “fat bacteria” can extract a significantly greater quantity of calories from the same amount of food as do normal bowel bacteria. There is great hope that doing a fecal transplant on an obese individual will stimulate more appropriate bacterial behavior, and weight loss will become much easier.

Data now exists that the bacteria in the gut impacts virtually all aspects of health. Cardiovascular well-being, emotional status, bone strength, as well as immune health are all dependent on a healthy bowel flora.

As our understanding of the enormous importance of bowel micro-biota (bacteria) grows, the indications for fecal transplant will expand greatly and public acceptance will follow. But there is no reason for you to wait. Dr. Lee, our naturopathic doctor, is one of only a tiny handful of specialists certified in the use of fecal transplant. She can expertly manage your case.

If you are interested in learning more about how fecal transplants can improve your health, we encourage you to call our office to schedule an appointment with Dr. Lee.

Monday, October 22, 2012

Today's "Overselling the microbiome award" Crohn's Disease and Bacteria

Uggh. Just read this: Specific bacterial species may initiate, maintain Crohn's. Basically it reports on a paper that showed a correlation between bacterial taxa and early Crohn's disease. The paper makes a big deal out of showing a correlation in the severity of pediatric Crohn's and the types of microbes found. Good. That is useful. But here is the thing. It is a $&*#($@(& correlation. They have NO IDEA if this is the result of the CD or the cause (or both). To go around pushing the idea that this is about bacteria initiating CD is misleading.

The news release says "The work may ultimately lead to treatment involving manipulation of the intestinal bacteria." True. The work may ultimately also lead to my screaming. Oh wait. It did already.

For more on Overselling the Microbiome see some of my other posts

As I have said many time. I believe the human microbiome is VERY important. I believe it probably plays a role in all sorts of human issues - health and disease. But we need to be careful not to be misleading about what we know and don't know ...

Tuesday, December 11, 2012

Award: Ridiculous, absurd, offensive overselling of the microbiome from Chalmers & Gothenburg

Wow. This is painful. There is a press release that came out a few days ago: Changes in the gut bacteria protect against stroke. In it they report on a new paper showing some interesting results comparing the metagenomes of gut microbiota in stroke patients vs healthy patients. They found some interesting differences. And they then made absurd, dangerous, self-serving claims that completely confuse the issue of correlation vs. causation.

Basically, they found carotenoid production genes to be more abundant in the people who were healthy. And they then appear to have concluded that production of carotenoids by bacteria in the gut protects from strokes. Completely ridiculous. No evidence whatsoever is presented that such production of carotenoids by gut microbes does anything of the kind. Compare the semi careful wording in the paper

Our finding of enriched levels of phytoene dehydrogenase in the metagenomes of healthy controls and its association with elevated levels of β-carotene in the serum may indicate that the possible production of this anti-oxidant by the gut microbiota may have a positive health benefit

To the drivel in the release

Our results indicate that long-term exposure to carotenoids, through production by the bacteria in the digestive system, has important health benefits. These results should make it possible to develop new probiotics. We think that the bacterial species in the probiotics would establish themselves as a permanent culture in the gut and have a long-term effect

Saturday, January 19, 2013

Overselling the microbiome: University Bern press release uses slight of hand to make mouse study seem to be about people

Interesting new paper came out recently on "Sex Differences in the Gut Microbiome Drive Hormone-Dependent Regulation of Autoimmunity." It is alas in Science so it is not available openly.

Anyway there are some news stories about the article where you can get the gist of it. Best one is probably the blog post by Christine Gorman: Transplanted Bacteria Turn Up Testosterone to Protect Mice against Diabetes. The story is pretty interesting.

For those who do not know I have been a bit obsessed about the connection between diabetes and the microbiome for a while. See my Ted talk for example where I discuss my own personal connection to this issue.

But the science is not what I want to talk about here. What I want to talk about is how science press releases can just be awful. The one for this paper is like some sort of con artist's scheme. Here it is on Science Daily: Good bacteria in the intestine prevent diabetes, study suggests. First, they lure you in with a headline that, well, fails to mention that the study was in mice. And then they keep trying to lure you with some lines about humans and their microbes. In fact, the first two and half paragraphs I think are pretty deceptive.

All humans have enormous numbers of bacteria and other micro-organisms in the lower intestine. In fact our bodies contain about ten times more bacteria than the number of our own cells and these tiny passengers are extremely important for our health. They help us digest our food and provide us with energy and vitamins. These 'friendly’ commensal bacteria in the intestine help to stop the 'bad guys’ such as Salmonella that cause infections, taking hold. Even the biochemical reactions that build up and maintain our bodies come from our intestinal bacteria as well as our own cells.

Pretty important that we get along with these little bacterial friends... definitely. But as in all beautiful relationships, things can sometimes turn sour. If the bacteria in the intestine become unbalanced, inflammation and damage can occur at many different locations in the body. The best known of these is the intestine itself: the wrong intestinal bacteria can trigger Crohn’s disease and ulcerative colitis. The liver also becomes damaged when intestinal bacteria are unbalanced.

Research groups led by Professor Jayne Danska at the Sick Children’s Hospital of the University of Toronto and Professor Andrew Macpherson in the Clinic for Visceral Surgery and Medicine at the Inselspital and the University of Bern have now shown that the influence of the intestinal bacteria extends even deeper inside the body to influence the likelihood of getting diabetes. In children and young people, diabetes is caused by the immune cells of the body damaging the special cells in the pancreas that produce the hormone insulin.

Yup - lots and lots of stuff about people. Which is fine. I like people. But the thing is. The paper is about mice. So lines like "have now shown that the influence of the intestinal bacteria extends even deeper inside the body to influence the likelihood of getting diabetes" are kind of misleading because so far there has been no mention of mice and that line is they only true for mice, not people. And then they wrap up this section with another line about people, clearly trying to imply that the "have now shown ..." part is relevant to people.

And then, finally, they turn to mice.

By chance, 30 years ago, before the development of genetic engineering techniques, Japanese investigators noticed that a strain of NOD laboratory mice tended to get diabetes. These mice (also by chance) have many of the same genes that make some humans susceptible to the disease. With the help of the special facilities of the University of Bern and in Canada, these teams have been able to show that the intestinal bacteria, especially in male mice, can produce biochemicals and hormones that stop diabetes developing.

And then they go back to people.

Diabetes in young people is becoming more and more frequent, and doctors even talk about a diabetes epidemic. This increase in diabetic disease has happened over the last 40 years as our homes and environment have become cleaner and more hygienic. At the moment, once a child has diabetes, he or she requires life-long treatment.

"We hope that our new understanding of how intestinal bacteria may protect susceptible children from developing diabetes, will allow us to start to develop new treatments to stop children getting the disease," says Andrew Macpherson of the University Bern.

Wow. So in a press release about a paper that is about mice, there are three sentences about mice and the rest are about people. The thing is, in case you don't know - mice are not the same as people. Just saying. And for trying to overplay the connection of their work to humans, I am giving the writer's of this press release my coveted Overselling the Microbiome Award.

Past posts about this award include:

Tuesday, August 31, 2010

Clarification to Overselling Microbiome Award to Marshall Protocol: Critique of some claims by supporters, not protocol per se

OK time for a bit of a clarification.

Recently I gave out a somewhat aggressive "Overselling the microbiome award" to supporters of what is called the Marshall Protocol. I have started this award because I feel that many working on microbiomes have been overselling the potential for these studies to lead to cures and treatments for all sorts of ailments. And certainly, some associated without the Marshall Protocol are making what I consider to be extremely overstated claims about this particular treatment.

But after talking to a supporter of the protocol here at the microbiome meeting I should clarify here that I was not actually critiquing the protocol itself. I was criticizing some of the claims of supporters of the protocol. In a way I erred in the same way that critiques of genomics have erred - where some have said genome sequencing is not useful because some promoters of genome sequencing oversell it. So I should have been more careful .. I should have focused on the claims about the protocol by some supporters. I stand by my criticism of many of these claims. The protocol seems to have no evidence that it works. And thus I did not like the claims that it cured all sorts of ailments.

But overselling the protocol by some supporters does not mean that the protocol does not work (though, again, there is no published evidence that it works). And overselling by some also does not mean that all supporters oversell it. It seems clearly that some of the supporters are sincerely interested in testing whether it works. In fact the person I talked to said they will work very hard to make sure that claims without evidence are removed from the Knowledge Base web site associated with the group supporting the protocol. I hope that is true. I am still skeptical about the activities of some supporters of the Marshall Protocol and whether the protocol can work. But at least some of the supporters really want to do clinical trials and use science to test the Protocol.

UPDATE 2019. I was being WAY too nice with this post. I was trying to engage the people behind the MP to help move them into doing real science. And so I wrote this to give them a chance to shy away from some of the claims. But in retrospect that was really just being too nice. This was at least a the time, a scam. I have no idea if any evidence has been developed to support it since, but I sincerely doubt it.

Sunday, August 19, 2012

The microbiome in the news: risk of overselling but not always bad coverage

Well, in the space of about five or so years we have gone from everyone ignoring the "cloud" of microbes that live in and on various plants and animals (the so called microbiomes of these species) to everyone now basically implying that the microbiomes do EVERYTHING. Over the last few years I started to get stressed about this and started giving out "Overselling the microbiome" awards here. Some previous posts on this topic include:

That was five or so posts over a few years. But i certainly have seen more cases of overhyping and it does seem to be getting worse. One of the key aspects of overhyping is the continuous danger of correlation vs. causation. Microbial communities can be very very complex ecosystems. What many people/researchers do is the following:

identify a few groups of hosts (e.g., healthy vs. disease)
collect samples and characterize the microbial communities in the samples
carry out some clustering/correlation analysis to look for features of the microbial community that are correlated with the host classes (e.g., healthy vs disease)

Wednesday, May 27, 2015

Overselling the mcirobiome award: Dr Roizen's Preventative and Integrative Medicine Conference

Just got an email announcement for "Dr. Roizen's Preventative and Integrative Medicine Conference" in Las Vegas in December 2015.

The announcement did not start of well for me with the gender balance of the key speakers

But since I spoke at this meeting in 2013 and since there was a good gender balance at that meeting, I decided to give the benefit of the doubt and keep reading (though I note - not trying to say this 5:0 gender ratio is a good thing).

And this is when it got worse - here are the bullet points for what one should learn from attending this meeting

The key concept about optimal aging that Dr. Roizen learned from 56 million people who took the RealAge® test
Smart tips about changing you and your patient's microbiomes and what to do for your microbiome to promote weight loss and how it inhibits aging
How you can affect the role of the GI tract in chronic disease
How to understand the clinical utility of TMAO testing for monitoring cardiometabolic risk
The tricks about measuring your microbiome's effects
Why some choose a plant based diet and why you might not
What supplements do you and your patient's need with a plant based diet to decrease inflammation and improve your microbiome
Clarify how a systems-based approach can effectively treat illness and promote wellness

Now - I don't know much about Dr. Roizen or his optimal aging claims in his books (I am skeptical). But the microbiome stuff in here is silly.

Let's start with: "Smart tips about changing you and your patient's microbiomes and what to do for your microbiome to promote weight loss and how it inhibits aging". I wonder how he will give these smart tips when as far as I know there is nothing actually known about this. How the microbiome inhibits aging? Really? Is this going to be a summary of future research not yet done or even imagined?

What about "The tricks about measuring your microbiome's effects." So - there are 1000s of scientists studying this, they mostly say it is very very very hard to study the effects of the microbiome and Roizen and crew are going to solve this with a few "tricks"? So is he saying everyone in the field is incompetent since they can't measure these effects but he knows how to with a few tricks?

Dr. Roizen seems like a smart person and some of what I have heard from him sounds reasonable. These microbiome claims from him here are a clear example of "Overselling the microbiome" and buying into the hype and not staying with the science. Maybe he was not paying attention for my talk for this meeting in 2013 when I discussed overselling the microbiome

I hope he tones down his claims in the future ... but for now he is a winner of a coveted "Overselling the Microbiome Award". For other "winners" see here.

Saturday, May 10, 2014

Well, crap - crap does a crappy job as a treatment sometimes (re: fecal trasnplants and IBD)

Well, this seems like seriously big news in the microbiome world: Fecal Tx Flunks IBD Test but Optimism High. Charles Bankhead reports on results presented at the "Digestive Disease Week" meeting. At the meeting Paul Moayyedi from McMaster University reported that a clinical trial of fecal microbial transplants (FMT for short) was stopped midway through the trial due to "lack of efficacy". More specifically Bankhead reports

The investigators found no significant differences in the primary outcome or any of the secondary outcomes, which included the Inflammatory Bowel Disease Questionnaire and the EQ5D health status assessment

The researcher seems enthusiastic about FMT still but certainly this means that FMT for IBD is not going to be like FMT for CDiff (just wanted to make sure I got in a lot of abbreviations there). I am sure there will be much more to come on FMT and it would be good to see more detail on what was presented at the meeting (a paper, or poster, or such). But for now, this hopefully will temper some of the overselling of FMT that is going around (e.g., Overselling the microbiome award: Mercola/Perlmutter on fecal transplants for severe neurological dysfunction).

First multiple "Overselling the microbiome award": the Daily Mail article on Germs

At the recent "Future of Genomic Medicine" meeting, George Church gave me some grief over my "Overselling the microbiome award" because he thinks (rightly) that some people also undersell the microbiome.

So I set out today to find an example to give out such an award. And within seconds I bumped into this: Germs: There are bugs that cure infections, protect against stroke and even keep your skin clear | Mail Online in the Daily Mail.

Wow. And not in a good way. Oh well, so much for the underselling award. Just the title made me cringe. And so so so so many of the details are so so bad.

Where to start. I guess from the beginning.

".The secret lies in the balance of the bugs, which exist in a fragile ecosystem. Knock one out and the system goes haywire."

Umm. No. Not that I know of. Knock one out? What evidence is there for this? None.

"Imbalances in gut bacteria, for instance, have been linked with diabetes, obesity, autism, eczema, psoriasis, asthma and inflammatory bowel conditions such ulcerative colitis and Crohn’s disease"

".... may even ... cause ... multiple sclerosis "

Holy crap. That sounds awesome. Except that there are all correlations so far with no known causative role at least in humans.

Then they list some of the other good things microbes apparently have been proven to do:

"ANXIETY-BUSTING GUT BACTERIA"
"It seems that the type of bugs you have in your body can affect mood."

Though at least in this section they do refer to a mouse study but clearly imply this is true in humans too. It may be. But I am unaware of any studies proving it.

"BUGS ARE GOOD FOR YOUR SKIN"
"It's a common misconception that the cleaner the skin, the better — and the bacteria that live on our skin have an important role."

I am all for not killing all microbes willy nilly but their is certainly one part of the body that you probably do want to wash a lot - your hands. So As long as they don't say "Don't wash your hands" this could be OK.

So what do they say next:

‘If you wash your hands repeatedly, they dry out — this is partly because you wash away all the oils but also because you remove a large number of the bacteria that help maintain the skin’s condition,’ says Professor Mark Fielder, a medical microbiologist at Kingston University.

Oh FFS now they are basically telling people to not wash their hands.

"SHARE A KISS... AND BACTERIA"
‘Every time you kiss, for example, you exchange a million bacteria. 'So your gut microbiology becomes close to that of your loved ones.’

Sounds great. I could not find any references on the topic but sounds great.

"SOME TYPES MAY PREVENT STROKE"
Wherein the tell a story based on a press release which had led me to post the following: "Award: Ridiculous, absurd, offensive overselling of the microbiome from Chalmers & Gothenburg". Any idea if I think this is an accurate press release?

TRANSFUSION TO BEAT INFECTIONS
Wherein they discuss fecal transplants for C. difficile infections, which seem to work quite well and I have written about a lot (e.g. Transfaunation and Fecal Transplants: What Goes Around Comes Around, Literally and Figuratively). But then they kill their positive mojo on the topic by writing:

Lawrence Brandt, a professor of medicine and surgery at New York’s Albert Einstein College of Medicine, believes the treatment could work for other, non-gastro conditions, such as obesity and Parkinson’s.

Seriously? Fecal transplants for Parkinson's?

And it goes on and on including:
"SOME BACTERIA KEEP YOU SLIM"
"BUGS THAT HELP MEDICINE WORK"
"COULD THEY WARD OFF CANCER?"
"KEY TO BABIES’ IMMUNITY"

I mean - I really really do think the microbiome plays roles in many many parts of our lives. But those who promote it this much are the snake oil sellers of the modern era. A slight of hand here and soon they will be selling us some specific brand of probiotic or way to protect our microbiomes. So for this article the Daily Mail is getting my first multiple "Overselling the microbiome award." They could get 3 or 4 just from this article if not more. But I will just give them two. And I will keep searching for an underselling the microbiome recipient.

Wednesday, August 25, 2010

Overselling the microbiome award #2: The Marshall Protocol

Wow - until I started sniffing around actively, I never realized how much crap was out there in regard to the microbiome. But there is so so much. Certainly, the human microbiome (the microbes that live in and on people) is more important than people used to think. The microbes in and on us show some interesting correlations relative to disease and health states. And almost certainly changes in the microbiome likely cause some alterations in health state. Recent studies on fecal transplants, for example, suggest even that altering the microbiome is both possible and could be helpful in some cases. But we are really early in the work here.

But right now, for many health and disease states
(1) we don't know if the altered microbiome is a cause or an effect or not related at all and
(2) even if there were a causal relationship between microbes and various health/disease states, there will also be enormous complexities relating to history and genes that will be very hard to sort out
(3) even if we knew a causal relationship this would not mean we would know how to change the trajectory (e.g., what microbes are there) in a useful way

Because there is so much iffy stuff out there relating to the microbiome and because some are starting to use studies of the microbiome to indirectly lend credence to their crap, I have decided to start giving out an "Overselling the microbiome award". I gave out the first one a few days ago: Overselling the microbiome award: Stephen Barrie on pre and probiotics at the Huffington Post

Interesting, Barrie posted a comment on the blog trying to defend his post, but I was not convinced. I think he did not understand my point about correlation vs. causation but am not sure.

Anyway, after I wrote the response to Barrie I looked around the web for others using the term microbiome in what seemed to be unsavory ways. And I found a really painful one. This is something called the "Marshall Protocol Knowledge Base." This so called knowledge base is a web site set up to promote, you guessed it, the Marshall Protocol. The Marshall Protocol is "a curative medical treatment for chronic inflammatory disease." In turn this protocol is based on the Marshall Pathogenesis which is "A description for how chronic inflammatory diseases originate and develop." It follows that this Marshall Pathogenesis "posits that chronic diseases (termed Th1 illnesses), are the result of infection by an intraphagocytic, metagenomic microbiota of chronic bacterial forms that are often referred to as the Th1 pathogens." I have read the last sentence dozens of times and I still do not know what it means. What is a metagenomic microbiota? I just do not know.

Anyway, I am sure everyone will be shocked to find out that the Marshall Protocol Knowledge Base, the Marshall Protocol and the Marshall Parthogenesis are being promoted by someone named, well, Marshall (Trevor Marshall) who seems to be the head of the Autoimmunity Research Foundation which is the place promoting the Marshall Ps (I swear, I will not call it the Marshall Plan, I will not, I will not).

Based upon what appears to be little if any actual published research, the Marshall Protocol promotes the treatment of all sorts of ailments with in essence long term

high dose
cocktail of multiple antibiotics at apparently low dosage and a long term attempt to alter Vitamin D levels by treating in part with very high doses of a drug called olmesartan. Among the ailments that this protocol is claimed to help are Crohn's, Type I diabetes, Multiple Sclerosis, Psoriasis, Rheumatoid Arthritis, Celiac Disease, and many many more. (I note they say "The Phase II clinical trial conducted from 2002-2008 by the Autoimmunity Research Foundation has demonstrated applicability of this antibacterial therapy to a wide range of chronic Th1 immune illnesses " and then cite a powerpoint presentation).

I could go on and on. But it seems clear to me that they are both making mistaken claims about what we know about the effect of microbes on health as well as making almost absurd claims about how one treatment system can cure a series of diseases by fixing ones microbial content. Note I am NOT saying microbes have no connection to these ailments - studies are supporting the microbial diversity in people with these ailments is different than in people w/o the ailments. Nor am I saying that Vitamin D is unimportant. In fact, it is becoming clear that Vitamin D is much MORE important than people realized. But importance alas, is different that saying we know exactly WTF is going on. And certainly the treatment outlined by the MP folks here is not as far as I can tell supported by any evidence of effectiveness not is it obvious how it connects to scientific knowledge about microbes and vitamin D.

Fortunately, others have taken on the MP folks here and have written about how it appears to be a scam of sorts, and a potentially dangerous one at that. See for example:

I know, there are lots of medical scams out there. But this is the first one I have seen discussing metagenomics and the microbiome. And for that, I am giving the Marshall Protocol and the folks behind it, my second "Overselling the microbiome award".

UPDATE 7/18/2012 - some stories worth looking at

UPDATE November 2019.

See Buyer Beware: “Miracle Cures” for Sarcoidosis - see last sentence below in particular.

"Trevor Marshall came up with a treatment for chronic inflammatory diseases like sarcoidosis that consists of five seemingly simple steps. The first of these steps is to take a minimum of 40mg of olmesartan every 4-6 hours, which is a very high dosage. Olmesartan is not a drug that is commonly administered to treat sarcoidosis – in fact, it is used to treat high blood pressure, which is not one of the more prominent symptoms in sarcoidosis. Marshall protocol also requires limiting one’s Vitamin D intake, which means avoiding foods that are rich in Vitamin D as well as sun exposure. Vitamin D irregularity is common in sarcoidosis, but it is certainly not the root of the problem. However, Marshall Protocol bases its treatment on the belief that sarcoidosis is caused by an excess of Vitamin D paired with infection. We do not know what exactly causes sarcoidosis, but we do know that it is characterized by the formation of granulomas, not infection or Vitamin D irregularities. Focusing solely on these symptoms in treatment of sarcoidosis is missing the mark. Marshall Protocol is an expensive treatment, and there is no real evidence on its efficacy and we cannot be sure that it is harmless."

And also see Disciplinary Action against Susan J. Shlifer, M.D.

"USE OF HIGH RISK AND INEFFICACIOUS MARSHALL PROTOCOL 2.11 The "Marshall Protocol" implemented by Respondent in her treatment of patients is not supported by placebo controlled clinical trials or animal experiments. Developed by a non-physician, this protocol is contrary to the standard of care for treatment of anti-inflammatory and autoimmune diseases in the following aspects."

Tuesday, July 08, 2008

Overselling genomics Award #5: Duckweed will save the world

OK. I really wanted to leave this one alone because it involves the Joint Genome Institute (JGI) where I work part of the time. And I really like JGI and what it is doing in many aspects of genomics. But this one is just so over the top that I could not leave it alone. There is a press release from Rutgers that came out regarding a new project to sequence the duckweed genome (see News: Duckweed genome sequencing has global implications) and the Eureka release here

And this one is just so over the top in terms of overselling I do not know where to begin. First, they had me at the title

Duckweed genome sequencing has global implications

But the subtitle is even better

Pond scum can undo pollution, fight global warming and alleviate world hunger

There is really little else to say. I commend the JGI and DOE for supporting this work as it sounds reasonable and work on this organism may have many uses. But, umm, this was the most obvious "Overselling genomics award" I have ever given.

Wednesday, August 18, 2010

Overselling the microbiome award: Stephen Barrie on pre and probiotics at the Huffington Post

Yes, I think the microbes that live in and on people are important, interesting, cool, and worthy of lots and lots of attention. However, I am getting sicker and sicker of the ways in which the effects of these microbes are, well oversold. So today I am starting a new series here on the Tree of Life - the "Overselling the Microbiome and Probiotics Award."

And, we have a winner today. The winner is Stephen Barrie who has posted something at the paragon of high quality science - the Huffington Post (for more on the dubious science at Huffington Post, a good place to look is Bora's Blog Around the Clock). Well, Barrie really takes the cake on this one

Stephen Barrie, ND: The Keys to Maintaining a Healthy Gut

He starts off OK - referring to the number of microbes in the human ecosystem and even quoting Jeroen Raes, who does some great work.

Then he mentions how

"These bacteria have a profound influence on human physiology, your immune system, your nutrition, and are crucial for human life."

OK I can go with this -- maybe an exaggeration but still within reasonable confines. Then the woppers begin

"The health of your body and mind is largely tied to the health of your gut".

Wow- that is one serious jump - from these microbes have a profound influence to the gut driving health of body and MIND.

Then he goes back to some OK territory again, discussing some functions known for gut microbes, like vitamin production, preventing infection, etc. But just after this he switches to the woppers again claiming that out of balance microbes can cause allergies, inflammatory bowel disease, eczema, arthritis, irritable bowel disease, obesity, autism and personality changes including paranoia, hostility, aggression and so on. Completely ludicrous actually. What we know about these issues is that researchers have found that microbial populations may be altered in people with these maladies. But that does not mean the alteration in the microbes caused these maladies. It could be that other factors cause both the malady and the microbial alteration or the malady itself could lead to altered microbial populations.

But wait, it gets a bit better. Now that he has established that microbes cause all these problems, he tells us how to

"avoid one of the emerging causes of both obesity and food allergies? Lower your risk of inflammatory bowel disease, irritable bowel disease, eczema, colon cancer (15) strengthen your immune system? All this while reducing any levels of paranoia or hostility (and retaining your Jon Stewart sense of humor)."

The recipe for prevention is as follows:

Eat a low fat diet rich in vegetables, fruits and complex carbohydrates

Limit consumption of animal protein

Reduce sugar consumption

Increase pre-biotic and probiotic intake

Consume enough soluble and insoluble fiber to maintain a daily bowel movement. A slow bowel transit time leads to increased exposure of your body to toxic bowel contents.

Reduce dietary sulfate consumption.

Again, I am all for more research into the microbiome. And I think microbes that live with us must have all sorts of positive and negative effects on our health. And yes, I understand why "probiotics" and "prebiotics" are getting lots of hype. But because Barrie has gone from what must be a gut feeling (sorry) to making medical claims without evidence and prescribing treatments to cure ailments that probably don't exist, he is the recipient of my first "Overselling the microbiome award".

Tuesday, August 26, 2014

Overselling the Microbiome Award: The Microbiome Diet Book

Well, umm, I do not know what to say: The Microbiome Diet: The Scientifically Proven Way to Restore Your Gut Health and Achieve Permanent Weight Loss: Raphael Kellman MD: 9780738217659: Amazon.com: Books. I got pointed to this book by Dorothy Timmermans and she wondered if this was a case of "overselling the microbiome" or not. I guess I don't know because I have not read the book. Nor will I most likely. But I think almost certainly it is a case of "Overselling the Microbiome" based just on reading the blurb on Amazon from the Publisher which I paste below. It contains a litany of over the top statements:

Cutting-edge science has shown that the microbiome is the secret to healthy weight loss and to feeling healthy, energized, optimistic, and at the top of your game. The microbiome is a whole inner world that lives within your intestines—trillions of tiny microbes that help you extract the nutrients from your food, balance your mood, and sharpen your clarity and focus.

These beneficial bacteria make up a separate ecology within the body and have an enormous influence on your metabolism, your hormones, your cravings—even your genes. The microbiome's health is intimately involved with yours: when it flourishes, you flourish. When it craves sugar, so do you. When it operates at peak efficiency, so does your metabolism. And when your microbiome is out of balance, you might find yourself gaining weight or unable to lose weight, no matter how much you exercise or how carefully you eat. To achieve your ideal weight, you need the help of your microbiome.

Now, drawing from nearly two decades of experience as a specialist in functional medicine and intestinal health, Raphael Kellman, MD, has developed the first diet based upon on these scientific breakthroughs. The Microbiome Diet offers an effective three-phase plan to heal your gut, reset your metabolism, and achieve dramatic, sustainable weight loss. The Microbiome Diet will help you...

Reset your metabolism

Free yourself from food cravings and uncontrollable appetite

Incorporate prebiotics, probiotics, and healing foods into every meal

Lose weight—and keep it off—with a nonrestrictive life plan

With delicious recipes, convenient meal plans, and helpful information on Microbiome Superfoods and Supersupplements—including prebiotics and probiotics—The Microbiome Diet gives you the tools to achieve your healthy weight, boost your mood, regain your mental focus, and be in your best shape for life.

Sound too good to be true? Well, that is because it is.

Monday, September 10, 2012

Overselling the microbiome award: MedicalDaily on Effects of Sugary Drink

There is a news article of possible interest in Medical Daily: Sugary Drinks Increase Bad Bacteria in Gut, Risk of Diabetes : Consumer News This article reports on a paper in Obesity Reviews. Alas the paper is not freely available. But the PhD thesis from one of the authors is. The thesis is fascinating - I have read much of it now and skimmed other parts and it has the article as Chapter 2. There are a few differences in the abstract - for example the Obesity Reviews paper does not start off with "The saying “you are what you eat” is no longer pure folklore but is scientifically substantiated by recognition of host-microbe interactions promoting digestion, absorption and metabolism." which is in the thesis chapter. But my guess is the published article is very similar to the thesis chapter.

The news article really goes overboard in hyping what appears to be little more than a correlation. Among the issues I have:

Title: Sugary Drinks Increase Bad Bacteria in Gut, Risk of Diabetes

Whew. It is a doozy. No evidence that the bacteria found are "bad" as far as I can tell. No evidence that sugary drinks specifically cause the increase. The paper is a review paper outlining a lot of prior work and some theories hypothesizing connections between fructose and sweeteners and the microbiome and obesity. But I don't see any evidence of specific increases in bad bacteria in the gut.

Byline: Sugary drinks help bad microbes grow in the human gut. This increase leads to many health complications like obesity and metabolic syndrome, raising risk of diseases associated with metabolic syndrome like diabetes.

Wow. Even worse than the title. Sugary drinks help the bad microbes grow. And this leads to many health complications. No evidence is presented for this.

In this case it is certainly much better to go to the source than to read the news story since the source (the PhD thesis and presumably the review paper) is quite thorough and interesting. It has some fascinating ideas about sugar and sugar substitutes and their potential effects.

Mind you, I think microbes play a role in obesity too. But the simple "sugary drinks CAUSE growth of bad bacteria which CAUSES health problems" well, if only it were so. So for their overselling the effects of sugar and the microbiome without evidence I am giving the Medical Daily a highly coveted "overselling the microbiome award".

Tuesday, June 24, 2008

Overselling genomics award #4: University of Western Ontario and Graham Thompson on honeybee altruism

In my blog I give out some snarky awards for things that annoy me including the Genomics by Press Release Award and the Adaptationomics Award and the Overselling Genomics Award. Sometimes I really want to give something an award but I am not sure what it should get. That is the case here. There is what I find to be a painful press release on "Selfish Genes" in honeybees put out by University of Western Ontario. This press release relates to a paper being published in Genetics. on QTL mapping in honeybees and searching for alleles/genes that suppress the reproductive activity in worker bees. This suppression is a form of altruistic behavior in a way and has been the subject of a good deal of research. Basically, the ended up mapping some of the suppression to a few regions of the genome.

The press release however, goes way way overboard in interpreting their results and claiming "New Discovery Proves 'Selfish Gene' Exists." They imply throughout the press release that prior work simply suggested that selfish genes were theoretically possible in this case and that now with their results they have been proven. For example they quote the lead author Graham Thompson:

This means that the 'selfish' gene does exist, not just in theory but in reality.

This is way beyond an overstatement. Their results are nice and interesting but they are part of a continuum of work on bees (and other selfish systems) and do not in any obvious way suddenly prove the existence of this selfish gene compared to prior work that they imply was just guesswork. I am personally baffled by the extent of this claim -- basically ignoring work by many others as well as work in a variety of systems outside of bees. They end the press release with the following:

"This basically provides a validation for a huge body of socio-biology," says Thompson, who adds the completion of Honey Bee Genome Project in 2006 was crucial to this discovery.

For that last statement, I am thus giving them my "Overselling genomics award" #4. But they easily could have gotten a few others.

NOTE - I had changed the award to just U. Western Ontario and not including Thompson because it is the University that appears to be responsible for the press release not Thompson. However, a commenter (Oliver) convinced me that if we want to clean up press releases we need to make the scientists involved in the story help make sure the press releases are clean, so I put Thompson back in.

Hat tip to T. Ryan Gregory for pointing this out. And you should check out his new Genomics by press release "award" at his blog Genomicron. I will probably be writing about the same story soon.

Wednesday, August 15, 2007

Overselling Genomics Award #2

Well, all I can say is "Aaaaargh" again. So I am awarding my second overselling genomics award to a Press Release from U. Florida entitled "Conquest of land began in shark genome" relating to a paper in PLoS One on shark development . The press release centers on a reported finding that

Using molecular markers to study the formation of skeletal cartilage in embryos of the spotted catshark, UF scientists isolated and tracked the activity of Hox genes, a group of genes that control how and where body parts develop in all animals, including people.

Now admittedly, this is not genomics here - but the press release just had to use genomics in the title so my automated google search for "genome" and "evolution" picked it up. So - why do they get the overselling award? Read more in the press release:

The finding shows what was thought to be a relatively recent evolutionary innovation existed eons earlier than previously believed, shedding light on how life on Earth developed and potentially providing insight for scientists seeking ways to cure human birth defects, which affect about 150,000 infants annually in the United States.

Yes that is right, this genome-ish gene expression study in sharks is going to help cure human birth defects (note the paper in PLoS One seems entirely reasonable ... this is another case of press releases being disconnected from the science - and is another reason to support OA publications because here you can actually all go and read the paper and ignore the press release).

In addition, the press release says

“We’ve uncovered a surprising degree of genetic complexity in place at an early point in the evolution of appendages,” said developmental biologist Martin Cohn, Ph.D., an associate professor with the UF departments of zoology and anatomy and cell biology and a member of the UF Genetics Institute. “Genetic processes were not simple in early aquatic vertebrates only to become more complex as the animals adapted to terrestrial living. They were complex from the outset. Some major evolutionary innovations, like digits at the end of limbs, may have been achieved by prolonging the activity of a genetic program that existed in a common ancestor of sharks and bony fishes.”

Now I accept that the specific details of Hox gene expression here might have been surprising but what friggin evolution textbook are these people reading if they are surprised that there is not a chain of life going from less complex to the pinnacle of complexity in humans? Hopefully not mine.

Monday, October 15, 2007

Overselling genomics (and men) award #3 - Newsweek Magazine

Newsweek Magazine has a feature on the "10 hottest nerds" that they say are "10 of the most esteemed biologists" in the w0rld. And they ask for their insights into various things. The people are

Eric Lander
Leroy Hood
Craig Venter
David Botstein
Svante Paabo
Philip Sharp
Rudolph Jaenisch
Kari Stefansson
George Church
Jay Keasling

Sure these people have done good things and I truly respect most of them in many ways. But are they kidding me? This is who they pick? First of all, all men? Mostly, all people who have been around the block too. Plus, almost all these people work in something connected to genomics (Lander, Hood, Venter, Botstein, Paabo, and Church are major genomics players; Keasling and Sharp and Stefansson are heavily genomics-based).

They couldn't come up with a single woman? Or anyone doing anything else? Or any new researchers? This whole thing is completely egregious. There are plenty of completely cool things going on in biology that have little if any connection to genomics, that are not men, and/or are not established researchers.

And to get the conversation going here are some people they could have considered to diversify in at least one dimension (i.e., the male versus female thing):

I came up with this list in about 20 minutes, based mostly on people I know. And of course, there are TONS of other women in biology who are doing fantabulous research. Even if one did not know anything, a little time on Google pulls up a vast collection of resources -- (e.g., see L'Oreal's for Women in Science page or this Wikipedia page for more suggestions). And of course lets not forget that genomics is not the only thing going on in biology.

So - Newsweek - you are getting my third "Overselling Genomics Award" and on top of that a bonus "Overselling Men" award. All I can say is - what were you thinking?

Friday, January 17, 2014

#Badomics word of the year already? Yup. The 'Consciousome' from Deepak Chopra

Oh my. As many out there know I have a thing with "badomics" words. These are words someone has invented where they have added the ome suffix on to the word to try and capture some of the hype of genomics. And though many many people do this, the ones I call "badomics" words are the ones where the ome addition is all hype and no use. And this AM I was informed of a doozy via Twitter:

@phylogenomics Have you seen 'consciousome'? http://t.co/oUJf8Sumyy
— Blanca Himes (@blancahimes) January 17, 2014

And so I went to the link and found this: Self-Directed Biological Transformation Initiative -- A New Frontier 'Consciousome' | Deepak Chopra and Rudolf E. Tanzi. And what I found there was almost a textbook example of how to create a badomics word. Here is the critical paragraph

The current frontier in brain research, to map the entire connectivity of the brain, the so-called connectome project, points to an even more exciting frontier, the "consciousome." This takes the brain to the next level, where we need to explore how our conscious choices may liberate us from biology-as-destiny. Our conscious choices and reactions to life experiences remodel the neural circuitry of our brains and, now, we need to explore the effects on our genomes.

Just what is the consciousome? I cannot tell. But it has something to do with genomics. And with consciousness. Hmm. They try to clarify later on

Where the connectome is like a diagram of all the telephone wiring in a city, the consciousome embraces the conversations taking place using the wiring.

Not really helping. So - what does it have to do with genomics? Unclear until later

By opening up the genetic doorway to consciousness, however, we take a leap forward. For example, recent studies indicate that meditation can have a strong effect on the length of chromosome telomeres, the nucleotide sequences that protect chromosomes from the deterioration linked to aging. That these beneficial effects occur immediately indicates just how responsive genetic activity is to mind-body interventions -- something never previously suspected.

So - the consciousome is the affect of conscious thought on the genome? Whether or not you think this is something worth studying, the slapping on of the ome term on the end of consciousness is a self directed thought that should never have been done. There is no entity that is the consciousome. The term makes no sense. It is certainly a badomics word of grand magnificence.

I note - there is some seriously bizarre other stuff in this article like the following:

In our Self-Directed Biological Transformation Initiative, a 100-subject study to map biological transformation, leaders in the fields of healthcare, art, business, environment, sports, entertainment, science and technology will be given a protocol to measure new genetic activity, searching for positive evolutionary effects

What? How exactly are they searching for "positive evolutionary effects" and what does that even mean? And why do this with the "leaders in the fields ...". How are they supposed to be different?

And also

This "soft inheritance," in which the parents' life experiences and behavior may directly influence the genome of their offspring (transmitted via the epigenome), is arguably the most profound "living legacy" we can pass along to our children.

So now they have gone from a few studies in mice showing epigenetic inheritance of a few things to the "most profound living legacy we can pass along to our children". Uggh. Talk about overselling genomics - this is overselling a word / field that does not even exist yet and the word certainly should not exist ever. Personally, I think brain science is very very interesting and important. Let's not cloud it up by coining new fuzzy terms, trying to capture the hype of genomics, and overselling the science. And for this, Deepak Chopra, Rudolf Tanzi and their coauthors Tara Sheahan, Gina Murdock, and
Glenda Greenwald are winners of the coveted "Worst New Omics word award."

Wednesday, August 28, 2013

Overselling the microbiome award: VIB press release saying "Intestinal flora determines health of obese people"

Some really cool new papers are out on the human microbiome today. But alas that is not what I am here to talk about. I am here, once again, to complain about overselling the microbome. There is a headline from a press release from one of the institutes involved in one of the new studies that really irks me: "Intestinal flora determines health of obese people". As far as I can tell from reading the paper under discussion in this PR, nothing showed that the flora "determined" the health of obese people. Yes, the flora had really interesting correlations with health status. But "determines health" implies that the flora were the causal component of the health of obese people. And as far as I can tell this was not shown. What was shown was that the microbial communities - and some metrics of those communities like richness - can help predict risk of individuals for various health related ailments.

Now, mind you, the person discussed in this PR Jeroen Raes is completely brilliant and one of my favorite people in science in many ways. And also it is important to point out that the paper does not make these claims. The paper says things like

Our classifications based on variation in the gut microbiome identify subsets of individuals in the general white adult population who may be at increased risk of progressing to adiposity-associated co-morbidities