Gutsy New Ways To Become Healthy?

      130 Comments on Gutsy New Ways To Become Healthy?

Two articles about inserting foreign substances into our intestines to achieve better health both happened to arrive in my email inbox today.  We’ll start with the one that won’t make you lose your appetite.

Intestinal Device Mimics Bariatric Surgery’s Antidiabetic Effects

Improved glucose parameters, substantial weight loss, and increased incretin hormone levels can be achieved by the insertion of a novel, minimally invasive, intestinal device in obese patients with type 2 diabetes.

Hmmm … must be something that vaporizes refined carbohydrates as they come down the tube.

The use of a duodenal-jejunal bypass liner (DJBL) not only improves hemoglobin A1c and aids weight loss, but also appears to increase levels of glucagon-like peptide (GLP)-1 and peptide YY while in place, according to the findings of a small study presented at the annual meeting of the European Society for the Study of Diabetes.

Although the effects may be temporary, they could offer patients a reversible alternative to bariatric surgery that helps to kick-start weight loss and self-management of diabetes, said study author Dr. Charlotte de Jonge of Maastricht University Medical Centre in the Netherlands. “Not all patients want [bariatric] surgery, as it is permanent.”

I’d rather see someone with diabetes choose a reversible alternative over gastric bypass any ol’ day.  But if the goal is weight loss and management of diabetes, why not try a reversible low-carbohydrate diet first?

The DJBL (EndoBarrier) is a 60-cm impermeable sleeve that is inserted and removed endoscopically, and which effectively blocks the duodenum and proximal jejunum in a manner similar to the Roux-en-Y-gastric bypass procedure. It is thought to work by creating a physical barrier between ingested food and the intestinal wall, and perhaps alters the activation of incretin hormones in the gut.

Good lord … so the key to treating diabetes is apparently to eat what you’ve been eating, but prevent your body from absorbing it.  Right.  And the key to avoiding headaches is to keep pounding your head on your desk, but put a pillow on the desk first.

Within 1 week after implantation, fasting and area under the curve (AUC) glucose concentrations were improved (11.4±0.5 mmol/L vs. 8.9±0.4 mmol/L and 1,999±88 vs. 1,535±53), respectively. In addition, AUC concentrations of GLP-1 increased from 2,584 at baseline to 4,112 at removal and PYY from 4,440 to 6,448 (P less than .01 for all comparisons with baseline).

When the device was removed at 6 months, a significant mean weight loss of 13 kg (P less than .001) had been recorded, with a mean loss of excess weight of 30% (P less than .001), said Dr. de Jonge. Importantly, mean HbA1c decreased from 8.4% at baseline to 7.0% at removal (P less than .001) and there was a reduction in the use of antidiabetic medication in all but one of the study participants.

Well, when you prevent much of what people eat from being absorbed, I’d expect their glucose levels to drop and their need for medication to drop with it.  But Dr. Eric Westman and others have achieved the same result with diet.  In one of his studies, 95% percent of the subjects who adopted a low-carb diet reduced or eliminated their need for diabetes medications.

If this procedure mimics the effects of gastric bypass, then I’d be worried that the people who have it done will become vitamin deficient and end up with brittle bones and other negative health effects.  That’s what often happens with gastric bypass, as I wrote about in a previous post.

And now for the second article about intestinal invasion – if you haven’t eaten dinner yet, you may want to read this later. (To read the full article online, you need to register with MedPage Today.)

Fecal Transplant Flushes Insulin Resistance

Obese patients with a constellation of symptoms known as the metabolic syndrome improved insulin sensitivity with a fecal transplant from healthy thin donors, researchers here reported.

Recruiting those healthy thin donors must’ve required a clever sales pitch.  I don’t even like to pee in a cup.

After six weeks, peripheral insulin sensitivity significantly improved in 18 patients who received feces from lean donors compared with those who received an autologous transplant (P<0.05), said Anne Vrieze, MD, of the Academic Medical Center in Amsterdam, and colleagues. There was also a trend toward improvement in hepatic insulin sensitivity but it wasn’t significant, they reported at the European Association for the Study of Diabetes Meeting.

“This confirms the potential role of gut microbiota in the disturbance of glucose and lipid metabolism in obesity,” Vrieze said during the presentation. “The challenge is to use this knowledge to develop therapies.”

Yes, it’ll be interesting to see how much Merck and Pfizer end up charging for skinny-guy poop.  On a positive note, this could provide a whole new career for naturally-thin unemployed guys.  As it is now, most of the people paid to create s@#$ are in government.

John Buse, MD, PhD, of the University of North Carolina at Chapel Hill, cautioned that the researchers didn’t yet present data on actual differences in gut bacteria after transplantation, but the idea was promising.

“It’s interesting,” he told MedPage Today. “There’s little data, so it’s hard to tell. But it’s a cool idea.”

Um … cool idea?  No, a Victoria’s Secret model using coconut oil as an all-over moisturizer is a cool idea.

Animal studies affirmed an association between obesity and gut microbiota, as animals given bacteria from the feces of obese mice had a significantly greater increase in total body fat than those colonized with a “lean” microbiota, Vrieze said. But data on a clinical roll for gut microbiota are scarce.

I’m not sure what a clinical roll means.  Perhaps they’re referring to those little round bread-like things you get in the hospital if they’ve put you on a heart-healthy low-fat diet.

Vrieze and colleagues enrolled 18 obese men ages 21 to 65 with metabolic syndrome who weren’t taking medication for their condition and who hadn’t used antibiotics in the last three months. All of them kept a food and exercise diary over the study period.

All patients had jejunum biopsies and a bowel lavage to clear their own native bacteria. They were then randomized to either allogenic transplant of feces from lean male donors or autologous transplantation.

I’m guessing the original proposal called for 500 patients, but only 18 didn’t run screaming from the room when the investigators explained, “Well, what we’re going to do is clear all the poop out of your bowels, then we’ll either insert some skinny guy’s poop in your bowels, or we’ll re-insert your own poop.  No, sorry, we can’t tell you whose poop you’ll get.  That would violate the double-blind protocol.  What?  No, you can’t ask the skinny guys to avoid spicy foods.”

Fecal transplantation programs — while far from common — actually are already in place at a few centers in the U.S. based on some evidence suggesting efficacy in tough-to-treat gastrointestinal infections with the bacteria Clostridium difficile.

Since the gut plays an active role in regulating hormones that impact both obesity and diabetes associated with obesity, the focus has expanded to bacteria in the gut.

If the procedure turns out to produce significant weight loss, I’m guessing fecal transplantation will become much more common.  I’m also guessing that pretty much everyone who loses weight that way will lie about it.

“Oh, thank you.  Yes, I’ve lost 60 pounds.  Excuse me?  Uh … well … I started doing Pilates every day.”


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130 thoughts on “Gutsy New Ways To Become Healthy?

  1. Tammy

    Who comes up with this stuff? Who is paying for this research? Unbelievable.

    GI dynamics funded the first study. I assume they make the inplant device. No idea who would fund the poo study.

  2. marilynb

    “Are they naturally lean dogs?”

    Well, not exactly. They have very short legs and very long ears – you think that would be a problem?

    Yes, you could end up with long ears.

  3. Lauren

    Wait, wait – you take poop from one person and inject it into another, and that’s legitimate medical science? Ew. Just ew. I thought we all figured out poop is not a viable medicine, like, 200 years ago? ~ L

    We may have to re-think our position on that one.

  4. marilynb

    I care for 22 dogs in my home and would be happy to donate some poo. Bring your own shovel.

    Are they naturally lean dogs?

  5. Julie

    There might be something to this. Both of my dogs are lean and they eat each other’s poo. I was going to put a stop to this, but I don’t want my dogs to be over weight.

    Now you have to get them to share with some fat dogs.

  6. Beowulf

    I had to exercise self-restraint while driving yesterday. I wanted to hit my head against the steering wheel after hearing on the radio about the growing market for diabetes and cancer drugs in developing nations. Market growth here is slowing, but the more we export our lousy way of eating to the rest of the world, the more we can export our drugs too. Looks like most of these studies are about new, expensive treatments to offer when a cheap alternative (hey, try low-carb!) is available to all.

    First we send them our sodas and our wheat. Then we send them our drugs.

  7. Blanche

    They can always come up with a way that will mean more medical business.
    This means that they can have more patients using one or more money making treatments.

    The first idea of something temporary sounds like a kick start to yo-yo dieting. The fecal implant may bring with it more than weight loss. Just like transfusions have brought problems, so could this procedure.

    The simple no profit way isn’t what the powers that be see or want. Getting off junk (crap) food isn’t very popular with the medical or pharmaceutical industry. Now, they found a more expensive way to put higher quality crap in.

    I like this blog it keeps me motivated enough to want to avoid anything pharmaceutical or medical. That is done by eating well.

    Bingo. My goal is to avoid doctors as much as possible for the next 50 years.

  8. Jen

    I think you are unjustly poo-pooing (groan) a fascinating line of research that holds great promise. The results show that the gut flora exerts powerful influence over metabolism. How? What are the mechanisms? There’s much more to this than “disgusting new weight loss treatment.”

    By the way, fermented foods and probiotics contain only a few species of bacteria, none of them common among the hundreds of species to be found in a healthy adult gut.

    I don’t totally poo-poo the poo research, but I’m not signing up for a clinical trial either.

  9. Debbie

    Who ever thought of this must have fecal matter instead of gray and white matter. Oh brother, what next???

  10. Brandon

    Fecal transplant isn’t that out there and has been used for treating people who have killed off their intestinal flora due to antibiotics. Probiotics sometimes have trouble getting in the front door.

    No idea why it works, and I’d guess that poor dietary habits can quickly kill the beneficial bacteria.

    I’m sure there are benefits in some cases … but YUCK!

  11. Andrea Lynnette

    I have no doubt that the device worked as well as bariatric surgery. I just know that the gastric bypass doesn’t work very well. Every time you hear someone talk about the benefits of bariatric surgery, you need to remember and say aloud in response: “five years!” Because that’s how long you lose and keep off weight with a painful, dangerous, invasive surgery. After five years (roughly) you start gaining weight back and after ten, you are just like someone who went on a long-term diet and then went off it. I’ll find and link to the study if I can. I know it was in the International Journal of Obesity a few years ago.

    Also, the second part (or should I say, part #2?) is beyond disgusting. If the crap these doctors are shoving at their patients is “good” because it contains gut flora, aren’t there better, less-horrifying ways to get it? Can’t you just take some pro-biotic pills, or eat some super-yogurt? Why would anyone do that?

    I’ve hard of people regaining all the weight after gastric bypass but haven’t seen data on the percentage. If you find that article, definitely link to it.

  12. Angelyne

    Stop pooping all over the idea 🙂 It’s rather an exciting new avenue for research. Someone said, I forget who, that we are entering the age of the gut biota, which might prove to be as important as the age of the antibiotics. Think of this. A human body is about 10% human cells and 90% bacteria. Some bacteria can actually “talk” to our body, using the same chemical signals our cells uses to communicate with each other. This might be why candida can induce cravings for carbs.

    So yeah poop is yucky. But that’s just our modern sensibilities at work here. The idea of eating insects, or for some people organ meat, produces almost the same revulsion. It’s a cultural aversion, yet million of people eat this daily.

    I’ll admit, however, that I can stay objective so as long as it’s just a theory/therapy. Having to undergo that particular therapy, would be a different thing. But I guess you could say the same thing for maggot and leech therapy, which are both very valuable, if also rather icky.

    Some researchers refer to the gut as a second brain. Interesting area of research, but … YUCK!

  13. Mike P.

    Good Lord!! With articles like you referenced, I always try to think what Grok would do [Mark Sisson’s caveman]. I just can’t envision Grok transplanting poo.

    It is amazing that someone…somewhere decided to sign up to this. Most people would hesitate to shake your hand if you sneezed in them, but they’re ok with poo transplanting. Crazy.

    Keep up the good work Tom!

    I hope Grok’s response to poo was to step around it and move on.

  14. Peggy Holloway

    I needed a pillow on my desk last night during the evening news. The teaser was the discovery that a common drug used in diabetics could be the key to treating Alzheimer’s. The upshot was the growing belief that there is an association between diabetes and Alzheimer’s. Since diabetics have high blood sugar levels, researchers were surmising that lowering blood sugar could help Alzheimer’s patients. The solution – inject Alzheimer’s patients with insulin.
    Bang head hard on desk. Ouch.

    Oh, lordy.

  15. Soul

    As someone with IBS, I couldn’t stop laughing at the last idea mentioned, of healthy gut donors to help with insulin sensitivity. I could get to crude with this one, but one thing I recall was having to provide stool samples for testing at the hospital one time. And being given a little small cup for the sample. Some doctors can have a good sense of humor, and not realize it sometimes I think.

    A small cup for a stool sample? I wonder how the janitorial staff feels about that.

  16. Galina L.

    I remember reading about fecal transplants in the blogs”Cooling inflammation” and “Evolutionary Psychiatry” a while ago. As I understand, the potential donors suppose to be thin, allergies free, happy individuals. I remember thinking that I knew actually no one with such set of qualities. Many naturally thin people are somebody with neurotic kind of personalty and can’t eat when they are stress-out.My son is naturally thin with multiple allergies. What if such rare people indeed exist and would be in a future carry a movie-star status? Imagine a photo on a cover of some popular magazine with famous and rich fecal donor, or interview with him or her about how such perfect fecal quality was achieved. What about premium material obtained from famous Kitovans? Sounds fanny, but what do we know about the future? Better than Prozac or Lipitor, at least.

    Prozac and Lipitor are already s@#$ as far as I’m concerned.

  17. Joe Lindley

    Tom,

    Hilarious – and sad that folks are going to such extremes.
    Well, it could be worse… I used to be in the hyperthermia field (using heat to treat cancer). Using heat was experimented with back in the 20s by some researcher, who, to treat syphilis, gave his patients fecal matter (to eat) which caused infection and very high fever. For the ones who survived, it cured them of syphilis because of the high fever. Desperation leads to desperate acts.

    Yikes.

  18. Miriam

    I dunno, my worst poop eaters tend to be the chunky ones.

    Maybe they’re trying to get “skinny” poop?

  19. palo

    I have some concerns about the poo technique:

    1.Like all poo, transplanted poo will eventually come out. Do you recycle your own poo to maintain the appropriate flora? Or do you get a refill of new poo? How often will you need a refill?

    2. Will you need to go to a clinic for a refill or will home kits be available?

    3. Combined injected and local poo will overload your intestines. Will you be able to hold it or could it cause an unexpected accident?

  20. Princess Dieter

    I don’t even do those fecal things the doc is always trying to get me to do cause I refuse to do anything with my own poop other than flush it. Never mind another person’s poop. This is like phobia-level with me. I ran screaming from the room when I first found out there are folks who do sex play with poo…and eat it, too. Um, excuse me, I have to run screaming again…

    ….back.

    Can’t they just give us the good microflora or whatever and leave the poop out of the procedure? Huh? Can’t they? ; )

    Let’s hope.

  21. NM

    Crazy medicine doesn’t just lie at these extremes. I had a routine blood test, and they happened to do a lipid panel.

    My GP called me in to discuss my “alarmingly high” cholesterol.

    Here’s the “alarm”:
    My HDL was 2.1 (over 81 in US units).
    My triglycerides were 0.67 (59).
    My total cholesterol was thus “above” what they wanted (can’t remember the exact total figure, as I found it irrelevant!)

    I said “but doctor, my trig/HDL ratio is 0.3. That’s considered a good cardiovascular marker”.
    “What have triglycerides got to do with it?” he exclaimed.
    “Studies have shown, doctor, that high HDL and low triglycerides are a potent marker of cardiovascular health”, I replied.
    “I’ve never heard of that”.
    “Really? It’s quite a well known marker. I think I have high HDL and low trigs because I eat a low carb, moderate fat and protein diet”
    “Ah ha! That explains your dangerous cholesterol levels! You must stop this fad diet immediately”
    “But my HDL is over 2! That’s good! And my fasting glucose levels were good too”
    “That’s irrelevant! Your total cholesterol is too high!”
    “But my HDL to total cholesterol ratio is excellent too, according to statistical markers, isn’t it?”
    “Who’s been telling you this nonsense! We need to bring your total down!”
    “But my high total is artificially elevated by my high HDL, wouldn’t you say? And since you don’t look at the density of my LDL, but just use a fairly dodgy calculation, why must I take that seriously?”
    “What do you mean calculated LDL?”
    “You don’t do a direct count. It says calculated on the sheet”
    “I don’t know what that means. What I do know is that sacrificing HDL for a better total value is worth it if you want to stay healthy. You must stop eating all fats immediately except for some vegetable fats!”

    Unbelievable. That’s a trained doctor, giving “official” medical advice.
    He couldn’t tell me to loose weight (I have an slim athletic build), he couldn’t tell me to stop smoking (I never have) and couldn’t tell me to cut down on my drinking (I have maybe one glass of wine a week). Thus, his only option was to tell me to “stop eating all fats” and to come back in six months for a “further test”, whereafter “we’ll have to consider pharmacological intervention”.

    So I can get my HDL to plummet and my trigs to soar up, merely to make the magic total number look better in his records. And then, no doubt, bring on the muscle-rotting statins! Huzzah!

    Oh, and by the way, he is fat and wheezy, and I noted he had to catch his breath walking up one flight of stairs.

    Sigh. I think I shan’t bother attending next time I receive a panicky letter.

    I feel you. I had to educate a doctor about HDL and triglycerides when he told me my total cholesterol was too high — it was 203.

  22. marilynb

    “Are they naturally lean dogs?”

    Well, not exactly. They have very short legs and very long ears – you think that would be a problem?

    Yes, you could end up with long ears.

  23. Julie

    There might be something to this. Both of my dogs are lean and they eat each other’s poo. I was going to put a stop to this, but I don’t want my dogs to be over weight.

    Now you have to get them to share with some fat dogs.

  24. Brandon

    Fecal transplant isn’t that out there and has been used for treating people who have killed off their intestinal flora due to antibiotics. Probiotics sometimes have trouble getting in the front door.

    No idea why it works, and I’d guess that poor dietary habits can quickly kill the beneficial bacteria.

    I’m sure there are benefits in some cases … but YUCK!

  25. Mike P.

    Good Lord!! With articles like you referenced, I always try to think what Grok would do [Mark Sisson’s caveman]. I just can’t envision Grok transplanting poo.

    It is amazing that someone…somewhere decided to sign up to this. Most people would hesitate to shake your hand if you sneezed in them, but they’re ok with poo transplanting. Crazy.

    Keep up the good work Tom!

    I hope Grok’s response to poo was to step around it and move on.

  26. Soul

    As someone with IBS, I couldn’t stop laughing at the last idea mentioned, of healthy gut donors to help with insulin sensitivity. I could get to crude with this one, but one thing I recall was having to provide stool samples for testing at the hospital one time. And being given a little small cup for the sample. Some doctors can have a good sense of humor, and not realize it sometimes I think.

    A small cup for a stool sample? I wonder how the janitorial staff feels about that.

  27. Miriam

    I dunno, my worst poop eaters tend to be the chunky ones.

    Maybe they’re trying to get “skinny” poop?

  28. palo

    I have some concerns about the poo technique:

    1.Like all poo, transplanted poo will eventually come out. Do you recycle your own poo to maintain the appropriate flora? Or do you get a refill of new poo? How often will you need a refill?

    2. Will you need to go to a clinic for a refill or will home kits be available?

    3. Combined injected and local poo will overload your intestines. Will you be able to hold it or could it cause an unexpected accident?

  29. Princess Dieter

    I don’t even do those fecal things the doc is always trying to get me to do cause I refuse to do anything with my own poop other than flush it. Never mind another person’s poop. This is like phobia-level with me. I ran screaming from the room when I first found out there are folks who do sex play with poo…and eat it, too. Um, excuse me, I have to run screaming again…

    ….back.

    Can’t they just give us the good microflora or whatever and leave the poop out of the procedure? Huh? Can’t they? ; )

    Let’s hope.

  30. NM

    Crazy medicine doesn’t just lie at these extremes. I had a routine blood test, and they happened to do a lipid panel.

    My GP called me in to discuss my “alarmingly high” cholesterol.

    Here’s the “alarm”:
    My HDL was 2.1 (over 81 in US units).
    My triglycerides were 0.67 (59).
    My total cholesterol was thus “above” what they wanted (can’t remember the exact total figure, as I found it irrelevant!)

    I said “but doctor, my trig/HDL ratio is 0.3. That’s considered a good cardiovascular marker”.
    “What have triglycerides got to do with it?” he exclaimed.
    “Studies have shown, doctor, that high HDL and low triglycerides are a potent marker of cardiovascular health”, I replied.
    “I’ve never heard of that”.
    “Really? It’s quite a well known marker. I think I have high HDL and low trigs because I eat a low carb, moderate fat and protein diet”
    “Ah ha! That explains your dangerous cholesterol levels! You must stop this fad diet immediately”
    “But my HDL is over 2! That’s good! And my fasting glucose levels were good too”
    “That’s irrelevant! Your total cholesterol is too high!”
    “But my HDL to total cholesterol ratio is excellent too, according to statistical markers, isn’t it?”
    “Who’s been telling you this nonsense! We need to bring your total down!”
    “But my high total is artificially elevated by my high HDL, wouldn’t you say? And since you don’t look at the density of my LDL, but just use a fairly dodgy calculation, why must I take that seriously?”
    “What do you mean calculated LDL?”
    “You don’t do a direct count. It says calculated on the sheet”
    “I don’t know what that means. What I do know is that sacrificing HDL for a better total value is worth it if you want to stay healthy. You must stop eating all fats immediately except for some vegetable fats!”

    Unbelievable. That’s a trained doctor, giving “official” medical advice.
    He couldn’t tell me to loose weight (I have an slim athletic build), he couldn’t tell me to stop smoking (I never have) and couldn’t tell me to cut down on my drinking (I have maybe one glass of wine a week). Thus, his only option was to tell me to “stop eating all fats” and to come back in six months for a “further test”, whereafter “we’ll have to consider pharmacological intervention”.

    So I can get my HDL to plummet and my trigs to soar up, merely to make the magic total number look better in his records. And then, no doubt, bring on the muscle-rotting statins! Huzzah!

    Oh, and by the way, he is fat and wheezy, and I noted he had to catch his breath walking up one flight of stairs.

    Sigh. I think I shan’t bother attending next time I receive a panicky letter.

    I feel you. I had to educate a doctor about HDL and triglycerides when he told me my total cholesterol was too high — it was 203.

  31. Anne

    Everyone gets an oral fecal transplant at the time of birth. This is supposed to come from the mother during a vaginal birth. I read one study that said the first nurse to handle the baby also contributes to the gut flora of the baby.

    Just my luck … I didn’t get a skinny-guy nurse.

  32. C

    That is the most disgusting thing I have ever heard of. I’ll stick to soccer and steak, thank you very much.

  33. Anne

    Everyone gets an oral fecal transplant at the time of birth. This is supposed to come from the mother during a vaginal birth. I read one study that said the first nurse to handle the baby also contributes to the gut flora of the baby.

    Just my luck … I didn’t get a skinny-guy nurse.

  34. Andi

    This is bloody disturbing then again so is the look of so many people that bitch at me and my darling hubby that we eat too much meat and not enough bread. Though with the way doctors act about bacteria thought they would be trying to “decontaminate” the Digestive system.

    Tell those people to eat their bread, take their prescription drugs, and leave you alone.

  35. Marilyn

    I LOVE this post. AND all the comments! I haven’t laughed so hard for WAY too long!! My husband hears me roaring from the next room and shouts out, “NOW what did you read??”

    As someone who was chronically constipated most of my life, and morbidly obese for DECADES (I’m now down 95 pounds from my all-time high weight of 350, so I still have quite a ways to go!) – I find your blog even more fascinating than FAT-HEAD THE MOVIE. Of course, I was urged by more than one doctor to have gastric bypass, but watching the results, especially long-term, nixed THAT idea, as far as I’m concerned! Everyone I know who has had the surgery, even so-called “successes”, has regained a great deal of the weight they lost AND several of them need periodic iron and/or vitamin-mineral IV infusions, as their bodies can no longer extract these essential nutrients from ANY amount of food.

    I LOVE the idea of slender superstar fecal providers being on magazine covers in the future! But now that I’m no longer constipated, I can’t imagine getting my money’s worth from Slenderella’s fecal donation because it wouldn’t hang out in my gut long enough!!

    Thanks for a wonderful blog, Tom – I visit your site every day in the hope of getting “the hot poop”, and today you delivered in spades!! 🙂

    XOXO – M

    Consider it the poop scoop of the week.

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