Popular gut probiotic craps out in randomized controlled trial (arstechnica.com)

126 points by zdw a year ago

188 comments:

by njtransit a year ago

It’s interesting that both groups had their number of bowel movements double or more. Perhaps a lot of constipation is actually dehydration.

by mirekrusin a year ago

Like this magic pill to loose weight that you need to take before every meal with large glass of water, where pill is optional.

by tyre a year ago

or Emegen-C or hangover cures

by jeltz a year ago

If they contain some salt they are better than just water.

by Nifty3929 a year ago

If you take one of these little pills with a large glass of water for every alcoholic beverage you drink, then it will prevent hangovers.

by gus_massa a year ago

I agree, and that's why they used a "randomized triple-blind placebo-controlled clinical trial".

by datavirtue a year ago

Bingo. These finding probably aren't much of a surprise to many. Hydration is huge, as is having a well functioning and diverse biome that you feed regularly with raw fruits and vegetables. I have had my biome die back to the point of medical emergency and had to restore it. Keifer, various Greek yogurts, etc did nothing to help. I took half a bottle of a few pills that were loaded with different strains. Not only did it restore bowel function to its former glory, it improved my health overall and I feel like a teenager again (46). I was deficient and suffering for decades and just thought it was normal. It dawned on me that most people are likely suffering.

I'm far too overweight for my liking but now I don't feel fat. Restoring the biome made me stronger and more resilient (my muscles stay stronger between workouts). I just feel good all the time now. Before this I had psychologically written myself off as dying and was ready to accept my fate.

by dylan604 a year ago

> These finding probably aren't much of a surprise to many.

Conversely, you might be surprised at how many this is new information. Just because you learned something does not mean everyone hearing the information at the same time. Some people require hearing/reading something new only one time, others takes many attempts. I think the number of people that walk around with a suboptimal fluid intake is much higher than we might hope, especially in the USA

by lukevp a year ago

This sounds super interesting. The pills you are talking about are probiotics? Have some links to which ones you took and maybe some research you did about this?

by datavirtue a year ago

Check my other replies for the brands. I don't think it matters as long as the quality is assured. I had known about probiotics for decades but never realized how fundamental they were to overall health. When I was going through this I just thought about my symptoms and took a hail Mary with this treatment. Bowel movements were extremely stressful at that stage. I was depriving myself of anything solid to alleviate the issues but overall I was not getting better. Previous to that I was doing fine, or so I thought. I never ate out, rarely ate meat or anything processed.

You will know when it's restored, you can even eat garbage (meat, processed foods) and your gut will process it and move on. You should be able to notice the subtle changes when you eat something that does not digest readily. It's not the acid and body mechanics, it's mostly the bacteria giving you life by breaking down nutrients and solids. Feed it what it needs and it will sustain itself. Raw and fermented vegetables.

by maxerickson a year ago

Meat is nutritious and very satisfying per calorie, it is not "garbage". To think it is garbage is to have a very confused view of nutrition.

by consteval a year ago

Ultra processed red meats are garbage. They contain far too much saturated fats and not nearly enough nutrients. Even their protein per calorie is not particularly good.

Humans of the past ate game meat. Very low fat, and almost all unsaturated fat. Closer to an avocado than a steak.

by kbmr a year ago

Which pills specifically did you take?

by hn_version_0023 a year ago

You should return and tell us with some specificity what you took.

by datavirtue a year ago

I'm hesitant to mention brands. Any independently tested product with a wide variety of strains should be good. I started on Physicians Choice from Amazon and followed up with Garden of Life (not sure who sells it). During repair phase I would only eat salads made of hand shredded green and purple cabbage and kale. Equal amounts cabbage kale mixture and shredded ice berg lettuce. I used ranch dressing and added other vegetables and crushed corn chips. To each his own.

These were huge salads. I couldn't even think of eating anything else after I finished them.

by calf a year ago

Wait what. I am 99% convinced my gas and bowel problem, an impairment at this point, is IBS or SIBO that started 12 years ago. I never thought a about just taking a half bottle of pills to see what would happen, I am going to have to look into this.

by olyjohn a year ago

What the hell? Half bottle of what pills? Are you and the parent a bot?

by datavirtue a year ago

Half a bottle over two weeks. Geesh.

by magicalhippo a year ago

Probiotic pills presumably.

by elcritch a year ago

I’m assuming the parent meant pills with few different strains. Seems like a massive dose of a few different strains would approach that of a fecal transplant.

by datavirtue a year ago

You can't just slam pills. The pills contain the bacterium. You have to send it raw vegetables to feed it so it multiplies and sustains itself.

by calf a year ago

Oh no, I was confused because a lot of people say to try probiotic pills, but for many people they just don't work. So when you originally wrote half a bottle that confused me, I interpreted it as you were doing something different than those who tried probiotic pill supplements.

Could you describe your dosage? Was it a one pill per meal and you saw results after a few weeks? And you said raw vegetables to help it. I would like to try that, and any other specific things you did that worked.

by captain_coffee a year ago

what did you take - specifically?

by MostlyStable a year ago

That's plausible, but also, could be the frequent things just getting better on their own over time.

by MilnerRoute a year ago

I actually thought it was misleading of the headline to say the probiotic crapped out...

A lot of people take probiotics to improve their general digestion (and not specifically for constipation). But it sounds like the study didn't even look at any of the other uses at all...

by the_sleaze_ a year ago

Best gut related health I ever had was living in France and eating stinky raw cheeses and different fermented foods. Like clockwork.

by darth_avocado a year ago

There’s two different effects hidden in that statement

> living in France

I have had similar experience where my gut health was immediately, noticeably better in Europe. I was eating the same foods and somehow it was better.

> Eating stinky raw cheeses and different fermented foods

Raw and fermented foods in cultures across the world are linked to better gut health. However, industrial fermentation and packaging won’t help you as much because the diversity of microbes drops and packaging often kills most of them. We need to bring back the culture of home fermentation.

by murukesh_s a year ago

>I have had similar experience where my gut health was immediately, noticeably better in Europe. I was eating the same foods and somehow it was better.

Could be due to you being in a better mental state. Gut-brain axis is very evident for me personally. If I am tense gut is the first to get affected.

by 4gotunameagain a year ago

The refusal to over-industrialise food in Europe (compare to the US) leads to higher quality, more "natural" food.

by FredPret a year ago

Another possibility: dishwashers are more rare in Europe - the soap residue some of them leaves on irritates some stomachs.

by looperhacks a year ago

That sounds counter-intuitive? I doubt most people take the time to rinse everything off with clear water. Dishwashers on the other hand always have a rinsing step

by AyyEye a year ago

There is enough residue left over that even diluted 1:10 its still cytotoxic. [1]

I seem to recall a post here a while ago showing that dishwasher residue was genotoxic as well but can't find it atm.

[1] https://www.sciencedirect.com/science/article/pii/S009167492...

by selimthegrim a year ago

It was about the rinse aids in commercial dishwashers at commercial dose levels. Residential levels were not shown to be harmful.

by dithered_djinn a year ago
by literalAardvark a year ago

I've healed several friends' tummies by telling them to stop using rinse aid.

It's very, very definitely a thing.

by pfdietz a year ago

Maybe the problem is rinse aids in dishwashers? These prevent spotting on glass by adding detergent.

I just put water in the rinse aid dispenser of my dishwasher.

by selcuka a year ago

> I just put water in the rinse aid dispenser of my dishwasher.

Curious... Rinse cycle already uses plain water, so you are adding water to... water?

by pfdietz a year ago

It's to keep the annoying "fill the rinse aid dispenser" light from always being on.

by bluGill a year ago

redacted, see correct info in replies

by pfdietz a year ago

I don't believe that's true. To quote wikipedia: "Rinse aid (sometimes called rinse agent) contains surfactants and uses Marangoni stress to prevent droplet formation, so that water drains from the surfaces in thin sheets, rather than forming droplets."

Looking at the back of a bottle of Finish Jet Dry (which I have refilled with water), the original stuff's first ingredient (after water) is "C 12-15 Alcohols Ethoxylated Propoxylated". These are nonionic surfactants, and are not what one normally means by "alcohol" (ethanol).

I can understand where the idea came from. Drinks like wine will exhibit sheeting on the sides of glasses too. The concentration of alcohol needed for that to happen is probably too high in a dishwasher, I'd imagine.

by pxndxx a year ago

Yeah but dishwasher soap is a different kind of soap, it's way stronger. Plus dishwashers also use rinse aid which has its own set of problems.

by a year ago
[deleted]
by homarp a year ago
by FredPret a year ago

I'd love to see this stat but I don't have access - mind posting the gist of it?

by pas a year ago

the travel makes people on average bodily better. usually a lot of walking involved, which has a lot of health benefits, especially for folks who come from the US

by waihtis a year ago

> my gut health was immediately, noticeably better in Europe

Its because a lot of the weird artificial junk that are allowed to be put into your food is illegal in Europe. Even things like popular sweeteners have been shown to have a negative effect on your gut health.

by azinman2 a year ago

Europe puts plenty of E numbers in their food (the US just spells it out versus hiding it under a number). There are things illegal in the US that are used in food in Europe. A lot of the time, at least for things like pesticides, the different is country of origin of manufacturer.

by jenny91 a year ago

E numbers have very little to do with this. They are just a way to categorize food additives.

by mikrl a year ago

Growing up in the EU in the 00s there was always the public health concerns of E numbers causing this or that.

Ironic in a way, because E numbers mean that the specific chemical has been cleared as a foodstuff in the EU, IIRC.

Though I suppose it’s more concerning if an approved substance has some unforeseen effect versus an unapproved one and you’d want to investigate further.

I guess it shows how government regulation of naturally occurring substances (though perhaps synthesized, or refined) carries with it a new set of incentives, and reasons to be political. Not that I’m against regulation, but it’s hard if not impossible to have a truly politically neutral approach.

by azinman2 a year ago

What else would you characterize “ weird artificial junk” as?

by literalAardvark a year ago

E numbers cover everything that can be added to food. Some examples would be E164 Saffron, E290 carbon dioxide, E428 gelatin.

None of these are anywhere near the "weird chemicals category". You'll find that all euro foods have Es in them, but it doesn't mean they have half-tested industrial food additives in them.

by azinman2 a year ago

Those are very selective things you picked.

E100–E199: Food coloring, such as turmeric (E100) and paprika (E160c)

E200–E299: Preservatives, such as sulfur dioxide (E220)

E300–E399: Antioxidants and acidity regulators, such as ascorbic acid (E300)

E400–E499: Thickeners, stabilizers, emulsifiers, and gelling agents

E500–E599: Acidity regulators and anti-caking agents

This is pretty much the spectrum. Red 40, aka Allura Red AC aka E129 is illegal in the US, legal in the EU, and carries a warning in the EU. Let’s not pretend that the wonderful world of chemicals and industrialization doesn’t exist in Europe.

by literalAardvark a year ago

No one is pretending anything. I said all foods in the EU have E numbers in them, but it doesn't mean they have industrial chemicals.

Allura red isn't illegal in the US.

Also, just wondering, what do you think is the problem with turmeric and paprika?

by sroussey a year ago

The preservatives in flour / bread / etc are illegal in Europe. My sister is allergic and can’t have any bread in the USA. But can in France and Italy.

by raydev a year ago

Please share the names of these preservatives.

by 10xalphadev a year ago

Durex and Trustex.

by ara_ohanian a year ago

[dead]

by waihtis a year ago

Yeah, things like titanium dioxide are considered a carcinogen by the International Agency for Research on Cancer (IARC) yet FDA says its safe for use in food. But i guess trust the science and authorities

by pas a year ago

IARC usually says that something has carcinogenic potential, which is almost completely useless information for something that we already ingest in absurd quantities without a cancer epidemic.

by raydev a year ago

> a lot of the weird artificial junk that are allowed to be put into your food is illegal in Europe

What are some examples? A list would be helpful.

by Spooky23 a year ago

I don’t follow this too closely, but having been in Europe for a few weeks, the food tastes noticeably better and is often cheaper than the US.

One of the things you notice is shorter ingredient lists on prepared food. The ingredients in Italy for McDonald’s French fries are: potato, salt, oil. In the US there’s 7-8 including hydrogenated soybean oil and flavor/color agents. Oreos were similarly different, and arguably better tasting.

I believe they regulate flavors and coloring additives differently, and many people feel both of these type of items can be problematic.

by SoftTalker a year ago

Also non-flouridated, non-chlorinated water.

by manoweb a year ago

I lived most of my life in an alpine European village; water was chlorinated and flourinated, more than in my current US location. There was a huge difference in mineral content, US water being almost distilled (1 to 3 French degrees hardness) VS something like 15-20 in Europe

by azinman2 a year ago

Water hardness varies by location worldwide, including the US.

by pfdietz a year ago

Non-flouridated is gluten-free, right?

by verisimi a year ago

Artisanal

by hedora a year ago

Most sweeteners also have been shown to cause more weight gain than sugar (they screw up your metabolism). Unless you’re diabetic, there’s literally no reason to consume them.

by cenamus a year ago

I'd like to see a source on that, because (excessive) sugar literally causes diabetes.

And of course high sweetener consumption is must be strongly linked with in general high calorie input and overweight people trying to reduce calorie consumption.

by Spivak a year ago

Your first point probably isn't actually true. The research that first connected the two showed that across a population sugar consumption up -> diabetes rates up. But it turns out that when you control for weight the effect of sugar specifically is much much smaller. To the point where if you're a healthy weight your sweet tooth isn't moving the needle.

by loeg a year ago

No, they have not. The evidence points the opposite way (people lose more weight on non-nutritive sweeteners than sugar).

by Spivak a year ago

Oh that's not true at all. First I think they taste better, they're sweet without being syrup-y. Second it allows me to drink a lot of soda, 5+ cans a day adds up when it has calories. I have no expectation that it helps me lose weight, it's just tastier water.

It's funny that folks will look down on diet soda but then be fine with tea and coffee and sports drinks like the bubbles make it meaningfully different.

by riffraff a year ago

5+ cans of soda a day seems unhealthy even if it's not caloric, the gas and acid will mess up your stomach.

It is not just tastier water.

by Spivak a year ago

Given that in France "water" means carbonated water and you have to specifically ask for "still water" I can't imagine the gas being that bad for you.

Acid I can get behind but soda is by far the least acidic thing I consume on the daily.

by Spooky23 a year ago

The carbonation creates carbonic acid in your teeth. It’s a huge driver of calories.

Of the of the issues with diet soda in particular is your tastes favor sweets. I used to drink 4-8 cans of Diet Dr Pepper daily. When I stopped, after a couple of weeks I found my taste preferences to be very different. I’d favor savory more attractive and sweet stuff would seem too sweet.

by Spivak a year ago

I can't fine anything talking about carbonic acid and calories. Is there something you're referring to?

by Spooky23 a year ago

Sorry - it was supposed to be “cavities”. Too late to edit I’m afraid.

by kyleee a year ago

Maybe they meant cavities?

by cnasc a year ago

Probably typed “caries” and got autocorrected

by jonnycomputer a year ago

I agree about diversity. We use a very limited range of cultures in mass manufactured foods.

by Brian_K_White a year ago

But of course can never happen because it only takes a minority to cry about a few factual bad stories and present the fallacious "is it worth it" argument. "Is your epicurian enjoyment worth even one dead baby?" And a majority who have no reason to think much about it go along with it because no one will say "yes it's worth it" and few are able to articulate how the question was invalid in the first place.

The opposite minority argument, that variety, depth, richness, are important, not luxuries, don't have their own dead babies to present. They do exist, but they aren't visible except in aggregate. You can measure a change in average health over the course of entire generations, and from that you can extrapolate the change in number or frequency of deaths, and then you could compare numbers of dead babies. But you can't obviously show any particular cause & effect because there are so many other variables, and even if you could, it took entire generations whole lives lived and died before they could benefit anyway.

by gamblor956 a year ago

But of course can never happen

Home fermentation of foodstuffs is allowed, and always has been.

Lots of people do it. Kits are available on Amazon, and many grocery stores will even sell them in-store. As other people on this thread of have pointed out, they ferment a lot of their own foods and drinks.

What isn't allowed is selling home-fermented stuff to others. When someone goes commercial, rules kick in to protect their customers

by Brian_K_White a year ago

What can never happen is the majority agreeing that it's good, and actually doing it, and having this become so accepted that it is no longer disallowed for selling. Without selling, most people will not get it.

It's possible. A wave could go through where it becomes popular and the majority adopt some new attitude on that topic. But it "can never" because of the dynamic I expressed. That works against it. The new thought is not developing in a vacuum.

by gamblor956 a year ago

having this become so accepted that it is no longer disallowed for selling.

This is a nonsensical train of thought that conflates multiple distinct issues.

Fermented products are already widely sold in stores and restaurants. And homemade foodstuffs can already be sold but are subject to the same rules and regulations that govern foods made in commercial facility. These rules generally preclude the sale of homemade fermented foodstuffs, because the risk of contamination if the foods are improperly fermented is extremely high and most home kitchens lack the necessary equipment or facilities needed because this is all very expensive compared to consumer equipment. This is why there are so few fermented foodstuffs available at farmer's markets in the U.S.; the initial capital outlay puts it out of reach.

by tyre a year ago

okay wow deep breath, you can just ferment things at home, it’s fine, I did it twice last week

by a year ago
[deleted]
by Brian_K_White a year ago

That doesn't actually solve anything.

by daneel_w a year ago

How do you know until you've fermented something at home and risked life, limb, dead babies etc. by consuming it? I think more people die from food poisoning in restaurants each year than people do from doing something stupid while making sourdough bread, natto, tempeh, kombucha, beer, wine etc. at home.

by elcritch a year ago

Also, it’s usually pretty obvious when fermenting goes bad. My take is fermentation takes a while which really allows the biological process to become really positive or really rancid.

by Brian_K_White a year ago

It doesn't solve anything because it's an individual action to a societal problem.

by daneel_w a year ago

There's no societal problem of hidden deaths because of fermented foods. But assuredly there is because of "safe" ultra-processed convenience foods.

by Brian_K_White a year ago

The societal problem is that we have low quality food. Across the board. Every where you go, all that's available is mostly low quality.

The option to spend more money, or have your own garden, or do some kind of home production is a vanishingly insignificant individual action that solves nothing except for like 11 people.

by jajko a year ago

My wife recently got Kombucha mushroom from a friend, and got into fermenting it herself. Its trivial to do, you need to really screw up something for it to go wrong, tons of good bacteria inside. She takes some basic precautions like avoiding metal parts (since the drink becomes acidic), otherwise its on autopilot, good bacteria outcompete everything else for resources.

She mixes it with some cut fruits to get some sugars for fermentation, the result is very mild alcohol content (maybe 0.5%) and it tastes like cider. I mix it maybe 1:3 with water and its semi-eternal homemade drink. Can't really complain.

That and of course french cheese, we live maybe 5km from French border and for cheese its much better place than even Switzerland (sorry guys gruyere is great but french variety is huuuuge in comparison and they even usually have specialties like old dutch gouda which is taste heaven for me and various truffle-infused ones).

by Y_Y a year ago

Fyi kombucha isn't made from a "mushroom". It's a combination of bacteria and yeast and can be found in the liquid itself or the pellicle (blob of organic tissue) that forms during fermentation.

https://en.m.wikipedia.org/wiki/SCOBY

by murkt a year ago

Wow, hearing about “tea mushroom” (that’s how it’s called in Ukraine) for my whole life, and it’s not a mushroom!

Fascinating.

by zdragnar a year ago

Well, it is a partly a yeast, which is a fungus, as are mushrooms. The main thing is that it is a symbiotic combination of particular yeast and bacteria strains, unlike what is used for brewing alcoholic drinks (just yeast) or fermenting dairy into yogurt (just bacteria).

Kefir is another combination of yeast and bacteria, though different strains.

by dyauspitr a year ago

It’s called a scoby

by bloaf a year ago

There are some choices you can make that seem innocuous but dramatically increase the chances of lethal outcomes, like using corn or coconut.

https://www.youtube.com/watch?v=yXnSYfv6bCA https://en.wikipedia.org/wiki/Bongkrek_acid

by jajko a year ago

Thank you, I would never thought about using corn for such stuff, but that coconut surprised me

by maxerickson a year ago

Are you lactose intolerant?

A small amount of lactose can have a sort of laxative effect without causing discomfort.

by m3kw9 a year ago

Gotta hit up the cheese fests now

by XorNot a year ago

This is about Bifidobacterium animalis subsp. lactis.

Personally I take L. Reuteri supplements, which for me have made an unbelievable difference in suffering from IBS symptoms (and have some clinical evidence to support having an effect). This was a result a recommendation somewhere else on HN about 2 years ago now, so I'll pass it forward whenever the topic comes up.

In my experience it took about 3 months to see effects (during which time I did feel somewhat worse), and currently if something happens - i.e. I get sick - then there's a bit of reversion towards feeling bad. But: I was also able to stop taking them for about 6-9 months before it seemed like the effect was diminishing.

by bloopernova a year ago

This has helped some folks' IBS symptoms: https://www.vsl3.com/

Contains:

  Streptococcus thermophilus 
  Bifidobacterium breve 
  Bifidobacterium lactis (previously classified as B. longum)
  Bifidobacterium lactis (previously classified as B. infantis)
  Lactobacillus acidophilus
  Lactobacillus plantarum
  Lactobacillus paracasei
  Lactobacillus helveticus (previously classified as L. delbrueckii subsp. bulgaricus)
I'll have to research L Reuteri, thank you for mentioning it.
by eth0up a year ago

Might include b. subtilis on your list.

by a year ago
[deleted]
by graeme a year ago

Which version of L. Reuteri did you take?

by XorNot a year ago

I use Biogaia Protectis by brand.

by silisili a year ago

Same. Immensely helped my gut, and uh, other things too.

by mg a year ago

There is a lot of confusion on how to interpret studies.

The reasoning of this article seems to be "The study did not produce a significant result, therefore the treatment is ineffective".

But that is not how to think about significance.

Otherwise, you could show for any treatment that it is ineffective. By simply doing a study small enough to produce an insignificant result.

by loeg a year ago

True, but in this case the study sponsor is financially motivated to find a non-null result, not a null result.

by jessriedel a year ago

This mistake is so unbelievably frequent. Need a concise quip like “correlation isn’t causation”.

by mg a year ago

Yes, that might be helpful.

First attempt:

    Insignificant does not mean ineffective
Not as good as "correlation isn't causation" though. I wonder if there is a better quip. Or if the concept is too complex to wrap in a catchy statement.
by jessriedel a year ago

“Insignificance isn’t ineffectiveness”

by nikolay a year ago

Don't buy probiotics - eat quality grass-fed organic yogurt (such as Trimona [0]) and home-made sauerkraut - these have centuries of evidence. As a Bulgaria, we traditional make sauerkraut every year. It's pretty easy to have it, you just need a little more attention to it in the first weeks. The juice is amazing, too. You can buy it from Amazon [1].

[0]: https://trimonafoods.com/

[1]: https://amzn.to/3ZO0Sxl

by bossyTeacher a year ago

> these have centuries of evidence

This sounds like the good old 'we have always done it therefore it must be good'. That is not evidence.

by nikolay a year ago

Read the work of Ilya Ilyich Mechnikov [0].

[0]: https://en.wikipedia.org/wiki/%C3%89lie_Metchnikoff

by permo-w a year ago

and by "evidence" you mean?

by nikolay a year ago

Longevity in general (don't judge by today's fully Lidl-ized & Kaufland-ized diet of modern Bulgarians). The research dates back to the 19th century and Ilya Ilyich Mechnikov [0].

[0]: https://en.wikipedia.org/wiki/%C3%89lie_Metchnikoff

by 2OEH8eoCRo0 a year ago
by jessriedel a year ago

That article says

> Epidemiological research on specific health effects of yogurt is still limited but a few studies suggest a benefit.

It then describes three non-randomized observational studies.

by nikolay a year ago

That's the issue with nutrition - you can't really randomize as every person is on a different diet that's hard to control. Plus, how are you going to radomize when people know what they're eating - you can't create non-yogurt that's identical to yogurt for the controls!

by jessriedel a year ago

Well, you can’t blind it but you can still randomize. If your outcome variables are sufficiently objective and important (e.g., mortality or cancer risk, not just perceived health), the possibility that the causality flows through a placebo effect is much less worrying. If [people correctly believing that they ate yogurt] reduces [the incidence of cancer], great!

by nikolay a year ago

I meant to say blind, not randomize, sorry.

by bossyTeacher a year ago

So you admit that those links you posted don't constitute evidence towards the products you suggested. Interestingly enough, you were so happy to dismiss the studies about probiotics yet you are so keen not to do the same for yours even when none of them have any evidence towards its benefits

by albertsw a year ago

Huberman [1] lists several studies emphasising mucrobiota diversity and health as the major factor. These studies seen to find that the way to get it is fermented foods, like sauerkraut, kimchi, kefir etc. and that commercial probiotics don't seem to do much.

[1] https://www.hubermanlab.com/newsletter/6-key-tools-to-improv...

by trilbyglens a year ago

Should be noted that constipation relief is far from the only benefit that probiotics provide to your gut biome. Healthy gut biome has been linked to lower levels of depression and lots of other things seemingly unrelated.

by raincole a year ago

> Should be noted that constipation relief is far from the only benefit that probiotics provide to your gut biome.

You mean claimed to provide.

by hanniabu a year ago

Anecdotal but I'm on a very strict diet, to the point where I have the same thing every meal, every day. There's certain probiotics I take that help bowel movements and some that slow things down. It's very repeatable and given I eat the same thing every meal every day and I'm on a regular eating and activity schedule that leaves very little other variables.

My guess is that for regular people the benefit is insignificant but it's greater for people with issues (dysbiosis).

And the type of dysbiosis you have will determine the effect of the probiotics. For some it can slow motility or cause constipation and others increase motility or cause diarrhea.

There's so many internal variables with your gut microbiome and there's a general lack of reliable methods to test your microbiome. This makes tests like these really difficult and also makes it difficult to treat digestion issues. Because of this, all gastro doctors can really do is slap on IBS/IBS label but not really have a course of action with any decent success rate.

by homebrewer a year ago

Read the article, placebo was just as effective as these "probiotics".

by ecef9-8c0f-4374 a year ago

Wasn't this only about supplementation?

by samuraijack a year ago

Why is it interesting to just test one brand of probiotic with a single strain of bacteria?

Surprised to see it on arstechnica and HN.

by SammyStacks a year ago

Yeah, both the title and content of the arstechnica are spreading misinformation. The mainstream media has always been terrible at accurately representing the findings of a given academic study, but this is disappointing.

The study was conducted with people who had chronic constipation as measured by complete spontaneous bowel movements (CSBMs). A bowel movement qualifies as a CSBM if the individual had not used a laxative within the last 24 hours. Prior to intervention, participants had a mean of 0.77 CSBMs/week with an SD of 1.0. That is quite extreme so the results of the study cannot be generalized to the general public.

Additionally, both the probiotic group and control group experienced positive effects, even if the probiotic group didn't outperform the control group. That's extremely meaningful and requires further investigation. Perhaps the belief of taking a digestive supplement caused individuals lower stress and/or motivated other healthy lifestyle changes? Science shouldn't be viewing the placebo effect as evidence that something else is BS; we need to view the placebo effect as a psychological tool to effect positive change.

Finally, the study tested only one bacteria strain. I have not seen any recommended probiotic supplement that includes only one strain of bacteria.

More research is needed; the title is clickbait and the article doesn't sufficiently emphasize the major limitations of the study. Really a shame to see that type of reporting.

by loeg a year ago

The companies selling products containing that bacteria would like to sell more units. Agree that the null result is not super interesting.

by jonnycomputer a year ago

For what it's worth, I always thought that yogurts, etc. are better at slowing down digestion/dealing with diarrhea than constipation.

by guilhas a year ago

That is my experience too. Although *google says this probiotic is associated with both diarrhea and constipation, by improving gastrointestinal health

And would probably depend on what caused their constipation

by uslic001 a year ago

Gastroenterologist here: Almost all probiotics are just a placebo with good marketing. There are a few that actually help like Florastor for C difficile colitis (https://florastor.com/) and VSL#3 for Ulcerative Colitis (https://www.vsl3.com/). Stop wasting your money.

by gojomo a year ago

I'd never heard a single strain could affect constipation, so these results unsurprising.

Where attention to the gut biome has really saved lives is when a person has massive Clostridium difficile overgrowth – which is more associated with uncontrollable diarrhea than constipation. This state of extreme illness is typically only possible because prior antibiotic use cleared out the natural variety of commensal bacteria that normally keeps this particular strain at bay (or totally absent).

In such cases, people near death can bounce back after a full-spectrum "fecal microbiome transplant" (FMT) where all of the hundreds-or-more of distinct bacterial species are transferred from a healthy donor to the patient.

It's quite hard to package all those sensitive, beneficial, adapted-just-to-the-human-gut strains for reproducible evaluation & administration – so FMT is hard to fit into standard medical studies & FDA approval processes.

But sometimes a mere dot's worth of a healthy person's feces can be a miracle cure for someone else! So, a company has driven an approval of their particular $10k-per-treatment shit-pill through FDA processes, and partially as a consequence, the FDA has been cracking down on people arranging FMTs in less-formal & far-cheaper ways – despite a great record of safety and effectiveness.

A well-informed & highly-opinionated rant on this topic: "A Monopoly on Poop" https://stephenskolnick.substack.com/p/a-monopoly-on-poop

by sgc a year ago

Apparently almost any strain of lactobacillus should be able to make some type of yogurt (each one with a distinct flavor). I have taken relatively expensive probiotic supplements sold in a very famous supermarket in the US known for this type of thing (yes, that one), which claim to have close to a dozen strains of lactobacillus. It was utterly incapable of even beginning to make yogurt. It was just plain milk at the end of the process, not even a discernible yogurty taste to it. On the other hand, we had great success using a cheap yogurt starter we found sitting around that had expired 5 years ago. I would love to have a full spectrum of probiotics, but can't spend the money to actually find one that works, so I have to stick to homemade yogurt.

by frereubu a year ago

After getting really annoyed with the pseudoscientific naming around this I built a whole site about it a couple of decades ago to get to the top of search results and got threatened with a lawsuit by Danone...

https://whatisbifidusregularis.org/

by guilhas a year ago

More specifically "probiotic X didn't work for Chinese people with constipation"

But that's a typical arstechnica title

by hnpolicestate a year ago

The thing that has treated acute IBS episodes for me is ib guard. The green box. Though I'm pretty sure the primary ingredient is just peppermint oil.

by giardini a year ago

Maybe they need to move upstream.

My wife is all-enthusiastic about oral probiotics (as a cure-all). She's been watching some Chinese medical experts yak about that.

by PorterBHall a year ago

“Popular gut probiotic craps out…”

My hat’s off to the copy editor who wrote that headline.

by Havoc a year ago

How does one actually go about procuring good probiotics? Short of doctor I mean

by zdw a year ago

The headline is some of the best output I've recently seen.

by itronitron a year ago

It's a solid and well-formed contribution.

by hedora a year ago

Yeah, but the register is more regular. This one’s been ripening for a decade and is as fresh as the day it was produced:

https://www.theregister.com/2014/01/20/haribo_gummy_bears_im...

by hanniabu a year ago

Both of you sound like bots

by projektfu a year ago

That was the wrong criticism and your model will need to be retrained. The correct response is "this isn't Reddit".

by exe34 a year ago

good bot

by Ekaros a year ago

I prefer these bots to those that prose profusely generating larger than human piles of crap...

by zdw a year ago

Ah, I'm not definitely not todsacerdoti , who automated reposting all of lobste.rs to HN.

My pithy comment was actually inspired by Sir Patrick Stewart's interview about his role in the Emoji movie: https://youtu.be/CgAIqP6hNlQ?t=215

by morkalork a year ago

Beth Mole is as consistent as ever

by ramesh31 a year ago

Every so often you get the chance to make something perfect. Must have been a good day.

by AlbertCory a year ago

Whenever some theme gets broad advertising, I get suspicious. "Helps boost the immune system!" -- WTF does that mean?

"Probiotics for gut health!" -- yeah, right. Get back to me in 10 years when you have some actual evidence.

by manoweb a year ago

[flagged]

by Texasian a year ago

Did… you really just use the term Chinamen in 2024?

by a year ago
[deleted]
by ramesh31 a year ago

>Did… you really just use the term Chinamen in 2024?

Yeah it's really not the preferred nomenclature.

by surgical_fire a year ago

Would chinaperson be better?

by secondcoming a year ago

Almost as bad as using ellipses in a sentence for dramatic effect...

by spondylosaurus a year ago

Lactose tolerance is a fluke, not the norm. Unless you're of European (+ non-Jewish) descent, you probably won't be able to digest most dairy products as an adult.

by gojomo a year ago

I know that's the conventional wisdom, but as an adult of European descent who usually handles lactose/dairy well, I sometimes have periods of reduced tolerance, perhaps due to changes in my gut biome.

And there's evidence even lactose-intolerant ("lactase nonpersistent") demographics can tolerate ever-larger amounts of lactose with a gradual ramp-up of consumption that shifts their gut biomes in a different direction:

https://pubmed.ncbi.nlm.nih.gov/38159728/

There's a chance the conventional view overweights human genetics and underweights biome, which could create a self-fulfilling diagnosis of "lactose intolerance".

That is: a person notices a bad reaction, and is told (influenced by demographic tendencies) "oh, as an adult you'll inevitably be lactose-intolerant". They avoid dairy, further thinning (or completely eliminating) the bacteria that could help from their gut, ensuring a more-noticeable negative reaction upon further consumption.

OTOH, if the right bacterial mix was maintained, or reintroduced then maintained if necessary, many considering themselves lactose-intolerant might not persistently be.

(Separate from the bacteria themselves assisting in lactose digestion, there's even some chance that the positive or negative shock of a wildly-changed biome might epigenetically affect the beyond-childhood activation of the human genome's own lactase genes – a possibility mentioned in the middle of this microbiologist's writeup: https://www.cnn.com/2019/04/17/health/lactose-intolerance-mi... )

by spondylosaurus a year ago

My gastroenterologist says that intestinal illness can render you temporarily lactose intolerant for a few weeks after the fact. That might be what's happening to you, or some version of it!

by lotsofpulp a year ago

There are a billion plus South Asians that eat a ton of dairy. Cows are even sacred.

Lactose tolerance is a very wide scale, from zero tolerance to even cheese to being able to drink multiple glasses of milk without getting diarrhea.

Based on anecdotal evidence and the seeming popularity of pizza, a lactose intolerance so great that cheese is an issue seems to be rare.

by spondylosaurus a year ago

Many cheeses contain little to no lactose, which may be a factor :) But yes, being raised in a dairy-heavy culinary culture is one predictor of continued lactose tolerance into adulthood.

by pfdietz a year ago

Lactase persistence is also common in many parts of Africa.

by permo-w a year ago

I would be surprised if they eat any cheese whatsoever. most eastern asians are lactose intolerant

by spants a year ago

[flagged]

by homebrewer a year ago

Just wondering, have you ever managed to convert or convince a single person by acting like a stereotypical vegan?

by kstenerud a year ago

If you're not going to judge people, then why bother at all?

by hinkley a year ago

How do you know if someone is a vegan?

by cwbriscoe a year ago

Don't worry, they will tell you.

by loeg a year ago

There's absolutely no evidence that a vegan diet provides a benefit for gut health relative to a diet including meat.

by wusher a year ago

I had the exact opposite experience. when I stopped eating meat I got worse. When I stopped eating vegetables I got better. I’m not saying you shouldn’t eat vegetables, I’m saying your claim isn’t as strong as you think it is and peoples gut issues are different.

by lepus a year ago

A lot of people go all in on increasing dietary fiber and then experience gut issues and think it must be the plants when they didn't work into it slowly enough. It's like going to the gym and and feeling sore all over all the time or even getting injured and then concluding that going to the gym is bad when no one told you that you should start easy. In my opinion there's harm in how people fail to communicate how to get started on plant based diets when they miss important issues like this that can permanently put people off from it.

by dpassens a year ago

Am I misunderstanding or do you really not eat any vegetables at all, not even in a dish with meat?

by BenjiWiebe a year ago

Some friends of mine tried the carnivore diet for a while. From what I understood they did not eat meat dishes that included vegetables.

by bryant a year ago

If the concern is just meat, why not go vegetarian instead?

by CapitalistCartr a year ago

Wearing this leather belt is what's causing my constipation.

by hinkley a year ago

Get a bigger belt, friend.

by 2OEH8eoCRo0 a year ago

Because it's more about being an absolutist snob than anything. Vegans don't eat honey. If I have a pet hen I can't eat the eggs? Ridiculous.

by SoftTalker a year ago

What kind of vegetarian? Some allow eating eggs and dairy. Some allow fish or even birds.

by BenjiWiebe a year ago

Some friends of mine tried the carnivore diet. One thing they noticed was improved gut health.

by hanniabu a year ago

Some people have dysbiosis which makes it impossible to have most vegetables

by shermantanktop a year ago

People who have things which are exotic, rare, or complicated don’t present some kind of existence proof against advice directed at a general population which doesn’t have those conditions.

by hanniabu a year ago

People that are healthy don't need probiotics either, sooo ....

by rbattula a year ago

im over ars

by ptsneves a year ago

It also became a site I rarely visit compared to some years back when I did several times a day and even subscribed. They have some good writers in house but otherwise it has descended into politics and pop culture movies and gadgets, with the odd ode to violence like monkey torture stories or Viking eviscerations. The space news are maybe the best online.

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