Wednesday, June 21, 2017

Irresponsible reporting on "poop doping" from the Washington Post

UPDATE 1 - see below - the author updated her article including some of my critiques.
UPDATE 2 - also see Embryette Hyde's post about using (or not using) the American Gut data to inform lifestyle changes
UPDATE 3. June 25. - Boing Boing picked up the story.  Without major caveats.  I posted a comment there pointing to my blog and answered one other comment but then was not aware the discussion was going on much more there until a Tweet today.  Some interesting discussions there and also some strange things.  Some criticisms of me (some reasonable .. some a bit much).
UPDATE 4. June 26. Nicholas Starapoli at the Genetic Literacy Project critiques the stories on poop doping. Poop doping: No, elite athletes can’t improve performance by optimizing gut bacteria
UPDATE 5. Also see Beth Skwarecki Sex, Poop, and Champagne Are Great, But Their Health Benefits Are Overrated

Went on a bit of a Twitter tirade last night. See more below



The Washington Post story, by Marissa Payne, requires a log in but the article is now in other papers that are free online including the Denver Post here.

It is just really bad reporting because the claims of one scientist are presented as facts without any scrutiny and these claims need lots of scrutiny.

Recently this story was covered in Bicycling Magazine and I gave them an "overselling the microbiome" award for their reporting on it.  I guess I am pretty surprised that the Washington Post doubled down on some of the claims.

Here is some commentary on just some of what is wrong with the Post article.

"Peterson, herself a pro endurance mountain biker, has discovered that the most elite athletes in the sport have a certain microbiome living in their intestines that allow them to perform better"
No evidence has been presented anywhere that these microbes "allow them to perform better".  At best, there may be evidence that elite athletes in this case have different microbes.   That as far as I know has not been presented for the case here.  Seems possible.  But this of course does not mean that those microbes they have allow for better performance.  There could be dozens of reasons why such athletes have differences in their micro biomes (e.g., diet, exercise, interactions all effect the microbiome).
Peterson didn’t decide on the fecal transplant solely to enhance her performance during her mountain bike races, but to cure a host of symptoms that have affected her since she was a child and contracted Lyme disease.
Seriously?  This basically is implying that she did a self fecal transplant that enhanced her performance and cured her Lyme disease.  She is an N of 1.  She did a fecal transplant and then some of her self assessed health changed.  What about, say, the placebo effect?  Or, how about - 100 other things changed in her life before and after the fecal transplant which could have affected her.  Or maybe the antibiotics she claimed to have taken before the transplant did something?  Ridiculous to make any claims about her self fecal transplant having any known impact.

Then there is this
“I had no microbes to help me break down food, and I had picked up bugs in the lab where I was working because my system was so weak and susceptible,” she told Bicycling.
This is a pretty stunning claim. She had no microbes that help break down food before this?  And she also had been infected by microbes from the lab where she worked?  I don't buy either of these claims.

And what about
“I just did it at home,” she said of the February 2014 procedure. “It’s not fun, but it’s pretty basic.”
Referring to home fecal transplants.  I mean, I am all for people doing really whatever they want at home.  But they should do it with their eyes as wide open as their other parts.  And that requires the full poop on fecal transplants.  They have real and potential risks (e.g., see this).  One can get pathogens from them.  The transplant itself could have negative effects.  And if one assumes the microbiome has major effects, then one might get other unwanted traits from the donor too.  It is dangerous to promote self fecal transplants without discussing any of the possible risks.

Overall, I find this reporting by the Post to be dangerous.  And no the one caveat in the article below is not enough
Peterson said it’s too early to make any concrete conclusions about how the microbiome affects performance, but she’s convinced there’s enough evidence to suggest it does make a difference.
How about instead of "she is not convinced" saying "There is no evidence for any of her claims and this is snake oil".  That would be more accurate.





UPDATE June 21 2:54 PM

Marissa Payne updated her story with some comments from me

See https://twitter.com/MarissaPayne/status/877631691883298816

Because the text has been changed in the Washington Post story I am posting the text here from the Denver Post version in case it gets updated too, so people can see the original.

-------------------------------
To be a professional cyclist, one must have guts, microbiologist Lauren Peterson says, and she doesn’t just mean that in the metaphorical sense. Peterson, herself a pro endurance mountain biker, has discovered that the most elite athletes in the sport have a certain microbiome living in their intestines that allow them to perform better, and if you don’t have it, well, there may soon be a way to get it.

“Call it poop doping if you must,” Peterson told Bicycling magazine last week about her research.

Peterson, a research scientist at the Jackson Laboratory for Genomic Medicine in Farmington, Connecticut, heads up an initiative called the Athlete Microbiome Project, in which she compares stool samples of elite cyclists to amateur bikers. Her findings strikingly shine a light on a handful of microorganisms that apparently separate the guts of elite athletes from average people.

The most important, perhaps, is Prevotella. Not typically found in American and European gut microbiomes, Prevotella is thought to play a role in enhancing muscle recovery.

“In my sampling, only half of cyclists have Prevotella, but top racers always have it,” she told Bicycling. “It’s not even in 10 percent of non-athletes.”

Peterson reports she hosts Prevotella in her own gut – but not naturally. In fact, she might be the first case of “poop doping,” thanks to a fecal transplant she administered herself three years ago. Her donor? Another elite athlete.

Peterson didn’t decide on the fecal transplant solely to enhance her performance during her mountain bike races, but to cure a host of symptoms that have affected her since she was a child and contracted Lyme disease.

“I had no microbes to help me break down food, and I had picked up bugs in the lab where I was working because my system was so weak and susceptible,” she told Bicycling.

But, she continued, “I couldn’t find a doctor who could help me” since in the United States, fecal transplants are only performed to treat serious cases of Clostridium difficile, a disease that causes chronic diarrhea. And so Peterson went rogue.

Peterson detailed her decision to perform the “risky” procedure on herself on the podcast “Nourish Balance Thrive” last year. She admitted to thinking it was a “bad idea” at first because if not done with proper screenings of both parties, it could worsen a person’s problems. But through chance, she came across a donor, an elite long-distance racer, who had his microbiome mapped and screened after a case of food poisoning, which showed he was otherwise healthy. So Peterson took antibiotics to wipe out her own gut bacteria and essentially performed a reverse enema.

“I just did it at home,” she said of the February 2014 procedure. “It’s not fun, but it’s pretty basic.”

Within a month, Peterson said, she began feeling better than she’d felt in years.

“I had more energy than I knew what to do with,” she told the same podcast last year. “Like everything just changed.”

More importantly for her life’s work, however, her own success with the fecal transplant gave her the idea to start the Athlete Microbiome Project, for which she rounded up 35 of her cycling friends, according to the Scientist magazine, to kick off her research.

Along with Prevotella, Peterson said she also identified another possibly performance-enhancing microbe called Methanobrevibacter archaea, which Peterson found to be more prevalent in the samples from elite athletes. This bacteria’s function is also opaque, however, Peterson told the Scientist, “it allows your entire gut microbiome to work more efficiently” by more effectively breaking down complex carbohydrates in the gut.

Peterson said it’s too early to make any concrete conclusions about how the microbiome affects performance, but she’s convinced there’s enough evidence to suggest it does make a difference.

“What we’re learning is going to change a lot for cyclists as well as the rest of the population,” Petersen told Bicycling magazine. “If you get tested and you’re missing something, maybe in three years you’ll be able to get it through a pill instead of a fecal transplant. We’ve got data that no one has ever seen before, and we’re learning a lot. And I think I can say with confidence that bacterial doping . . . is coming soon.”

1 comment:

  1. "What about, say, the placebo effect?"

    After she bought the Chronic Lyme story? Unpossible!

    ReplyDelete

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