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?

Microbes and obesity - more connections

A couple of recent papers on weight-loss surgery and microbes have gotten a lot of attention to the idea that obesity and microbes have a more than just coincidental connection.

Some of the news stories on the topic are below. A few of them are a bit over the top but the new work seems pretty sound so this is definitely worth a look.

• Fox: After weight-loss surgery, new gut bacteria keep obesity away
• National Post 'Weight loss bacteria' found in gut may play key role in fighting ...
• BBC: Bacteria find 'key to treating obesity without surgery'
• CBS: Gut bacteria may be key to weight loss
• LA Times Bacteria may provide some of gastric bypass surgery's boost
• NY Times: Bacteria in the Intestines May Help Tip the Bathroom Scale, Studies Show
• Nature via Scientific American: Gut-Microbe Swap Helps with Weight Loss

I can't keep up so here are some unfiltered links on obesity and microbiomes

I just can't keep up.  These seem like they might be worth reading.  But no time to blog about them.  So here are some possible things to look at if you care about obesity and its possible connection to the microbiome.

Blogs

• Antiobiotics May Be Making You Fat Smithsonian Blog
• Antibiotics fuel obesity by creating microbe upheavals | Not Exactly ... THE Ed Yong

News stories:

• Cluster 1
• Gut bacteria linked to obesity-related health problems Baltimore Sun on U. MD study
• Cluster 2
• Could obesity be a gut reaction? Brisbane Times
• Weight bugging you? Solution may be in the gut Sydney Morning Herald
• Cluster 3
• Could Antibiotics Be A Factor In Childhood Obesity? NPR
• Baby obesity and antibiotics link
• Livestock drugs 'link' to obesity epidemic
• Antibiotics could make your baby fat
• Cluster 4 
• Manipulating gut flora could help tackle obesity
• Antibiotics may cause microbes to tip the balance (Nature blog)

And I am sure there is a lot more ....

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".